Is this doctor the most influential spreader of Covid-19 misinformation online?

The article that appeared online on February 9th began with a seemingly innocuous question about the legal definition of vaccines. Then, over its next 3,400 words, it declared coronavirus vaccines were “a medical fraud” and said the injections did not prevent infections, provide immunity or stop transmission of the disease.

Instead, the article claimed, the shots "alter your genetic coding, turning you into a viral protein factory that has no off-switch". Its assertions were easily disprovable. No matter. Over the next few hours the article was translated from English into Spanish and Polish. It appeared on dozens of blogs and was picked up by anti-vaccination activists, who repeated the false claims online. The article also made its way to Facebook, where it reached 400,000 people, according to data from CrowdTangle, a Facebook-owned tool.

The entire effort traced back to one person: Dr Joseph Mercola. Mercola, a 67-year-old osteopathic physician in Florida, has long been a subject of criticism and US government regulatory actions for his promotion of unproven or unapproved treatments. But most recently he has become the chief spreader of coronavirus misinformation online, according to researchers.

The activity has earned Mercola, a natural-health proponent with an Everyman demeanour, the dubious distinction of the top spot in the 'Disinformation Dozen'

An internet-savvy entrepreneur who employs dozens, Mercola has published more than 600 articles on Facebook that cast doubt on Covid-19 vaccines since the pandemic began, reaching a far larger audience than other vaccine sceptics, according to an analysis by the New York Times. His claims have been widely echoed on Twitter, Instagram and YouTube.

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The activity has earned Mercola, a natural-health proponent with an Everyman demeanour, the dubious distinction of the top spot in the "Disinformation Dozen", a list of 12 people responsible for sharing 65 per cent of all anti-vaccine messaging on social media, according to the US nonprofit Center for Countering Digital Hate. Others on the list include Robert F Kennedy jnr, a longtime anti-vaccine activist; and Erin Elizabeth, founder of the website Health Nut News, who is also Mercola's girlfriend.

"Mercola is the pioneer of the anti-vaccine movement," says Kolina Koltai, a researcher at the University of Washington who studies online conspiracy theories. "He's a master of capitalising on periods of uncertainty, like the pandemic, to grow his movement."

Some high-profile media figures have promoted scepticism of the vaccines – notably, Tucker Carlson and Laura Ingraham of Fox News, although other Fox personalities have urged viewers to get the shots. Now Mercola and others in the Disinformation Dozen are in the spotlight as vaccinations in the United States slow, just as the highly infectious Delta variant has fuelled a resurgence in coronavirus cases. More than 97 per cent of people hospitalised for Covid-19 in the US are unvaccinated, according to the Centers for Disease Control and Prevention.

US president Joe Biden has blamed online falsehoods for causing people to refrain from getting the injections. But even as Biden has urged social-media companies to “do something about the misinformation”, Mercola shows the difficulty of that task.

Over the past decade Mercola has built a vast operation to push natural-health cures, disseminate anti-vaccination content and profit from all of it, say researchers who have studied his network. In 2017 he filed an affidavit claiming his net worth was “in excess of $100 million”, or more than €84 million.

And rather than directly stating online that vaccines do not work, Mercola’s posts often ask pointed questions about their safety and discuss studies that other doctors have refuted. Facebook and Twitter have allowed some of his posts to remain up with caution labels, and the companies have struggled to create rules to pull down posts that have nuance.

"He has been given new life by social media, which he exploits skillfully and ruthlessly to bring people into his thrall," says Imran Ahmed, director of the Center for Countering Digital Hate, which studies misinformation and hate speech. Its "Disinformation Dozen" report has been cited in US congressional hearings and by the White House.

In an email, Mercola says it is “quite peculiar to me that I am named as the #1 superspreader of misinformation”. Some of his Facebook posts have been liked by only hundreds of people, he says, so he does not understand “how the relatively small number of shares could possibly cause such calamity to Biden’s multibillion dollar vaccination campaign”.

Mercola began a cycle. It starts with making unproven and sometimes far-fetched health claims and then selling products online that he promotes as alternative treatments

The efforts against him are political, Mercola adds, and he accuses the White House of "illegal censorship by colluding with social media companies". He does not address whether his coronavirus claims are factual. "I am the lead author of a peer reviewed publication regarding vitamin D and the risk of Covid-19 and I have every right to inform the public by sharing my medical research," he says. The New York Times has been unable to verify the claims in the study, which was published by Nutrients, a monthly journal from Molecular Diversity Preservation International, a nonprofit in Switzerland.

