Shares

Having written about quackery in general and, in particular, antivaccine pseudoscience for over 14 years now, I like to think that I’m in a position to notice trends. I do, of course, realize that my perception of the existence of such trends could well be a product of confirmation bias or other selective memory; on the other hand, I think I’m probably on to something. For instance, when during my first full year of blogging in 2005, I noticed a tendency of the press that used to drive me crazy. Whenever there was a story about vaccines or autism, pretty much every journalist writing or producing every news story seemed to feel obligated to include a quote or interview with someone from “the other side” (i.e., antivaxers) for “balance.” Many were the posts I wrote back then railing about this tendency towards false balance; these days, I see a lot less of it, and I can’t recall the last time I’ve written a rant about it. These days, stories about vaccines and antivaxers tend to be much more science-based and much less prone to “false balance”. Also, thanks to multiple measles outbreaks, antivaxers are taking a beating in the court of public opinion—and deservedly so.

Unfortunately, there are two media areas where antivaxers still have pretty much free reign. One is social media, primarily (but not limited to) Facebook and Twitter. The other is streaming services such as Amazon Prime, Netflix, and Hulu, where quack propaganda movies have long been readily available, including antivaccine movies like VAXXED. It’s not just antivaxers, either. For instance, a month ago, it was announced that Netflix is teaming up with Gwyneth Paltrow and Goop to produce a series for the streaming service. As Variety reported:

Goop, the lifestyle and wellness juggernaut founded a decade ago by Oscar winner Gwyneth Paltrow, is expanding its original content efforts with a new docuseries at Netflix, an exclusive podcast partnership with Delta Air Lines, and a slew of programming centered around beauty, food, and books.

Still untitled, Goop’s streaming series will hit Netflix this fall and consist of 30-minute episodes hosted by the site’s editors, chief content officer Elise Loehnen and Paltrow. The team will utilize experts, doctors, and researchers to examine issues relating to physical and spiritual wellness.

As we’ve written before multiple times here, although it is best known for Jade Eggs that it recommends that women place in their vaginas, Goop is a wretched hive of scum and quackery that has featured quacks ranging from “holistic psychiatrist” Kelly Brogan (who is both rabidly antivaccine and an HIV/AIDS denialist) to Mark Hyman, to a number of other quacks, psychic mediums, and other purveyors of New Age woo. No doubt, the upcoming Netflix series will continue to market the same prescientific, pseudoscientific, and mystical nonsense that is encompassed and promoted by the Goop brand.

What’s more interesting, however, is what happened at Amazon Prime last week.

Amazon Prime, YouTube, and antivaxers

Last week, CNN Business published a story, “Anti-vaccination conspiracy theories thrive on Amazon“. Basically, CNN noted something that those of us who’ve paid attention to the antivaccine movement have known for a long time, namely that streaming services frequently offer what I like to call quack documentary movies, or, more properly, quack infomercials and propaganda disguised as legitimate documentaries. The problem goes way beyond just antivaccine documentaries, but CNN focused on antivaccine movies and books:

Amid a growing measles outbreak in the United States, the role of powerful tech companies like YouTube and Facebook in spreading vaccine misinformation is under heavy scrutiny.

But there is another massive platform offering spurious anti-vaccination content to people seeking information, a review by CNN Business reveals: Amazon, the world’s largest online marketplace. And, asked about it, an Amazon spokesperson only pointed CNN Business to the company’s content guidelines page, which says the following: “As a bookseller, we provide our customers with access to a variety of viewpoints, including books that some customers may find objectionable. That said, we reserve the right not to sell certain content, such as pornography or other inappropriate content.”

A recent search for “vaccine” on Amazon (AMZN) yielded a search page dominated by anti-vaccination content. Of the 18 books and movies listed on the search page, 15 contained anti-vaccination content. The first listing was a sponsored post — that is, an ad for which Amazon was paid — for the book “Vaccines on Trial: Truth and Consequences of Mandatory Shots” by Pierre St. Clair, which Amazon was also offering for free to Kindle Unlimited subscribers.
Among the search results were books and movies that made their anti-vaccination stance clear in their titles, like the movies “We Don’t Vaccinate!” and “Shoot ‘Em Up: The Truth About Vaccines.”

