Dr Z has me more confused and conflicted ( a likeable personality) than ever

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Zubin Damania photographed in his studio, August 5, 2020.

Fighting Anti-Vaccine Pseudoscience, One Viral Video at a Time

On the social media frontlines with anti-anti-vaxxer Zubin Damania, aka ZDoggMD.

By Thomas Buckley

In January, as the first cases of Covid-19 were gaining global attention, Nicole Baldwin, a pediatrician in Cincinnati, posted a playful 15-second clip on TikTok, listing the diseases that inoculation prevents and rebuking the conspiracy theory that vaccines cause developmental disorders. After accruing a dozen or so views, she posted it to her Facebook, Instagram, and Twitter accounts in the hope it would reach a wider audience. Almost overnight, it did, but not the audience she intended.

“Come near me or my child with a needle and I will put it in your jugular,” one comment read. “Dead doctors don’t lie,” read another. A militia of vaccine opponents, thousands strong, was conducting a coordinated attack. Not content to keep it to social media, they threatened Baldwin’s practice, leaving false reviews meant to incriminate her on Google and Yelp. Some made threats to her life that were repeated and credible enough to land a police detail outside her home.

As the fervor grew, Todd Wolynn, a fellow doctor and a co-founder of Shots Heard Round the World, an informal group that seeks to protect vaccine advocates from online abuse, enlisted 16 volunteers to help get hateful posts removed and some of their 6,000 authors banned. Wolynn also thought a counterattack might be in order—so he called in Zubin Damania.

Damania is something of a health-care avenger. His YouTube videos, in which he raps in costume or rants about the anti-vaccine movement and wider problems with the medical system, have been viewed tens of millions of times. He’s one of a growing number of physicians turned online influencers able to communicate compellingly to viewers who might otherwise fall prey to pseudoscience. After getting the call from Wolynn, he organized a virtual rally, calling on health workers of all stripes to post videos, statements, and evidence to discredit Baldwin’s aggressors alongside the hashtag #DoctorsSpeakUp. The resulting campaign trended nationally on Twitter.

Bloomberg Businessweek cover image for issue dated Aug. 17, 2020.
▲ Featured in Bloomberg Businessweek, Aug. 17, 2020. Subscribe now. PHOTO ILLUSTRATION BY 731; GETTY IMAGES (9); ALAMY (4)

Damania’s ambition to vanquish the so-called anti-vax movement was born out of a conversation he had about a decade ago with a pediatrician friend who said enough parents were declining to vaccinate their children that a resurgence of potentially fatal diseases could result. Anti-vaccine sentiment has continued to spread since then, as opponents gather on Facebook, Reddit, and other forums, swelling their numbers with catchy, (literally) viral clips, sensationalistic rhetoric, and a litany of hashtags designed to draw viewers down social media’s algorithmic rabbit holes. Such is their reach that last year the World Health Organization named growing hesitation toward common vaccines as one of the top 10 threats to human health. In the U.S., the vaccination rate among kindergartners has fallen below the targeted 90% in a majority of states, a decline that last year led to the country’s most severe measles outbreak in a quarter century.

No Vaccines, Please

Share of Americans from different demographic groups who say they’d decline a free, approved Covid-19 shothttps://www.bloomberg.com/toaster/v2/charts/fe117efcfa7f4c2abe75541214e228a6?web=true&hideLogo=true&interactive=undefined&hideTitles=true&webTheme=business&preventMobileFont=true


The fight against vaccine misinformation has taken on new urgency during the current pandemic. Life won’t return to normal unless an overwhelming majority of people develop some measure of immunity to the novel coronavirus, which essentially means either sufficient numbers get a vaccine or get the disease and develop antibodies, even as many more victims die along the way. Yet a poll published by Gallup in early August found that 35% of surveyed Americans would decline a government-approved Covid-19 shot offered to them at no cost.

