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Copyright (c) 2024 Omad Naif Aldhafeeri, Hamed Tarqi Alanazi, Ahmed Asi Hassan Alshammari, Abdullah Ali Mesfer Alharbi, Salamah Falah Aljameeli, Mashari Saad D Alshammari, Faisal Asi H Alshammari, Majed Hussain M Alanazi

This work is licensed under a Creative Commons Attribution 4.0 International License.
Weaponized Ignorance: A Narrative Review of Digital Infodemics as a Determinant of Health Equity and National Security in the Post-Truth Era
Corresponding Author(s) : Omad Naif Aldhafeeri
Saudi Journal of Medicine and Public Health,
Vol. 1 No. 2 (2024)
Abstract
Background: In the contemporary digital ecosystem, the emergence and amplification of health-related misinformation and disinformation—termed “infodemics”—has become a parallel crisis to biological pandemics. These infodemics, whether organic or deliberate, erode the foundational pillars of effective public health: trust, social cohesion, and evidence-based decision-making.
Aim: This narrative review aims to critically analyze the mechanisms and impacts of digital infodemics, framing them as a direct, non-traditional determinant of population health outcomes, health equity, and national security.
Methods: A comprehensive literature search was conducted across interdisciplinary databases (PubMed, Scopus, PsycINFO, Communication & Mass Media Complete) for peer-reviewed articles, reports, and policy documents from 2010-2024.
Results: The review identifies a triad of infodemic impacts: (1) Cognitive Sabotage, which fragments shared reality and fuels science denialism; (2) Behavioral Non-Compliance, directly reducing adherence to protective measures and vaccine uptake, disproportionately harming marginalized groups; and (3) Institutional Erosion, systematically degrading trust in health authorities and democratic institutions. These effects are often amplified by algorithmic platform architecture and, in some cases, deployed as a geopolitical strategy.
Conclusion: Digital infodemics constitute a profound threat to 21st-century health security, acting as a force multiplier for pathogens and a driver of inequity. Countering this threat requires a paradigm shift: recognizing information integrity as a public good and building multidisciplinary resilience through prebunking, strategic communication, platform accountability, and media literacy integrated into health equity frameworks.
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- 1. Abad, N., Bonner, K. E., Kolis, J., Brookmeyer, K. A., Voegeli, C., Lee, J. T., ... & Cohn, A. (2024). Strengthening COVID-19 vaccine confidence & demand during the US COVID-19 emergency response. Vaccine, 42, 125604. https://doi.org/10.1016/j.vaccine.2024.01.029
- 2. Aïmeur, E., Amri, S., & Brassard, G. (2023). Fake news, disinformation and misinformation in social media: a review. Social Network Analysis and Mining, 13(1), 30. https://doi.org/10.1007/s13278-023-01028-5
- 3. Béchard, B., Gramaccia, J. A., Gagnon, D., Laouan-Sidi, E. A., Dubé, È., Ouimet, M., ... & Tremblay, S. (2024). The resilience of attitude toward vaccination: Web-based randomized controlled trial on the processing of misinformation. JMIR Formative Research, 8, e52871. https://doi.org/10.2196/52871
- 4. Bradshaw, S., & Howard, P. N. (2018). The global organization of social media disinformation campaigns. Journal of International Affairs, 71(1.5), 23-32. https://www.jstor.org/stable/26508115
- 5. Broniatowski, D. A., Jamison, A. M., Qi, S., AlKulaib, L., Chen, T., Benton, A., ... & Dredze, M. (2018). Weaponized health communication: Twitter bots and Russian trolls amplify the vaccine debate. American journal of public health, 108(10), 1378-1384. https://doi.org/10.2105/AJPH.2018.304567
