@article {1395986,
	title = {Vaccine Hesitancy and Online Information: The Influence of Digital Networks},
	journal = {Health Educ Behav},
	volume = {45},
	year = {2018},
	month = {2018 08},
	pages = {599-606},
	abstract = {AIMS: This article analyzes the digital childhood vaccination information network for vaccine-hesitant parents. The goal of this study was to explore the structure and influence of vaccine-hesitant content online by generating a database and network analysis of vaccine-relevant content.

METHOD: We used Media Cloud, a searchable big-data platform of over 550 million stories from 50,000 media sources, for quantitative and qualitative study of an online media sample based on keyword selection. We generated a hyperlink network map and measured indegree centrality of the sources and vaccine sentiment for a random sample of 450 stories.

RESULTS: 28,122 publications from 4,817 sources met inclusion criteria. Clustered communities formed based on shared hyperlinks; communities tended to link within, not among, each other. The plurality of information was provaccine (46.44\%, 95\% confidence interval [39.86\%, 53.20\%]). The most influential sources were in the health community (National Institutes of Health, Centers for Disease Control and Prevention) or mainstream media ( New York Times); some user-generated sources also had strong influence and were provaccine (Wikipedia). The vaccine-hesitant community rarely interacted with provaccine content and simultaneously used primary provaccine content within vaccine-hesitant narratives.

CONCLUSION: The sentiment of the overall conversation was consistent with scientific evidence. These findings demonstrate an online environment where scientific evidence online drives vaccine information outside of the vaccine-hesitant community but is also prominently used and misused within the robust vaccine-hesitant community. Future communication efforts should take current context into account; more information may not prevent vaccine hesitancy.},
	keywords = {Child, Consumer Health Information, Health Knowledge, Attitudes, Practice, Humans, Internet, Mass Media, Narration, Parents, Treatment Refusal, United States, Vaccination, Vaccines},
	issn = {1552-6127},
	doi = {10.1177/1090198117739673},
	author = {Getman, Rebekah and Helmi, Mohammad and Roberts, Hal and Yansane, Alfa and Cutler, David and Seymour, Brittany}
}