And, of course, as I’ve long known, Amazon Prime offered Andrew Wakefield and Del Bigtree’s antivaccine conspiracy epic VAXXED, which I described as “antivaccine propaganda at its most pernicious” when it first came out and how it featured the “CDC whistleblower” conspiracy theory, which claimed that a “whistleblower” (CDC scientist William Thompson) made a claim that the CDC had destroyed evidence demonstrating that MMR vaccination was associated with an increased risk of autism in African-American boys. It was a conspiracy theory whose birth I watched in August 2014, it is not what antivaxers claim, and the science presented to support it is epidemiological nonsense.

According to CNN:

Amazon also offers its Prime members a number of anti-vaccination movies for free viewing on Prime Video, like “VAXXED: From Cover-Up to Catastrophe,” which was dropped from the Tribeca Film Festival in 2016 following a public outcry.

Its director, Andrew Wakefield, has played a central role in spreading anti-vaccine propaganda. Wakefield was part of a team of researchers who published a 1998 study that became the basis for the anti-vaccination movement. The study was later retracted and Wakefield was stripped of his medical license.

Amazon declined to comment on how much it was paid for the ad for “Vaccines on Trial” or whether it has accepted money to promote any other anti-vaccination books or movies.

My guess: Quite a bit.

It’s not just Amazon and Amazon Prime that have been facilitating the spread of antivaccine conspiracy theories. A recent BuzzFeed report described how YouTube was recommending antivaccine content in its searches and after users watched any video related to vaccines:

For example, last week, a YouTube search for “immunization” in a session unconnected to any personalized data or watch history produced an initial top search result for a video from Rehealthify that says vaccines help protect children from certain diseases. But YouTube’s first Up Next recommendation following that video was an anti-vaccination video called “Mom Researches Vaccines, Discovers Vaccination Horrors and Goes Vaccine Free” from Larry Cook’s channel. He is the owner of the popular anti-vaccination website StopMandatoryVaccination.com.

In fairness, the results were mixed, but there was a lot of antivaccine misinformation that came up in vaccine-related searches:

But while in some cases search queries like “should i vaccinate my kids” led to authoritative sources and entertainment, in other cases, the exact same search led down a misleading path. In one instance, after a search for “should i vaccinate my kids,” YouTube played a pro-vaccine video called “Why Are Vaccines Required Before My Child Goes to School?” from the Philadelphia Children’s Hospital but followed it with a recommendation for “Mom Researches Vaccines, Discovers Vaccination Horrors and Goes Vaccine Free.” That was followed by “You’ll Be Glad You Watched This Before Vaccinating Your Child!” from iHealthTube, which was followed by three videos in a row featuring anti-vaccination activists Dr. Sherri Tenpenny and Dr. Suzanne Humphries.

Regular readers will be familiar with Tenpenny and Humphries. Both are radical antivaccine activists. Also, videos from VAXXED TV featured prominently.

Of course, popular YouTube content producers can make quite a bit of money running ads during the videos featured on their channels, because ad revenue is based on the number of times the video is viewed. So it is a big deal that YouTube now prohibits antivaccine channels from monetizing their videos by running ads; lack of monetization will hinder the ability of the owners of such channels to make new antivaccine videos. However, I can’t help but note that that doesn’t fix the problem of those videos being on YouTube in the first place and showing up so prominently in searches. YouTube claims that it’s tweaking its “Up Next” recommendation algorithm to prevent the spread of antivaccine videos. We’ll just have to wait and see how successful that is.

But what about Amazon? Apparently Amazon was not happy about the negative publicity that the CNN Business story sent its way. A mere two days later, I received this email from the VAXXED crew (yes, I’m on the mailing list). Here’s what it said:

The pro-pharma folk have won a significant victory today against safer vaccines and health freedom. Following Rep. Adam Schiff’s letter to Google and Facebook, Pinterest responded by removing searches about safer vaccines and vaccine injury so those who are questioning vaccines or want to learn more about the risks can no longer find this information and are limiting advertising possibilities. YouTube also made the decision to limit the monetization of vaccine-questioning content on their platform.

Rep. Schiff sent a second letter to Amazon this morning, which resulted in Vaxxed being removed from Amazon Video, including Prime and streaming. It was available to stream in the U.S., UK, Canada and Australia and had been readily available since 2016 with Amazon earning healthy margins, especially on Prime.

