Misinformation About COVID-19 Vaccines on Social Media: Rapid Review

"The 45 included studies about misinformation on social media platforms about COVID-19 vaccines suggest that there should be great concern about the volume of misinformation being spread, and the association between COVID-19 vaccine misinformation and vaccine hesitancy."

Social media plays a crucial role in disseminating both correct information and misinformation about infectious diseases and vaccines. False claims about adverse vaccine side effects, such as that the measles, mumps, and rubella (MMR) vaccine can cause autism, were already considered a threat to global health before the outbreak of COVID-19. This study synthesises existing research on misinformation about COVID-19 vaccines spread on social media platforms and its effects. It also seeks to understand whether misinformation about autism and COVID-19 vaccines is being spread on social media platforms.

On September 9 2021, the researchers performed a literature search of PubMed, PsycINFO, ERIC, EMBASE, Cochrane Library, and the Cochrane COVID-19 Study Register. They included publications in peer-reviewed journals that fulfilled the following criteria: original empirical studies, studies that assessed social media and misinformation, and studies about COVID-19 vaccines. The researchers identified 3 main themes of misinformation: medical misinformation, vaccine development, and conspiracies:

The search yielded 757 records, with 45 articles selected for this review. The researchers grouped the studies into 2 major categories according to data sampling: one group gathered data through surveys, interviews, or focus groups; the other group gathered data from social media platforms. The largest total population sample in the first group of 22 studies came from Europe, with 27,975 respondents in total. In fact, a majority of studies were from industrialised Western countries. Twitter was the most studied social media platform, followed by Facebook, YouTube, and Instagram.

Nineteen of the studies measured or discussed the effect of social media misinformation on vaccine hesitancy. The evaluation of the certainty of evidence of these studies was classified as moderate or low to moderate according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria in 2 cases. For the rest of the studies, the certainty of evidence according to GRADE was considered low or very low. Overall, the studies implied that the misinformation spread on social media had a negative effect on vaccine hesitancy and uptake. For example, one of the 2 studies with a higher certainty of evidence analysed the perceived accuracy of COVID-19-vaccine-related tweets when they were moderated by smart device technology that Twitter applies to COVID-19 misinformation. The results from the 304 participants suggested that vaccine-hesitant users ignored warnings as long as the tweets aligned with their personal beliefs. According to the review's researchers, "there is a need for more robust designs to become more certain regarding the actual effect of social media misinformation on vaccine hesitancy."

Only 1 study contained misinformation about autism as a side effect of COVID-19 vaccines. "Considering the history of misinformation about vaccines and autism over the past 2 decades, more research should focus on this topic. One could also speculate whether this would have played out differently if COVID-19 vaccines were more targeted toward younger children."

This review demonstrated that more studies are needed from the Global South and on social media platforms other than Twitter and Facebook. For example, TikTok is a very popular platform worldwide that is often used by people who are younger than, for instance, the average Twitter user.

Reflecting on the findings, the researchers note that fear of side effects is a major concern when it comes to vaccine hesitancy, and, as this review shows, this concern can easily turn into medical misinformation and exaggerations of side effects. When the researchers examined the types of reported misinformation, they also found that a lot of misinformation is grounded in conspiracy theories. Some of this fear has historical roots, such as in the United States, where the Tuskegee Syphilis study (1932-1972) used African Americans to observe untreated syphilis and therefore denied them treatment. This example highlights that a lack of trust in public health institutions might have deep historical roots in some countries and cultures. Other issues to be aware of are religious concerns and vaccine hesitancy. Several studies reported on misinformation about the content and development of vaccines, using wording such as "cells from aborted children", which can cause worry in some religious communities.

The researchers suggest that, to prevent these misconceptions from taking hold, health authorities should openly address and discuss false claims - with both cultural and religious awareness in mind. Other proposed approaches to infodemic management are: first, monitoring information (infoveillance); second, enhancing and building eHealth literacy and science literacy capacity; third, encouraging quality improvement processes such as fact-checking and peer review; and finally, facilitating accurate and timely knowledge translation.

In conclusion: "Misinformation about COVID-19 vaccines is still thriving on social media platforms." Addressing this problem requires attention to the "balance between people's right to speak their minds and strategies to counter the spread of misinformation."