If you assess Estonia’s situation regarding the spread of health-related disinformation—meaning false or misleading information—on a scale from one to ten, where do we stand?
Somewhere in the middle of the scale. Health-related disinformation has become more widespread in recent years, but this is also true in other areas. During the Covid-19 pandemic, we saw how concerning various bits of information could be as they began circulating, for example, in the United States and eventually made their way around the world to Estonia.
Health-related disinformation spreads in much the same way as other conspiracy theories, like the claim that the U.S. Apollo moon landing was faked or that airplane contrails are used to poison people. Those who spread conspiracy theories tend to behave similarly: when they come across an intriguing piece of information, they eagerly share it on social media or even make irrational decisions based on it.
Health-related disinformation can be a simple false claim, but it can also be part of a network aimed at selling lifestyle products. Anti-vaccine messaging, for example, may be part of someone’s marketing strategy rather than a genuine desire to share “truthful” information. That’s why it’s important to always consider the potential commercial motives behind the spread of disinformation.
Photo: private collection.
How much of the spread of health-related disinformation is spontaneous, and how much stems from foreign information manipulation and interference (FIMI)?
The share of hostile, foreign-origin information in the spread of health-related disinformation is relatively small. But it can be useful for eroding trust in the government and sowing societal confusion. It’s a powerful tool because health is something everyone cares about. We know that health-related issues can even divide families—for example, when a mother agrees to vaccinate a child, but the father does not.
Even today, some of the information fragments shared in Estonia are part of an influence package that can be traced back to Russia or China.
Can you give an example?
A good example of generating general distrust is the activity of the Russians during the Covid-19 pandemic. On the one hand, they claimed that Sputnik V was the best vaccine in the world. The second part of that disinformation campaign was the claim that Western-produced vaccines—like Pfizer, Moderna, and AstraZeneca—were useless and, instead of saving lives, actually caused additional symptoms. Some communities in Estonia readily swallowed this false information, and at the Health Board we were constantly asked when Sputnik V would be added to the list of available vaccines in Estonia. Sputnik V served as a prime example of how the production of disinformation aligns with influence operations that prioritize personal interests.
Even today, news is being spread that the Russians are on the verge of completing a cancer vaccine. By creating such stories, they are laying the foundation for future narratives that depict the decaying West as unhelpful, while Russian scientific excellence can prevent cancer with a single injection. Generally, only audiences outside of Russia receive this kind of information.
The 19th century saw the emergence of the first anti-vaccine protests. But how much is vaccine resistance in today’s social media-driven society influenced by, first, state interests; second, business interests, and third, influencers who profit from spreading disinformation because it helps them gain a large following on platforms like YouTube or Instagram?
The globally circulating anti-vaccine messages at the start of the Covid-19 pandemic could almost always be traced back to the same individuals and organizations, which undoubtedly had business interests behind them. These business interests were either related to selling certain products or to gaining followers on social media—followers who could then be monetized through advertising revenue as influencers.
The more popular an influencer is, the more their platform, Meta, X, or another, profits.
The sources of health-related disinformation have been studied, and it has ultimately been found that a significant number of conspiracy theories or fragments of false information can be traced back to roughly a dozen individuals. Among them is the current U.S. Secretary of Health, Robert F. Kennedy Jr. The companies led by Kennedy have received millions of dollars, and Kennedy himself has earned hundreds of thousands of dollars in direct profit from producing and spreading disinformation.
Another example is Alex Jones, whose media empire made millions by broadcasting outrageous theories daily through his vast network. His dissemination of false claims eventually led to legal action and bankruptcy proceedings. There’s a limit to everything!
Screenshot: Facebook.
Does the same model work in Estonia?
Estonia’s advertising market is so small that it’s hard to talk about direct profit. However, there are outlets that primarily focus on oppositional content, whether it pertains to health or other issues. For example, the websites Telegram.ee and Objektiiv.ee ask people for donations to support their operations.
