Intended for healthcare professionals

Rapid response to:


Information wars: tackling the threat from disinformation on vaccines

BMJ 2019; 365 doi: (Published 13 May 2019) Cite this as: BMJ 2019;365:l2144


Rebuilding trust in immunisation is key to tackling vaccine hesitancy


We have reached the point where we should consider compulsory vaccination

Rapid Response:

An appeal to authority is not the same as an appeal to knowledge

I read the article by Martin McKee and John Middleton [1] with dismay, and ask what sense there can be in the fundamental attitude that all opinion favorable to vaccine products is correct (apparently by virtue of being favorable) and all opinion unfavorable to vaccine products malicious. The world they describe is very far from one I am familiar with. In the world I see people share bona fide information on-line, obtained from official sources, scientific articles, Patient Information Leaflets etc. And by ordinary standards they have a right: these are materials which belong in the public domain. I have never encountered anything on the web which plausibly could be identified as state misinformation or espionage about vaccine (it may occur in some territory of cyberspace which I have never visited): what we are talking about by and large is material which is well sourced, but not necessarily favorable to the industry and its apologists. Most troubling is that it is impossible to verify McKee and Middleton's claims that people are spreading false information, let alone deliberately. As with anything there must be some level of error but I am very far from sure that this is the main problem: what I see is people pasting and linking to materials of genuine concern, and which is not being addressed by our governments or officials. However much they may want to marginalise such data under the rubric "the benefits greatly outweigh the risks" or even the grandiose "vaccines are safe" a lot of it is not trivial.

Earlier this year I was lamenting with McKee the "hidden power of corporations" and concluded my short letter with comment [2,3]:

"But still we do not learn. Readers might like to view the list of the CDC Foundation corporate partners (motto: "Together our impact is greater") which includes the Coca-Cola Company but also virtually every other major corporation, and every major pharmaceutical company ... At least Coca Cola was not supposed to improve your health."

Neither has the World Health Organization been historically above suspicion [4], and I have written about problems with measles data over a number of years [5-10] . Whatever the concerns about the spread of measles it should not be at the expense of truth.

I could write at much greater length but what we should have is not an "information war" but an honest discussion about the limits of science and knowledge, and decent respect for people who report harm, rather than the hostility which seems to be the currency. This way we will progress.

[1] McKee & Middleton, 'Information wars: tackling the threat from disinformation on vaccines',
BMJ 2019; 365 doi: (Published 13 May 2019)

[2] John Stone, 'Re: The hidden power of corporations', 23 January 2019,


[4] John Stone, 'Fear of the disease is not a reason for confidence in the product...', 21 March 2019,

[5] John Stone, 'Re: MMR, measles, and the South Wales Evening Post' 4 May 2013,

[6] John Stone, 'Re: Measles: Europe sees record number of cases and 37 deaths so far this year', 6 September 2018,

[7] John Stone, 'Re: Measles: Europe sees record number of cases and 37 deaths so far this year', 11 September 2018,

[8] John Stone, 'Information and Misinformation: the Global Health Security Agenda' 5 March 2019,

[9] John Stone, 'Re: Measles cases rise 300% globally in first few months of 2019 - how long is a piece of string?' , 17 April 2019,

[10] John Stone, 'Re: Measles cases rise 300% globally in first few months of 2019', 23 April 2019,

Competing interests: No competing interests

15 May 2019
John Stone
UK Editor
London N22