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CALVIN. A content analysis of online discussions on pediatric vaccinations



Schulz P. J.


Fadda M.



Cafaro T.


Mammolo I.


Medolago G.


Buzzolini J.



In March 2012, a local court in Rimini, north-east Italy, awarded the Bocca family Euros 174,000 ($240,000) after ruling that the MMR vaccination had caused autism in their son. Evidence suggests that this event has triggered an ignite debate among parents and medical professionals. However, despite a great amount of literature on parental attitudes and beliefs over MMR, popular communication platforms such as the Internet have drawn little attention thus far. Few studies based in Australia, Canada, Germany, Italy and the UK have conducted a quantitative analysis of online parents’ discussions about childhood immunizations. The present study aims at assessing parents’ online debates on the MMR vaccination through a quantitative content analytical approach, with a special look at the impact of the Rimini case.

It has been widely proved that media attention on certain events can have a powerful influence on people’s attitudes. Furthermore, parents seem to prefer personal and emotive narratives over scientific evidence when looking for health-related information. We thus speculated that the news about the Rimini trial might affect people’s concerns over MMR side effects as expressed in online discussions. It was hypothesized that the number of comments displaying safety concerns will increase over time, while an opposed trend will be observed for the number of contributions including accurate and complete information.

We identified three popular Italian online forums that address topics related to parenthood. A selection of threads using the keyword “vaccin*” was performed. Each thread was then evaluated for appropriateness (it should deal with the MMR vaccination) and length (number of posts ≥ 5). Each post included in the selected threads was then independently categorized by two coders using a pre-defined coding scheme focusing on participants’ position on MMR, main content of the post, accuracy and completeness of the information provided. Furthermore, we extracted a number of details about the users from their public profile such as gender and number of posts. We computed a Cohen’s Kappa coefficient to estimate intercoder reliability. Frequency distributions were calculated, while group classifications and predictors were related by cross tabs with Chi2-test.

Studies have shown that the Internet represents a powerful vehicle for anti-vaccination information to reach parents and influence their perceived risk of vaccinating, particularly when this information includes narratives about vaccine adverse events. Furthermore, there is evidence that Internet users are more likely to come across low-quality information and rely on perilous sources. It is up to vaccination advocates to direct parents to official and reliable information and address their concerns in a way that is suitable for the online environment.

Additional information

Start date
End date
12 Months
Funding sources