Some of those seeking to combat vaccine misinformation stick to staid recitations of scientific fact. Damania does do serious interviews with leading medical professionals, but more than most, he hits anti-vaxxers where they lurk. His videos are often goofy, profane, or outraged; one fitting the latter two descriptions, A Doctor Reacts to “Plandemic,” posted in response to the widely circulated pseudoscientific documentary claiming the flu shot contains coronaviruses, has attracted 3 million views.

To mitigate the influence of anti-vaxxers, Damania argues, more of his colleagues will have to find imaginative ways to connect with an audience prone to getting its diagnostics from Facebook groups. “We’re probably a good three years of hard work behind in terms of cultural influence, and we just have to fight fire with fire,” he says. “If the anti-vaxxers are weaponizing social media and using the algorithms to their advantage, then why shouldn’t we?”

In the 1990s, Andrew Wakefield, a doctor at the Royal Free Hospital in London, published a pair of papers in the prestigious medical journal the Lancet, positing links between vaccination and disease. The first, from 1995, claimed that 3,545 people who’d received a live measles vaccine for a 1964 trial had experienced higher prevalence of Crohn’s disease and other digestive disorders than an unvaccinated control group. The second, published in 1998, sought to establish a link between autism and the measles, mumps, and rubella vaccine, based on a study in which the parents of 8 of 12 autistic children described the onset of behavioral symptoms associated with the disorder within two weeks of receiving an MMR vaccination.

The papers brought Wakefield international fame, despite comprehensive epidemiological studies subsequently carried out by the U.K. National Health Service, the U.S. National Academy of Sciences, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention showing that no link existed between the MMR vaccine and autism. In 2000, Wakefield appeared on 60 Minutes, where he falsely claimed during a heated debate that the MMR vaccine’s cumulative strength made it more likely to adversely affect children than separate doses for the three target viruses. A year later, he resigned from the Royal Free Hospital and decamped to the U.S., where he became one of the most prominent promoters of anti-vaccination conspiracy theories and medically unsubstantiated cures for autism.

In 2010, Wakefield was struck from the U.K.’s medical register following the longest ethics investigation in the history of Britain’s General Medical Council. The council found that, among other breaches, he’d once paid children at his son’s birthday party to let him draw their blood. It also said that he’d failed to disclose glaring conflicts of interest, such as his application to patent a rival vaccine to the common MMR shot, and that he’d been paid almost $1 million to carry out his research by lawyers representing families seeking to sue vaccine manufacturers. The Lancet’s editor-in-chief subsequently retracted the 1998 paper, calling it “utterly false.” The following year, the British Medical Journal published an editorial showing that Wakefield had manipulated evidence to reach his conclusions.

As his stature declined in respectable circles, Wakefield went after a fringier and more impressionable segment of the American populace. His notoriety spiked in 2016, when a film he’d produced, Vaxxed, was released and he spoke at a seven-day “Conspira-Sea” cruise off the coast of Mexico, alongside fellow guests such as a self-described alchemist who claimed to have visited secret colonies on Mars. In the runup to that year’s U.S. election, Wakefield and two other noted anti-vaxxers also had an audience in Florida with Donald Trump, who’d repeatedly proclaimed a link between the MMR vaccine and autism prior to running for president.

Throughout the decade, millions of anti-vax sympathizers were banding together online to craft and spread propaganda, coordinate conferences and demonstrations, and mount guerrilla efforts to abuse vaccination advocates. They exploited gaps in social media oversight, often working anonymously and adopting tactics such as sharing the same video hundreds of times to hike its chances of going viral. Occasionally, their aversion to evidence-based medicine hurt one of their own. Earlier this year, for example, a 4-year-old boy died of influenza in Colorado after his mother, one of 148,000 followers of a Facebook group called Stop Mandatory Vaccination, decided to treat him with a concoction of breast milk, elderberry, and thyme recommended by a fellow member, rather than with the antiviral flu drug the child’s pediatrician had prescribed.

