The video posted to TikTok showed a woman in a blue cardigan and brown medical scrubs dancing to a remix of Wale's "Lotus Flower Bomb."
On screen, sandwiched between two sparkle emojis, the woman, who said she was a pharmacy technician, had written, "Most common meds I've filled that cause cancer." She then went on to claim medications like hormonal birth control, cholesterol medications and chemotherapy were cancer causing.
So, Savannah Sparks, another TikTok user who goes by “Rx0rcist,” made her own video, part of what would become an ongoing series debunking medical misinformation on the app.
“My name’s Savannah. I’m a doctor at a pharmacy, and I’m about to absolutely wreck your s---,” Sparks says in the video before launching into a fact-check of the pharmacy technician's claims.
But Sparks didn't stop there. She then contacted the woman's supervisor.
"Her scope of practice doesn't allow her ... to counsel on medications so, especially coming from the realm of pharmacy, which is my wheelhouse, I really went in on that individual and I was like, 'You really should not be talking about this,'" Sparks said.
Sparks, 31, a Mississippi-based lactation consultant and doctor of pharmacy who is also a mother of a 2-year-old daughter, has become a prolific watchdog on TikTok for those she says are trying to spread misinformation — especially health care workers spreading bogus information about Covid-19.
“In the past, I have been a little more reserved with how aggressive I have gone after these people, but the longer this pandemic went on, and the more and more misinformation we started seeing as health care workers on social media, the less I started caring about my tone and coming across a certain way,” Sparks said.
This has earned her a massive following on TikTok. Her account has more than 467,000 followers and her videos rack in hundreds of thousands — and sometimes millions — of views.
Sparks said she is not only looking for the removal of health care misinformation on the platform, but she also wants accountability.
"Anything that forces somebody to change their way of thinking ... it makes them angry," Sparks said. "So, keeping that in mind, the fact that I'm doing this to so many people, I accept I'm doing exactly what I need to be doing, and I'm exactly where I need to be."
This approach to calling alleged offenders out has made her the target of online harassment. Her address has been posted on extremist websites, and her inboxes have been flooded with threats of rape and death against both her and her daughter, which, at one point, became so relentless it nearly drove her off the internet.
Misinformation and callouts
Sparks’ most exhaustive callouts are part of a series on her TikTok that she calls “Petty Journal Club with Sav.” She said the videos began as a way to thwart general health care misinformation from spreading on the app, but soon morphed to be more specific as she said she realized some health care workers were not only propagating misinformation about the pandemic, but also teaching their followers how they could get around Covid restrictions.
Using public information and social media, Sparks said she would identify the TikTokers making dubious claims or bragging about skirting rules and contact their employers or, in the most egregious cases, their respective field’s licensing board in an attempt to hold them accountable.
And with TikTok’s algorithm frequently elevating Sparks’ videos to the “For You” page, the platform’s infinite scroll homepage, she continued to draw in even more viewers and followers.
Sparks decides how to handle bad actors on a case-by-case basis, she said, contacting a person privately if she feels their intent is not malicious. If a person makes what she thinks is a major misstep — like a health care worker saying they don’t wear masks outside of work, spreading misinformation about medications or stealing vaccination cards — Sparks said she will share that person’s offending TikTok with her followers, explaining why the person is wrong.
“It’s different for each case depending on how much information I can get on an individual and how egregious their error was online, because some aren’t as bad as others,” Sparks said.
Sparks says one of her first "Petty Journal Club with Sav" videos was the pharmacy technician, who claimed certain medications cause cancer.
When Sparks contacted the woman’s supervisor on Facebook, the supervisor was shocked, she said.
“She was like, ‘Oh, my gosh. I’m ashamed. I can’t believe she’s posting that kind of information,’” Sparks recalled.
Karen North, a professor of digital social media at the University of Southern California’s Annenberg School for Communication and Journalism, said one reason viewers are drawn to this type of content is because it's like a catharsis for their real-life frustration around rule breakers.
“We all know people who have done things that step over the lines in terms of what we think is right during a pandemic, whether it’s not wearing a mask or being anti-vaxxers or jumping the line to get a vaccine … to the extent we’re frustrated by people we know in our own social circles who are breaking our rules. We can now go online and not only watch someone break a rule but watch someone attack someone for breaking a rule,” North said.
After a public callout on her page, Sparks said, the subject will sometimes go private or delete their various social media accounts.
Sparks says she is meticulous about her work and knows she has a responsibility to do her due diligence first because her callouts could have hundreds of thousands of eyes on them and serious ramifications for the poster.
“Even if they volunteer all that information on their own, linking their social media and where they work, unless I can be pretty certain that what they’re saying is not a joke or what they’re saying does have some malicious intent, I’m not going to push hard because I know that when I go in, I go all in,” she said.
