Online Discourse and Trends Surrounding HPV Vaccination for Head and Neck Cancer Prevention

Objective: In 2020, the Food and Drug Administration (FDA) approved Merck's GARDASIL 9 for prevention of certain human papillomavirus (HPV)-related head and neck cancer. This study characterizes the sentiment and themes of HPV vaccination online discourse surrounding the 2020 FDA recommendation. Study Design: Retrospective cohort. Setting: Data from 2018 to 2022: Reddit, Teen VaxView (Centers for Disease Control and Prevention), and Google Trends. Methods: Online public discourse was assessed by searching Reddit for user submitted posts using relevant keywords. Reddit posts were categorized by a trained machine learning classifier. Natural language processing calculated positive/negative sentiment, polarity, and frequent nonstop words. Google Trends assessed relative search popularity, and TeenVaxView assessed HPV vaccinations among adolescents. Statistical relationships were assessed using linear and logarithmic regression models. Results: Analysis of 2751 Reddit posts demonstrated a balanced overall positive/negative sentiment, with a substantial positive trend over the study period (P =.05). Most posts were personal stories/questions (n = 1997, 72.6%) and conspiracy posts made up a just a small minority (n = 186, 6.8%). Discussion including head and neck anatomical and cancer terms significantly increased (P =.01). Vaccination coverage trended upward significantly for males and females (P <.01). A significant relationship was found between positive sentiment trend and vaccination coverage (P =.02). Conclusion: Discourse surrounding the HPV vaccine has been increasingly positive in sentiment and changes in FDA guidelines correlated with increased discussion of HPV-related head and neck cancer. There was a concurrent increased adolescent vaccination rate.