The Italian Five Star Movement (M5S) is without doubt one of Europe’s strangest and most poorly understood political forces. Founded in October 2009, in less than a decade this anti-corruption party, which pledges to be ‘beyond left and right’, has grown from a small-scale social movement to become the largest force in a governing coalition. As a model of expansion there is simply nothing quite like it. The meaning of this ‘Italian anomaly’, however, remains unclear to many beyond the country’s borders. Often the participants in the M5S are presented as radical reformists, the natural inheritors of the ‘direct democratic’ occupy movement. On the other hand, their fans include the far-right media mogul Steve Bannon, who has credited them as the avant garde of a ‘new sovereigntist’ trend in Europe. The reality is a mix of the two. While claiming to speak for the proverbial 99%, and providing a platform for ‘independent’ citizens to candidate themselves, the M5S is and has always been controlled by an obscure digital-corporate interface, one that has a clear investment in the rise of a new right-wing populism and which has had little qualms about using fake news as a strategy for obtaining power.
For many years the leaders of M5S have worked to outflank incumbent parties across the political spectrum by focusing on areas that they have failed to adequately confront in the eyes of the electorate. From environmental questions to digital rights to welfare, the party has successfully presented itself as something new and revolutionary, able to deliver where experts and technocrats have failed in the past. Of all the propaganda weapons this movement has adopted as part of its general campaign to undermine the ‘old elite’, anti-vaccine discourse has proved one of the most successful. This issue – so intimate, personal, and fraught with anxiety – has proved a perfect vehicle for conjuring up a new base beyond old political divisions. From a grassroots to ministerial level, members of the movement have exploited a non-partisan fear for years now, sharing unverified pseudo-science to present their own party as an enlightened force, acting in the genuine interests of people against the murky agenda of Big Pharma. Today, however, as the scale of the network of misinformation involved in the campaign becomes ever more clear, in the context of a spike in measles cases, and the threat of a medical emergency, the ethics of such behaviour is being increasingly called into question. M5S is only one part of this story, but their role in perpetuating a dangerous anti-scientific turn has, as I shall demonstrate, been more than incidental.
The art of the conspiracy theory
For the purposes of modern political populism the origins of most anti-vaccine propaganda can be traced to a study by the British gastroenterological surgeon Andrew Wakefield. In 1998 Wakefield published a report in the respected scientific journal ‘The Lancet’ that proposed a demonstrable link between the MMR vaccine (measles, mumps rubella) and autism. Scientific consensus – not an ‘ideology’ but facts proven by experiments and studies – had already proved that vaccines were far safer than being exposed to the respective diseases and entailed minimal risk. Wakefield’s study, however, went in the face of this agreed state of affairs by arguing for a direct causal connection with the neurodevelopmental disorder. There were some deep flaws in both the methodology and funding of the project. His sample, for example, was made up of only 12 individuals, all handpicked by he himself, and included hypothetical qualitative reporting based on interviews with the children’s parents. More gravely, it was later revealed that one of the funders of Wakefield’s study included a lawyer working on an anti-vax case who had paid him directly. Worse still, it was later demonstrated that Wakefield himself was working on a prototype alternative measles vaccine, a fact which, in tandem with these other considerations, ultimately discredited his paper.
It took twelve years after the publication of Wakefield’s study for the Lancet to distance themselves from its findings. The damage, though, was already done. In the period it took to re-investigate the claims made, the case made ripples around the world. All manner of political groups from right wing nationalists to unaffiliated new age groups latched onto it. Among them were Beppe Grillo, the television comic, and Gianroberto Casaleggio, an eccentric tech entrepreneur, who together were soon to found the Five Star Movement. As early as 1998 Grillo was making jokes about vaccines. In his stand-up show Apocalisse morbida [Soft Apocalypse], for example, he playfully riffs around NoVax sentiment. “They told us diphtheria was disappearing because of vaccines” he says, “but really it was disappearing for its own fucking reasons.” “In the medieval times it was God that made us ill, not multinationals” he continues, pointing to several out of focus, de-contextualized, graphs which profess to show a link between inoculation and various ailments. Casaleggio, a man who preferred to stay in the shadows, would confine himself to vague proclamations about the pharmaceutical industry. Nonetheless, the memetic potential of anti-vaccine sentiment, its political potential, were tested even before the movement’s foundation. It was in its very DNA.
