April 2013 - UNICEF Social and Civic Media Section, DOC, NYHQ / Regional Office for Central and Eastern Europe and the Commonwealth of Independent States

1. UNICEF & Anti-Vaccination Trends
Tracking anti-vaccine sentiment in
Eastern European social media
networks
April 2013
Social and Civic Media Section, DOC, NYHQ
Regional Office for Central and Eastern Europe and the Commonwealth of Independent States
To see the working paper and other resources, please click here
For comments and questions, please email ceecis@unicef.org

2. The need for social
media research

3. Social media is a global phenomenon.
3

4. Purpose: to better understand anti-
vaccination conversations & factors that
affect parental decisions in Eastern
Europe.
4

5. 5
To reach this goal, we developed questions to guide the
research.
– Why parents are refusing vaccinations?
– What are the concerns about vaccines?
– What are their ideas/perceptions?
– Who is influencing the discussion?
– Which networks are being used?
– Where are they located?
– How to respond?

6. 6
The monitoring approach
Social media conversations offer the depth of qualitative
research and the sample sizes of quantitative research in
real time.
– How do we detect digital smoke signals?

7. 7
Using various types of metrics & data collection
Volume Channels Engagement
Sentiment
Analysis

8. 8
Research findings will have real world applications.

9. 9
Important questions to keep in mind
– How can we ensure ethical consideration regarding
privacy?
– What pieces of data are valid and useful to the
research?
– How do we apply this research in a greater context
considering the limitations?

10. Social Media Research:
Methodology

11. Phase 1
– Identify goals
– Gather research
– Identify topics
– Identify languages
– Set up tracking
11
We structured the research into four phases.
Spotlight Pages
– UNICEF Networks: Facebook, Twitter, YouTube
– Regional Pages: USA, Russia, Romania, Poland
Search Queries
– UNICEF + Vaccines
– WHO + Vaccines
– CDC + Vaccines
– Anti-vaccination (general)
Language
– English
– Polish
– Russian
– Romanian
Phase 3
– Extract & compile data
– Quantitative & qualitative
analyses
– Research influencers
– Review & translate verbatim
mentions
Phase 4
– Gather insights from data
analyses
– Synthesize non-English
insights
– Construct the final report
– Make strategic
recommendations based on
key insights
Phase 2
– Scrub data
– Refine queries
– Identify topics
– Add new queries to
segment data by topic
Query Topics
– Side effects
– Efficacy
– Unnecessary
– Religion/Ethics
– Distrust
Government/Ind
ustries
– Chemicals/Unna
tural
– Western Plot
– Developmental
disabilities
– Pakistan ban

12. We analyzed conversations from 22,000 people across
social media.
12
From May to July 2012, 22,000 people participated in social media discussions
about vaccination refusal in English, Russian, Romanian and Polish.

13. The Global
Conversation

14. 14
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
Men Women
Gender
Facebook
Blog
YouTube
Twitter
Forum
News
Other*
7% 3%
39%
35%
26%
24%
19%
18%
7%
17%
2% 2%
Men Women
Age
60+
50 - 60
40 - 50
30 - 40
20 - 30
10 - 20
Young women say more in the global anti-vaccination
conversation on Facebook.

15. 0.4%
0.5%
0.6%
0.6%
0.7%
2%
2%
3%
3%
82%
Pakistan
Ireland
India
Mexico
Germany
Canada
Australia
Panama
UK
USA
Locations
15
Anti-vaccination discussions typically occur in the US
on Blogs, Facebook, & Forums.
Blog
47%
Facebook
25%
Forum
14%
News
5%
Twitter
5%
Tumblr
3%
YouTube
1%
Networks
Positive
6%
Neutral
51%
Negitive
43%
Sentiment

16. 16
English is the most common language used to discuss
anti-vaccination followed by Polish & Russian.
English
88%
Polish
8%
Russian
3%
Romanian
1%
Anti-vaccination discussions
0%
Polish
67%
Russian
25%
Romanian
8%
Non-English discussions

