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The Centers for Disease Control and Prevention (CDC) hired a marketing firm to write what looked like news articles but were actually ad placements created to persuade parents of young children and elderly people to get flu shots, according to documents obtained by Children’s Health Defense (CHD).

The documents, obtained through a Freedom of Information Act request, show the CDC in September 2020 hired Weber Shandwick, a marketing firm, to create and place unattributed articles on news sites.

The campaign was part of a multi-year, $32 million dollar contract between Weber Shandwick and the CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) to promote influenza vaccination and strengthen NCIRD’s immunization program.

The FOIA-requested contract specifies the ad agency will develop a wide variety of media strategies to deliver the CDC/NCIRD’s message on flu vaccines — but not always in its name — including writing unbranded articles for media distribution, spokesperson training, celebrity outreach, social media blitzes, social listening and monitoring, podcasting and more.

The contract could be renewed for a total award of $55.2 million, according to USAspending.gov, a federal grants database.

The broader campaign, described in the documents obtained by CHD, is dedicated to implementing “strategic health communication to provide a full range of communication support to change attitudes and behaviors to prevent diseases of interest to NCIRD.”

Every year the CDC launches a flu vaccination campaign — seeking to vaccinate every person in the U.S. ages 6 months and older.

Past campaign strategies have been largely fear-based, with the CDC’s in-house marketing team explicitly encouraging television personalities and public health experts and others to “state concern and alarm (and predict dire outcomes)” for flu season and to represent each flu season in ways that will “motivate behavior (e.g., as ‘very severe,’ ‘more severe than last or in past years,’ ‘deadly’).”

The CDC recently incorporated another strategy that researchers call “native advertising,” which involves training and/or paying trusted, non-governmental actors to promote vetted ideas in conversation, community spaces and social media in ways that don’t appear to the targeted individual to be linked to official government campaigns.

Starting in 2021, the CDC spent hundreds of millions of dollars using these same advertising strategies to push the COVID-19 vaccines among communities of color.

‘Leveraging content with third-party credibility’

The FOIA documents — which only partially fulfilled CHD’s request and came heavily redacted — show Weber Shandwick subcontracted with Brandpoint, another public relations firm with expertise in “MAT release,” to create the articles related to flu shots.

MAT release means developing “branded, consumer-facing” articles that look like news articles, but are actually ads. Brandpoint specializes in making such ads and distributing them to a wide network of print and online publishers.

According to Brandpoint’s website, “These articles allow brands to leverage their own content and the credibility of third-party media companies while reaching consumers on the local news and media sites they frequent daily.”

In other words, the articles and announcements encouraging flu vaccination appear to be news, posted in English and Spanish on websites and radio stations that people know and trust, such as the San Antonio Express-News, the Houston Chronicle, WJCL in Savannah, Georgia, and KSBW in Salinas, California, according to the documents.

For example, Brandpoint has a Los Angeles Times content page that links to several of its articles. The print ads sometimes, but not always, carry a small label that marks them as a “paid post” but does not indicate who paid for them.

Figure 1: Sample Brandpoint Copy
Figure 2: Sample Brandpoint Image

For the flu vaccination campaign, Brandpoint developed article-like content, which included images of children, and paid to place them on different news sites. The CDC approved the ads, and most of them focus on childhood vaccination.

Some of the stories outlined CDC recommendations, but they don’t appear to be written by the CDC. Instead, the listed author is Brandpoint — often written as “(BPT)” — and the articles follow journalistic style conventions, so there is no way for the reader to know the CDC bankrolled the information.

Brandpoint committed to running ad articles on at least 800 online locations, flooding people’s media landscape with CDC-sponsored content. Many of Brandpoint’s story links from this campaign no longer work.

CHD is working to obtain records not yet provided by the CDC related to the agency’s contract with Weber Shandwick.

CDC supported ‘intentionally unbranded’ messaging to avoid appearance of ‘top-down’ advice

Since 2021, the CDC has spent hundreds of millions of dollars in grants to create “culturally tailored” pro-vaccine materials and train “influential messengers” to promote COVID-19 and flu vaccines in communities of color in every state across the country.

The CDC’s strategy included training clergy members, teachers, neighborhood businesses, community organizations and others to promote its COVID-19 and flu vaccine messaging so it would appear those messages came from within people’s existing communities, rather than from the federal government.

FOIA documents show this “native marketing” strategy began at least as early as 2020. In this case, the strategy focused on placing “organic” messages in third-party and social media — places the marketing agencies identified would be most likely to influence the target audiences.

Peer-reviewed research published in Plos One in 2020 found that messaging on social media that was unbranded — not visibly associated with the CDC or other government agencies — was more likely than a “top-down” approach to yield “positive attitudes toward the flu vaccine,” particularly among African American and Latino people.

The research, funded by healthcare giant Kaiser Permanente, paid micro-influencers to select vetted messages and use them to create their own original content promoting flu vaccination on their social media pages.

Payment, which varied according to each influencer’s reach and influence, ranged from $84 to $360 per influencer.

Content was “intentionally unbranded to ensure that it aligned with the look and feel of their [influencer’s] pages.”

