Research from six countries including UK, USA and China shows that social media platforms are an important source of information about COVID-19 for some migrant and ethnic minority populations

New research to be presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2022, Lisbon, 23-26 April) reviews 21 studies from six countries on using social media for health information about COVID-19 – and shows that, for some migrant and ethnic minority populations, social media platforms such as Facebook, Twitter and YouTube, are important sources of information on COVID-19.

There were positive and negative associations with social media use reported, with some evidence suggesting circulating misinformation and social media use may be associated with lower participation in preventative health measures, including vaccine intent and uptake, findings which are likely to be relevant to multiple population groups.

However, the study – by Dr Lucy Goldsmith and Dr Sally Hargreaves (St George’s, University of London, UK) and colleagues – also highlights positive social media experiences that can increase the likelihood that people in these marginalised groups will be vaccinated – such as those posts that share personalised and culturally tailored public health information.

The authors say: “Urgent actions are now needed to better understand the use of social media platforms for accessing health information by different population groups ­– particularly groups who are marginalised from health systems.  Effective approaches are needed for  tackling circulating misinformation, and to seize on opportunities to make better use of social media platforms to support public health communication and improve vaccine uptake.”

The COVID-19 pandemic has been accompanied by a so called ‘infodemic’, defined by the WHO as excessive information ‘including false/misleading information’ which can amplify harmful messages and challenge trust in health authorities. Populations experiencing barriers to robust public health information, including migrants and ethnic minority groups, may be disproportionately impacted by misinformation circulating via social media, including on social media platforms (Facebook, Twitter, YouTube, Instagram), yet this has not been well evaluated to date.

In this research, the authors completed a systematic review to establish the use of social media by migrant and ethnic minority groups to access COVID-19 health information, and the extent to which this has influenced their response to COVID-19, including vaccination intention and uptake.

The authors systematically reviewed research listed in the WHO Global Research on COVID-19 database* for papers reporting the use of social media by migrants and ethnic minorities globally for information about COVID-19 and the impact of social media on the response of these groups to COVID-19. They included papers in all languages, with no geographical restrictions.

The final analysis included 21 studies from 6 countries (China, Jordan, Qatar, Turkey, UK and US) after screening 1849 unique records. For some migrants and ethnic minority groups, consistent use of social media platforms for sharing and receiving COVID-19-related health information was reported in several included studies. For example, social media was reported to be the preferred source of information about COVID-19 for international migrants in China (WeChat was used by 94.5% of respondents for COVID-19 information). Among 389 Syrian refugee mothers in Jordan, Facebook and WhatsApp were the main sources of COVID-19 information for 87% and 69% of respondents respectively.

The authors explain that some migrants and ethnic minority groups may experience barriers to accessing official public health information about COVID-19 in their host country, including language barriers, poor access, and low health literacy. Some studies made links between social media and circulating misinformation in migrant and ethnic minority groups, though evidence was limited. A small number of studies linked social media use with lower participation in preventative measures such as vaccination intent among migrants and ethnic minority groups, a finding generalisable to other population groups.

For example, A UK qualitative study of undocumented migrants found that among 23 participants who were hesitant about receiving a vaccine some participants described fears around theories based on misinformation, often originating from social media or word of mouth, with many describing feeling conflicted about which information sources to trust. Data suggest exposure to misinformation on social media correlates negatively with vaccine intent, but where social media is used to share personalised and culturally tailored public health information, there is a positive correlation with health knowledge and vaccine intent.

The study collated common misinformation circulating via social media platforms, including:

• Many will be infertile after having the COVID-19 vaccine.
• The COVID-19 vaccine contains a chip to track individuals.
• Yale University and the U.S. government are experimenting with propaganda to persuade Americans to take an unsafe experimental vaccine.
• Testing for COVID-19 is pointless as it gives so many false positives. Self-isolation is also ineffective.
• Children who test positive for COVID-19 at school will be taken into care and isolated from their parents until they test negative.
• All the monkeys used in initial testing of the COVID-19 vaccine later contracted COVID-19.
• COVID-19 is propaganda designed to control society.
• China or other governments deliberately made COVID-19 to control the population.
• COVID-19 has been invented to force everyone to use contactless payments which the government uses to track people
• 5G technology caused COVID-19

Other studies demonstrated how social media can successfully provide public health information in the media channel preferred by targeted groups in multiple languages. Local, trusted voices, including community leaders, delivering specific and targeted messages to counter fake news was also indicated to be successful.

The authors conclude: “Social media networks are important sources of health information for migrants and ethnic minority populations. Data, however, are lacking, particularly from low and middle-income settings, and further research is needed to better understand the impact of circulating misinformation via social media platforms on all populations, but particularly those who may be marginalised from health systems. In addition, it will be important now to seize on opportunities to make better use of social media platforms to support public health communication and improve vaccine uptake globally.”