Misinformation

In the September 2020 issue of AJPH, Schillinger et al.¹ used an innovative epidemic metaphor to propose a framework that examines how social media affects public health. In their article, the authors acknowledged that misinformation (disseminated via social media) is damaging and sows distrust in public health: this has been well established.² Misinformation and its more nefarious relative, disinformation, are indeed a problem for public health scientists whose interest is promoting health. Many individuals in the public feel alienated from science—which may fuel distrust³—and social media platforms provide an opportunity to engage with others, potentially even instigating debate on a topic. Should a misinformation campaign gain considerable traction, scientists and public health practitioners will take notice and act to dispel the myth and, in some cases, conduct further scientific inquiry.

Yet occasionally there may be indirect and unrealized benefits of misinformation for public health, and this should be acknowledged in frameworks such as the one being proposed. Analogy for this comes from the unfortunate and fallacious claim that the measles-mumps-rubella vaccine causes autism. This debunked yet widely disseminated claim has spurred many observational studies,⁴ and confidence in the safety of this vaccine has been further bolstered by vaccine misinformation. Sadly, the number of individuals harmed from not vaccinating because of this misinformation may outweigh any benefits from these additional studies. As another example, the availability of thimerosal-free vaccines is in part a result of misinformation surrounding the preservative and its role in autism despite no causal relation.⁴

Public engagement with social media also motivates accountability and transparency for scientists and public health practitioners. A deliberate misinformation campaign based on an obscure research article suggests that there was an opportunity for full disclosure of research protocols, analytic codes, and data. AstraZeneca’s release of their coronavirus disease 2019 vaccine clinical trial protocol is a proactive example (an “inoculant” in the framework’s terminology) of transparency to strengthen public confidence.⁵ An open and transparent science is crucial in the era of the “reproducibility crisis.”⁶

This is not a case of the ends justifying the means. This is an opportunity to be introspective as a field to better understand our shortcomings with respect to communication and dissemination. Frameworks such as those proposed by Schillinger et al.¹ are useful in this regard, provided we share the onus for misinformation, which may lead to further scientific inquiry or greater transparency in our work.