key: cord-0962745-b1rf6i0u authors: Xiang, David; Lehmann, Lisa Soleymani title: Confronting the Misinformation Pandemic date: 2021-05-13 journal: Health Policy Technol DOI: 10.1016/j.hlpt.2021.100520 sha: 710e3a16dfa78bc2960a5fb191bd012d61a86133 doc_id: 962745 cord_uid: b1rf6i0u nan LZSLehmann@gmail.com, Cell: 617-529-1309 Highlights -Vaccine hesitancy is increasing in the US and worldwide, and medical misinformation is a significant contributor to this declining acceptance of vaccines. -False information spreads faster than true information, and the pandemic has increased the degree to which individuals consume information online, where misinformation is more likely to appear, creating a vicious cycle. -We offer recommendations for a collaborative framework between medical and scientific organizations and technology and social media companies to collectively address medical misinformation and directly combat vaccine hesitancy. -Medical misinformation will always exist, but we offer an innovative and unique approach to confronting this misinformation. vaccine rollout and distribution, developing sustainable and sound strategies to mitigate and combat misinformation is crucial. In the recent past, vaccine distrust, driven by the spread of misinformation, has steadily led to decreased immunization rates and increased deaths in the US and globally due to lack of vaccination [1] . Recent studies also demonstrate that online misinformation campaigns are associated with a drop in vaccination coverage over time, which presents considerable obstacles to achieving herd immunity in many countries worldwide [2] . significant in the US [3] . A recent Gallop Poll found that overall, 42% of US adults and 52% of non-white adults would refuse a vaccine [4] . This racial disparity in vaccine acceptance may be one factor in the current discrepancies in vaccinations in the US; across 40 states, the Covid-19 vaccination rate is almost twice as high as the rate for Hispanic people, and 1.7 times as high as the rate for Black people [5] . These concerning statistics highlight the racial disparities in the uptake of the Covid-19 vaccines, which stem from factors such as access, structural racism, and hesitancy and mistrust to not just vaccines, but the healthcare system in general. Many states are beginning to implement strategies to address these disparities, such as purposely placing vaccine clinics in underserved areas or collaborating with community-based health centers to conduct effective communication and education, but vaccine and healthcare distrust, coupled with lack of access, will continue to serve as major barriers to addressing racial equity in Covid-19 vaccine efforts [6] . Moreover, from a global perspective, an international vaccine confidence study conducted between 2015 and 2019 found that confidence in the importance of vaccines is most strongly associated with vaccine uptake, with receiving sound medical information also a significant factor [7] . This demonstrates how important it is that the spread of false information regarding vaccines is limited and how the propagation of accurate medical advice should be prioritized. Misinformation also stems from many sources, ranging from word of mouth, social media channels, television, and popular entertainment and media organizations. Unfortunately, false news spreads faster than the truth, and the pandemic has concurrently created a vicious cycle in which individuals are consuming more news online due to health-related concerns, simultaneously increasing their exposure to misinformation [8] . With the increased information circulating online, this has created an "infodemic," described by the World Health Organization (WHO) as excess information in times of a pandemic, containing misinformation that cause confusion and further harm one's health [9] . Thus far, a wide spectrum of false conspiracy theories have already spread online, from claims that AstraZeneca's vaccine contains aborted fetal tissue, that the vaccine attacks a gene that impacts a person's spirituality, and that the vaccines contain microchips. With this milieu of falsified claims, the landscape of uncertainty has only grown since the development of the vaccine. Therefore, immediate, organized action is needed to rebuild trust in public health systems. Methods to address negative and false discourse about Covid-19 and health safety measures, as well as anti-vaccination content, are essential. However, action cannot be one-sided; instead, progress must be collaborative in order to be sustainable and far-reaching. Therefore, we provide recommendations for coordinated action by the global corporate and scientific community to strengthen the credibility of professional expertise and directly confront the misinformation pandemic and vaccine hesitancy. Recently, there have been public calls to action by medical professional societies to address medical misinformation, suggestions for medical journals to actively counteract misinformation, and even recommendations for collaboration between social media editors of medical organizations [10, 11] . Concurrently, social media and technology companies such as Google, Facebook, and Twitter are establishing methods to track, identify, and act on misinformation by labeling false claims, increasing access to fact-checked information, and removing false information that will harm the public's health [12] . While these ongoing efforts are much needed, increased active partnerships between public health researchers, healthcare organizations, medical journals, and technology companies measures to address misinformation, and allow them to rely on expertise from credible and longstanding leaders in science and medicine. Importantly, these partnerships also improve the public perception of science and offer collaborative strategies to address misinformation effectively and sustainably, especially in a current period in which vaccine misinformation is directly contributing to hesitancy, distrust, and reduced uptake [14] . Combatting medical misinformation during a pandemic can seem like a Sisyphean task, but there are effective and actionable steps that healthcare providers, professional societies, medical journals, and technology companies can take, especially in cooperation with each other. Misinformation will always exist-the generators of misinformation have no incentive to cease, and so it is the responsibility of individuals, organizations, and technology companies to collaboratively ensure no oxygen is provided for the flames of misinformation. Even more so now, during the pandemic and the continually growing reliance on online platforms for information consumption, the professionals and organizations that make up healthcare and medicine should be highly motivated to address medical misinformation, for the health of patients and the well-being of all. To prevent future infections and deaths from Covid-19, it is critical that true medical information about the safety and efficacy of vaccines is communicated to all communities. None declared Ethical approval Not required Technology platform flags potential instance of medical misinformation on its site. Notification sent to team at partner medical journal or organization. Team reviews and evaluates the case, identifies instances of misinformation, and creates a short brief/justification to summarize and classify potential issues. Findings are classified into three general categories: accurate, uncertain, and false information. Accurate info remains as is. Uncertain info is flagged for further review by both partners. False info is suggested to be removed or properly labeled. Findings published in a newly created misinformation section of the journal to serve as a database for cases of addressing medical misinformation, and for transparency/visibility . Once shared with the partner technology platform, the platform makes these findings easily accessible and shared concurrently with the original source. Correct information and the team's published findings are prioritized for online users. Routine check-ins and discussions continue between partner organizations in order to better establish protocols and troubleshoot for confusing situations or unaddressed questions. The biggest pandemic risk? Viral misinformation Social media and vaccine hesitancy A global survey of potential acceptance of a COVID-19 vaccine More Americans Now Willing to Get COVID-19 Vaccine Latest Data on COVID-19 Vaccinations Race/Ethnicity How are States Addressing Racial Equity in COVID-19 Kaiser Family Foundation 2021 Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study The spread of true and false news online World Health Organization Counteracting Health Misinformation: A Role for Medical Journals? Social Media in the Times of COVID-19 COVID-19: $6.5 million to help fight coronavirus misinformation Join to Combat Covid-19 Misinformation Officials gird for a war on vaccine misinformation