Here’s the rationale Amazon provided for why it pulled Vaxxed:

Availability Issue: We are always listening to customer feedback and iterating on their behalf. During a quality assurance review, we found that the following title contains content that doesn’t meet our customer content quality expectations. As a result, all offers (“Included with Prime”, Buy, and Rent) have been removed. We will not be accepting resubmission of the impacted titles. This will not impact any royalties accrued through the date it was removed and will follow standard payment timelines.

Yes, pressure is working. Not only has YouTube taken actions to make it almost impossible for makers of antivaccine video content to monetize their wares, but Amazon removed antivaccine videos, including VAXXED from its streaming service.

What about Netflix and Hulu?

Of course, Amazon Prime is a major streaming service, and YouTube is a ubiquitous source of all manner of videos, but they’re not the only game in town. That made me wonder: What about Netflix and Hulu, the other major streaming services that feature a wide variety of content? So I did a search on Netflix for the word “vaccine”. The first movie that came up was What the Health? Oddly enough, it’s a documentary that touts a vegan diet as the healthiest, but, as Harriet Hall pointed out when she reviewed the movie, it also features all manner of conspiracy theories claiming that major health organizations and government agencies have been “bought” by Big Food and Big Pharma and are conspiring to hide the truth from the public. I saw no mention of vaccines in the trailer for the film, but I did see a whole lot of pharma bashing and conspiracy mongering.

So, not wanting to sit through the whole quackfest, given that Harriet had already done so, I skimmed it on Netflix to see if there were any mention of vaccines. From what I saw, I concluded that, if anything, Harriet was too easy on this movie. I’ve rarely seen such a load of New Age codswallop in a single film featuring a veritable boatload of quacks. However, I found almost nothing about vaccines, although I did see a lot of references to “toxins”. Either way, it’s a quack film.

Other films that my search produced included Rotten, which purports to reveal the “dirty secrets” of our food supply, Take Your Pills, Heal (a film featuring Deepak Chopra), The Magic Pill (a film about ketogenic diets), and a number of other films that had no apparent relationship to vaccines, such as FYRE: The Greatest Party That Never Happened. There didn’t appear to be any obviously flagrant antivaccine films, although there were definitely quack documentaries popping up. So I did a search on “immunization” and another on “autism”. The results were similar: Some quack movies, some non-quack movies, and no obviously antivaccine movies.

What about Hulu? I did similar searches on this streaming platform and found no obviously antivaccine content. No obviously quacky movies came up in these searches, either. This led me to wonder: What about other forms of quack “documentaries” other than antivaccine movies. After all, as I noted about Amazon Prime in a Tweetstorm the other day:

Yes, Burzynski: Cancer Cure Cover-up and Cancer Can Be Killed, the first a hagiography of cancer quack Stanislaw Burzynski and the second movie a propaganda film for cancer quackery, are still very much available on Amazon Prime. The Burzynski documentary appears to be a combination of the two Burzynski documentaries that I’ve reviewed before on this very blog edited down to one movie, while Cancer Can Be Killed has also been reviewed here and found to be propaganda for cancer quackery.

Antivaccine movies are gone, but quack movies aplenty remain

Given that observation, I decided to do some similar searches on all three of the main streaming platforms plus YouTube using cancer-related terms in order to see what sort of quackery comes up. I limited myself to cancer because it was a manageable task for a single blog post and started with Amazon Prime and the simplest possible search, the word “cancer”. The first movie that came up was a very good one, the PBS docu-series based on the book by cancer doctor and researcher Siddhartha Mukherjee, Cancer: The Emperor of All Maladies. So far, so good. I saw that series when it aired on PBS, and it was excellent. Another film that came up was A Few Things About Cancer, a documentary about “a newlywed couple’s quarter-life crisis through stage four cancer.”

