SINGAPORE, June 12 — Mr Jake Goh, 51, a principal of a privately-run pre-school, does not mind it when people label him as a conspiracy theorist or an anti-vaccine advocate.

"Whether I am a conspiracy theorist or not, time will tell. I’m not trying to argue with people, I’m just here to offer an alternative view. If they decide to let their children be jabbed, I can only warn them,” said Mr Goh.

He is an admistrator of two Telegram groups that discuss Covid-19 and vaccine injuries, each with thousands of members surfacing claims that the two authorised vaccines here — Pfizer-BioNTech and Moderna — have caused serious side effects such as stroke.

This is despite the fact that the Singapore Government has authorised the Pfizer-BioNTech vaccine for teens aged 12 to 15, with an expert committee and the Health Sciences Authority (HSA) assessing that the vaccine is safe and efficacious to use for this group.

"You can gather a lot of knowledge from the internet. Not everything the doctor says about vaccines is correct,” said Mr Goh.

Mr Goh was not always so radical, having dutifully received flu jabs and other types of vaccines in the past. His transformation to become an anti-vaccine advocate began last year during the pandemic, after reading articles about the drug industrial complex behind cholesterol research.

Nowadays, he gets his information from YouTubers who discuss health issues and have a wide following, as well as from health journals that he reads to "get to the source” directly.  After all, newspapers can be biased, he claimed.

His contrarian views have led to conflicts with people around him. His best friends removed him from their Facebook friends list because his anti-vaccine posts have become "too extreme” lately.

His sister, who lives in France where some 110,000 people have died from Covid-19, often chides him for telling others not to get the jab when he has not seen firsthand how horrific the disease can become outside of Singapore.

But he is immovable in his radical belief that a good vaccine is not available because their development is rushed: "People say I believe in conspiracy theories, that I am an anti-vaxxer, that I am crazy. Oh yes, I get that a lot.”

Mr Goh is not the only one who has been socially distanced this way during the pandemic.

Artist Zelda, 34, has also seen her family ties and long-standing relationships strained or severed, as a result of her wild and unsubstantiated claims — such as one proclaiming that vaccines are part of a money-grubbing conspiracy by the "global public health mafia”.

First, it was with her father, who reads the newspapers and has been vaccinated, and whom she often had heated arguments with.

To her, official narratives from governments and experts obscure the truth, while alternative viewpoints from YouTube commentators deserve to be heard.

Then, the fallout also spread to her close friends, whom she has known for decades, after she began sharing articles depicting Covid-19 as a lab-made bioweapon, and defending these articles when her friends challenged her.

Sick of arguing whenever Zelda shares articles about such theories on their mutual chat groups, some of her childhood friends have since shut her out of their lives. She declined to give her full name.

Wistfully, one of these friends told TODAY: "She was always the first one to diffuse an argument. But now she believes so much in this that she’s willing to just abandon friends over it.”

Speaking to TODAY, Zelda recounted how voicing out these "alternative facts” during the pandemic had caused people around her to blow a fuse.

With her father, she no longer desires to discuss such theories at the dinner table. "We just say hello and good morning, that sort of thing. It’s much healthier this way.”

"In this pandemic, it is quite sobering that the things that we believe in shape us, down to the relationships that we have,” she added, referring to how she is no longer on talking terms with some of her friends.

As Singaporeans, and people elsewhere, suffer from an information overload regarding Covid-19 — where fact, fiction and half-truths abound — it takes patience and effort to engage people with strongly held beliefs that are based on falsehoods, sid Ms Tin Pei Ling, Member of Parliament (MP) for MacPherson.

"(They) could have good intentions too. But if one shuts them out completely, it means there are no more chances to give them the right facts, and does not give you the opportunity to understand each other better,” the chairperson of the government parliamentary committee for communications and information said.

Beyond that, misinformation about the virus has far more serious implications as it could waylay Singapore’s pandemic plans, experts said.

As of June 9, Singapore has vaccinated around 44 per cent of its population with at least one dose of the Pfizer-BioNTech or Moderna vaccines. Three in four seniors above 60 have had their jabs or booked an appointment.

But along with this progress, the number of incidents involving misinformation has also increased lately, some noted.

There have been three incidents about coronavirus-related falsehoods requiring the use of Singapore’s fake news law, the Protection from Online Falsehoods and Manipulation Act (Pofma), in the span of a month from April to May, noted Mr Ryan Lim, founding partner of digital management consultancy QED Consulting.

What makes this pandemic a perfect storm for misinformation to be reinforced and spread is because it concerns a new virus, fast-emerging viral strains, and cutting-edge vaccines that will take time to fully understand them. ― Photo by Nuria Ling for T

On June 8, Health Minister Ong Ye Kung acknowledged these issues playing out on social media that had cast doubt on the safety of Covid-19 vaccines, claiming that mRNA vaccines, such as Pfizer’s and Moderna’s, do not work.

