Questioning Vaccination Discourse (Quo VaDis): A Corpus-Based Study

The Quo VaDis project applies the latest techniques for large-scale computer-aided linguistic analysis to discussions about vaccinations in public discourse, and specifically in: social media discussions in English, UK Parliamentary debates and UK national press reports. The goal is to arrive at a better understanding of pro- and anti-vaccination views, as well as undecided views, which will inform future public health campaigns.

The project will be based in the world-renowned ESRC Centre for Corpus Approaches to Social Science (CASS) at Lancaster University, which was awarded a Queen's Anniversary Prize for Higher and Further Education in 2015. An interdisciplinary project team will work in interaction with three main project partners: Public Health England, the Department of Health and Social Care and the Department for Digital, Culture, Media & Sport.

The World Health Organization's (WHO) list of top ten global health threats includes 'vaccine hesitancy' - 'a delay in acceptance or refusal of vaccines despite availability of vaccination services'. Vaccination programmes are currently estimated to prevent between 2 and 3 million deaths a year worldwide. However, uptake of vaccinations in 90% of countries has been reported to be affected by vaccine hesitancy. In England, coverage for all routine childhood vaccinations is in decline, resulting in the resurgence of communicable diseases that had previously been eradicated. In August 2019, the UK lost its WHO measles elimination status.

The reasons for vaccine hesitancy are complex, but they need to be understood in order to be addressed effectively. This project focuses on discourse because the ways in which controversial topics such as vaccinations are talked about both reflect and shape beliefs and attitudes, which may in turn influence behaviour. More specifically, vaccinations have been the topic of UK parliamentary debates since before the first Vaccination Act of 1840; they have been increasingly discussed in the UK press since the early 1990s; and anti-vaccination views in particular have been described as part of a complex network of 'anti-public discourses' which, in recent years, are known to be both spread and contested on social media.

This project will involve the analysis of three multi-million-word datasets: (1) English-language contributions to three social media platforms: Mumsnet, Reddit and Twitter since the inception of each platform - respectively, 2000, 2005 and 2006; (2) UK national newspapers since 1990; and (3) UK parliamentary debates since 1830. These datasets will be analysed in a data-driven fashion by means of the computer-aided methods associated with Corpus Linguistics - a branch of Linguistics that involves the construction of large digital collections of naturally-occurring texts (known as 'corpora') and their analysis through tailor-made software. A corpus linguistic approach makes it possible to combine in a principled way the quantitative analysis of corpora containing millions of words with the qualitative analysis of individual texts, patterns and interactions. In this way, we will identify and investigate the different ways in which views about vaccinations are expressed in our data, for example, through patterns in choices of vocabulary, pronouns, negation, evaluation, metaphors, narratives, sources of evidence, and argumentation. We will reveal both differences and similarities in pro- and anti-vaccination views over time and across different groups of people, particularly as they form and interact on social media.

Our findings will make a major contribution to an understanding of views about vaccinations both in the UK (via our parliamentary and news datasets) and internationally (via our social media datasets). Through the involvement of our Project Partners, as well as more general engagement activities, these findings will be used as evidence for the design of future public health campaigns about vaccinations.

The Quo VaDis project will help reduce vaccine hesitancy - one of the World Health Organization's current top ten global health challenges - by providing the most systematic and in-depth diachronic account to date of the expression of views about vaccinations in public discourse in English. This includes particularly discussions of vaccinations on social media, where vaccine hesitant views develop and spread in ways that cannot easily be countered via traditional approaches based on education and the provision of scientifically 'accurate' information. This has consequences in terms of morbidity and mortality from vaccine-preventable diseases, such as measles.

This project will benefit public health bodies that deal with the uptake of vaccination programmes at the population level, including particularly childhood vaccinations, in the UK and internationally. These include: the three Project Partners who will be involved in the project - Public Health England, the Department of Health & Social Care and the Department for Digital, Culture, Media & Sport; WHO Europe, who have expressed an interest in the project's findings; and other potential stakeholders with whom we will share our findings, such as Gavi, the Vaccine Alliance (https://www.gavi.org). Additional beneficiaries include social media platforms (and particularly the ones we will study: Twitter, Reddit and Mumsnet) and the mainstream media.

These different stakeholder organisations will benefit from detailed evidence about how different views about vaccinations are expressed (including pro- and anti-vaccination views, as well as undecided views) and how they develop and spread in public discourse, including particularly online. Public health bodies such as Public Health England and the Department of Health & Social Care will use the findings to design messages and campaigns about vaccinations that are tailored to the language and concerns of specific vaccine hesitant groups. Public and private organisations involved in online communication, such as the Department for Digital, Culture, Media & Sport, will use the findings as part of their initiatives to increase safety and combat disinformation in digital communication (see letters of support from Project Partners for more detail).

All stakeholder groups will also benefit from information about the websites/pages that are most frequently linked from social media posts about vaccinations, and how they have changed over time. This information will be used as the basis for decisions about views that need to be particularly taken into account and/or countered, as well as websites that may be banned or blocked, depending on the relevant legal context.

Ultimately, by helping address vaccine hesitancy, this project will reduce morbidity and mortality from vaccine-preventable diseases, which have significant personal, financial and societal consequences.