SCIENCE sciencemag.org“I feel a bit embarrassed by it all,” Burioni
says, seeming not at all embarrassed but
very much amused. (In fact he seems to rel-
ish the publicity, having recently appeared
on an Italian comedy show in a version of
Name That Tune.) He’s proud that despite
all the media appearances he hasn’t missed
giving a lecture and continues to work full-
speed in his lab.
Yet it hasn’t all been fun. His time for fam-
ily and leisure has suffered. More disturb-
ing, at one point police had to stand watch
over his house after someone threatened his
daughter online—one of many death threats.
In 2018, Burioni and his family were vaca-
tioning at the beach town of Rimini when a
vaccine opponent caught sight of him and
posted on the web. Within minutes an on-
line posse had weighed in with suggestions
on how to harass him; on the advice of police
he and his family went elsewhere.
He’s also been the subject of
more substantive criticism for
his “Burioni blasts”—devastating
replies to even the mildest op-
position. When a Facebook fol-
lower said he was trying to figure
out the vaccine issue in his own
head, Burioni replied, “When
you go on social media you can
be reasonably sure that the inte-
rior of that head is as empty as a
tire tube.” He’s also been known
to ban even mild critics from
his Facebook page and discount
the work of science journalists
on the vaccine issue. “This is not
what you would call public out-
reach,” says Sergio Pistoi, a science
writer and molecular biologist
in Tuscany.
Burioni’s broadsides polarize
and oversimplify a complicated
discussion, adds Fabio Turone,
a science writer and director of
the Center for Ethics in Science
and Journalism. Fewer than 1% of Italians
are hard-core vaccine deniers, he says; but
about 15% are “vaccine hesitant” because
they have concerns about vaccines or find
them hard to get. (In Italy, doctors at the
public health service—not the child’s pe-
diatrician—administer vaccinations, and
some health service centers closed after
the budget crash of 2008.) Such people are
best reached by persuasion, not mockery,
Turone says.
Roberta Villa, a journalist and doctor,
calls for a more empathetic approach. Her
YouTube videos show her sitting at her
kitchen table, a cup of coffee in hand and
a drawing of Snoopy in the background, ex-
plaining that as a mother of six she under-
stands that all parents want to protecttheir children. That’s why scientists have
examined vaccines with such care, she tells
viewers. “People are much more educated
than they used to be,” she says. “They want
to understand what we are doing to their
children. So you cannot approach them in a
paternalistic way.”
Others appreciate Burioni’s no-holds-
barred style. “I know he likes to make jokes
that sometimes can be seen as abrasive,”
says Guido Silvestri, a longtime friend and a
pathologist at Emory University. “But what
kind of debate can you have with someone
who says that vaccines are a conspiracy to
kill children? He’s the one scientist who
stood up and said, ‘This is bullshit.’”THINGS ARE IMPROVING. In the summer of
2017, after the nadir in vaccination rates
and the spike in preventable disease, thegovernment passed a law that set up pub-
lic education programs and requires all
schoolchildren to get 10 essential vaccina-
tions before kindergarten. Even though the
law is loosely enforced, it’s working. Vacci-
nation rates have rebounded, according to
Italy’s National Institute of Health. After
bottoming out at 85.3% in 2015, measles
vaccination has risen to 94.1%, within strik-
ing distance of the 95% needed to prevent
outbreaks when single cases pop up. The
law has proved so effective that France and
Germany passed similar laws in 2019.
Burioni and others don’t claim he is re-
sponsible for the turnaround, but public
health researchers say the “Burioni effect”
has altered public discourse. Four years
ago, googling “vaccines” in Italy wouldbring up a list of antivaccination groups
among top results. Now, the first hits in-
clude Burioni’s websites and the vaccine
information sites created by the World
Health Organization and Italy’s health au-
thorities. Similarly, radio and TV shows
have become more likely to book scientists
instead of actors and DJs to discuss vac-
cination, according to Lopalco and others
who monitor the media.
Recently, Burioni expanded his cam-
paign for science. In late 2018, he and half
a dozen colleagues created Medical Facts,
a web portal that posts news, advice, and
comments on a variety of health issues.
In January 2019, he and Silvestri posted
a manifesto called “The Pact for Science,”
supporting research and education and
calling for the use of objective science in
government decisions. It has attractedthousands of signatures from people as
diverse as the head of the left-leaning
democratic party and Grillo himself, one
of Italy’s original vaccine deniers. In June
2019, Burioni and colleagues created a
group related to the pact that will advocate
for science and help local judges gather
better information when adjudicating
cases involving science and health.
“The world has changed,” Burioni says,
acknowledging both the good and “cata-
strophic” effects of social media. “Science
needs to find a new voice—not the lan-
guage of scientific congresses, but a lan-
guage that’s understandable, passionate,
and convincing.” jDouglas Starr is a journalist in Boston.NEWS | FEATURESCREDITS: (GRAPHIC) N. DESAI/
SCIENCE
; (DATA) EPICENTRO; F. D’ANCONA
ET AL
., EURO SURVEILL.
24(26), (2019);
INTEGRATED SURVEILLANCE OF MEASLES AND RUBELLA IN ITALY
, 55, (2019)
05000Number of casesVaccination rate100000708090100 %2000 2005 2010 2015 2018Setback and recovery
After rising for years, measles vaccination rates in Italy fell until 2015 because of unfounded safety concerns, abetted by some
government and court actions; measles cases spiked. Public education and a 2017 law have boosted rates since then.3 JANUARY 2020 • VOL 367 ISSUE 6473 19
Published by AAAS