{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:03:59Z","timestamp":1782846239751,"version":"3.54.5"},"reference-count":65,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Infodemiology"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Digital media memes have emerged as influential tools in health communication, particularly during the COVID-19 pandemic. While they offer opportunities for emotional engagement and community resilience, they also act as vectors for health misinformation, contributing to the global infodemic. Despite growing interest in their communicative power, the role of memes in shaping public perception and misinformation diffusion remains underexplored in infodemiology.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This integrative review aims to analyze how memes influence emotional, behavioral, and ideological responses to health crises, and to examine their dual role as both contributors to and potential mitigators of infodemics. The paper also explores strategies for integrating memes into public health campaigns and infodemic management.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A comprehensive literature search was conducted across 3 major databases (MEDLINE, Scopus, and Web of Science), identifying a total of 386 records. Following duplicate removal and eligibility screening, 14 peer-reviewed studies published between 2020 and 2025 were included. An integrative narrative approach was used to synthesize evidence on social media behavior, misinformation dynamics, and digital health campaigns. The analysis was grounded in infodemiological and infoveillance frameworks as established by Eysenbach, incorporating insights from psychology, media studies, and public health.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Memes function as emotionally salient and visually potent carriers of health-related narratives. While they can simplify complex messages and foster adaptive humor during crises, they are also susceptible to distortion, particularly in echo chambers and conspiracy communities. Findings reveal that misinformation-laden memes often leverage humor and disgust to bypass critical thinking, and their viral potential is linked to emotional intensity. However, memes have also been successfully integrated into prebunking strategies, increasing engagement and reducing susceptibility to false claims when culturally tailored. The review identifies key mechanisms that enhance or hinder the infodemiological value of memes, including political orientation, digital literacy, and narrative framing.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Memes are a double-edged sword in the context of infodemics. Their integration into infodemic surveillance and digital health campaigns requires a nuanced understanding of their emotional, cultural, and epistemic effects. Public health institutions should incorporate meme analysis into real-time infoveillance systems, apply evidence-based meme formats in prebunking efforts, and foster digital literacy that enables critical meme consumption. Future infodemiology research should further explore the long-term behavioral impacts of memetic misinformation and the scalability of meme-based interventions.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/77029","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T11:25:06Z","timestamp":1752751506000},"page":"e77029-e77029","source":"Crossref","is-referenced-by-count":2,"title":["Internet Memes as Drivers of Health Narratives and Infodemics: Integrative Review"],"prefix":"10.2196","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-6117","authenticated-orcid":false,"given":"Alvaro","family":"Carmona Pesta\u00f1a","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5183-5679","authenticated-orcid":false,"given":"Iv\u00e1n","family":"Herrera-Peco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6330-9177","authenticated-orcid":false,"given":"Beatriz","family":"Jim\u00e9nez-G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8440-716X","authenticated-orcid":false,"given":"Carolina","family":"Su\u00e1rez-Llevat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"R1","unstructured":"Dawkins R . The Selfish Gene. Oxford University Press; 1976."},{"key":"R2","unstructured":"Managing the COVID-19 infodemic: promoting healthy behaviours and mitigating the harm from misinformation and disinformation. World Health Organization. Sep 23, 2020. URL: https:\/\/www.who.int\/news\/item\/23-09-2020-managing-the-covid-19-infodemic-promoting-healthy-behaviours-and-mitigating-the-harm-from-misinformation-and-disinformation [Accessed 09-12-2025]"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.33621\/jdsr.v5i3.151","article-title":"Meme-ifying data: the rise of public health influencers on Instagram, TikTok, and Twitter during COVID-19","volume":"5","author":"MacDonald","journal-title":"JDSR"},{"key":"R4","unstructured":"Chang HCH Pham B Ferrara E . Parasocial diffusion: K-pop fandoms help drive COVID-19 public health messaging on social media. arXiv. Preprint posted online on Oct 7, 2021. [doi: 10.48550\/arXiv.2110.04149]"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1177\/08901171241272075","article-title":"Using online memes to communicate about health: a systematic review","volume":"39","author":"Occa","journal-title":"Am J Health Promot"},{"issue":"7","key":"R6","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1016\/j.ajic.2020.11.019","article-title":"Healthcare