Perceptions and sentiments associated with HPV vaccine uptake among Indian Reddit users: a qualitative social media analysis
Cervical cancer is mainly caused by the human papillomavirus (HPV), a sexually transmitted infection. An effective prevention method includes early screening and vaccination. HPV vaccine uptake is low in India, despite the approval of various vaccines. It has been observed that multiple factors affect the uptake of the vaccine. Social media platforms give space to the users to vocalize their views better. Therefore, this study aims to assess the perceptions and sentiments associated with HPV vaccine uptake among Indian Reddit users. This qualitative study analyzed the posts related to the HPV vaccine during the timeframe of 1 July 2023 to 31 December 2024, taken from the Indian population's Reddit social media platform. Sentiment analysis was done on sentiment distribution using the Valence Aware Dictionary and sEntiment Reasoner (VADER) package. Content analysis was done manually using a deductive approach, and a stepwise thematic analysis was done. The 5 A model (access, availability, awareness, acceptance, and activation) was used as the conceptual framework for vaccine uptake. For other relevant analysis, R software version 4.5.0 was used. A total of 3,743 Reddit posts were extracted, and 339 of these were found to be relevant according to the 5 A framework and subsequently coded. Among the coded texts, the majority of responses were found to have a neutral sentiment (46%), followed by positive sentiments (33.6%) and negative sentiments (20.4%), respectively. Four themes were identified: access, availability, awareness, and acceptance. A tree-cum heat map for both positive and negative sentiments shows the frequency of the codes in accordance with their repetition in the posts. High cost, safety concerns, misinformation, limited access, and cultural factors were the key negative sentiments identified, while positive sentiments included right knowledge, healthcare worker (HCW) recommendations, personal health beliefs, and past experiences. Social media and peer influence emerged as both an enabler and a challenge. The study reveals a complex mixture of knowledge gaps, attitudes, systemic barriers, and social influences that inform decision-making. These findings may help policymakers to enhance the vaccine coverage in an effective manner through targeted, culturally sensitive awareness campaigns during the national rollout.