Trying to help parents decide to vaccinate kids against HPV? Consider storytelling

In a study published today in the journal Health Education and Behavior, researchers from Drexel's Dornsife School of Public Health analyzed 360 randomly selected Instagram posts from a pool of 3,378 English-language posts about HPV vaccination. Although the majority of posts were pro-vaccine (56 percent), anti-vaccine messages -- the majority of which featured a narrative structure -- experienced much higher engagement, including more "likes" (24 vs 86 "likes," on average). The team's findings on the value of narratives in increasing social media engagement could guide public health communications efforts, and are among the first to look at HPV vaccine-related content on Instagram.

The majority of pro-vaccine posts -- 61 percent -- shared actionable information about the vaccine, while only 45 percent featured personal narratives (i.e., elements of a story). Researchers suggest that pro-vaccine posts may garner greater engagement if they continue to provide information and evidence, while communicating this through a more narrative structure.

The current Drexel study helps researchers understand how broad these anti-vaccine sentiments are on Instagram. It also yields insight into how these commonly used messaging strategies may have a different appeal compared to pro-vaccine messages. The authors see great opportunity for communicating health information on Instagram. More than a third of United States adults, and 71 percent of those ages 18-24 use the platform, according to a 2018 Pew Research Center report.

"In recent years, we're seeing a resurgence of misleading anti-vaccination messages and related misinformation spreading through social media," said senior author Philip M. Massey, PhD, an associate professor of community health and prevention in the Dornsife School of Public Health. "By studying what makes these messages so effective online, we can improve fact-based, pro-vaccination messaging aimed at improving public health."

The benefits of the HPV vaccine in the prevention of a number of cancers in boys and girls are well-documented, yet the anti-vaccine movement has gained ground in recent years through "bots" and efforts by groups to spread false information through online communities, according to a 2017 study in the journal Human Vaccines and Immunotherapeutics.

HPV is the most common sexually transmitted infection in the United States and can cause six different types of cancer in women and men, including nine out of every 10 cases of cervical cancer and seven out of 10 oral cancers, according to the Centers for Disease Control and Prevention (CDC).

The CDC recommends that all children ages 11-12 receive the vaccine. If the first dose is received before age 15, only two doses are needed (it's three doses if they start later in life). Despite these recommendations and established success of the vaccine at preventing cancer-causing HPV, just over half of those eligible are fully up-to-date on vaccination, according to an August 2019 CDC report.

This research adds to a growing volume of work looking at social media's impact on the public health push for HPV vaccination. In recent related studies, Massey and his colleagues analyzed nearly 200,000 tweets about HPV vaccination and found that 39 percent of tweets were positive, while only 25 percent were classified as negative.

The researchers also published a study in February 2018 offering insights on how and when health professionals tweet about the HPV vaccine. They are now embarking on NIH-funded research to build on those findings. Specifically, the team plans to use large-scale data to determine whether narrative Twitter posts increase HPV vaccination more effectively than non-narrative posts.

The study was supported by the National Cancer Institute. In addition to Massey, co-authors include Matthew D. Kearney and Michael Hauer of Drexel, and Preethi Selvan and Amy E. Leader of Thomas Jefferson University.