One common anti-vaccine conspiracy theory is that the people promoting vaccines are a small, shadowy, well-organized group, a kind of syringe-wielding, surgical mask-covered Deep State forcing their views on an unsuspecting public. The reality, ironically, shows that it's anti-vaccine groups who are small, well-organized and well-funded: in a major new study on vaccine-related Facebook ads, researchers found that over half of anti-vaccine ads on the platform are purchased by just two anti-vax groups, who have successfully gamed Facebook's advertising system, spending minimal amounts of money to reach thousands of people with concocted tales of "medical malfeasance, coverups, and corruption," the study found.

At the same time, pro-vaccine ads were less coordinated and ran a much greater risk of being pulled down for terms of service violations, because many of them were placed by first-time buyers who were less likely to know how to work within Facebook's rules on "political" advertising, which govern vaccine ads.

The study was published on November 13 in the journal Vaccine by researchers from University of Maryland, the George Washington University, and Johns Hopkins University. It's the first major study of public health advertising on Facebook, and the most eyebrow-raising finding is just who is buying and promoting most of the anti-vaccine ads. "Among anti-vaccine advertising buyers," the researchers wrote, "two were responsible for a majority (54 percent) of content: World Mercury Project and an individual buying for the group Stop Mandatory Vaccination."

World Mercury Project is a group started by environmental activist turned anti-vaccine campaigner Robert F. Kennedy Jr.; the organization has since changed its name to the blander Children's Health Defense. They present themselves as a public health organization; in reality, the group's leadership is stacked with longtime anti-vaccine activists and their work is almost entirely concentrated on making unfounded claims about the purported risks of vaccines. (The group was originally called "World Mercury Project" because Kennedy was focused on the claim that vaccines contain a type of mercury harmful to human health; he's since broadened his argument considerably and recently claimed at the anti-vaccine AutismOne conference that arguably every child is "vaccine injured" in different ways.

Stop Mandatory Vaccination, meanwhile, is largely the work of one man, Larry Cook, who's based in Southern California and whose entire focus is using Facebook to spread anti-vaccine claims, both through ads and groups. (Cook, who has no medical training of any kind, is also "weighing the launch" of an anti-vax dating site, NBC News reported earlier this year.)

By contrast, the researchers found that most pro-vaccine ads were paid for by first-time buyers and often geographically targeted to a small area and focused on one type of vaccine. "Most pro-vaccine advertisements (81 percent) focused on a specific vaccine, with influenza vaccine the most common," the researchers wrote, "Promotional advertisements were typically vaccine specific (95.8 percent name a single vaccine), geographically tailored (77.8 percent ran in a single state), and paid for by a local health organization (for instance, The Minnesota Department of Health or Blue Cross Blue Shield of Kansas City)."

There were also a number of "philanthropic advertisements," the researchers found, which advertised vaccines indirectly "often by highlighting international vaccine campaigns," the researchers wrote. "For instance, the Bill & Melinda Gates Foundation accounted for 47 percent of the philanthropic advertisements with 18 ads about ongoing global campaigns to end polio."

Meanwhile, anti-vaccine advertisements opposed vaccinations in general, without singling out specific ones, and were "thematically more unified," the researchers found, which makes sense, given that most of them were published by the same two guys.

"In these ads, the most common approach was to describe the risks of vaccination," the researchers wrote. "Two common tactics included presenting parental accounts of injured children (e.g. ‘‘Our family was full of life and love, but then the DTaP Vaccine stole that away. . .”); and presenting research on alleged vaccine harms or flaws in medical research (e.g. ‘‘Flu Shot Bombshell. Vaccine Safety Testing Never Done. . .”). Closely related were advertisements alleging medical, governmental, and pharmaceutical corruption related to vaccines. These advertisements describe medical malfeasance, coverups, and corruption, often linked to purported evidence of vaccine harms."

Another subset of ads focused on so-called "vaccine choice" and parental rights, wording that's becoming more and more common. "While these advertisements did not directly challenge vaccination safety, they opposed mandatory vaccination, informed parents about vaccine exemptions, and/or extolled the benefits of ‘‘natural” immunity," the researchers wrote. (A common tactic, for instance, is to argue that measles is no big deal and strengthens immune protections in the future, which is a lie.) Anti-vaccine ads of all types, the researchers found, "commonly included links to further resources, events to attend, seminars to screen, and products to buy." (Stop Mandatory Vaccination, for instance, is pointedly not a non-profit and Cook refused to disclose to the Daily Beast how much fundraising goes to him directly.)

The study published in Vaccine was made possible by Facebook's newly public Ad Library; it was made available in late 2018 to reduce the amount of criticism Facebook received for being a disastrously efficient conduit for misinformation, xenophobia, and elections-tampering. Midway through the study, in March of this year, Facebook also pledged to "combat vaccine misinformation," promising to reduce the rankings of pages and groups that spread vaccine misinformation. "When we find ads that include misinformation about vaccinations, we will reject them," Facebook's newsroom pledged in a press release. "We also removed related targeting options, like 'vaccine controversies.'

But the researchers found some evidence that Facebook's new zeal for "transparency" was actually leading them to take down many pro-vaccine ads, for failing to correctly identify their funding sources. That's not some kind of conspiracy; most of the pro-vaccine ad buyers were first-time buyers, less likely to understand that they had to follow the rules for "political" ads.

"By accepting the framing of vaccine opponents—that vaccination is a political topic, rather than one on which there is widespread public agreement and scientific consensus—Facebook perpetuates the false idea that there is even a debate to be had," David Broniatowski said in a news release. He's an associate professor of engineering management and systems engineering at GW, and was the "principal investigator" of the study. "This leads to increased vaccine hesitancy, and ultimately, more epidemics."

"Worse," Broniatowski added in the release, "these policies actually penalize pro-vaccine content since Facebook requires disclosure of funding sources for 'political' ads, but vaccine proponents rarely think of themselves as political. Additionally, vaccine opponents are more organized and more able to make sure that their ads meet these requirements."

Moreover, those ads are also very, very cheap; the researchers found that the groups were often spending less than $500 per ad to routinely reach "audiences between 5,000 and 50,000 people." A small price to pay to destabilize public health.