Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 16, 2024
Date Accepted: Dec 31, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Understanding Public Attitudes Towards Human Papillomavirus Vaccination in Japan: Insights from Social Media Stance Analysis Using Large Language Models
ABSTRACT
Background:
Despite the reinstatement of proactive human papillomavirus (HPV) vaccine recommendations in 2022, Japan continues to face persistently low HPV vaccination rates, which pose significant public health challenges. Misinformation, complacency, and accessibility issues have been identified as key factors undermining vaccine uptake.
Objective:
This study aimed to understand how factors such as misinformation, public health events, and attitudes towards other vaccines such as COVID-19, influence HPV vaccine hesitancy by analyzing the evolution of public attitudes towards HPV vaccination in Japan by examining social media content.
Methods:
We collected tweets related to HPV vaccine from 2011 to 2021. Traditional natural language processing (NLP) methods and large language models (LLMs) were used to perform stance analysis of the collected data. The analyses included stance identification, time-series analysis, topic modeling, and logic analysis. We framed our findings within the context of the WHO's 3Cs model—Confidence, Complacency, and Convenience.
Results:
Public confidence in the HPV vaccine may fluctuated in response to government policies and media events, and misinformation can play a critical role in eroding trust. Complacency increased following the suspension of recommendations in 2013 but decreased as advocacy resumed in 2020. Accessibility (Convenience) was also found to be a key determinant of vaccination uptake. HPV vaccines are often used as supportive evidence towards other vaccines, such as those against COVID-19.
Conclusions:
Our findings underscore the importance of targeted public health interventions to restore and maintain vaccine confidence in Japan. Although vaccine confidence has increased slowly, sustained efforts are necessary to ensure long-term improvements. Confidence in one vaccine may positively influence perceptions of other vaccines. Addressing misinformation, reducing complacency, and enhancing vaccine accessibility are key strategies for improving vaccine uptake. Increased confidence in HPV vaccines appeared to have a positive influence on confidence in other vaccines, such as those against COVID-19. This study also demonstrated the utility of LLMs in providing a comprehensive understanding of public health attitudes. To effectively combat vaccine hesitancy and improve coverage, interventions must prioritize consistent communication, localized strategies, and integrated approaches to vaccine narratives.
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