Main Article Content
Health Communication, Vaccine Hesitancy, Vaccinarsi, Digital Media
Background and aim: Vaccinarsinsardegna.org website is a medical and scientific communication portal regarding vaccinations of Sardinia region. This article aims to present the structure of the portal, to demonstrate the actions carried out to provide accurate information for users and to analyse the website’s activity from its launch until the current pandemic period in terms of dissemination and visibility.
Methods: Various metrics such as the number of visits to the site (sessions, number of users and average session duration), user behaviour (pages viewed, bounce rate and organic search) and the session acquisition path (direct traffic, referrals and social traffic) were recorded, extrapolated and processed with Google Analytics. Qualitative and normally distributed quantitative variables were summarised with absolute (relative) frequencies and means. The statistical differences between the two periods (before and during the anti-COVID-19 vaccination campaign) were evaluated applying the Wilkoxon runk-sum test. A two-tailed p-value less than 0.01 was considered to be statistically significant.
Results: The metrics recorded using Google Analytics show that from its publication to date, the VaccinarSinSardegna.org portal has significantly increased its visibility: in fact, the number of users who have accessed the site, the number of sessions and individual web pages visited have grown exponentially. These findings are confirmed by the increasing number of visits to both versions of the regional website (Italian- and English-language) during the COVID-19 emergency and COVID-19 vaccination campaign. When the total values recorded over the period were compared, an overall increase in metrics was observed—the number of individual users, visits and individual pageviews rose in a statistically significant way.
Conclusions: Based on the success on VaccinarSinSardegna and given its potential for expansion to include further collaborations with national and international scientific bodies, the authors affirm that similar initiatives should be implemented in the fight against vaccine hesistancy.
2. Delany I, Rappuoli R, De Gregorio E. Vaccines for the21st century. EMBO Mol. Med. 2014; 6:708–720. doi: 10.1002/emmm.201403876
3. Tognotti E. The eradication of smallpox, a success story for modern medicine and public health: What lessons for the future? J. Infect. Dev. Ctries. 2010; 4:264–266. doi: 10.3855/jidc.1204.
4. Stefanelli P, Bellino S, Fiore S, Fontana S, Amato C, Buttinelli G. Regional Reference Centres of the National Surveillance System for Acute flaccid paralysis. Hospital discharges-based search of acute flaccid paralysis cases 2007-2016 in Italy and comparison with the National Surveillance System for monitoring the risk of polio reintroduction. BMC Public Health. 2019; 15;19(1):1532. doi: 10.1186/s12889-019-7617-0. PMID: 31730455; PMCID: PMC6858761.
5. Bechini A, Ninci A, Del Riccio M, et al. Impact of Influenza Vaccination on All-Cause Mortality and Hospitalization for Pneumonia in Adults and the Elderly with Diabetes: A Meta-Analysis of Observational Studies. Vaccines (Basel). 2020; 30;8(2):263. doi: 10.3390/vaccines8020263.
6. Boccalini S, Bechini A. Is it time to reconsider measles, mumps, and rubella immunisation strategies? Lancet Infect Dis. 2021; 21(2):160-161. doi: 10.1016/S1473-3099(20)30519-3. Epub 2020 Sep 1.
7. Bonanni P, Zanella B, Santomauro F, Lorini C, Bechini A, Boccalini S. Safety and perception: What are the greatest enemies of HPV vaccination programmes? Vaccine. 2018; 28;36(36):5424-5429. doi: 10.1016/j.vaccine.2017.05.071. Epub 2017 Jun 10.
8. Costantino C, Caracci F, Brandi M, et al. Determinants of vaccine hesitancy and effectiveness of vaccination counseling interventions among a sample of the general population in Palermo, Italy. Hum. Vaccin. Immunother. 2020; 16:2415–2421. doi: 10.1080/21645515.2020.1728157
9. Arghittu A, Dettori M, Azara A, et al. Flu Vaccination Attitudes, Behaviours, and Knowledge among Health Workers. Int. J. Environ. Res. Public Health. 2020; 17:3185. doi: 10.3390/ijerph17093185.
10. Volker V, Gülhan D, Leonard R, Friedland JK, Marla S. Understanding modern-day vaccines: What you need to know. Ann. Med. 2018; 50:110–120. doi: 10.1080/07853890.2017.1407035
11. Arghittu A, Dettori M, Masia MD, Azara A, Dempsey E, Castiglia P. Social deprivation indexes and anti-influenza vaccination coverage in the elderly in Sardinia, Italy, with a focus on the Sassari municipality. J Prev Med Hyg. 2019; 59(4 Suppl 2):E45-E50. Published 2019 Feb 28. doi:10.15167/2421-4248/jpmh2018.59.4s2.1077
12. Bonanni P, Angelillo IF, Villani A, et al. Maintain and increase vaccination coverage in children, adolescents, adults and elderly people: Let’s avoid adding epidemics to the pandemic: Appeal from the Board of the Vaccination Calendar for Life in Italy: Maintain and increase coverage also by re-organizing vaccination services and reassuring the population. Vaccine. 2021; 39:1187–1189. doi: 10.1016/j.vaccine.2020.10.024.
