Background: COVID-related misinformation is prevalent online, including on social media. The purpose of this study was to explore factors associated with user engagement with COVID-related misinformation on the social media platform, TikTok.

Methods: A sample of TikTok videos associated with the hashtag #coronavirus were downloaded on September 20, 2020. Misinformation was evaluated on a scale (low, medium, high) using a codebook developed by experts in infectious diseases. Multivariable modeling was used to evaluate factors associated with number of views and presence of user comments indicating intention to change behavior.

Results: 166 TikTok videos were identified. Moderate misinformation was present in 36 (22%) videos, and high-level misinformation was present in 11 (7%). After controlling for characteristics and content, videos containing moderate misinformation were less likely to generate a user response indicating intended behavior change. By contrast, videos containing high-level misinformation were less likely to be viewed but demonstrated a non-significant trend towards higher engagement among viewers.

Conclusions: COVID-related misinformation is less frequently viewed on TikTok but more likely to engage viewers. Public health authorities can combat misinformation on social media by posting content of their own.