It's not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook

Beth L Hoffman; Elizabeth M Felter; Kar-Hai Chu; Ariel Shensa; Chad Hermann; Todd Wolynn; Daria Williams; Brian A Primack

doi:10.1016/j.vaccine.2019.03.003

It's not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook

Vaccine. 2019 Apr 10;37(16):2216-2223. doi: 10.1016/j.vaccine.2019.03.003. Epub 2019 Mar 21.

Authors

Beth L Hoffman¹, Elizabeth M Felter², Kar-Hai Chu³, Ariel Shensa⁴, Chad Hermann⁵, Todd Wolynn⁶, Daria Williams⁷, Brian A Primack⁸

Affiliations

¹ Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States; Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, United States. Electronic address: blh72@pitt.edu.
² Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, United States. Electronic address: emfelter@pitt.edu.
³ Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States. Electronic address: chuk@pitt.edu.
⁴ Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States. Electronic address: ariel.shensa@pitt.edu.
⁵ Kids Plus Pediatrics, 4070 Beechwood Blvd., Pittsburgh, PA 15217, United States. Electronic address: chad@kidspluspgh.com.
⁶ Kids Plus Pediatrics, 4070 Beechwood Blvd., Pittsburgh, PA 15217, United States. Electronic address: todd@kidspluspgh.com.
⁷ Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States. Electronic address: dcw36@pitt.edu.
⁸ Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States; Health Policy Institute, University of Pittsburgh, 311 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, United States; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States. Electronic address: bprimack@pitt.edu.

PMID: 30905530
DOI: 10.1016/j.vaccine.2019.03.003

Abstract

Background: Due in part to declining vaccination rates, in 2018 over 20 states reported at least one case of measles, and over 40,000 cases were confirmed in Europe. Anti-vaccine posts on social media may be facilitating anti-vaccination behaviour. This study aimed to systematically characterize (1) individuals known to publicly post anti-vaccination content on Facebook, (2) the information they convey, and (3) the spread of this content.

Methods: Our data set consisted of 197 individuals who posted anti-vaccination comments in response to a message promoting vaccination. We systematically analysed publicly-available content using quantitative coding, descriptive analysis, social network analysis, and an in-depth qualitative assessment. The final codebook consisted of 26 codes; Cohen's κ ranged 0.71-1.0 after double-coding.

Results: The majority (89%) of individuals identified as female. Among 136 individuals who divulged their location, 36 states and 8 other countries were represented. In a 2-mode network of individuals and topics, modularity analysis revealed 4 distinct sub-groups labelled as "trust," "alternatives," "safety," and "conspiracy." For example, a comment representative of "conspiracy" is that poliovirus does not exist and that pesticides caused clinical symptoms of polio. An example from the "alternatives" sub-group is that eating yogurt cures human papillomavirus. Deeper qualitative analysis of all 197 individuals' profiles found that these individuals also tended to post material against other health-related practices such as water fluoridation and circumcision.

Conclusions: Social media outlets may facilitate anti-vaccination connections and organization by facilitating the diffusion of centuries old arguments and techniques. Arguments against vaccination are diverse but remain consistent within sub-groups of individuals. It would be valuable for health professionals to leverage social networks to deliver more effective, targeted messages to different constituencies.

Keywords: Anti-vaccination; Facebook; Health communication; Social media.

MeSH terms

Autistic Disorder / epidemiology*
Autistic Disorder / etiology
Evaluation Studies as Topic
Humans
Immunization Programs
Public Opinion*
Social Media*
Social Networking
Socioeconomic Factors
Vaccination / adverse effects*
Vaccination / psychology
Vaccines / adverse effects

Substances

Vaccines