How Misinformation Starts

Unpacking a small-ball COVID vaccine conspiracy theory from this week.

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How does a piece of viral misinformation get its wings? Sometimes it’s malice—a doctored video, a fabricated quote. Sometimes it’s ignorance—a misreading of a graph or piece of data. Other times, however, the trouble starts with an institutional failing; a bureaucratic attempt to make things tidier than they are, a sloppy piece of mainstream journalism. This week provided a small-scale but instructive example of this latter phenomenon.

Could it be that the COVID vaccines, far from making people less likely to catch the disease and spread it to others, actually makes people spread the virus more? Such a claim has been ping-ponging around MAGA Twitter over the last 24 hours, with all advancing it relying on the same source: a screenshot from a USA Today article posted by right-wing cable pundit and strategist Jason Meister.

“NBC News, citing unnamed officials aware of the decision,” USA Today wrote Wednesday, “reported it comes after new data suggests vaccinated individuals could have higher levels of virus and infect others amid the surge of cases driven by the delta variant of the coronavirus.”

The quote is legit—so what gives here?

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  1. Sam Pfanstiel

    Can we also agree that “data suggests” is poorly worded as well? Where is the AP stylebook (or a 10th grade English grammar textbook) when you need it?

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    Ben Connelly

    Thank you, Andrew! This was insightful and I learned a lot. To be honest, until you pointed it out, I missed the wordplay and immediately assumed that “ new data suggests vaccinated individuals could have higher levels of virus and infect others amid the surge of cases driven by the delta variant of the coronavirus.” Meant higher levels that non vaccinated people, which made no sense. This article is an excellent reminder of the power of clarity in writing and communication and how omission can obscure or change the meaning of a statement. And an illustration of the discrepancy between the logical conclusion and the immediate one.

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    Mick.Staton

    This article is an interesting take on both misinformation and blind faith in other information. The USA Today article was correct. What scientists are finding is that people who are vaccinated are not only still contracting covid, but are seeing viral loads high enough to spread the infection. That is not misinformation, and it is not even a mistaken quote or taken out of context.

    The Maga/Anti-Vax crowd has taken this and run with it to make the case why people should not get vaccinated, but the Anti-Maga/Pro-Vax crowd has also decided that, if the Maga/Pro-Vax crowd are latching onto this story, then they must reject this news and double down on the efficacy of the vaccine.

    The truth of the matter is this. These vaccines are still in the testing stage. They are still gathering data. On top of that, these are not a typical vaccine like in the past where you are given an inert, or weakened, form of the virus and allowing your body to build an immunity. The mRNA technology has never been used in this way in such wide-scale use before.

    Someone given a polio or smallpox vaccine would not be able to catch the virus once vaccinated, much less produce enough viral load to become contagious to others. Furthermore, someone who had already had a disease and recovered, like polio or the measles, would not be given a vaccine because their body has already produced the antibodies to fight it off. I never had a chickenpox vaccine because I HAD the chickenpox as a kid.

    The real question I think needs to be asked here is, why are fully vaccinated people still contracting covid and producing a viral load high enough to become contagious?

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    1. CatoTheElder

      Some viruses, such as influenza and coronaviruses (incl. SARS-CoV2, the virus causing Covid) mutate readily enough and in such fashion as to produce new strains quickly and commonly. When a virus changes the site recognized by an antibody, the antibody’s effectiveness may be reduced or even eliminated. The rest of the virus may be the same or very similar to the original, causing similar disease, but the antibodies produced by the immune system response to the vaccine, as we see in influenza, and Covid, may be less effective.

      We see this with influenza quite literally all the time, and it’s not surprising to see it happen with Covid. Some viruses, like polio and smallpox, don’t evolve so quickly or readily, and (thankfully) the vaccines work well for much longer periods of time.

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    Victor Clairmont

    Conspiracies!

    Conspiracies everywhere!

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    1. CatoTheElder

      I think the line is “Vultures! Vultures everywhere!” ;-)

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    Show Jay Janney the 🚪!

