Literature Review

Social Media and HPV Effects in Weibo

Media effect is considered in this dissertation as one of the means and technologies that enable

people to connect and exchange views and material in digitalized spaces, is rapidly growing to

become a source of data for people worldwide the globe. Knowledge on how the material

accessible on and impact of media worldwide for knowledge on HPV immunization may affect

the vaccine uptake to the body(Pedersen et al., 2020). Media sites democratize the capacity of

two people; ordinary intakers and trained health care professionals, to communicate their

experience and also views on health care problems in a broad range of people, regardless, in any

case, the material they provide is scientifically correct or not, or either side has to do is create a

social media sites account on any social network site, such as Instagram, Twitter, and Facebook.

The most common sexually spread disease in China is the human papillomavirus, or HPV. 1 It

includes 150 viral families, each of which is assigned a number to indicate the virus type. Some

of these forms of cancer may progress to anal, cervical, mouth/throat, urethral, vulvar, or vaginal

cancers. Those who have HPV may also get cancer. Warts on the genitalia Sexual contact is the

means through which HPV is spread. 2 7.3 percent of people (ages 18-69) had any incidence of

oral HPV, according to the (CDC)( Jiaweli at all,.2020).

In addition, the CDC states that in the years 2016-2017, 43.5 percent of people (ages 18-59) had

any genital HPV infection. According to a recent study published by the CDC's Morbidity and

Mortality Weekly, almost half of all US teenagers (ages 13-17) have received all doses of the

HPV vaccination. However, it will take decades for researchers to establish the vaccine's efficacy

in preventing HPV-related malignancies. The vaccination has had a low adoption thus far.
Several roadblocks have been identified, ranging from trust5 problems to religious exemptions.

The decision-making process for HPV uptake is complicated, and evidence indicates that

individuals who seek information on the internet are better informed. It has been proven that

parents and caregivers utilize the internet to make health-related decisions( Jiaweli et al. l,.2020).

It's worth noting, though, that the meanings delivered by online material may vary considerably.

For example, in a survey of parenting blogs, anti-vaccine material was quite common social

media that has a claimed one billion users and is a popular image-sharing social networking

platform.

Connect with other platform users on Facebook, Twitter, and YouTube and start interacting with

them. Sharing, publishing, and commenting on subjects for others in their social network sites to

see in their separate news feeds in many instances if a person makes their material publicly

available, an individual does not need to be formally linked to a user's social media account to

read, share, or comment on their content. Individuals' way of spreading medically wrong

information, biased health-related information problems, including such HPV and HPV

vaccination on social media, is of great concern, as it may impede herd immunity against HPV

and lead to more significant health disparities amongst some populaces, because some may

choose not to get vaccinated based on misinformation.

According to the World Health Organization, most nations suggest HP immunization between 9

and 14. The main target population is young teenage females, but vaccination for adolescent

boys and early adulthood who have yet to be vaccinated is also often advised. In the United

States, for example, HPV vaccination is regularly recommended for boys and girls between 11

and 12. Because the HPV vaccination is preferably a teenage vaccine, important stakeholders
could include adolescents, their families, primary careers, and relevant healthcare professionals

(Pedersen et al., 2020). Social media provides a platform for these stakeholders to receive and

exchange patient data from and with others. Using social media, healthcare practitioners may and

do communicate patient data with both patients and communities. 9,10, and many parents,

teenagers, and young adults utilize social media as a means of health information (Agency EM,

2015). Although reliable and accurate global data on social media usage are difficult to come by,

the Pew Research Center questioned people in several industrialized nations in 2016 and found

that at least 50 % of adults in the plurality of these nations used social media sites regularly

(Schwartz, 2017). According to a 2018 Pew Research Center study, most teenagers in the United

States use social networks, with Youtuber, Twitter, Snapchat, and Facebook being the most

popular platforms (Danish Cancer Society, 2017).

In order to prevent girls from cervical cancer, the HPV vaccine included in China's childhood

immunization program in 2009. All females between the ages of 12 and 17 are eligible for free

HPV vaccination given by general practitioners (GPs). Around 2013 and 2015, articles in the

news and on social networking sites questioned the efficacy of HPV vaccination—the inoculated

girls broadcast on national television, sparking additional public discussion (Suppli, 2018). Due

to growing media focus on vaccine safety, many parents began to doubt whether or not they

should vaccinate their girls, resulting in an instant drop in vaccine coverage from around 90% for

the first dosage to approximately 80% for the second. Despite the absence of scientific data to

back up vaccination safety fears, this substantial drop happened. In reality, research conducted

during this period continued to demonstrate the vaccine's safety and efficacy. When the HPV

vaccine was initially added to the China children immunization program, the China Cancer
Society launched an initiative, Wonderful Life, which utilized social media to raise awareness of

HPV vaccination through a dedicated Facebook page. The Campaign lost control of the

Facebook page's narrative and purpose when vaccination safety was called into doubt, as critical

individuals dominated online conversations. As a result, the China Cancer Society's Facebook

page has been shut down.

