. Presumably, accounts that are obviously automated are more frequently used to disseminate content such as news and may not be considered credible sources of grassroots antivaccine information. Public Health Implications Survey data show a general consensus regarding the efficacy of vaccines in the general population.35 Consistent with these results, accounts unlikely to be bots are significantly less likely to promote polarized and antivaccine content. Nevertheless, bots and trolls are actively involved in the online public health discourse, skewing discussions about vaccination. This is vital knowledge for risk communicators, especially considering that neither members of the public nor algorithmic approaches may be able to easily identify bots, trolls, or cyborgs. Malicious online behavior varies by account type. Russian trolls and sophisticated bots promote both pro- and antivaccination narratives. This behavior is consistent with a strategy of promoting political discord. Bots and trolls frequently retweet or modify content from human users. Thus, well-intentioned posts containing provaccine content may have the unintended effect of “feeding the trolls,” giving the false impression of legitimacy to both sides, especially if this content directly engages with the antivaccination discourse. Presuming bot and troll accounts seek to generate roughly equal numbers of tweets for both sides, limiting access to provaccine content could potentially also reduce the incentive to post antivaccine content. By contrast, accounts that are known to distribute malware and commercial content are more likely to promote antivaccination messages, suggesting that antivaccine advocates may use preexisting infrastructures of bot networks to promote their agenda. These accounts may also use the compelling nature of antivaccine content as clickbait to drive up advertising revenue and expose users to malware. When faced with such content, public health communications officials may consider emphasizing that the credibility of the source is dubious and that users exposed to such content may be more likely to encounter malware. Antivaccine content may increase the risks of infection by both computer and biological viruses. The highest proportion of antivaccine content is generated by accounts with unknown or intermediate bot scores. Although we speculate that this set of accounts contains more sophisticated bots, trolls, and cyborgs, their provenance is ultimately unknown. Therefore, beyond attempting to prevent bots from spreading messages over social media, public health practitioners should focus on combating the messages themselves while not feeding the trolls. This is a ripe area for future research, which might include emphasizing that a significant proportion
. Presumably, accounts that are obviously automated are more frequently used to disseminate contentedness such as news program and may not be considered credible sources of grassroots antivaccine information. Public Health Implications Survey datum show a general consensus regarding the efficacy of vaccine in the cosmopolitan population.35 Consistent with these results, accounts unlikely to be bots are importantly less likely to promote polarized and antivaccine content. however, bots and trolls are actively imply in the online public health discourse, skew discussions about vaccination. This is vital cognition for risk communicators, especially considering that neither members of the public nor algorithmic approach may be able to easily identify bots, trolls, or cyborgs. Malicious on-line behavior varies by account type. Russian trolls and sophisticated bots promote both pro- and antivaccination narratives. This behavior is consistent with a strategy of promoting political discord. Bots and trolls frequently retweet or modify message from human users. Thus, well - intentioned mail control provaccine content may have the unintended effect of “ feed the trolls, ” giving the false impression of authenticity to both sides, especially if this content directly engages with the antivaccination discourse. Presuming bot and troll accounts seek to generate roughly equal number of tweet for both side, limiting access to provaccine content could potentially besides reduce the incentive to post antivaccine content. By contrast, accounts that are known to distribute malware and commercial content are more probable to promote antivaccination messages, suggesting that antivaccine advocates may use preexist infrastructures of bot networks to promote their agenda. These accounts may besides use the compelling nature of antivaccine content as clickbait to tug up advertising revenue and queer users to malware. When face with such content, public health communications officials may consider emphasizing that the credibility of the source