Schillinger and Ramírez Respond

We appreciate the acknowledgment that misinformation and disinformation, the effects of which can be amplified via social media channels, are serious problems. However, the claim that they are “a problem for public health scientists” is not expansive enough because this type of communication does not just make scientists’ work more challenging; it jeopardizes the public’s health. Although the SPHERE (Social media and Public Health Epidemic and REsponse) framework presented in our article can inform the work of scientists, its overarching objective is to enable a clearer understanding of how social media can influence public health.

In addition to the obvious harms that misinformation can generate, other harms also may result. Such forms of communication do not represent an efficient, ethical, or reliable means to foster the scientific transparency, accountability, and responsiveness that Goldstein rightly demands. Over more than a decade, the misinformation campaign related to childhood vaccines and autism led to preventable suffering and countless deaths across the globe as well as the diversion of precious public dollars that could have been dedicated to better understanding and treating this disorder as well as funding that could have been spent on immunization and related advances.¹ Furthermore, disproving this misinformation occupied time and attention from the scientific community that could have been better spent elsewhere. Funding to support science, and the time and attention of scientists, are not limitless public resources. Responding to misinformation is not a sound mechanism to drive scientific policy, budgets, or research agendas.

We do agree that there is value in understanding misinformation. Tracking misinformation can help public health communicators develop inoculation and countermessaging campaigns to advance public health.² Analyzing themes or narratives that underlie arguments made in misinformation campaigns can provide insights into contemporary tensions in the relationship between society and the scientific and medical communities, insights that can be harnessed to promote a healthier relationship.³

We agree that the public cannot be a passive recipient of scientific and medical information; it has an important role to play in informing, shaping, and regulating science. History has taught us that scientific “truth” is a moving target, that science can be hijacked in ways that jeopardize rather than promote public health,⁴ and that the authority of science can even be harnessed to justify inhumane policies.⁵ As such, fostering open and reasoned critical public discourse about science and health indeed is in the public interest. The challenge before us is how to create online spaces that allow productive, bidirectional communication between influencers from the public sector and communicators from science to advance public health.