He was referring to a petition by 12 doctors, who had disagreed with the Government’s decision to roll out mRNA vaccines, and also discouraged parents from vaccinating their children.

Eleven of the doctors later retracted their statement, and the authorities as well as a number of other infectious diseases experts were quick to respond to these vaccine claims.

While the viral situation is under control in Singapore presently, Dr Shashi Jayakumar, head of S Rajaratnam School of International Studies’ Centre of Excellence for National Security (CENS), warned that the Covid-19 situation could very well turn critical again for Singapore.

And if it does, and if trust in the state and institutions is shaken as a result, malicious rumours, falsehoods, half-truths and misinformation would be back to plague Singapore’s pandemic response once again.

"We are starting from a good position now. But hypothetically, if there is wave after wave of infections, and lockdowns after lockdowns are needed, that would be the fertile ground for malicious misinformation to proliferate,” he said.

Fact, Fiction and the Unknown

Tracing the roots of misinformation to their sources would likely reveal one of several motivations behind its spread: These include political and ideological reasons, commercial profit, mischief, but also cases of genuine misunderstanding, said experts.

QED’s Mr Lim said: "Such false content tends to thrive in an environment with a high degree of anxiety and ambiguity. The successful spread will create a vicious circle that encourages more of such content to be created.”

To date, Pofma has been used in 14 separate instances concerning Covid-19-related falsehoods.

But the amount of misinformation being spread during the pandemic is far more numerous than those flagged by the fake news law, which on its own, is insufficient to stop people from believing these claims, said experts.

Associate Professor Alton Chua from the Wee Kim Wee School of Communication and Information at Nanyang Technological University said that while Pofma is designed to nip the spread of falsehood in the bud, it is no silver bullet when it comes to shaping beliefs.

People can also suffer from confirmation bias, choosing to interpret information in a way that conforms to their existing beliefs, he said. That means that those who are sceptical about Covid-19 vaccines, for example, tend to exaggerate reports they come across about post-vaccination complications.  

"The mindset of ‘better be safe than sorry’ is ironically what compels these people to share untruths,” he said.

Fast-Evolving Pandemic Conducive for Misinformation

When it comes to Covid-19, however, the scientific nature of the coronavirus and vaccines renders it hard for people to make their own conclusions about the science. Thus, it is key that people can turn to experts with the right credentials and experience to help them sort fact from fiction.

What makes this pandemic a perfect storm for misinformation to be reinforced and spread is because it concerns a new virus, fast-emerging viral strains, and cutting-edge vaccines that will take time to fully understand them.

And with science still playing catch-up with an evolving disease, there is a danger that misinformation can fill in the void and could even foster mistrust of scientific methods.

Dr Carol Soon and Mr Shawn Goh from the Institute of Policy Studies (IPS) at the Lee Kuan Yew School of Public Policy said that a study they conducted last year had found that false information relating to health and medicine was second out of 11 topics that were most frequently believed by Singaporeans.

Falsehoods about international and foreign affairs came out tops in the study.

Falsehoods on Vaccine Safety

What makes this pandemic a perfect storm for misinformation to be reinforced and spread is because it concerns a new virus, fast-emerging viral strains, and cutting-edge vaccines that will take time to fully understand them. ― Photo by Nuria Ling for T

Dr Soon and Mr Goh warned that they have observed increasingly active forms of "online mobilisation” among people who circulate unverified information or mistruths about Covid-19 vaccine safety and its purported side effects.

The IPS researchers observed that people have been setting up Facebook groups to share misinformation, and creating Google forms to solicit stories and cases of vaccine injuries, often without the full context.

"Mobilisation is also taking place in closed-group platforms such as WhatsApp and Telegram. The end-to-end encryption technology that undergirds instant messaging apps hinders timely misinformation detection and debunking,” they said.

Mr Jake Goh, who runs one such group on Telegram, claimed that its purpose is to create awareness because "transparency is needed in public health”, so that the public can make an informed decision about vaccines.

"We are filling the gap that the Ministry of Health and all the relevant authorities are not providing or not announcing,” he said.

He claimed that his vaccine scepticism is backed by his own research into the clinical trial data of existing vaccines.

The HSA reported in May that out of the 3.7 million vaccine doses administered until May 23, there were 157 reports of serious adverse effects such as anaphylaxis, but no deaths have been linked to the vaccines so far.

On this, IPS’ Dr Soon and Mr Shawn Goh said that it is often the case that those who go the extra mile to look up information on vaccine efficacy may end up reinforcing their own beliefs.

"Their false beliefs may be reinforced when they draw invalid conclusions from scientific studies without a full appreciation of their robustness, or if they turn to ‘scientific journals’ that are not actually recognised by the expert community,” they said.

Referring to these online mobilisation efforts, Dr Soon and Mr Shawn Goh added: "Without intervention, these online spaces allow anti-vaccine views to fester and gain perceived legitimacy as they grow in size.”

Establishing Links between Vaccines and Deaths: What Public Needs to Understand

Experts stressed the importance in trusting the scientific method — that conclusions can only be reached after observations, experiments and measurements are done.