In the early days of the M5S, before its official registration as a party, Beppe Grillo’s blog served as the main media and organisational hub for the movement. This was not, it should be emphasised, an independent platform, but owned and managed directly by Casaleggio’s association. One section of Grillo’s blog labelled ‘health’ contained several explicit references to vaccines. An article from 8 April, 2007, for example, called ‘the autism epidemic’, begins with a claim that 1 in 150 children now suffer from autism while 20 years ago the figure was 1 in 2000. The correct figure for the latter statistic is 1 in 200. Grillo here has “accidentally” added a zero. He goes on, unqualified, to state that unspecified “scientists” attribute this to pollution, diet, drugs and vaccines. As with the Wakefield case, there is no causal evidence here, only a vague correlation.
Casaleggio, meanwhile, who was more abstruse in his temperament and approach, worked on building a shadowy meta-narrative to support precisely these kind of claims. In 2008 his association published a video that presented the history of civilisation as a kind of biopolitical conspiracy. Savonarola, the famously severe Dominican monk, is presented as the inventor of a kind of proto email, while Mussolini and the nazis come across as technological geniuses who for all their ills projected humanity forwards on its teleological destiny. All of this is accompanied by the expected claims about masonic, religious and financial orders that control the world. While there is no explicit reference to vaccines per se the video talks about population control and the management of bodies in general as part of the journey towards an apparent utopian society which will apparently arrive on 14 August 2054 with the name ‘Gaia’.
According to a small clarification below the video, “these views do not reflect either the politics of M5S or those of Casaleggio”. Taken together with the activities of Grillo’s blog at this time, however, there is a clear agenda at work: to destabilise Truth, and trust in experts of all kinds. In 2010, in a more clear cut example of this tendency, another, even more popular, blog post was published under the title ‘vaccines can kill’. It told another unqualified story about a family whose young child had been disabled “as a result of” the polio vaccine. This time, Grillo explicitly linked the tragedy to Casaleggio’s propaganda. This child died, he says, “because healthcare has too many economic interests, separated from the health of citizens.” There is no accurate science about vaccines here. Once again the purpose was unambiguously political: to generate a narrative about a distant world order, of masons, bankers, socialists, capitalists, all of them, as a ‘threat’. The movement, it ‘obviously’ followed, was presented as the ‘solution’.
This kind of argument exists in all countries and is clustered among a broad range of online communities. In the case of Italy, though, one of the main distinguishing factors was that by this point Grillo’s blog was not a marginal media source, but had a reach of over 1 million, and was therefore comparable to a major newspaper. While most of the blog featured jokes about corrupt politicians, and utopian cyberpunk fantasies, it wielded considerable influence in framing, or in this case, undermining, scientific knowledge and its public communication. At the same time, it should be remembered, Grillo’s blog was a profit-making initiative. Controversial stories, like those around the supposed danger of vaccines, naturally brought more traffic and revenue, as well as exposure for the new party. Grillo, in other words, became a kind of megaphone to fund both the movement and the association.
A network of misinformation
The scale of online propaganda did not stop there. In 2013 when the M5S, emerged against all expectations as Italy’s single largest political party, its principle organisational culture changed. New figures emerged in the party, rising the ranks of the grassroots to take control of policy-making. The emphasis moved seemingly away from such conspiratorial logics, towards long-term and more pragmatic planning. The M5S, it was clear, needed to present itself as a force capable of governing, potentially in the near future. At the same time, in a counterintuitive trend, this period saw a closer and closer overlap between the movement and antivax campaigners, which in the past had been more easily separated. The main venue for this crossover was in a number of apparently independent magazines which were both explicitly antivax and served to promote the M5S.
One of Italy’s most important sources of misinformation regarding health issues in general has been La Fucina, a clickbait hub that, in just a few years, established an audience of over one million followers. From the very beginning, the editors of this space specialized in pseudo-science stories, of which the main source was a certain Professor Giuseppe Di Bella. This discredited medical professional has long been famous for his unverifiable claims that chemotherapy is ineffective. He has also questioned the effectiveness of several traditional medicinal practices, including vaccines, and linked specific pills and injections to the papillomavirus, which, he claims, against global consensus, is a precursor to cancer. In its early days, Grillo used to share stories from this site that made unsubstantiated and manipulative claims like ‘pesticides cause celiac disease’ and that pomegranate is ‘a natural vaccine’ against the flu. While not directly connected with the Five Star Movement as an organisational entity, La Fucina was owned by the Casaleggio association.