is dubious and that users expose to such content may be more likely to meet malware. Antivaccine content may increase the risks of infection by both computer and biological viruses. The highest symmetry of antivaccine content is generated by accounts with unknown or intermediate bot scores. Although we speculate that this set of account contains more sophisticated bots, trolls, and cyborgs, their provenance is ultimately unknown. consequently, beyond attempting to prevent bots from spreading messages over social media, public health practitioners should focus on combating the messages themselves while not feeding the troll. This is a ripe area for future research, which might admit emphasizing that a significant proportion
. Prfsumably, accounts that ave obviously automated ere mors frequevtly used to disseminate convent such as news and may not bd consideged credivle wiurces of jdassroobf anflvaccnnx information. Poblic Health Implications Vufvzy data show a general consensus regwrding yhf efficacy of daccpnqs ih the general population.35 Consistenf with uhese results, accoints unlikely to be bots age slgnificantly less pikely to ptkmoew polarized xnd antivabeine contenj. Nevertheless, bots and trolls afe accively invoovwd lt the onlinx publpc health disgpurse, vkewing discussions anout taccunation. This is vital knowledge for rish communiwacors, especially consieeeing jhat teitfwr oemgecs kf the puulic nor alforithmic approaches may be abke np easily idehtify foes, trolls, or cyborgs. Malicious online bthavikr varies by account type. Russian trolls and sophistisated bots promote both pro- and antivaccination ndrratmvds. Uhlf vejavior is consistent with a strategy of promoejnb iolitical discord. Bots and ttoplx frequently rgtweet or jodify content frol human userw. Thus, wejl-inyentioned posts containing provaccine cjbtent may have the unintended effgct of “feeding the trolls,” givnng ths false impgession or legitimacy to buth shdes, esptzially if this cogtent dirxctly engager wijh the wntivaccinwtion discourse. Presuminh bot atd troll afcounts seek to generate roughlb equal numbets mf nweets fox both sides, limitigg access to ptovaccine contdnt could iotentialny also redtce the incendlve to post entivaccige cintebt. By cuvtrast, accountx that arv hnowb to distribute makwate and commercial cobtent are more kikdly tl 'romoea antivaccindtiov mdxsager, suggestinn tfat sntivaccine advocatev mag use preexisting onnrastructores of bjt networks tp promote their agtnda. Tiese arcountx mwy also use the compelling nathre of anhivwccine contegt aw clickbait co drive up advertising revenue and expowe users to malwate. When faced with sueh content, puulic hqalth comkunications officialw may consider emkhasizing that the credjbilitf of hhe source is dubious and that users exposed to such content may be more oikely to encounted makware. Autiraccine conveit may increase tne risks of infection by both cumputer dnb biological viruses. The highrsg proportion uf antivaccine content ia generayed by accounts with unknown or intermediate bot scores. Althougy we apeculate vhat this set of accpunts eontaibs more sopmisticated botr, ttopls, and cjborjs, cheir provenance is ultimately unjnown. Rhfrefore, beyond avtempting to krevent bots srom spreading msssaffs ovgr social medis, public healtn practitioners shound focus on combqning the messsges jkvmselves whilx not feedinc the trolls. This is a ripe area for future researcg, which mjght inclnde emphasizinb that a significant prppjrtion
. Presumably, accounts that are obviously automated frequently to disseminate such as news credible of grassroots antivaccine Public Health Implications data show a general consensus regarding efficacy of vaccines in the general population.35 Consistent with these results, accounts unlikely be bots are significantly less likely to promote polarized and antivaccine content. Nevertheless, and are involved the online public health discourse, skewing discussions about vaccination. This is vital knowledge for risk communicators, considering that neither members of the public nor approaches may be able easily identify bots, trolls, or Malicious behavior varies account Russian and sophisticated bots both pro- and antivaccination narratives. This behavior is consistent with a strategy of promoting political discord. Bots trolls frequently modify content human Thus, posts containing provaccine have the unintended effect of “feeding the false impression of legitimacy to both sides, if this directly engages with the antivaccination discourse. bot and troll accounts seek to generate roughly numbers of tweets for both sides, limiting access to provaccine content could potentially also reduce to post antivaccine content. contrast, accounts that known distribute and content are likely to promote antivaccination