Round table: Online anti-vaccination movements: the role of social media in public health communications
Authors:   Organised by: EUPHA (HP), DPH, EUPHA (IDC) Chair persons: Luís Saboga-Nunes - EUPHA (HP), Patty Kostkova - UK
Published: November 2019

Digital health has revolutionised healthcare, with implications for understanding public reaction to health emergencies and interventions. Social media provides a space where like-minded people can share interests and concerns in real-time, regardless of their location. This can be a force for good, as platforms like Twitter can spread correct information about outbreaks, for example in the 2009 swine flu pandemic. However, social media can also disseminate incorrect information or deliberately spread misinformation leading to adverse public health sentiment and outcomes. The current issues around trust in vaccines is the best-known example. Vaccine hesitancy, traditionally linked to issues of trust, misinformation and prior beliefs, has been increasingly fueled by influential groups on social media and the Internet. Ultimately, anti-vaccination movements have the potential to lead to outbreaks of vaccine-preventable diseases, especially if refusal is concentrated locally, creating vulnerable populations. For example, 2018-19 saw a large increase in incidence of measles in the US and Europe (where cases tripled from 2017), two regions where the disease was already or almost eliminated. In 2019, the World Health Organisation listed anti-vaccination movements as one of the top 10 threats to global public health. HPV vaccination is another example of the impact of anti-vaccination movements. As viral videos originating on YouTube spread across social networks, uptake has tumbled in a number of countries, with Japan, Denmark, Colombia and Ireland being badly hit. In Japan, the government came under sufficient pressure that they de-recommended HPV vaccine, seeing an 80% uptake rate fall below 1% in 2014. There have been reports of successful interventions by national governments. A recent campaign run by the HPV Alliance (a coalition of some 35 private companies, charities and public institutions) in Ireland has seen rates below 40% back up to a national average of 75%. A combination of hard-hitting personal testimonials, social media and traditional media promoted the HPV vaccine. Despite this, systematic engagement and supranational strategies are still in the early stages of being formulated. As misleading information spread through social media and digital networks has undesirable impact on attitudes to vaccination (and uptake rates), urgent actions are required. Analysis and visualisation techniques mining data streams from social media platforms, such as Twitter, Youtube enable real-time understanding of vaccine sentiments and information flows. Through identification of key influencers and flashpoints in articles about vaccination going viral, targeted public health responses could be developed. This roundtable discussion will showcase different ways in which media and social networks, accessible in real-time provide an opportunity for detecting a change in public confidence in vaccines, for identifying users and rumors and for assessing potential impact in order to know how to best respond.

Key messages

Social media has significantly enhanced our understanding of anti-vaccination movements and potential impact on public health attitudes and behaviors regarding vaccination. Innovative methods of analysing social media data, from digital health, data science and computer science, have an important role in developing health promotions to counter anti-vaccination movements.