17. Blog
86%
Facebook
8%
News
6%
Twitter
0%
Forum
0%
Tumblr
0%
0.4%
0.5%
0.6%
0.6%
0.7%
2%
2%
3%
3%
82%
Pakistan
Ireland
India
Mexico
Germany
Canada
Australia
Panama
UK
USA
English
Blog
47%
Facebook
25%
News
5%
Twitter
5%
Forum
14%
YouTube
1%
Tumblr
3%
0.5%
0.5%
1%
1%
1%
1%
5%
5%
15%
65%
Uzbekistan
Azerbaijan
Latvia
Kazakhstan
Belarus
Netherlands
Germany
USA
Ukraine
Russia
Russian
17
Blogs allow anti-vaccination discussions to reach outside countries & populations.
0.5%
0.5%
0.5%
0.5%
1%
3%
9%
11%
74%
UK
Portugal
Bulgaria
Colombia
Italy
Germany
Moldova
USA
Romania
Romanian
0.3%
0.3%
0.3%
0.4%
1%
2%
3%
4%
15%
71%
India
Czech Republic
Denmark
Indonesia
France
UK
Netherlands
Germany
USA
Poland
Polish
Blog
65%Facebook
25%
News
2%
Twitter
24%
Forum
4%
Blog
85%
Facebook
25%
News
1%
YouTube
1%

18. 18
Blogs, Forums, & Facebook facilitate the most engaging
discussions about anti-vaccination.
0
5000
10000
15000
20000
25000
30000
35000
40000
Blog News Forum Facebook Twitter Reddit YouTube Tumblr Other*
Posts
Interactions

19. 19
Opportunities exist for UNICEF to join organic anti-
vaccination discussions.
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
4/1 4/8 4/15 4/22 4/29 5/6 5/13 5/20 5/27 6/3 6/10 6/17 6/24 7/1 7/8 7/15 7/22 7/29
UNICEF/WHO/CDC + Vaccines Anti-Vaccination
CDC
Announces
Autism
Increase
CA Bill
AB2109
CDC: Measles
Incidence
increased in 2011
VT Debates Ending
“Philosophical
Exemption”
WA Increase
in Whooping
Cough
Mayim Bialik on
NPR’s Science
Friday does not
vaccinate her kids
Autism One
Conference
2012 in Chicago
CDC’s Vaccines For
Children study shows
vaccines improperly stored
Dr. Oz admits not
vaccinating kids, while
advocating for vaccines.
Whooping Cough
Outbreak in OR
Mike Huckabee
supports Pakistan to
ban polio vaccine.
Pampers supports
UNICEF giving
tetanus shots.
Immunization
Week in Zimbabwe
Freedom Fest
2012 in Las
Vegas
CDC: Whooping Cough
Epidemic worst in 50
years, calling for adult
vaccinations.

20. Anti-vaccination
Arguments

21. 27%
6%
24%
15%
1%
14%
4%
9%
English
Religion/Ethics
Side effects
Distrust Government/Industries
Toxins/Unnatural
Unnecessary
Developmental Disabilities
Efficacy
Western Plot
21
The prevalence of anti-vaccination topics shows the
specific concerns associated with each population.
0%
65%
32%
3%
Romanian
11%
35%
7%6%
7%
19%
3%
12%
Polish
98%
2%
Russian

22. VACCINUL ANTI -HPV UCIDE!!! O elevă de 14 ani din
Marea Britanie a murit după ce i-a fost
administrată o doză de vaccin împotriva
cancerului de col uterin: Vaccinuri inutile si
periculoase: “Gardasil (Silgard) şi Cervarixul sunt
două vaccinuri folosite împotriva virusului HPV (şi nu
a cancerului de col uterin cum ni se spune)!
HPV vaccine KILL! A student of 14 years in
Britain died after being administered a
dose of vaccine against cervical cancer:
unnecessary and dangerous vaccines
"Gardasil (Gardasil) and Cervarix are two
vaccines against HPV (not cancer cervical
we are told)!
22
Romanian Examples
The proponents of the vaccination theory: Jenner and Pasteur's followers - the Vaccine Mafia
In the United States, it is widely known across media channels that over 5,000 families believe that
their children's autism was caused by this vaccine, however the actual number is certainly much
greater. Such legislative decisions against ROR include a 90,000 pound settlement to a little boy called
Robert Fletcher for cerebral lesions as well as a 1.5 million dollar settlement to Hannah Poling's parents
who started showing autism signs the day after receiving six different vaccines including ROR.

