Information, Communication & Society

ISSN: 1369-118X (Print) 1468-4462 (Online) Journal homepage: http://www.tandfonline.com/loi/rics20

Mapping the anti-vaccination movement on

Facebook

Naomi Smith & Tim Graham

To cite this article: Naomi Smith & Tim Graham (2017): Mapping the anti-vaccination movement
on Facebook, Information, Communication & Society, DOI: 10.1080/1369118X.2017.1418406

To link to this article: https://doi.org/10.1080/1369118X.2017.1418406

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 INFORMATION, COMMUNICATION & SOCIETY, 2017
https://doi.org/10.1080/1369118X.2017.1418406

Mapping the anti-vaccination movement on Facebook

Naomi Smitha and Tim Grahamb
a
School of Arts, Humanities and Social Sciences, Federation University Australia, Gippsland, VIC, Australia;
b
Research School of Computer Science, and Research School of Social Science, Australian National University,
Canberra, ACT, Australia

ABSTRACT ARTICLE HISTORY

Over the past decade, anti-vaccination rhetoric has become part of Received 5 January 2017
the mainstream discourse regarding the public health practice of Accepted 13 December 2017
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childhood vaccination. These utilise social media to foster online

KEYWORDS
spaces that strengthen and popularise anti-vaccination discourses. Anti-vaccination; social
In this paper, we examine the characteristics of and the discourses network analysis; topic
present within six popular anti-vaccination Facebook pages. We modelling; social network
examine these large-scale datasets using a range of methods, sites; social media
including social network analysis, gender prediction using
historical census data, and generative statistical models for topic
analysis (Latent Dirichlet allocation). We find that present-day
discourses centre around moral outrage and structural oppression
by institutional government and the media, suggesting a strong
logic of ‘conspiracy-style’ beliefs and thinking. Furthermore, anti-
vaccination pages on Facebook reflect a highly ‘feminised’
movement ‒ the vast majority of participants are women.
Although anti-vaccination networks on Facebook are large and
global in scope, the comment activity sub-networks appear to be
‘small world’. This suggests that social media may have a role in
spreading anti-vaccination ideas and making the movement
durable on a global scale.

Introduction
This paper examines the structure and discourse of anti-vaccination public Facebook
pages and considers how the properties of anti-vaccination networks on Facebook may
be analogous to social movements. Understanding pockets of resistance to vaccination
as a public health exercise provides important insights into how these attitudes may be
effectively countered. Effective disease prevention is contingent on high levels of vacci-
nation compliance and coverage within networked populations. When these networks
of coverage are disrupted or begin to disintegrate, diseases such as pertussis (or whooping
cough), measles, and polio re-emerge. Globally, there has been an increased politico-legal
mandate on maintaining high levels of vaccination amongst the community.1
Efforts to increase community vaccination rates to effective standards have not been
without resistance. There have been concerted attempts, both online and offline, to pre-
vent the passage of legislation via techniques of intimidation and coercion, such as

CONTACT Naomi Smith n.smith@federation.edu.au School of Arts, Humanities and Social Sciences, Federation
University Australia, PO Box 3191, Gippsland, VIC 3841, Australia
© 2017 Informa UK Limited, trading as Taylor & Francis Group
 2 N. SMITH AND T. GRAHAM

‘doxing’,2 stalking, and death threats (Diresta & Lotan, 2015). This suggests that individ-
uals who are opposed to vaccination, known as anti-vaccinators or ‘anti-vaxxers’, are
serious about protecting their refusal to vaccinate, and use a variety of means to mobilise
the cause. Anti-vaccinators oppose all forms of childhood vaccinations and believe that
vaccinations are toxic, and cause a variety of illnesses and adverse reactions including
autism. As most anti-vaccination communication and organisation takes place online
(Diresta & Lotan, 2015), public social media sites such as Facebook and Twitter provide
rich sources of information regarding the dynamics, discourse characteristics, and net-
worked dimensions of the anti-vaccination movement, making social media a significant
sight for further scholarly analysis.