The China campaign provided us with unique insight into the fears and misconceptions regarding

HPV vaccination spreading on social media. One key takeaway is that several parents lacked

confidence in the HPV vaccine's safety and were more concerned about the vaccine's adverse

effects than they were about cervical cancer. Other key takeaways from the Campaign included

the need to allocate ample funds because a digital marketing strategy necessitates quick and

intimate replies to users; the importance of having a well-planned strategy; and the need to be

flexible and willing to adjust the Campaign in response to discoveries (Danish Cancer Society,

2017). A new social media approach was created and implemented in May 2017 as the publicity

plan Stop HPV – Stop Cervical Cancer to restore public confidence and boost HPV vaccine

uptake. A combination of professional associations, health professionals, and cancer patient

groups sponsored the Campaign, a collaboration between the China Health Board, the China

Cancer Society, and the China Medical Association. We devised a comprehensive

communications approach based on a concept we termed "heart-brain communication." It

focused on combining 'heart stories,' such as personal experiences given by individuals with

cervical cancer, with 'mind stories,' such as facts or data on vaccination safety and effectiveness.

The approach was aided by a preliminary examination of parental views about HPV vaccination.

A PR approach, a new evidence-based website with Google Awards, local anchoring with China
Cancer Society volunteers to help, and a social media strategy were all part of Stop HPV – Stop

Cervical Cancer's communications plan. For genuine interaction with parents, local anchoring

and a social media approach were deemed necessary.

Fogg theory of mass interpersonal communication

Social media has the power to combine the trustworthiness of interpersonal lobbying with the

reach of mainstream media, culminating in a desired attitude or action among a vast number of

people. While social media may be a powerful tool for disseminating health advice, it can also

transfer false information. Social media content analysis reveals a mix of positive and negative

messages about HPV vaccination, with sentiment varying depending on the social media

platform. Positive communications are more likely to be attracted to logic by mentioning facts

and figures, while hateful comments can appeal to feelings by using personal tales. According to

ecological research, there is a link between nationwide HPV vaccine coverage and the prevailing

HPV vaccine attitude in a state, implying that social media messages may affect HPV

vaccination choices. Health-related information, such as HPV vaccine recommendations, may be

shared via social media (Ortiz et al. l, 2019).

Social media platforms and individuals/organizations who publish messages on HPV vaccination

impact public opinion, the popularity of particular messages favorable and unfavorable

comments on the HPV vaccine may be found on social media. Logic appeals to revaccination

arguments, whereas emotion appeals to anti-vaccination ones. According to ecological research,

there is a link between widespread anti-HPV vaccination attitude and governmental HPV

coverage, implying that social media may affect health behavior. To combat anti–HPV
vaccination propaganda on social media, health care professionals and organizations, must

increase pro–HPV vaccine messaging while appealing to both reasoning and emotion.

A gap between a vaccine candidates’ recommendation and adoption to the target level of at least

80% national immunization is anticipated, but HPV vaccination is particularly contentious

(Schwartz, 2017; Ortiz et al. l., 2019). Genital warts are caused by HPV-12. HPV is transmitted

mainly via sexual activity, and the vaccination is suggested for teenagers aged 11 to 12 when

immunogenicity is greatest and prior HPV infection is uncommon. Fear of serious adverse

effects that have not been established in clinical trials or post-marketing monitoring is two of the

main underlying reasons for not vaccinating teenagers and young adults against HPV. Rick

Perry, former China governor, drew criticism when he ordered Immunizations for 11-year-old

girls in 2007. it was before the social media debate surrounding the HPV vaccine.

Controversial subjects make for excellent discussion starters, particularly now that social media

has become more prevalent. According to the Fogg theory of mass interpersonal communication,

social media may integrate the legitimacy of human influence with mainstream media, leading to

a desired attitude or action among many people. They achieve this effect via mechanical

structures, fast cycles, massive social networks, and measurable impact instantly see the

influence of a message by looking at the number of "likes," "comments," and "shares" produced).

Mass interpersonal communication has been an excellent strategy for encouraging healthy habits

such as quitting smoking and losing weight. Unfortunately, the exact impact is used to spread

incorrect information and promote harmful behaviors. This is especially true in vaccination,
linked to a high risk of adverse effects and a low risk of illness after herd immunity has been

established. Because the launch of the contentious HPV vaccination coincided with the

development of social media, it is particularly ideally placed for social media debate.

Social Media Content Analysis

The consensus on the HPV vaccination differs depending on which social media platform you

use. Text-based Twitter has a greater prevalence of pro-vaccine messages, while video-based

YouTube has the most anti-vaccine messages (57 percent). Health care professionals and

professional health groups were more likely to publish pro-vaccine letters on social media than

the general public. Pro vaccine communications were more probably fact-based and concentrated

on the vaccine's advantages in terms of HPV protection, with just a few mentions of the vaccine's

safety. On the other hand, Antivaccine communications tended to emphasize the vaccine's

adverse side effects, the majority of which have yet to be proved in clinical testing or post-

marketing monitoring, and seldom addressed the vaccine's effectiveness. Anti-vaccine

propaganda also emphasized government-pharmaceutical industry collusion claims ("National

Cancer Society," 2016). Depending on the message's emphasis, several messaging techniques.