Around such outlets, a filter bubble forms—when people search for a certain type of information and end up with these sources, they begin to sink deeper and deeper into the mire of disinformation. For those inside the filter bubble, it starts to feel like the entire world is one big deception, governments can’t be trusted because they all lie, the Earth is actually flat, and vaccines are designed to poison people.
How does the global spread of health-related disinformation get affected when someone like Kennedy, opposed to science-based medicine and vaccines, is appointed as U.S. Secretary of Health?
The fear was greater than the reality. In fact, Kennedy has retracted or softened some of his earlier positions. He previously promoted the idea that vaccines cause autism, even though this claim has been disproven hundreds, if not thousands, of times by new scientific studies. He hasn’t fully retracted that claim even now, but has said he’s willing to apologize if presented with convincing evidence that there is no link between autism and vaccination.
So, Minister Kennedy’s public statements still show a degree of lingering skepticism. However, the entire system remains intact. Vaccinations in the U.S. are functioning, and when there was a recent measles outbreak, Kennedy himself urged people to get vaccinated against measles.
Estonia doesn’t have a figure quite of that caliber, but can you imagine if someone like Kalle Grünthal became Minister of Health? That’s the beauty of democracy—it’s entirely possible. However, having a vaccine-skeptical minister doesn’t seem like a particularly promising prospect for someone expected to lead the sector.
Today, we’re putting a great deal of effort into convincing parents to vaccinate their newborns against various childhood diseases. Unfortunately, vaccination coverage is sometimes so low that outbreaks of old infectious diseases are becoming increasingly likely. In a twisted way, some parents even blame the deaths of their unvaccinated children on vaccinated ones, claiming they carry and spread the disease asymptomatically. In the world of conspiracy theories, this kind of blame-shifting mindset is very common.
Minister Kennedy did, in fact, terminate a $500 million program for the development of mRNA-based Covid-19 vaccines, claiming that the vaccine causes more harm than good.
That’s correct. Here in Estonia, we’ve also had to explain the necessity and safety of mRNA vaccines. I’ve personally highlighted the actions of Dr. Helen Lasn, a practicing family physician, who has repeatedly shared false information about mRNA vaccines on her social media. This instance is a particularly difficult case, as a family doctor is a graduate of a medical faculty, and, therefore, her words are trusted. She has a large following on social media, but spreading such false claims undermines everything the entire medical community has worked for.
Screenshot: YouTube.
We don’t have an effective remedy for such cases. In Finland, there is a commission operating under the Health Authority that can summon a doctor who has violated ethical guidelines. One possible sanction is to prohibit them from practicing medicine for a period of time. The University of Tartu issues medical diplomas that are valid for life. Even if a doctor is completely opposed to science-based medicine, the medical diploma still legitimizes them—even if they recommend homeopathic remedies or all sorts of bizarre concoctions to patients.
The Covid-19 pandemic hit Estonia at one of its weakest points, as the Health Board was among the most underfunded government agencies. Consequently, the initial crisis communication was quite poor. What is the situation now?
Overall, our communication readiness is definitely better now. We need to prioritize the ability to monitor social media spaces in real time in the coming years. We do have tools for tracking traditional media outlets, but everything happening on TikTok, Telegram, Facebook, and other social platforms remains largely uncharted territory.
We could, in theory, have AI-based tools that help detect fragments of disinformation before they begin to spread widely. But on the one hand, social media platforms themselves have restricted such scanning capabilities, and on the other, strict data protection laws prevent the kind of automated monitoring that would be required.
That’s why the Health Board employs a web advisor whose job is to physically monitor various discussion groups across different platforms. If something catches their attention, they either alert other authorities—if it involves a legal violation—or personally respond to debunk the disinformation in that group. However, if a single individual experiences blocking in a specific social media group, the disinformation persists in that group. Moreover, debunking false information isn’t always the most effective tool, because believers are difficult to convince with facts—faith is often stronger than science.