The same is true of TzeTze, which until recently was one of the main sources spreading gossip and political conspiracy theories on the Italian internet. For years, articles like “the girl with no vagina, see it to believe it!” appeared alongside propaganda against the centre-left Partito Democratico (PD) and alarmist, and false, claims about the supposedly fatal health problems of various celebrities, including actors, singers and politicians. Nevertheless, Grillo was happy to define the site in 2011 as “true, plausible and believable”, counterposing it to a version of the internet “desired by JP Morgan and the global masons to control all information.” There are few specific claims about vaccines left online, though the language and content is, obviously enough, anti-scientific. Mozzarella has not, in any scientific studies, been proved to be lethal. Neither is Jerusalem artichoke a cure for diabetes. TzeTze too was owned by the Casaleggio association and unsurprisingly cited La Fucina as one of its ‘reliable’ sources.
In 2016 Buzzfeed published a now much-referenced investigation called ‘Italy’s Most Popular Political Party Is Leading Europe In Fake News And Kremlin Propaganda’ which, alongside other sites, singled out both La Fucina, and TzeTze as culprits. Following this investigation, the former rebranded as a health food blog while the latter deleted its site and its political output. A portion of the activist base, though, had already latched on. Individual anti-vaxers from pages like autismo e vaccini [autism and vaccines] and vaccini basta [stop vaccines] (26k likes) were already sharing news regularly from sites like these, therefore making themselves ever-more susceptible to advertising from the Casaleggio association and by extension, propaganda associated with M5S. There are a few explicit testimonies to such a bond. Facebook groups like L’attivista a cinque stelle [Five Star activists] (145k likes), Governo a cinque stelle [Five Star to Government] (183k likes), and Lombardia 5 stelle [Lombardy Five Star] (19k likes), were sharing links to sites like ‘anticasta’ and ‘the new world order will fall’ claiming, amongst other things, that doctors were being paid extra to give people unnecessary vaccines.
Given the irresponsible nature of these claims, one might reasonably have expected politicians to have distanced themselves from the phenomenon. On the contrary, prominent M5S members supported the grassroots swell. In 2014 twelve members of the movement (Corda, Rizzo, Artini, Basilio, Tofalo, Paolo Bernini, Frusone, Cecconi, Baroni, Dall’Osso, Grillo and Mantero) signed a draft proposal for a law (2077) which included the clause that: “recent studies have put into light a relationship between vaccines and a few illness like leukemia, poisoning, inflammation, immunosuppression, transmissible genetic mutations, tumor diseases, autism and allergies.” Given this, in a clear nod to the activist base from Facebook groups like those previously mentioned, they argued for a full scale investigation for future policy.
Neither were these twelve members alone. In a revealing interview with the alternative news site, fanpage.it, Giacomo Giannarelli, now head of the Tuscan branch of M5S, was surprisingly frank about his lack of knowledge on the topic. Paradoxically, however, he presented this as exactly the reason people should trust him: “I’m not an expert neither in health or in vaccines” he admitted, “but there are studies that seem to show that there are problems that can come from some vaccines and which can arise in children. As a parent I want to make an informed choice on the vaccination conversation.” In a TV interview from October 2015, Paola Taverna went as far as to claim that pharmaceuticals wanted to cover up the negative impacts of vaccines. Such sentiment even made it into the European election campaign of that same year. Piernicola Pedicini, who was candidating himself with the M5S, claimed that the scientific community had apparently “abandoned evidence approach to medicine” while calling on Italians to “vaccinate less, vaccinate better.”
There are several more examples at a local level. Some councils as in Parma, were arguing for ‘free choice’ on vaccines. At protests in the surrounding region, but also elsewhere in the country, the M5S flag was clearly visible among independent anti-vaxxers. In debates on the theme, organised by the movement, pro and anti-vaccine advocates were brought together on a ‘level playing field’. As a result, people claiming that “vaccines are useless, it’s better to just eat a lot of walnuts” were given a platform which suggested they be taken as seriously as medical professionals. This was, by now, a hot topic in public conversation, and while the movement alone was not responsible for what was to follow the data is striking. In 2013, Italian measles coverage was at 90.35%, already relatively low. By 2015, however, amidst various propaganda campaigns, including that of the movement, it had dropped to 85.29%. Not only was this a significant change, it brought coverage 10% below the required level to guarantee ‘herd immunity’. As a result, vulnerable people, those who for whatever reason already had compromised immune systems, were put at risk. Coverage below 85%, meanwhile, increases the risk that existing viruses might mutate, potentially harming everyone, including those vaccinated.
