With the potential for a safe, healthy return to normalcy on the horizon, vaccine uptake has been in the spotlight. For some, there’s a genuine lack of vaccine confidence that may stem from a lack of trust, cultural barriers, and systemic racism and discrimination. People have a legitimate desire for knowledge, and many people are seeking more information on this complex topic.
But what happens when people seek answers on the virtual shelves of the world’s largest bookshop?
Simply put: they’ll get bad answers, and dangerous ones. The top search results for ‘vaccines’ are packed with disinformation. The first page of results, in fact, is almost entirely composed of anti-vaxx tracts, all ‘explaining’ how modern medicine poses a clear and present danger to you and your children. (The remainder being horror films and The Vaccines’ albums.)
Some of these books appear respectable, and drape themselves in science; others are more overtly conspiratorial, and a quite few are very clearly unhinged manifestos. The titles range from Miller’s Review of Critical Vaccine Studies (which promises the reader “a large body of scientific evidence confirming numerous vaccine safety deficits”) to Vaccine-nation: Poisoning the Population, One Shot at a Time to the more respectable-sounding. The trend continues through the first several pages of results, and within all the relevant sub-categories.
If I spouted the following nonsense on Twitter - “Polio is not even contagious or infectious“ or “vaccines are actually implicated in most diseases today” - my account would be suspended. Yet these statements are drawn from the descriptions of Amazon products. The spread of vaccine misinformation is not solely limited to Amazon. Every other major platform, however - Google, Facebook, Twitter, Reddit, YouTube - is fully and publicly engaged in limiting the publication of misinformation. Vaccine misinformation is a public health issue with both a moral and a medical imperative at stake. Amazon is the fourth largest website - of any type - in the UK.
There’s also a substantive difference between merely posting misinformation in a public place, and selling a book about it. The simple act of providing such books lends false credibility to anti-vax conspiracies, creating a social norm in which anti-vax conspiracies are somehow a reasonable part of the discourse. Books convey expertise and authority, and the mere existence of available pseudo-science texts in the world’s largest bookstore is often interpreted as ‘evidence’ of that pseudo-science’s legitimacy. These books are given even more authority by the fact that they are endorsed with the platform’s badges of honour. Anyone Who Tells You That Vaccines Are Safe and Effective Is Lying, for example, is Amazon’s ‘#1 Best Seller in the Children’s Vaccination & Immunisation Category’.
Disinformation on Amazon is not a free speech issue. Amazon is a private platform, and the products for sale are a matter of company policy, not an expression of fundamental human rights. If people are actively using the Amazon platform to spread dangerous lies during a pandemic, then Amazon should quash it, not quietly take a cut of the profits. There are ancillary concerns as well. The reviews of these books act as a form of unmoderated social network. Even a cursory skim through the reviews of books like Anyone Who Tells You demonstrates how they are reinforcing and spreading disinformation, as reviewers discuss the issues and suggest other, similarly problematic texts to each other.
Chillingly, looking up even one anti-vax book on Amazon has a terrifying knock-on effect: the algorithm happily serves you many more in the ‘suggested reading’ and ‘customers also bought’ categories. Similarly, these books are included as part site’s routine, algorithmic promotions.
Vaccines: The Biggest Medical Fraud in History actually comes with an Amazon alert... for quality issues. It seems that its ‘image resolution is poor’. Although ironic, this also demonstrates that the platform already has tools in place to monitor content, to take reports, and to warn consumers. However, unlike other online platforms, there is not even the option for customers to report vaccine-related disinformation. Amazon’s tools are not available for, nor being used to, address this pressing issue.
So what is to be done? Amazon has removed material in the past - including QAnon merchandise and books promoting conversion therapy. It is often a belated decision, but it is at the least, some form for response. When challenged last month around their decision to remove a 2019 book that framed sexual identities as ‘mental illness’, Amazon’s VP of Public Policy stated: “We reserve the right not to sell certain content. All retailers make decisions about what selection they choose to offer, as do we”. Unfortunately the best - and only option - currently available to us is to hope that someone at Amazon makes the right decision about these books too.
Jared Shurin is a communications strategist, focusing on social and behaviour change challenges. He is an occasional editor; his latest is The Outcast Hours (with Mahvesh Murad, from Solaris).