How one GP is tackling the ‘dangerous’ scourge of medical misinformation

Evelyn Lewin

9/03/2021 4:55:23 PM

Dr Preeya Alexander is worried about the spread of COVID-19 misinformation on social media and fears it will only become worse as the vaccine rollout gets underway.

Dr Preeya Alexander
Dr Preeya Alexander received death threats when she talked about vaccines in the media last year.

For a number of years, Dr Preeya Alexander has been worried about the growing threat of medical misinformation.
It was the catalyst for her launching The Wholesome Doctor Instagram account and blog, but despite her best efforts, Dr Alexander is afraid that the issue is getting worse.
‘Social media has really changed the game for health professionals in that anyone – literally anyone – can now dish out health misinformation to huge numbers of followers,’ she told newsGP.
‘I find it extremely frustrating and I think it’s extremely dangerous.’
Even though medical misinformation has been a serious issue for years, Dr Alexander is particularly worried about the impact it could have as Australia rolls out the COVID-19 vaccine; especially as the Therapeutic Goods Administration (TGA) has restricted what health professionals can say about the vaccine online.
‘[The TGA] hamstrung the medical profession – really, all health professionals – when it said we need to be really careful about sharing our expert health opinions when it came to vaccination,’ she said.
However, it placed no such restrictions on a number of high-profile celebrities and influencers who Dr Alexander believes are spreading ‘huge amounts of misinformation’ about medical issues like vaccination ‘with not a skerrick of evidence’ to support the claims.
‘These people are free to say whatever they like with minimal repercussion, whereas we were told by the TGA that there could be significant repercussions for us if we discussed even the merits of vaccination within a pandemic, and that’s deeply concerning,’ she said.
‘It’s frustrating because there are clearly double standards for an unqualified health influencer [as opposed to] a health expert who actually has the qualifications to speak about health issues.’
Dr Alexander notes the TGA has since softened its stance, but says issues remain as some of the current standards about doctors’ use of social media are ‘fairly grey’ and open to interpretation.
‘I think more needs to be done to give us very clear guidelines on what is and isn’t allowed [to be said on social media] by the health profession,’ she said.
‘The guidelines from the TGA need to be much clearer.’
As it stands, the current TGA advice states that presenting factual and balanced information about COVID-19 vaccines is ‘unlikely’ to be considered as advertising or promotional, ‘subject to the context in which the information is presented’.
‘As a general guideline, if the content persuades consumers, for example through the use of promotional terms or language, to seek out COVID-19 vaccines, then it would be considered advertising,’ the guideline states.
Examples of ‘factual and balanced’ information unlikely to fall foul of the regulator include: 

  • a doctor providing their general view in relation to vaccination broadly (provided they do not promote individual vaccines – COVID-19 or otherwise)
  • technical information relating to how the vaccines were developed and manufactured
  • sharing scientific reports from reputable sources (like the World Health Organization) about vaccination
  • re-tweeting or sharing valuable newsworthy information from reputable sources about the COVID-19 vaccines that would not have the effect of promoting the vaccines; or
  • presenting comprehensive information that does not emphasise the benefits over, for example, the risks and limitations.
However, Dr Alexander remains concerned that restrictions placed on doctors about vaccines will limit the information the public receives via social media from health professionals.
As a result, she says even though the public already receives a ‘very skewed’ view on vaccines, the issue is exacerbated on social media.

It is important to encourage open discussion about concerns in a non-judgemental format.

‘Health professionals are literally silenced,’ she said. ‘Some of us were already nervous about discussing vaccination on social media, and now it’s even more complicated and anxiety-provoking.’
Dr Alexander is also concerned about how this silence is interpreted by the public.
‘That’s always been a fear of mine, if I’m being honest,’ she said.
‘People who are opposed to vaccination will often say, “The doctors are quiet. Of course they can’t talk … they’re all in the pocket of Big Pharma”.’
But while Dr Alexander is worried about how much misinformation the public is exposed to, she is also concerned that doctors may not be aware that any of this is happening.
‘As a profession we need to be so aware of what our patients are exposed to, so we can truly combat the misinformation and stop it from doing damage on a big scale,’ she said.
‘At the moment, what we’re seeing is these myths and misinformation on social media undermine a public health initiative in the vaccine rollout, and that’s terrifying.
‘And it’s terrifying that there’s a cohort of us who aren’t even aware of it.
‘They don’t know what their patients are exposed to, so how do you combat that in a consulting room when your patient is reluctant about vaccination?
‘How do you truly combat it if you don’t know what they’re actually seeing? They’re seeing stuff about tracking by the government, they’re seeing stuff about vaccines altering your DNA; that’s what they’re being exposed to.
‘I feel like a lot of our profession aren’t aware of what we’re really up against.’
As such, Dr Alexander believes it is important for health professionals to check their patients’ understanding and beliefs about vaccines, while also encouraging open discussion about concerns in a non-judgemental format.
She says there are a lot of patients who are not opposed to vaccinating per se, but are ‘slightly nervous’ about the COVID-19 vaccine and want more information.
‘I think we could do better at reassuring the community that [it] is completely okay to have questions and encourage them to ask the right people; people who are qualified, like their GP,’ she said.
‘Some people are feeling cautious which is fine, but they are then feeling labelled, judged or alienated by others, simply for wanting to ask questions.’
As a result, these people can gravitate towards groups who are more accepting of their concerns, which is ‘incredibly saddening and frustrating’.
Dr Alexander would like to see the medical profession elevate their voices about health issues in general, but can also understand why some might be reluctant.
‘Doctors are so worried about being attacked,’ she said. ‘I had death threats against my family when I spoke about vaccines last year.
‘People are really nervous about putting themselves out there, so we’re already on the back foot.
‘It’s like we’re starting 50 metres behind in a race that we’re never going to win.’
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Dr Graham James Lovell   10/03/2021 8:13:09 AM

I don’t believe I can ethically and morally give a true consent to any patient about to receive the Corona virus vaccine. As effectively the TGA “threats” have hamstrung us from clarifying the limited information the government wants us to conform to .
It feels like I’m living in a Communist state! I recommend reading the on line article from Hilda Bastion on how this type of government rhetoric actually harms rather than helps the immunisation program by destroying patient trust of them and us .

Dr Suzanne Michelle Daly   10/03/2021 8:44:41 AM

I have a soft approach You want to have some protection or not.I accept the answer it is their choice and it does not matter to me and I don't let it

Dr Steven Julius Sommer   10/03/2021 8:52:56 AM

Why is it that the UK has such a low rate of vaccination refusal (about 1 % I've heard). Can we learn from them? or is it just that death and morbidity are so imminent there that they don't have the 'luxury' to faff around with crazy theories.

Dr Abdul Ahad Khan   10/03/2021 10:23:29 AM

2. Mass IMMUNISATION is needed.
3. The Populace needs to be Re-assured that the COVID Vaccine is quite SAFE & it
has minimal Side-Effects.
4. The Social Media is full of MIS-INFORMATION.

Under these Circumstances, it is only us GPs who can remove our Patients' Fears.
Practicing PREVENTIVE MEDICINE is the Heart & Soul of General Practice.

When the Voice of us GPs are being MUTED, where is the Outrage & the Voice of RACGP / AMA ???