    The original NBC article would have been better yet had it included some sense of proportionality. How much more of a risk is there now? Has the Pfizer effectiveness dropped from 95% to 90% (not too much to worry about IMHO), or has it dropped to 30-40% (IMHO a much bigger issue). In stats we look at both significance and effect size. If the effect size is tiny, who gives a rat's butt about it (beside, Putin, and other rats)? Publish and contextualize the effect size, that will help reduce misinformation.

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    1. Shaybult

      Well effect size (and more data in general) *should* help reduce misinformation. But given that so many people still don't understand what "95% effective" means ("5 out if 100 vaccinated people will get covid!") I'm not holding my breath.

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  6. Alex DeLarge

    If you are going to do a self-righteous article about "misinformation," is it too much to ask that you, like, actually show the claim at issue is wrong?

    I won't go down the rabbit hole of the technical debate among immunologists as to whether the mRNA vaccines could actually facilitate covid transmission. (It has something to do with a virus's ability to bind with "deficient" antibodies generated by the vaccine). But suffice it to say that it is a legit issue of concern that has nothing to do with the verbiage of some NBC story.

    This article is frankly lame. It sidesteps the actual issue and smacks of the censors doing damage control. Weak.

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      Andrew Egger

      Thanks for reading, Alex!

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      1. Alex DeLarge

        You're welcome.

        Btw, you claimed it was "misinformation" to ask the question: "Could it be that the COVID vaccines, far from making people less likely to catch the disease and spread it to others, actually makes people spread the virus more?"

        But the real answer to that question is: "Yes, it could be." The technical issue is "Antibody Dependent Enhancement ("ADE")." Here's a paper discussing the issue:

        "Here, we review the possible antibody-dependent enhancement (ADE) occurrence, known for dengue infections, when there is a second infection with a different virus strain. Consequently, preexisting antibodies do not neutralize infection, but enhance it, possibly by triggering Fcγ receptor-mediated virus uptake. No clinical data exist indicating such mechanism for SARS-CoV-2, but previous coronavirus infections or infection of SARS-CoV-2 convalescent with different SARS-CoV-2 strains could promote ADE, as experimentally shown for antibodies against the MERS-CoV or SARS-CoV spike S protein."

        https://pubmed.ncbi.nlm.nih.gov/32506725/

        It is thus entirely possible that ADE is making vaccinated people more susceptible to the delta variant. This possibility is supported by Fauci's statement yesterday that: "'When you look at the level of virus in the nasopharynx of a vaccinated person who gets a breakthrough infection with Delta, it is exactly the same as the level of virus in an unvaccinated person who's infected," https://www.dailymail.co.uk/health/article-9839697/Fauci-says-CDC-changed-mask-guidance-vaccinated-people-spread-Indian-Delta-variant.html (The CDC is withholding the specific data on infected vaccinated people so that's not a good sign either).

        According to your article, Fauci is engaged in misinformation. But at this point the MSM hack-o-sphere has lost track of what they are supposed to claim is true.

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        1. CatoTheElder

          Your post here is a beautiful example of failure to understand leading to promulgation of misinformation.

          Alec did not claim that it was misinformation to ask the question you cite, and which he says was “ping-ponging around MAGA Twitter”. The excitement was produced by a bit of misinformation presented in USA Today—a statement, incomplete, which allowed for misunderstanding of what had elsewhere been reported (by NBC) more accurately.

          You compound your own error when you, naively, one must presume, present the claim that “Yes, it’s possible that the COVID vaccines…make the virus spread more”, and support that statement by claiming that the culprit could be Antibody Dependent Enhancement (ADE), thus confusing one rare, and with regards to COVID-19, thus far entirely hypothetical event, in which a small number of people who have, either natively developed or introduced by vaccination, effective antibodies against a given strain of a virus (the virus most commonly discussed in this context is the Dengue virus), and, when exposed to a different strain of the virus, the particularities of the patient’s immune system response, and myriad complex factors presently poorly understood combine to produce an ineffective immune response, to the point of more severe disease occurring than would otherwise be expected.

          Let’s consider Dengue virus again, as it is the best known of only a few rare viruses that are known to be associated with ADE in humans.

