In some cases, anti-vaccine activists are fabricating stories of deaths that never occurred.
"This is exactly what anti-vaccine groups do," said Dr. Peter Hotez, an infectious diseases specialist and author of "Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science."
Anti-vaccine groups have falsely claimed for decades that childhood vaccines cause autism, weaving fantastic conspiracy theories involving government, Big Business and the media.
Now, the same groups are blaming patients' coincidental medical problems on covid shots, even when it's clear that age or underlying health conditions are to blame, Hotez said. "They will sensationalize anything that happens after someone gets a vaccine and attribute it to the vaccine," Hotez said.
As more seniors receive their first covid shots, many will inevitably suffer from unrelated heart attacks, strokes and other serious medical problems — not because of the vaccine but, rather, their age and declining health, said epidemiologist Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy.
For example, in a group of 10 million people, nearly 800 people ages 55 to 64 typically die of heart attacks or coronary disease in one week, Osterholm said. Public health officials "are not ready" for the onslaught of news and social media stories to come, he cautioned.
"The media will write a story that John Doe got his vaccine at 8 a.m. and at 4 p.m. he had a heart attack," Osterholm said on his weekly podcast. "They will make assumptions that it's cause and effect."
Public health officials need to do a better job communicating the risks — real and imagined — from vaccines, said Osterholm, who served on President Joe Biden's transition coronavirus advisory board.
"You get one chance to make a first impression," Osterholm said. "Even if we come back later and say, "No, [the deaths] had nothing to do with vaccination, it was coronary artery disease,' the damage has already been done."
Anti-vaccine groups such as the National Vaccine Information Center and Children's Health Defense, founded by Robert F. Kennedy Jr., are already inflaming fears about a handful of deaths — mostly in Europe — that have followed the worldwide rollout of immunizations.
In a blog post, Kennedy scoffed at autopsy results that concluded a Portuguese woman's death was unrelated to a vaccine. He cast doubt on statements by medical authorities in Denmark who said the deaths of two people there after vaccination were due to old age and chronic lung disease. In an interview, Kennedy said the post-vaccination deaths of some very frail and terminally ill nursing home patients in Norway are a danger sign. Norwegian officials have said the elderly patients died of their underlying illnesses, not from the vaccine.
"Coincidence is turning out to be quite lethal to COVID vaccine recipients," Kennedy wrote. Kennedy described the deaths as suspicious, accusing medical officials of following an "all-too-familiar vaccine propaganda playbook" and "strategic chicanery."
Here in the U.S., vaccine opponents have pounced on the tragedy of Dr. Gregory Michael, a 56-year-old Florida obstetrician-gynecologist, to sow doubts about vaccine safety and government oversight. Michael died Jan. 5 after suffering a catastrophic drop in platelets — elements in the blood that control bleeding — suggesting he may have developed immune thrombocytopenia.
According to a Facebook post by his wife, Heidi Neckelmann, doctors tried a variety of treatments to save her husband, but none worked.
A spokesperson for the Centers for Disease Control and Prevention said the agency is investigating Michael's death, as it does for all suspected vaccine-related health problems.
California authorities had recommended pausing vaccinations with a particular batch of covid vaccines made by Moderna because of a high rate of allergic reactions. Following an investigation, vaccinations resumed a few days later.
"We're going to see these events happen, and we have to follow up on every one of these cases," Osterholm said. "I don't want people to think that we're sweeping them under the rug."
Many Americans were already nervous about covid vaccines, with 27% saying they "probably or definitely" would not get a shot, even if the shots were free and deemed safe by scientists, according to a December survey by KFF. (KHN is an editorially independent program of KFF.)
These people may be particularly susceptible to vaccine misinformation, said Rory Smith, research manager at First Draft, a nonprofit that reports on misinformation online.
A rare condition
Seven experts in blood disorders interviewed by KHN said there's not enough information available to blame Michael's decline on a vaccine and that the demonstrated benefits of covid vaccinations vastly outweigh any potential risk of bleeding. Even if investigators conclude that Michael's vaccine caused his death, it would still be an incredibly rare event, given that more than 20 million doses have been administered.
"It shouldn't give anyone pause about whether the vaccine is safe or not," said Dr. James Zehnder, a hematologist and director of clinical pathology at Stanford Medicine.
Michael's bleeding disorder could have been developing silently for some time, said Dr. Adam Cuker, director of the Penn Blood Disorders Center at the Hospital of the University of Pennsylvania. It could be a coincidence that Michael started showing symptoms shortly after vaccination, he said. About 30 Americans are diagnosed with immune thrombocytopenia every day.
