The top 100 Twitter influencers in cardiology

ImportanceTwitter represents a growing aspect of the social media experience and is a widely used tool for public education in the 21^st century. In the last few years, there has been concern about the dissemination of false health information on social media. It is therefore important that we assess the influencers of this health information in the field of cardiology.ObjectiveWe sought to identify the top 100 Twitter influencers within cardiology, characterize them, and examine the relationship between their social media activity and academic influence.DesignTwitter topic scores for the topic search “cardiology” were queried on May 01, 2020 using the Right Relevance application programming interface (API). Based on their scores, the top 100 influencers were identified. Among the cardiologists, their academic h-indices were acquired from Scopus and these scores were compared to the Twitter topic scores.ResultWe found out that 88/100 (88%) of the top 100 social media influencers on Twitter were cardiologists. Of these, 63/88 (72%) were males and they practiced mostly in the United States with 50/87 (57%) practicing primarily in an academic hospital. There was a moderately positive correlation between the h-index and the Twitter topic score, r = +0.32 (p-value 0.002).ConclusionOur study highlights that the top ranked cardiology social media influencers on Twitter are board-certified male cardiologists practicing in academic settings in the US. The most influential on Twitter have a moderate influence in academia. Further research should evaluate the relationship between other academic indices and social media influence.     

Advancing Strategies for Agenda Setting by Health Policy Coalitions: A Network Analysis of the Canadian Chronic Disease Prevention Survey

ABSTRACT

Health in all policies can address chronic disease morbidity and mortality by increasing population-level physical activity and healthy eating, and reducing tobacco and alcohol use. Both governmental and nongovernmental policy influencers are instrumental for health policy that modifies political, economic, and social environments. Policy influencers are informed and persuaded by coalitions that support or oppose changing the status quo. Empirical research examining policy influencers’ contact with coalitions, as a social psychological exposure with health policy outcomes, can benefit from application of health communication theories. Accordingly, we analyzed responses to the 2014 Chronic Disease Prevention Survey for 184 Canadian policy influencers employed in provincial governments, municipalities, large workplaces, school boards, and the media. In addition to contact levels with coalitions, respondents’ jurisdiction, organization, and ideology were analyzed as potential moderators. Calculating authority score centrality using network analysis, we determined health policy supporters to be more central in policy influencer networks, and theorized their potential to impact health policy public agenda setting via priming and framing processes. We discuss the implications of our results as presenting opportunities to more effectively promote health policy through priming and framing by coordinating coalitions across risk behaviors to advance a societal imperative for chronic disease prevention.     

#DoctorsSpeakUp: Lessons learned from a pro-vaccine Twitter event

BackgroundIn response to growing anti-vaccine activism on social media, the #DoctorsSpeakUp event was designed to promote pro-vaccine advocacy. This study aimed to analyze Twitter content related to the event to determine (1) characteristics of the Twitter users who authored these tweets, (2) the proportion of tweets expressing pro-vaccine compared to anti-vaccine sentiment, and (3) the content of these tweets.MethodsData were collected using Twitter’s Filtered Streams Interface, and included all publicly available tweets with the “#DoctorsSpeakUp“ hashtag on March 5, 2020, the day of the event. Two independent coders assessed a 5% subsample of original tweets (n = 966) using a thematic content analysis approach. Cohen’s κ ranged 0.71–1.00 for all categories. Chi-square and Fisher’s exact tests were used to examine associations between tweet sentiment, type of account, and tweet content (personal narrative and/or statement about research or science). Accounts were analyzed for likelihood of being a bot (i.e. automated account) using Botometer.ResultsOf 847 (87.7%) relevant tweets, 244 (28.8%) were authored by a Twitter user that identified as a parent and 68 (8.0%) by a user that identified as a health professional. With regard to sentiment, 167 (19.7%) were coded as pro-vaccine and 668 (78.9%) were coded as anti-vaccine. Tweet sentiment was significantly associated with type of account (p < 0.001) and tweet content (p = 0.001). Of the 575 unique users in our dataset, 31 (5.4%) were classified as bots using Botometer.ConclusionsOur results suggest a highly coordinated response of devoted anti-vaccine antagonists in response to the #DoctorsSpeakUp event. These findings can be used to help vaccine advocates leverage social media more effectively to promote vaccines. Specifically, it would be valuable to ensure that pro-vaccine messages consider hashtag use and pre-develop messages that can be launched and promoted by pro-vaccine advocates.     