          Dengue has four serotypes, or variants, in a broader but current parlance. If a person contracts Dengue Fever, say from serotype 1, (DENV1), they will generally produce a measurable, protective immune response manifest as antibodies against the virus. These protective antibodies are often generated against surface proteins of the virus, so that the invader is caught and dealt with before the virus has entered the host’s cells and begun replication and disease. Some of these same surface proteins are often the “key” that the virus carries to bond to the “lock” of a surface protein on the host’s cells; once these two proteins bind, the virus particle is attached to the cell, the membranes of cell and virus envelope fuse, and the virus enters the cell.

          In some rare instances—and no one understands why just yet—a patient may be exposed to another serotype of Denge Virus—let us suppose it’s type 4, just to pick one—and this DENV4 virus has surface proteins that are just slightly different than those of DENV1. Thus, it might be that the protective antibodies developed by the host when ill with DENV1 prove protective against DENV4, perhaps even equally so, or maybe at some lower level of effectiveness. Or maybe the antibodies aren’t effective at all. In some (again, rare) cases, the antibodies produced by the immune system’s “memory” of DENV1 may be not only ineffective in neutralizing invader, but actually seem to enhance the virus’s ability to attach to cell surface proteins, fuse membranes with the cell, and invade the cell. This enhanced disease process is called Antibody Dependent Enhancement (ADE)—see above.

          When ADE occurs in a second infection with a closely related virus variant, the disease is more severe, more difficult to treat, and perhaps more likely to be lethal. We should be thankful that these events seem quite rare. The work done to understand ADE suggests that many factors are important and necessary for ADE to occur, ranging from specific types of antibodies, particular types of Fc component and Fc receptor regulation, to certain types of viruses, target cells for those viruses, and more. To date, the general consensus is that there is little or no evidence that suggests that ADE is or has been occurring in COVID-19 patients.

          There are problems with such conclusions, however. Firstly, it is very difficult to discern whether a severely ill patient is just severely ill, or ADE played a role in enhancing disease severity. There are no lab tests, no blood markers, no diagnostic x-rays, etc., for determining when ADE is occurring, and causing increased disease severity.

          This brings us to where we can now consider the statement about virus shedding—which is what we speak of when speak of amounts of virus in the throat, nose, etc., and which when expelled into the air can, if they encounter another potential host, possibly make that person sick with COVID-19. As most everyone reading this knows, the scary variant of the moment is the Delta variant of SARS-CoV2. This is the one that is described as being much, much more infectious/contagious than the “original” virus, but it’s disease course—that is, its severity, hospitalization rates and mortality rates, etc.,—is not much different.

          The most likely explanation for why patients who have had COVID-19 vaccinations and then contract the Delta-variant form of the virus and then have viral loads more or less commensurate with sick patients—even though these vaccinated persons typically are not very ill—is that the antibodies produced by their immune systems, which were tailored by their bodies against the original (Alpha) variant, and their antibodies are somewhat protective—enough to reduce disease, perhaps—but not enough to significantly reduce the amount of virus shedding.

          This scenario does not suggest that ADE is playing a role, at least as ADE is presently understood. We must recall that ADE results in increased severity of disease—and we have no evidence that vaccinated people are actually getting more sick than unvaccinated people. Actually, the opposite is the case, as is generally well-known. Even though the vaccines used the Alpha variant, they do provide significant protection against other variants of the virus, and *especially* in reducing the likelihood of hospitalization and death.

          Finally, no, Alec’s article does not suggest that Dr. Fauci “engaged in misinformation”. It is your misunderstanding of things reported and described that leads to that conclusion.

          Almost as a post-script, I’ll suggest that if people wish to read more about ADE and whether it’s a real concern in COVID-19, here’s an article (which requires a fair bit of information/science literacy, I’m afraid, but…):

          https://www.nature.com/articles/s41586-020-2538-8

          This is a much better-written article than the one cited by Mr. DeLarge.

          There. Done. I’ve written this very quickly, and went and grabbed the Nature article I’d seen a couple weeks or so ago as an aid in understanding for those who wish more reading. I apologize if I’ve muddled things a bit, been less than clear, etc.

