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Deep learning analysis of trajectories and spatial variations in HPV vaccine discussions on Chinese Weibo – Communications Medicine

Abstract

Background

Since 2020 China has piloted free human papillomavirus (HPV) vaccinations to address low coverage. We aim to assess the public perceptions, perceived barriers and facilitators towards HPV vaccination in real time, utilizing deep learning-driven social media listening.

Methods

We collected all HPV vaccination discussions on Weibo, a popular Chinese social media platform, made from 2018 to 2023. We annotated 6600 randomly sampled posts manually against behavior change theories, and iteratively fine-tuned and trained deep learning models to auto-annotate all collected posts. Temporal and geographic analyses were conducted regarding public attitudes towards HPV vaccination and their determinants.

Results

Among 1,972,495 posts identified as relevant to HPV vaccines, deep learning models achieve a predictive accuracy of 0.78 to 0.96. 66.6% and 6.1% of posts contain positive and negative attitudes, respectively. The prevalence of positive attitudes increases from 15.8% to 79.1% (P = 3.02×10−11), negative attitudes decline from a peak of 20.3% to 5.5% (P = 1.28×10−5), and misinformation declines from 36.6% to 10.7% (P = 1.33×10−6). Central regions of China exhibit a higher prevalence of positive attitudes, whereas Beijing, Shanghai and northeastern regions show higher prevalence of negative attitudes and misinformation. Positive attitudes are significantly lower for 2-valent vaccines (65.7%) than 4-valent (79.6%; P = 0.0005) or 9-valent vaccines (74.1%; P = 0.0005).

Conclusions

Social media listening represents a promising and economically feasible surveillance approach for timely monitoring of public perceptions of vaccination and a potential tool for policymakers to understand public response to policy adaptation.

Plain Language Summary

The HPV (Human Papillomavirus) vaccination can reduce the chances of getting cervical and some other cancers by reducing the likelihood of being infected with HPV. HPV vaccination rates in China remain low despite government efforts to expand access. Understanding public perceptions of HPV vaccines can help guide strategies for improving vaccination coverage. We analyzed nearly two million posts about HPV vaccines on Weibo, a popular Chinese social media platform, from 2018 to 2023. We used a type of AI, called deep learning algorithms, to classify posts by attitudes towards vaccination, health beliefs, exposures to misinformation, and practical barriers to getting vaccinated. We found that positive attitudes increased substantially over time, while negative attitudes and misinformation declined. However, concerns about vaccine accessibility remained common, and some regions and vaccine types showed higher levels of negative attitudes. These findings suggest that social media monitoring using artificial intelligence can help policymakers track public opinions in real time and inform development of targeted strategies to improve vaccination uptake.

Acknowledgements

The computations in this research were performed using the CFFF platform of Fudan University.

Funding

This work is supported in part by a research grant from Investigator-Initiated Studies Program (No. 61185) of MSD. L.L. is supported by the AIR@InnoHK administered by the Innovation and Technology Commission of the Government of the Hong Kong Special Administrative Region. The funders had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The opinions expressed in this paper are those of the authors and do not necessarily represent those of MSD.

Author information

Author notes

  1. These authors contributed equally: You Wang, Haoyun Yang, Zhijun Ding.

Authors and Affiliations

  1. School of Public Health, Fudan University, Shanghai, China

    You Wang, Haoyun Yang, Zhijun Ding, Yingchen Zhou, Liyan Ma & Zhiyuan Hou

  2. NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China

    You Wang, Haoyun Yang, Zhijun Ding, Yingchen Zhou, Liyan Ma & Zhiyuan Hou

  3. Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA

    Xinyu Zhou

  4. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK

    Leesa Lin

  5. Laboratory of Data Discovery for Health, The University of Hong Kong, Hong Kong SAR, China

    Leesa Lin

  6. WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China

    Leesa Lin

Authors

  1. You Wang
  2. Haoyun Yang
  3. Zhijun Ding
  4. Xinyu Zhou
  5. Yingchen Zhou
  6. Liyan Ma
  7. Leesa Lin
  8. Zhiyuan Hou

Corresponding author

Correspondence to Zhiyuan Hou.

Ethics declarations

Competing interests

Zhiyuan Hou received funding from Merck Investigator Initiated Studies (61185). Leesa Lin is part of the research group from the Vaccine Confidence ProjectTM at LSHTM, which, during the same period of the study, received research grants from GlaxoSmithKline, Merck, and Meta. The other authors declare no competing interests.

Consent to publish

Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

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Cite this article

Wang, Y., Yang, H., Ding, Z. et al. Deep learning analysis of trajectories and spatial variations in HPV vaccine discussions on Chinese Weibo. Commun Med (2026). https://doi.org/10.1038/s43856-026-01720-5

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  • DOI: https://doi.org/10.1038/s43856-026-01720-5

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