Sayer Ji is a 48-year-old proponent of what he calls natural medicine.
"My parents didn't know about natural medicine, so it really wasn't until I was 17 that I learned some basic principles of nutrition and self care," he told attendees at a recent virtual conference. "I was liberated from needing pharmaceutical medicines."
Ji was also there promoting his website, full of natural remedies and reams of anti-vaccine misinformation. He sells subscriptions for anywhere from $75 to $850 a year.
He is one of many anti-vaccine advocates with a business on the side. They promote false claims about the dangers vaccines pose, while selling treatments, supplementals or other services. Their potential market is the roughly 20% of Americans say they do not want to get vaccinated against the coronavirus, according to recent polling.
Health experts worry that the misinformation being spread is doing real damage. Without sufficient vaccination, communities could see a resurgence of the virus, particularly in the coming fall and winter months.
Ji has spent years pushing scientifically disproven views about vaccines and other conventional medical treatments, but the coronavirus pandemic gave him and others in the anti-vaccine community a new set of talking points. "This is the new medical apartheid, this is the new biosegregation that they want to roll out across the world," he warned of the vaccination campaigns during a lengthy Facebook video posted earlier this year.
"COVID was the opportunity," says Imran Ahmed, chief executive of the Center for Countering Digital Hate, a non-profit group that tracks anti-vaccination misinformation. "COVID generated a lot of anxiety and conspiracies and misinformation thrive where there is anxiety."
As people have searched online for information on the virus and vaccines, Ji and others have upped their rhetoric, while continuing to promote their books, workshops and other products. Research by the Center for Countering Digital Hate shows it can work. 147 key anti-vaccination accounts have managed to grow their followings by at least 25% since the start of the pandemic.
And Ahmed believes for those with something to sell, anti-vaccine conspiracy theories serve a second important purpose.
"One of the things that antivaxxers have to do to sell their own remedies... is to persuade people not to trust authorities they've trusted in the past," Ahmed says.
By using conspiracy theories to turn people away from mainstream medicine, these entrepreneurs are creating customers: "Once they've managed to hook someone, they can then sell to them for a lifetime."
That selling can be big business. One of the leading anti-vaccine advocates, Joseph Mercola, is believed to bring in millions each year through his companies, which sell an array of branded natural supplements, beauty products and even pet supplies. In a written statement to NPR Mercola's company said he "rejects your biased accusation of promoting misinformation."
Separately, in an interview with NPR, Sayer Ji denied that his website was a major source of income.
"I mean I'm a published author, so I encourage people listening to buy my book if they're interested. How about that. So there it is, I've just promoted something, I'm a shill for the anti-vax industry," he said.
"Ultimately, my point though is that I work for a living, and I always have very hard."
He says his primary motive is to provide information to anyone interested in reading it.
Promoting products is not always a cynical move, says Kolina Koltai, a researcher who studies the anti-vaccine movement at the University of Washington. She believes that many are sincere in their beliefs about vaccines.
"If you really want to make that your life's mission, you need to make income somehow," she says. "We live in this capitalist society."
Regardless of motivation, she believes that money is a major part of a feedback loop that continues to drive vaccine misinformation on social media. The extended public health crisis has created a marketing opportunity that "just gives you more and more followers and more and more money."
Ahmed adds that while the anti-vaccine community's self-made personalities resemble others who have proliferated in the age of social media influencers, the potential damage they can cause is real. "Someone who's promoting lipstick isn't going to lead to us not being able to contain a pandemic that's already taken half-a-million lives," he says.
But the crisis is also bringing more scrutiny to anti-vaccine promoters. Sayer Ji's Instagram account was suspended in April after he repeatedly posted misleading and false information. Other anti-vaccine advocates have toned down their rhetoric on large platforms like Facebook. Koltai says losing these accounts could pose a threat to their livelihoods.
"When they get kicked off of their social media platforms I do think they take a major hit to their business models," she says.
On May 4, Joseph Mercola announced that he would remove all information on COVID-19 from his website. In a lengthy post, he cited threats against him as the reason, rather than business or legal considerations. As of May 10, many posts about COVID-19 still appeared on the site.
For his part, Ji says the biggest hit to his web traffic actually came before the pandemic, in 2019, when Google changed its search algorithms to hide anti-vaccine sites like his.
And he says he doesn't worry much about the financial implications of getting kicked off social media sites either.
"Social media deplatforming? Give me a break," he says. "We have hundreds of thousands and millions of followers out there. In part because we do a really good job of providing information that people want."
His company's Facebook account continues to promote vaccine misinformation to half-a-million followers. And lately he has added a big red stamp to it that reads "censored."