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          1. Sam Pfanstiel

            Most underrated content on the Internet today. Thank you for taking the time to write this thorough explanation. And of course as expected, Alex can’t be bothered to acknowledge that he had fallen prey to the very sort of misinformation he had intended to expose, but we can hope this information was helpful stop its spread. I applaud you for helping keep the Internet (and The Dispatch) clear of such chatter (if only incrementally). +1

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          2. CatoTheElder

            I immediately realized that I’d mistakenly attributed the article to the wrong author. My apologies to Andrew Egger, the actual author of the article, who deserves full credit for same. Alec may have gotten Andrew a cup of coffee or something, I suppose, but apparently no real contribution to the article.

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          Mudskipper

          You appear to be conflating issues. Vaccinated people who become infected might have the same viral load as infected unvaccinated people, but that does not mean that they are more likely to spread the virus than unvaccinated people, nor does it mean they are more susceptible to virus, if by susceptible you mean more likely to become seriously ill. All evidence shows the exact opposite: vaccinated people are less likely to become seriously ill. So Fauci is not speading misinformation when he says they might have the same viral load because that claim is NOT the same as saying that the vaccinated are more likely to spread Covid than the unvaccinated.

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        Aylene Wright

        I am sure you also appreciate the 1 or 2 cents his subscription fee contributes to your yearly income as well. 😉

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    Aylene Wright

    Thanks Andrew for wading through MAGA Twitter so we don't have to. And I agree with the general sentiment that "the vaccines don't really work" misinformation isn't just coming from the MAGA side these days.

    That being said I think the "get the vax so you can ditch the mask" messaging was problematic to begin with, as it validates the idea that masks are ridiculously heavy burdens that are torturing the populace, and that we should greet the vaccines as a liberating army from the masks, as opposed to the virus itself.

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    1. Alex DeLarge

      ". . . the vaccines don't really work" misinformation. . . "

      It depends how you define "really work," doesn't it? The job of a vaccine is to create immunity. So if two vaccinate people in a room still have to wear masks to avoid infecting each other, one can fairly conclude that the vax isn't "really working" to create immunity.

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      1. CatoTheElder

        No. Troll immunobiology is completely different.

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        1. Alex DeLarge

          Different than what? WTF are you talking about.

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        Man-Eating Cow

        The vaccines are 95% effective in preventing infection by original strain, and 86% effective in preventing infection from delta. In other words, it's 20 times more likely you'll be infected from an exposure to original strain if you're not vaccinated, and over seven times more likely you'll be infected from an exposure to delta strain if you're not vaccinated.

        I'm not sure how any reasonable person can conclude that that's "not really working."

        I don't regard the mandate that two unvaccinated people in a room must be masked as proof the vaccines "don't really work." I regard it as evidence that someone is finding the risk from two vaccinated people being unmasked in the same room more frightening than I think is reasonable.

        I understand that someone else might regard a sevenfold-reduced risk of infection as still too much risk of infection. That's a cost/benefit analysis that's going to be very different from individual to individual. But I would prefer not to have someone else's cost/benefit analysis rammed down my throat.

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  8. Vantenn

    NBC's Dilanian wasn't precise either. When he says that the fully vaxxed are "contracting COVID" he needs to pair that w the fact that breakthrough infections are extremely rare. Folks who read what he reported could conclude that it's quite common for the vaxxed to become infected. That solidifies the fears of both sides- the "must maskers" and the antivaxxers. Sloppy reporting from top to bottom.

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      Show Jay Janney the 🚪!

      Reporting the number of cases would help. Maybe TheDispatch could add that to their daily report?

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    2. Alex DeLarge

      The problem arises from an internal contradiction in the narrative.

      The narrative says that getting vaccinated makes you safe from infection, which is why everyone needs to be vaccinated.

      But the narrative also says that the unvaccinated are still a deadly threat to the vaccinated, which is also why everyone needs to be vaccinated.

      These messages are working at cross-purposes. That's one reason why the party line's marketing has been such a sh*t show.

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    Tracie

    So, conspiracy theorists hold USA Today in high regard, don't check their sources, and lack insight to note their own confirmation biases.

    Not surprising. Don't blame the internet.

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    mel ladi

    Boy, as a retired librarian, I find the info/misinformation movement fascinating. They didn’t teach me this in library school. I can only hold journalist so much responsible. Are we not teaching info literacy in school? I thought we were.