The timing of Michael's illness suggests it had another cause, doctors said. According to his wife's Facebook post, his bleeding problems began three days after his first covid shot. It takes the body 10 to 14 days after vaccination to generate antibodies, which would be needed to cause immune thrombocytopenia, said Dr. Cindy Neunert, a pediatric hematologist at the Columbia University Irving Medical Center in New York City.
In most cases, the cause of thrombocytopenia is never known, said Dr. Deepak Bhatt, executive director of interventional cardiovascular programs at Brigham and Women's Hospital in Boston.
Immune thrombocytopenia is linked, rarely, to certain vaccines, with about 26 cases for every 1 million doses of measles-mumps-rubella vaccine.
But it can also be caused by viruses themselves, including measles and the novel coronavirus, said Dr. Sven Olson, an assistant professor of hematology-medical oncology at Oregon Health & Science University's school of medicine.
Many patients with immune thrombocytopenia are now wondering if they should be vaccinated against covid, Cuker said. Cuker said he urges nervous patients to be vaccinated, noting that any problems could be managed by closely monitoring their platelet levels and adjusting medication if needed.
Even in patients with underlying bleeding conditions, "it's still safer to get vaccinated than to get covid," Zehnder said.
"If you give a vaccine to a large enough number of people, there are going to be rare adverse events but there are also going to be coincidental events unrelated to the vaccine," Cuker said. "If an anti-vaccine group uses a single case, where no link has been proven, to discourage people from vaccination, that's terrible."
Barbara Loe Fisher, president of the National Vaccine Information Center, said her site provides balanced information from reputable news sources, including CNN, CBS and the Miami Herald, as well as Pfizer and the CDC.
In an interview with KHN, Kennedy said he questions why government officials have been so quick to dismiss connections between vaccinations and deaths. "How in the world do they know if it's a vaccine injury or not?" he asked.
"We don't discourage anybody from getting vaccinated," Kennedy said. "All we're doing is conveying the data, which is what the government should be doing. ... We print the truth, which is what the medical agencies ought to do."
Alternative facts?
Opponents of vaccination have belittled concerns about the novel coronavirus for months, opposing masks and fighting stay-at-home orders and contact tracing, said Richard Carpiano, a professor of public policy and sociology at the University of California-Riverside.
"They have come out against every public health measure to control the pandemic," Carpiano said. "They have said public health is public enemy No. 1."
Recently, anti-vaccine activists have been so eager to discredit immunizations that they have blamed covid for the deaths of people who are very much alive.
Social media users selectively edited a video of a Tennessee nurse, Tiffany Dover to make it appear as if she dropped dead after being vaccinated, when in fact she simply fainted, said Dorit Reiss, a professor at the UC Hastings College of Law in San Francisco. Although Dover quickly recovered, social media users posted a fake death certificate and obituary. Anti-vaccine activists also harassed Dover and her family online, said Reiss, who chronicled Dover's ordeal in a blog post.
Anti-vaccine activists are adept at manipulating video, Smith said.
"They are notorious for using videos and images purportedly showing the adverse effects of vaccines, such as autism in children and seizures in other vaccine recipients," Smith said. "The more emotive and graphic the videos and images — irrespective of whether it's actually linked at all to vaccines or not — the better."
In December, multiple Facebook posts falsely claimed that an Alabama nurse died after receiving one of the state's first covid vaccines. One Twitter user went so far as to identify the nurse as Jennifer McClung, who worked at Helen Keller Hospital in Sheffield, Alabama. In fact, McClung died of covid. Social media posts spread so widely that Alabama health department officials contacted every hospital in the state to confirm that no vaccinated staff member had died.
Anti-vaccine groups often build fables around "a tiny, tiny grain of truth," Smith said. "This is why misinformation, specifically vaccine misinformation, can be so convincing. ... But this information is almost always taken completely out of context, creating claims that are either misleading or outright false."
The Ron Paul Institute for Peace and Prosperity twisted a news story about the deaths of 24 people at an upstate New York nursing home, incorrectly blaming their deaths on covid vaccinations. The original article noted, however, that a covid outbreak at the nursing home began in late December, before residents received any vaccines. Covid vaccines, which require two doses for full protection, did not arrive in time to save the residents' lives.
Kennedy repeated the misinformation — again incorrectly blaming the residents' deaths on vaccines — in his blog, although he linked to a local news station that reported the information correctly.
Distorting facts to discourage vaccination, Cuker said, is "very irresponsible and damaging to public health."
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