Networks, Web 2.0 and anti-vaccination

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The Internet is a well-established and important site of health-related information seeking

behaviour (Camerini, Diviana & Tardini, 2010; Percheski & Hargittai, 2011), and more-
over has a significant role in shaping health behaviours (Gray, Klein, Noyce, Sesselberg,
& Cantrill, 2005; Smith, Wickes, & Underwood, 2015; Vaterlaus, Patten, Roche, &
Young, 2015). However, the present literature on anti-vaccination is sporadic, limited
(Kata, 2010; 2012), and is not often linked with broader sociological understanding of
e-health practices. Primarily, the literature examines anti-vaccination from a public health
perspective (Betsch, Bohm, & Chapman, 2015; Butler & MacDonald, 2015). There is a lack
of ongoing research regarding the anti-vaccination community online, an important site of
discourse and community organisation.
Anti-vaccination websites, both static, and social media based are highly prevalent
online and may be more compelling sources of information than pro-vaccination websites,
with the former exhibiting a capacity to influence vaccination practices (Davies, Chapman,
& Leask, 2002; Kata, 2012). However, very few websites present as explicitly ‘anti-vacci-
nation’, instead, websites claim to be ‘pro-safe vaccines’, or in favour of ‘vaccine choice’,
whilst simultaneously claiming that vaccines include toxic and harmful substances
(Kata, 2012). Such strategies accompanied by emotional appeals to parents’ protective
instincts (Davies et al., 2002) make it more difficult for parents to critically evaluate the
nature of vaccine-related health information online.
Davies et al. (2002) suggest it is likely that, in seeking information about immunising their
children, parents will encounter a range of convincing anti-vaccination materials. Much of
the appeal of anti-vaccination sites is in the genuine pain of those touched by childhood ill-
ness and death, and the lack of a seemingly adequate medical explanation (Davies et al.,
2002). In this instance, anti-vaccination reasoning fills this ‘void’ by placating parents
who feel abandoned or dismissed by the medical community. Grant et al. (2015) similarly
concluded that anti-vaccination websites are much more effective at utilising their social
interactivity than pro-vaccine websites. The focus on social interactivity effectively creates
communities of people who are affected by and are sceptical of vaccine practices. This
further highlights how anti-vaccination websites may be more effective in affirming and
transmitting beliefs than the ‘information repository’ style of the pro-vaccine websites.
In the context of social media, Oh, Lauckner, Boehmer, Fewins-Bliss, and Li (2013) find
that Facebook is a powerful platform for seeking and sharing health-related content, primar-
ily due to its interactive nature that facilitates the exchange of social support. The limited
 INFORMATION, COMMUNICATION & SOCIETY 3

research that does exist has examined the impact of ‘Web 2.0’ in vaccination decision mak-
ing arguing that users of Web 2.0 applications (social media) have the capacity to influence
and shape public discourse regarding vaccination in a viral manner both positively and
negatively (Betsch et al., 2012). This is in part due to the networked properties of social
media like Facebook. As such, discourse needs to be considered in conjunction with network
properties that make the anti-vaccination community possible online.
Social media has also fuelled the growth of ‘consumer autonomy’ in health care, where
patients are expected and have been encouraged to take an active role in managing their
own health (Dutta-Bergman, 2004). However, the growth of patient ‘consumer autonomy’
has also created ‘flattening’ of expertise, where power shifts from doctors to patients. The
redefinition of expertise has created an environment for anti-vaccination activists to effec-
tively spread their message (Kata, 2012). Insofar as vaccination can be considered as a
‘health problem’, the emergence of public anti-vaccination pages on Facebook can be
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understood as compelling sites of social support for those who refuse to vaccinate. How-
ever, presently little is known about these public Facebook page communities, including
foundational knowledge about the size of these communities, who participates, how
users are connected within the space, and what kinds of topics are discussed via user com-
ments. This is a gap we aim to addresses in the analysis that follows. As Smith and O’Mal-
ley (2016) argue, online networks like Facebook, together with portable digital devices, ‘act
as a catalyst to mobilize individual and collective protest that … serves both personal and
communal ends’ (p. 5). In this paper, we make the significant step of applying methods
from computational social science towards understanding the anti-vaccination movement
on Facebook as a site of mobilisation for anti-vaccination practices. In order to address
this, we are focussed on determining the networked properties of the anti-vaccination
communities on Facebook selected for analysis. This includes accounting for their size,
shape, and levels of connectedness. Additionally, we are also interested in the topics of dis-
cussion, or the discourse on these pages, as previous research by Davies et al. (2002) and
Kata (2012) suggest that these are potent motivators. However, a large-scale analysis of
anti-vaccination is presently lacking from scholarly literature.

