Reporters and science communicators commonly point to widespread COVID misinformation to explain why so many people are skeptical of vaccines and other infection-control measures. Bad pandemic takes clearly influence the public, but there's much more to the story.
We've all heard the argument, and it goes like this: misinformation drives millions of people into COVID denialism. They consume countless hours of conspiratorial videos demonizing masking and vaccination, promoting the lab-leak hypothesis, and chastising NIAID chief Dr. Tony Fauci. Before long, they're immune to science-based arguments and unwilling to comply with infection-control measures that will help end this pandemic. Misinformation is, therefore, public health enemy number one, or perhaps number two after COVID-19 itself.
This narrative has been a part of the accepted wisdom going back almost to the beginning of the pandemic. “The crippling spread of COVID-19 across the globe has progressed in parallel with a flood of information online relating to the pandemic,” ABC News reported in April 2020:
The World Health Organization branded that spread as an 'infodemic' earlier this year. The 'infodemic' has highlighted the importance of readers identifying false information about the coronavirus and those who might be spreading it.
There's no doubt that fringe commentators—like “mRNA vaccine inventor” Dr. Robert Malone—do the public a great disservice by spreading nonsense about the COVID shots and ineffective treatments like ivermectin.  But the influence these iconoclasts wield has been oversold by commentators struggling to explain why so many people are skeptical of the pandemic response.
I've argued elsewhere that the pandemic response, shot through with hypocrisy, politics, and disrespect for the public's concerns, created much of its own opposition. That conclusion is still valid, but it points toward a more comprehensive explanation of the problem: people often have complex motivations for spurning public health guidance that have little to do with the misinformation they may consume.
What do we know about misinformation?
First up, what do studies investigating the impact of misinformation show? The evidence is quite mixed, as it turns out. As the authors of a January 2021 study noted:
"While some studies find associations between belief in COVID-19 misinformation and reduced self- protective behaviors, others find no evidence of associations. Still others find associations for some behaviors but not others."
Research of this nature is often limited by its design or the quality or size of the sample surveyed, so we should take these results with a grain of salt. Nonetheless, when people explain why they don't wear masks, for example, we should take their answers seriously if we really want to understand their motivations.
In this specific study of nearly 1,000 Americans, a "nationally representative sample," the researchers found that participants were less likely to follow social distancing and masking guidance because they doubted the efficacy of those interventions. Their acceptance of misinformation was correlated with these behaviors in a cross-sectional analysis,
"However, the relationships between belief in misinformation and protective behaviors are smaller than the relationships between the protective behaviors and their related beliefs. Further, misinformation-protective behaviors associations disappear after adjusting for behavioral beliefs.
In longitudinal analyses, we found that behavior-specific beliefs (and not belief in misinformation) were significant lagged predictors of protective behaviors, further supporting an inference that these beliefs are not only correlated with behavior but also predict change in those behaviors."
The researchers concluded from these results that it's better to address someone's “behavior-specific beliefs” instead of trying to debunk every bit of COVID-related nonsense on the internet, a fool's errand since there are “hundreds if not thousands of discrete rumors … which have emerged across several different media platforms and have waxed and waned in their prominence over the course of the pandemic.”
Where do behavior-specific beliefs come from?
This is the next question we need to answer. Fortunately, quite a few studies have looked at this as well. According to a November 2021 analysis, “Preventive actions are determined by perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action, such as media exposure.” Closely related are demographic factors. For instance, women are typically more willing to practice protective behaviors than men, as are older individuals compared to their younger counterparts (ages 18-29).
Put another way, several variables have influenced our individual responses to COVID-19, media consumption being only one of them. But even here, we have to stress that access to accurate news isn't always the answer. As the authors of a September 2020 study conducted in Australia explained:
"Although media exposure early in the outbreak appears to have facilitated health-protective behaviors, media fatigue—where people become desensitized to ongoing messaging—may reduce this effect as the pandemic continues."
Paradoxically, some consumers will draw the opposite conclusion from the same information.
"Repeated media exposure may also lead to heightened stress and anxiety, which can have longer-term health effects, as well as contributing to excessive or misplaced health-protective behaviors such as presenting for diagnostic testing when actual risk of exposure is low (Garfin et al., 2020)."
Most of us know from experience that these contrasting effects are real and very serious. On occasion, the press has observed that some among us tend toward excessive fear of infection but rarely does anyone put all this information together into a comprehensive analysis of what motivates our behavior. A more complex but less cartoonish account of why people become COVID skeptics emerges when we do.
Pandemic-related nonsense continues to proliferate online, and ACSH will always call it out. But the science community has largely overlooked other important variables that help explain why many people hold contrarian views about COVID-19. If we want to reach them, let's take their motivations seriously.
 Malone has emerged as one of the chief spokesmen for the anti-vaccine movement during the pandemic. He is one of many scientists who helped develop mRNA vaccine technology, but he has oversold his contribution to this research. See this video for a refutation of his arguments.