Anti-vaccine activists, Web 2.0, and the postmodern paradigm--an overview of tactics and tropes used online by the anti-vaccination movement

Websites opposing vaccination are prevalent on the Internet. Web 2.0, defined by interaction and user-generated content, has become ubiquitous. Furthermore, a new postmodern paradigm of healthcare has emerged, where power has shifted from doctors to patients, the legitimacy of science is questioned, and expertise is redefined. Together this has created an environment where anti-vaccine activists are able to effectively spread their messages. Evidence shows that individuals turn to the Internet for vaccination advice, and suggests such sources can impact vaccination decisions - therefore it is likely that anti-vaccine websites can influence whether people vaccinate themselves or their children. This overview examines the types of rhetoric individuals may encounter online in order to better understand why the anti-vaccination movement can be convincing, despite lacking scientific support for their claims. Tactics and tropes commonly used to argue against vaccination are described. This includes actions such as skewing science, shifting hypotheses, censoring dissent, and attacking critics; also discussed are frequently made claims such as not being "anti-vaccine" but "pro-safe vaccines", that vaccines are toxic or unnatural, and more. Recognizing disingenuous claims made by the anti-vaccination movement is essential in order to critically evaluate the information and misinformation encountered online.     

“You Are Not Alone”: Advice Giving for Parents of Children Living with Complex Chronic Conditions

ABSTRACT

Parental advice giving serves as an important form of informational support for parents of children living with complex chronic conditions (CCCs). These messages can provide backchannel insights into social challenges, best practices, and may offer different forms of experiential wisdom garnered from their own parental caregiving experiences. Contributing to the naturalistic, health-context investigations of advice messages, we interviewed 35 parents who discussed their experiences with parenting their medically complex child. Part of the broader interview protocol asked parents about advice they would offer to other parents like them. We conducted a thematic analysis of parents’ responses to these questions to understand advice content, form of advice giving messages, challenges experienced by parents, and suggested best practices for managing a child’s CCC. We present our findings and discuss implications on educating health care professionals about how to cultivate advice networks and the need for more parent peer mentoring programs.     

Temporal trends in anti-vaccine discourse on Twitter

Despite vaccination’s role in preventing communicable diseases, misinformation threatens uptake. Social media may disseminate such anti-vaccination messages. We characterized trends in pro- and anti-vaccination discourse on Twitter. All tweets between 2010 and 2019 containing vaccine-related hashtags were identified. Pro- and anti-vaccine tweets and users per quarter (3-months) were tabulated; discussion subcommunities were identified with network analysis. 1,637,712 vaccine-related tweets were identified from 154 pro-vaccine and 125 anti-vaccine hashtags, with 86% of users posting exclusively pro-vaccine and 12% posting exclusively anti-vaccine hashtags. Pro-vaccine tweet volumes are larger than anti-vaccine tweets and consistently increase over time. In contrast, anti-vaccine tweet volumes have decreased since 2014, despite an increasing anti-vaccine user-base. Users infrequently responded across pro/anti-vaccine alignment (0.2%). Despite greater volumes of pro-vaccination discourse in recent years, and the anti-vaccination content userbase being smaller, the anti-vaccine community continues to grow in size. This finding coupled with the minimal inter-communication between communities suggests possible ideological isolation.     

Shades of gray in vaccination decisions – Understanding community pharmacists’ perspectives of,and experiences with,influenza vaccine hesitancy in Ontario,Canada

Background and objectivesVaccine hesitancy (VH) has been increasingly recognized as a global threat to public health. Yet, limited research exists exploring healthcare providers’ experience of this phenomenon. Our study aims to understand community pharmacists’ attitudes towards, and experiences with, influenza VH, and explore factors impacting their engagement with patients on the influenza vaccine.MethodsA semi-structured interview guide was developed, and interviews were conducted to saturation with community pharmacists practicing in Ontario, Canada. Interview data was transcribed verbatim and analyzed using a thematic content analysis framework. The analysis yielded 110 unique codes, which were merged into five major themes and 15 sub-themes.ResultsA total of 22 pharmacists were interviewed to achieve saturation. Most pharmacists were authorized to administer injections (n = 20, 90.9%) and practiced for >20 years (n = 16, 72.7%). Pharmacists’ engagement with patients on the influenza vaccine was found to be modulated by a complex and mutually reinforcing constellation of attitudes and behaviours which include: a binary (pro-vaccine or anti-vaccine) perception of patient vaccination decisions; a conflation of those expressing hesitancy with those who are anti-vaccine; and a passive approach to patient engagement, wherein patients were found to be the primary initiators of vaccine conversations. Although pharmacists recognized the importance of educating patients and addressing their vaccine-related concerns, barriers such as limited time, inadequate staffing, and poor remuneration were found to restrict optimal patient engagement on influenza vaccinations.ConclusionWhile pharmacists hold the potential to effectively address influenza VH within their communities, future interventions must aim to break the loop of passive patient engagement and enable proactive pharmacist-patient interactions on influenza vaccinations in this setting.     

