TikTok and Its Importance in Monkeypox Public Health Engagement

To the Editors:

The current multi-country monkeypox (MPX) outbreak has generated immense interest in the disease in the general population, which has led to the use of the internet and social media as sources of information about MPX, especially in adolescents [1]. One of the most recent platforms to gain popularity is TikTok, a social network with more than one billion monthly active users, with more than 60% of them being aged less than 29 years. Interestingly, as per the Centers for Disease Control and Prevention, only in the United States, more than 1,500 cases of MPX cases have been reported in patients aged less than 25 years [2]. The widespread use of TikTok, particularly among adolescents, has the potential to have both thoughtful advantages and serious disadvantages. TikTok has been found useful in the adolescent health field during the COVID-19 pandemic to encourage beneficial behavior modification [3] but also the spread of misinformation [4]. However, the content of TikTok about MPX on the current outbreak is unknown.

Therefore, a search on TikTok was performed on September 13, 2022 to analyze the 100 most popular videos using the “monkeypox” hashtag. Two independent reviewers classified TikTok's overall information as ‘useful,’ ‘misleading,’ or ‘neither,’ crossing-match the publications and guidelines from the Centers for Disease Control and Prevention. Based on comments and a review of profiles, user accounts were classified based on content into the following categories: independent users, healthcare professionals, or others. Any discrepancies between the authors were resolved through discussion until a consensus was reached.

Our findings revealed the videos earmarked with the “monkeypox” hashtag reached 4.3 billion views, 4.2 billion likes, and 616,184 comments. The majority of videos (74%) were uploaded by independent users and 18% of videos were filmed by healthcare professionals. In addition, 26% were filmed by young adult patients tracking their recovery journeys. Most videos (53%) included provided serious information regarding MPX, 45% included humorous/nonserious content, and only one video (1%) displayed misinformation. Videos uploaded by healthcare professionals were less likely to have views and receive comments and likes compared to independent users (p < .001).

Compared to the information provided about MPX in the current outbreak, on other social networks like YouTube and Twitter [1,5], TikTok content was more likely to provide useful information, and misinformation was uncommon. The amount of engagement found in this study highlights the platform's huge capacity to promote sharing; therefore, TikTok could be an important platform for the dissemination of correct information about MPX in the adolescent population and our findings suggest the opportunity for healthcare professionals and institutions to exert more influence over TikTok, especially in the current MPX multinational outbreak.