The Vaccination Debate in the Post-Truth Era: Examining Social Media As Sites of Multi-Layered Reflexivity

On 8 January 2016, the Facebook CEO Mark Zuckerberg posted on his Facebook profile a picture of his two-month-old daughter, accompanied by a comment: “Doctor's visit -- time for vaccines!” In only few days, the post attracted more than 83,000 comments. The debate that followed the statement provides a unique insight into the public debate about vaccination, and medical knowledge more broadly, in the so-called post-truth era. Furthermore, the analysis empirically informs the theoretical debate about citizens’ reflexivity in relation to health care.

The following theoretical and empirical questions are addressed: To what extent do social media stimulate reflexivity and empowerment of citizens in relation to health care? What topics and arguments were articulated in relation to vaccination? What sources of “knowledge” about vaccination legitimized their standpoints? How were the cleavages between proponents and opponents of vaccination deepened and mitigated?

A combination of quantitative content analysis and qualitative discourse analysis is used. The contribution of the paper is threefold. First, the paper examines the dynamics between proponents and opponents of vaccination. Second, the analysis is situated within the context of previous debates on vaccination. While we argue that the key themes and arguments mirror the previous debates (e.g. Blume 2006, Hobson-Best, 2007; Kata 2011), we also highlight that the vaccination debate has its own history which has had post-truth attributes since ever and that this history is considered by participants in the debate. Third, this paper extends the notion of patients’ reflexivity, previously elaborated in the discussion of the role of Internet and informed patient (e.g. Lupton 1996, Adams 2010). We introduce the notion of multi-layered reflexivity and emphasise that in the post-truth context, reflexivity is not expressed only in relation to the topic of vaccination but also in relation to the post-truth conditions, within which this discussion takes place.