worker\u2019s perspectives on use of memes as an implementation strategy in infection prevention: an exploratory descriptive analysis","volume":"49","author":"Reynolds","journal-title":"Am J Infect Control"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2023.1264780","article-title":"Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners","volume":"5","author":"Fitzpatrick","journal-title":"Front Digit Health"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.2196\/46345","article-title":"A model of social media effects in public health communication campaigns: systematic review","volume":"25","author":"Kite","journal-title":"J Med Internet Res"},{"issue":"10","key":"R9","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1109\/JPROC.2023.3273517","article-title":"Unlocking the emotional world of visual media: an overview of the science, research, and impact of understanding emotion","volume":"111","author":"Wang","journal-title":"Proc IEEE"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112552","article-title":"Systematic literature review on the spread of health-related misinformation on social media","volume":"240","author":"Wang","journal-title":"Soc Sci Med"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","first-page":"16598","DOI":"10.1038\/s41598-020-73510-5","article-title":"The COVID-19 social media infodemic","volume":"10","author":"Cinelli","journal-title":"Sci Rep"},{"issue":"9","key":"R12","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1016\/s0002-9343(02)01473-0","article-title":"Infodemiology: the epidemiology of (mis)information","volume":"113","author":"Eysenbach","journal-title":"Am J Med"},{"issue":"6","key":"R13","doi-asserted-by":"publisher","DOI":"10.2196\/21820","article-title":"How to fight an infodemic: the four pillars of infodemic management","volume":"22","author":"Eysenbach","journal-title":"J Med Internet Res"},{"issue":"5 Suppl 2","key":"R14","doi-asserted-by":"publisher","first-page":"S154","DOI":"10.1016\/j.amepre.2009.07.023","article-title":"Infoveillance: tracking online health information and cyber behavior for public health","volume":"37","author":"Eysenbach","journal-title":"Am J Prev Med"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","journal-title":"BMJ"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"35","DOI":"10.7592\/EJHR2021.9.4.558","article-title":"Ephemeral mimetics: memes, an X-ray of COVID-19","volume":"9","author":"Mart\u00ednez Cardama","journal-title":"EJHR"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1177\/20563051251318122","article-title":"Viral justice: TikTok activism, misinformation, and political engagement","volume":"11","author":"Jalli","journal-title":"Soc Media Soc"},{"issue":"11","key":"R18","doi-asserted-by":"publisher","first-page":"2573","DOI":"10.5455\/annalsmedres.2019.09.514","article-title":"The impact of social media news on the health perception of society","volume":"26","author":"Isik","journal-title":"Ann Med Res"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","DOI":"10.1177\/20563051221150412","article-title":"Misinformation on misinformation: conceptual and methodological challenges","volume":"9","author":"Altay","journal-title":"Social Media + Society"},{"issue":"12","key":"R20","doi-asserted-by":"publisher","DOI":"10.2196\/25230","article-title":"Social media and the transformation of the physician-patient relationship: viewpoint","volume":"23","author":"Forgie","journal-title":"J Med Internet Res"},{"issue":"4","key":"R21","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1057\/s41271-020-00247-w","article-title":"Leveraging media and health communication strategies to overcome the COVID-19 infodemic","volume":"41","author":"Mheidly","journal-title":"J Public Health Policy"},{"issue":"1","key":"R22","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.4102\/phcfm.v12i1.2389","article-title":"Social media health promotion in South Africa: opportunities and challenges","volume":"12","author":"Kubheka","journal-title":"Afr J Prim Health Care Fam Med"},{"issue":"1-2","key":"R23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10875301.2020.1861161","article-title":"The COVID-19 misinformation challenge: an asynchronous approach to information literacy","volume":"24","author":"Bonnet","journal-title":"Internet Ref Serv Q"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.822300","article-title":"A study on the correlation between media usage frequency and audiences\u2019 risk perception, emotion and behavior","volume":"12","author":"Li","journal-title":"Front Psychol"},{"issue":"8","key":"R25","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11081338","article-title":"Investigating the psychological, social, cultural, and religious predictors of COVID-19 vaccine uptake intention in digital age: a media dependency theory perspective","volume":"11","author":"Ma","journal-title":"Vaccines (Basel)"},{"issue":"9748","key":"R26","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1016\/S0140-6736(10)60809-4","article-title":"Use of mass media campaigns to change health behaviour","volume":"376","author":"Wakefield","journal-title":"Lancet"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","DOI":"10.2196\/19145","article-title":"The role of YouTube and the entertainment industry in saving lives by educating and mobilizing the public to adopt behaviors for community mitigation of COVID-19: successive sampling design study","volume":"6","author":"Basch","journal-title":"JMIR