Some nurses are joining anti-vaccine-mandate protests. Here's how that could cause issues.

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A few hundred protesters lined the sidewalk Monday outside Rady Children’s Hospital in San Diego to rally against California’s impending vaccination mandates for health care workers. And to the disappointment of many medical professionals, some of the protesters were nurses wearing hospital scrubs.

It was the kind of protest that was common earlier in the pandemic but lost steam this year as restrictions eased. But a resurgent coronavirus and sluggish vaccine uptake have led to a push for vaccination mandates and masking rules — and renewed protests.

Vaccination mandates have given new focus to some Covid deniers and anti-vaccination activists, helping to align disparate “liberty” groups around a single cause, as lockdowns did earlier in the pandemic. Among them are nurses who have been vocal opponents of various pandemic mitigation efforts, some of whom have become adept at garnering social media attention, mainly on Instagram, Facebook and TikTok.

It’s a dynamic that experts warn can have an outsize impact on vaccination discourse, particularly as the nurses’ messages can go far beyond the protests or their limited social media audiences and carry a veneer of medical industry credibility.

“It’s not that the nurses necessarily themselves have a really big reach, but their videos always seem to be found by people who are anti-vax, who then duet or reshare it and use the credibility of that medical professional to bolster the argument that they’ve been correct all along,” said Rachel Moran, a postdoctoral fellow at the University of Washington’s Center for an Informed Public who studies misinformation on the internet.

The protest in San Diego, where some participants chanted repurposed pro-abortion rights slogans like “our body, our choice,” was one of more than a dozen organized outside California hospitals in recent days, organized by a group called America’s Healthcare Workers for Medical Freedom and promoted through a new, anonymous Instagram account with 5,500 followers made up of a stable of registered nurses who are also anti-vaccination influencers on the app.  

Other recent protests have gotten similar boosts on Instagram, which is owned by Facebook. Calling themselves “freedom keepers,” at least six individual accounts have spent the last week promoting America’s Healthcare Workers for Medical Freedom protests, posting flyers for rallies, among other posts, which feature vaccination misinformation dressed in a feminine aesthetic well-known to wellness and lifestyle influencers, including pastel colors and trendy cursive fonts. 

The individual accounts present a hodgepodge of vaccination misinformation, including distorted data from the Vaccine Adverse Event Reporting System, to suggest that the vaccines are killing thousands of people. 

A Facebook spokesperson said the company was looking into the accounts and would take action if they violated the company's policies.

As part of a sweeping set of mandates across the state, California’s Public Health Department has required its more than 2 million health care workers in hospitals, skilled nursing facilities and doctor’s offices to be fully vaccinated against Covid by Sept. 30. The pop-up protests come at a time when hospitals throughout the country are increasingly implementing mandates to combat stalled vaccination efforts among health care workers, even as the delta variant threatens to overload intensive care units again. 

Like other protests against lockdowns, masks and other measures to mitigate Covid’s spread, the events, ostensibly for health care workers, attracted other participants, including some who are stringently against all childhood vaccinations and others who are seemingly politically motivated to recall California Gov. Gavin Newsom. In livestreams from this week’s events, the protesters’ signs, which included QAnon slogans and the text of the Nuremberg Code (a guideline for ethical medical research), gave clues to the myriad motivations of participants. 

The small but vocal group of activists behind America’s Healthcare Workers for Medical Freedom include the account’s newsletter host, Lauren Mochizuki, an emergency room nurse and personal finance blogger in Orange County, California, who also runs the Instagram account nurses4informedconsent, a private account with just 1,800 followers. Mochizuki, who made news at the start of the pandemic for bringing attention to the struggle of front-line health care workers, did not reply to a request for comment. 

Heather Knapp, 35, a registered home health nurse in Riverside, California, posted videos from several of the protests to her 33,000-follower Instagram account, Nurses4freedom. She said the recent rallies were an effort to bring awareness to the concerns of health care professionals who, despite the scientific consensus, question the safety of vaccines. 

“I’m not an anti-vaxxer,” Knapp said. “Our organization is anti-mandate.”

Health care workers have never been immune from anti-vaccination views. Online groups like Nurses Against Mandatory Vaccines were early participants in the modern anti-vaccination movement and have been known to rally behind health care professionals who refuse yearly flu shots. Since the pandemic began, Covid and vaccine misinformation has permeated mainstream nursing groups and led professional groups like the American Nurses Association to announce support for the vaccines and warn against online misinformation that erodes public trust. 

Moran said viral videos of anti-vaccination nurses are “leveraging the credibility of medical professionals” to create a false impression that there is considerable debate about Covid vaccines among doctors and nurses when, in reality, there is a consensus about their efficacy and safety.

“There’s a hypocritical argument where anti-vaxxers for a long time have spread distrust in institutions and science and medicine,” Moran said. “But on the flip side, when there is a doctor or someone with an advanced degree or medical experience who says something that aligns with their anti-vax message — suddenly that institutional expertise is credible again.”

Knapp said that she and others were concerned about unknown “long-term safety effects,” including to women’s fertility, and that information about treatments like ivermectin, a drug used to prevent parasites in animals, was being “censored.”

Knapp also said her organization was expanding to include firefighters and law enforcement agents. 

“We’re not giving in,” she said, adding that more rallies in additional states were scheduled for next week. 

While more than 96 percent of practicing doctors in the U.S. have been fully vaccinated, according to an American Medical Association survey, some other health care workers are more hesitant. One in 4 hospital workers with direct contact with patients had not received a single dose of a Covid vaccine by the end of May, according to a WebMD and Medscape Medical News estimate using data collected by the Department of Health and Human Services.

Some health care workers are going online to evade the impending mandates. In HealthCare Workers for Freedom, a new, separate private Facebook group with 3,000 members, self-identified health care workers offer support and trade tips for filing requests for religious exemptions and contacts for lawyers who would represent vaccine refusers. The group was buzzing Wednesday morning about a proposed walkout to protest the mandates, although some members expressed hesitation. “I hope no one is abandoning patients to walk out,” a member posted.

Facebook and its photo-sharing app, Instagram, have struggled to curb the spread of misinformation about vaccines on both platforms, despite numerous policy updates and other measures aimed at removing anti-vaccination content.

TikTok has similarly tried to limit the spread of misinformation, but the app has also become an important outlet for people looking to push back against mandates and spread vaccine hesitancy. 

Moran said the nurses are consistently going viral on TikTok, which anti-vaccination influencers scour for credible-seeming messengers and where use TikTok’s sharing function, called “dueting,” to expand their audiences.

Moran said TikTok creates a vicious cycle of disinformation and debunking on TikTok. The nurses’ videos are debunked by well-meaning users in duets, which are then rebutted by anti-vaccination proponents, creating a false sense of ambiguity and debate about the vaccines’ safety.

“At the end of the day, all it does is push this impression that there is this 1:1 argument that’s going on where 50 percent of nurses agree with this and 50 percent don’t, and it’s nothing of the sort,” Moran said.

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