Tracking Anti-Vaccination Sentiment in Eastern European Social Media Networks

"'A lie can travel halfway around the world while the truth is putting on its shoes.' Mark Twain's quote is more relevant than ever in times of online communication, where information or misinformation, bundled in bits and bytes, streams around the earth within seconds."

Marking World Immunization Week 2013, this working paper tracks and analyses the rise of online anti-vaccination sentiments in Central and Eastern Europe by examining conversations across social media in 4 languages. The paper proposes a research model that detects and clusters commonly used keywords and intensity of user interaction. It also details key language and arguments used, as well as the influencers shaping the online conversation. The end goal is the development of targeted and efficient engagement strategies for health and communication experts in the field as well as for partner organisations. The paper was developed jointly by United Nations Children's Fund (UNICEF) Social and Civic Media Section and UNICEF Regional Office for Central and Eastern Europe and the Commonwealth of Independent States (CEE/CIS).

As detailed here, vaccination coverage in this region is generally high. As a result, vaccine-preventable childhood diseases like polio and measles have been absent in most countries for the past few decades. This has led to complacency toward the diseases and has unfortunately made vaccines, rather than the diseases, the focus of debate and discussion. Meanwhile, poorly managed immunisation campaigns in some countries have caused widespread mistrust of vaccines and government vaccination programmes. Most countries have run what are described here as "sluggish, high-handed public communication campaigns while avoiding transparent dialogue with the public on possible side effects, coincidental adverse events and other safety issues. Moreover, when new vaccines have been introduced, they have often just exacerbated the public's existing doubts, hesitations or outright resistance. Into this mix, rapid penetration of the internet in the region has provided a powerful, pervasive platform for anti-vaccine messages to be disseminated."

Researchers selected social media channels, languages, and formulated key word strings for online searches from May 1 2012 to June 30 2012. Messages from over 22,300 participants using English, Russian, Romanian, and Polish languages were monitored by volume (using mentions, views, postings), by: (i) channels through which users exchange content, (ii) engagement (how users respond, like, share), and (iii) sentiment analysis to detect positive and negative attitudes.

In brief, using those social media monitoring tools, the research described in this paper provides evidence that parents are actively tapping into social media networks to decide whether to immunise their children. The main findings are:

• In all 4 languages, blogs are the most frequently used channel for posting anti-vaccine content in social media (86% in Romanian, 85% in Polish, 65% in Russian, and 47% in English). Facebook is the second largest channel among all 4 languages. Twitter is the second largest channel in Russian, with 24% of total volume.
• While conversations on forums only make up 2% of total conversations, they account for 25% of interactions. The data skew towards female audiences on issues such as developmental disabilities (59%), chemical and toxins (56%), and side effects (54%). Men focus on arguments around conspiracy theory (63%) and religious/ethical beliefs (58%). Participants discussing anti-vaccination sentiments are approximately 56% female and 44% male.

During the observed time period, the most messages in English recorded used key words stemming from conspiracy theories, distrusts against governments, and the pharmaceutical industry. Religious and ethical beliefs, as well as distrust against the United States (US) and other Western governments, drive the Russian-speaking discussions.

Anti-vaccination opinion leaders in the online world show varying characteristics. Often they appear well educated in alternative medicine. Some have no college education, while others are in the medical field (such as nurses). They often subscribe to social channels of homeopaths and alternative medicine advocates.

UNICEF urges governments and partners to invest further in identifying anti-vaccination sentiment and map the extent to which it influences parental decisions not to immunise children. It is suggested here that "[i]nternational agencies and other partners will need to combine forces and support governments to reverse this counterproductive trend and develop common strategies to promote immunization, as one of the most successful and cost-effective health interventions known in the world."