title: Social media as a platform for health-related public debates and discussions: the Polio vaccine on Facebook.
abstract: Social media can act as an important platform for debating, discussing, and disseminating information about vaccines. Our objectives were to map and describe the roles played by web-based mainstream media and social media as platforms for vaccination-related public debates and discussions during the Polio crisis in Israel in 2013: where and how did the public debate and discuss the issue, and how can these debates and discussions be characterized?
  
  
  
  Polio-related coverage was collected from May 28 to October 31, 2013, from seven online Hebrew media platforms and the Facebook groups discussing the Polio vaccination were mapped and described. In addition, 2,289 items from the Facebook group "Parents talk about Polio vaccination" were analyzed for socio-demographic and thematic characteristics.
  
  
  
  The traditional media mainly echoed formal voices from the Ministry of Health. The comments on the Facebook vaccination opposition groups could be divided into four groups: comments with individualistic perceptions, comments that expressed concerns about the safety of the OPV, comments that expressed distrust in the Ministry of Health, and comments denying Polio as a disease. In the Facebook group "Parents talk about the Polio vaccination", an active group with various participants, 321 commentators submitted 2289 comments, with 64 % of the comments written by women. Most (92 %) people involved were parents. The comments were both personal (referring to specific situations) and general in nature (referring to symptoms or wide implications). A few (13 %) of the commentators were physicians (n= 44), who were responsible for 909 (40 %) of the items in the sample. Half the doctors and 6 % of the non-doctors wrote over 10 items each. This Facebook group formed a unique platform where unmediated debates and discussions between the public and medical experts took place.
  
  
  
  The comments on the social media, as well as the socio-demographic profiles of the commentators, suggest that social media is an active and versatile debate and discussion-facilitating platform in the context of vaccinations. This paper presents public voices, which should be seen as authentic (i.e. unmediated by the media or other political actors) and useful for policy making purposes. The policy implications include identifying social media as a main channel of communication during health crises, and acknowledging the voices heard on social media as authentic and useful for policy making. Human and financial resources need to be devolved specifically to social media. Health officials and experts need to be accessible on social media, and be equipped to readily provide the information, support and advice the public is looking for.
authors.affiliation: Faculty of Education in Science and Technology, Technion - Israel Institute of Technology, Haifa, Israel.
authors.forename: Daniela
authors.identifier: 0000-0002-9824-9386
authors.initials: D
authors.lastname: Orr
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel.
authors.forename: Ayelet
authors.initials: A
authors.lastname: Baram-Tsabari
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel.
authors.forename: Keren
authors.initials: K
authors.lastname: Landsman
mesh_terms: D000070377:Anti-Vaccination Movement / Q000523:psychology*; D054626:Consumer Health Information / Q000379:methods; D005260:Female; D006291:Health Policy; D006801:Humans; D033181:Information Dissemination; D007557:Israel; D008297:Male; D008402:Mass Media / Q000706:statistics & numerical data; D010290:Parents / Q000523:psychology; D011051:Poliomyelitis / Q000517:prevention & control*; D023321:Poliovirus Vaccines / Q000276:immunology*; D011634:Public Health; D061108:Social Media / Q000706:statistics & numerical data*; D014611:Vaccination / Q000523:psychology*; D000072758:Vaccination Refusal
chemical_list: D023321:Poliovirus Vaccines
keywords: Facebook; Polio; Social media; Vaccination debates and discussions