YouTube a New Medium for Immunization Foes' Message

TORONTO, Dec. 6 -- Although only about a third of the videos about immunization posted on YouTube are negative, they are viewed more often than positive ones and get better ratings, investigators here said.

Of 153 videos on the video-sharing website that focused primarily on immunization, 73 (48%) were positive, 49 (32%) were negative, and 31 (20%) were ambiguous, reported Jennifer Keelan, Ph.D., of the University of Toronto, and colleagues in a research letter in the Dec. 5 issue of the Journal of the American Medical Association.

Action Points

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• Explain to interested patients that this study indicates that Internet-based information about immunization is often inaccurate or contains unsubstantiated information.
  
  
• Encourage patients to discuss immunization with you.

Negative videos had a median 520 views compared with just 181 for positive videos and received a mean rating of 4.4 stars compared with 3.5, they said.

"Approximately half of the videos posted were not explicitly supportive of immunization, and information in negative videos often contradicted the reference standard," the authors concluded. "The video ratings and view counts suggest the presence of a community of YouTube users critical of immunization."

Health care professionals have expressed concern about the quality and accuracy of health-related information available on the Internet, the authors noted. The concerns include information about immunization programs.

The authors could find no evidence of previous studies that had examined the content of immunization-related videos posted on YouTube, which was created in 2005 and allows users to share multimedia clips about virtually any topic.

Using the key words "immunization" and "vaccination," Dr. Keelan and colleagues searched the YouTube website, and identified all English-language videos containing any information about human immunization. The investigators extracted information about the length, content, and scientific claims made in the videos.

Additionally, they assessed YouTube user interaction with the videos, using view counts and viewer reviews reflected by a star-rating system, with one star for "poor" and five for "awesome."

Dr. Keelan and colleagues categorized videos as positive if the central message supported immunization or portrayed it in a positive light. Positive videos included public service announcements posted by government entities and messages from vaccine manufacturers.

Videos were classified as negative if the main message portrayed immunization negatively by emphasizing risks, promoting distrust of vaccine science, or advocating against immunization.

Videos were considered ambiguous if they consisted of a debate or were ambivalent (presenting positive and negative information).

The most common topic of the videos was general childhood vaccines (38 videos, 25% of the total). The most commonly discussed specific vaccine was the human papillomavirus vaccine (36, 24%). The authors considered 20 of the 36 HPV-focused videos to be positive, including four that were industry-sponsored. Among positive videos, public service announcements had the lowest star ratings and view counts.

Of the 49 negative videos, 22 (45%) conveyed messages or information that contradicted immunization guidelines. In contrast, none of the positive videos contained unsubstantiated or contradictory claims.

Topics dealt with most often in videos that contained unsubstantiated or contradictory information were HPV (10, nine of which were negative or ambivalent) and thimerosal (12, 11 negative and one ambivalent).

"Clinicians … need to be aware of Internet video-sharing sites and should be prepared to respond to patients who obtain their information from these sources," the authors said.

"The potential use of these sites for effective communication by health professionals should also be considered," they concluded.

Notice one action point is missing: to investigate the claims in the videos!!