# Human Papillomavirus Vaccination Policies and Discourse on Social Media

## TL;DR

This study examines how HPV vaccination policies in China influenced public discussions on social media, finding that policies reduced access concerns and increased awareness and gender equity conversations.

## Contribution

The study provides new insights into how national HPV vaccination policies in China affect public discourse and engagement on social media platforms.

## Key findings

- After policy implementation, discussions on vaccine accessibility decreased substantially.
- Conversations about health awareness and gender equity increased significantly.
- Social media data can offer timely insights into public responses to health interventions.

## Abstract

This cross-sectional study explores whether the 2 national human papillomavirus (HPV) vaccination policies were associated with increased public discourse related to the policies on a social media platform in China.

Were the 2 national human papillomavirus (HPV) vaccination policies in China associated with changes in public responses and engagement?

In this cross-sectional study using 3-year interrupted time-series analysis of 353 530 online posts (2021-2024), discussions on vaccine accessibility decreased substantially after policy implementation, while conversations about health awareness and gender equity issues increased.

Results of this study suggest that national HPV vaccination policies in China significantly influenced public perceptions and discussions, supporting efforts to achieve equitable vaccine uptake and cervical cancer elimination.

Cervical cancer remains a major public health challenge in China, and human papillomavirus (HPV) vaccine uptake remains far below the global average. Understanding public responses to national policy interventions is critical for promoting equitable vaccine access and uptake.

To assess the association between 2 national HPV vaccination policies (August 2022 age expansion approval for HPV vaccination [policy 1] and January 2023 National Action Plan for Accelerating the Elimination of Cervical Cancer [policy 2]) in China and public discourse and engagement on social media.

Cross-sectional study using interrupted time-series analysis of publicly available posts by individual users containing HPV-related and vaccine-related keywords from China’s largest text-based social media platform collected between December 2021 and December 2024. Latent Dirichlet allocation topic modeling was used to identify 16 topics grouped into 5 thematic domains.

Changes in the daily trends of public discussions across 5 thematic domains and 16 topics before and after policy implementation using interrupted time-series analysis.

This study analyzed 353 530 HPV-related posts on the social media platform from December 2021 to December 2024. Vaccine accessibility discussions initially increased following the age expansion policy (regression coefficient, 0.08; 95% CI, 0.05-0.12; P < .001). After the launch of the National Action Plan, discussions on the theme of vaccine accessibility decreased by 0.11 percentage points per day (95% CI, −0.14 to −0.08; P < .001). Conversely, discussions on awareness and knowledge increased by 0.04 percentage points per day (95% CI, 0.03-0.06; P < .001), as well as gender and sociocultural factors, which increased by 0.04 percentage points per day (95% CI, 0.02-0.06; P < .001).

These findings suggest that national HPV vaccination policies in China were associated with shifts in public discourse, including alleviated access concerns and increased health awareness and gender equity discussions. Social media data can provide timely insights into public responses to health interventions and inform strategies to promote equitable HPV vaccine uptake and cervical cancer elimination.