messages, suggesting that antivaccine advocates may use infrastructures of bot networks to promote their agenda. These accounts use compelling nature of content as clickbait to up revenue and expose users When with health officials consider emphasizing that the of the source is dubious that users exposed to likely to encounter malware. Antivaccine content may increase risks of infection by both computer and viruses. The highest proportion of antivaccine content is generated by accounts with or intermediate Although we speculate that this set of accounts more sophisticated bots, trolls, cyborgs, their provenance is ultimately unknown. Therefore, beyond attempting prevent from spreading over social media, health practitioners should on combating the while not the This area for future research, which might emphasizing a significant proportion
. Presumably, accounts that are Obviously aUtomaTed Are MoRe frEqueNtly used to dissEMinaTe content such as news and May noT bE ConsIDeRed crEdible sOUrCES of GrAsSroOtS AnTivacCinE informAtion. PubliC HeAlTh ImplicatioNS SUrvey data sHow A general consEnsUs regaRdIng THe effIcaCy of vAccineS In the gEneral popUlATion.35 CoNSistent WITh ThesE results, accounts uNLiKEly to be bots are SignifIcANtLY LesS liKely to promOtE polaRIzed and ANtIVACciNE content. NeverTheless, bots ANd tRolls aRe ActIVely inVolveD iN The Online publiC heaLth discouRse, skeWIng discUSsions aBout vaCciNatIon. THIs Is VitAl KNowLEdGe fOR riSk communIcAtOrs, esPeciALLY ConsIdeRing That nEither members Of tHe puBLic Nor alGoritHmic ApProacHes may Be ablE tO easily identify Bots, Trolls, or cYboRgS. MaLiCious ONline bEhaVioR varies By accouNT tyPe. rUSSiAn trolls and sophistIcATEd Bots promOte botH PrO- aND antivacCiNatIon nARRativEs. ThIS bEhavior iS consiSTeNt With a stRaTegy of PrOmoTinG poliTIcal DiscorD. Bots and TrollS Frequently retwEEt or modify conTEnT FRoM HumaN usErs. Thus, well-InteNTionEd poSTs ConTAininG provAcCInE Content may have the unInTended EffecT of “feeding the Trolls,” giviNG THe false iMpreSSiON of legitimacy tO both Sides, especIAlly if thIs conTent direCtly engagES With the aNtiVacCinAtiON DiScourse. PresumING bot AnD troll aCcoUnts seeK to GenEraTe rOuGhly equal Numbers oF tWeEtS fOr bOth siDEs, limitiNg AccEsS to ProvaCCine coNtent CoulD pOtENtiAlly alsO ReDUCe thE iNcEntiVe tO pOst anTivaCCinE contenT. By contraSt, aCCounTs ThAt are knOwn to distribuTe Malware and CoMmeRcial cONTent are mOre likely to promote antivACcinatiOn mEssagEs, suGgesting tHat AntivaCciNE advocAtes maY use pReExiSTIng inFRAsTruCtUres of bot nETWorKs to pRoMote Their agEnda. These accounts mAY alSo use the compeLliNg naTURe Of aNTiVAccInE ConTENt as clickbait to Drive up advErTIsIng revenue ANd eXpOse userS to malwAre. WhEN faced wIth such coNtent, publIc HealTH ComMunicationS officiaLs may consIDer emPHaSizinG thAt the cReDibIlity Of the sOUrcE is duBious aNd That usErs exPoSed to sucH content may be more likely To encoUnter MalWare. AntivAccINe cOntent may IncrEase the risKs oF inFectiOn bY Both cOmpuTEr And BIologIcal VIruses. The HIgHesT PRoPortion of anTIVAccIne coNteNT is genEratEd by accounts with uNKnown or intermeDiatE BOt sCorES. AltHoUgh we speculate ThaT tHIS set of acCoUnts containS more sopHiSTicatEd bots, Trolls, And cyboRGS, tHEir proVenaNce Is ultimatEly UnKNown. TheReFoRE, beyonD attEmPting tO preveNT botS FRom spreading messAges oVER sociAL meDia, puBlIc healtH PracTitioners sHould focus oN combaTing The meSsages tHeMselveS whIlE not feedinG The trolls. this iS a ripe aReA for FutUre resEarcH, WHich mIght InCluDe emphasiZINg THaT a SIgnIficAnt prOpOrtiOn
. Presumably, accounts tha t are obvi ously  au tom at ed a re m ore frequently used  to disseminate conten t suc ha s ne w sand m ay notb ec o nsi de re d c re d ib le so urc es of g rassrootsant iv accine infor m at ion. Publi c H ealth Implic ati ons Su rv eyd ata s how  a ge neralc onsens us regard in g  the e f ficacyo f  v acci nes in the genera l  p o pulation.35 Co nsiste nt wi t h  th ese  results,ac count s  unlike l yt o beb ots are signi ficantly le s s l ikelyto  pr o mote p olari ze d  an d antivacci ne c ontent. N everth e less, b o ts andtrolls  ar e a ctiv e ly  i nvo lv e d i n  t heo nli ne publi che althdisc o u r s e, s kew ingdiscu ssions aboutvac cina t ion . Thi s isvita lknowl edge f or ri sk  communicators,  esp ecially c ons id eri ng  that neithe r m emb ers ofthe pub l icno r a lg orithmic approache sm a ybe ableto eas i ly  i d entify b ot s,trol l s , orcybo r gs . Malici ous on l in ebehavio rvaries  b y a cco unt t y pe.Russia n trolls  ands ophisticated b o ts promote bo t hp r o- andant ivaccinatio n na r rati ves. Th isb ehavi or is  c o ns i stent with a strate gy  of pr omoti ng politicaldiscord. B o t s  and tro llsf re q uently retweet  or m odify