Covid-19 brought forth a number of previously unknown “opinion leaders” who opposed evidence-based medicine and were at times amplified by the media. What is the situation now?
At the Health Board, we’ve placed a strong emphasis recently on combating pseudoscience. Our articles mainly aimed to draw attention to services lacking a scientific basis that could pose risks to people’s health.
However, pseudoscience infiltrates various channels due to its mystique and allure. In today’s media landscape, this can also be described as “friend-marketing”—where, on one hand, certain media outlets discuss the importance of fact-checking and scientific evidence, while on the other, the same portal publishes glowing interviews with witches or self-proclaimed therapists who have no medical background whatsoever.
When these self-styled therapists offer services that resemble healthcare—making baseless promises and offering “help” for various health issues—people in dire health may end up missing out on timely medical care.
How has the rapid development of AI affected the spread of disinformation in the health sector?
What interests me most right now is how artificial intelligence and large language models are able to ensure that platforms like ChatGPT or others provide science-based information.
One of the challenges with these large language models is that AI, in a way, works through prediction—when a person asks a question, the AI generates a response that seems most likely to be correct. Just as one is followed by two, and two by three. But if a person starts asking follow-up questions, the AI may try to meet their expectations with explanations that could ultimately result in it telling them what they want to hear—just to appear agreeable.
To mitigate this risk, certain algorithms have been developed, but everyone working with AI has encountered instances where the technology has produced falsehoods.
Fortunately, the current situation is such that if you Google information about a health symptom you’re experiencing, Google’s results are often noticeably worse than what an AI model can already provide. On the other hand, a fully formed answer from AI takes away the opportunity to decide for yourself which source seems the most trustworthy among search results. The AI ends up thinking for us.
Currently, the major social media platforms’ algorithms encourage the spread of conflict-driven far-right and conspiracy-theory content, because it attracts the most attention and generates the highest profits for the platform owners. When it comes to political disinformation, the European Union has placed at least some level of responsibility on social media platforms; has the same been done in the health sector?
First of all, the European Union has adopted legislation regulating the use of artificial intelligence, which outlines quite specifically what is allowed and what is not. All AI-generated health-related responses should emphasize that for clarity and proper diagnosis, a person must consult a doctor. Fortunately, I’ve tested the responses in several variations, consistently including the recommendation to consult a physician.
On the other hand, family doctors are increasingly struggling with patients who have Googled or asked AI for a diagnosis and then demand tests based on that AI-generated information. Such demands can lead to significant costs for the state.
However, there’s also a positive side: answers found through AI or Google can prompt people to visit a doctor who otherwise wouldn’t have sought medical help—perhaps attributing their poor health simply to fatigue. Both patients and doctors will undoubtedly continue to utilize AI tools in the future, despite the potential drawbacks.
How well has the Estonian state handled communication during the African swine fever outbreak?
Applying the principles of crisis communication is crucial in this situation, and occasional setbacks should not deter us. The main priority is that the state must act as a state and prevent any further spread of the infection, for which very strict protocols have been established. Any doubts about the decisions made and potential sampling errors must be eliminated.
In such a case, protests are reasonable, and it is vital to address the issues that have caused worry and confusion. In this case, resistance and the desire to protest stem from a situation marked by uncertainty, lack of information, and perceived injustice—whether toward animals or businesses.
However, we should recognize the protest as a spontaneous political spectacle if its focus shifts to general opposition. There were certainly people at the outset who were genuinely concerned that animals might be culled needlessly, but even they should now understand that those pigs face death regardless—either to prevent the spread of African swine fever or to end up as sausages on our tables.
IMRE KAAS (42)
2003–2021 Host at Kanal 2
2021–June 2025 Head of Communications at the Health Board
Since 2024 Lecturer in Crisis Communication at the Estonian Academy of Security Sciences
