Social media and HPV vaccination: Unsolicited public comments on a Facebook post by the Western Cape Department of Health provide insights into determinants of vaccine hesitancy in South Africa

Alison B Wiyeh; Sara Cooper; Anelisa Jaca; Edison Mavundza; Duduzile Ndwandwe; Charles S Wiysonge

doi:10.1016/j.vaccine.2019.09.019

Social media and HPV vaccination: Unsolicited public comments on a Facebook post by the Western Cape Department of Health provide insights into determinants of vaccine hesitancy in South Africa

Vaccine. 2019 Oct 8;37(43):6317-6323. doi: 10.1016/j.vaccine.2019.09.019. Epub 2019 Sep 11.

Authors

Alison B Wiyeh¹, Sara Cooper², Anelisa Jaca³, Edison Mavundza⁴, Duduzile Ndwandwe⁵, Charles S Wiysonge⁶

Affiliations

¹ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa. Electronic address: wberiliy@yahoo.co.uk.
² Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa. Electronic address: sara.cooper@mrc.ac.za.
³ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa. Electronic address: Anelisa.jaca@mrc.ac.za.
⁴ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa. Electronic address: Edison.mavundza@mrc.ac.za.
⁵ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa. Electronic address: Duduzile.ndwandwe@mrc.ac.za.
⁶ Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. Electronic address: charles.wiysonge@mrc.ac.za.

PMID: 31521412
DOI: 10.1016/j.vaccine.2019.09.019

Abstract

On the 4 February 2019, the Western Cape Department of Health's Facebook page announced the implementation of a school-based vaccination campaign aimed to administer the first doses of human papillomavirus (HPV) vaccine in public schools to Grade 4 girls who are nine years old. This announcement was met with a flurry of social media responses posted on the campaign's Facebook page. This study identifies determinants of vaccine hesitancy amongst responses provided by social media users to this post. On 8 March 2019, we conducted a qualitative study including all 157 comments to the Facebook post. The post had 659 'emotion' reactions: 574 "likes", 62 "loves", 21 "angry faces", 2 "laughs", 2 "wows" and 1 "sad face". An overwhelming majority (636/659 i.e. 97%) of reactions were favourable to the HPV vaccination campaign. Out of the 157 comments, we judged 52 (33%) of them to be 'hesitant', suggesting that people with negative reactions though few in number, were more likely to be vocal deniers. Concern around the safety of HPV vaccines including effects on reproductive health was the most common theme identified. Other emerging themes included: risk of cervical cancer perceived as being low, issues around consent, concerns that girls are being used for research, questionable vaccine effectiveness, use of the school-based strategy for the campaign, risk-benefits calculations of HPV vaccination and constraints such as stock-outs. Knowing someone who had been affected or being at risk of cervical cancer, having knowledge about the causes of cervical cancer, confidence in the effectiveness and safety of the vaccine, knowing the vaccine was being used in high income settings, and having strong recommendations from the World Health Organisation and key actors seemed to increase the willingness to accept the vaccine. The magnitude and causes of HPV vaccine hesitancy need to be investigated to ensure the success of this programme.

Keywords: HPV vaccine; Social media; South Africa; Vaccine acceptance; Vaccine hesitancy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Health Knowledge, Attitudes, Practice*
Humans
Immunization Programs
Papillomavirus Infections / prevention & control*
Papillomavirus Vaccines / administration & dosage
Parents
Patient Acceptance of Health Care*
Social Media*
South Africa
Vaccination / psychology*
Vaccination / statistics & numerical data
Vaccination Refusal / psychology*

Substances

Papillomavirus Vaccines