- 6. Carley, K. M. (2020). Social cybersecurity: an emerging science. Computational and mathematical organization theory, 26(4), 365-381. https://doi.org/10.1007/s10588-020-09322-9
- 7. Compton, J., Van Der Linden, S., Cook, J., & Basol, M. (2021). Inoculation theory in the post‐truth era: Extant findings and new frontiers for contested science, misinformation, and conspiracy theories. Social and Personality Psychology Compass, 15(6), e12602. https://doi.org/10.1111/spc3.12602
- 8. Damasceno, C. S. (2021). Multiliteracies for combating information disorder and fostering civic dialogue. Social Media+ Society, 7(1), 2056305120984444. https://doi.org/10.1177/2056305120984444
- 9. DeStefano, F., & Shimabukuro, T. T. (2019). The MMR vaccine and autism. Annual review of virology, 6(1), 585-600. https://doi.org/10.1146/annurev-virology-092818-015515
- 10. Dickson, K., Aboltins, C., Pelly, J., & Jessup, R. L. (2023). Effective communication of COVID-19 vaccine information to recently-arrived culturally and linguistically diverse communities from the perspective of community engagement and partnership organisations: a qualitative study. BMC Health Services Research, 23(1), 877. https://doi.org/10.1186/s12913-023-09836-3
- 11. Donovan, J. (2020). Concrete recommendations for cutting through misinformation during the COVID-19 pandemic. American journal of public health, 110(S3), S286-S287. https://doi.org/10.2105/AJPH.2020.305922
- 12. Evanega, S., Lynas, M., Adams, J., Smolenyak, K., & Insights, C. G. (2020). Coronavirus misinformation: quantifying sources and themes in the COVID-19 ‘infodemic’. JMIR Preprints, 19(10), 2020.
- 13. Evanega, S., Lynas, M., Adams, J., & Smolenyak, K. (2023). Coronavirus misinformation: Quantifying sources and themes in the COVID-19 ‘infodemic.’[Internet]. 2020.
- 14. Ferrara, M., Langiano, E., Esposito, M., Lo Moro, G., Lombardi, R., Vuolanto, P., & De Vito, E. (2024). Key factors in complex public health interventions to address vaccine hesitancy using a multidisciplinary approach: the VAX-TRUST project. Health Education Research, 39(6), 487-494. https://doi.org/10.1093/her/cyae027
- 15. Freedman, L. (2019). Ukraine and the Art of Strategy. Oxford University Press.
- 16. Gruzd, A., Tangcharoensathien, V., Calleja, N., Nguyen, T., Purnat, T., D’Agostino, M., ... & Briand, S. (2023). Framework for Managing the COVID-19 Infodemic: Methods and Results of an Online, Crowdsourced WHO Technical Consultation. https://doi.org/10.32920/21992087
- 17. Guess, A. M., & Munger, K. (2023). Digital literacy and online political behavior. Political science research and methods, 11(1), 110-128. doi:10.1017/psrm.2022.17
- 18. Karami, A., Lundy, M., Webb, F., Turner-McGrievy, G., McKeever, B. W., & McKeever, R. (2021). Identifying and analyzing health-related themes in disinformation shared by conservative and liberal Russian trolls on twitter. International journal of environmental research and public health, 18(4), 2159. https://doi.org/10.3390/ijerph18042159
- 19. Kearney, M. D., Chiang, S. C., & Massey, P. M. (2020). The Twitter origins and evolution of the COVID-19 “plandemic” conspiracy theory. Harvard Kennedy School Misinformation Review, 1(3). https://doi.org/10.37016/mr-2020-42
- 20. Kuatewo, M., Ebelin, W., Doegah, P. T., Kpodo, L., Kpordorlor, A. G., Lissah, S., ... & Ansah, E. (2024). “People will not even bring out their children to be immunised, because of the corona vaccine”: fake news, misinformation, vaccine hesitancy and the role of community engagement in COVID-19 vaccine acceptance in Southern Ghana. medRxiv, 2024-12. https://doi.org/10.1101/2024.12.22.24319502
- 21. Loomba, S., De Figueiredo, A., Piatek, S. J., De Graaf, K., & Larson, H. J. (2021). Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nature human behaviour, 5(3), 337-348. https://doi.org/10.1038/s41562-021-01056-1
- 22. McIntyre, L. (2018). Post-truth. MIt Press.