Professor Teo Yik Ying, dean of the Saw Swee Hock School of Public Health, said that there is a clear difference between proof of absence and the absence of proof.

It is one thing to issue a statement such as "in all the participants in the clinical trials, we have not observed a death event”, as opposed to "this vaccine does not cause death in anyone who takes it”, he said.

"There is a need to systematically review the evidence of any mortality event that is suspected to be linked to the vaccine to understand whether taking the vaccine caused the fatality,” he added.

Because proper science takes time, it thus falls to a close partnership among responsible scientists, responsible media and trusted public agencies to be agile in responding to fake news in the meantime, he said.

All three parties are essential to this effort, since no single stakeholder holds all the cards needed to combat fake news.

The media and fact-checking organisations, for example, do not have the complete information needed to deal with complex scientific problems, but they should have access to trusted experts and policymakers to distill the information for the public.

This also means people should be wary of scientists who are not properly informed themselves, as well as irresponsible ones who could have been generating and spreading misinformation, said Prof Teo.

Orchestrated Disinformation Campaigns

Another aspect of misinformation concerns the threat of state-led disinformation campaigns, in the light of efforts by some countries to promote "vaccine diplomacy”.

China, for example, is donating vaccines to regions where its competition with the US for influence is intense, reported Reuters news agency. The US has also announced its plans to donate 500 million doses of vaccines to the developing world, including in Asia.

But could vaccine diplomacy also take on a more aggressive stance, such as by resorting to disinformation campaigns to discredit another country’s vaccine? Are such efforts already underway in Singapore?

It is possible, though drawing a link between a falsehood and a state-originated disinformation campaign is difficult, said Ms Dymples Leong, a senior analyst at CENS.

She noted that there has been misinformation revolving not just around vaccines in general, but also certain vaccines in particular.

Asked whether vaccine geopolitics are at play in Singapore, CENS’ Dr Jayakumar said there is no doubt that vaccine diplomacy is now an important "calling card” of national soft power, so there are tensions whenever that soft power is being undermined.

He said that messages of indeterminate origin have been bandied around on social media creating fear about certain vaccine types, though he agreed with Ms Leong that it is not easy to conclude that these are state-led efforts.

Nevertheless, Singapore is also being closely watched for what vaccines it buys and uses for its national vaccination programme, he added.

"It is universally recognised that when we choose certain vaccines, questions may be asked as to why we did not choose another one,” said Dr Jayakumar.

The first batch of Pfizer-BioNTech vaccines arrived in Singapore on Dec 21, 2020. Singapore is also being closely watched for what vaccines it buys and uses for its national vaccination programme, said CENS’ Dr Jayakumar. ― Photo by Raj Nadarajan for

Greater Transparency, Engagement the Antidote?

With such a wide spectrum of motivations behind the spread of misinformation, tackling pandemic falsehoods is a challenging task for any government, said experts.

Singapore cannot ignore malicious falsehoods, lest they take hold in society, said those interviewed.

Ms Tin, the MacPherson MP, told TODAY: "The Government is faced with the responsibility to contain and control the virus in the fastest time possible to reduce the damage to our people to the minimum possible.

"After all, at the national level, if there are people who are spreading misinformation, discouraging people from receiving the vaccination or from complying with the safety rules, then you can imagine how much it will slow down our pandemic response or even derail it.”

Fortunately, Singapore is not faring too bad when it comes to managing misinformation, said Assoc Prof Chua from the Wee Kim Wee School of Communication and Information.

Many were apprehensive when Singapore’s vaccination programme began in earnest earlier this year, but the myths were quickly dispelled through the mainstream media and with the help of infectious diseases experts, said Assoc Prof Chua.

IPS’ Dr Soon and Mr Goh said of these efforts: "Effective communication of science is needed to build resilience against vaccine misinformation and foster public trust in science.

"Public messaging should be clear and simple, for example by stating that vaccines are safe and effective, and highlighting scientific consensus on the matter helps inoculate people from being swayed by misinformation that claim otherwise.”

Dr Jeremy Lim, from the Saw Swee Hock School of Public Health, said that disagreements between doctors and professionals can still be cordial, agreeing to disagree.

That said, transparency must also come from scientists, doctors, public health professionals too, considering that the nature of novel diseases means there will be limited data and experience to go by.

"In public communications, it’s important to share views and recognise alternative ways of interpreting data, as well as be clear why one disagrees with certain points made,” said Dr Lim.

While some may argue that alternative views have been shut out of the official narrative, Singapore’s public communications strategies by and large have allowed national vaccination take-up rate to maintain a healthy trajectory, said those interviewed.

 After all, the proof is in the pudding, they said.

But at the individual level, when confronted with someone with wildly differing views that are based on falsehoods, Ms Tin urged people to not dismiss them and instead listen closely to their concerns.

"Sometimes that can be very difficult to do and it can be an emotional experience,” said Ms Tin. "But we just have to try.” ― TODAY