Site selection and methodological approach

The previous empirical literature suggests that there are, at present, no large-scale studies of
anti-vaccination sentiment on social media platforms like Facebook. In this research, we
examine the anti-vaccination movement on six public Facebook pages, discussed further
below. In doing so, we map the structure of the anti-vaccination movement on Facebook,
ascertain its gendered characteristics, as well as the topics most commonly discussed.
These three areas of focus can begin to provide an empirically grounded understanding
of this social movement on a major social media platform. In this section, we discuss our
analytic strategy, including: research site selection; data collection and network generation;
social network analysis (SNA); gender modelling; and text analysis via topic models.

Research site selection

As highlighted in the introduction, the anti-vaccination movement has attracted consider-
able mainstream media attention over the past 10 years. Matters relating to vaccination
 4 N. SMITH AND T. GRAHAM

Table 1. Purposive sample of six anti-vaccination Facebook pages.

Number of page likes
Facebook page (as of 3 December 2015)
Fans of the AVN 9811
Dr. Tenpenny on vaccines 173,410
Great mothers (and others) questioning vaccines 17,592
No vaccines Australia 3108
Age of autism 12,959
RAGE against the vaccines 14,611

and public health are frequently reported in the news. While the anti-vaccination commu-
nity is still comparatively small, it manages to garner a lot of attention and most of this
attention is a result of content produced in online communities loosely structured around
social media sites such as Facebook, Twitter, and YouTube. Comparing data on anti-vac-
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cination community across these three platforms is outside the scope of this research.
We have chosen to focus on Facebook as it is still the most popular social network site
in the world and has the broadest user base. A purposive sample of six Facebook pages was
selected by triangulating data (Denzin, 1970) from both Australia and North America,
providing two important, albeit considerably different, sites of current anti-vaccination
activity (see Table 1). Purposive sampling also helped us identify sites that were relevant
to the anti-vaccination movement, and provided interesting and important insights on the
anti-vaccination movement. In addition, conducting large-scale data analysis (detailed
below) the sites were also reviewed before data collection to ensure the timeline for
data collection (14 April 2013 and 14 April 2016) would be analytically useful (Smith &
O’Malley, 2016).
These sites including both ‘community’ pages and pages run by a public figure (e.g.,
Dr Tenpenny). Pages concerning a public figure has more like than community-based
pages, and Australia pages had fewer ‘Likes’ than pages that were more focus on North
America in tone and content. This is not surprising, given the relative population sizes of
Australia and the North America. The research sites we selected were chosen using the fol-
lowing criteria. The Facebook pages had to be explicitly anti-vaccination in focus, available
to the public, and easily discoverable through keyword searches such as ‘vaccine concern’,
‘vaccine choice’, ‘vaccines and autism’, and ‘anti-vaccination’. In addition, Facebook pages
must be frequently updated, that is, daily or with updates every other day. Pages must
also have a minimum of 1000 ‘likes’, as well as evidence of user activity and interaction,
including double digit likes on posts, as well as comments and ‘sharing’ of posts.
These criteria helped ensure we had active sites for data collection and a large enough
sample size to elicit sufficiently generalisable findings regarding the structure and compo-
sition of the anti-vaccination movement on Facebook. A range of methods was used to
answer the research questions of this study:

1. What are the networked properties of anti-vaccination communities on Facebook,

including their size, shape, and connectedness?
2. What types of anti-vaccination discourses are present within these communities?

