Messages from Social Media Influencers Increase Childhood Vaccine Acceptance in Diverse Populations

Theoretical Background and research questions/hypothesis: Rates of childhood vaccines, such as that for human papillomavirus (HPV) and COVID-19, are lower than desired and place the nation’s children at risk for serious disease and illness. Parental hesitancy towards vaccination is a major factor in suboptimal rates. The public health community has long utilized trusted messengers to deliver health messages. As more parents receive news and information from social media, we partnered with a diverse group of social media influencers to test their messages’ abilities to increase knowledge, favorable attitudes, and intentions to vaccinate their children against HPV and COVID-19.

Methods: Influencers created posts in their own words and language either, about the HPV vaccine or the COVID-19 vaccine. Next, influencers recruited their followers to complete a baseline survey, view their post, and immediately complete an endpoint survey. We assessed changes in vaccine knowledge, attitudes towards vaccination, and intentions to vaccinate their children against either HPV or COVID-19. Mean scores or frequencies were calculated for all variables and changes from baseline to endpoint were assessed with repeated measures t-tests.

Results: Social media influencers were either African American or Hispanic. All were female, their mean age was 44 and most had 2 or 3 children. Almost all had a college degree and all but one were married. The average time as an influencer was 9.5 years. For the COVID-19 vaccine, 108 followers viewed a post from their influencer and completed a survey. Three quarters (77%, n=83) were women and 56% (n=60) were Hispanic. More than half (59% n=64) had been following their influencer for more than 1 year and 61% (n=66) had been vaccinated against COVID-19. We observed significant positive changes from baseline to endpoint, after viewing a post, in knowledge about the vaccine (p= 0.006), perceiving the pandemic to be serious (p=0.045), and intentions to vaccinate their children against COVID-19 (p< 0.001). All followers had a high level of trust in their influencer. For the HPV vaccine, 134 followers viewed a post from their influencer and completed a survey. The majority (86%, n=115) were women and 59% (n=79) were African American. We observed significant positive changes from baseline to endpoint, after viewing a post, in almost all outcome measures: knowledge about the vaccine (p<0.001), perceiving HPV infection to be serious (p<0.001), perceiving the vaccine to be safe (p<0.001), and intentions to vaccinate their children against HPV (p< 0.001). All followers had a high level of trust in their influencer

Conclusions: Social media influencers can be trusted and effective messengers about vaccines. In this study, influencers were more successful in changing parental cognitions about the HPV vaccine than the COVID-19 vaccine; that may be due to the context of the vaccines at the time.

Implications for research and/or practice: While the pubic was inundated with messages about the COVID-19 vaccine during the pandemic, fewer parents were knowledgeable and aware of the HPV vaccine and may have been more receptive to learning about the HPV vaccine than the COVID-19 vaccine. Regardless, social media influencers should be incorporated into public health campaigns about vaccination.