Although hardcore anti-vaxxers are still fewer in number than proponents, they appear to be succeeding in growing the ranks of agnostics. A study published in Nature in May assessed almost 100 million people who’d expressed views on vaccines on Facebook and estimated, based on the pages they followed, that 4.2 million were anti-vaccine and 6.9 million were pro-vaccine, while a staggering 74.1 million were undecided. The authors raised the prospect that people holding anti-vaccination views would be the majority within a decade.

That same month, Wakefield appeared at the virtual Health Freedom Summit, where he suggested that the reported number of Covid-19 deaths—more than 735,000, so far—was “greatly exaggerated.” He also compared the vaccine industry to the slave trade and said the refusal to be immunized was worth dying for. Wakefield didn’t return phone calls or respond to voicemails and text messages seeking comment for this article.

The media and the medical profession have tried to challenge Wakefield and his followers. In the past decade, he’s topped Medscape’s annual list of the world’s worst doctors and been named one of science’s great frauds by Time magazine. He was also awarded a Golden Duck for “lifetime achievement in quackery” by the nonprofit Good Thinking Society. But Wakefield’s opponents have failed to match his followers’ energy and tech-forward methods.

That’s where Damania, who grew up in California, the child of two physicians, came in. In 2010 he uploaded his first video to YouTube, of his commencement speech at the University of California at San Francisco School of Medicine. From there he began to experiment, rapping about ulcers and crooning ballads such as Pull and Pray—The Safe Sex Song under his online moniker, ZDoggMD. As his channel grew in popularity, he became convinced that it could be an important platform for sound health information.

Zubin Damania photographed in his studio, August 5, 2020.

The following year, while Damania was working at Stanford University Medical Center and the Washington Hospital Healthcare System in Fremont, he uploaded Immunize, a parody of the Travie McCoy and Bruno Mars song Billionaire, which included the lyrics “Everywhere I turn my eyes/ The internet is spreading lies/ So many parents scared by fairy tales and hate/ I need to educate so I can vaccinate.” The video featured a fellow doctor as a scrub-wearing, sword- and nunchuck-wielding “immu-ninja.” “It was my first foray into that sort of counterprogramming, and it came from a place of just abject disgust,” says Damania, who’s 47, with excitable, deep-set brown eyes and a wide smile.

The video quickly racked up more than 200,000 views, accompanied by praise and disdain in equal measure. His critics questioned his credentials, posted his private information online, and even called Stanford to accuse him of ridiculing parents with “vaccine injured” children. Damania found the onslaught terrifying but fascinating. He learned that the more views and comments the video received, the more likely YouTube would suggest it to people searching for vaccine-related terms. Encouraged, he began spending more time on anti-vax Facebook groups, looking for insight into how their members created and shared viral content.

As he read, he came across a loose “anti-anti-vax” movement that had begun to form. Its leading lights included David Gorski, an American surgical oncologist who also served as managing editor of Science-Based Medicine, an informational website. Such work was honorable, in Damania’s view, but too dry. The groups “spent a lot of time countering all of the misinformation but doing it in a very unemotional, Spock-like way that I didn’t find particularly compelling for the average Joe,” he says. His attitude was, “Let’s get into the emotion of it, because that’s what really sways people.”

In 2012, Damania left Stanford to start a network of preventive-care clinics in Las Vegas, backed by Tony Hsieh, the chief executive officer of online clothier Zappos.com LLC. When the initiative foundered five years later, Damania moved his family back to California and began vlogging and public speaking full time, dubbing himself “Healthcare’s Unfiltered Voice” and traveling the world to lecture before institutions such as Doctors Without Borders. On his social media channels he kept staging satirical scenarios alongside grounded conversations with pro-vaccine figures, including one with the physician Paul Offit that was interrupted by anti-vaxxers violently pounding the studio walls. These days, Damania works out of a gated complex at an undisclosed Bay Area location, to ensure his safety. He regularly receives death threats—some, he says, peppered with the additional threat of castration.

