Social Media and Vaccine Hesitancy: Help Us Move the Needle.

With more than 75% of parents and pediatric caregivers getting their health-related information online, reaching families on social media is a powerful way to leverage the trust built in the examination room to address vaccine hesitancy. This article first reviews the ways the antivaccine movement has leveraged social media to expand its considerable influence, and why social media companies have failed to reduce antivaccine misinformation and disinformation. Next, it reviews the barriers to adoption of social media-based communication by pediatric health-care providers and concludes with action-oriented items to increase the adoption of this powerful tool.

#DoctorsSpeakUp: Lessons learned from a pro-vaccine Twitter event.

BACKGROUND: In response to growing anti-vaccine activism on social media, the #DoctorsSpeakUp event was designed to promote pro-vaccine advocacy. This study aimed to analyze Twitter content related to the event to determine (1) characteristics of the Twitter users who authored these tweets, (2) the proportion of tweets expressing pro-vaccine compared to anti-vaccine sentiment, and (3) the content of these tweets. METHODS: Data were collected using Twitter's Filtered Streams Interface, and included all publicly available tweets with the "#DoctorsSpeakUp" hashtag on March 5, 2020, the day of the event. Two independent coders assessed a 5% subsample of original tweets (n = 966) using a thematic content analysis approach. Cohen's κ ranged 0.71-1.00 for all categories. Chi-square and Fisher's exact tests were used to examine associations between tweet sentiment, type of account, and tweet content (personal narrative and/or statement about research or science). Accounts were analyzed for likelihood of being a bot (i.e. automated account) using Botometer. RESULTS: Of 847 (87.7%) relevant tweets, 244 (28.8%) were authored by a Twitter user that identified as a parent and 68 (8.0%) by a user that identified as a health professional. With regard to sentiment, 167 (19.7%) were coded as pro-vaccine and 668 (78.9%) were coded as anti-vaccine. Tweet sentiment was significantly associated with type of account (p < 0.001) and tweet content (p = 0.001). Of the 575 unique users in our dataset, 31 (5.4%) were classified as bots using Botometer. CONCLUSIONS: Our results suggest a highly coordinated response of devoted anti-vaccine antagonists in response to the #DoctorsSpeakUp event. These findings can be used to help vaccine advocates leverage social media more effectively to promote vaccines. Specifically, it would be valuable to ensure that pro-vaccine messages consider hashtag use and pre-develop messages that can be launched and promoted by pro-vaccine advocates.

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

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.

Psychometric evaluation of a caregiver diary for the assessment of symptoms of respiratory syncytial virus.

BACKGROUND: There are no clinical outcome assessment (COA) tools developed in accordance with Food and Drug Administration (FDA) guidance suitable for the evaluation of symptoms associated with respiratory syncytial virus (RSV) infection among infants. The Gilead RSV Caregiver Diary (GRCD) is being developed to fulfill this need; the present research evaluates the GRCD and documents its reliability, validity, and responsiveness among children < 24 months of age with acute RSV infection. METHODS: A prospective, observational study was conducted in the United States during the 2014-2015 northern hemisphere winter season. Subjects were < 24-month, full-term, previously healthy infants with confirmed RSV infection and ≤5 days of symptoms. The GRCD was completed twice daily for 14 days by caregivers. Additional data were collected during the initial visit, subsequent visits, and end-of-study interview. Test-retest reliability (kappa and intraclass correlation coefficients [ICCs]), construct validity (correlations and factor analyses), discriminating ability (analyses of variance and chi-square), and responsiveness (effect sizes and standardized response means) were evaluated. RESULTS: A total of 103 subjects were enrolled (mean age 7.4 ± 5.3 months). GRCD items were grouped into different subscales according to question content, which, with the exception of the behavior impact domain (ICC = 0.43), demonstrated internal consistency (alphas = 0.78-0.94) and test-retest reliability (ICCs = 0.77-0.94). Hypothesized correlations with parent global ratings of RSV severity ranged from 0.45 to 0.70 and provided support for construct validity. Support for discriminating ability was limited. Effect sizes ranged from - 1.48 to - 4.40, indicating the GRCD was responsive to change. CONCLUSIONS: These psychometric analyses support the validity, reliability, and responsiveness of the GRCD for assessing RSV symptoms in children < 24 months of age.