Creation of minimum guidelines for the development and improvement of national immunization program websites

Summary:

Digital media sources have enabled fast diffusion of vaccine information globally. While they can serve as reliable resources of information, a plethora of online content on vaccines that perpetuates misinformation and vaccine hesitancy also exists. It is therefore crucial for countries to offer credible and context-specific online information to address and counter vaccine misinformation. National immunization program websites can provide credible and accurate content on vaccines. A landscape analysis of currently available national immunization websites was conducted. We screened all 194 World Health Organization (WHO) member states to ascertain the number with substantive immunization content on essential vaccines, related vaccine preventable diseases, and national immunization schedule, that would be eligible for further assessment. In collaboration with the World Health Organization's Vaccine Safety Net, we developed a website grading tool for core components on content and website design that included six domains on content on vaccination, website design, linkage to external sources, findability of website, online presence, and website features to evaluate the eligible websites. In this presentation, we will discuss the findings from this evaluation of eligible national immunization program websites. We will present specific findings including scores for specific domains, regional and country-income level disparities, and elaborate on strengths as well as areas of improvement for immunization program websites. We will conclude by highlighting next steps in the use of this grading tool for country-level use and for updating the existing Vaccine Safety Net criteria that evaluates online vaccine safety content.

Background/Objectives:

Digital media sources have enabled fast diffusion of vaccine information globally. National immunization program (NIP) websites can provide credible and accurate content on vaccines, but not all countries have robust NIP websites. This information gap can lead to online content vacuums that can be filled with anti-vaccine website content and narratives that can be consumed by caregivers and communities. A landscape analysis of currently available NIP websites is needed to understand their web presence and identify areas of improvement for vaccine content and website design, which will ultimately inform the development of minimum guidelines for national immunization program websites.

Description of Intervention and/or Methods/Design:

We screened websites for all 194 World Health Organization (WHO) member states via a Google search using specific search terms to identify countries that have a NIP or government website with substantive vaccine content such as essential vaccines, related vaccine preventable diseases, and national immunization schedule. Concurrently, in collaboration with WHO's Vaccine Safety Net (VSN) initiative, we developed a website grading tool to assess the vaccine content and design based on existing US Health and Human Service guidelines for online resources, peer-reviewed literature, and current VSN evaluation criteria for online vaccine safety content. The grading tool included six domains: content on vaccination, website design, linkage to external sources, findability of website, online presence, and website features, with a total score of 36. Shortlisted websites that had substantive content were scored based on the developed grading criteria. Descriptive statistics were obtained on the specific domains as well as overall scores.

Results/Lessons Learned:

Of all 194 member states, 42 (22%) had NIP websites with substantive content that we assessed using the grading tool. Most websites (69%) were from high-income countries and 59% from the WHO European region. The average overall website score was 28.5/36. Average vaccine content score was 7.8/10. Eleven (26%) of the 42 websites did not have any content related to vaccine safety. With regards to website design, more than 78% of the websites were optimized for mobile phones and 66% had Google analytics installed. Thirty-two (76%) of the 42 websites had social media linkages. Only 29 websites (69%) of the 42 were findable using vaccination-specific search terms on country-specific Google search engines. For online presence, while all websites had appropriate logos of government websites, 10 (24%) websites had no date of review or update for content. Most websites had satisfactory layout for easy and intuitive viewing.

Discussion/Implications for the Field:

Our results highlight the need for development and improvement of NIP websites, especially in low- and middle- income countries. There is greater need for vaccine safety content to counter misinformation and better inform communities. Our website grading tool can serve as a template for minimum requirement for a functioning website with accurate content. These guidelines are now being used, together with other specific expertise, to update the current VSN evaluation criteria and have the potential to be developed into an assessment tool for use by countries to develop and/or improve their NIP websites.

Abstract submitted by:

Shibani  Kulkarni - Centers for Disease Control and Prevention (CDC) 
Palak  Patel - CDC
Jane  Gidudu - CDC 
Isabelle Sahinovic - WHO 
Elisabeth  Wilhelm - CDC