Analysis of tweets discussing the risk of Mpox among children and young people in school (May-Oct 2022): Public health experts on Twitter consistently exaggerated risks and infrequently reported accurate information
Authors: Knudsen Benjamin , Høeg Tracy Beth , Prasad Vinay 
Published: May 2023

AbstractImportanceTwitter is used by health professionals to relay information. We sought to investigate the use of tweets to describe Mpox risks to children and young people in school during summer/ fall of 2022.ObjectiveTo determine the number of tweets discussing the risk of Mpox to children and young people in school and 1) determine accuracy, 2) for inaccurate tweets, determine if risk was minimized or exaggerated and 3) describe the characteristics of the accounts and tweets which contained accurate vs. inaccurate information.DesignRetrospective observational study.SettingTwitter advanced search in January 2023 of tweets spanning May 18th, 2022, to September 19th, 2022.ParticipantsAccounts labeled as: MD, DO, nurse, pharmacist, physical therapist, other health care provider, PhD, MPH, other Ed. degree, JD, health/medicine/public policy reporter (including students or candidates) who tweeted about the risk of Mpox to children and young people in school.ExposuresTweets containing the keywords ‘school’ and ‘mpox’, ‘pox’, or ‘monkeypox’ from May to October 2022.MeasuresThe primary outcome was the total of and ratio of accurate vs inaccurate tweets, the latter further subdivided by exaggerating or minimizing risk, and stratified by account author credential type. Secondary outcomes included total likes, retweets and follower counts by accurate vs inaccurate tweets, by month and account credentials. Finally, Twitter user exposure to inaccurate vs accurate Mpox tweets was estimated.Results262 tweets were identified. 215/262 (82%) were inaccurate and 215/215 (100%) of these exaggerated risks. 47/262 (18%) tweets were accurate. There were 163 (87%) unique authors of inaccurate tweets and 25 (13%) of accurate tweets. Among health care professionals, 86% (95/111) of tweets were inaccurate. Only health reporters, (23/41) 56% of tweets, were more likely to provide accurate information, however this was driven by one reporter. Multiplying accuracy by followers and retweets, Twitter users were approximately 974x more likely to encounter inaccurate than accurate information.ConclusionCredentialed Twitter users were 4.6 times more likely to tweet inaccurate than accurate messages. We also demonstrated how incorrect tweets can be quickly amplified by retweets and popular accounts. In the case of Mpox in children and young people, incorrect information exaggerated the risks 100% of the time.Key PointsQuestionWere tweets during the summer/ fall of 2022 that discussed the risk of Mpox to children and young people in school more likely to be inaccurate or accurate?FindingsCredentialed Twitter users discussing the risk of Mpox to children and young people in schools were 4.6 times more likely to tweet inaccurate than accurate messages. 215/262 (82%) tweets were inaccurate and 215/215 (100%) of these exaggerated risks. 47/262 (18%) were accurate.MeaningTwitter users were more often exposed to inaccurate than accurate information about the risk of Mpox to children and young people in school.