User-Driven Comments on a Facebook Advertisement Recruiting Canadian Parents in a Study on Immunization: Content Analysis

Abstract

BackgroundMore people are searching for immunization information online and potentially being exposed to misinformation and antivaccination sentiment in content and discussions on social media platforms. As vaccination coverage rates remain suboptimal in several developed countries, and outbreaks of vaccine-preventable diseases become more prevalent, it is important that we build on previous research by analyzing themes in online vaccination discussions, including those that individuals may see without actively searching for information on immunization.ObjectiveThe study aimed to explore the sentiments and themes behind an unsolicited debate on immunization in order to better inform public health interventions countering antivaccination sentiment.MethodsWe analyzed and quantified 117 user-driven open-ended comments on immunization posted in the Comments section of a Facebook advertisement that targeted Canadian parents for recruitment into a larger study on immunization. Then, 2 raters coded all comments using content analysis.ResultsOf 117 comments, 85 were posted by unique commentators, with most being female (65/85, 77%). The largest proportion of the immunization comments were positive (51/117, 43.6%), followed by negative (41/117, 35.0%), ambiguous (20/117, 17.1%), and hesitant (5/117, 4.3%). Inaccurate knowledge (27/130, 20.8%) and misperceptions of risk (23/130, 17.7%) were most prevalent in the 130 nonpositive comments. Other claims included distrust of pharmaceutical companies or government agencies (18/130, 13.8%), distrust of the health care system or providers (15/130, 11.5%), past negative experiences with vaccination or beliefs (10/130, 7.7%), and attitudes about health and prevention (10/130, 7.7%). Almost 40% (29/74, 39%) of the positive comments communicated the risks of not vaccinating, followed by judgments on the knowledge level of nonvaccinators (13/74, 18%). A total of 10 positive comments (10/74, 14%) specifically refuted the link between autism and vaccination.ConclusionsThe presence of more than 100 unsolicited user-driven comments on a platform not intended for discussion, nor providing any information on immunization, illustrates the strong sentiments associated with immunization and the arbitrariness of the online platforms used for immunization debates. Health authorities should be more proactive in finding mechanisms to refute misinformation and misperceptions that are propagating uncontested online. Online debates and communications on immunization need to be identified by continuous monitoring in order for health authorities to understand the current themes and trends, and to engage in the discussion.

Systematic Literature Review on the Spread of Health-related Misinformation on Social Media

“…For instance, Basch et al (2017), Donzelli et al (2018) and Porat et al (2018) report high online prevalence and popularity of autism-related discussions in fora on vaccination. Tustin et al (2018) and Xu and Guo (2018) also reported widespread misinformation about side effects, as well as mistrust in government or pharmaceutical companies in discussions on vaccination. Krishna's (2017) study of active propagators of these messages found that those who were knowledge-deficient and vaccine-averse exhibit higher levels of activity than those who are not.…”

Analysis of the Anti-Vaccine Movement in Social Networks: A Systematic Review

“…Facebook users who showed negative feelings about vaccines are introduced as a "pro-science" group that tries to give information about vaccines that is supposedly being hidden [18]. Tustin et al [19] revealed that the comments of this social network mostly speak about distrust towards pharmacists or healthcare providers and include negative experiences with vaccines. These studies are based on the new advertising tool from Facebook, in which anti-vaccination ads have been included talking about alleged institutional fraud and promoting vaccination [20].…”

“…In terms of interaction, comments in favor of immunization receive more "likes" than those against [21], although the latter group consumes more content [22]. As on Twitter, antivaccine users based their posts and comments on personal stories, vaccines risks, vaccine components, distrust in pharmaceutical industry and conspiratory theories [18][19][20][21][22]. Even though pro-vaccine users and posts have more presence, anti-vaccine users seems to grow more cohesively on Facebook than pro-vaccine groups [22].…”

Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases

“…2,4,5 Amongst the barriers to universal vaccination, misinformation regarding the benefits, medicinal composition, and adverse effects of vaccination limits patient understanding and overall buy-in. 6 As patients increasingly consult the Internet and peer networks, such as those generated on social media, for health information, growing interest has emerged in the role of interactive social media in public health promotion. [7][8][9][10] However, there is also substantial potential for harmful misinformation to spread across networks which may be propagated via the contemporary anti-vaccination movement, fueling vaccine hesitancy.…”