Comparative study of mothers' knowledge of children immunization before and after mass media.

Past experience about immunization programs calls for continuous monitoring of a healthy attitude among users towards vaccination. The aim of this study was to assess the effect of health education messages (mass media) on knowledge and practice of mothers as regards compulsory vaccination schedule. Data were collected from 250 females attending MCH centers during the first half of 1991 for either vaccinating their children or receiving antenatal care (exposed group). These data were compared to the data collected from a group of mothers before implementation of the intense mass media campaign on immunization (1983), (non-exposed group). There was a significant increase in the mean score of knowledge among the exposed mothers. The mass media messages became the main source of information among the majority of the exposed group. Females utilizing mass media as their main source of information were largely having a satisfactory level of knowledge. This study recommends enforcement of mass media educational campaigns on childhood immunization as well as reconsideration paid to the nature and content of messages.     

Latin American Considerations for Infant and Young Child Formulae

Infant formula is the only acceptable substitute for breastmilk from 0 to 6 months old when human milk cannot be provided in sufficient amounts. Manufacturers have developed options that intend to meet the changing needs of the child aged from six to twelve months (follow-on formulae) and after the age of one year (young child formulae). The international code for marketing breast milk substitute stipulates standards for marketing practices of these products. In Latin America there are local variations of marketing practices. Novel marketing strategies such as advertising through social media and influencers pose new threats for breastfeeding success in Latin America. This review aims to examine variations in local regulations for marketing of infant formulae and to analyze the emerging phenomenon of influencer advertising. We reviewed the local norms for Latin American countries and examined differences and possible gaps. Emerging evidence of influencer marketing was explored. The results indicate that national regulations differ among Latin American countries, particularly with respect to product labelling and the requirement to use a local native language, highlighting the cost of the product, and different regulations prohibiting certain messages and illustrations. Regarding new marketing strategies, there is limited evidence on advertising infant formula through social media influencers, where different categories of marketing strategies can be described. More transparent reporting of social marketing by formula providers and more independent research on novel marketing strategies are needed.     

The echo in flu-vaccination echo chambers: Selective attention trumps social influence

BackgroundOnline discussions may impact the willingness to get vaccinated. This experiment tests how groups of individuals with consistent and inconsistent attitudes towards flu vaccination attend to and convey information online, and how they alter their corresponding risk perceptions.MethodsOut of 1859 MTurkers, we pre-selected 208 people with negative and 221 people with positive attitudes towards flu vaccinations into homogeneous or heterogeneous 3-link experimental diffusion chains. We assessed (i) which information about flu vaccinations participants conveyed to the subsequent link, (ii) how flu-vaccination related perceptions were altered by incoming messages, and (iii) how participants perceived incoming information.ResultsParticipants (i) selectively conveyed attitude-consistent information, but exhibited no overall anti-vaccination bias, (ii) were reluctant to alter their flu-vaccination related perceptions in response to messages, and (iii) evaluated incoming information consistent with their prior attitudes as more convincing.DiscussionFlu-vaccination related perceptions are resilient against contradictions and bias online communication. Contrary to expectations, there was no sign of amplification of anti-vaccine attitudes by online communication.     

Immunization promotion activities: are they effective in encouraging mothers to immunize their children?