23. Недавно проведённое большое исследование
подтверждает результаты других
независимых наблюдений, где сравнивались
привитые и непривитые дети. Все они
показывают, что вакцинированные дети
болеют от 2 до 5 раз чаще, чем
невакцинированные дети.
Source: http://epidemnews.ru Вакцинация против пандемического
гриппа H1N1, известного также как
"свиной", может приводить к развитию
синдрома Гийена-Барре, острого
полирадикулита у взрослых,
свидетельствуют данные канадских
ученых, опубликованные в журнале JAMA.
Source: www.rutoday.ru
A recent large study confirms the results of
other independent observations, which
compared vaccinated and unvaccinated
children. They all show that vaccinated
children suffer from 2 to 5 times more often
than non-vaccinated children.
Vaccination against pandemic influenza
H1N1, also known as "swine", can lead
to the development of Guillain-Barré
syndrome, acute poliradikulita in adults,
according to the Canadian researchers,
published in the journal JAMA.
23
Russian Examples

24. In Poland, no one was vaccinated, because the health minister, Ewa Kopacz, who is a doctor, decided
that it would not be too safe. "As a physician, I am guided by the principle of not harming others" -
Kopacz said in the Polish parliament in 2009. – ”We will not purchase vaccine for swine flu."
… in 2007 a ​​dozen of homeless people in Poland who, without their knowledge, were
vaccinated against bird flu– died …
For over 30 years in the U.S., pharmaceutical companies produce vaccines derived from
aborted fetal tissue (…)
24
Polish Examples

25. 25
English Examples

26. 26
Arguments against vaccination vary by gender.
Men tend to be more concerned with topics that focus on the bigger picture.
Women tend to be more concerned with granular topics, focusing on direct cause & effect.
59%
58%
54%
51%
48%
42%
41%
37%
41%
42%
46%
49%
52%
58%
59%
63%
Developmental Disabilities
Unnecessary
Side Effects
Chemicals/Unnatural
Distrust Government/Industry
Religion/Ethics
Efficacy
Western Plot
Female Male

27. 27
But analyzing various metrics pointed to three topics:
Distrust, Disabilities, Chemicals.
Rank by
Activity Volume
Rank by
Impact Ratio
Rank by
Conversation Density
Rank by
Engagement Rate
Religion/Ethics Developmental Disabilities
Distrust
Government/Industries
Developmental Disabilities
Distrust
Government/Industries
Distrust
Government/Industries
Developmental Disabilities Chemicals/Unnatural
Chemicals/Unnatural Chemicals/Unnatural Chemicals/Unnatural
Distrust
Government/Industries
Developmental Disabilities Unnecessary Side effects Unnecessary
Side Effects Side Effects Western Plot Religion/Ethics
Western Plot Religion/Ethics Unnecessary Efficacy
Efficacy Western Plot Religion/Ethics Western Plot
Unnecessary Efficacy Efficacy Side effects

28. Anti-Vaccination advocates leverage their social networks
to influence others about health, parenting, & policy.
Influencer Networks Description
Dr. Joseph Mercola Facebook, Twitter, Blog Naturopathic doctor against vaccines
Vactruth.com Blog
Concern with vaccines having aborted fetal tissue, chemicals used in pesticides, &
heavy metals
Zen Gardner – Just Wondering Blog Conspiracies aimed at media, government, science, etc.
Dr. Tenpenny on Vaccines Facebook, Twitter, YouTube, Pinterest Osteopathic doctor argues that vaccines cause brain injury
Left Brain/Right Brain Blog Autism news science & opinion, anti-vaccination leaning
Thinking Moms’ Revolution Blog, Facebook Parent-focused
Proud Parents of Unvaccinated Children Facebook
Argues that vaccinated children get unvaccinated children sick, doctors have
inadequate education, Big Pharma controls what doctors learn in medical school
The Refusers Facebook, Twitter, Tumblr
Anti-government, anti-corporate, argues that neurotoxins in vaccines cause brain
damage
Natural News Facebook, Twitter, YouTube, Pinterest, Blog Alternative Medicine blog
Greenmedinfo.com Blog Alternative Medicine blog
Worldtruth.tv
Facebook, Twitter, Reddit, Digg, LinkedIn,
Tumblr, Google+, YouTube
Argues the Pharmaceutical-Industrial Complex pushes harmful vaccines, and
vaccinated kids get more sick than unvaccinated kids
DailySalt.org Blog Alternative Medicine blog
Cafemom.com Forum Vaccination studies and effects explored
VaccineInjury.info Blog Argues for natural immunity to regain health
EverydayHealth.org Blog Alternative Medicine blog

