Vaccine Safety Communication in the Digital Age

"To counteract persistent efforts by vaccination sceptics on the Internet and social media, effective, visible communication of the value, benefits and safety of recommended vaccines and vaccinations is critically important."

The second face-to-face meeting of the Vaccine Safety Net (VSN) was held June 4-5 2018 in Veyrier-du-Lac, France. The VSN strives to ensure that reliable, understandable, evidence-based information on the safety of vaccines is available on the web to be readily found by all. Since the VSN was formed in 2003, websites and social media have become two of the most widely used platforms for providing and disseminating a wide array of health-related content, including information, guidance, and recommendations about vaccines. To that end, this meeting report shares challenges around, and strategies for, managing digital information and communications on vaccine safety in a credible way.

The meeting brought together 89 participants, including 60 VSN representatives from 27 countries in all 6 World Health Organization (WHO) regions. Network members and selected stakeholders discussed strategies to address internet users' information needs, reviewed ways to communicate the safety of vaccine through digital and social media, and debated the pertinence of addressing controversies and vaccine hesitancy in the digital sphere. The meeting documented progress in the Network, in terms of both size and diversity and also the range of activities. For example, new initiatives have been launched to address vaccine hesitancy. A long list of actionable items was compiled, ranging from broadening the VSN membership to enhancing communication strategies, such as improving the visibility of and access to vaccine safety communication messages and materials and scaling up website and social media activities. VSN also plans to foster more visible advocacy for vaccine safety communication with tools that include a repository of examples of vaccine safety communication and evidence. WHO, VSN members, and partners will work together to implement the activities recommended during the meeting, guided by a 2-year (mid-2018 to mid-2020) plan - see the report for details on the roadmap.

Throughout the document, VSN details many approaches for effective use of websites and social media to communicate the safety and value of vaccines, stressing considerations such as the following:

• When planning digital communications, it is important to consider questions such as: "What does success look like?" and "What are you trying to achieve, with whom?"
• The effectiveness of both traditional and digital vaccine information and campaigns will be increased by engagement with healthcare provider organisations, use of spokespeople to whom people can relate, communication research to identify effective messages and assess potential materials, and content directed towards the intended audience.
• Medical and scientific facts are important but often not enough. In many situations and settings, values, emotions, and illustrative personal stories can influence health decisions.
• Most people and parents or caregivers rely on healthcare providers for vaccine information and guidance. Therefore, healthcare providers should be assisted in communication and education on vaccines, including safety.
• Communication with parents, healthcare providers, and stakeholders should be in the language and channels they use, with positive messages (e.g., that highlight the safety and benefits of vaccines) that acknowledge their needs, values, goals, and priorities.
• Characteristics of effective vaccine and health-related communications, including for information provided on websites or through social media platforms, include empathy, caring, and authenticity. People who should receive recommended vaccines and parents and caregivers who make vaccination decisions for children want to know that public health agencies and healthcare providers care about them as individuals and are communicating the facts. Highlighting shared values and tailoring messages to their specific concerns and needs is often essential for building trust.
• While it can be helpful to know the content and distribution of negative, inaccurate, or misleading information, it is also important (and perhaps more important) to use websites and social media to highlight the value, benefits, and safety of recommended vaccines. It would be useful to identify and learn from the successes of others in using websites and social media to achieve positive outcomes.

Many ideas, recommendations, and possibilities were identified in the presentations and discussions at the meeting (see, for example, pages 17-18 of the report). A number of themes emerged with regard to the VSN, vaccine safety communication, use of websites and social media to provide information on the safety and benefits of vaccines, and the challenges faced in digital vaccine safety communication. Key takeaways include:

• Many immunisation programmes, including in government agencies, need more, sustained resources for websites and social media for creating and refreshing: content, visuals, interactivity, and new digital platforms and content for mobile phone platforms - as well as for research to evaluate effectiveness.
• Immunisation programmes should provide information on vaccines and vaccination proactively and in ways that are friendly to the audience, and resources should be provided to support such efforts by websites and social media.
• Healthcare providers are the most important channel for communication on vaccines for most parents. They must therefore have rapid, easy access to resources, materials, and messages that equip them with the knowledge and skills they need to communicate effectively with parents. Websites and social media can help to achieve this.
• Evidence and indicators should be generated of the value and effectiveness of digital communication to back current and future investment. Measures of the success of digital communication on vaccine safety might include greater vaccination coverage, greater acceptance by parents and providers of recommended vaccinations, better understanding by parents and providers about vaccines and vaccination recommendations, and greater visibility on search engines of information on vaccine safety.
• Practical website, social media, and software applications are needed to improve understanding, confidence, and trust in vaccines, including current and emerging technologies to automatise, target, or tailor messages and materials on vaccine safety.
• VSN member websites and web pages should be made more visible in widely used search engines.
• Some countries have issued guidance or recommendations on when and how to respond to negative comments on social media. A VSN guidance document might be helpful to many VSN members.

A final thought: "Listen to stakeholders and members of targeted populations and obtain feedback on vaccine safety communication, which, to be effective, must involve interaction, engagement and listening and not just delivery of information and messages."