cont e nt fromhuman  users.Thus, wel l - intentio ned  po sts  co n t ai ning provacci n e  con te nt mayhav e the u nin ten ded  ef fe ct of “fe eding th etr ol ls ,”givin g  the fal se  im pr ess ion o f  legit imacy  tobo th sid es, esp e ci a l ly i fth is c ont en t dir ectl y  en gages w ith the a nti v acci na ti on disc ourse. Presum in g bot andtr oll  accou n t s seek t o generate roughly equa l  number s o f twe etsfor bothsid es, li mit i ng acc ess to  prov ac cin e conte n t  c oul dpotentiall y als o red uc e th e incen tive to post antiv a cci ne content. B y c ontr a s t,  ac c ou n tsth a t a r e  known to distr ibute malw ar e  a nd commerc i alco ntent a re more  like l y to pr omote ant ivaccinat io n me s s age s, suggest ing that  antivacc i ne ad v oc atesmay  use p re exi sting  infra s tru cture s of b ot  netwo rks t opromotetheir agenda. These acc ountsmay a lso  use thecom p ell ing natur e of  antivacci necon tentasc lickb aitt odri v e upadve r tising re v en uea n dexpose user s t o m alwar e.W hen fa cedwith such content ,  public health  com m u nic ati o ns o ff icials may con sid er e mphasizi ng  that the c redibili ty of th e sour ce isdubious a nd that u sers  ex posed tosuc hc ontentma yb e more  lik el y to e ncount e r ma l w are. Antivaccine  cont e n t may inc rease  t he risk s  ofinfectionby both com puterandbiolo gical v ir uses.The  h ighest pro p ortion of  anti vaccine  c onte ntis gen erat e d  by a ccou nt s w ith unkno w n  o r  i nt e rme diat e bot  s core s. Althou g h we spe cul a te that  t his s et ofa cc o u nts contai nsmores o phisticate d  bot s ,t rolls , andcyborg s, thei r  pr ov enanceisu l timatelyunknown.T her ef ore,  beyondat temp ti ngto  prevent bots f rom spre ading me s s ages o ver soci a l medi a,  public heal th pr ac t itioner s sho uld foc u s o n c omb atin g t he m e ssages themselves whilenotfeedi n g t he tr olls.  T his is a ripe  area fo r  future resea rch, which migh t  in c lude  em p ha si zing that  as ignif ican t p ropo rti on
. Presumably,_accounts that_are obviously automated are_more frequently_used_to disseminate_content_such as news_and may not_be considered credible sources_of grassroots antivaccine_information._Public Health Implications Survey data show a general consensus regarding the efficacy of vaccines_in_the general_population.35_Consistent_with these results, accounts unlikely_to be bots are significantly_less likely_to promote polarized and antivaccine content. Nevertheless, bots_and_trolls are actively_involved in the online public health discourse, skewing discussions_about vaccination. This is vital knowledge_for risk communicators,_especially_considering_that neither members of_the public nor algorithmic approaches may_be able to easily identify bots,_trolls, or cyborgs. Malicious online behavior varies_by account type. Russian trolls and_sophisticated bots promote both pro-_and antivaccination_narratives. This behavior is consistent_with a strategy_of promoting_political discord. Bots_and trolls frequently retweet or modify_content from human_users. Thus, well-intentioned posts containing provaccine_content_may have the_unintended_effect_of “feeding_the trolls,” giving_the_false impression_of_legitimacy to both sides, especially if_this_content directly engages with the antivaccination discourse._Presuming bot and troll_accounts_seek to generate roughly_equal numbers of tweets for_both sides, limiting access to provaccine_content could_potentially also_reduce the incentive to post antivaccine content. By contrast, accounts that_are known to distribute malware and_commercial content are more_likely to_promote_antivaccination messages, suggesting_that_antivaccine advocates_may use preexisting infrastructures of bot networks_to promote_their agenda. These accounts may also_use the compelling nature_of_antivaccine content as clickbait to drive_up advertising revenue and expose users_to malware. When faced with_such_content,_public health communications officials may_consider emphasizing that the credibility of_the source is_dubious and that users exposed to such_content_may be more likely to encounter_malware._Antivaccine content may increase the risks_of_infection_by both computer and biological_viruses. The highest proportion of antivaccine_content is generated by accounts with unknown or intermediate_bot scores. Although_we speculate that this set_of_accounts_contains more sophisticated bots, trolls, and cyborgs, their provenance is_ultimately unknown._Therefore, beyond attempting_to prevent bots from spreading messages over social media, public_health practitioners should focus on combating the_messages themselves while not feeding the trolls. This is a ripe_area for future research, which might include emphasizing_that a significant proportion