We wanted to begin this article with the well-known line attributed to Mark Twain, “a lie can travel halfway around the world while the truth is putting on its shoes”, a phrase endlessly quoted by journalists and commentators, especially during the COVID-19 pandemic, as a shorthand for how disinformation spreads. But when we decided to check its source, we found its veracity was in question.

Despite being a favourite of the press, it turns out that Mark Twain may not have said it at all; the expression is far older, with versions appearing centuries earlier in the works of Jonathan Swift, for example. The irony is hard to miss: in trying to illustrate the dangers of misinformation, journalists have themselves uncritically repeated a misattributed quote, unknowingly demonstrating the very problem they were attempting to critique. It is a reminder of how easily an appealing line, repeated blindly and accepted as received wisdom, can pass for truth and how even those set out to warn against falsehoods are not immune to lapses in critical thinking.

Nonetheless, the sentiment behind the quote rings true. The acetaminophen-autism controversy is yet another reminder that falsehood often outruns truth. President Trump’s claim was unfounded, but it carried an immediacy that the institutional responses lacked. To understand why, we need to consider the knowledge gap: how misinformation closes it, falsely, but persuasively, while scientific institutions often leave it open with caveats and hedging. The questions here are:

·       Why does false information spread so quickly?

·       Why does it stick?

·       Why does it outrun information from official sources?

The Emotional Efficiency of Misinformation

Misinformation resonates because it is emotionally efficient:

·       Fear: Autism was framed as a dire threat to unborn children.

·       Certainty: The causal link was presented as fact, without qualifications.

·       Identity: The “tough it out” line appealed to cultural ideals of maternal stoicism and sacrifice.

In communication terms, Trump narrowed the gap between expert and lay knowledge not by teaching science but by giving people a story they could understand and repeat. The narrative was wrong but it was easy. It offered clarity where scientific messaging offered only complexity.

The Cautious Inefficiency of Scientific Messaging

By contrast, institutional responses showed the opposite traits:

·       Caveats: “Association has been described” and “causal link not established” are scientifically precise but emotionally inert.

·       Balance: Acknowledging “conflicting studies” demonstrates transparency but sounds like uncertainty.

·       Process talk: Announcing label reviews and future guidance emphasises diligence but communicates delay and, mostly, few lay people would understand the procedures anyway.

The choices widened the knowledge gap. They positioned the audience as outsiders to the medical conversation, spectators to a process they could not fully understand.

Health Literacy and the Gap

This dynamic ties directly to health literacy. Functional, interactive and critical health literacies are especially vulnerable to the knowledge gap. When institutions use inaccessible language, they undermine interactive literacy (the ability to engage in dialogue) and critical literacy (the ability to evaluate claims). In the void, misinformation appears more compelling. The false narrative speaks directly to fear and identity, while the scientific narrative speaks past the audience.

Why Institutions Leave the Gap Open

Why do institutions persist in this style of communication? Partly it is risk aversion: hedging protects credibility. Partly it is habit: the medical register is deeply ingrained. And partly it is posturing: word salads make a person sound clever, after all. But all of this is a choice. Institutions choose to prioritise precision over resonance. By doing this, they choose to leave the gap open. In moments of controversy, that choice has consequences: people prefer what resonates and not necessarily what is accurate.

The Role of Commentators and Individual Clinicians

Not all voices faltered. Some clinicians and science communicators succeeded in communicating well:

·       Plain statements: “There is no link between Tylenol and autism.”

·       Empathetic framing: “We know this claim is frightening but untreated fever is more dangerous. Please treat it.”

·       Narrative countering: Recasting courage as care: “Protect your baby by protecting yourself”.

These messages combined accuracy with emotional accessibility. They closed the gap by speaking in the audience’s register without sacrificing truth. Their success highlights the shortcomings of institutional responses that did not.

Misinformation as a Gap-Filler

The acetaminophen controversy illustrates a broader principle: misinformation thrives not just because it is false but because it fills the silence left by institutions. When science speaks too cautiously, it creates space for simple, emotional answers. False information travels faster because it answers the emotional question, while science lingers on the technical one. Populism narrows the knowledge gap with feeling, while science widens it with caution.

Towards Better Practice

Closing the gap requires institutions to:

1.       Lead with clarity: Begin with the conclusion and not with the caveat.

2.       Pair facts with feeling: Recognise fear, identity and moral resonance as legitimate elements of communication.

3.       Invest in literacy: Support patient-friendly resources that strengthen function, interactive and critical health literacy.

4.       Counter narratives, not just facts: Challenge the emotional appeal of false information, not only its technical accuracy.

False information travels faster than truth not because the public prefers lies, but because institutions too often choose to leave the knowledge gap wide open. Populist rhetoric closes the gap, albeit falsely, by speaking in feeling. It gives people a taste of what they want to hear. Scientific institutions widen it with hedging and process talk. The lesson is that communication must be judged by accessibility and not just accuracy. If institutions want truth to catch up with false information, they must learn to close the knowledge gap themselves, by speaking in ways that resonate with both the mind and the heart.

Thank you for reading,

Mark Gibson, Leeds, United Kingdom

Nur Ferrante Morales, Bonilla de la Sierra, Spain

September 2025