13. Boccalini S, Bonanni P, Chiesi F, et al. The Experience of VaccinarSinToscana Website and the Role of New Media in Promoting Vaccination. Vaccines (Basel). 2020; 3;8(4):644. doi: 10.3390/vaccines8040644. PMID: 33153005; PMCID: PMC7712014.
14. Tabacchi G, Costantino C, Cracchiolo M, et al. Information sources and knowledge on vaccination in a population from southern Italy: The ESCULAPIO project. Hum Vaccin Immunother. 2017; 13(2):339-345. doi: 10.1080/21645515.2017.1264733. Epub 2016 Dec 29. PMID: 28032814; PMCID: PMC5328217.
15. World Healh Organization. Report of the SAGE Working Group on Vaccine Hesitancy. 2014 Available online: https://www.who.int/immunization/sage/meetings/2014/october/1_Report_WORKING_GROUP_vaccine_hesitancy_final.pdf. (accessed on 12 June 2021)
16. Dube E, Vivion M, MacDonald NE. Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: Influence, impact and implications. Expert Rev. Vaccines. 2015; 14:99–117. doi: 10.1586/14760584.2015.964212.
17. McClure CC, Cataldi JR, O’Leary ST. Vaccine hesitancy: Where we are and where we are going. Clin. Ther. 2017; 39:1550–1562. doi: 10.1016/j.clinthera.2017.07.003.
18. Dettori M, Pittaluga P, Busonera G, et al. Environmental Risks Perception Among Citizens Living Near Industrial Plants: A Cross-Sectional Study. Int J Environ Res Public Health. 2020; 6;17(13):4870. doi: 10.3390/ijerph17134870.
19. Dettori M, Deiana G, Balletto G, et al. Air pollutants and risk of death due to COVID-19 in Italy. Environ Res. 2021; 192:110459. doi: 10.1016/j.envres.2020.110459.
20. Dettori M, Arru B, Azara A, et al. In the Digital Era, Is Community Outrage a Feasible Proxy Indicator of Emotional Epidemiology? The Case of Meningococcal Disease in Sardinia, Italy. Int. J. Environ. Res. Public Health. 2018; 15:1512. doi: 10.3390/ijerph15071512
21. Zhao Y., Xu H. Chinese public attention to COVID-19 epidemic: Based on social media. medRxiv. 2020 doi: 10.1101/2020.03.18.20038026.
22. Banerjee D., Meena K.S. COVID-19 as an “Infodemic” in Public Health: Critical Role of the Social Media. Front. Public Health. 2021;9:610623. doi: 10.3389/fpubh.2021.610623.
23. mHealth: Use of Appropriate Digital Technologies for Public Health: Report by the Director-General. World Health Organization, 2017. Available online: https://apps.who.int/iris/handle/10665/274134. (accessed on 29 April 2021);
24. Chen YR, Schulz PJ. The Effect of Information Communication Technology Interventions on Reducing Social Isolation in the Elderly: A Systematic Review. J Med Internet Res. 2016; 28;18(1):e18. doi: 10.2196/jmir.4596.
25. Hilty D, Chan S, Torous J, Luo J, Boland R. A Framework for Competencies for the Use of Mobile Technologies in Psychiatry and Medicine: Scoping Review. JMIR Mhealth Uhealth. 2020; 8(2):e12229. Published 2020 Feb 21. doi:10.2196/12229
26. Odone A, Buttigieg S, Ricciardi W, et al. Public health digitalization in Europe: EUPHA vision, action and role in digital public health. European Journal of Public Health. 2019; 29: 28–35. https://doi.org/10.1093/eurpub/ckz161.
27. Free C, Phillips G, Felix L, Galli L, Patel V, Edwards P. The effectiveness of M-health technologies for improving health and health services: a systematic review protocol. BMC Res Notes. 2010; 6;3:250. doi: 10.1186/1756-0500-3-250.
28. Materia FT, Faasse K, Smyth JM. Understanding and Preventing Health Concerns About Emerging Mobile Health Technologies. JMIR Mhealth Uhealth. 2020; 25;8(5):e14375. doi: 10.2196/14375.
29. Liao CY, Liu WI. Current Status and Prospects for Information Communication Technology (ICT) in Allied Health Education. Hu Li Za Zhi. 2020; 67(5):6-11. Chinese. doi: 10.6224/JN.202010_67(5).02.
30. Ferro A, Bonanni P, Castiglia P, et al. Improving vaccination social marketing by monitoring the web. Ann Ig. 2014 May-Jun;26(3 Suppl 1):54-64. Italian. PMID: 25486693.
31. Ferro A., Odone A., Siddu A., et al. Monitoring the web to support vaccine coverage: Results of two years of the portal VaccinarSì Epidemiol. Prev. 2015;39(Suppl. 1):88–93.
32. Bordin P, Melot B, Tralli V, et al. Six years of activity of the Italian vaccine portal “VaccinarSì”: a web traffic evaluation using Google Analytics. Ann Ig. 2021 Mar-Apr;33(2):109-122. doi: 10.7416/ai.2021.2417. PMID: 33570083.
