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It’s not enough to have useful tools like vaccines to tackle disease epidemics. Those tools also need to be used. But countries are facing growing obstacles, from false information about disease threats to a lack of trust in the measures required to tackle them.

This gap between tools and trust can have major consequences. Across Europe and the US, we are seeing resurgent outbreaks of measles, leading to deaths among children. This is despite the availability of an effective, cheap and overwhelmingly . Meanwhile, reasoned debates about optimal policies for future pandemics are being sidelined by rumours and revisionism. Operation Warp Speed, which accelerated the development and rollout of mRNA Covid vaccines, was arguably the first Trump administration’s only major in terms of clearly improving lives. Yet the legacy of these tools, which ended the worst of the pandemic, is now being undermined by his very own second administration.

Human behaviour is one of the keys to understanding epidemics

If we want to control pathogens that spread among humans, we need to understand how infection spreads, and that means understanding human behaviour. This is why researchers like me now work extensively with behavioural data as well as clinical surveillance. For example, one of the earliest signs in March 2020 that the UK Covid epidemic had started to decline came from an . However, if we want to understand what drives the behaviour that shapes epidemics – and our ability to control them – we need to look even earlier, at the information and attitudes that shape how people act.

Over the past decade, I’ve written two on the spread of infections and information, and the evidence base we need to respond effectively. As with any risk, we first must measure the problem. In the modern era, ideas can spread rapidly across platforms and countries, evolving to become more “contagious” as they travel. When it comes to misinformation, belief in outright falsehoods is not the only challenge. There is also the question of technically-true-but-potentially-misleading content, which can have a on social media. For example, a headline reporting a death shortly after vaccination may be technically true, but on its own, it does not mean the vaccine caused the death, nor does it allow us to draw any conclusions about the overall safety of vaccines. Then there is the issue of a lack of belief in reliable information: too much credulity can be harmful, but so can too much cynicism.  A recent systematic review of news consumption concluded that ‘there is more room to increase the acceptance of true news than to reduce the acceptance of fact-checked false news’.

Tackling misinformation head on

As well as measuring the problem, there is the question of how to intervene. Like a biological pathogen, should we try and remove the harmful information itself? Or should we target the networks through which that harm spreads, like a form of social distancing? Or should we focus on reducing susceptibility to potentially harmful information? As well as measuring the reach and impact of misinformation, researchers are increasingly able to such as ‘prebunking’, which aim to proactively reduce the chances of believing misinformation that might be encountered in future.

In a world where ideas spread faster than pathogens, often undermining front-line countermeasures, we cannot afford to treat harmful information as a secondary threat. That is why the LSHTM Centre for Epidemic Preparedness & Response is hosting a major event on health misinformation in September to share ideas and insights to help people combat the rising tide of misinformation. With resurgent epidemics globally, alongside the risk of another pandemic, we need valuable tools like vaccines to be used in practice – rather than just useful in theory, now more than ever.