'A Mother's Intuition: It's Real and We Have to Believe in It': How the Maternal Is Used to Promote Vaccine Refusal on Instagram

"While the literature focusing on normative ideals of motherhood suggest social media platforms have become an important locale for these performances, what is under-explored is how these discourses are perpetuated online by anti-vaccine influencers."

Past research indicates that mothers bear the primary responsibility for decisions regarding their children's health, including regarding vaccination. Mothers are often strategically targeted by anti-vaccine advocates. This study analyses the techniques used by 13 anti-vaccine influencers to promote vaccine refusal on Instagram from January 2020 to July 2021. Specifically, it explores how notions of motherhood are conveyed online via three interrelated themes - the "intuitive mother", the "protective mother", and the "doting mother" - that are marshalled to amplify anti-vaccine content.

The paper begins with a brief history of the anti-vaccine movement. Notably, while many of the original anti-vaccinationists were "lone wolves", social networks enable these individuals to find like-minded communities online, to affirm anti-vaccine sentiments, and to amplify controversial content. These influencers have the capacity to persuade their followers to refuse vaccination and to cross-pollinate their ideas in like-minded communities (e.g., holistic health communities with overlapping concerns about state control in the form of government lockdowns and vaccine mandates).

There is a separate body of literature in sociology and cultural studies that explores how motherhood is represented in the media. One antecedent of anti-vaccine advocates and their channelling of the maternal can be identified in media depictions of mothers as entrepreneurs. These presentations of motherhood offer examples of mothers conducting business from the kitchen table while their children crawl underneath. Another precursor of motherhood that bears consideration in terms of the strategies adopted by anti-vaccine advocates is the notion of the "perfected maternal". One of the more well-known incarnations of this idea is "the mummy myth", in which to be considered a respectable mother, a woman must be entirely devoted to the physical, emotional, and intellectual well-being of her children every hour of the day. The costs associated with living up to this ideal are considerable, given that mothers are now integrated into the formal labour force, requiring time spent away from families while simultaneously demanding perfected presentations of motherhood. In response to these idealised representations of motherhood, another image of motherhood has emerged: Mothers "behaving badly". This satirical representation of the maternal, which has become prominent in film and television, is characterised by hedonism, chaos, and a lack of control.

This report examines the self-presentation techniques of 12 influencers whom the Center for Countering Digital Hate (CCDH) refers to as the "Disinformation Dozen", as well as the defamed former medical professional Andrew Wakefield, whose discredited measles, mumps, and rubella (MMR) study reignited the anti-vaccine movement in the late 1990s. These accounts were selected on the basis of their influence (e.g., social media followings and accelerated growth), engagement (i.e., shares), and capacity to target and profit from the vaccine hesitant. After analysing the Instagram pages of these influencers, the researchers examined the tactics they use to encourage mothers to join the anti-vaccine movement and to promote anti-vaccine claims.

All the influencers whose content the researchers analysed deployed representations of motherhood to promote anti-vaccine messaging. With these representations, influencers are able to appeal to cultural beliefs about motherhood, both experienced and imagined, to influence parental decision-making regarding vaccination. The analysis identified three prominent, interrelated themes of motherhood used by anti-vaccine influencers to encourage vaccine refusal:

• The protective mother: Here, the mother's role is depicted primarily in terms of ensuring her child's safety and protecting them from harm. This theme is commonly manifest in terms of diet and lifestyle choices, a so-called "natural" mother protecting her child from toxins and unnatural chemicals in the form of food and vaccines. For the most part, these influencers refute claims they are anti-vaccine, instead alleging to be concerned with "safety" (Wakefield, July 3 2020). Influencers use evocative, visual imagery to affectively connect with online audiences, appealing to the protective dimensions of motherhood. For example, several posts adopt the visual technique where children and babies are depicted directly gazing into the camera to appeal to audiences to protect them. Video updates and handwritten letters supposedly written by mothers apologising to their children for failing to protect them from harm feature prominently on these accounts. In addition to these personal anecdotes, hashtags are commonly used to extend audience reach. For example, beginning on May 3 2021, Wakefield hijacked the #SavetheChildren, #SaveourChildren and #SavetheBabies hashtags to promote his new film, which not only made Wakefield's posts more discoverable but also associated the anti-vaccine movement and the Save the Children movement as common efforts to protect innocent children from harm.
• The intuitive mother: In these posts, maternal intuition is celebrated as an innate form of wisdom, privileged as a superior form of knowledge derived from lived experience in contrast to the medical establishment. The overarching message is that truth is not about "logic" but is instead grounded in feeling and intuition. This framing builds on a legacy of positioning anti-vaccine content as natural and holistic in contrast to mainstream medicine, which is depicted as purely instrumental. This theme of maternal intuition is communicated on Wakefield's account via personal anecdotes in the form of quotes (January 3 2021), video updates (May 12 2021), and letters to expectant mothers (December 14 2020). Mothers' stories are recounted as a way to spread disinformation by legitimising fears, uncertainty, and doubts regarding vaccines. Another influencer's series of posts emphasises female power - sharing videos of fellow females "speaking truth to power" (Brogan, May 14 2020) and accessing their "collective intuition" (Brogan, July 4 2020) as a way to liberate themselves from corporate and government control.
• The doting mother: Depictions directly showcasing mothers through posts that communicate unwavering devotion to their children are commonly associated with influencers who themselves are mothers and who advocate anti-vaccine sentiment. Accompanied by illustrations of mothers tenderly embracing their child, these depictions elevate the mother-child relationship as paramount and pure. The by-product of this symbolic framing is that the mother's experiences - and accounts of vaccine hesitancy and vaccine injury - are elevated above paternal and abstract medical expertise. In the case of one influencer, the techniques used involve teasing viewers with a glimpse into ostensibly private motherhood experiences, which increases the sense of intimacy with the audience. Such portrayals resonate with other anti-vaccine social media content that appear to create communities of people who are affected by and are sceptical of vaccination.

As noted here, despite the fact that most of the Disinformation Dozen are men, there is a noticeable absence of representations of masculinity and fatherhood in their posts. The overriding presumption is that childrearing is a maternal concern, with mothers the primary focus of anti-vaccine posts. All the tropes analysed privilege a feminine, intuitive, holistic approach to knowledge. They also portray a limited and restricted representation of the maternal. Whereas, as noted above, popular media representations of the maternal have shifted over time to combine idealisation with self-deprecation ("behaving badly"), the tropes put forward by anti-vaccine advocates appeal to more traditional understandings of femininity and the maternal.

Thus, this article has demonstrated how, in addition to generic claims that vaccines cause harm, injury, and death, tropes of the protective mother, the intuitive mother, and the doting mother are used to encourage vaccine refusal by invoking hegemonic ideals of the "good mother" as one who is natural, holistic, and authentic; anti-vaccination a feminine ideal to which mothers ought to aspire. Authenticity is framed here as a form of embodied native expertise, uncorrupted by culture, the State, and corporate interests.

Awareness of these strategies may help guide practitioners seeking to combat the spread of disinformation and anti-vaccine content on social media platforms such as Instagram.