The hundreds of videos he’s posted since 2010 have now cumulatively attracted about 60 million views—enough to gain the notice of social media executives, who’ve long been criticized for their inaction on misinformation. “Facebook and YouTube are well aware of what we do,” he says. “I’ve had calls with their highest folks, where we talk about how it’s possible to cut through the haze of misinformation and promote the information that’s actually positive.”

Damania isn’t seeking censorship of anti-vax content. His preferred approach is tagging, along the lines of the disclaimers Twitter has started to affix to troublesome tweets. On YouTube, he says, this might consist of banners linking to channels like his, reading, “Hey, by the way, this is total BS—here’s a video that tells you why.”

Despite his online stardom, Damania started worrying earlier this year that his work wasn’t helping bring about some of the larger changes he’d had in mind when he set out—grand goals such as galvanizing U.S. health care to reform with an emphasis on preventive care. In some videos he solemnly asked viewers whether his work mattered and whether he should quit. Hundreds of people wrote in saying he’d changed their minds about vaccines. He also got supportive notes from some of the U.S.’s most accomplished health-care figures. And one junior doctor said Damania’s videos about coping with burnout had pulled him back from the brink of suicide.

When the pandemic took hold, Damania swiftly gained tens of thousands of new followers on YouTube and Instagram. His Facebook page jumped by 400,000 followers, to 1.8 million. Americans were hungry for reliable information on the virus, on immunity, on whether Plandemic was real, on whether President Trump was on to something when he mused about injecting bleach. The attention reinvigorated Damania and got him thinking ahead to the showdown that’s all but sure to take place if a vaccine becomes available. “The anti-vaxxers will activate en masse and try to sow enough doubt and dissension that you will not get the critical vaccination levels and it will fail,” he says.

Still from Zubin Damania's video "Dan (An Eminem Antivax Anthem)
▲ Damania performing in his video Dan.SOURCE: YOUTUBE

The anti-vax movement has long since popularized the belief that Big Pharma and the CDC are conspiring to profit from medicine they know to be unsafe. Damania foresees a distinct challenge with Covid-19 in the unprecedented pace at which large pharmaceutical companies are racing to develop vaccines, gain regulatory approval, and build out their supply chains. The scientific consensus around the safety of current vaccines exists in part because they were tested over a time frame that’s typically three to four years and because they ultimately went on to decades of harmless use in large populations. Damania is concerned that, if a Covid-19 shot becomes available, anti-vaxxers will accuse manufacturers and regulators of rushing out a dangerous product, regardless of how thorough the trial process has actually been.

Medical workers should be prepared, he says, to mount a major communication effort to get the vaccination rate where it needs to be. Others share his thinking. A working group at Johns Hopkins University, for example, published a report last month that includes recommendations to U.S. policymakers and doctors for persuading the public to accept a future vaccine to prevent Covid-19. The report emphasizes continuously sharing data about its benefits, risks, and supply.

In June, after a flurry of anti-vax sites falsely claimed Bill Gates had said a coronavirus vaccine could kill 1 million people, Damania uploaded his most ambitious music video to date. Set to Eminem’s Stan—in which the rapper imagines getting letters from an obsessive, increasingly aggrieved fan—the parody version, Dan, has ZDoggMD receiving pleas for attention from an anti-vaxxer who has, among other afflictions, been bitten by his service weasel, which he’s fed a measles-laced burrito in an attempt to confer immunity without a vaccine. ZDoggMD ultimately replies in a firm but compassionate tone: “I know you’re mad, Dan/ I’m sad you don’t feel heard/ But I get mad when kids get hurt/ Because damn, these vaccines work.” Dan, like Stan, dies before he can hear the rapper’s message, but he was never the target audience, anyway. As long as viewers get it, Damania says, it’s one more step toward turning the anti-vax tide.


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