Intended for healthcare professionals

Feature Essay

New power versus old: to beat antivaccination campaigners we need to learn from them—an essay by Kathryn Perera, Henry Timms, and Jeremy Heimans

BMJ 2019; 367 doi: (Published 21 November 2019) Cite this as: BMJ 2019;367:l6447
  1. Kathryn Perera, director1,
  2. Henry Timms, senior adviser2,
  3. Jeremy Heimans, cofounder and chief executive2
  1. 1NHS Horizons, Coventry CV1 2WT, UK
  2. 2Purpose, New York, USA
  1. Correspondence to: Kathryn Perera kathryn.perera{at}

Healthcare professionals have grown up in “old power” institutions, but only by understanding how “new power” works can we respond effectively to the antivaccination narratives spread on social media, surmise Kathryn Perera, Henry Timms, and Jeremy Heimans

Shanelle Cartwright is a 20 year old mother of two young children and a social media influencer. Her personal account on Instagram has 7000 followers. Tens of thousands more people have interacted with the “healthy lifestyle” messages she promotes in blogs and online interviews.

The wife of a prominent rugby league player, Cartwright uses her global profile to share antivaccination stories. Some take the form of “informational pieces” and some cite, for instance, the books of Suzanne Humphries, a US nephrologist and prominent voice in the antivaccination community.

Others are deeply personal. They invite Cartwright’s virtual community to learn about her parenting philosophy, accompanied by photos of her young family. In a recent series of posts, Cartwright explained her decision not to vaccinate her children, citing her own experiences of developing “allergies and autoimmune disorders” as a result of vaccination, leading to a “(sloooow) process of healing.”

One of Cartwright’s most shared posts states that she would rather home school her children than succumb to clinical and governmental pressure to vaccinate them.

Restrictions on content

Facebook, which owns Instagram, recently introduced tougher rules for users sharing antivaccination content. As a result, Cartwright and other influencers like her have seen their accounts restricted. Yet such case-by-case restrictions do little to stem the surge of self organising networks that drive the rapid spread of antivaccination messages around the world.

The motivations of these communities vary widely. Some are driven by a suspicion of science and concerns about personal liberty—“I know what’s best for my child.” Others focus on “clean living”—emphasising homeopathic remedies over vaccination. Still others …

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