Vaccine hesitancy and (fake) news: Quasi-experimental evidence from Italy

Health Econ. 2019 Nov;28(11):1377-1382. doi: 10.1002/hec.3937. Epub 2019 Aug 20.


The spread of fake news and misinformation on social media is blamed as a primary cause of vaccine hesitancy, which is one of the major threats to global health, according to the World Health Organization. This paper studies the effect of the diffusion of misinformation on immunization rates in Italy by exploiting a quasi-experiment that occurred in 2012, when the Court of Rimini officially recognized a causal link between the measles-mumps-rubella vaccine and autism and awarded injury compensation. To this end, we exploit the virality of misinformation following the 2012 Italian court's ruling, along with the intensity of exposure to nontraditional media driven by regional infrastructural differences in Internet broadband coverage. Using a Difference-in-Differences regression on regional panel data, we show that the spread of this news resulted in a decrease in child immunization rates for all types of vaccines.

Keywords: Internet; child immunization rates; fake news; social media; vaccine hesitancy.

MeSH terms

  • Child
  • Communication*
  • Diphtheria-Tetanus-Pertussis Vaccine / therapeutic use
  • Humans
  • Italy
  • Measles-Mumps-Rubella Vaccine / therapeutic use
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Poliovirus Vaccines / therapeutic use
  • Social Media
  • Vaccination Coverage / statistics & numerical data
  • Vaccines / therapeutic use*


  • Diphtheria-Tetanus-Pertussis Vaccine
  • Measles-Mumps-Rubella Vaccine
  • Poliovirus Vaccines
  • Vaccines