Quantifying Public Engagement With Science and Malinformation on COVID-19 Vaccines: Cross-Sectional Study

Medical journals are critical vanguards of research, and previous years have seen increasing public interest in and engagement with medicoscientific findings. How findings propagate and are understood and what harms erroneous claims might cause to public health remain unclear, especially on publicly contentious topics like COVID-19 vaccines. Gauging the engagement of the public with medical science and quantifying propagation patterns of medicoscientific papers are thus important undertakings. In contrast to misinformation and disinformation, which pivot on falsehood, the more nuanced issue of malinformation, where ostensibly true information is presented out of context or selectively curated to cause harm and misconception, has been less researched. As findings and facts can be selectively marshaled to present a misleading picture, it is crucial to consider this issue and its potential ramifications.

This study aims to quantify patterns of public engagement with medical research and the vectors of propagation taken by a high-profile incidence of medical malinformation.

In this work, we undertook an analysis of all altmetric engagements over a decade for 5 leading general-purpose medical journals, constituting approximately 9.8 million engagements with 84,529 papers. We identify and examine the proliferation of sentiment concerning a high-profile publication containing vaccine-negative malinformation. Engagement with this paper, with the highest altmetric score of any paper in an academic journal ever released, was tracked across media outlets worldwide and in social media users on Twitter (subsequently rebranded as X). Vectoring media sources were analyzed, and manual sentiment analysis on high-engagement Twitter shares of the paper was undertaken, contrasted with users' prior vaccine sentiment.

Results of this analysis suggested that this COVID-19 scientific malinformation was much more likely to be engaged and amplified with negative by vaccine-negative Twitter accounts than neutral ones (odds ratio 58.2, 95% CI 9.7-658.0; P<.001), often alluding to the ostensible prestige of medical journals. Malinformation was frequently invoked by conspiracy theory websites and non-news sources (71/181 citations, 39.2%) on the internet to cast doubt on the efficacy of vaccination, many of whom tended to cite the paper repeatedly (51/181, 28.2%).

Our findings suggest growing public interest in medical science and present evidence that medical and scientific journals need to be aware of not only the potential overt misinformation but also the more insidious impact of malinformation. Also, we discuss how journals and scientific communicators can reduce the influence of malinformation on public understanding.