33. Arghittu A, Dettori M, Dempsey E, et al. Health Communication in COVID-19 Era: Experiences from the Italian VaccinarSì Network Websites. Int J Environ Res Public Health. 2021; 25;18(11):5642. doi: 10.3390/ijerph18115642
34. Presidenza della Repubblica Italiana Legge Costituzionale del 18 ottobre 2001, n. 3 Modifiche al Titolo V della Parte Seconda Della Costituzione. (GU Serie Generale n.248 del 24-10-2001) Available online: https://www.gazzettaufficiale.it/eli/id/2001/10/24/001G0430/sg. (accessed on 29 April 2021).
35. Ministero della Salute Centro Nazionale per la Prevenzione e il Controllo delle Malattie. Programma CCM 2014. “Monitorare la Fiducia del Pubblico nei Programmi Vaccinali e le sue Necessità Informative Sviluppando un Sistema di Decisione Assistita per le Vaccinazioni Tramite il Sito “vaccinarsi.org” e Altri Siti e Social Network Specificatamente Dedicati Alle Vaccinazioni”. Available online: http://www.ccm-network.it/progetto.jsp?id=node/1884&idP=740. (accessed on 29 April 2021).
36. Gianfredi V, Provenzano S, Santangelo OE. What can internet users’ behaviours reveal about the mental health impacts of the COVID-19 pandemic? A systematic review. Public Health. 2021; 198:44-52. doi: 10.1016/j.puhe.2021.06.024.
37. Report Digital 2020 We Are Social e Hootsuite. Available online: https://wearesocial.com/it/blog/2020/01/report-digital-2020-i-dati-global. (accessed on 29 April 2021);
38. Kata A. A postmodern Pandora’s box: anti-vaccination misinformation on the Internet. Vaccine. 2010; 17;28(7):1709-16. doi: 10.1016/j.vaccine.2009.12.022.
39. Kestenbaum LA, Feemster KA. Identifying and addressing vaccine hesitancy. Pediatr Ann. 2015; 44(4):e71-5. doi: 10.3928/00904481-20150410-07.
40. Gianfredi V, Moretti M, Lopalco PL. Countering vaccine hesitancy through immunization information systems, a narrative review. Hum Vaccin Immunother. 2019; 15(11):2508-2526. doi: 10.1080/21645515.2019.1599675.
41. Tozzi AE, Gesualdo F, D’Ambrosio A, et al. Can Digital Tools Be Used for Improving Immunization Programs?. Front Public Health. 2016; 4:36. doi:10.3389/fpubh.2016.00036.
42. Stockwell MS, Fiks AG. Utilizing health information technology to improve vaccine communication and coverage. Hum Vaccin Immunother. 2013; 9(8):1802-11. doi: 10.4161/hv.25031.
43. World Health Organization. Guiding Principles for Immunization Activities during the COVID-19 Pandemic. Interim Guidance. 2020; Available online: https://apps.who.int/iris/bitstream/handle/10665/331590/WHO-2019-nCoV-immunization_services-2020.1-eng.pdf?sequence=1&isAllowed=y. (accessed on 29 April 2021).
44. D’Alessandro D, Gola M, Appolloni L, et al. COVID-19 and Living space challenge. Well-being and Public Health recommendations for a healthy, safe, and sustainable housing. Acta Bio Med. 2020; 2091(9-S):61-5. DOI https://doi.org/10.23750/abm.v91i9-S.10115
45. Gu H, Chen B, Zhu H, et al. Importance of Internet surveillance in public health emergency control and prevention: evidence from a digital epidemiologic study during avian influenza A H7N9 outbreaks. J Med Internet Res. 2014 Jan 17;16(1):e20. doi: 10.2196/jmir.2911. PMID: 24440770; PMCID: PMC3906895.
46. Carducci A, Fiore M, Azara A, et al. Pro-Environmental Behaviors: Determinants and Obstacles among Italian University Students. Int. J. Environ. Res. Public Health 2021; 18, 3306. https://doi.org/10.3390/ijerph18063306
47. Carducci A, Fiore M, Azara A, et al. Environment and health: Risk perception and its determinants among Italian university students. Sci Total Environ. 2019 Nov 15;691:1162-1172. doi: 10.1016/j.scitotenv.2019.07.201. Epub 2019 Jul 16. PMID: 31466198.
48. Dettori M, Arghittu A, Deiana G, et al. Influenza Vaccination Strategies in Healthcare Workers: A Cohort Study (2018–2021) in an Italian University Hospital. Vaccines. 2021; 9(9):971. https://doi.org/10.3390/vaccines9090971.
49. Law n. 3, 11/01/2018. Delega al Governo in materia di sperimentazione clinica di medicinali nonche’ disposizioni per il riordino delle professioni sanitarie e per la dirigenza sanitaria del Ministero della salute (GU Serie Generale n.25 del 31-01-2018). Italy. Available online: https://www.gazzettaufficiale.it/eli/id/2018/1/31/18G00019/sg. (accessed on 30 June 2021);