A crisis of credibility: the global cost of US vaccine misinformation
Analysis of almost 300 million tweets on the social platform X in 2021 found that only 800 ‘superspreader’ accounts were responsible for a third of all vaccine misinformation retweets, with the most prominent account belonging to Robert F. Kennedy Jr., accounting for more than 13% of these retweets. These accounts operated primarily within the U.S. digital ecosystem but had global reach, reinforcing the role of American-origin misinformation as a destabilizing force in international vaccination confidence. Illustration by Duke University
The Lancet
The global health community faces a deepening challenge—not only from infectious diseases but also from a pandemic of misinformation. The USA, long a cornerstone of global health leadership, has become an unexpected source of global instability in vaccination confidence. While U.S. institutions such as the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) remain internationally respected, their credibility has been compromised by domestic political interference, institutional undermining, and unregulated digital platforms. The consequences are global.
During the COVID-19 pandemic, contradictory messaging on masking, vaccine safety, and mandates created domestic confusion and emboldened fringe narratives. While misinformation is not uniquely American, its scale and global reach are. An analysis of 316 million vaccine-related tweets from October, 2019 to March, 2021 across 18 languages found that the USA functioned as a major exporter of COVID-19 vaccine misinformation, with American accounts disproportionately represented as central hubs in global misinformation networks.
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