{"doi":"10.3389/frhs.2025.1578992","title":"Negative vaccine sentiments on South African social media platforms before the COVID-19 pandemic: a mixed methods study","abstract":"<h4>Introduction</h4>During the pre-pandemic era, negative vaccine sentiments did not feature in South African publications reporting on infant vaccination uptake. In contrast, vaccine hesitancy is an established driver of suboptimal COVID-19 vaccine uptake in South Africa, suggesting that the COVID-19 pandemic increased vaccine hesitancy in South Africa. This study used data from a social media tracking project to investigate vaccine sentiment expressed on South African social media platforms in the pre-pandemic era.<h4>Methods</h4>This mixed-methods study analysed South African social media [Twitter (now X); online news forums; microblogs] posts mentioning vaccine-related words from 1 December 2016-31 May 2017. Content analysis was used to assign vaccine sentiment, and thereafter a step-wise thematic content analysis of negative sentiment posts was conducted using NVivo12®.<h4>Results</h4>Of 10,997 posts about human vaccines, 16.2% expressed negative vaccine sentiments. Specific vaccines were discussed in 35.9% of posts, with human papillomavirus (HPV) vaccines attracting the most negative sentiments (31.9% of all negative posts). The majority of negative posts included links to articles emanating from other countries, predominantly the USA. Five themes were identified: Vaccine safety; autism; vaccine effectiveness; conspiracy theories; and philosophical/religious objections.<h4>Discussion</h4>Relatively high levels of pre-existing negative sentiments toward vaccines were expressed in the pre-pandemic era, with HPV vaccines attracting the most negative comments. These results provide a baseline for comparison to post-pandemic social media studies and may prove useful for measuring the impact in South Africa of global policies introduced to limit the spread of vaccine mis- and disinformation.","journal":"Frontiers in Health Services","year":2025,"id":5780,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.0449,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-05-30","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":55883,"name":"Rosemary J. Burnett","orcid":"0000-0003-1346-1570","position":1,"is_corresponding":false},{"id":55884,"name":"Zeenat Ismail","orcid":null,"position":2,"is_corresponding":false},{"id":55885,"name":"Johanna C. Meyer","orcid":"0000-0003-0462-5713","position":3,"is_corresponding":false},{"id":55886,"name":"Zulkifli Ismail","orcid":null,"position":4,"is_corresponding":false},{"id":55882,"name":"Michelle M. Matsangaise","orcid":null,"position":0,"is_corresponding":true}],"reference_count":50,"raw_metadata":null,"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}