Questions posed to Vira the chatbot demonstrated the level of misinformation and disinformation people must wade through to get the facts they want about vaccines.
It’s been three months since the Johns Hopkins International Vaccine Access Center (IVAC) launched Vira, an artificial intelligence “chatbot,” to help answer questions about COVID-19 vaccines from a U.S. public still too wary of getting vaccinated.
The results: Vira has interacted with almost 7,000 people in exchanges involving nearly 20,000 questions, answers, and follow-up comments.
Many people ask Vira about vaccine safety and side effects: Will the shot make them feel sick? Will side effects cause them to miss work? Will vaccines lead to harmful health conditions?
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Other inquiries imply distrust of pharmaceutical companies and worries about whether vaccination can affect pregnancy and fertility. Many ask about how vaccines will affect their personal health issues, queries that Vira advises them to ask of their personal health care practitioners.
“These questions demonstrate a healthy skepticism that is good and rational — people are mindful of what they put in their bodies,” said Dr. Naor Bar-Zeev, an associate professor of International Health at IVAC who serves as primary investigator on a study evaluating user engagement with the chatbot. “Overall, the leading questions show that people are well informed and up to date. People are concerned about questions that the scientific community has not sufficiently addressed.”
Others who have reviewed Vira’s interactions said the questions reveal that people asking questions have a good grasp on the headlines about vaccine safety and effectiveness. A recent leading concern has been how well the vaccines protect against the Delta variant of COVID-19, which is at least twice as transmissible as the original strain. People also ask if vaccines cause mutations (answer: vaccines actually help stop mutations by slowing the spread of SARS-CoV-2).
IVAC researchers working with artificial intelligence (AI) scientists at IBM Research designed Vira—short for Vaccine Information Resource Assistant (VaxChat.org). Vira relies on deep learning models that were trained to map user inputs to intents and concerns from the database. In addition, Vira uses Key Point Analysis technology on user questions to surface emerging concerns, continuously expanding the database with concerns it did not know how to answer.
“Models we’re using in Vira today are very much cutting edge—the latest and greatest in deep learning methodologies,” said Dr. João Sedoc, a technology advisor who helped conceptualize the chatbot as a faculty member at the Whiting School Center for Speech and Language.
Vira was launched to help public health communicators expand their efforts to provide trustworthy information about COVID-19 vaccines at a time when data shows mistrust translates into lower vaccination rates.
More than 1 in 4 Americans eligible for a COVID-19 vaccine in September has yet to get a single dose, fueling continued disease spread and hindering pandemic recovery efforts. Worldwide, fewer than 1 in 3 people are fully vaccinated, with much lower vaccination rates in low- and middle-income countries. Health agencies are fighting against viral online misinformation and disinformation. Misinformation is strongly associated with declines in vaccine uptake, perpetuating the spread of SARS-CoV-2.
Research has shown people may view chatbots as nonjudgmental, making them more willing to seek answers for questions about fears and misunderstandings that they may be embarrassed to ask another person.
“Like a confessional booth, if you talk to a chatbot you are little bit more free to say what you are wanting to say,” said Dr. Simon Mutembo, an IVAC physician and epidemiologist who has consulted on the Vira project.
Some recalcitrant rumors about vaccines can be found in Vira’s logs, including the popular lie that the vaccines contain microchips. Some have even asked Vira how to update the microchips they believe have been inserted into them by vaccination. It’s a question practitioners are not surprised to see.
“People ask me whether government is putting these chips in,” said Kim Thomas, an ambassador with the Vaccine Acceptance and Access Lives in Unity, Education, and Engagement (VALUE) project in Baltimore City, which was just ranked as having one of the highest vaccination rates among a set of 326 jurisdictions. “One person standing around will blurt that out, and others will be like—yeah, is that true?”
Sandra Dobson, an outreach coordinator for VALUE, said Vira has equipped her and her colleagues with a powerful tool as backup to their efforts to debunk such rumors.
“Our Baltimore City vaccine ambassadors use the chatbot frequently,” Dobson said. “It’s a quick and accurate way to get information, and it’s helpful whenever there’s a question they can’t answer—they can go to Vira and get the answer.”