Previously submitted to: Online Journal of Public Health Informatics (no longer under consideration since Oct 14, 2026)
Date Submitted: Aug 10, 2026
Open Peer Review Period: Aug 21, 2026 - Oct 16, 2026
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Textual Dynamics of Voluntary and Mandatory Vaccine Debates in Online Health Communities
ABSTRACT
Background:
Vaccines are essential public health interventions, yet they remain controversial, with individuals expressing differing views about their risks, benefits, and acceptance. Social media platforms provide large amounts of publicly available data that can be used to examine public perceptions and concerns regarding vaccination. Comparing discussions of mandatory and voluntary vaccines may provide insight into the factors shaping online vaccine-related discourse.
Objective:
This study aimed to examine and compare online discussions of a mandatory vaccine, the measles, mumps, and rubella (MMR) vaccine, and a voluntary vaccine, the influenza (flu) vaccine, using text analysis of Reddit discussions.
Methods:
Publicly available Reddit data were collected in May 2020. Initial Reddit threads containing “MMR vaccine” or “measles, mumps, and rubella vaccine” in the title were collected for the MMR vaccine, while threads containing “flu vaccine” or “influenza vaccine” in the title were collected for the flu vaccine. All replies to the identified initial posts were subsequently collected. The final dataset comprised 11,176 MMR vaccine-related posts and 10,152 flu vaccine-related posts. Descriptive and text analysis techniques were used to characterize and compare discussions concerning the two vaccine types, including patterns of interaction, post scores, and major topics of discussion.
Results:
The MMR vaccine dataset contained 11,176 posts, compared with 10,152 posts in the flu vaccine dataset. MMR vaccine-related discussions generated more comments than discussions concerning the flu vaccine. MMR-related posts also had a higher average Reddit post score than flu vaccine-related posts. Text analysis indicated that discussions about mandatory MMR vaccination were more interactive and focused primarily on risks associated with vaccination. In contrast, discussions concerning voluntary flu vaccination focused more strongly on vaccine effectiveness and individual decisions about whether to receive the vaccine. Statistical significance measures, including P values and confidence intervals, were not available from the provided study information.
Conclusions:
Online discussions differ according to whether a vaccine is mandatory or voluntary. Discussions of the MMR vaccine were characterized by greater interaction and greater emphasis on vaccination-related risks, whereas discussions of the flu vaccine focused more on effectiveness and individual vaccination decisions. These findings demonstrate the potential of Reddit data and text analysis to identify vaccine-specific public concerns and may help health agencies, healthcare providers, caregivers, and researchers develop more targeted approaches to vaccine communication and education.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.