There currently do not seem to be any policies or regulations against promoting anti-vaccination content via Facebook ads.

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As it comes under increasing pressure from lawmakers and public health advocates that it take action to clamp down on anti-vaccine misinformation, Facebook continues to allow people and groups to run ads promoting it. On Thursday, California Rep. Adam Schiff sent Facebook CEO Mark Zuckerberg and Google CEO Sundar Pichai a letter outlining concerns with the way the big tech platforms surface anti-vaccine content, and ramping up the pressure on them to take action. “The algorithms which power these services are not designed to distinguish quality information from misinformation or misleading information," Schiff writes. "And the consequences of that are particularly troubling for public health issues.”

In response to Schiff's demand that the platform do something about the growing anti-vax community, Facebook said in a statement to Bloomberg News that it is currently "exploring additional measures to best combat" anti-vax content. Facebook is currently looking at "reducing or removing this type of content from recommendations, including Groups You Should Join, and demoting it in search results, while also ensuring that higher quality and more authoritative information is available." All of this comes days after a massive Guardian report detailing how networks of massive anti-vax groups and pages have created an algorithmic feedback, pushing users into deeper and deeper vaccine-skeptic rabbit holes. While Facebook is mulling over exactly how to combat a topic as complex and emotional as the anti-vaccination misinformation, members of its community continue to use the site's tools to promote themselves. For a clear look at how this simple, ad-driven feedback loop works, let's take a look at "Stop Mandatory Vaccination," one of the more prolific Facebook communities for anti-vaxxers.

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Larry Cook, the former executive director of the California Naturopathic Doctors Association, is the owner of stopmandatoryvaccination.com. The website is a one-stop shop for anti-vaxxers. It hosts articles, embeds from Cook's YouTube channel, advertisements for anti-vax books and documentaries, a directory of medical professionals who oppose vaccination, and, of course, a donation button. Cook has raised nearly $80,000 on GoFundMe since 2015. On his page, he claims he's spent about $35,000 of that on Facebook ads over the last four years.

According to an analysis by BuzzSumo, a website that tracks sharing across social media, stopmandatoryvaccination.com has had about 400,000 engagements on Facebook in the last year, with an article getting about 7,000 engagements on average. The most shared article in the last year was published last February. It's a story about a real court case titled "$250,000 Awarded to Parents After Their Healthy Infant Is Killed by Vaccines," and it has about 70,000 engagements on Facebook. Like most digital publishers — anti-vax or not — the key to getting articles to proliferate across the internet is via a website's Facebook page or Facebook group. The Stop Mandatory Vaccination Facebook page has about 125,000 followers and the private Group attached to it is one of the larger anti-vax communities on Facebook with about 150,000 members. As for why Stop Mandatory Vaccinations, and the pages and groups like it, have become so popular on Facebook over the last few years, Cook told BuzzFeed News he believes it's because pro-vaccine advocates don't attempt to reach anyone on social media. "The hardcore pro-vaccine advocates do not create content, Page and Groups, that attract large followers to Facebook since that line of thinking is already the common conversation and agreement in mainstream media and the public eye," Cook said. To get a sense of scale for how effective Cook's Stop Mandatory Vaccinations Facebook page is, it's had close to 1 million shares in the last year, according to social media intelligence app CrowdTangle.

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Much of the Stop Mandatory Vaccinations page's reach does seem to be organic. "Building an audience on a Facebook Page — any Facebook Page — is almost always best done be sharing content that people want to see," Cook said.

But, perhaps complicating any decision Facebook eventually makes about anti-vaccination content, it is possible to boost anti-vax posts beyond their normal organic reach via Facebook's advertising tools. According to the advertising info section on Stop Mandatory Vaccination, Cook has eight posts currently running as ad campaigns on Facebook. He declined to share how much money he spends on Facebook ads. "I sponsor posts as I see fit," he said. Posts currently sponsored by Cook include a video titled "Vaccines Devastated Their Children," featuring testimonials from parents who claim their children were injured or killed by vaccinations, a link to the "$250,000 Awarded to Parents After Their Healthy Infant Is Killed by Vaccines" article on Cook's website, a video explaining how to build up your child's immune system without vaccinations through a concept called "natural immunity," and another link to an article on Cook's website titled "35 Facts and Reasons Why I Became an Avid Ex-Vaxxer and No Longer Vaccinate." Facebook is currently looking into how anti-vax communities use promotional tools on the platform. Cook said he sees the entire argument about anti-vax content on Facebook as a free speech issue.

"A Facebook group allows the assembly of like-minded individuals to engage in free exchange of thought," he said. "I would suggest to you that calls for the shutdown of our groups directly contradict some of the most foundational principles of freedom we have."

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