- 23. Murdan, S., Ali, N., Darlow, J., Christopher, E., Tolani, F., & Ashiru-Oredope, D. (2023). Enhancing the training of community engagement officers to address vaccine hesitancy: a university and local authority collaboration. Perspectives in Public Health, 143(4), 190-192. https://doi.org/10.1177/17579139221145616
- 24. Pennycook, G., Binnendyk, J., Newton, C., & Rand, D. G. (2021). A practical guide to doing behavioral research on fake news and misinformation. Collabra: Psychology, 7(1), 25293. https://doi.org/10.1525/collabra.25293
- 25. Reding, D. F., & Wells, B. (2022). Cognitive warfare: NATO, COVID-19 and the impact of emerging and disruptive technologies. In COVID-19 Disinformation: A Multi-National, Whole of Society Perspective (pp. 25-45). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-94825-2_2
- 26. Revez, J., & Corujo, L. (2024). Scientists’ behaviour towards information disorder: A systematic review. Journal of Information Science, 01655515241244460. https://doi.org/10.1177/01655515241244460
- 27. Roozenbeek, J., Schneider, C. R., Dryhurst, S., Kerr, J., Freeman, A. L., Recchia, G., ... & Van Der Linden, S. (2020). Susceptibility to misinformation about COVID-19 around the world. Royal Society open science, 7(10), 201199. https://doi.org/10.1098/rsos.201199
- 28. Shin, J., Dobson, G. B., Carley, L. R., & Carley, K. M. (2024, December). Design, Modeling and Simulation of Cybercriminal Personality-Based Cyberattack Campaigns. In 2024 Winter Simulation Conference (WSC) (pp. 2058-2069). IEEE. https://doi.org/10.1109/WSC63780.2024.10838743
- 29. Skafle, I., Nordahl-Hansen, A., Quintana, D. S., Wynn, R., & Gabarron, E. (2022). Misinformation about COVID-19 vaccines on social media: rapid review. Journal of medical Internet research, 24(8), e37367. https://doi.org/10.2196/37367
- 30. Tangcharoensathien, V., Calleja, N., Nguyen, T., Purnat, T., D’Agostino, M., Garcia-Saiso, S., ... & Briand, S. (2020). Framework for managing the COVID-19 infodemic: methods and results of an online, crowdsourced WHO technical consultation. Journal of medical Internet research, 22(6), e19659. https://doi.org/10.2196/19659
- 31. Uscinski, J. E., Enders, A. M., Klofstad, C., Seelig, M., Funchion, J., Everett, C., ... & Murthi, M. (2020). Why do people believe COVID-19 conspiracy theories?. Harvard Kennedy School Misinformation Review, 1(3). https://doi.org/10.37016/mr-2020-015
- 32. Van der Linden, S., Roozenbeek, J., Maertens, R., Basol, M., Kácha, O., Rathje, S., & Traberg, C. S. (2021). How can psychological science help counter the spread of fake news?. The Spanish journal of psychology, 24, e25. doi:10.1017/SJP.2021.23
- 33. Vosoughi, S., Roy, D., & Aral, S. (2018). The spread of true and false news online. science, 359(6380), 1146-1151. https://doi.org/10.1126/science.aap9559
- 34. Wardle, C., & Derakhshan, H. (2017). Information disorder: Toward an interdisciplinary framework for research and policymaking (Vol. 27, pp. 1-107). Strasbourg: Council of Europe.