A ‘flexible obligation’
In 2017/18, against precisely this backdrop, Italy was hit with the worst measles epidemic it had seen in over a decade. This was no coincidence. Neither, to be clear, was it caused by the M5S. Measles comes in cycles and this was not the most terrible outbreak of all time. It was, however, a serious peak which saw a sudden 600% increase in cases, resulting in 5006 ill individuals and 12 deaths. Italy, which has a population of just 60 million, entered into the top ten countries in the world in terms of the total number of cases, just one place behind China, whose population, of course, is 1.3 billion. A national emergency was promptly declared by both the government and WHO.
At this time the Partito Democratico was still in power, and worked hard to contain the spread. Beatrice Lorenzin, the then Health minister, proposed a new law to raise the number of compulsory vaccinations, and further enforced the rule that children be required to prove their coverage by providing medical certificates in order to attend school. The M5S, both on the web, and at a movement level, led the counterattack. In Montecitorio, for example, the same area where local Five Star Movement were most overtly entwined with the anti-vax campaign, Davide Barillari, then a councillor for the region of Lazio, promised that the party had “a health reform ready” for when they were in power which would reflect “the dangers of vaccines.” Davide Bono, another M5S councillor in Turin, was making the same argument. Virginia Raggi, the mayor of Rome, was pleading to Lorenzin that kids who aren’t vaccinated should be allowed to stay in school. More explicitly still, Luigi di Maio, the movement’s new head, promised in early 2018 to undo the Lorenzin decree saying they were “against the obligation to vaccinate, but yes to recommending it.”
A few months later M5S did indeed find themselves in power. Now they were faced with a dilemma. If the anti-vax agenda had been a useful vehicle in earlier moments of their growth, the question of actual policy, in the context of an epidemic, was another one entirely. Following the death of Gianroberto Casaleggio, the eponymous association had already denied having ever supported anti-vaccine agenda. A few other politicians had also sought to distance themselves in the meantime. Nonetheless the momentum was still there from the activist grassroots. On the web, in comments, on M5S affiliated sites, there was considerable public outcry, with supporters calling on the movement to abolish the Lorenzin law as promised. Several prominent ministers attempted to downplay the seriousness of the issue. In a line that seemed straight out of one of Beppe Grillo’s stand-up shows, Paola Taverna, for example, who was by now vice-president of the Italian Senate, remarked that “as kids we’d immunise ourselves by going to a sick friend’s house”. Worse still was to come from Barillari who, with the NoVax community in Montecitorio watching him, published an invective on Facebook in which he, perhaps inadvertently, revealed the power-hungry reality of his party:
Politics comes before science. Politicians need to listen to science, to collaborate, not to be ordered by science about what is right and wong, accepting the words of mainstream opinion like it was religious dogma. Because science MUST BE DEMOCRATIC, and therefore it needs to listen to everyone… including researchers and scientists who, with data in their hands, contest official dogmas.
Remarks like these are questionable enough during campaigns, but even more so coming from representatives of a ruling party. Since last spring it has been up to the new health minister, Giulia Grillo (no relation to the comic), to set the M5S line. In a series of interviews, she has continued to present herself not as anti-vaccine, but as ‘pro choice.’ Initially she admitted that the previous Lorenzin law, had proved a success and pledged, against the line set out by Di Maio, that it would not be scrapped. At the same time, in flagrant contradiction of this, she went on to say that she could not ‘discriminate against children.’ Meanwhile, in order to protect her colleagues from attacks in the media, she claimed, in what is a demonstrable falsehood, that her movement had “never said anything against vaccines.” After a few months there was no avoiding defining her position, which she did, finally, in a perfect example of the new populist language. The new Italian policy on vaccines was to be one of ‘flexible obligation.’
