---
# System prepended metadata

title: Misinformation Fallout
tags: [live-v0.1, ' misinformation']

---

---
title: Misinformation Fallout
tags: live-v0.1, misinformation

permalink: https://c19vax.scibeh.org/pages/misinfo_fallout
---
{%hackmd 5iAEFZ5HRMGXP0SGHjFm-g %}
{%hackmd GHtBRFZdTV-X1g8ex-NMQg %}

# Fallout from COVID-19 misinformation
 
<span style="color:green">Beliefs in COVID-19 misinformation have been associated with reduced trust in public health guidelines and readiness to get vaccinated in multiple countries ([Roozenbeek et al., 2020](https://royalsocietypublishing.org/doi/full/10.1098/rsos.201199)). </span>As such, COVID-19 misinformation has a wide range of negative consequences for individuals and society overall:
* People who are misled often fail to engage in health-protective behaviours.
* People who are misinformed are less likely to get vaccinated.
* Misinformation has been directly linked to increased mortality rates.
* Misinformation and conspiracy theories have been linked to violence.

## Reduced health-protective behavior

A study by [Allington, Duffy, Wessely, Dhavan,  & Rubin, (2020)](https://www.cambridge.org/core/journals/psychological-medicine/article/healthprotective-behaviour-social-media-usage-and-conspiracy-belief-during-the-covid19-public-health-emergency/A0DC2C5E27936FF4D5246BD3AE8C9163) found a strong negative relationship between COVID-19 conspiracy beliefs and COVID-19 health-protective behaviours. That is, the more people endorsed conspiracy theories, the less likely they were to look after themselves and others. For example, instead of staying home and social distancing, believers in conspiracy theories tended to disregard those precautions. This is potentially problematic because these are behaviours known to reduce the risk of catching and spreading COVID-19 ([CDC, 2021](https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html)). 

Indeed, there is evidence to suggest that areas with greater exposure to cable news shows that downplay the threat of COVID-19 (e.g., Fox News) exhibit more non-compliance with stay-at-home orders ([Simonov, Sacher, Dube, & Biswas, 2020](https://https://www.nber.org/papers/w27237 )) and experience a greater number of cases and deaths ([Bursztyn, Rao, Roth, & Yanagizawa-Drott, 2020](https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3580487)).

<span style="color:green">Moreover, online disinformation and conspiracy theories can drive people to experiment with or demand unapproved and ineffective treatments, such as ivermectin or hydroxychloroquine ([Bertin, Nera, & Delouvée, 2020](https://www.frontiersin.org/articles/10.3389/fpsyg.2020.565128/full)).

## Reduced intent to vaccinate 

<span style="color:green">It is almost a truism that vaccine misinformation can reduce vaccine confidence and thus uptake, and therefore misinformation is indirectly causing hospitalizations and deaths in the unvaccinated ([Islam et al., 2021](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251605); [Pierri et al., 2021](https://arxiv.org/abs/2104.10635); [Loomba et al., 2021](https://www.nature.com/articles/s41562-021-01056-1)). 

Higher levels of COVID-19 conspiratorial thinking are also associated with being less willing to get tested for COVID-19 and reduced willingness to be vaccinated ([Freeman et al., 2020a](https://www.cambridge.org/core/journals/psychological-medicine/article/coronavirus-conspiracy-beliefs-mistrust-and-compliance-with-government-guidelines-in-england/9D6401B1E58F146C738971C197407461)). Unfortunately, conspiratorial thinking is far from rare, with approximately 25% of people in England showing conspiratorial thinking. ([Freeman et al., 2020a](https://www.cambridge.org/core/journals/psychological-medicine/article/coronavirus-conspiracy-beliefs-mistrust-and-compliance-with-government-guidelines-in-england/9D6401B1E58F146C738971C197407461)).

[Freeman et al., (2020b)](https://www.cambridge.org/core/journals/psychological-medicine/article/covid19-vaccine-hesitancy-in-the-uk-the-oxford-coronavirus-explanations-attitudes-and-narratives-survey-oceans-ii/C30FDB5C3D87123F28E351FDAAD5351A) found that 86% of vaccine hesitancy was predicted by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. This demonstrates that belief has a large impact as to whether individuals decide to get vaccinated. They found that while 72% of people in England were willing to be vaccinated, 17% were unsure, and 12% strongly hesitant.

<span style="color:green">Although it is difficult to establish a causal link, it has been established that U.S. residents who get their news mainly or exclusively from Facebook have much lower COVID-19 vaccination rates than those who do not use Facebook, and this has been attributed to the vast amount of misleading vaccine information circulating on the platform ([Lazer et al., 2021](https://osf.io/uvqbs/)).

<span style="color:green">[Wise (2021)](https://www.bmj.com/content/373/bmj.n921) argues that misinformation about the AstraZeneca vaccine in particular reduced public confidence in the vaccine, which [led to unwarranted skepticism and reduced uptake](https://www.politico.eu/article/trust-oxford-astrazeneca-coronavirus-vaccine-wanes-europe-survey/). 

<span style="color:green">In the UK, the vaccination uptake in younger people has been slower than it was in older age groups when they were first offered vaccination, and this has been in part [attributed to disinformation](https://blogs.bmj.com/bmj/2021/10/14/covid-19-vaccination-in-children-adolescents-and-young-adults-how-can-we-ensure-high-vaccination-uptake/?utm_source=twitter&utm_medium=social&utm_term=hootsuite&utm_content=sme&utm_campaign=usage). For example, a [bogus “consent form” with a fake NHS logo has been distributed to parents via schools](https://www.reuters.com/article/factcheck-nhs-letter-idUSL1N2QV1X4). 