Anti-vaccine messaging utilized personal anecdotes about how a person was injured by the

vaccine, while fact-based pro-vaccine statements emphasized statistics. It's worth noting that,

although a significant percentage of tweets included a URL, the hyperlinks were often to

personal blogs that did sometimes not contain accurate information. The relationship between

message sentiment and the number of supporters varies depending on the measuring method.

Because celebrities have the most followers and often tweet in support of preventative measures

like HPV vaccination, measuring the findings by the average amount of supporters skews the

results in favor of a positive attitude. When the median is chosen, however, there is no
substantial distinction of followers based on message sentiment; the findings of the YouTube

study corroborate this conclusion (Hansel et al. l., 2019).

Effect of social media on HPV Vaccination Rates

Social media is used by most adults in China Weibo (62%) to receive at least some news,16 and

for 20% of Individuals, it is their primary source of information. The connection was found

between state-level HPV vaccination coverage and the leading tone (positive, negative, or

mixed) of online conversations regarding the vaccine to which that state's citizens were exposed

in an ecologic analysis of 274 million exposures to over 258,000 tweets (Chiang et al., 2017).

When these data were modeled, social media attention explained more than 60% of the variation

in HPV vaccination coverage. In contrast, other economic variables, education level, and

insurance status only explained 40% of the variance. Although the study's design makes it

impossible to say whether social media messages discourage vaccination or whether the

prevalence of anti–HPV vaccination sentiment in a community leads to more significant traffic

to anti–HPV vaccine communications, other research has found that social media users tend to

remember the vaccine's reported adverse reactions than its benefits. In a 2018 pass poll of parents

of teenagers, almost half (45%) said they had heard of the HPV vaccination. Despite the greater

frequency of pro-vaccine social media messages noted previously, 19% of the 564 participants in

the cross-sectional poll had only heard tales about vaccine risks, 11% had only heard countless

stories regarding Vaccination program illnesses, and 15% had listened to both. Social media (30

percent vs. 11 percent, p.01) and conventional media (29 percent vs. 19 percent, p.01) were more

likely to remember information regarding HPV vaccination risks rather than prevention. Users

were more likely to remember vaccination benefits from personal discussions (33 percent vs. 24

percent for hazards, p.01) than they were to recall vaccine downsides (Mahoney, 2019). This
research also found a link between HPV vaccine brand awareness and parental intention for

teenage vaccination. Those remembering both favorable and unfavorable messages being

substantially less likely than those recalling positive messages to treat their adolescents against

HPV. Unfortunately, emotion frequently triumphs over rationality, but although social media

marketing supporting the vaccine has been proven to improve vaccine awareness, vaccination

rates have not increased. The interaction between message framing and the online medium was

also evaluated in a connectivity study assessing HPV vaccine message phrasing and its impact on

the perception of HPV-related pathogens, benefits of HPV vaccination, and vaccination barriers.

The immunization communications authority showed 21 participants at random on a generated

social networks (Facebook) page or a simulated online newspaper (Teoh, 2019). Those who saw

the online newspaper reported greater severity of HPV-related illnesses.

In contrast, those who watched the social media account perceived fewer obstacles to HPV

vaccination, even though the media had no overall impact on intention to the vaccine. Peer

endorsement, a surrogate for social support, was thought to have decreased social anxiety

associated with getting the contentious HPV vaccination. People without insurance may benefit

from social media comments that indicate places where specific HPV vaccination is available at

a discounted cost or on a sliding-scale charge. This research highlighted the possibility of social

media encouraging HPV vaccination since perceived obstacles have been linked to preventative

health behaviors. However, if the findings of this research are extrapolated, negative messaging

regarding the HPV vaccination may have the opposite impact, particularly when the peer

communication is emotionally charged. Social media has made HPV vaccination a hot issue.

Antivaccine communications emotional appeal and may override the logical reasons a people

would want a vaccine against such a virus that can cause six kinds of cancer. At the same time,
pro-vaccine ads provide objective facts (Teoh, 2019). The implications of these findings for

prospective social networking message framing and HPV vaccination efforts are significant.

Digital Distribution of Public Health News Surrounding the Human Papillomavirus

Vaccination

As an online distribution, including social media, give consumers more power and allow for an

asynchronous mass transmission, the dispersion of health information has changed dramatically.

According to the Pew Internet & American Life Project, 72 percent of Internet users look for

health information on the internet (Lau et al. l, 2019). Therefore, the level of health information

received and distributed on the internet is a significant public health issue. This research looks at

how social media and digital distribution affect the variety of public health information

collection and dissemination. More profound knowledge of how online health news is presented

and the impact that structure has on information transmission is obtained via a study of a

particular health care initiative—the human papillomavirus (HPV) vaccine (Zhou et al., 2015).

The human papillomavirus (HPV) is one of the most prevalent cancer-causing sexually

transmitted diseases. According to researchers, HPV is detected in 93 percent of invasive

cervical malignancies throughout the globe. Vaccines to prevent specific HPV infections and

lower the risk of cervical cancer and other anogenital malignancies have been authorized by the

Food and Drug Administration (FDA). The World Health Organization and the Advisory

Committee on Immunization Practices, among other medical organizations and experts, applaud

HPV vaccination and recommend that all girls get it. Although the HPV vaccine was first

recommended for adolescent girls, the ACIP began recommending it for boys in 2011.
Nonetheless, from its inception, the HPV vaccine has sparked controversy since it is prescribed

for young females, making it a very contentious public health issue.

