Instagrammers' attitude towards Human Papillomavirus (HPV) vaccine: A review

Instagram is one of the most widely used social-media platforms and is becoming a growing forum for discussing health-related topics (HIV, cancer, vaping, alcohol, self-harm behavior, etc.). However, also antivaccine activists often upload posts with hashtags displaying antivaccine intentions on social media. Considering that the most of Instagram users have an age stackable to the age indicated for Human Papillomavirus (HPV) vaccination, the aim of our review was to investigate Instagrammers' attitude toward HPV vaccination. In October-November 2020 we performed a search for original peerreviewed papers in the electronic database PubMed (MEDLINE). The key search terms were "Instagram AND Vaccine", "Instagram AND HPV Vaccine", "Instagram AND HPV", "Instagram AND Papillomavirus". We searched for studies published without any temporal limit, reporting information useful to understand Instagrammers' attitudes or feelings about HPV vaccination. We considered eligible for the review articles reporting clear data on: i) number of analyzed post; ii) study period; iii) a deep and clear analysis of posts referred to HPV vaccine; iv) other interesting data related to HPV/HPV vaccine. Descriptive studies written in English, French, Spanish, Italian have been considered eligible. The literature search yielded 21 publications but 2 manuscripts met the inclusion criteria. The studies involved 510 Instagram posts with a mean number of likes ranging from 27.7 to 50. The most of them were PRO-vaccine (up to 55.8%); nevertheless, ANTI-vaccine posts had significantly more likes than PRO-vaccine posts (all p < .05). Anti-vaccine posts were less likely to mention prevention and cancer, compared to pro-vaccine posts. Posts with only female figures tended to be provaccine. Concluding, the importance of Instagram as a new source of information for patients should not be underestimated. Healthcare professionals should be aware of this tool and should intervene in order to ensure a proper and correct information.