Assessment and analysis of content and quality of children's influenza vaccine information on BiliBili, Douyin, and Xiaohongshu

TL;DR

This study evaluates the quality of children's influenza vaccine information on Chinese short video platforms and finds that content varies in reliability and source.

Contribution

The study provides the first assessment of vaccine-related video content quality on Douyin, BiliBili, and Xiaohongshu using standardized medical benchmarks.

Findings

Douyin videos had higher user engagement compared to BiliBili and Xiaohongshu.

Professional health sources provided higher quality videos than ordinary users.

No significant differences were found between the three quality scoring systems used.

Abstract

Each year, influenza vaccines play a vital role in preventing millions of illnesses and reducing flu-related healthcare visits. Short video platforms (including Douyin, BiliBili, and Xiaohongshu) are powerful vehicles for information sharing and are saturated with videos about children's influenza vaccines. Nevertheless, the quality of these videos remains undetermined.

This study aims to assess the quality and reliability of videos addressing children's influenza vaccines on three short video platforms: Douyin, BiliBili, and Xiaohongshu.

Using a cross-sectional survey design, this study examined three short video platforms (all mainland China versions). In February 2025, the research team searched Douyin, BiliBili, and Xiaohongshu for the keyword “children's influenza vaccine,” selecting 300 videos (100 per platform) for analysis. We extracted basic video information, coded the content, and identified each video's source. Two independent reviewers then evaluated video quality using the American Medical Association (JAMA) benchmarks, the modified DISCERN (mDISCERN) criteria, and the Global Quality Score (GQS).

A detailed analysis of 300 videos revealed that on Douyin and Xiaohongshu, most videos were created by professionals and lay users, whereas on BiliBili, most were uploaded by non-profit organizations. Douyin stood out in user engagement, as its videos received significantly higher numbers of likes, comments, favorites, and shares than those on BiliBili and Xiaohongshu (p < 0.001). Furthermore, we observed a strong positive correlation between overall quality scores and comment volume (Spearman ρ = 0.90, p < 0.001); correlations with likes (ρ = 0.77) and favorites (ρ = 0.73) were moderate but still significant (p < 0.001). Score differences also emerged based on source type (p < 0.001). Videos published by health professionals were rated highest, ordinary-user videos received lower ratings, and those from news agencies and non-profit organizations fell in between. In terms of quality ratings, there were no statistically significant differences among the GQS, JAMA, and mDISCERN scoring systems.

These findings suggest that Douyin, BiliBili, and Xiaohongshu offer moderately rated scientific content regarding children's influenza vaccines. Viewers should exercise caution when watching related videos on these platforms. Moving forward, both the platforms and content creators must strive to improve video quality and reliability to boost vaccination rates. These efforts have important implications for clinical practice, offering new perspectives for health education interventions and better promoting public awareness of vaccination's significance—ultimately contributing positively to public health.

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