- 35. Zarocostas, J. (2020). How to fight an infodemic. The lancet, 395(10225), 676. https://doi.org/10.1016/S0140-6736(20)30461-X
References
1. Abad, N., Bonner, K. E., Kolis, J., Brookmeyer, K. A., Voegeli, C., Lee, J. T., ... & Cohn, A. (2024). Strengthening COVID-19 vaccine confidence & demand during the US COVID-19 emergency response. Vaccine, 42, 125604. https://doi.org/10.1016/j.vaccine.2024.01.029
2. Aïmeur, E., Amri, S., & Brassard, G. (2023). Fake news, disinformation and misinformation in social media: a review. Social Network Analysis and Mining, 13(1), 30. https://doi.org/10.1007/s13278-023-01028-5
3. Béchard, B., Gramaccia, J. A., Gagnon, D., Laouan-Sidi, E. A., Dubé, È., Ouimet, M., ... & Tremblay, S. (2024). The resilience of attitude toward vaccination: Web-based randomized controlled trial on the processing of misinformation. JMIR Formative Research, 8, e52871. https://doi.org/10.2196/52871
4. Bradshaw, S., & Howard, P. N. (2018). The global organization of social media disinformation campaigns. Journal of International Affairs, 71(1.5), 23-32. https://www.jstor.org/stable/26508115
5. Broniatowski, D. A., Jamison, A. M., Qi, S., AlKulaib, L., Chen, T., Benton, A., ... & Dredze, M. (2018). Weaponized health communication: Twitter bots and Russian trolls amplify the vaccine debate. American journal of public health, 108(10), 1378-1384. https://doi.org/10.2105/AJPH.2018.304567
6. Carley, K. M. (2020). Social cybersecurity: an emerging science. Computational and mathematical organization theory, 26(4), 365-381. https://doi.org/10.1007/s10588-020-09322-9
7. Compton, J., Van Der Linden, S., Cook, J., & Basol, M. (2021). Inoculation theory in the post‐truth era: Extant findings and new frontiers for contested science, misinformation, and conspiracy theories. Social and Personality Psychology Compass, 15(6), e12602. https://doi.org/10.1111/spc3.12602
8. Damasceno, C. S. (2021). Multiliteracies for combating information disorder and fostering civic dialogue. Social Media+ Society, 7(1), 2056305120984444. https://doi.org/10.1177/2056305120984444
9. DeStefano, F., & Shimabukuro, T. T. (2019). The MMR vaccine and autism. Annual review of virology, 6(1), 585-600. https://doi.org/10.1146/annurev-virology-092818-015515
10. Dickson, K., Aboltins, C., Pelly, J., & Jessup, R. L. (2023). Effective communication of COVID-19 vaccine information to recently-arrived culturally and linguistically diverse communities from the perspective of community engagement and partnership organisations: a qualitative study. BMC Health Services Research, 23(1), 877. https://doi.org/10.1186/s12913-023-09836-3
11. Donovan, J. (2020). Concrete recommendations for cutting through misinformation during the COVID-19 pandemic. American journal of public health, 110(S3), S286-S287. https://doi.org/10.2105/AJPH.2020.305922
12. Evanega, S., Lynas, M., Adams, J., Smolenyak, K., & Insights, C. G. (2020). Coronavirus misinformation: quantifying sources and themes in the COVID-19 ‘infodemic’. JMIR Preprints, 19(10), 2020.
13. Evanega, S., Lynas, M., Adams, J., & Smolenyak, K. (2023). Coronavirus misinformation: Quantifying sources and themes in the COVID-19 ‘infodemic.’[Internet]. 2020.
14. Ferrara, M., Langiano, E., Esposito, M., Lo Moro, G., Lombardi, R., Vuolanto, P., & De Vito, E. (2024). Key factors in complex public health interventions to address vaccine hesitancy using a multidisciplinary approach: the VAX-TRUST project. Health Education Research, 39(6), 487-494. https://doi.org/10.1093/her/cyae027
15. Freedman, L. (2019). Ukraine and the Art of Strategy. Oxford University Press.
16. Gruzd, A., Tangcharoensathien, V., Calleja, N., Nguyen, T., Purnat, T., D’Agostino, M., ... & Briand, S. (2023). Framework for Managing the COVID-19 Infodemic: Methods and Results of an Online, Crowdsourced WHO Technical Consultation. https://doi.org/10.32920/21992087
17. Guess, A. M., & Munger, K. (2023). Digital literacy and online political behavior. Political science research and methods, 11(1), 110-128. doi:10.1017/psrm.2022.17
18. Karami, A., Lundy, M., Webb, F., Turner-McGrievy, G., McKeever, B. W., & McKeever, R. (2021). Identifying and analyzing health-related themes in disinformation shared by conservative and liberal Russian trolls on twitter. International journal of environmental research and public health, 18(4), 2159. https://doi.org/10.3390/ijerph18042159
19. Kearney, M. D., Chiang, S. C., & Massey, P. M. (2020). The Twitter origins and evolution of the COVID-19 “plandemic” conspiracy theory. Harvard Kennedy School Misinformation Review, 1(3). https://doi.org/10.37016/mr-2020-42
20. Kuatewo, M., Ebelin, W., Doegah, P. T., Kpodo, L., Kpordorlor, A. G., Lissah, S., ... & Ansah, E. (2024). “People will not even bring out their children to be immunised, because of the corona vaccine”: fake news, misinformation, vaccine hesitancy and the role of community engagement in COVID-19 vaccine acceptance in Southern Ghana. medRxiv, 2024-12. https://doi.org/10.1101/2024.12.22.24319502
21. Loomba, S., De Figueiredo, A., Piatek, S. J., De Graaf, K., & Larson, H. J. (2021). Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA. Nature human behaviour, 5(3), 337-348. https://doi.org/10.1038/s41562-021-01056-1