These research questions broadly fit into two approaches: social network analysis and text
analysis. This section provides details about the methods used for each of these approaches.
 INFORMATION, COMMUNICATION & SOCIETY 5

Data collection and network generation

As discussed previously, data were collected from six public Facebook pages. Data were
collected using the Facebook Application Programming Interface (API) and the ‘Social-
MediaLab’ package for the R programming language (Graham & Ackland, 2016). Three
years of data were collected, that is, any ‘posts’ that were posted between 14 April 2013
and 14 April 2016. Following this, for each post, a maximum of 1000 user-submitted
‘likes’ and 1000 user-submitted comments were collected.3 This included the text content
of the comments. As Table 2 shows, the data includes 14,736 unique posts, 242,813 unique
users, over 2.5 million ‘likes’, and 291,520 comments. Table 2 also includes the total num-
ber of ‘shares’ across all posts for each of the six pages. A ‘share’ means that a viewer of a
post has shared the post and any associated links within their personal network.
Altogether for this data set, anti-vaccination posts were shared over 2 million times.
The median number of shares per post was 11 and the average was 138. About 15%
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posts had zero shares.

These data were used to generate social networks for further analysis using the methods
in Graham and Ackland (2016). This is a novel approach to representing Facebook data
that has not yet been widely utilised in academic research. For each Facebook page, we cre-
ated a network represented as a two-mode, directed and labelled multi-graph. As Figure 1
shows, these networks consist of two types of ‘nodes’4 and two types of links or ‘edges’
between nodes. Nodes can be either a ‘user’ or a ‘post’ and edges are either a ‘like’ or a
‘comment’ directed from a given user to a given post. For example, in Figure 1 we see
that user j has commented on post z and liked post k, whereas user h has only commented
on post k. Because the networks are multi-graphs, it is possible that a given user can com-
ment and like a given post, represented by two distinct edges. Further, users can comment
multiple times on a given post (represented by multiple edges), but can only ‘like’ a post
once.
Using the two-mode page-level networks, we also constructed one-mode projections of
each network in order to examine the co-commenting activities of users. Commenting on
a post requires more effort than simply clicking ‘like’ and arguably represents a more
‘involved’ activity on the part of the user. Creating networks from the comment activity
of users provides a more fine-grained understanding of the structure and nature of user
interactivity on the anti-vaccination pages, even though Facebook does not directly provide
this type of data. In order to achieve this, we firstly created sub-graphs of the networks that
contain only ‘comments’ edges, thereby excluding ‘likes’ data from the network. Second, we
projected each comments sub-graph to construct another network that includes only users,
providing a ‘user comments’ network. As Figure 2 shows, for each user i and j within a given

Table 2. Descriptive statistics of Facebook anti-vaccination pages.

Page No. posts No. users No. likes No. comments No. shares
AVN_Living_Wisdom 1424 11,554 81,606 13,786 31,908
AVN Living Wisdom 2256 17,815 159,738 15,802 100,566
Rage against vaccines 2999 10,137 74,857 10,842 37,593
Age of autism 2172 11,383 69,265 7579 29,686
GMAOQV 2303 6390 55,135 8051 23,321
No vaccines Australia 3582 211,891 2,091,254 235,460 1,801,598
Total (unique) 14,736 242,813 2,531,855 291,520 2,024,672
 6 N. SMITH AND T. GRAHAM
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Figure 1. Sample anti-vaccination Facebook post.

network, an undirected edge is created if the users both co-commented on any post. Thus we
set a very low bar for creating a relationship between users: two users are connected merely if
they have both commented on the same post within the 3-year period for a given page-level
network. Additionally, each edge in the ‘user comments’ networks has a weight value that
represents how many times two users co-commented on any posts together. This is illus-
trated in Figure 3 by the ‘thickness’ of each edge.
 INFORMATION, COMMUNICATION & SOCIETY 7

Figure 2. Structure of the Facebook page-level networks.