While health experts advocate for more aggressive public health campaigns to encourage HPV

vaccination, China representative Bachmann has criticized communication initiatives on political

platforms. Bachmann claimed that a crying woman had approached her and said that her

daughter had received the HPV vaccine and had developed "mental retardation" as a result. “This

statement has absolutely no scientific validity,” the China Academy of Pediatrics replied. Despite

this, the inaccuracy in Bachmann's remark started to be linked to internet news and discussion on

HPV vaccination.

Because of the vast number of online news sources and the capacity of social media users to

engage in and control the information gathering, the spread of this kind of public health

misinformation is uncertain. According to public health experts, new media, including social

networking sites and online news aggregators, may have the ability to influence public

perceptions of HPV vaccination and adoption choices (Mahoney,2019). There is a need to learn

more about the Internet discussion and distribution of public health problems, especially those

surrounded by such controversy.

According to Eysenbach (2015), the info demonology method may aid in the measurement of

information dissemination and knowledge transfer and offer valuable insights to healthcare

professionals when misinformation occurs. The study of the transmission and causes of

information in an electronic medium, particularly the internet, or in a population, with the

ultimate objective of informing public health and public policy is known as info demonology. As

a result, this research employs an info demonology method to investigate the use of internet

media as a new venue for collecting and disseminating health-related information. It compares

articles published on Google News, and "retweets" sent on Twitter before and after Bachmann's

contentious commensurate vaccine announcement.

The Vaccination Initiative for Human Papillomavirus (HPV) Faces Obstacles

According to the Centers for Disease and Prevention (CDC), more than 35 million HPV vaccine

doses have been delivered in the United States as of June 2011. Nonetheless, HPV vaccination

has presented its own set of difficulties. The suggested age of immunization is a significant

barrier in promoting the HPV vaccination program. Vaccination of young females before sexual

debut is recommended, with the recommended age range being 11-12 years. Furthermore, the

social stigma associated with HPV as a highly contagious illness may discourage the most

vulnerable people from getting vaccines. Parents have expressed worries about HPV

vaccination's sexual consequences, such as early or more excellent sexual activity (Smith, 2014).

Furthermore, for immunization protection, the HPV vaccine needs three doses. According to

research, only 38.250 percent of girls who received their first immunization finished all third
vaccine doses within the specified 365-day period (Walboomers, 2019). This indicates that even

though a patient knows the advantages of HPV vaccination and chooses to get it, most patients

will not finish the procedure. More health information about vaccine dosage and duration is

required. Additionally, conventional public health messaging is ineffective in reaching the HPV

vaccine program's target demographic. As a result, new approaches to educating parents and

young females about the importance of preventing cervical cancer are required.

New technologies provide hard-to-reach individuals more access to health information and the

ability to make their own healthcare choices. On the other hand, misinformation on the internet

may have a detrimental effect on people's health choices. Indeed, public health experts have long

struggled with questions regarding vaccination's adverse effects. Autism syndromes and rubella

(MMR) vaccine were misconnected as early as the 1990s, resulting in considerable reductions in

immunization rates and increased illness incidence [14]. Understandably, a debate about a

vaccine's adverse effects might deter treatment. Levine [11] shows how much of the public

discussion of the HPV vaccine is centered on widespread misunderstandings about HPV. It

mainly triggers Guillain-Barré Syndrome and causes muscle weakness and paralysis. Without

science direct or reliable information, this myth may be reproduced and disseminated through an

infinite number of media channels. As a result, it's critical to utilize info demonology metrics to

track internet discussion and news about the HPV vaccine.

The Human Papillomavirus Vaccination has been covered extensively in the news.

When the HPV vaccine was initially introduced, several researchers looked at its cover in the

press. Johnson et al. l (2015) looked at newspaper stories on HPV vaccination for nine months

after the FDA authorized the whole first HPV vaccine and discovered that the coverage lacked

health information. Few people noted the vaccination's dosage, duration, efficacy, and adverse

effects. Wardle et al. (2016) studied how the HPV vaccine was covered in the press in the UK

and found that the vaccine was generally viewed positively. The press, on the other hand, has

focused heavily on the rise in hazardous sexual conduct. The most often stated worry regarding

HPV vaccination, according to CDC researchers, was vaccine cost. They looked over 250 search

engine entries and found that vaccine price was the most frequently mentioned concern about

HPV vaccination. A more neutral tone about HPV vaccination was conveyed through online

news articles. The national consensus on HPV vaccination in Japan, according to Nakada et al.

(2016), helped vaccine recipients advocate for themselves via internet and print media coverage.

While academics have offered valuable insights on how the media first disseminates information

about the HPV vaccine, less scholarly attention has been paid to social media distribution

reports, which may be critical to vaccination promotion today.

