The document discusses the role of social media in public health, particularly its influence on vaccination attitudes and behaviors. It highlights how people seek information online and the disparities in vaccination sentiments across different platforms, revealing trends and demographics in anti-vaccination discussions. The document concludes with the potential for strategic public health initiatives based on social media data to enhance vaccine uptake and confront misinformation.

1. What can Social Media Offer Public Health?
Sarah Amani
Chief Clinical Information Officer (CCIO)
Twitter: @S_Amani

2. About Me

4. What is Social Media?
Social media refers to the means of interactions
among people in which they create, share, and
exchange information and ideas in virtual
communities and networks.

5. • Facebook = Friend Builder
• Twitter = Broadcast & Community Builder
• YouTube = Broadcast Content to the World
• Flickr = Photographs to Inspire
• LinkedIn = Professional Connections
• Blogs = Your own online newspaper
• Social Bookmarking (Digg, Stumble) = Sharing
information

7. “The impact of social media on the balance
of power and knowledge between patient
and professional is enormously
significant...”
Disruptive Innovation Report, 2008

8. Implications
• Majority do vaccinate & immunise
themselves & their children
• But many have concerns over safety
• They are seeking information online & via
social media
• How reliable is this information?

9. The Wisdom of Crowds?

10. “A lie can travel halfway
around the world while the
truth is putting on its shoes.”
Mark Twain

11. INSIGHT
A Variety of Factors Influence Behaviour
Personal factors
• Knowledge and awareness – people might not have a good understanding of problem
• Attitudes – view on importance
• Habit – whether or not their other children had it
• Perceived behavioural control – how easy/hard they think it will be
• Emotions – fear of jabs, belief in probability of occurrence
Social factors
• Norms – how does their action fit within their peer groups/community?
Local and wider environment
• Travelling to the GPs
• Pre-existing condition
• Attending with multiple children
• Non-English speakers

12. Ajzen Theory of Planned Behaviour
Behavioural Beliefs
“This act will (will not) have
positive consequences.”
Subjective Norms
“People who are important to
me think I should (not do)
this.”
Perceived Behavioural
Control
“It will be easy (difficult) for me
to do this.”
Behavioural Intention
“I intend (do not intend) to do
this.”
Behaviour
“I actually do
(do not do)
this.”

13. Tracking Anti-Vaccination Sentiment in Europe Using
Social Media. Unicef, April 2013

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

17. 1. Positive: A positive sentiment means the author is likely to get the influenza A (H1N1)
vaccine e.g.
“Off to get swine flu vaccinated before work.”
2. Negative: A negative sentiment means the author is unlikely to get the influenza A
(H1N1) vaccine e.g
“What Can You Do To Resist The U.S. H1N1 "Vaccination" Program? Help Get Word Out.
The H1N1 "Vaccine" Is DIRTY. DontGetIt.”
3. Neutral: No clear sentiment can be detected e.g.
“The Health Department will be offering the seasonal flu vaccine for children 6 months - 19
yrs. of age starting on Monday, Nov. 16.”
4. Irrelevant: The tweet is not clearly about the influenza A(H1N1) vaccine.
“Filipino discovers new vaccine against malaria that 'treats' the mosquitoes, too!”

18. Results
•477,768 collected tweets,
•318,379 were classified as relevant to the influenza A (H1N1) vaccine.
•Of those, 255,828 were classified as neutral
•26,667 as negative,
•35,884 as positive.

19. Figure 1. (A) Total number of negative (red), positive (green), and neutral (blue) tweets relating to influenza A(H1N1)
vaccination during the Fall wave of the 2009 pandemic.
Salathé M, Khandelwal S (2011) Assessing Vaccination Sentiments with Online Social Media: Implications for Infectious Disease Dynamics and
Control. PLoS Comput Biol 7(10): e1002199. doi:10.1371/journal.pcbi.1002199
http://www.ploscompbiol.org/article/info:doi/10.1371/journal.pcbi.1002199

20. Main Limitations
1. Observational study - can't exclude other confounding factors (e.g.
vaccine supply)
2. Users of online social media might not be a representative sample of the
population;
3. Messages may be interpreted differently by different users, and
sentiment analysis is not 100% accurate

21. "These results could be used strategically to
develop public-health initiatives," Salathé
explained.
"For example, targeted campaigns could be
designed according to which region needs more
prevention education.
Such data also could be used to predict how many
doses of a vaccine will be required in a particular
area."

22. East Sussex County Council & NHS
Public health behaviour change
social media case study
Boosting the uptake of MMR vaccination

23. Creating a Social Movement:
Protecting & Improving the Lives of Children in
Sussex
www.qubemedia.ne
t
www.qubemedia.net

24. ‘We drip-fed messages and stories about MMR
without becoming repetitive’

25. So What?
• We MUST all play our part
• We NEED to improve digital literacy in the NHS
• We MUST confront misinformation
• We CAN increase immunisation

28. #NIC24

29. #NIC24

30. Thank You
Any Questions?
Any Questions?
sarah.amani@sabp.nhs.uk
@S_Amani