Mass media communication is an important strategy for increasing parental uptake and to promote community participation when large-scale immunization activities are carried out. In Mexico, the National Vaccination Council (CONAVA) launches three immunization campaigns every year accompanied by three vaccination promotion campaigns. This study was conducted to assess whether communication activities to promote CONAVA's Second National Health Week (SNHW) were effective in providing information to mothers about the importance of immunizing their children under five years of age and in prompting them to seek immunization services. A probability sample of mothers living in the metropolitan area of Mexico City and having at least one child under five years old was selected for the study. Four outcome variables were defined as measuring the impact of the campaign: (1) mothers' knowledge about the SNHW; (2) mothers' comprehension indicating how well they understood the campaign messages (aware, partly aware and unaware); (3) mothers' motivation, i.e. whether or not they sought out immunizations for their children under the age of five and (4) mothers' opinion of how well they liked the messages. A total of 935 mothers were interviewed; 88.2% knew about the SNHW, 64.3% were aware that the campaign aimed to provide immunizations, and most held a favorable opinion about the messages. Among aware mothers, 87.5% of their children received immunizations. In this group 72.1% were prompted by the information in the campaign to seek immunizations for their children while 27.9% had to be personally invited to participate in the campaign. The latter occurred either when health workers or volunteers visited mothers in their homes or by soliciting mothers' participation as they visited or passed by immunization health posts. In the unaware mothers group, 72.7% of their children received immunizations; 62.5% of the mothers took their children because of information they received through the campaign while 37.5% had to be personally invited to immunize their children. Mothers with better socioeconomic status were more aware of the campaign, but a high percentage of them did not seek immunizations, while mothers with middle and lower socioeconomic status were motivated to immunize their children through the campaign. Promotion activities and messages communicated through the mass media were appropriate to inform and motivate mothers to seek immunization services for their children.     

Vaccine information seeking on social Q&A services

Experts are concerned about the spread and recalcitrance of vaccine misinformation and its contribution to vaccine hesitancy. Despite this risk, little research attention has been paid to understanding how individuals seek vaccine information online and evaluate its trustworthiness. Here, we hypothesized that when vaccine-hesitant parents seek information about vaccines, they prefer trustworthy sources based on their competence, integrity and benevolence. We explored this issue using 4910 questions and 2583 answers retrieved from two social question-and-answer (Q&A) platforms: “Yahoo! Answers” and the Facebook group “Talking about Vaccines.” We examined what kinds of questions are asked about vaccines, to what extent they are explicitly directed at health professionals or parents, and what features of the answers predict perceived answer quality, based on the theory of epistemic trust. The findings indicate that on different platforms, vaccine-related questions focus on different topics; namely, questions on one platform focused on the risks and benefits of vaccination, whereas they dealt with vaccine schedules on the other. On both platforms, most questions did not specify that an answer should be based on professional expertise or parents' experience. Both pro-vaccine and anti-vaccine answers were proportionately represented among the “best answers”. However, if an answer was written by a health professional, the askers and the community on “Yahoo! Answers” were twice as likely to choose it as the “best answer” to a vaccine-related question, irrespective of whether it encouraged or discouraged vaccination. By contrast, an online experiment revealed that both the identity of the respondent and the stance towards vaccination affected the perceived trustworthiness of the answers. These findings indicate that despite the proliferation of anti-vaccine messages, epistemic trust in mainstream science and medicine is robust. User responses to expert answers suggest that expert outreach in online environments may be an effective intervention to address vaccine hesitancy.     

Attitudes and Communication Preferences for Vaccines among Pregnant Women Receiving Care at a Safety-net Hospital

ObjectiveWe aimed to understand pregnant women's perceptions of vaccination during pregnancy and to assess their reaction to different vaccine messages.Study DesignEnglish-speaking pregnant women aged 18 years or older who received prenatal care at a safety-net hospital participated in qualitative interviews. Interview topics included attitudes toward vaccinations in general and toward influenza and tetanus–diphtheria–pertussis vaccination in pregnancy. Participants were also queried regarding sources of vaccine information, and were asked to provide feedback on specific messages regarding maternal vaccination.ResultsTwenty-eight pregnant women participated in interviews. Participant age ranged from 18 to 40 years old; 64% were insured through Medicaid. All participants had positive attitudes toward routine vaccinations and had received vaccinations for themselves and their children. Attitudes were less favorable for influenza vaccines than other vaccines. Participants reported receiving vaccine information from multiple sources. Stories about vaccine harms worried participants, even when they did not trust the sources of negative information. All stated that their health care providers were the most trusted source of information. Participants felt that the most important messages to encourage maternal vaccination were that maternal vaccination protects the baby after birth and maternal vaccination is safe for both mother and baby. Participants were not motivated to vaccinate by messages about the severity of maternal disease.ConclusionsMaternal vaccinations are important to protect pregnant women and infants from influenza and pertussis. Focusing on messages related to vaccine safety and protection of the infant are motivating to mothers, especially when delivered by trusted health care providers.     

