Background: Between the United States and Canada, TikTok hosts more than 175.8 million active users. While originally known for entertainment, the platform has rapidly evolved into a major source of education, news, and health-related content. Because of its wide reach and immediate accessibility, it is essential to evaluate the accuracy and quality of medical information being disseminated. In this study, we assessed the reliability, quality, and profession of creators producing TikTok videos under the hashtag #Flushots.Given the public health relevance of influenza vaccination, misinformation on this topic has the potential to influence vaccine uptake and community health outcomes. Social media platforms often lack standardized oversight mechanisms, making user-generated content highly variable in accuracy. Understanding who creates this content and how it is presented can help identify gaps in public health communication. Ultimately, improving the reliability of medical information on TikTok may enhance patient education and promote evidence-based health behaviors.
Methods: Two new TikTok accounts were created to minimize algorithm-driven personalization. The hashtag #flushot was searched on TikTok, and the top 50 videos appearing in the United States and top 50 videos in Canada were reviewed. For each video, creator and video characteristics were recorded, including creator type and demographic information. Video informational quality was assessed using the DISCERN questionnaire, which evaluates the reliability of health information, and the Global Quality Scale (GQS), a 5-point measure of overall educational quality. All statistical analyses, including comparisons between creator groups and countries, were performed using Microsoft Excel.
Results: Across 100 videos, healthcare providers (HCPs) produced higher-quality content than non-healthcare creators. HCP videos had significantly higher DISCERN (2.03 vs 1.42, p = 0.005) and GQS scores (2.37 vs 1.29, p = 0.0002). This pattern held in both countries, with HCPs outperforming non-HCPs in the United States and Canada on both DISCERN and GQS measures (all p < 0.05). Country comparisons showed similar quality among HCP creators, while Canadian non-HCP videos had higher DISCERN scores than US non-HCPs (p = 0.03). Engagement metrics (likes and shares) did not differ significantly between groups.
Conclusions: Healthcare professionals consistently produced higher-quality TikTok content than non-healthcare creators in both the United States and Canada, although engagement levels were similar across groups. These findings highlight the need to promote accurate, clinician-created information while addressing the popularity of lower-quality content posted by non-professionals. Additionally, the results underscore the importance of strengthening digital health literacy so viewers can better distinguish credible information from misinformation. Efforts to elevate trustworthy content may benefit from platform-level interventions, such as verification mechanisms or algorithmic promotion of evidence-based videos. Future research should explore the impact of targeted educational campaigns on user engagement with high-quality content. Ultimately, enhancing the visibility of reliable medical information is critical to supporting informed public health decision-making.
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