She does, however, recall once getting a detail of a callout wrong. A nurse, whom she had called out, listed a hospital as an employer on her Facebook, which Sparks included in a video about the nurse. The only problem? The nurse no longer worked there and a horde of Sparks’ followers had contacted the facility demanding that person be fired.
“People started calling that hospital and then I reached out to the hospital directly and said, ‘This is what has happened. I’m sorry,’" Sparks said.
The roots of callout culture
Jessa Lingel, an associate professor at the Annenberg School for Communication at the University of Pennsylvania who studies digital culture, said callout culture has a long history on social media, and began as a way for people of color to create accountability around major social issues.
“Cancel culture, callout culture, that really comes from practices on Black Twitter of bringing attention to an issue and saying, hey, this is a thing where we need to align. Whether it’s #MeToo in its early days, that originated on Black Twitter, or whether that’s tied to Black Lives Matter or police brutality. Callout culture originated on Black Twitter,” she said.
Lingel added that callout culture has since evolved from a political tool into a way individuals can get back at one another on social media for real or perceived grievances. This often gives way to someone being labeled a “Karen.”
But Sparks has embraced the Karen moniker when it comes to her TikTok content — and she’s not the only one.
TikToker Aunt Karen, 31, who asked that NBC News not use her real name or location in order to protect her safety, is renowned on the app for calling out those who have been caught engaging in racist behaviors.
“The internet has always been a tool, but now it’s an even bigger tool and it’s the main frame for holding people accountable,” Aunt Karen said.
Behind the scenes, Sparks and Aunt Karen said the people who make content calling out bad behavior on the internet, many of whom are women, have built a network supporting one another, and sometimes work together.
“What I think is great is even though we all call people out, there’s different things that these creators speak out on. Aunt Karen talks a lot about racism and, as [she’s] a woman of color, I can learn a lot from that … Not only do I get to make a friend but I learn a ton from these people,” Sparks said.
While experts say Sparks and Aunt Karen’s callouts — which have collectively drawn millions of views — can provide a counternarrative to those seeking more information, they’re doubtful TikTok vigilantism will change people’s deep-seated views, adding that research into online shaming shows it doesn’t generally bring about significant change.
“Health care workers during Covid have enjoyed a lot of public support generally speaking and so that doesn’t mean mistakes can’t be made and that we shouldn’t pay attention to those mistakes. But, in general, the research on online shaming is not optimistic on whether any of this is going to have much of an impact,” Lingel said.
Research also shows that online shaming is inherently impossible to police and can devolve into abuse, including threats of physical or sexual violence. Moreover, online shaming tends to dehumanize those on the receiving end and can turn a person who has violated a social norm into a target undeserving of empathy in the eyes of an online mob.
The subjects of callout culture are not the only ones who have had to pay a price for having the eyes of the internet locked on them.
On March 28, Sparks posted a video announcing she was stepping away from TikTok because of an onslaught of harassment.
She said her address and phone number were posted online, and that her direct messages on Instagram were flooded with death threats directed both at her and her young daughter. Her business pages were bombed with negative reviews. And links to her TikTok account were posted to extremist forum 4chan.
“They posted aerial photos of my mom’s house on 4chan, which they paired next to a video of me and my sister dancing in her backyard to confirm that I was still at her house so they could plan to murder, rape, and kill me,” Sparks said.
Sparks said she had always endured modest backlash for her content, but the harassment ratcheted up in March to the point it became unbearable.
"I was getting probably a hundred [direct messages] a day, just every few minutes in my message requests on Instagram, in comments," she said, recalling that she was sent messages "saying things like, ‘Kill yourself,’ ‘I’m going to rape you,’ ‘I’m going to rape your daughter,’ Very graphic.”
The wave of ceaseless harassment and threats began, she said, after she posted a video about safety precautions she takes when running and got worse when she began calling out the alleged forged vaccine cards that some health care workers were bragging about on TikTok.
“They went to my Facebook business page, they found my family, they found all my friends and started messaging them. Same thing, just graphic kinds of death threats,” Sparks said.
Then, she said, when her information ended up on 4chan, she said trolls began contacting businesses she affiliates with as a lactation consultant, claiming she was a racist and asking that they no longer do business with her. The attacks continued to escalate until someone posted her phone number and the aerial photo of her mother’s house.
NBC News reviewed nearly 20 of the threats sent to Sparks, some of which were sent by accounts with names like “times_up_savannah,” created solely to harass her.
Sparks eventually filed a complaint with her local sheriff’s office and then made the decision to make her callout videos private and step away from TikTok.
But about two weeks later she returned to the app. She said she feels it’s her “duty to stand up and do the right thing,” emphasizing that she wants to use her platform to be an ally to marginalized voices and to others like Aunt Karen, who are also making callout content on TikTok.
“If I’m not willing to do it, who else would step up to do it?” Sparks said. “... A lot of people say, ‘Well, it’s not a big deal, it’s just TikTok.’ But the things that I talk about are a huge deal. Public health is a huge deal, especially when 500,000 Americans have died from this virus.”