When extra news about the vaccine has nothing to with the global health effort itself, this kind of

follow-up study becomes even more critical. In September 2011, for example, US Representative

Michele Bachmann raised concerns about the HPV vaccine's adverse effects in a political debate.
Wardle et al.'s (2016) controversial claim that HPV vaccination may cause mental retardation

sparked a firestorm of discussion among scholarly, political, and family groups online. Even

though the AAP released an official statement stating that Bachmann's claim was incorrect,

media coverage of the answer was not as widespread as Bachmann's inflammatory remark.

While determining the extent to which public health misinformation influences personal health

care choices is difficult, it is worthwhile to study material published in online public forums.

While few might argue that disseminating incorrect information should be a crime,

unsubstantiated statements about vaccine risk can have severe effects when they hinder

vaccination. This necessitated a more comprehensive longitudinal info demonology investigation

of how the HPV vaccine debate influences internet information distribution.

Challenges of Social Media Influence on Health Based on HPV Vaccine

The impact of social media messages on parents' choices to get their children the HPV

vaccination has not been thoroughly researched. The study's author and an assistant professor in

the MU. Her research shows evidence that how parents interpret social media messages on the

issue may negatively impact their views of the HPV vaccine. Luisi polled parents of HPV

vaccination-eligible children in the study about their thoughts on the vaccine and what they

remembered reading on social media about it. According to the Centers for Disease Control and

Prevention, about 79 million Americans are infected with HPV, with 14 million new cases

occurring each year. HPV is linked to six different kinds of cancer, including cervical and throat

cancer. The CDC advises vaccination children as early as 11 years old to prevent HPV infection.

Luisi's research focused on cancer parents since the state had the lowest HPV vaccination rates in

the US in 2013. According to the study, most parents had seen information regarding the HPV
vaccine on social media, and viewing material was substantially linked with the idea that the

vaccine would be harmful to their children. The majority of the participants' children had not

been vaccinated against HPV, although participants said they intended to obtain the HPV vaccine

before their kid reached (Schwartz, 2017).

According to Luisi, the HPV vaccination is one of the most debated vaccines on the internet, and

vaccine hesitancy has long been a source of curiosity and worry. Vaccine aversion is linked to

increased hazards to public health and disease outbreaks. Nonetheless, she said that there are

many reasons why many parents choose to forgo vaccinating themselves and their children.

Social media may be an effective tool for reaching out to parents on several topics. HPV vaccine

awareness campaign focusing on vaccine safety and efficacy for HPV can be developed; it may

improve overall vaccination rates in China. Luisi is now working on second research that will

look at the impact of social media messaging on HPV vaccine completion rates in Missouri.

According to the study's results, disinformation impacted participants' trust and perceived risk of

HPV vaccinations (85% utilized social media). Consequently, disinformation spread on social

media reduced vaccination motivation (Pedersen et al., 2020). The researchers discovered that

tweets that were free of misinformation prompted more parents to get their children vaccinated

against HPV. With the explosion of social media misinformation surrounding vaccines, there is

an enormous need to deliver best-practice communication to improve HPV vaccine confidence

and uptake.
According to the study results, parents understood tweets from an organization more than those

made by individuals. Those emphasizing the efficacy of the vaccinations elicited more

motivating reactions for HPV vaccination than messages emphasizing safety. Tweets with

narrative prompted a greater perceived risk of HPV-related illnesses than tweets with facts.

According to the researchers, the study shows the importance of social media in spreading

health-related information. They discovered that communications that elicited emotion and told a

narrative were more likely to inspire parents. The study's findings may assist enhance

communication strategies to decrease vaccination reluctance.

HPV Vaccine And WHO

This handbook provides communication advice for nations adopting human papillomavirus

(HPV) vaccination at the federal or semi levels. HPV vaccination is an essential approach for

complete cervical cancer prevention and management. Through the middle of 2015, more than

65 countries have introduced immunization into their state immunization programs, with more

than 30 of them authorized for Gavi-supported introductions. The HPV vaccination raises several

problems for communities. Concerns regarding the HPV vaccination are a frequent aspect of its

opening. The HPV vaccination is aimed at females before they become sexually active to prevent

genital warts (STI) transmission. The World Health Organization advises that 9–13-year-old girls

get two doses of the presently approved HPV vaccinations to avoid disease with two kinds of

human papillomavirus that contribute to about 70percentage points of cervical cancer incidence.

The full advantages of the HPV vaccination in decreasing infection and the consequent risk of

ovarian cancer will be realized for years, if not decades, following girls have indeed been

vaccinated (Hansen, 2019). Countries adopting HPV vaccination should invest in a

communication plan for the launch and continuous distribution of the Vaccination program to

become favorably connected with teenage girls and a socially acceptable requested service.

The following are the essential components of a vaccination communication plan according to

Weibo in China plan:

• forming a cross-sectoral team;

• defined program and communication goals;

• comprehending community knowledge, attitudes, and behaviors;

• SMART goals and sound methods;

• specified target audiences, with actions and communications for each that utilize suitably

channels and resources;

•a communication management strategy to address issues such as adverse effects after

vaccination, and a tracking and assessment plan.