Using best-worst scaling to rank factors affecting vaccination demand in northern Nigeria

BackgroundUnderstanding and ranking the reasons for low vaccination uptake among parents in northern Nigeria is critical to implement effective policies to save lives and prevent illnesses. This study applies best-worst scaling (BWS) to rank various factors affecting parents’ demand for routine childhood immunization.MethodsWe conducted a household survey in Nahuche, Zamfara State in northern Nigeria. Nearly two hundred parents with children under age five were asked about their views on 16 factors using a BWS technique. These factors focused on known attributes that influence the demand for childhood immunization, which were identified from a literature review and reviewed by a local advisory board. The survey systematically presented parents with subsets of six factors and asked them to choose which they think are the most and least important in decisions to vaccinate children. We used a sequential best-worst analysis with conditional logistic regression to rank factors.ResultsThe perception that vaccinating a child makes one a good parent was the most important motivation for parents in northern Nigeria to vaccinate children. Statements related to trust and social norms were ranked higher in importance compared to those that highlighted perceived benefits and risks, healthcare service, vaccine information, or opportunity costs. Fathers ranked trust in the media and views of their leaders to be of greatest importance, whereas mothers placed greater importance on social perceptions and norms. Parents of children without routine immunization ranked their trust in local leaders about vaccines higher in considerations, and the media’s views lower, compared to parents with children who received routine immunization.ConclusionsFraming immunization messages in the context of good parenting and hearing these messages from trusted information sources may motivate parental uptake of childhood vaccines. These results are useful to policymakers to prioritize resources in order to increase awareness and demand for childhood immunization.     

Mothers of young children cluster into 4 groups based on psychographic food decision influencers

This study explored how mothers grouped into clusters according to multiple psychographic food decision influencers and how the clusters differed in nutrient intake and nutrient content of their household food supply. Mothers (n = 201) completed a survey assessing basic demographic characteristics, food shopping and meal preparation activities, self and spouse employment, exposure to formal food or nutrition education, education level and occupation, weight status, nutrition and food preparation knowledge and skill, family member health and nutrition status, food decision influencer constructs, and dietary intake. In addition, an in-home inventory of 100 participants' household food supplies was conducted. Four distinct clusters presented when 26 psychographic food choice influencers were evaluated. These clusters appear to be valid and robust classifications of mothers in that they discriminated well on the psychographic variables used to construct the clusters as well as numerous other variables not used in the cluster analysis. In addition, the clusters appear to transcend demographic variables that often segment audiences (eg, race, mother's age, socioeconomic status), thereby adding a new dimension to the way in which this audience can be characterized. Furthermore, psychographically defined clusters predicted dietary quality. This study demonstrates that mothers are not a homogenous group and need to have their unique characteristics taken into consideration when designing strategies to promote health. These results can help health practitioners better understand factors affecting food decisions and tailor interventions to better meet the needs of mothers.     

Message Framing Strategies to Increase Influenza Immunization Uptake Among Pregnant African American Women

We explored the attitudes, opinions, and concerns of African American women regarding influenza vaccination during pregnancy. As influenza immunization coverage rates remain suboptimal in the United States among this population, we elicited message framing strategies for multicomponent interventions aimed at decreasing future incident cases of maternal and neonatal influenza. Semi-structured in-depth interviews (N = 21) were conducted with pregnant African American women at urban OB/GYN clinics who had not received an influenza vaccine. Interviews were transcribed, subjected to intercoder reliability assessment, and content analyzed to identify common thematic factors related to acceptance of the influenza vaccine and health communication message preferences. Four major themes were identified. These were communication approaches, normal vaccine behavior, pregnancy vaccination, and positive versus negative framing. Two strong themes emerged: positively-framed messages were preferred over negatively-framed messages and those emphasizing the health of the infant. Additionally, previous immunization, message source, and vaccine misperceptions also played important roles in decision-making. The majority of women indicated that positively framed messages focusing on the infant’s health would encourage them to receive an influenza vaccine. Messages emphasizing immunization benefits such as protection against preterm birth and low birth weight outcomes have potential to overcome widespread negative community perceptions and cultural beliefs. Additionally, messages transmitted via interpersonal networks and social media strongly influence motivation to obtain vaccination during pregnancy. The findings of this study will assist in developing tailored messages that change pregnant African American women’s influenza vaccination decision-making to achieve improved coverage.     

