How has the flu virus infected the Web? 2010 influenza and vaccine information available on the Internet.
BACKGROUND
The 2009-10 influenza pandemic was a major public health concern. Vaccination was recommended by the health authorities, but compliance was not optimal and perception of the presumed associated risks was high among the public. The Internet is increasingly being used as a source of health information and advice. The aim of the study was to investigate the characteristics of websites providing information about flu vaccine and the quality of the information provided.


METHODS
Website selection was performed in autumn 2010 by entering eight keywords in two of the most commonly used search engines (Google.com and Yahoo.com). The first three result pages were analysed for each search, giving a total of 480 occurrences. Page rank was evaluated to assess visibility. Websites based on Web 2.0 philosophy, websites merely displaying popular news/articles and single files were excluded from the subsequent analysis. We analysed the selected websites (using WHO criteria) as well as the information provided, using a codebook for pro/neutral websites and a qualitative approach for the adverse ones.


RESULTS
Of the 89 websites selected, 54 dealt with seasonal vaccination, three with anti-H1N1 vaccination and 32 with both. Rank analysis showed that only classic websites (ones not falling in any other category) and one social network were provided on the first pages by Yahoo; 21 classic websites, six displaying popular news/articles and one blog by Google. Analysis of the selected websites revealed that the majority of them (88.8%) had a positive/neutral attitude to flu vaccination. Pro/neutral websites distinguished themselves from the adverse ones by some revealing features like greater transparency, credibility and privacy protection.


CONCLUSIONS
We found that the majority of the websites providing information on flu vaccination were pro/neutral and gave sufficient information. We suggest that antivaccinationist information may have been spread by a different route, such as via Web 2.0 tools, which may be more prone to the dissemination of "viral" information. The page ranking analysis revealed the crucial role of search engines regarding access to information on the Internet.
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy.
Loredana
L
Covolo
Silvia
S
Mascaretti
Anna
A
Caruana
Grazia
G
Orizio
Luigi
L
Caimi
Umberto
U
Gelatti
D054626:Consumer Health Information / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D020407:Internet; D058873:Pandemics; D018570:Risk Assessment
D007252:Influenza Vaccines