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Media and Communication (ISSN: 2183–2439)
2020, Volume 8, Issue 2, Pages 364–375

DOI: 10.17645/mac.v8i2.2847


The Visual Vaccine Debate on Twitter: A Social Network Analysis

Elena Milani 1,*, Emma Weitkamp 1 and Peter Webb 2

1 Department of Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK;
E-Mails: [email protected] (E.M.), [email protected] (E.W.)
2 Department of Health and Social Sciences, University of the West of England, Bristol, BS16 1QY, UK;
E-Mail: [email protected]

* Corresponding author

Submitted: 29 January 2020 | Accepted: 18 April 2020 | Published: 26 June 2020

Pro- and anti-vaccination users use social media outlets, such as Twitter, to join conversations about vaccines, dissemi-
nate information or misinformation about immunization, and advocate in favour or against vaccinations. These users not
only share textual content, but also images to emphasise their messages and influence their audiences. Though previous
studies investigated the content of vaccine images, there is little research on how these visuals are distributed in digital en-
vironments. Therefore, this study explored how images related to vaccination are shared on Twitter to gain insight into the
communities and networks formed around their dissemination. Moreover, this research also investigated who influences
the distribution of vaccine images, and could be potential gatekeepers of vaccination information. We conducted a social
network analysis on samples of tweets with images collected in June, September and October 2016. In each dataset, pro-
and anti-vaccination users formed two polarised networks that hardly interactedwith each other, and disseminated images
among their members differently. The anti-vaccination users frequently retweeted each other, strengthening their relation-
ships, making the information redundant within their community, and confirming their beliefs against immunisation. The
pro-vaccine users, instead, formed a fragmented network, with loose but strategic connections that facilitated networking
and the distribution of new vaccine information. Moreover, while the pro-vaccine gatekeepers were non-governmental
organisations or health professionals, the anti-vaccine ones were activists and/or parents. Activists and parents could po-
tentially be considered as alternative but trustworthy sources of information enabling them to disseminatemisinformation
about vaccinations.

activism; misinformation; social media; social

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