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As outlined in the previous section, we constructed seven ‘page-level networks’ for

further analysis, one for each anti-vaccination page and an additional network of all the
pages combined (herein the ‘movement-level network’). As Table 3 shows, the networks
are relatively large scale. The largest page-level network was VaccineInfo, which rep-
resented over 80% of the total users, posts, and user activity. The movement-level network
had over a quarter million unique users and posts (nodes) and nearly 3 million likes and
comments (edges).
Although a large number of users participated within the page-level networks, we find
that only a small portion of users participate regularly. The majority of users only liked or
commented on a post once or twice within the 3-year period, constituting a kind of ‘tran-
sient’ user. To obtain these results, we examined the out-degree distribution for each page-
level network. In other words, how many times did each user like and/or comment on
posts within each page-level network? As Table 4 shows, we observe that the out-degree
distribution is highly skewed. There is a small subset of users within each page who are
highly active in terms of liking and commenting on posts, and a ‘long tail’ of users who
are very infrequent in their activity. This supports the finding that the majority of activity

Figure 3. Structure of the Facebook one-mode network projection of user co-comment activity.
 8 N. SMITH AND T. GRAHAM

Table 3. Node and edge count statistics for the page-level networks.
Page/network Nodes Edges
AVN living wisdom 12,978 95,392
Rage against vaccines 20,071 175,540
Age of autism 13,136 85,699
GMAOQV 13,555 76,844
No vaccines Australia 8693 63,186
Vaccine info 215,473 2,326,714
Movement-level network 257,549 2,823,375

within each page derives from ‘transient’ users who only post once or twice within the
3-year period.
The next step of the analysis examined what percentage of users were active between
multiple anti-vaccination pages. Are users active on one page or do they participate across
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multiple pages? For each page-level network i and j, we calculated how many users who
participated in network i also participated in network j, expressed as a percentage.
Table 5 shows the percentage of users who participated between pairs of page-level net-
work. On average, only about 11% of users were active across any two given pages. How-
ever, an exception was the ‘Vaccine Info’ page network, whereby approximately one-third
of users were also active on other pages. Whilst this makes sense given the large size of the
‘Vaccine Info’ page, it also indicates that this page is singularly important within the anti-
vaccination movement on Facebook.
We now turn attention to the one-mode ‘user co-comment’ networks that were pro-
jected from the page-level two-mode networks. As discussed previously, these networks
depict only users (nodes) and comment activity (edges), whereby an edge between two
users means that they both commented at least once on any post within a given network
over the 3-year period. These one-mode projections of the networks provide a different
picture of the anti-vaccination movement on Facebook, because the focus is on users
and their comment activity (rather than ‘likes’). As argued previously, commenting
requires more effort and is more involved than simply ‘liking’ a post. Comments also con-
tribute differently to the spread of anti-vaccination discourse and ideas, given that users
are able to read each other’s’ comments, interpret and learn from them, and engage in dis-
course by posting their own comments. Therefore, these networks provide specifically
interesting perspectives on user (co)participation and discourse dynamics within each
page and across the entire movement-level network.
Table 6 provides descriptive statistics of each projected user co-comment network. As
the ‘edges’ values in Table 5 shows, a large number of users co-comment together within
each network during the 3 years. Indeed, across the entire movement-level network there

Table 4. Out-degree distribution of user activity by page-level network.

Users who liked and/or commented As a percentage of total activity
Page-level network two times or less within network
AVN living wisdom 7359 64%
Rage against vaccines 10,375 58%
Age of autism 6384 63%
GMAOQV 6602 58%
No vaccines Australia 4268 67%
Vaccine info 133,588 63%
 INFORMATION, COMMUNICATION & SOCIETY 9

Table 5. Percentage of user participation across pairs of page-level networks.

