Allergists Can Fight Misinformation by Anticipating Sources of Confusion and Engaging Patients With Facts and Curiosity

Esther Landhuis

November 12, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

With the Delta variant taking hold and COVID cases on the rise in mid-July, US Surgeon General Vivek Murthy, MD, MBA, released an advisory declaring that misinformation was a serious health threat and urging Americans to help slow its spread during the pandemic and beyond.

Last weekend, speakers at the American College of Allergy, Asthma, and Immunology (ACAAI) 2021 Annual Meeting, in New Orleans, Louisiana, issued a similar call to arms. "We have to take advantage of the very special role that we all play in the lives of our patients," said David Stukus, MD, an allergist-immunologist and professor of clinical pediatrics at Nationwide Children's Hospital, Columbus, Ohio. "We want to use that trust that we've developed with them to help combat misinformation."

According to a poll conducted by the Kaiser Family Foundation, personal doctors and pediatricians topped the list of trusted sources for reliable COVID-19 vaccine information, Gerald Lee, MD, associate professor of pediatrics at Emory University School of Medicine, Atlanta, Georgia, told attendees.

Social media usage has soared over the past decade. Today, 7 in 10 Facebook users say they visit the site daily, and nearly 80% of Americans who regularly get news on Snapchat and TikTok view social media as an important source of vaccine news, according to Pew Research Center data that Lee presented at the meeting.

Although research shows that most people do a decent job discriminating truth from fake news, when it comes to sharing news on social media platforms, that discernment drops considerably. "Users share misinformation without considering accuracy," said Lee, citing a March 2021 study published in Nature. Social media algorithms tend to promote content that is emotionally engaging. This amplification allows "a small number of activists to achieve influence," Lee said. Their continued, repetitive messaging "perpetuates misinformation to being accepted by the public," he said.

Anne Ellis, MD, chair of allergy and immunology at Queen's University, in Kingston, Ontario, Canada, called for vigilance among allergy practitioners to fight the cycle of misinformation and not let fake news shape medical decision making. "Make facts your hook when you're talking to patients" and explain that "science is an evolving process," Ellis said at ACAAI.

"Providing facts not only helps patients trust and value their provider's input, but facts also help patients challenge anxiety-provoking information they may have learned via social media," Tamara Hubbard, LCPC, told Medscape Medical News. Hubbard, a licensed counselor in the Chicago area, works with food-allergy families and maintains a resource website that includes an international directory of allergy-informed clinical therapists.

Stukus encouraged physicians to anticipate patients' confusion and to be proactive about engaging people on these topics. "Ask questions," he said. "See if they have any concerns about health-related information or about things impacting their allergic conditions." Observe nonverbal cues, he said. For example, when asking patients whether they have concerns about the COVID vaccine, "they may say no, but their body may say something different." Then, he said, take time "to dive into the nuance."

In addition, he advised clinicians to bear in mind the fact that many patients have trouble comprehending risk and to seek different ways to convey health information. "It's one thing to say only five out of a million people have anaphylaxis to COVID vaccines," Stukus said. "You can also state that 999,995 people out of the million didn't have anaphylaxis when they got a COVID vaccine. Some people need to hear that."

He advised that when conversations wander into unfamiliar territory, one should be humble and transparent. If a patient throws a stumper, "I say, 'I honestly don't know. But you've given me an assignment that I'll happily take on, so I can give you the right information about that particular question you just asked,' " Ellis said.

Stukus has consulted for Before Brands, Integrity CE, and Kaleo; works as social media editor for the American Academy of Allergy, Asthma and Immunology (AAAAI) and is associate editor for Annals of Allergy, Asthma and Immunology; and receives honoraria from the American College of Allergy, Asthma and Immunology (ACAAI), the American Academy of Pediatrics, and AAAAI. Ellis has received an honorarium from AstraZeneca to give webinars on managing allergic and adverse reactions to COVID-19 vaccines. Lee reports no relevant financial relationships. Hubbard is an allied health member of ACAAI and AAAAI and completed a paid project for the nonprofit organization Food Allergy Research and Education.

American College of Allergy, Asthma, and Immunology (ACAAI) 2021 Annual Meeting: Presented November 6, 2021.

Esther Landhuis is a freelance science journalist in the San Francisco Bay Area. She can be found on Twitter @elandhuis.

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