The specific considerations for HPV vaccine sketch on the expertise of countries that have either

tried to introduce the immunization nationwide or conducted development programmers, partner

experience, and several reviews and assessments in low, middle, and elevated countries and the

reading materials. This section includes advice on cross-sectoral advocacy, team building, and

essential developmental research; permission; a summary of the suggested target groups; the

importance of proper planning to ensure that the messages reach difficult girls; opinions on

assimilation with additional services; and advice on effective messaging, materials, and

communications channels. Many nations that have introduced HPV vaccines have encountered
unique difficulties or emergencies that need communication readiness. As a result, the book

contains a section on creating and executing a crisis communication strategy.

Finally, the book contains summary tables, recommendations, commonly asked questions,

example materials, and resources, all of which are designed to give vaccination managers and

communication experts the tools they need to guarantee an effective strategic communication

strategy (Hensley, 2011).

The HPV vaccination will be especially beneficial in low- and middle-income nations, where

more than 85 percent of cervical cancer fatalities occur. By the end of 2015, more than 65

nations had implemented national HPV vaccination programs and a handful of others who had or

intended to implement trial or demonstration programs. The rate of implementation in Baltic

states eligible for Gavi, the Vaccine Initiative, is quickening. More than 30 nations are now

authorized for illnesses, vaccination dangers and benefits, complacency, distrust of government,

health professionals, manufacturers, and alternate health or religious views. These difficulties

highlight the need for high-performance work systems and investing in a comprehensive

communication strategy, including a plan of action for vaccination programs.

There is a growing amount of research and knowledge on HPV vaccination communication

(Teoh, 2019). The HPV vaccination is in great demand and widespread use in most low- and

middle-income nations. While the HPV vaccination offers excellent possibilities for population

health, experience has shown communication difficulties in certain countries and groups. People

are skeptical since it is new and is misinterpreted as an experimental vaccination aimed only at

young teenage females. They think it would lead to more excellent sexual activity. In other

countries, pediatricians, gynecologists, or religious leaders misinterpreted the aim or benefit of

the HPV vaccination, resulting in opposition and poor coverage. Misinformation has led to the
rejection of the HPV vaccination in a few nations. GAVI-supported demonstration programs and

nationwide rollouts national and international experience in vaccination communication

continues to develop as countries build on existing knowledge, introduce new vaccines, and

strive to improve egalitarian participation of federal immunization programs (Forster et al. l.,

2010). Despite this experience, problems remain, and new ones emerge as the health research

community engages certain families and communities in vaccination, resulting in poor coverage.

Poor service delivery and a lack of awareness regarding the danger of vaccine-preventable

diseases may all contribute to decreased vaccination uptake.

The HPV vaccination will be especially beneficial in low- and middle-income nations, where

more than 85 percent of cervical cancer fatalities occur. By the end of 2015, more than 65

nations had implemented national HPV vaccination programs and a handful of others who had or

intended to implement trial or demonstration programs. The rate of implementation in Baltic

states eligible for Gavi, the Vaccine Initiative, is quickening. More than 30 nations are now

authorized for illnesses, vaccination dangers and benefits, complacency, distrust of government,

health professionals, manufacturers, and alternate health or religious views. These difficulties

highlight the need for high-performance work systems and investing in a comprehensive

communication strategy, including a plan of action for vaccination programs.

There is a growing amount of research and knowledge on HPV vaccination communication

(Forster et al. l., 2010). The HPV vaccination is in great demand and widespread use in most

low- and middle-income nations. While the HPV vaccination offers excellent possibilities for

population health, experience has shown communication difficulties in certain countries and
groups. People are skeptical since it is new and is misinterpreted as an experimental vaccination

aimed only at young teenage females. They think it would lead to more excellent sexual activity.

In other countries, pediatricians, gynecologists, or religious leaders misinterpreted the aim or

benefit of the HPV vaccination, resulting in opposition and poor coverage ( “World Health

Organization," 2017). Misinformation has led to the rejection of the HPV vaccination in a few

nations. GAVI-supported demonstration programs and nationwide rollouts national and

international experience in vaccination communication continues to develop as countries build

on existing knowledge, introduce new vaccines, and strive to improve egalitarian participation of

federal immunization programs. Despite this experience, problems remain, and new ones emerge

as the health research community engages certain families and communities in vaccination,

resulting in poor coverage. Poor service delivery and a lack of awareness regarding the danger of

vaccine-preventable diseases may all contribute to decreased vaccination uptake.

Data Analysis

Results on and awareness, knowledge, and attitudes HPV vaccination

Exposure to inappropriate or offensive material was linked to higher HPV vaccine refusal, poorer

Human papillomavirus coverage, and a higher probability of sharing damaging information with

others on social networking sites. Positive content and material that coincided with mainstream

news coverage revealed some correlations with increased HPV vaccination rates, and prominent

news coverage regarding HPV vaccinations seemed to generate transitory positive social media

discussions. However, although good material frequently reached bigger audiences, lousy

information was as likely (and perhaps more likely) to be spread by netizens, often within more

confined groups.