Public Health Surveill"},{"issue":"6","key":"R28","doi-asserted-by":"publisher","first-page":"455","DOI":"10.2471\/BLT.20.276782","article-title":"COVID-19-related misinformation on social media: a systematic review","volume":"99","author":"Gabarron","journal-title":"Bull World Health Organ"},{"issue":"1-2","key":"R29","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1002\/ajcp.12801","article-title":"This is fine: using memes to examine resilience, coping, and community for sexual minority men and nonbinary individuals during COVID\u201019","volume":"76","author":"Griffith","journal-title":"American J of Comm Psychol"},{"issue":"2","key":"R30","doi-asserted-by":"publisher","first-page":"353","DOI":"10.17645\/mac.v8i2.2852","article-title":"Memes of Gandhi and Mercury in anti-vaccination discourse","volume":"8","author":"Buts","journal-title":"MaC"},{"issue":"3","key":"R31","doi-asserted-by":"publisher","DOI":"10.1177\/20531680231193514","article-title":"By any memes necessary: belief- and chaos-driven meme diffusion in conspiracy networks","volume":"10","author":"Farhart","journal-title":"Res Polit"},{"issue":"3","key":"R32","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1177\/1750698017701615","article-title":"Conspiracy theories as part of history: the role of societal crisis situations","volume":"10","author":"van Prooijen","journal-title":"Mem Stud"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.2196\/40244","article-title":"Primary perspectives in meme utilization as a digital driver for medical community engagement and education mobilization: pre-post study","volume":"10","author":"Wang","journal-title":"JMIR Hum Factors"},{"issue":"1","key":"R34","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1192\/bjb.2020.120","article-title":"The contagiousness of memes: containing the spread of COVID-19 conspiracy theories in a forensic psychiatric hospital","volume":"46","author":"Panchal","journal-title":"BJPsych Bull"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2024.340","article-title":"Social media memes and early public opinion formation regarding Highly Pathogenic Avian Influenza (HPAI) as a public health threat in the United States","volume":"19","author":"Pascual-Ferr\u00e1","journal-title":"Disaster Med Public Health Prep"},{"issue":"6380","key":"R36","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.1126\/science.aap9559","article-title":"The spread of true and false news online","volume":"359","author":"Vosoughi","journal-title":"Science"},{"issue":"2","key":"R37","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1037\/h0101809","article-title":"Reminders and repetition of misinformation: Helping or hindering its retraction?","volume":"6","author":"Ecker","journal-title":"J Appl Res Mem Cogn"},{"issue":"17","key":"R38","doi-asserted-by":"publisher","DOI":"10.3390\/s24175456","article-title":"PolyMeme: fine-grained internet meme sensing","volume":"24","author":"Arailopoulos","journal-title":"Sensors (Basel)"},{"issue":"4","key":"R39","doi-asserted-by":"publisher","DOI":"10.1177\/20563051241296256","article-title":"Never mess with the \u201cmemers\u201d: how meme creators combat misinformation","volume":"10","author":"Mihailescu","journal-title":"Soc Media Soc"},{"issue":"5","key":"R40","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1007\/s11245-024-10112-0","article-title":"The function of memes in political discourse","volume":"43","author":"Anderau","journal-title":"Topoi (Dordr)"},{"issue":"5","key":"R41","doi-asserted-by":"publisher","first-page":"1990","DOI":"10.1108\/INTR-07-2022-0573","article-title":"Combating misinformation with internet culture: the case of Brazilian public health organizations and their COVID-19 vaccination campaigns","volume":"33","author":"Marx","journal-title":"INTR"},{"issue":"19","key":"R42","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191912969","article-title":"COVID-19 in memes: the adaptive response of societies to the pandemic?","volume":"19","author":"Sk\u00f3rka","journal-title":"Int J Environ Res Public Health"},{"issue":"9","key":"R43","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138740","article-title":"Emotional dynamics in the age of misinformation","volume":"10","author":"Zollo","journal-title":"PLoS One"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1057\/s41599-024-03083-5","article-title":"Emotions unveiled: detecting COVID-19 fake news on social media","volume":"11","author":"Farhoudinia","journal-title":"Humanit Soc Sci Commun"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1177\/07439156221103852","article-title":"Disinformation and echo chambers: how disinformation circulates on social media through identity-driven controversies","volume":"42","author":"Diaz Ruiz","journal-title":"J Public Policy Mark"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2024.108338","article-title":"Strategies to combat misinformation: enduring effects of a 15-minute online intervention on critical-thinking adolescents","volume":"159","author":"Orosz","journal-title":"Comput Human Behav"},{"issue":"5","key":"R47","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1080\/10410236.2019.1573295","article-title":"Seeking formula for misinformation treatment in public health crises: the effects of corrective information type and source","volume":"35","author":"van der Meer","journal-title":"Health Commun"},{"issue":"5","key":"R48","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1080\/13669877.2018.1443491","article-title":"The