Wellness Influencer Responses to COVID-19 Vaccines on Social Media: A Longitudinal Observational Study

BackgroundOnline wellness influencers (individuals dispensing unregulated health and wellness advice over social media) may have incentives to oppose traditional medical authorities. Their messaging may decrease the overall effectiveness of public health campaigns during glob...

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Main Authors: Gabrielle O'Brien, Ronith Ganjigunta, Paramveer S Dhillon
Format: Article
Language:English
Published: JMIR Publications 2024-11-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2024/1/e56651
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author Gabrielle O'Brien
Ronith Ganjigunta
Paramveer S Dhillon
author_facet Gabrielle O'Brien
Ronith Ganjigunta
Paramveer S Dhillon
author_sort Gabrielle O'Brien
collection DOAJ
description BackgroundOnline wellness influencers (individuals dispensing unregulated health and wellness advice over social media) may have incentives to oppose traditional medical authorities. Their messaging may decrease the overall effectiveness of public health campaigns during global health crises like the COVID-19 pandemic. ObjectiveThis study aimed to probe how wellness influencers respond to a public health campaign; we examined how a sample of wellness influencers on Twitter (rebranded as X in 2023) identified before the COVID-19 pandemic on Twitter took stances on the COVID-19 vaccine during 2020-2022. We evaluated the prevalence of provaccination messaging among wellness influencers compared with a control group, as well as the rhetorical strategies these influencers used when supporting or opposing vaccination. MethodsFollowing a longitudinal design, wellness influencer accounts were identified on Twitter from a random sample of tweets posted in 2019. Accounts were identified using a combination of topic modeling and hand-annotation for adherence to influencer criteria. Their tweets from 2020-2022 containing vaccine keywords were collected and labeled as pro- or antivaccination stances using a language model. We compared their stances to a control group of noninfluencer accounts that discussed similar health topics before the pandemic using a generalized linear model with mixed effects and a nearest-neighbors classifier. We also used topic modeling to locate key themes in influencer’s pro- and antivaccine messages. ResultsWellness influencers (n=161) had lower rates of provaccination stances in their on-topic tweets (20%, 614/3045) compared with controls (n=242 accounts, with 42% or 3201/7584 provaccination tweets). Using a generalized linear model of tweet stance with mixed effects to model tweets from the same account, the main effect of the group was significant (β1=–2.2668, SE=0.2940; P<.001). Covariate analysis suggests an association between antivaccination tweets and accounts representing individuals (β=–0.9591, SE=0.2917; P=.001) but not social network position. A complementary modeling exercise of stance within user accounts showed a significant difference in the proportion of antivaccination users by group (χ21[N=321]=36.1, P<.001). While nearly half of the influencer accounts were labeled by a K-nearest neighbor classifier as predominantly antivaccination (48%, 58/120), only 16% of control accounts were labeled this way (33/201). Topic modeling of influencer tweets showed that the most prevalent antivaccination themes were protecting children, guarding against government overreach, and the corruption of the pharmaceutical industry. Provaccination messaging tended to encourage followers to take action or emphasize the efficacy of the vaccine. ConclusionsWellness influencers showed higher rates of vaccine opposition compared with other accounts that participated in health discourse before the pandemic. This pattern supports the theory that unregulated wellness influencers have incentives to resist messaging from establishment authorities such as public health agencies.
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spelling doaj-art-0bc00efbbeb84773a25c941f739504ea2025-08-20T02:07:23ZengJMIR PublicationsJournal of Medical Internet Research1438-88712024-11-0126e5665110.2196/56651Wellness Influencer Responses to COVID-19 Vaccines on Social Media: A Longitudinal Observational StudyGabrielle O'Brienhttps://orcid.org/0009-0001-3198-3586Ronith Ganjiguntahttps://orcid.org/0009-0003-7292-8254Paramveer S Dhillonhttps://orcid.org/0000-0002-0994-9488 BackgroundOnline wellness influencers (individuals dispensing unregulated health and wellness advice over social media) may have incentives to oppose traditional medical authorities. Their messaging may decrease the overall effectiveness of public health campaigns during global health crises like the COVID-19 pandemic. ObjectiveThis study aimed to probe how wellness influencers respond to a public health campaign; we examined how a sample of wellness influencers on Twitter (rebranded as X in 2023) identified before the COVID-19 pandemic on Twitter took stances on the COVID-19 vaccine during 2020-2022. We evaluated the prevalence of provaccination messaging among wellness influencers compared with a control group, as well as the rhetorical strategies these influencers used when supporting or opposing vaccination. MethodsFollowing a longitudinal design, wellness influencer accounts were identified on Twitter from a random sample of tweets posted in 2019. Accounts were identified using a combination of topic modeling and hand-annotation for adherence to influencer criteria. Their tweets from 2020-2022 containing vaccine keywords were collected and labeled as pro- or antivaccination stances using a language model. We compared their stances to a control group of noninfluencer accounts that discussed similar health topics before the pandemic using a generalized linear model with mixed effects and a nearest-neighbors classifier. We also used topic modeling to locate key themes in influencer’s pro- and antivaccine messages. ResultsWellness influencers (n=161) had lower rates of provaccination stances in their on-topic tweets (20%, 614/3045) compared with controls (n=242 accounts, with 42% or 3201/7584 provaccination tweets). Using a generalized linear model of tweet stance with mixed effects to model tweets from the same account, the main effect of the group was significant (β1=–2.2668, SE=0.2940; P<.001). Covariate analysis suggests an association between antivaccination tweets and accounts representing individuals (β=–0.9591, SE=0.2917; P=.001) but not social network position. A complementary modeling exercise of stance within user accounts showed a significant difference in the proportion of antivaccination users by group (χ21[N=321]=36.1, P<.001). While nearly half of the influencer accounts were labeled by a K-nearest neighbor classifier as predominantly antivaccination (48%, 58/120), only 16% of control accounts were labeled this way (33/201). Topic modeling of influencer tweets showed that the most prevalent antivaccination themes were protecting children, guarding against government overreach, and the corruption of the pharmaceutical industry. Provaccination messaging tended to encourage followers to take action or emphasize the efficacy of the vaccine. ConclusionsWellness influencers showed higher rates of vaccine opposition compared with other accounts that participated in health discourse before the pandemic. This pattern supports the theory that unregulated wellness influencers have incentives to resist messaging from establishment authorities such as public health agencies.https://www.jmir.org/2024/1/e56651
spellingShingle Gabrielle O'Brien
Ronith Ganjigunta
Paramveer S Dhillon
Wellness Influencer Responses to COVID-19 Vaccines on Social Media: A Longitudinal Observational Study
Journal of Medical Internet Research
title Wellness Influencer Responses to COVID-19 Vaccines on Social Media: A Longitudinal Observational Study
title_full Wellness Influencer Responses to COVID-19 Vaccines on Social Media: A Longitudinal Observational Study
title_fullStr Wellness Influencer Responses to COVID-19 Vaccines on Social Media: A Longitudinal Observational Study
title_full_unstemmed Wellness Influencer Responses to COVID-19 Vaccines on Social Media: A Longitudinal Observational Study
title_short Wellness Influencer Responses to COVID-19 Vaccines on Social Media: A Longitudinal Observational Study
title_sort wellness influencer responses to covid 19 vaccines on social media a longitudinal observational study
url https://www.jmir.org/2024/1/e56651
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