<span style="color:green">Misinformation can be particularly impactful if it comes from health professionals, as the example of [mixed messages given to pregnant women demonstrates](https://www.theguardian.com/world/2021/jul/13/mixed-advice-driving-covid-vaccine-hesitancy-in-pregnant-uk-women?CMP=Share_iOSApp_Other). 

<span style="color:green">Preprints - research papers that have not undergone critical peer review, or indeed those that have been rejected by journals after peer review - are another potential source of misinformation, if the research rests on questionable analyses, contains errors, or is published by authors with vested interests ([Bagdasarian, Cross, & Fisher, 2020](https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01650-6)). This means that claims with poor evidence can make their way into headlines and viral social-media posts that create misconceptions that can lead to vaccine hesitancy. For example, a preprint by [Kafil et al. (2021)](https://www.medrxiv.org/content/10.1101/2021.09.13.21262182v1) exaggerating the risks of heart issues following COVID vaccination was retracted, but had been [disseminated widely through the (social) media](https://www.cbc.ca/news/health/covid-19-vaccine-study-error-anti-vaxxers-1.6188806); see [here](https://www.politifact.com/article/2021/sep/20/doubts-raised-over-preprint-study-regarding-myocar/) for a similar case).  

**Check out our [dedicated page](https://c19vax.scibeh.org/pages/publicattitudes) for the latest on public attitudes towards the COVID-19 vaccine.**
    
## <span style="color:green">Self-treatments with harmful substances

<span style="color:green">Misinformation about effective treatments for COVID-19 have been widespread throughout the course of the pandemic.
    
<span style="color:green">[The FDA](https://https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19) highlight reports of several patients requiring medical intervention and hospitalisation after taking ivermectin intended for livestock. In large doses, ivermectin can be extremely dangerous, and the medications provided to animals are considerably different than those intended for humans. Ivermectin is not approved for use in the treatment of COVID-19.

<span style="color:green">Following misinformation about disinfectants for COVID-19 prevention, [the CDC](https://https://www.cdc.gov/mmwr/volumes/69/wr/mm6923e2.htm?s_cid=mm6923e2_w) found a concerning number of survey respondents had either intentionally used household disinfectants directly on their skin, to wash their food, and had even inhaled or ingested these products.

<span style="color:green">Similarly, a number of cases of self-medication with hydroxycholoroquine or chloroquine were reported which have led to hospitalisations and even fatalities. In June 2020, [The FDA](https://https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or) revoked the emergency use authorization (EUA) to use hydroxychloroquine and chloroquine to treat COVID-19, and in July 2020, issued a detailed [safety review](https://https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/OSE%20Review_Hydroxychloroquine-Cholorquine%20-%2019May2020_Redacted.pdf) outlining the considerable risks of self-medicating with unprescribed hydroxychloroquine, including serious heart rhythm problems, blood and lymph system disorders, kidney injuries and liver failure.

    
## Violence

[Jolly and Paterson (2020)](https://bpspsychub.onlinelibrary.wiley.com/doi/pdf/10.1111/bjso.12394) found that belief in 5G COVID-19 conspiracy theories was associated with state anger, which in turn associated with a greater justification of real-life and hypothetical violence toward 5G mobile technology. This conspiracy theory has no basis in fact and is the result of people linking two new things that arrived at the same time - the pandemic and the rollout of the 5G network - are somehow connected to each other.

<span style="color:green">Misinformation has also been linked to hostility towards social groups perceived to be associated with COVID-19 ([Šrol, Cavojova, & Mikušková, 2021](https://psyarxiv.com/y4svc/)).

<span style="color:green">Misinformation about COVID treatment has led to [hospital staff being harassed and threatened](https://www.nbcnews.com/tech/tech-news/vigilante-treatments-anti-vaccine-groups-push-people-leave-icus-rcna2233). Healthcare staff are also being abused and threatened for promoting vaccination and sending out vaccination reminders ([Rimmer, 2021](https://www.bmj.com/content/373/bmj.n1665?utm_source=twitter&utm_medium=social&utm_term=hootsuite&utm_content=sme&utm_campaign=usage)).  

**Check out our [dedicated page](https://c19vax.scibeh.org/pages/misinfo_conspiracytheories) about COVID-19 conspiracy theories and how to deal with them.**

## Conclusion

Debunking of COVID-related misinformation is important because it may keep people from harming themselves and others by violating health guidelines. Debunking misinformation may also reduce demand for ineffective treatments and the propensity to share misinformation online ([MacFarlane et al. 2020](https://dx.doi.org/10.31234/osf.io/q3mkd)). 

**Detailed recommendations for best-practice debunking can be found in the [_Debunking Handbook 2020_](https://sks.to/db2020).**

----
<sub>Page contributors: Briony Swire-Thompson, Stephan Lewandowsky, Ullrich Ecker, Victoria Louise Smith </sub>

{%hackmd GHtBRFZdTV-X1g8ex-NMQg %}
{%hackmd TLvrFXK3QuCTATgnMJ2rng %}
{%hackmd oTcI4lFnS12N2biKAaBP6w %}