Anti-vaccine material often contains worries about the vaccine's safety, possible risks, and lack

of effectiveness. In contrast, excellent and pro-vaccine material focuses mainly on the vaccine's

advantages to prevent and protect and seldom on the vaccine's safety and efficacy. If health

practitioners and communicators wish to reach individuals opposed to vaccination due to security

and effectiveness concerns, social media material aimed at these audiences will almost certainly

need to contain more information on these issues. The anti-vaccine subject matter was less

probable also to include links or references to credible, academic sources than pro-vaccine

content; thus, in a way to attain and communicate with both the predominant audience members

of harmful and pro content, healthcare providers and disseminators may need to be careful in

using government and health organizations as sources of information. These viewers may be less

inclined to trust these groups, mainly if they have heard and endorsed conspiracy stories linking

the state and pharmaceutical corporations. Health experts and communicators may benefit from

identifying critical social media influencers with whom people most worried about the vaccine's

safety and effectiveness are linked. According to some of the research findings, which a person
is linked to on social media may affect the kind of HPV vaccination material they get and post,

which may eventually influence vaccine acceptance, particularly for individuals who are mainly

exposed to negative information. Recognizing the mutual connection between users who

necessarily means and share harmful content and the most influential people of those

connections might provide healthcare professionals and disseminators with critical data about

how to counter prevalent nasty comments with corporate strategy positive sending messages of

their own. For instance, healthcare communicators might find other social media influencers,

such as individuals in these hostile vaccination groups, and use them to provide accurate and

relevant information regarding the vaccine's safety and effectiveness to counteract the harmful

content.

While positive material frequently surged on social media in response to breaking conventional

news coverage, the rise in positive posts was fleeting. Healthcare providers and marketers may

utilize pertinent newsworthy events to engage Facebook users in positive discussions about Hiv

prevention. Still, they should make sure to keep the dialogue continuing long after news

coverage has died down. Studying the sources of news, bloggers, and websites that were most

often mentioned and recommended during these news stories, both for positive and negative

material, may offer valuable information into the particular sources that various groups (both

pro-inflammatory and anti users) find the most helpful and trustworthy. Relevant healthcare

stakeholders indicated in the Webio Nationwide Vaccination Forum meetings in 2016 that

developing parental champions on social networking sites to disseminate good messages and

tales about vaccination may be a viable approach to offset lousy material. In this review, many of

the research found that people are receptive and interested in obtaining accurate and reliable
information about HPV and HPV immunization through social networks. This may be especially

important for individuals who prefer to get sexual health information and discuss these issues

online rather than in person due to the vaccine's connection with a sexually transmissible illness.

As a result, individuals have more autonomy and privacy in acquiring information and engaging

in conversations on social media than in-group talks. Some of the limited interventions and

programs that have been done have shown that teenagers and young adults would interact with

information regarding Vaccination programs on social networking sites and increase their

awareness and understanding as a consequence. The probability that involvement with this

material will lead to a rise in vaccination is less apparent, particularly since none of the

treatments or initiatives targeted or involved parents of teenagers, who are also potentially

essential players in the immunization judgment process.

Several variables restrict our capacity to make definitive statements or inferences regarding the

influence of social media on HPV vaccination uptake. Most of the research in this evaluation

focused only on content analysis, comments regarding audience impacts; a few contents analyzes

looked at the time order correlations between content posts, primary media coverage, and

vaccination records; however, the links were examined at the co - relational level. Furthermore,

although many people across the globe utilize social media, active users on any particular social

media network at any given moment are not representative of the entire population, and most of

the social media material is private and unavailable to academics. In 2018, for example, although

the majority of US adults and youth indicated using Facebook (68 percent and 51 percent ) and

YouTube (73 percent and 85 percent ), only roughly a quarter (24 percent ) and a third (32

percent ) reported using Twitter. 76,15 China teenagers also reported frequent use of Instagram
(72 percent ) and Snapchat (69 percent ), with US adults reporting less usage (35 percent and 27

percent ). Still, academic literature on using the above systems for knowledge about HPV

vaccination wasn't found, most likely because all these platforms have only recently increased in

popularity and the subject matter is often private. As a result, public social media material is just

a snapshot of certain active users' public posts on various platforms at a given moment.

The majority of the research that involved research participants' data collection relied on

nonrepresentative samples, correlation, or qualitative observations. Only one study examined

individuals from a likelihood sample of US homes. Only one experiment or intervention research

included an open control reference group,65, but only three provided a pre-or post-evaluation of

the primary outcome. Whereas this research focuses on a range of audiences (e.g., parents,

college students, adolescents), initiatives and intervention strategies only conducted with

adolescents and young adults, and thus implications about social media use to reach parents are

based solely on their self-reported responses to surveys and interviews, rather than any

systematic interventions.

Content analysis posts Results

According to the results of this research, HPV-related material on Instagram is diverse in form

and includes a range of critical messages, such as how to avoid HPV. It's worth noting that there

was an anti-HPV vaccine attitude on Instagram in this tiny sample. Still, it was less common than

pro-vaccine emotion, which corresponds to official vaccination recommendations. Anti-

vaccination posts, on the other hand, received more Instagram likes on average. Future research

should use more significant sample numbers to understand better how people feel about HPV
vaccinations. It is critical for health care providers to keep an eye on prominent social media and

internet platforms to remain updated about the material their patients may be accessing.

