Using Social Media for Vaccination Promotion: Practices and Challenges

"Study participants expressed optimism about social media's potential for promoting vaccination, but identified obstacles to exploiting its promise."

Vaccination misinformation is prevalent on social media and has potential to decrease public confidence or trust in the safety and effectiveness of vaccines. This research aimed to understand and analyse the experiences of vaccine-promoting organisations on social media, including how they use it and the challenges they face.

In October 2017, the researchers assembled a list of Australian organisations promoting vaccination on Facebook and Twitter, purposively sampling from 5 categories: advocacy groups, government health departments, health services, professional associations, and technical/scientific organisations. Between November 2017 and July 2018, 21 individuals responsible for routine social media activity or strategy in 17 vaccine-promoting organisations took part in 60-minute face-to-face or telephone interviews.

Participants largely discussed experiences on Facebook, which was favoured because of its direct access to audiences, who were mostly information-seeking parents. Participants viewed Twitter as valuable for networking with other organisations, the media, and high-profile individuals; they perceived Instagram as potentially useful but in practice used the platform infrequently. Among the advantages of using social media for vaccine promotion participants cited were: direct and fast access to audiences, low entry costs, opportunities to interact with and understand users, ease of reaching large or specific groups, and ability to evaluate campaigns. Sharing information, raising awareness about vaccination, and developing a voice were their chief aims in using social media. Participants also cited joining public conversations about vaccination, creating communities, raising their public profile, and networking with the media and other organisations. A few explicitly mentioned countering anti-vaccine sentiment as a reason for engaging on social media.

Perceived stumbling blocks to using social media optimally for these purposes included: social media's fast-paced evolution, limited resources, and insufficient organisational buy-in. On the latter point, for example, some accounted for the reluctance to commit to social media by pointing to their leaders' limited personal experience with the medium. As a result of these barriers, several day-to-day activities were perceived as problematic:

• Reaching broad, diverse audiences: Using humour or entertainment - in contrast to messaging that just tells people what to do - was one technique perceived as effective. Fostering interactivity by joining conversations and answering questions was seen as effective for fostering engagement but often challenging due to lack of staff and/or the need to communicate as a "faceless" presence.
• Tracking and analysing conversations (social media listening): Finite resources, prioritisation of less labour-intensive activities, and lack of expertise impeded the organisations' ability to draw on insights gathered through listening - for example, by detecting particular audience group concerns and adapting messages accordingly.
• Measuring impact: Primarily, participants measured impact using social media metrics, such as reach, number of followers, and engagement. These metrics were acknowledged as inadequate measures of real-world attitude or behaviour change. Advocacy group participants in particular characterised silent audiences as wary of making themselves publicly visible and thus difficult to gauge.

In response, the researchers offer several recommendations for vaccine-promoting organisations:

• Commit to the participatory nature of social media by joining conversations and interacting authentically.
• Prioritise social media listening across a range of platforms, using approaches such as sharing information with like-minded organisations and developing affordable alternatives to commercial listening tools to amplify listening capacity.
• Move beyond a reliance on metrics to measure impact, such as by creating closed groups or encouraging private messaging to allow wary audiences to share their views with confidence, or by designing projects that link social media activity with changes in community attitudes and behaviour.

In turn, social media platforms could play a role in vaccine promotion by continuing to develop and test standards for moderating content (to prevent the spread of misinformation) and by broadening collaborations with credible vaccine-promoting organisations to prioritise accurate information. Furthermore, the researchers urge these platforms to be transparent about algorithm changes determining post priority, to renew vaccine-promoting organisations' organic reach, and to support the development of tools that assess information credibility and that enable affordable and sensitive social media listening.

In conclusion, by analysing the obstacles vaccine-promoting organisations face when using social, this study hopes to inform future strategies and solutions to combat vaccine hesitancy.