29. 29
Dr. Tenpenny targets women with emotional appeal &
medical authority.
40K Facebook Fans
1.6K Twitter Followers
48 Pinterest Followers
Features
– Multiple social networks
– Multiple websites
– Digital content variety
– Women-focused
– Authoritative

30. 30
Natural News presents as an accessible health &
wellness authority.
270K Facebook Fans
51K Twitter Followers
4.6K Pinterest Followers
42K YouTube Subscribers
Features
– Multiple social networks
– Digital content variety
– Lifestyle oriented
– Free Information
– Authoritative

31. Insights &
Implementation

32. Core Members
Intense Member
Alert Members
32
Model of Anti-vaccination Sentiment Identification
& Salience
1
2
3

33. Comprehensive Education
Uninformed
33
Why do parents refuse vaccinations for their children?
How do they feel?
Acknowledgement
Transparency
More Vaccine Research
Accessible Information
Assurance
Freedom to Choose
Opportunity to contribute
Disempowered
Distrustful
Suspicious
Skeptical
Scared
Frustrated
Conflicted
Guidance
What do they want?

34. 34
Engagement strategies flowed directly from our findings.

35. Thank you
and do you have questions?
Email us at ceecis@unicef.org

36. Appendix

37. 37
Popular arguments reflect traditional American values.
Religion/Ethic
s
27%
Distrust
Government/
Industries
24%
Chemicals/No
n-natural
15%
Development
al Disabilities
14%
Western Plot
9%
Side effects
6%
Efficacy
4%
Unnecessary
1%
Social Media Participants
The relative popularity of topics
reflects the collective concerns
of the English-speaking Anti-
Vaccination community—
freedom, ethics, religion, and
health—typical values of most
Americans.

38. 38
Each metric tells a slightly different story about each topic
Interactions
Posts
Activity Volume Impact Ratio
Topic Impact
Developmental Disabilities 2.7
Distrust Government/Industries 1.9
Chemicals/Unnatural 1.9
Unnecessary 1.6
Side Effects 1.1
Religion/Ethics 1
Western Plot 1
Efficacy 0.9
• Looking at activity volume showed Religion/Ethics to be the most engaging topic.
• Looking at impact ratio showed Developmental Disabilities to be the most engaging topic.

39. 39
Each metric tells a slightly different story about each topic
Topic Density
Distrust Government/Industries 7.9
Developmental Disabilities 6.9
Chemicals/Unnatural 6.9
Side effects 6.3
Western Plot 5.8
Unnecessary 5.5
Religion/Ethics 5.2
Efficacy 4.4
People per Conversation Engagement Rate
Topic Engagement
Developmental Disabilities 20%
Chemicals/Unnatural 16%
Distrust Government/Industries 14%
Unnecessary 14%
Religion/Ethics 11%
Efficacy 11%
Western Plot 11%
Side effects 10%
• More people were involved per conversation about Distrust Government/Industries.
• Posts about Developmental Disabilities became conversations more frequently than other topics.

40. 40
The Refusers advocate against vaccines through music
& “authenticity."
10K Facebook Fans
13K Twitter Followers
139 YouTube Subscribers
Features
– Multiple networks
– Entertainment content
– Social activism
– American values
– Conspiracy

41. 14K Facebook Fans
730 Twitter Followers
444 YouTube Subscribers
41
VacTruth.com triggers parental fears by emphasizing
responsibility.
Features
– Multiple social networks
– Educational
– Empowering
– Authoritative
– Clean, simple design