fake news game: actively inoculating against the risk of misinformation","volume":"22","author":"Roozenbeek","journal-title":"J Risk Res"},{"key":"R49","doi-asserted-by":"crossref","unstructured":"Barman D Conlan O . Evaluating prebunking and nudge techniques in tackling misinformation: a between-subject study on social media platforms. Presented at: HT \u201924: Proceedings of the 35th ACM Conference on Hypertext and Social Media; Sep 10-13, 2024; Poznan, Poland. [doi: 10.1145\/3648188.3675125]","DOI":"10.1145\/3648188.3675125"},{"issue":"3","key":"R50","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1111\/bjop.12551","article-title":"A comparison of prebunking and debunking interventions for implied versus explicit misinformation","volume":"113","author":"Tay","journal-title":"Br J Psychol"},{"issue":"2","key":"R51","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1007\/s11109-010-9112-2","article-title":"When corrections fail: the persistence of political misperceptions","volume":"32","author":"Nyhan","journal-title":"Polit Behav"},{"issue":"3","key":"R52","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1177\/08901171211070958","article-title":"How to combat health misinformation: a psychological approach","volume":"36","author":"Roozenbeek","journal-title":"Am J Health Promot"},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.2196\/65521","article-title":"Understanding and combating misinformation: an evolutionary perspective","volume":"4","author":"Bragazzi","journal-title":"JMIR Infodemiology"},{"issue":"2","key":"R54","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1007\/s10900-022-01170-9","article-title":"A multifaceted campaign to combat COVID-19 misinformation in the Hispanic community","volume":"48","author":"Silesky","journal-title":"J Community Health"},{"issue":"1","key":"R55","doi-asserted-by":"publisher","DOI":"10.1186\/s41235-024-00581-7","article-title":"Don\u2019t believe them! Reducing misinformation influence through source discreditation","volume":"9","author":"Ecker","journal-title":"Cogn Res Princ Implic"},{"issue":"6","key":"R56","doi-asserted-by":"publisher","first-page":"e397","DOI":"10.1016\/S2468-2667(24)00031-8","article-title":"Beyond misinformation: developing a public health prevention framework for managing information ecosystems","volume":"9","author":"Ishizumi","journal-title":"Lancet Public Health"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.51541.1","article-title":"Other ways of communicating the pandemic - memes and stickers against COVID-19: a systematic review","volume":"10","author":"Moya-Salazar","journal-title":"F1000Res"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2024.105478","article-title":"Have we found a solution for health misinformation? A ten-year systematic review of health misinformation literature 2013\u20132022","volume":"188","author":"Zhang","journal-title":"Int J Med Inform"},{"issue":"7","key":"R59","doi-asserted-by":"publisher","DOI":"10.2196\/17296","article-title":"Assessing the credibility and authenticity of social media content for applications in health communication: scoping review","volume":"22","author":"Jenkins","journal-title":"J Med Internet Res"},{"issue":"8","key":"R60","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-072258","article-title":"Conflict of interest and funding in health communication on social media: a systematic review","volume":"13","author":"Helou","journal-title":"BMJ Open"},{"issue":"1","key":"R61","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14885-0","article-title":"The potential of social media in health promotion beyond creating awareness: an integrative review","volume":"22","author":"Ghahramani","journal-title":"BMC Public Health"},{"issue":"12","key":"R62","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0296102","article-title":"Social media as a tool for oral health promotion: a systematic review","volume":"18","author":"Farrokhi","journal-title":"PLoS One"},{"key":"R63","doi-asserted-by":"publisher","DOI":"10.2196\/54241","article-title":"Social media potential and impact on changing behaviors and actions in skin health promotion: systematic review","volume":"27","author":"Brzozowska","journal-title":"J Med Internet Res"},{"issue":"12","key":"R64","doi-asserted-by":"publisher","first-page":"3173","DOI":"10.1017\/S136898002300246X","article-title":"A scoping review of health promotion interventions delivered via social media to women of reproductive age","volume":"26","author":"Henderson","journal-title":"Public Health Nutr"},{"issue":"5","key":"R65","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1007\/s00103-024-03836-2","article-title":"Mis- and disinformation in social media: mitigating strategies and public health implications","volume":"67","author":"Sch\u00fcz","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"}],"container-title":["JMIR Infodemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/infodemiology.jmir.org\/2025\/1\/e77029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:09:02Z","timestamp":1782842942000},"score":1,"resource":{"primary":{"URL":"https:\/\/infodemiology.jmir.org\/2025\/1\/e77029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,19]]},"references-count":65,"URL":"https:\/\/doi.org\/10.2196\/77029","relation":{},"ISSN":["2564-1891"],"issn-type":[{"value":"2564-1891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,19]]},"article-number":"v5i3e77029"}}