Instagram posts and comments reveal a gap in HPV vaccine messaging in Türkiye

A content analysis of 2,362 Instagram posts and 5,609 associated comments about HPV vaccination in Türkiye has found a striking mismatch between what content producers publish and what audiences say in response. The study, published in BMC Women’s Health, applied the 5C psychological antecedents of vaccination model—a framework that organizes vaccine hesitancy into confidence, complacency, constraints, calculation, and collective responsibility—to social media conversations gathered during HPV Awareness Month in March across a three-year period from 2021 to 2023.

The researchers collected posts containing HPV-related hashtags and independently coded both posts and comments using the 5C model, with two researchers conducting the coding separately. Among the posts analyzed, 64.8% were categorized as irrelevant content and therefore contained no 5C model categories at all. Within the posts that did receive 5C codes, confidence in HPV vaccination was the most common dimension, accounting for 45.6% of assigned post codes (452 of 991). This suggests that when organizations and individuals posted about the HPV vaccine, reassurance about the vaccine’s safety and effectiveness was the dominant message they chose to convey.

The composition of that messaging varied by who was posting. Associations allocated a higher proportion of their content to HPV vaccine awareness, whereas posts by hospitals and healthcare professionals were more frequently promotional or unrelated to the vaccine discussion. This pattern is notable because healthcare institutions might be expected to lead public education efforts, yet the analysis indicates their Instagram output skewed toward promotional material rather than targeted awareness content.

The picture changed sharply when the researchers turned to the comments beneath those posts. Among comments, 75.1% were unclassifiable within the 5C framework, but among those that could be coded, constraints emerged as the most common theme, representing 51.5% of assigned comment codes (788 of 1,529). These constraint-related comments were primarily concerned with vaccine cost and limited accessibility—practical barriers rather than doubts about the vaccine itself. Confidence and calculation were also frequently discussed themes in the comment section, indicating that audiences weighed personal risk and benefit alongside their trust in the vaccine.

The contrast between producer-generated content and audience responses is the study’s central finding. While posts emphasized confidence, the audience conversation gravitated toward constraints such as affordability and access. This divergence suggests that public health messaging centered on reassurance may not be addressing the concerns that people actually raise when they engage with HPV vaccine content online. The authors argue that the findings highlight the need for accurate, evidence-based, and engaging digital health communication strategies.

Human papillomavirus vaccination is described in the study as an effective strategy for preventing HPV-related cancers, but the researchers note that communication gaps and barriers to information access remain critical public health concerns. Social media platforms have become vital sources of vaccine-related information and provide a key environment for public discussions about vaccination, which makes platforms like Instagram a natural setting for studying how hesitancy manifests in real time.

Based on these patterns, the study concludes that Instagram serves as an important platform for public discussions about HPV vaccination in Türkiye, and that healthcare institutions and professionals should take a more active role in addressing vaccine hesitancy through social media. The authors recommend developing digital public health strategies that address online concerns directly, strengthen communication accuracy, and foster an informed decision-making environment—approaches that would, in principle, bring institutional messaging into closer alignment with the constraint-driven questions audiences are already asking.

The study is an observational content analysis of social media posts and comments during a single awareness month each year, so it captures discourse patterns rather than vaccination behavior or outcomes, and the high proportion of irrelevant posts and unclassifiable comments limits how much of the online conversation could be mapped onto the 5C framework. The article was published as open access on 23 October 2026 and is being shared early to provide faster access to peer-reviewed, accepted research, with the version subject to further edits before the final Version of Record replaces it.

Subject of Research: Content analysis of HPV vaccine hesitancy discourse on Instagram in Türkiye using the 5C model of vaccination psychology

Article Title: Public health communication and HPV vaccine hesitancy discourse on instagram in Türkiye: A 5C model-based content analysis

Article References: Erensayın, B., Bilim, İ. S., Bilge, Ç., & Kaydırak, M. (2026). Public health communication and HPV vaccine hesitancy discourse on instagram in Türkiye: A 5C model-based content analysis. BMC Women's Health. https://doi.org/10.1186/s12905-026-05024-7

Image Credits: AI Generated

DOI: 10.1186/s12905-026-05024-7

Keywords: HPV vaccine, vaccine hesitancy, Instagram, Türkiye, 5C model, public health communication, social media, content analysis, vaccine cost, health communication, Public, health