A native of Chicago, Mercola started a small private practice in 1985 in Illinois. In the 1990s he began shifting to natural-health medicine and opened his main website, mercola.com, to share his treatments, cures and advice. The site urges people to “take control of your health”.

In 2003 he published a book, The No-Grain Diet, which became a New York Times bestseller. He has since published books almost yearly. In 2015 he moved to Florida. As his popularity grew, Mercola began a cycle. It starts with making unproven and sometimes far-fetched health claims, such as that spring mattresses amplify harmful radiation, and then selling products online – from vitamin supplements to organic yogurt – that he promotes as alternative treatments.

To buttress the operation he set up companies like Mercola.com Health Resources and Mercola Consulting Services. These entities have offices in Florida and the Philippines with teams of employees. Using this infrastructure, Mercola has seized on news moments to rapidly publish blog posts, newsletters and videos in nearly a dozen languages to a network of websites and social media.

His audience is substantial. Mercola’s official English-language Facebook page has more than 1.7 million followers, while his Spanish-language page has 1 million followers. The New York Times also found 17 other Facebook pages that appeared to be run by him or were closely connected to his businesses. On Twitter, he has nearly 300,000 followers, plus nearly 400,000 on YouTube.

Mercola has a keen understanding of what makes something go viral online, according to two former employees, who decline to be identified because they have signed nondisclosure agreements. He routinely does A/B testing, they say, in which many versions of the same content are published to see what spreads fastest online. In his email, Mercola says, “Translation and a variety of media positions are standard for most content oriented websites.”

Facebook says it has labelled many of Mercola’s posts as false, banned advertising on his main page and removed some of his pages after they violated its policies. Twitter says it has also taken down some of Mercola’s posts and labelled others. YouTube says Mercola is not part of a programme from which he can make money from ads on his videos.

In 2012 Mercola began writing about the virtues of tanning beds. He argued that they reduced the chances of getting cancer, while also selling tanning beds with names like Vitality and D-lite for $1,200-$4,000, or €1,000-€3,300, each. Many of the articles were based on discredited studies.

When coronavirus hit last year, Mercola jumped on the news, with posts questioning the origins of the disease

The US Federal Trade Commission brought false-advertising claims against Mercola in 2017 based on the health claims about tanning beds. He settled and sent €248 million ($2.95 million)in refunds to customers who bought the tanning beds. The US Food and Drug Administration has also issued warning letters to Mercola for selling unapproved health products in 2005, 2006 and 2011.

Many of Mercola’s claims have been amplified by other vaccine sceptics, including Elizabeth. She worked for Mercola.com from 2009 to 2011, according to her LinkedIn page. But while Elizabeth and others are overtly anti-vaccine, Mercola has appeared more approachable because he takes less radical positions than his peers, Koltai says. “He takes away from the idea that an anti-vaccination activist is a fringe person.”

In an email Elizabeth says she is “shocked to have been targeted as one of the 12” in the “Disinformation Dozen” and calls it a “witch hunt.”

When coronavirus hit last year, Mercola jumped on the news, with posts questioning the origins of the disease. In December he used a study that examined mask-wearing by doctors to argue that masks did not stop the spread of the virus. He also began promoting vitamin supplements as a way to ward off coronavirus. In a warning letter on February 18th the Food and Drug Administration said Mercola had “misleadingly represented” what were “unapproved and misbranded products” on Mercola.com as established Covid-19 treatments.

In May Mercola took down many of his own Facebook posts to evade the social network's crackdown on anti-vaccine content. Facebook also recently removed his February 9th article. But Mercola has continued to raise vaccine questions. In a recent Facebook post he used another study to mull how useful the Pfizer vaccine is against Covid-19 variants. One headline in the post says the vaccine is only 39 per cent effective, but it does not cite another statistic from the study that says the vaccine is 91 per cent effective against serious illness.

“Is this possible? We were told 95 percent effectiveness,” he wrote. Within a few hours the post had been shared more than 220 times. – New York Times