Beth Hoffman, B.Sc., graduate studentUniversity of Pittsburgh Graduate School of Public HealthResearch Assistant,University of Pittsburgh Center for Research on Media, Technology and Health

Anti-Vaccine Groups Are Not Just Worried About Autism Interview with:

Beth Hoffman, B.Sc., graduate studentUniversity of Pittsburgh Graduate School of Public HealthResearch Assistant,University of Pittsburgh Center for Research on Media, Technology and Health

Beth Hoffman

Beth Hoffman, B.Sc., graduate student
University of Pittsburgh Graduate School of Public Health
Research Assistant,
University of Pittsburgh Center for Research on Media, Technology and Health What is the background for this study? What are the main findings?

Response: Vaccine refusal is a public health crisis – low vaccination rates are leading to outbreaks of deadly vaccine-preventable diseases. In 2017, Kids Plus Pediatrics, a Pittsburgh-based pediatric practice, posted a video on its Facebook pagef eaturing its practitioners encouraging HPV vaccination to prevent cancer. Nearly a month after the video posted, it caught the attention of multiple anti-vaccination groups and, in an eight-day period, garnered thousands of anti-vaccination comments.

Our team analyzed the profiles of a randomly selected sample of 197 commenters in the hopes that this crisis may be stemmed if we can better understand and communicate with vaccine-hesitant parents.

We determined that, although Kids Plus Pediatrics is an independent practice caring for patients in the Pittsburgh region, the commenters in the sample were spread across 36 states and eight countries.

By delving into the messages that each commenter had publicly posted in the previous two years, we also found that they clustered into four distinct subgroups:

  • “trust,” which emphasized suspicion of the scientific community and concerns about personal liberty;
  • “alternatives,” which focused on chemicals in vaccines and the use of homeopathic remedies instead of vaccination;
  • “safety,” which focused on perceived risks and concerns about vaccination being immoral; and
  • “conspiracy,” which suggested that the government and other entities hide information that this subgroup believes to be facts, including that the polio virus does not exist. What should readers take away from your report?

Response: As far as we know, this is the first study to use social network analysis to look at the characteristics of those spreading anti-vaccine content on social media. It also shows that people who are against vaccines are not a monolithic group who all believe the MMR vaccine causes autism. The presence of these distinct subgroups cautions against a blanket approach to public health messages that encourage vaccination. For example, telling someone in the ‘trust’ subgroup that vaccines don’t cause autism may alienate them because that isn’t their concern to begin with. Instead, it may be more effective to find common ground and deliver tailored messages related to trust and the perception mandatory vaccination threatens their ability to make decisions for their child, What recommendations do you have for future research as a result of this work?

Response: We want to understand vaccine-hesitant parents in order to give clinicians the opportunity to optimally and respectfully communicate with them about the importance of immunization. Future study should involve assessing various approaches to communicating with vaccine-hesitant parents and ways to counter anti-vaccination messaging on social media. Specifically, future work could involve interventions related to media literacy, the use of entertainment narratives to promote pro-vaccine messages, and targeted messaging to various subgroups. Is there anything else you would like to add?

Response: Additional authors on this research are senior author Brian Primack, M.D., Ph.D., director of the University of Pittsburgh Center for Research on Media, Technology, and Health, and dean of the University of Pittsburgh  Honors College; Elizabeth Felter, Dr.P.H., Kar-Hai Chu, Ph.D., Ariel Shensa, M.A., and Daria Williams, all of Pitt; and Todd Wolynn, M.D., and Chad Hermann, Ph.D., of Kids Plus Pediatrics.

All funding to perform this analysis was provided by the University of Pittsburgh. 


Beth L. Hoffman, Elizabeth M. Felter, Kar-Hai Chu, Ariel Shensa, Chad Hermann, Todd Wolynn, Daria Williams, Brian A. Primack. It’s not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook. Vaccine, 2019; DOI: 10.1016/j.vaccine.2019.03.003 

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Last Updated on March 26, 2019 by Marie Benz MD FAAD