• Axén I
• Bergström C
• Bronson M
• Côté P
• Glissmann Nim C
• Goncalves G
• Herbert JJ
• Hertel JA
• Innes S
• Larsen OK
• Meyer AL
• O'Neill S
• Perle SM
• Weber KA II
• Young KJ
• Leboeuf-Yde C

• Affiliation / Centre for Disability Prevention and Rehabilitation (CDPR), Ontario Tech University and Canadian Memorial Chiropractic College (CMCC)
• Affiliation / Evidence Based Chiropractic Network
• Affiliation / Institut Franco-Européen de Chiropraxie (IFEC)
• Affiliation / Karolinska Institutet. Institute of Environmental Medicine. Unit of Intervention and Implementation Research for Worker Health
• Affiliation / Murdoch University. College of Science, Health, Engineering and Education. Discipline of Psychology, Exercise Science, Counselling and Chiropractic (PESCC)
• Affiliation / Norwegian Chiropractic Research Foundation
• Affiliation / Ontario Tech University. Faculty of Health Sciences
• Affiliation / Private Practice
• Affiliation / Stanford University School of Medicine. Division of Pain Medicine, Systems Neuroscience and Pain Lab. Department of Anesthesiology, Perioperative and Pain Medicine
• Affiliation / Umeå University. Department of Clinical Sciences
• Affiliation / University Hospital of Southern Denmark. Spine Centre of Southern Denmark
• Affiliation / University of Bridgeport. School of Chiropractic
• Affiliation / University of Central Lancashire. School of Sport and Health Sciences
• Affiliation / University of New Brunswick. Faculty of Kinesiology
• Affiliation / University of Southern Denmark. Institute of Regional Health Research
• Affiliation(G) / Australia / Western Australia / Perth
• Affiliation(G) / Canada / New Brunswick / Fredericton
• Affiliation(G) / Canada / Ontario / Kirkland Lake
• Affiliation(G) / Canada / Ontario / Oshawa
• Affiliation(G) / Canada / Ontario / Toronto
• Affiliation(G) / Denmark / Odense
• Affiliation(G) / France / Ivry-sur-Seine
• Affiliation(G) / Norway / Oslo
• Affiliation(G) / Norway / Tønsberg
• Affiliation(G) / Sweden / Stockholm
• Affiliation(G) / Sweden / Umeå
• Affiliation(G) / United States / California / Palo Alto
• Affiliation(G) / United States / Connecticut / Bridgeport
• Chiropractic / standards
• Communication
• Coronavirus Infections
• COVID-19
• Data Collection / methods
• Deception
• Health Education
• Information Dissemination
• Information Seeking Behavior
• Internet / standards
• Manipulation, Spinal
• Open Access Document
• Pandemics
• Professionalism
• Social Media

Background: In March 2020, the World Health Organization elevated the coronavirus disease (COVID-19) epidemic to a pandemic and called for urgent and aggressive action worldwide. Public health experts have communicated clear and emphatic strategies to prevent the spread of COVID-19. Hygiene rules and social distancing practices have been implemented by entire populations, including ‘stay-at-home’ orders in many countries. The long-term health and economic consequences of the COVID-19 pandemic are not yet known.

Main text: During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements.

We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies.

Conclusions: Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.

Author keywords: Covid-19, Chiropractors, Spinal manipulation, Professional traditionalism, Infodemic, Debate

Author affiliations: IA: Karolinska Institutet, Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Stockholm, Sweden; IA: The Norwegian Chiropractic Research Foundation "Et liv I Bevegelse", ELIB, Oslo, Norway; CB: Umeå University, Department of Clinical Sciences, Unit of Obstetrics and Gynecology, Umeå, Sweden; MB: Evidence Based Chiropractic Network, Private practice, Kirkland Lake, Ontario, Canada; PC: Faculty of Health Sciences, Ontario Tech University and Centre for Disability Prevention and Rehabilitation at Ontario Tech University and Canadian Memorial Chiropractic College, Oshawa [and Toronto], Ontario, Canada; CGN, SO: Spinecentre of Southern Denmark, University Hospital of Southern Denmark, Odense, Denmark; CGN, SO, CL-Y: Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; GG, A-LM: Institut Franco-Européen de Chiropraxie [IFEC], Ivry-sur-Seine, France; JJH: Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada; JJH: Discipline of Psychology, Exercise Science, Counselling and Chiropractic, Murdoch University, Perth, Australia; JAH: Private practice, Tønsberg, Norway; SMP: College of Health Sciences, School of Chiropractic, University of Bridgeport, Bridgeport, Connecticut, United States; KAW II: Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Systems Neuroscience and Pain Lab, Palo Alto, California, United States; KJY: University of Central Lancashire, School of Sport and Health Sciences, Preston, United Kingdom

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