22. McIntyre, L. (2018). Post-truth. MIt Press.
23. Murdan, S., Ali, N., Darlow, J., Christopher, E., Tolani, F., & Ashiru-Oredope, D. (2023). Enhancing the training of community engagement officers to address vaccine hesitancy: a university and local authority collaboration. Perspectives in Public Health, 143(4), 190-192. https://doi.org/10.1177/17579139221145616
24. Pennycook, G., Binnendyk, J., Newton, C., & Rand, D. G. (2021). A practical guide to doing behavioral research on fake news and misinformation. Collabra: Psychology, 7(1), 25293. https://doi.org/10.1525/collabra.25293
25. Reding, D. F., & Wells, B. (2022). Cognitive warfare: NATO, COVID-19 and the impact of emerging and disruptive technologies. In COVID-19 Disinformation: A Multi-National, Whole of Society Perspective (pp. 25-45). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-94825-2_2
26. Revez, J., & Corujo, L. (2024). Scientists’ behaviour towards information disorder: A systematic review. Journal of Information Science, 01655515241244460. https://doi.org/10.1177/01655515241244460
27. Roozenbeek, J., Schneider, C. R., Dryhurst, S., Kerr, J., Freeman, A. L., Recchia, G., ... & Van Der Linden, S. (2020). Susceptibility to misinformation about COVID-19 around the world. Royal Society open science, 7(10), 201199. https://doi.org/10.1098/rsos.201199
28. Shin, J., Dobson, G. B., Carley, L. R., & Carley, K. M. (2024, December). Design, Modeling and Simulation of Cybercriminal Personality-Based Cyberattack Campaigns. In 2024 Winter Simulation Conference (WSC) (pp. 2058-2069). IEEE. https://doi.org/10.1109/WSC63780.2024.10838743
29. Skafle, I., Nordahl-Hansen, A., Quintana, D. S., Wynn, R., & Gabarron, E. (2022). Misinformation about COVID-19 vaccines on social media: rapid review. Journal of medical Internet research, 24(8), e37367. https://doi.org/10.2196/37367
30. Tangcharoensathien, V., Calleja, N., Nguyen, T., Purnat, T., D’Agostino, M., Garcia-Saiso, S., ... & Briand, S. (2020). Framework for managing the COVID-19 infodemic: methods and results of an online, crowdsourced WHO technical consultation. Journal of medical Internet research, 22(6), e19659. https://doi.org/10.2196/19659
31. Uscinski, J. E., Enders, A. M., Klofstad, C., Seelig, M., Funchion, J., Everett, C., ... & Murthi, M. (2020). Why do people believe COVID-19 conspiracy theories?. Harvard Kennedy School Misinformation Review, 1(3). https://doi.org/10.37016/mr-2020-015
32. Van der Linden, S., Roozenbeek, J., Maertens, R., Basol, M., Kácha, O., Rathje, S., & Traberg, C. S. (2021). How can psychological science help counter the spread of fake news?. The Spanish journal of psychology, 24, e25. doi:10.1017/SJP.2021.23
33. Vosoughi, S., Roy, D., & Aral, S. (2018). The spread of true and false news online. science, 359(6380), 1146-1151. https://doi.org/10.1126/science.aap9559
34. Wardle, C., & Derakhshan, H. (2017). Information disorder: Toward an interdisciplinary framework for research and policymaking (Vol. 27, pp. 1-107). Strasbourg: Council of Europe.
35. Zarocostas, J. (2020). How to fight an infodemic. The lancet, 395(10225), 676. https://doi.org/10.1016/S0140-6736(20)30461-X