Social media influencers can be used to deliver positive information about the flu vaccine: findings from a multi-year study.

Large-scale digital flu vaccine campaigns have experienced difficulty increasing vaccination coverage among African Americans and Hispanics, and are routinely inundated by negative responses from vaccine opponents. A digital campaign employing user-generated content from social media 'micro' influencers who are predominantly followed by African Americans and Hispanics was implemented during the 2018-19 and 2019-20 flu seasons to disseminate positive information about the flu vaccine. At the time, this constituted the largest influencer-driven health campaign focused on these communities in the United States. Comments on posts were qualitatively coded to determine content perceptions among those exposed to posts. Digital metrics were also analyzed. During Year 1, posts reached 9 million+ social media users and generated 64 612 likes or shares, and 1512 responses. In Year 2, posts reached 8 million+ users and generated 155 600 likes or shares, and 3122 responses. Around 94% of public responses to posts were positive, suggesting this is a promising strategy to communicate health information and could shift social norms, particularly for heavily debated topics such as vaccination. This strategy represents a more community-led and participatory approach than most large-scale vaccination campaigns have attempted, with immediate applicability to communications about the COVID-19 vaccine.

Using social media influencers to increase knowledge and positive attitudes toward the flu vaccine.

Seasonal influenza affects millions of people across the United States each year. African Americans and Hispanics have significantly lower vaccination rates, and large-scale campaigns have had difficulty increasing vaccination among these two groups. This study assessed the feasibility of delivering a flu vaccination promotion campaign using influencers, and examined shifts in social norms regarding flu vaccine acceptability after a social media micro influencer campaign. Influencers were asked to choose from vetted messages and create their own original content promoting flu vaccination, which was posted to their social media pages. Content was intentionally unbranded to ensure that it aligned with the look and feel of their pages. Cross-sectional pre- and post-campaign surveys were conducted within regions that received the campaign and control regions to examine potential campaign impact. Digital metrics assessed campaign exposure. Overall, 117 influencers generated 69,495 engagements. Results from the region that received the campaign showed significant increases in positive beliefs about the flu vaccine, and significant decreases in negative community attitudes toward the vaccine. This study suggests that flu campaigns using a ground-up rather than top-down approach can feasibly reach at-risk groups with lower vaccination rates, and shows the potentials of using an influencer-based model to communicate information about flu vaccination on a large scale.