For months it was unclear what this would mean. Gradually, however, it became apparent that this would in fact entail a quite significant alteration to Lorenzin’s law, to enable children to be admitted to school based on a ‘self declaration’ of vaccination on the part of the parents, and so without medical proof. The President of the Republic, Sergio Mattarella, spoke out unambiguously against the government as a result, stating “anyone who goes against science is wrong.” Some regions like Tuscany and Piemonte, where measles had been worst in 2017, have turned to local legislation to make certification necessary. Meanwhile over 300,000 people have signed a petition against the new flexibility. Even within the M5S there have been several vocal opponents to this measure, including Elena Fattori, a Senator, who opposed Grillo’s initial measure. Figures like this were soon proved correct. That summer, during the school holiday, a video went viral a NoVax mother, anonymised, from Brescia, showing people how to fake the form.
The result was, predictably, chaos. Some schools opened in autumn 2018 requiring certificates while others permitted self-declarations. Checks had to be carried out at great expense. To this day there has been little clarity from the national government on what the future will hold. When the epidemic showed signs of returning, the ministry suggested it should be obligatory again. At the same time, though, in parallel to this concession, the influence of the anti-vax movement seems to be increasing. The ONB, Italy’s official order of biologists, for example, has now given EUR10k to the biggest ‘scientific’ anti-vax proponents in Italy, a company called Corvelva, to help them research the risks of technologies that have already been proven safe. More recently, last December, Grillo sacked the entire board of health experts to the government, many of whom had ties to Lorenzin. It was revealed, by Siliquini, the outgoing president, that in all the time since M5S has been in power they had never turned to this board of experts for advice. This is even more concerning given the two bills that are now being considered regarding this question. One would abolish obligatory vaccination altogether, another would maintain it only in low coverage areas. There is a valid concern that anti-vax sentiment, which, for all this propaganda, is shared only by around 1 in 5 Italians, will determine the government’s long-term legislation, and, ultimately, put lives at risk.
The figures for 2018 were not as bleak as 2017, but still concerning. In the first nine months of last year there were 2295 recorded cases of measles in Italy; hardly the conditions on which to shift policy. Fortunately, medical professionals and politicians from across the spectrum are working to maintain the obligatory measure and improve scientific literacy. Last month, Roberto Burioni, an academic and medical professional, who has endured years of death threats for challenging anti-vax pseudoscience, published a policy recommendation which included, quite simply, the proposal that decisions on vaccines be legally tied to scientific consensus. It has attracted signatories from across the political spectrum. One of the biggest surprises, for many, was the co-founder of M5S, Beppe Grillo. Just over a year ago, when the New York Times accused him of perpetuating anti-vaccine propaganda, he rejected such claims as ‘fake news’. Now he is seemingly on their side. The question of why is an open one. Personal guilt? Personal branding? It is impossible to say. The reaction from many in the M5S, though, has been predictable. The official Facebook page is still filled with people calling Grillo a ‘traitor’, of ‘selling out to big pharma’. Luigi Di Maio, now the real face of the movement, has also seemed to relish in attacking his old mentor: “Science is OK” he recently reflected, “but not Burioni…”
U-turns at this stage, though, are too little too late. M5S came to power riding, the anti-vax wave, among other things, with little concern for the consequences. Beppe Grillo had a large role in this, as did the Casaleggio association, local politicians, mayors and senators, right the way up to the health secretary herself. All of these actors took a gamble, seizing on a sensitive issue, manipulating information, for their political, and very often, personal benefit. While this has proved successful in the short term, among some constituencies, anti-vax was always a niche issue; one more suited to opposition that governance. However dangerous the situation regarding herd immunity, the majority of Italians remain in favour of vaccinations. Meanwhile, those who had not previously seen this as a big issue are increasingly alienated from the movement’s authoritarian political stance. Even anti-vax campaigners have begun to see the political response as inconsistent and weak. As a result, M5S is haemorrhaging support everywhere, not only due to their incompetency regarding health policy, but as a result of a similarly amateurism in the faces of economic questions, and issues concerning migration. While the leaders continue to bask in their newfound power, their base is hardly loyal, and as more and more actors work to educate on this question, the scale of hypocrisy will be more widely understood. Supporters of M5S must now face up to an uncomfortable truth. While they might criticise Big Pharma for both rational and less rational reasons, it is their movement, one that is both pseudo-democratic and pseudo-scientific, that now poses the biggest threat to public health in Italy.