Betydelsen av sociala medier för beslut om vaccination - en litteraturöversikt

Syftet med den här litteraturöversikten är att undersöka vilken eventuell betydelse som sociala medier har för beslut om vaccination samt om sociala medier påverkar täckningsgraden i nationella vaccinationsprogram. En litteratursökning utfördes i Lunds universitets samlade biblioteksdatabas Summon. Söktermerna relaterade till sociala medier och vacciner. Efter gallring inkluderades 55 internationella och vetenskapligt granskade artiklar varav 50 (91 %) var publicerade 2006 eller senare. Det är en övervikt av brittiska och amerikanska artiklar i materialet. Vaccinmotstånd har inte uppstått med de sociala mediernas framväxt. Däremot eftersöker allmänheten hälsoinformation på internet i allt större utsträckning, inte minst i Sverige. Det kan förklara det växande intresset bland forskare för de sociala mediernas betydelse i hälsokommunikation. Twitter, Facebook och YouTube används i stor omfattning av både vaccinförespråkare och vaccinmotståndare. Enligt litteraturen utgör de här sociala medierna en stor potentiell tillgång för hälsoaktörer. Medan allmänhetens intresse tycks öka konstant befinner sig hälsoaktörer däremot olika långt fram när det gäller att utnyttja dessa mediers potential. Litteraturöversikten ger inga belägg för att sociala medier har påverkat vaccinationstäckningen i negativ bemärkelse, men frågan behöver följas framöver i takt med att utnyttjandegraden av sociala medier i målgrupperna ökar. Det går inte att säga att vaccinkritiska budskap är överrepresenterade i sociala medier. De tycks snarare vara i minoritet. Samtidigt verkar negativa budskap få större spridning proportionellt sett jämfört med positivt inställda budskap. Bristen på vetenskapliga publikationer som fokuserar på relationen sociala medier och folkhälsa i en svensk kontext är påtaglig. Behovet av svenska och nordiska studier inom ämnesområdet är alltså stort. Vid en internationell jämförelse framträder Sverige och övriga Norden i en klass för sig vad gäller regelbundet internetanvändande. Det finns därför anledning för hälso- och sjukvårdsmyndigheter att öka sin närvaro i de sociala medierna

Change in Population Prevalences of Human Papillomavirus after Initiation of Vaccination: The High-Throughput HPV Monitoring Study.

Organized human papillomavirus (HPV) vaccination was introduced in Sweden in 2012. On-demand vaccination was in effect from 2006 to 2011. We followed the HPV prevalences in Southern Sweden from 2008 to 2013

Highest Vaccine Uptake after School-Based Delivery - A County-Level Evaluation of the Implementation Strategies for HPV Catch-Up Vaccination in Sweden

Background The Swedish school-based vaccination programme offers HPV vaccine to girls born >= 1999 in 5-6th grade. In 2012, all counties introduced free-of-charge catch-up vaccination campaigns targeting girls born 1993-1998. Varying vaccine uptake in the catch-up group by December 2012 suggested that some implementation strategies were more successful than others. In order to inform future vaccination campaigns, we assessed the impact of different implementation strategies on the county-level catch-up vaccine uptake. Methods We conducted an ecological study including all Swedish counties (n = 21), asking regional health offices about the information channels they used and where vaccination of the catch-up target group took place in their counties. The uptake of >= 1 dose by 30 September 2014 was estimated using data from the voluntary national vaccination register. We investigated associations between counties' catch-up vaccine uptake, information channels and vaccination settings by calculating incidence rate ratios (IRR) and 95% confidence intervals (CI), using negative binomial regression models. Results County level catch-up vaccine uptake varied between 49-84%. All counties offered vaccination through primary health care settings. Apart from this eight (34%) also offered the vaccine in some of their schools, four (19%) in all their schools, and two (10%) in other health care centres. The information channels most frequently used were: information at the national on-line health care consulting web-page (100%), letter/invitations (90%), and advertisement (81%). Counties offering vaccination to girls in all schools and counties offering vaccination in some of their schools, reached higher vaccine uptake compared to counties not offering vaccination in any of their schools (all schools adjusted IRR: 1.3, 95% CI: 1.1-1.5, some schools adjusted IRR: 1.2, 95% CI: 1.1-1.3). Conclusion Counties offering HPV vaccination to catch-up groups in schools reached the highest vaccine uptake. No information channel explained differences in county-level vaccine uptake. Our findings suggest that catch-up vaccination outside the national vaccination program can reach a high uptake at the population level if it is implemented primarily with an organized delivery (e.g. in schools)

The Participation of HPV-Vaccinated Women in a National Cervical Screening Program: Population-Based Cohort Study.

Concerns have been raised that HPV-vaccination might affect women's cervical screening behavior. We therefore investigated the association between opportunistic HPV-vaccination and attendance after invitation to cervical screening.A cohort of all women resident in Sweden, born 1977-1987 (N=629,703), and invited to cervical screening, was followed October 2006 - December 2012. Invitations to screening were identified via the National Quality Register for Cervical Cancer Prevention, as was the primary outcome of a registered smear. Vaccination status was obtained from two nationwide health data registers. Hazard ratios (HR) were estimated using Cox regression adjusted for age, education level and income (HRadj). Women were individually followed for up to 6 years, of which the first and second screening rounds were analyzed separately.Screening attendance after three years of follow-up was 86% in vaccinated women (N=4,897) and 75% in unvaccinated women (N=625,804). The crude HR of screening attendance in vaccinated vs. unvaccinated women was 1.31 (95% CI 1.27-1.35) in the first screening round. Adjustment for education and income reduced but did not erase this difference (HRadj=1.09, 95% CI 1.05-1.13). In the second screening round, attendance was likewise higher in HPV-vaccinated women (crude HR=1.26, 95% CI 1.21-1.32; HRadj=1.15, 95% CI 1.10-1.20).HPV-vaccination is so far associated with equal or higher attendance to cervical screening in Sweden in a cohort of opportunistically vaccinated young women. Most but not all of the difference in attendance was explained by socioeconomic differences between vaccinated and unvaccinated women. HPV vaccine effectiveness studies should consider screening attendance of HPV-vaccinated women when assessing incidence of screen-detected cervical lesions

Catch-up vaccine uptake.

<p>Percentage of girls born 1993–1998 that had received at least one dose of HPV vaccine on 30 September 2014, presented by county.</p

Description of information channels and vaccination settings used among counties to implement catch-up vaccination of girls born 1993–1998, Sweden 2012–2014.

<p>Description of information channels and vaccination settings used among counties to implement catch-up vaccination of girls born 1993–1998, Sweden 2012–2014.</p