    Anybody care to answer this question? Over on Twitter the anti-vax brigade is all about touting breakthrough infections in the vaccinated. What are they trying to prove? I don’t get it.

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    1. CatoTheElder

      Unfortunately, no, we are not routinely teaching information literacy, as you put it. In the context of science, such would include at least moderate mathematics skills, some logic, some statistics and probability analysis skills, and some, well, some science. It’s actually quite depressing how little the typical American high school graduate is actually expected to know (as measured by what it takes to get a diploma) in these areas.

      I volunteer as a tutor in remedial math classes at a nearby school, or did, pre-pandemic. I sometimes have to backup and teach knowledge and skills that should have been required—not just “taught”, or “presented”, but required as in *learned* several years prior. And we’re not talking calculus or trigonometry here. In conjunction with that, I’ve had science teachers tell me that they’re sometimes not allowed to include any “complicated” mathematics in their instruction in say, general chemistry. (This is at the high school level.) In addition, the teachers are often frequently instructed to encourage the students to use a programmed electronic calculator and just input the values, “so the kids can focus on the science”.

      Yup. We’re gonna be focused on the science, so they can graduate high school, take the bare minimum of math in college, and then go “Huh?” when someone tries to explain mortgage interest calculations to them when they’re trying to determine how much house they can buy.

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      Mudskipper

      I am convinced that there are a lot of people who get some sort of ego-boost out of being contrarians and "proving" how much smarter they are than the fancy-pants experts. They all hang together and give each other high-fives and much ego-stroking. Global-warming skeptics are full of these people. They comb the literature for "mistakes" or alleged smoking-guns and bring them like treasures to their like-minded skeptics. Most of the time, they simply don't understand the literature and badly misinterpret it. Mixed with these folks are bad-actors who have yet other motives for deliberately injecting misinformation into the stream and the so-called skeptics pretty much swallow wholesale because their skepticism runs only one way.

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      1. Shaybult

        Yes! Even here in TD comments, I've seem multiple (usually poorly written in addition to poorly reasoned) posts saying "Aha! I've found something the experts missed/covered up/lied about!" And every time it's because they don't understand what they've read.

        I'm not saying I necessarily know more than those posters; vaccine, immunity, and epidemiology science is far beyond me. But that's why I don't try to act like some sort of amateur expert.

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        mel ladi

        I think you nailed it, as you often do. I also think bad-actor foreign actors must figure into it. Last night on Twitter there was a supposed Seattle pulmonologist reporting ten people in ICU with only two vaxxed. I didn't do my research -- so grain of salt here -- but several people easily disproved what he was saying. Did damage to the vax cause, I'd think.

        I was left to wonder if the guy was real and pushing a narrative (out of concern) or hacked in order to help the anti-vaxxers. I'm not saying he was hacked but it was a very effective takedown for a supposed accurate "expert".

        I feel sure the same is happening with climate skeptics. Science is iterative and builds upon itself. New knowledge informs, builds on, questions, casts doubt on previous knowledge. It's good thing. You can never drive a stake in the ground and say this is it, this is the "truth." That kind of amorphousness can be very difficult to wrap one's head around, IMO. It's mamas-milk for bad actors.

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      Beth

      Sadly, critical consumption of media and social media seems to be on the wane in all corners, all demographics. It actually seems to be most pronounced with some of my older family members, so I'm not going to blame the schools for it.

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        mel ladi

        Throwing this out there as an older family member: Back before the sainted Reagan, we had the fairness doctrine & a limited number of inputs that provided our news. People also argue we had a stronger sense of community due to participation in church and civic affairs in person. Except for a personal interest I wasn't taught about how to evaluate information in school. Perhaps some of us oldsters are too trusting or too stuck in our ways.

        I was taught civics, however. So there's that.

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          Man-Eating Cow

          My training in how to evaluate information in public school was "We are teaching you truth and you will be graded on your ability to repeat it back."

          Not a very satisfactory model.

          Alas, "We are giving you two positions on an issue, and you will be graded on your ability to judge which has the better case", while a far better form of education, also requires far better educators.

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