While the United States has come to accept the fact that the Russian government has been funding a direct effort to affect American perceptions of one another and the nation’s democratic process, most tend to see the issue through a partisan lens. Russian information operations, however, exist outside of the American domestic political squabbles, and in fact, rely heavily on America’s willingness to attack one another in order to achieve the levels of success they have to this point — and those efforts extend well beyond the scope of a single election, or even a series of them.

Russia and China, both of which hold elections but neither of which are beholden to America’s four-year cycles of administrative turnover, don’t have to operate within the same timelines employed by American endeavors. Every four years, a shift in executive leadership comes with a shift in focus and, often, a revamp of foreign policy and strategy. America’s competitors, however, benefit from long durations of singular leadership, allowing for the development of manipulation and disinformation strategies that span across years and American administrations. It would be a mistake to think of Russia’s information operations as an endeavor aimed at securing the White House for Donald Trump — the endeavor has always been multifaceted and layered, with a number of efforts and outcomes ranked in order of preference, perhaps, but with no singular goal beyond sowing discord among the American people, and as a result, weakening the nation on the international stage.

Now, some of the same Russian groups that have been linked to disinformation campaigns relating directly to American elections have been implicated in an ongoing social media effort to advance an anti-vaccination agenda among the American people. “Anti-vaxxers,” as they tend to be called, believe that the rounds of vaccinations provided to American children cause more harm than good, despite the scientific consensus stating otherwise.

“Although it’s impossible to know exactly how many tweets were generated by bots and trolls, our findings suggest that a significant portion of the online discourse about vaccines may be generated by malicious actors with a range of hidden agendas,” the new study’s lead author, David Broniatowski, said. Oddly, trolls linked to Russia participated in both sides of the debate, suggesting that their intentions may not have been to convince people not to vaccinate their children, but rather to stoke the embers of confrontation that were developing among those engaged with the discussion. This method is similar to Russian tolls organizing both protests and counter-protests at the same locations on the same dates with the intention of inciting violence between the two groups.

“By playing both sides, they erode public trust in vaccination, exposing us all to the risk of infectious diseases,” Johns Hopkins University’s Mark Dredze explained.

Despite the fact that most Americans see the health benefits of vaccinations, a look at the online discourse would give an onlooker a decidedly different perspective, giving the appearance of a fierce cultural battle raging between social classes within the United States. The intent of this effort, it seems, would be to drive wedges further between American groups, not unlike Russian efforts to stoke racial tensions in places like Ferguson, Missouri.

“One of the things about them that was weird was that they tried to — or they seemed to try to — relate vaccines to issues in American discourse, like racial disparities or class disparities that are not traditionally associated with vaccination,” David Broniatowski said. He served as a lead author on the study and works as an associate professor in the School of Engineering and Applied Science at George Washington University.

The study, published last week in the American Journal of Public Health, comes to a clear conclusion in that regard:

Whereas bots that spread malware and unsolicited content disseminated antivaccine messages, Russian trolls promoted discord. Accounts masquerading as legitimate users create false equivalency, eroding public consensus on vaccination.

This is consistent with a strategy of promoting discord across a range of controversial topics — a known tactic employed by Russian troll accounts. Such strategies may undermine the public health: normalizing these debates may lead the public to question long-standing scientific consensus regarding vaccine efficacy.