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The COVID-19 pandemic has highlighted the need for reliable information, especially around vaccines. Vaccine hesitancy is a growing concern and a great threat to broader public health. The prevalence of social media within our daily lives emphasizes the importance of accurately analyzing how health information is being disseminated to the public. TikTok is of particular interest, as it is an emerging social media platform that young adults may be increasingly using to access health information.
The objective of this study was to examine and describe the content within the top 100 TikToks trending with the hashtag #covidvaccine.
The top 250 most viewed TikToks with the hashtag #covidvaccine were batch downloaded on July 1, 2021, with their respective metadata. Each TikTok was subsequently viewed and encoded by 2 independent reviewers. Coding continued until 100 TikToks could be included based on language and content. Descriptive features were recorded including health care professional (HCP) status of creator, verification of HCP status, genre, and misinformation addressed. Primary inclusion criteria were any TikToks in English with discussion of a COVID-19 vaccine.
Of 102 videos included, the median number of plays was 1,700,000, with median shares of 9224 and 62,200 followers. Upon analysis, 14.7% (15/102) of TikToks included HCPs, of which 80% (12/102) could be verified via social media or regulatory body search; 100% (15/15) of HCP-created TikToks supported vaccine use, and overall, 81.3% (83/102) of all TikToks (created by either a layperson or an HCP) supported vaccine use.
As the pandemic continues, vaccine hesitancy poses a threat to lifting restrictions, and discovering reasons for this hesitancy is important to public health measures. This study summarizes the discourse around vaccine use on TikTok. Importantly, it opens a frank discussion about the necessity to incorporate new social media platforms into medical education, so we might ensure our trainees are ready to engage with patients on novel platforms.
Social media has become a prominent vehicle for educating both learners and the public. Learners and young physicians are increasingly savvy with these technologies [
Although the rapid development and emergency approval of multiple vaccines is something to be celebrated, vaccine hesitancy and misinformation remain significant obstacles to global vaccination. Vaccine hesitancy has been noted as one of the greatest threats to global health by the World Health Organization in 2019 [
Misinformation occurs when incorrect information is unintentionally propagated [
TikTok is the twin of “Douyin”—the Chinese short video app, originally known as “Musical.ly”—later rebranded as TikTok to a western audience [
Given the vast implications of perpetuating medical misinformation during the onset of the COVID-19 pandemic, past research has sought to explore TikTok’s role in vaccine misinformation. A study from the end of 2020 [
To close the gap between public perceptions and the science behind vaccines, there is certainly an avenue for engaging learners and providing them with tools to engage with the public more robustly [
Our cross-sectional study seeks to examine trends and attitudes toward COVID-19 vaccines by analyzing the most viewed TikToks with the hashtag #covidvaccine in July 2021 and specify which of these were generated by physicians and other HCPs.
We conducted a cross-sectional study of published TikToks with the hashtag #covidvaccine to characterize the discourse regarding vaccine use on the platform and to explore HCPs presence on the app regarding vaccine use. Furthermore, HCPs were identified and validated (ie, through regulatory bodies), which helped to show HPCs at what fields can better understand the sentiments of the general population, especially in regard to misinformation being spread.
The most viewed TikToks with the hashtag #covidvaccine were batch downloaded using the open source TikTokApi Python wrapper [
Primary inclusion criteria were any TikToks in English with discussion of a COVID-19 vaccine (either positive, negative, or neutral). Inclusion criteria were purposefully left as broad as possible to encompass as many TikToks that would refer to the COVID-19 vaccine and could be potentially viewed by a general TikTok user in the future. Exclusion criteria were TikToks in languages other than English and those not relating to COVID-19 vaccine or vaccine use (
Schematic workflow with inclusion and exclusion criteria.
The coding information was combined with the metadata to generate descriptive statistics and graphs. The data extraction and visualization workflow can be found in the study’s GitHub repository [
This study only analyzed publicly available data from existing data sets, and results do not contain any identifiable information that is not already in the public domain or are presented in aggregate.
Of the 102 coded TikToks, 19 (18.6%) contained vaccine-hesitant messaging, whereas 83 (81.3%) were provaccine. Median plays between these two groups were 290,000 and 160,000, respectively. Of note, many of the provaccine TikToks were simply people recording themselves receiving the vaccine or recording their experience and symptoms post vaccination. Other broad themes noted in the provaccine category were people celebrating vaccines as a measure to ending lockdowns, encouraging others to vaccinate themselves. Vaccine-hesitant TikToks generated higher median comments, shares, and author followers than provaccine TikToks (
General metrics of characteristics for both vaccine-hesitant and provaccine individual TikToks.
Characteristics | Vaccine hesitant (N=19)a | Provaccine (N=83)a |
Plays, median (IQR) | 2,900,000 (1,400,000-4,500,000) | 1,600,000 (1,100,000-3,000,000) |
Likes, median (IQR) | 447,800 (194,400-666,450) | 220,600 (168,250-369,200) |
Comments, median (IQR) | 6253 (3402-10,900) | 2963 (1408-5480) |
Shares, median (IQR) | 18,500 (4448-61,100) | 8986 (2636-16,800) |
Followers, median (IQR) | 191,400 (17,150-312,150) | 55,550 (7690-210,200) |
Health care expert, n (%) | 0 (0) | 15 (18) |
TikTok still present as of November 29, 2021, n (%) | 19 (100) | 75 (90) |
aTikToks were categorized as created by either a layperson or health care expert.
Violin plot depiction of individual TikTok metrics stratified as either vaccine hesitant (n=19) or pro-vaccine (n=83) as presented within
General metrics of individual TikTok characteristics created by laypeople or health care experts. Of note, 4 of the 15 health care expert–created TikToks are from the same user, Dr Noc.
