Responses to HPV Vaccination Campaigns in The Netherlands: an analysis of discussions on Twitter
by Marieke Graef
Even though the human papillomavirus vaccine (HPV) is an effective and safe instrument to decrease HPV infections and cases of several types of cancer, the Dutch HPV vaccination rate has been suboptimal from the start and has even shown a decline in the last two years. This study sought to assess the determinants of HPV vaccination uptake in the Netherlands and how the vaccine and RIVM and GGDTwente messages were discussed on Twitter from 2011 till 2016. Method: All Dutch language tweets mentioning HPV from the years 2011 till 2016 were collected from a database, amounting to a total of 17319. A content analysis of all tweets was carried out manually. The content of the GGDTwente and RIVM tweets was examined as well as responses to these tweets. Furthermore, the tweets were analyzed for specific determinants of HPV vaccination uptake and general sentiments. Results: The GGDTwente and RIVM only became truly active on Twitter regarding the HPV vaccination program in 2015. The RIVM tweets received significantly more response, though this response mostly consisted of retweets. Nearly all GGDTwente tweets concerned vaccination schedules. By far the most common determinant of low vaccination uptake in tweets from the public was the fear of side-effects, with scare stories going viral in 2015 and 2016 especially. On the other hand, publications on the high number of HPV infections among women received a lot of attention as well. Overall, the general sentiment towards the HPV vaccine on Twitter was more positive than negative in the first years, but due to stories about side-effects turned more negative in 2015. Conclusions: The results show that the fear of side-effects is something that needs to be addressed by public health authorities. Additionally, more practical measures such as a school-based vaccination program may be a great way to help increase the vaccination rate.