Unfortunately, the next few films in the search were not so good:

  • Cancer Can Be Killed. I’ve already discussed this film in this post.
  • The Answer To Cancer. Its blurb: “In Calcutta, India, the Banerji Protocol, named for a 150-year-old dynasty of doctors and based on the research of homeopathy founder Samuel Hahnemann, can naturally cure cancer and other chronic diseases. The Answer to Cancer is a documentary of this revolutionary alternative cancer treatment.” Yes, it’s a movie about treating cancer with homeopathy, dangerous quackery.
  • Healing Cancer from the Inside Out. Its blurb: “The video covers the failings of conventional treatments and how cancer can be successfully healed with dietary treatments and natural supplementation. Participants include T. Colin Campbell, Ph.D. (The China Study), Brian Clement, Ph.D. (Hippocrates Health Institute), Charlotte Gerson (The Gerson Institute), Mirea Ellis (The Kushi Institute) and many more.” Holy crap! Brian Clement? The Gerson protocol? It doesn’t get quackier than that. This is more dangerous quackery.
  • The Big Secret. Its blurb: “This documentary explores the truth behind some of today’s most widely-accepted medical practices, and seeks to expose how the focus on corporate profits influences traditional medical treatment in the United States.” This one definitely sounds dodgy. It could be a legitimate expose of corporate malfeasance, or not. So I checked out the movie’s website, and the answer is: Yes, it’s a quack movie, featuring quacks like Stephanie Seneff (the one who predicted that by 2030 100% of children born that year will become autistic), Kelly Brogan, a functional medicine quack Filomena Trindade, Dale Bredesen (the one who claims to be able to cure Alzheimer’s disease), and a host of other cancer quacks.
  • Burzynski: Cancer Cure Cover Up. I’ve discussed Burzynski more times than I can remember on this blog. My favorite summary is this article I wrote for Skeptical Inquirer five years ago.

Most of the rest of the results were dramas involving cancer or standard documentaries about some aspect of cancer or another, but, as you can see, there were plenty of quack movies. Now let’s move on to Netflix. I’ll give Netflix credit. I didn’t see any obviously quacky movies in its search results, just a lot of cancer-related dramas and documentaries—and comedy. (Indeed, amusingly the first result was Denis Leary’s 1992 standup comedy special No Cure for Cancer.) I did a similar search on Hulu, which returned a mix of the conventional and bizarre, for instance Stand Up To Cancer, VICE Special Report: Killing Cancer, and RX Early Detection: A Cancer Journey with Sandra Lee, mixed with a whole lot of movies and TV shows about dancing and dancers. So basically Hulu and Netflix did OK.

It was with trepidation that I moved on to YouTube, where, as you might guess, the results were not so good. Prominent in the first page of results were videos like a Great Day Houston segment touting a new reality series about Stanislaw Burzynski patients called My Cancer Free Life; episode one of cancer quack Ty Bollinger’s video series The Truth About Cancer: A Global Quest, which Harriet has reviewed and found to be full of quackery and that I mentioned to discuss an episode that marketed the cancer quackery Rigvir; Every Cancer Can be Cured in Weeks explains Dr. Leonard Coldwell; How Laetrile (B-17 or Amygdalin) effectively destroys cancer cells; Top 20 Cancer Killing Foods; Cancer Cures: FDA Corruption In America; Murdered for Curing Cancer: The Story of Dr. Max Gerson w/ Dr. Patrick Vickers; and many other videos promoting quackery. True, there were videos that appeared to be science-based (e.g., Introduction to Cancer Biology (Part 4): Angiogenesis and What is cancer radiotherapy and how does it work?), but my estimate is that about 75% of the search results on the first page were videos promoting quackery. I also know your mileage may vary because Google tailors your results based on your search history, but there’s no denying that there’s a heck of a lot of cancer quackery on YouTube that pops up in search results.