AVN living Rage against Age of No vaccines Vaccine
wisdom vaccines autism GMAOQV Australia info
AVN living wisdom 100% 7.8% 2.9% 4.6% 9.6% 31.3%
Rage against 5% 100% 5.3% 9.6% 4.9% 46.1%
vaccines
Age of autism 2.8% 8% 100% 6.6% 2% 27.6%
GMAOQV 4.4% 14.2% 6.4% 100% 3.4% 41.5%
No vaccines 14.4% 11.2% 3% 5.4% 100% 29.4%
Australia
Vaccine info 1.9% 4.3% 1.7% 2.6% 1.2% 100%

are nearly 17 million occurrences of users co-commenting on a post. However, the ‘den-
sity’ values of the networks reveal that of all the possible co-comments between users, only
a small percentage are actually observed. In other words, across the entire movement-level
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network, about 2% of users have co-commented with another user on any post during the
3-year period. This suggests that, on the whole, users are not acting together in a coordi-
nated fashion, but instead supports the idea of users as ‘transient’ visitors, as the previous
analysis indicated. However, even if two users have not directly co-commented together
on the same post, this does not mean that they are not potentially influenced by each
other’s comments or connected in analytically interesting ways.
To examine this further, we assess whether the user co-comment networks exhibit the
property of being ‘small world’ networks (Watts & Strogatz, 1998). As Shirky argues, small
world networks ‘have two characteristics that, when balanced properly, let messages move
through the network effectively’ (2008, p. 215). The first characteristic is that small groups
of nodes in the network are highly clustered and inter-connected. The second characteristic
is that large groups of nodes in the network are sparsely inter-connected. Small world net-
works enable infectious diseases to spread much more quickly and easily than other types
of networks, such that the dynamics of the network is an ‘explicit function of structure’
(Watts & Strogatz, 1998, p. 441). Small world networks are also interesting because
they are robust and resistant to damage. That is, randomly removing nodes from the net-
work will not significantly impact the effectiveness and dynamics of the network. In terms
of the anti-vaccination movement on Facebook, if these networks are ‘small world’ then
this has repercussions for the dynamics of the movement and how ideology is diffused
via comment activity, which is discussed later.
We use the approach of Watts and Strogatz (1998) to assess whether the user co-com-
ment networks are ‘small world’. A network is ‘small world’ if it satisfies two conditions.
First, its average local clustering coefficient must be much greater than a random network
generated from the same set of vertices. Second, the mean shortest path length of the

Table 6. Descriptive statistics for projected user networks.

Page/network Nodes Edges Density
AVN living wisdom 3674 112,138 0.017
Rage against vaccines 4953 175,966 0.014
Age of autism 2814 45,510 0.011
GMAOQV 3232 87,463 0.017
No vaccines Australia 2160 43,106 0.018
Vaccine info 67,832 16,328,286 0.007
Movement-level network 78,487 16,784,282 0.005
 10 N. SMITH AND T. GRAHAM

network must be approximately the same as the associated random network. We con-
structed six random networks corresponding to the vertex sets of the six user co-comment
networks, along with a seventh random network corresponding to the movement-level co-
comment network. The random networks were created using the Erdős-Rényi model
implementation in the ‘igraph’ R package (Csardi & Nepusz, 2006).
The results in Table 6 suggest that each of the networks is ‘small world’ given that they
approximately satisfy the two conditions set out by Watts and Strogatz (1998). In this way,
the average local clustering coefficient scores are much greater for the observed networks
versus the random networks (bolded in brackets), and the mean shortest path length
scores are approximately the same between the observed and random networks.

