How should we address stories of death after vaccination?
New study analyzes how vaccine content shared on Facebook influences people’s decision to vaccinate
Rumors about COVID vaccines were among the most viral topics during the pandemic, sowing doubt over and over again and contributing to an estimated 250,000-300,000 deaths in the US that could have been prevented by vaccination.
Why did this happen? And what do we do about it?
A very cool new study published in Science helps answer this question. What they found was surprising.
1. Vaccine misinformation can impact anyone
The scientists surveyed thousands of people to see how exposure to different vaccine-related posts impacted people’s willingness to vaccinate.
They found exposure to vaccine misinformation (content that is false or misleading, as defined by professional fact-checkers) decreased intention to vaccinate, regardless of:
prior vaccination status
prior intention to vaccinate
political party
age
gender
This suggests vaccine misinformation can influence anyone—even those who have a positive view of vaccines.
2. Suggestion of harm had the most influence
Posts that suggested vaccines may cause harm to health reduced intention to vaccinate the most (see Figure 1 below). The veracity of the claim (true or not) and the source (reputable or not) did not have a big influence.
3. “Vaccine-skeptical” content, not fact-checked falsehoods, had a larger impact
The scientists analyzed 13,206 links about COVID vaccines shared on Facebook. Links were separated into two categories:
Flagged misinformation—posts/articles that contained outright falsehoods and were fact-checked as false or out-of-context, like vaccines have 5G.
“Vaccine-skeptical” content—articles that were not flagged by fact-checkers and were not necessarily factually false but raised doubt about vaccines, such as true stories of death after vaccination.
For individuals, seeing flagged misinformation had a bigger negative impact on people’s willingness to get vaccinated.
However on the population level, it switched: unflagged vaccine-skeptical content, including content from mainstream sources, had a much larger impact because it reached far more people. Averaged across all U.S. Facebook users, flagged misinformation reduced intention to vaccinate by 0.05% per user, while unflagged vaccine-skeptical content reduced it by 2.3%. That’s a 46-fold difference.
4. Top viewed “hesitancy-inducing” links included true stories of death after vaccination
The very top link—with 55 million views reaching one in five U.S. Facebook users—was the article below, which reported the death of a doctor from a rare clotting disorder shortly after his first COVID vaccination.
This was not the only example. The study authors state:
“We found that coverage of young, healthy people’s deaths after vaccination—with headlines that did not contextualize how exceedingly rare such deaths were, or the uncertainty of the vaccine’s role in causing these deaths—achieved disproportionate reach, and therefore had a disproportionate estimated impact, during this time period.”
How should we approach viral stories of death after vaccination?
Correcting blatant falsehoods is an obvious choice. But addressing the viral “hesitancy-inducing” articles that don’t contain outright falsehoods—such as true stories of death after vaccination—is much trickier.
On one hand, rare vaccine deaths do occur. There have been rare deaths after the J&J vaccine from a clotting disorder, and rare deaths from myocarditis after mRNA vaccination. It is critical to monitor deaths after vaccination to detect true safety signals. Efforts to discourage reporting would be unethical and disastrous—both for vaccine safety (we need to be able to detect those rare safety signals) and for public trust in vaccine safety.
On the other hand, coincidental deaths after vaccination are statistically bound to happen. When a vaccine is given to millions of people, there are guaranteed to be stories of strokes and heart attacks shortly after, as some of these people were going to have strokes and heart attacks regardless.
The challenge occurs when these stories become headline news, as it distorts risk perception. When rare and/or unconfirmed risks are highlighted and seen millions of times while the benefits of vaccination are given less attention, it falsely elevates perceived risk. The decision to vaccinate is always a decision of risk versus benefits, and this distortion makes the risk/benefit tradeoff seem much worse than it actually is.
This can have a big impact—this study found that “vaccine-skeptical” content reduced intention to vaccinate by 2.3% per U.S. Facebook user, translating to an estimated 3 million fewer vaccinated Americans. True stories, when taken out of context, can cause real harm.
So what should we do?
Don’t suppress; do contextualize. Some may push to label these news stories as “misinformation” or “misleading” and pressure social media companies to downrank them in their algorithms. This would backfire—I cannot think of a way to lose the public’s trust faster than trying to suppress true reports of death after vaccination. Instead, we should be transparent and help contextualize what’s going on. If a specific article goes viral, perhaps a flag providing that contextualization could be added on social media platforms alongside the article.
Tell people what to expect ahead of time (pre-bunking). We likely could have prevented a lot of fear if we had a large coordinated effort to explain the post hoc fallacy, that coincidental deaths after vaccination were expected, and how scientists discern true vaccine side effects from coincidence.
Make headlines better. Many people only read the headline and miss the contextualization found in the article. When reporting deaths after vaccination, clearly framing the rarity and uncertainty of causal connection in the headline would help tremendously.
Finally, we’re talking here about viral headline news, not personal stories. If someone’s loved one died shortly after getting vaccinated, the most important thing you can offer is kindness and empathy, not a discussion of the post hoc fallacy.
Bottom line
A lot of vaccine content on social media lives in a gray area—viral stories that are true or have a kernel of truth but are missing important context. These stories can have a huge negative impact, but if true stories are attacked as “misinformation,” this will likely confuse people even more. Instead, we should focus on providing context and helping people understand when their perception of risk has been distorted.
Sincerely, Dr. P
Kristen Panthagani, MD, PhD, is a resident physician and Yale Emergency Scholar, completing a combined Emergency Medicine residency and research fellowship focusing on health literacy and communication. In her free time, she is the creator of the medical blog You Can Know Things and author of YLE’s section on Health (Mis)communication. You can find her on Threads, Instagram, or subscribe to her website here. Views expressed belong to Dr. P, not her employer.
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I really wish people would stop referring to the pandemic in past tense. It's still ongoing. The only thing that's over is the emergency designation. The vaccine hesitancy and outright disinformation has been going on for more than a decade. Social media doesn't remove the disinformation even when reported over and over again. We aren't going to gain traction wth the anti-vaccine/anti-science people. My degrees are in psychology and these people are essentially in a cult at this point. They do not listen to reason or facts and the cognitive dissonance they experience is so severe that they rationalize away anything you tell them. Not to mention the rampant Dunning-Kruger that's come out of all this.
Because the facts are that according to the review done of autopsy reports by the NIH, done in 2024, there are only 28 confirmed dealths due at least in part to covid vaccine induced myocarditis. All adults. They all died within a week of getting vaccinated. So we now know that people will not die months or years after being vaccinated for Covid. But you can't convince an anti-vaxxer of that. I have tried for years, even before the pandemic. Everyone needs to read Dr. Peter Hotez's book 'The Deadly Rise of Anti-science'.
Good analysis thank you.
With vaccine-hesitant patients I acknowledge their concerns about side effects and adverse events, which are rare and real, while then pointing out that whatever possible side effects one might develop from Covid vaccines/boosters, the actual disease will raise that bet 10 fold and more. Covid re-exposure is a certain, so think flu shots.
And when I’m really trying to persuade someone before backing off for a final time, maybe I’ll counter the statistically likely post hoc fallacy they just told me about with any number of stories of my patients who died of Covid, had lung transplants after Covid, had accelerated dementia after Covid, are physically disabled by long covid post exertional malaise and cognitive damage, aka brain damage.
Is that wrong? Are we on the evidence/scientific side above the power of the story? Is it manipulation when it’s built on a foundation of truth and beneficence?