The “native advertising” strategy is used commonly in advertising, but prior to this study, it was untested in public health. It’s based on research demonstrating people are more likely to engage with — and change their behavior based on — content they don’t think is tied to a campaign or to advertising.

When people in the study’s target region, particularly among “at-risk groups,” were exposed to messaging from people with whom they “had trusting relationships,” they were in fact more likely to change their attitudes and behaviors regarding the flu vaccine than when the message came from the “top-down.”

But unbeknownst to them, the messages were created by researchers to include “pre-selected” and “vetted facts,” including messages like “everyone needs a flu shot,” side effects are minimal, the flu vaccine is “safe and effective,” etc.

Influencers also were instructed not to use the word “vaccine” but rather “shot” because of negative associations with the word vaccine.

A $10 billion market by 2030

The flu vaccine market is booming, according to market analysts who estimate the global flu vaccine market will grow to $10 billion by 2030, up from $5 billion in 2020.

Allied Market Research makes this projection based on the fact that “Healthcare organizations all over the world like Centers for Disease Control and Prevention (CDC) have suggested vaccines” for the treatment of influenza.

Several major pharmaceutical companies produce flu vaccines available in the U.S., including AstraZeneca, GlaxoSmithKline, Mylan, Novartis, Sanofi-Aventis, Sanofi Pasteur and Seqiris.

The CDC says private vaccine producers projected they will produce 173.5 million to 183.5 million doses of quadrivalent influenza vaccines for the 2022-2023 season in the U.S.

Since the start of the COVID-19 pandemic, the CDC has advocated that people get the flu and COVID-19 vaccines and CDC vaccine promotion funding targeted the two vaccines together.

The CDC’s Advisory Committee on Immunization Practices in 2021 unanimously voted 14-0 to co-administer the COVID-19 and flu vaccine to adults and children, with no scientific evidence to back the decision.

When the U.S. Food and Drug Administration (FDA) vaccine advisory committee met in January, representatives from the CDC and FDA reported they thought instances of stroke following receipt of Pfizer’s new booster in the elderly may be connected to the flu vaccine and said they would conduct research to determine if this was the case.

When asked by a committee member if it would be prudent to separate the flu and COVID-19 vaccines for elderly people, the CDC’s Dr. Tom Shimabukuro, responded:

“I think talking about spacing the vaccine is premature and I’ll just reinforce that the CDC’s recommendation for COVID vaccination and for flu vaccination have not changed.”

The Allied Market Research report confirms that pairing the two vaccines is good for the flu vaccine markets.

It states, “The COVID-19 outbreak is anticipated to have a positive impact on growth of the global influenza vaccine market. As the number of the population affected with COVID-19 virus increases, the demand for influenza vaccine surges.”

Government efforts — which by the CDC have amounted to hundreds of millions of dollars for flu and COVID-19 — help Big Pharma’s profits soar.

“Increase in government support and surveillance regarding vaccination against influenza on the national and global levels to monitor the supply, distribution, and administration of flu vaccines is one of the crucial factors driving the market growth,” the report states.

Flu vaccine comes with risks, no evidence it’s effective

Although the CDC reports 36,000 to 80,000 deaths per year from flu, data from the U.S. Department of Health and Human Services — available on the National Center for Health Statistics (NCHS) website — show that CDC’s annual estimates are off by orders of magnitude, according to Robert F. Kennedy, Jr., CHD chairman on leave, who outlined the existing scientific data on flu in a May 2020 letter to Sanjay Gupta.

NCHS data report the average number of mortalities attributable to influenza on death certificates is little more than 1,000, but the CDC is able to inflate the data by conflating flu and pneumonia deaths, BMJ Senior Editor Peter Doshi reported.

Doshi charged the CDC with deliberately lying about annual flu deaths to “[work] in manufacturers’ interest by conducting campaigns to increase flu vaccination.” He warned that “by arbitrarily linking flu with pneumonia, current data are statistically biased.”

Even its promoters concede the flu vaccine has low efficacy. The Mayo Clinic reports the flu vaccine is, at best, 50% effective for reducing the risk of illness among healthy adults ages 18 to 64 (a group with already low flu risk) and the CDC reports it is 40-60% effective at reducing risk.

Two Cochrane reviews found the scientific data provides “no evidence for the utilization of vaccination against influenza in healthy adults as a routine public health measure” and no evidence that the vaccine reduces transmission.

The Cochrane researchers accused the CDC of deliberately misrepresenting the science in order to support their universal influenza vaccination recommendation.

Even the National Institutes of Health reported there is no evidence that flu vaccination in elderly adults reduces mortality from flu.

Evidence shows the vaccine carries serious risks. Roughly two-thirds of the claims compensated in the National Vaccine Injury Compensation Program (5,297 claims) have been for influenza vaccine injuries. In 2021, the total compensation to date — paid by U.S. taxpayers — was almost $4.5 billion, CHD reported.

And there is a lack of safety studies for two of the most targeted demographics for the flu shot — children and pregnant women, Kennedy wrote. In fact, studies have linked flu vaccination to miscarriages and birth defects.