The problem goes beyond antivaccine pseudoscience

So Amazon Prime and YouTube have taken action to limit the reach of antivaccine propaganda, Prime Video by removing antivaccine content and YouTube by demonetizing antivaccine content. Even so, I can’t help but note that Prime Video hasn’t quite managed to remove all antivaccine content. For instance, it still offers the film Trace Amounts: Autism, Mercury, and the Hidden Truth as part of its link with Food Matters TV. Indeed, as subscribers know, if you have an Amazon Prime subscription, you can also pay extra add subscriptions to a number of other streaming services through Amazon and access their content through Prime Video rather than needing a separate app. (I never do this because I think the Amazon Prime app is a confusing, ugly mess and would thus rather access the other streaming service to which I subscribe, BritBox through its own app.) As a result of noticing this, I found a number of other very quacky movies on Prime Video, such as Mobilize (a “cell phone radiation will kill you”-type of documentary); Cut, Poison, Burn (yes, a cancer quackery-promoting film), and The Great Culling: Our Water (a fear mongering film about water fluoridation). You get the idea. Amazon Prime still has a long way to go, even with regard to removing antivaccine content. In addition, I’ve already described the quackery available on YouTube and how YouTube’s search algorithms seem to favor the quackery over scientifically sound content. Basically, from my unscientific perusal of their content, my assessment is that, as far as wretched hives of scum and quackery in the mainstream (as opposed to alternative medicine) online video world go, YouTube is, hands down, the worst. After that I would have said that it was definitely Amazon Prime followed by Netflix, but Netflix is in business with Gwyneth Paltrow and Goop and I view actively producing quack propaganda to be a far worse offense than simply hosting already existing quack propaganda. That means Netflix edges out Prime. Finally, Hulu appears, by far, to host the least amount of scientifically dodgy content.

So what should be done? I note that the problem goes far beyond just antivaccine pseudoscience. In fact, it goes beyond streaming platforms. For instance, Facebook has become a major hub through which antivaccine messages are amplified and spread, as has Twitter, where Russian bots might even be further amplifying antivaccine fear mongering and pseudoscience. Last week, in response to pressure, Facebook announced that it will soon take action against misinformation about vaccines:

Public health experts have pointed fingers at social media platforms, saying that false claims that vaccines cause autism and other diseases have frightened parents into refusing to vaccinate, resulting in the current measles outbreak that started in Washington state.

The Facebook representative, who asked not to be named, said the social media giant is working with health experts to decide what changes to make and considering a combination of approaches to handle vaccine misinformation. These approaches wouldn’t take misinformation off Facebook but rather make it less prominent.

For example, groups that promote vaccine misinformation wouldn’t show up in the list of groups that Facebook recommends users join. Also, Facebook would make sure that posts containing vaccine misinformation would appear farther down in a user’s newsfeed.

And:

Facebook is also considering making changes in its advertising policy, according to the representative. A CNN search on Facebook’s archived advertisement website found that several groups that promote false information about vaccines are advertising on the site.

Another change would involve putting results with vaccine misinformation farther down when people search for certain terms. This could result in major changes. According to recent CNN searches on Facebook, anti-vaccine groups now show up high on the list of results when the word “vaccine” is searched.

Meanwhile, Pinterest, a social media platform on which 80 percent of mothers and 38 percent of fathers in the United States have accounts, hobbled its search box so that searches for vaccine-related terms, such as “vaccine”, “vaccination”, and “antivax” don’t turn up any results. It is a rather radical method intended as a temporary stopgap measure while a permanent solution is developed.

It is clear that social media and streaming services have provided excellent platforms for antivaxers to use to spread their misinformation, to the point that the companies running these services are feeling the heat to “do something”, with mixed results. Preventing these services from serving as nodes to spread antivaccine propaganda will be difficult. For one thing, it isn’t always easy to distinguish legitimate questioning from antivaccine propaganda. For another thing, although streaming platforms are under no obligation to host content they do not wish to host, on social media platforms issues of free speech are harder to dodge, even though social media platforms are not obligated to host speech they do not wish to. Automated algorithms are not very effective, and Facebook’s content moderators, for instance, are overworked and grossly underpaid—and suffer psychological trauma from their job.

Still, I can’t help but conclude that, however inadequate they are, actions by Amazon, Facebook, Pinterest, and YouTube are a good first step in combatting the use of their platforms to spread antivaccine misinformation. Unfortunately, they do nothing about the larger problem of the promotion of dangerous quackery on their platforms, of which cancer quackery is only one example. There’s a lot more that needs to be done to protect parents and patients, and it will not be easy or straightforward.

Shares

Posted by David Gorski

Dr. Gorski's full information can be found here, along with information for patients. David H. Gorski, MD, PhD, FACS is a surgical oncologist at the Barbara Ann Karmanos Cancer Institute specializing in breast cancer surgery, where he also serves as the American College of Surgeons Committee on Cancer Liaison Physician as well as an Associate Professor of Surgery and member of the faculty of the Graduate Program in Cancer Biology at Wayne State University. If you are a potential patient and found this page through a Google search, please check out Dr. Gorski's biographical information, disclaimers regarding his writings, and notice to patients here.