Social Media Engagement and Influenza Vaccination during the COVID-19 Pandemic: Cross-sectional Survey Study

Background: Vaccines are one of the most important achievements of modern medicine. However, their acceptance is only partial, with vaccine hesitancy and refusal representing a major health threat. Influenza vaccines have low compliance since repeated, annual vaccination is required. Influenza vaccines stimulate discussions both in the real world and online. Social media is currently a significant source of health and medical information. Elucidating the association between social media engagement and influenza vaccination is important and may be applicable to other vaccines, including ones against COVID-19.
Objective: The goal of this study is to characterize profiles of social media engagement regarding the influenza vaccine and their association with knowledge and compliance in order to support improvement of future web-associated vaccination campaigns.
Methods: The survey was hosted on an Israeli website for the management of surveys in Hebrew (IMKFORMS). Its address was disseminated by publishing it on Facebook, Twitter, and LinkedIn and instant messaging platforms (WhatsApp, Telegram) and by sending its link via email to personal and professional contact lists. The survey answers were collected during April 2020. Anonymous and volunteer participants aged 21 years and over answered 30 questions related to sociodemographics; social media usage; influenza- and vaccine-related knowledge and behavior; health-related information searching, its reliability, and its influence; and COVID-19-related information searching. A univariate descriptive data analysis was performed, followed by multivariate analysis via building a decision tree to define the most important attributes associated with vaccination compliance. The data analysis was performed with R, version 4.0.2. The psych package was used for computing the internal consistency of reliability of the answers to the matrix multipoint scale questions. The compareGroups package was used for statistical computations. The rpart package was used for the decision tree processing.
Results: A total of 213 subjects responded to the survey, of whom 207 were included in the analysis; the majority of the respondents were female, were aged 21 to 40 years, had 1 to 2 children, lived in central Israel, were secular Israeli natives, had higher education, and had a salary close to the national average. Most respondents (128/207, 61.8%) were not vaccinated against influenza in 2019 and used social media. Participants that used social media were younger, secular, and living in high-density agglomerations and had lower influenza vaccination rates. The perceived influence and reliability of the information on social media about COVID-19 were generally similar to those perceptions about influenza.
Conclusions: Using social media is negatively linked to compliance with seasonal influenza vaccination in this study. A high proportion of noncompliant individuals can lead to increased consumption of health care services and can, therefore, overload these health services. This is particularly crucial with a concomitant outbreak, such as COVID-19. Health care professionals should use improved and targeted health communication campaigns with the aid of experts in social media. Targeted communication, based on sociodemographic factors and personalized social media usage, might increase influenza vaccination rates and compliance with other vaccines as well.

Benis A, Khodos A, Ran S, Levner E, Ashkenazi S, Social Media Engagement and Influenza Vaccination During the COVID-19 Pandemic: Cross-sectional Survey Study
J Med Internet Res 2021;23(3):e25977, doi: 10.2196/25977, PMID: 33651709, PMCID: 7968480