Characteristics | Layperson (N=87) | Health care expert (N=15) |
Supporting vaccine, n (%) | 68 (78) | 15 (100) |
Plays, median (IQR) | 1,700,000 (1,100,000-3,300,000) | 1,300,000 (1,200,000-2,050,000) |
Likes, median (IQR) | 252,600 (180,800-501,900) | 173,100 (162,250-205,100) |
Comments, median (IQR) | 3545 (1408-7108) | 4562 (2268-5998) |
Shares, median (IQR) | 10,300 (3034-20,750) | 6885 (3142-12,200) |
Followers, median (IQR) | 53,000 (7804-198,300) | 209,000 (44,400-610,200) |
TikTok still present as of November 29, 2021, n (%) | 81 (93) | 13 (87) |
Violin plot depiction of individual TikTok metrics stratified by TikTok creator, either layperson (n=87) or health care expert (n=15), as presented within
Beyond general TikTok metrics, we performed content analysis to identify certain perceptions and misinformation associated with TikToks (n=19, 18.6%) containing vaccine-hesitant content. Most of vaccine-hesitant TikToks (n=10, 53%) did not voice any particular vaccine-hesitant themes other than that the person chose not to get vaccinated. From the remaining (n=9, 47%) vaccine-hesitant TikToks, several vaccine-hesitant sentiments were noted as follows:
We do not know the long-term side effects
The vaccine injects you with a microchip
The vaccine makes you magnetic
From these 9 vaccine-hesitant TikToks, 5 (55%) TikToks were listed as the individual creator’s “Top Liked” video; 8 of the 9 (88%) vaccine-hesitant TikToks pertained in some way to parodying or alluding to the vaccines causing neurological side effects that included dystonia or dysarthria; 2 out of the 9 (22%) vaccine-hesitant TikToks alleged that the vaccine injects you with a microchip that may make the individual magnetic.
When attempting to verify HCP status of all (n=15) HCP-related TikToks, 12 (80%) Tik Toks were able to be attributed to a verified HCP through assessing medical professional registries, professional or academic institutions, and social media verification blue check marks (on TikTok and Instagram;
Analysis of the specialty of the health care expert TikTok creators who were subsequently verified by JL and KvK. Total specialty number (n=12) does not align with total number of health care professional–created TikToks (n=15), as one creator within the research scientist category (Dr Noc) created multiple (n=3) TikToks within our analysis.
Specialty | Creators in each field, n | creators verified, n/N (%) |
Physician | 6 | 5/6 (83) |
Nurse | 2 | 2/2 (100) |
Doula | 1 | 0/1 (0) |
Pharmacist | 1 | 0/1 (0) |
Phlebotomist | 1 | 1/1 (100) |
Research scientist (Immunology) | 1 | 1/1 (100) |
Our study characterized the content on TikTok during the summer of 2021 by analyzing TikToks tagged under the hashtag #covidvaccine. The results allow us to draw some conclusions regarding attitudes prevalent on TikTok during this time. Most of TikToks were supportive of vaccination, though the vaccine-hesitant content garnered more likes, shares, and views. HCPs represented a small portion of creators and all created provaccine content. Generally, vaccine-hesitant content reflected fears about side effects of the vaccine that were unfounded, such as magnetism.
Over 80% (n=83) of TikToks included in the study contained provaccine sentiments (
Nevertheless, even with the improvements in promoting vaccine use, none of the 9 TikToks containing misinformation from our original analysis were removed from the TikTok platform by November 2021. This suggests that TikTok may not be fully successful with their misinformation policy and is still struggling with detecting misinformation on the platform, with certain vaccine-hesitant content remaining on the app for more than 5 months. It is important to note that the deletion of provaccine content TikToks may have been due to a variety of reasons, such as the user leaving the TikTok app, or more worryingly, due to harassment over provaccine sentiments [
Our analysis found that HCP-created TikToks accounted for 15% (n=15) of the total 102 most popular TikToks, and only 6% (n=6) were posted by physicians. This is only a slight increase from Southwick et al’s findings of 4% of individuals who were posting vaccine content on TikTok self-reporting as HCPs [
As this was a cross-sectional study, there are inherent limitations to interpreting trends found on TikTok for the month of July. The TikToks deemed viral at the time may not be viral currently, and this may change the viewership metrics. Future studies may benefit from comparing several cross-sectional studies and perform content analysis on how trends change over time as more vaccinations are rolled out globally. Our data extraction is also limited by TikTok’s algorithm, which is known to show users content related to their interests. Although the extracted TikToks were highly viewed, it is difficult to determine whether the views originated from people being recommended content by the “For You” page algorithm or whether individuals specifically searched out the #covidvaccine hashtag. Due to the small sample size of HCP content creators, it is difficult to draw conclusions on what makes an HCP creator reach a broad audience.
Further studies should work to continue to characterize HCP content to gain an understanding of how HCPs can better combat misinformation. Examination of more than one hashtag could better categorize the growing field of vaccine-related content. Furthermore, comparing the TikToks at two different time points could better depict the ever-changing discourse of vaccine use on TikTok. Future studies should seek to understand the underlying causes that allow TikToks with blatant misinformation to succeed on the app.
Given the 3 billion views of content about #covidvaccine [
The most viewed TikToks with the hashtag #covidvaccine downloaded.
TikToks reviewed by 2 authors (JL and KvK) encoded or categorized.
health care professional
The authors would like to thank Dr Yusuf Yilmaz for his invaluable help with citation management and TMC’s research group for their constructive feedback throughout the research process. TMC has received funding for her work about social media for education and knowledge translation from the Physician Services Incorporated (PSI) foundation in Ontario, Canada.
None declared.