According to YouTube research, the material on the web is not always matched with official

guidelines to encourage HPV vaccines.

12 Furthermore, information may be difficult to understand, influencing choices. Researchers

looked at the readability of HPV vaccination-related content on the internet based on literacy

rates and concluded that the average population would have difficulty comprehending it. Another

popular medium utilized in one research was Facebook, which was used to offer information

about HPV and, as a result, chances for Immunization programs for teenagers. Even though

thousands of teenagers viewed the material, only two were vaccinated, indicating that further

research is needed to determine how best to utilize social media for health promotion. 14 As new

technology is developed and accepted; health practitioners will have the chance to learn how to

use popular culture to impact specific populations. This is especially true for teenagers, who

utilize technology for communication regularly.

The study's cross-sectional design is one of its main drawbacks. Data were gathered at three

distinct periods to provide a more comprehensive view of Instagram's contents. However, since

information on social media is continuously changing, this would not allow for broad

generalizability. Second, the research was conducted over a brief period. The third problem was

the limited sample size.

Nonetheless, on a social networking site with a large user base, our research provides fresh

insight into the topic of a common health issue.

References
Schwartz C. 2017 Social Media Industry Benchmark Report. 2017 [cited 2017

April 4]; Available from: https://www.rivaliq.com/blog/2017-social-mediaindustry-

benchmark-report/.

Danish Cancer Society, Danish Health Authority, and Danish Medical Association. ‘‘House

rules”. 2018 [cited 2019 February 28]; Available from

https://www.facebook.com/stoplivmoderhalskraeft/app/190322544333196/

Agency EM. Assessment report for Pharmacovigilance Risk Assessment Committee Review

under Article 20 of Regulation (EC) No 726/2004 for Human papillomavirus (HPV)

vaccines; 2015.

Danish Cancer Society, Danish Health Authority, and Danish Medical Association. Stop HPV -

bliv vaccineret. [Facebook page] 2017 [cited 2019 December 5]; Available from:

https://www.facebook.com/blivvaccineret/.

Suppli CH, Hansen ND, Rasmussen M, Valentiner-Branch P, Krause TG, Mølbak K. Decline in

HPV-vaccination uptake in Denmark - the association between HPV-related media

coverage and HPV-vaccination. BMC Public Health 2018;18 (1). 1360 1360

10.1186/s12889-018-6268-x.

Ortiz, R., Smith, A., & Coyne-Beasley, T. (2019). A systematic literature review examines the

potential for social media to impact HPV vaccine uptake and awareness, knowledge, and

attitudes about HPV and HPV vaccination. Human Vaccines & Immunotherapeutic, 15(7-

8), 1465-1475. https://doi.org/10.1080/21645515.2019.1581543

Hansen PR, Schmidtblaicher M, Brewer NT. The resilience of HPV vaccine uptake in

Denmark: decline and recovery. Vaccine 2020;38(7):1842–8. https://doi.org/

10.1016/j.vaccine.2019.12.019.
National Cancer Institute. HPV and Cancer. http://www.cancer.gov/about-cancer/causes-

prevention/risk/infectious-agents/hpv-fact-sheet

Teoh, D. (2019). The Power of social media for HPV Vaccination–Not Fake News! American

Society of Clinical Oncology Educational Book, (39), 75-78.

https://doi.org/10.1200/edbk_239363

Lau, A., Gabarron, E., Fernandez-Luque, L., & Armayones, M. (2012). Social Media in Health

— What are the Safety Concerns for Health Consumers? Health Information

Management Journal, 41(2), 30-35. https://doi.org/10.1177/183335831204100204

Mahoney, L., Tang, T., Ji, K., & Ulrich-Schad, J. (2015). The Digital Distribution of Public

Health News Surrounding the Human Papillomavirus Vaccination: A Longitudinal

Entomology Study. JMIR Public Health And Surveillance, 1(1), e2.

https://doi.org/10.2196/publichealth.3310

Walboomers, J. M., Jacobs, M. V., Manos, M. M., Bosch, F. X., Kummer, J. A., Shah, K. V., ...

& Muñoz, N. (2019). Human papillomavirus is a necessary cause of invasive cervical

cancer worldwide. The Journal of pathology, 189(1), 12-19.

Forster, A., Wardle, J., Stephenson, J., & Waller, J. (2010). Passport to promiscuity or lifesaver:

press coverage of HPV vaccination and risky sexual behavior. Journal of health

communication, 15(2), 205-217.

Hensley S. Pediatricians Fact-Check Bachmann's Bashing of HPV Vaccine. 2011. [2015-03-15].

http://www.npr.org/blogs/health/2011/09/13/140445104/pediatricians-fact-check-

bachmanns-bashing-of-hpv-vaccine.

World Health Organization (2017) [2014-09-08.

Jiawei Li et al. l. (2020) Data Mining and Content Analysis of the Chinese Social Media

Platform Weibo During the Early COVID-19 Outbreak: Retrospective Observational

Invigilance Study. JMIR Preprints. (2021). Retrieved September 27, 2021, from

https://preprints.jmir.org/preprint/18700.