Network analysis and gender modelling

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The generation of networks from the Facebook data resulted in seven networks, that is,
one network for each anti-vaccination page and one large-scale network constructed
from the entire dataset across all six pages. A range of SNA methods were employed to
analyse the network data, including descriptive statistics for network characteristics
(Kolaczyk & Csárdi, 2014, pp. 44–58). In addition to understanding how anti-vaccination
Facebook pages are structured as networks we also wished to examine the gender compo-
sition of the networks, in order to ascertain the extent to which the anti-vaccination move-
ment on Facebook is gendered.
Very little information is provided by the Facebook API regarding the individual
characteristics of users. Currently, only the user names are made available through the
public search API. However, for this study we wanted to understand the gender5 of
users who are participating in the Facebook anti-vaccination networks. To achieve this,
we modelled the gender of users based on their first or ‘given’ name. We used the method
implemented by Mullen (2016) in the ‘gender’ software package. As Mullen (2016)
describes, this approach ‘encodes gender based on names and dates of birth using historical
datasets. By using these datasets instead of lists of male and female names, this package is
able to more accurately guess the gender of a name, and it is able to report the probability
that a name was male or female’ (p. 1). Thus for each user in our networks we extracted the
first name and used this to predict whether the user was more likely to be male or female.
For the ‘gender’ package functionality, we used the ‘SSA’ method, which queries names
based on the U.S. Social Security Administration (SSA) baby name dataset (from 1932
to 2012). This returned a list of the first names along with the probability for male and
female, or an ‘unknown’ value for names that do not appear in the SSA dataset.
As Table 7 shows, the findings suggest that the majority of people who participate
within the anti-vaccination movement on Facebook are female. On average, the ratio of
male to female is approximately 1:3, indicating a pronounced gender imbalance in
terms of participation within the anti-vaccination movement on Facebook. We also
find that the gender imbalance is even more skewed for the most active users, which we
define as the top 10% of users by number of comments and likes. As the figures in brackets
in Table 6 show, men are consistently under-represented within the set of most active
users, whilst women are consistently over-represented. Notably, a small percentage of
users had names that were not able to be modelled using the gender analysis, resulting
in the ‘unknown’ observations.
 INFORMATION, COMMUNICATION & SOCIETY 11

Table 7. ‘Small world’ metrics for user co-comment networks VS random

graphs (bolded in brackets).
Average local clustering Mean shortest path
Page/network coefficient length
AVN living wisdom 0.803 (0.017) 2.3 (2.34)
Rage against vaccines 0.811 (0.014) 2.371 (2.341)
Age of autism 0.817 (0.012) 2.458 (2.67)
GMAOQV 0.848 (0.017) 2.732 (2.381)
No vaccines Australia 0.816 (0.019) 2.527 (2.451)
Vaccine info 0.797 (0.007) 2.196 (2.025)
Movement-level 0.797 (0.005) 2.351 (2.091)
network

Using the node-level ‘gender’ attribute we can also examine the distribution of edges by
gender, that is, the proportion of directed edges that have a female versus male source
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node. This provides a better indication of user activity by gender, i.e., likes and comments
on the Facebook posts. As Table 8 shows, the edge-level user activity within the networks
is slightly more skewed in terms of gender distribution, with an increase of 4.2% compared
to the node-level gender distribution. Across the entire movement-level network, 21.9% of
user activity is male, 71.4% is female, and 6.7% is not estimated (gender unknown).
Figure 3 provides a network visualisation of the anti-vaccination movement, where the
colour of the nodes represents gender. Male nodes are yellow, female are purple, and
the ‘posts’ nodes are light blue. The network is overwhelmingly purple, reflecting the pre-
dominantly female gender of the users (Figure 4 and Table 9).

Text analysis and topic modelling

Turning attention towards the comment text, we wanted to understand what users of the
anti-vaccinations pages were talking about, including what might be driving the user-gen-
erated discourse for this movement on Facebook. To achieve this, we performed topic
modelling on the complete set of comment text (i.e., across the 6 Facebook pages) to
examine what kind of latent ‘topics’ might be driving the discourse. We selected a topic
modelling approach known as Latent Dirichlet Allocation or ‘LDA’ (Blei, Ng, & Jordan,
2003). Informally, LDA represents a set of text documents in terms of a mixture of topics
that generate words with particular probabilities. For example, the comment ‘Kill one
person, go to jail, kill thousands and pay a fine. Where is the justice?’ might be largely
generated from a topic labelled Crime and Justice, associated with words such as criminal,
abuse, murder, crime, jail, justice, experiment, fraud, kill.