Vaccine-related advertising in the Facebook Ad Archive

BackgroundIn 2018, Facebook introduced Ad Archive as a platform to improve transparency in advertisements related to politics and “issues of national importance.” Vaccine-related Facebook advertising is publicly available for the first time. After measles outbreaks in the US brought renewed attention to the possible role of Facebook advertising in the spread of vaccine-related misinformation, Facebook announced steps to limit vaccine-related misinformation. This study serves as a baseline of advertising before new policies went into effect.MethodsUsing the keyword ‘vaccine’, we searched Ad Archive on December 13, 2018 and again on February 22, 2019. We exported data for 505 advertisements. A team of annotators sorted advertisements by content: pro-vaccine, anti-vaccine, not relevant. We also conducted a thematic analysis of major advertising themes. We ran Mann-Whitney U tests to compare ad performance metrics.Results309 advertisements were included in analysis with 163 (53%) pro-vaccine advertisements and 145 (47%) anti-vaccine advertisements. Despite a similar number of advertisements, the median number of ads per buyer was significantly higher for anti-vaccine ads. First time buyers are less likely to complete disclosure information and risk ad removal. Thematically, anti-vaccine advertising messages are relatively uniform and emphasize vaccine harms (55%). In contrast, pro-vaccine advertisements come from a diverse set of buyers (83 unique) with varied goals including promoting vaccination (49%), vaccine related philanthropy (15%), and vaccine related policy (14%).ConclusionsA small set of anti-vaccine advertisement buyers have leveraged Facebook advertisements to reach targeted audiences. By deeming all vaccine-related content an issue of “national importance,” Facebook has further the politicized vaccines. The implementation of a blanket disclosure policy also limits which ads can successfully run on Facebook. Improving transparency and limiting misinformation should not be separate goals. Public health communication efforts should consider the potential impact on Facebook users’ vaccine attitudes and behaviors.     

Discussing mental illness in Chinese social media: the impact of influential sources on stigmatization and support among their followers

A content analysis was conducted to examine depression-related discourses by public opinion leaders and mainstream media in the Chinese social media platform Sina Weibo, as well as the impact of these discourses on their followers. The study revealed that stereotypical presentations of people with depression by influential sources often promoted stigmatization of or reduced support for depressed individuals among their followers. Environmental and genetic attributions for the disease in the original posts reduced stigmatization in the response posts. Information about recovery and treatment proved to be a double-edged sword, reducing stigmatization and support among followers at the same time. The use of a crime context to discuss depression in the original posts often promoted stigmatization, while discussing it in a health context increased support in the response posts.     

Determinants of information diffusion in online communication on vaccination: The benefits of visual displays

ObjectiveSocial media are an increasingly important source of information on the benefits and risks of vaccinations, but the high prevalence of misinformation provides challenges for informed vaccination decisions. It is therefore important to understand which messages are likely to diffuse online and why, and how relevant aspects—such as scientific facts on vaccination effectiveness—can be made more comprehensible and more likely to be shared. In two studies, we (i) explore which characteristics of messages on flu vaccination facilitate their diffusion in online communication, and (ii) whether visual displays (i.e., icon arrays) facilitate the comprehension and diffusion of scientific effectiveness information.MethodsIn Study 1, 208 participants each rated a random sample of 15 out of 63 messages on comprehensibility, trustworthiness, persuasiveness, familiarity, informativeness, valence, and arousal, and then reported which information they would share with subsequent study participants. In Study 2 (N = 758), we employed the same rating procedure for a selected set of 9 messages and experimentally manipulated how scientific effectiveness information was displayed.ResultsStudy 1 illustrated that scientific effectiveness information was difficult to understand and thus did not diffuse well. Study 2 demonstrated that visual displays improved the understanding of this information, which could, in turn, increase its social impact.ConclusionsThe comprehensibility of scientific information is an important prerequisite for its diffusion. Visual displays can facilitate informed vaccination decisions by rendering important information on vaccination effectiveness more transparent and increasing the willingness to share this information.