Table 8. Gender composition of anti-vaccination networks by user (top 10% most

active users in brackets).
Page/network Male Female Unknown
AVN living wisdom 20.3% (18%) 71.3% (75.2%) 8.4% (6.8%)
Rage against vaccines 18.4% (13.2%) 74.5% (81.4%) 7% (5.4%)
Age of autism 15.6% (11.6%) 78.2% (84.3%) 6.3% (4%)
GMAOQV 11% (6.5%) 82.7% (88%) 6.3% (5.5%)
No vaccines Australia 25.7% (21.3%) 65.1% (68.9%) 9.2% (9.9%)
Vaccine info 24.1% (21.4%) 68.5% (72%) 7.4% (6.6%)
Movement-level network 23.6% (20.2%) 68.9% (73.3%) 7.5% (6.5%)
 12 N. SMITH AND T. GRAHAM
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Figure 4. The anti-vaccination ‘movement-level’ network on Facebook (node colour = gender).

A key question for LDA topic modelling is how many topics k to choose. The value of k
must be specified prior to running the algorithm. There are several approaches to selecting
the number of topics, although no standardised practice is currently agreed upon. The
hierarchical Dirichlet process is often regarded as an optimal approach to choosing k,
however, our dataset was too large for it to be tractable (Teh, Jordan, Beal, & Blei,
2006). Therefore, we used a data-driven and mathematical approach combined with a
heuristic approach that aimed to maximise the interpretability and usefulness of the topics.
First, we cleaned the text data to prepare it for analysis. This involved three main steps:
removing extremely infrequent and extremely frequent words using term frequency-
inverse document frequency (tf-idf); converting all words to lowercase; and removing
punctuation. Second, we used Ponweiser’s (2012) approach to model selection by harmo-
nic mean. We ran 35 different LDA models using values of k ranging from 2 to 70
(sequenced by intervals of 2). From these models, we could determine which value of k

Table 9. Gender composition of anti-vaccination networks by user activity

(source of edge).
Page/network Male Female Unknown
AVN living wisdom 18.7% 73% 8.4%
Rage against vaccines 14.8% 78.5% 6.7%
Age of autism 13% 80.8% 6.2%
GMAOQV 9.1% 84.6% 6.3%
No vaccines Australia 23.2% 67.4% 9.4%
Vaccine info 23.3% 70.1% 6.6%
Movement-level network 21.9% 71.4% 6.7%
 INFORMATION, COMMUNICATION & SOCIETY 13

produced the maximum harmonic mean of the log-likelihood, given the data. Third, we
plotted the harmonic mean of log-likelihood values by each number of topics k. Using Cat-
tell’s scree test (Cangelosi & Goriely, 2007, p. 10), we were able to identify the inflection
point or ‘elbow’ in the graph, at which there was no significant increases in log-likelihood
values for the models. There were no significant increases after k = 26. Using Cattell’s scree
test as a heuristic guide, we were able to select 26 topics as the number for further analysis
and interpretation.
The final part of analysis used LDA topic modelling to examine what kinds of ‘topics’
might be driving anti-vaccination discourse on Facebook. As discussed earlier, the chosen
number of topics was 26. Out of all the topic only one topic (Topic 8 in Table 10) was
identified as a ‘junk’ topic (Nikolenko, Koltcov, & Koltsova, 2015). The word probabilities
in this topic word were not interpretable and not relevant to our analyses. In addition to
this, some topics also include ‘junk’ terms, words that were not interpretable in relation to
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others in the topic. These terms are generally considered to be an artefact of social media
data. These terms were manually excluded from the final analysis presented below. The
findings of these results are summarised in this section. Table 10 provides a list of the
topic labels, which were interpreted based on the terms that were assigned with highest
probability to each topic. In order to add interpretive depth to the topic models presented,
we have labelled these topics with a qualitative label that best reflects the topic. These
qualitative labels are based on our observation of anti-vaccination pages over the past
year, which occurred alongside data collection and analysis. The qualitative labels were
further informed by existing anti-vaccination literature.

Table 10. Results of topic models.

Topic
Topic 1: Activism
Topic 2: Governance
Topic 3: Media, censorship, and
‘cover up’
Topic 4: Vaccination as genocide
Topic 5: Zika Virus and Gates
Foundation
Topic 6: Moral transgressions
Topic 7: Vaccine injury
Topic 8: Junk topic
Topic 9: Food as medicine
Topic 10: Chemtrails and
Agriscience
Top 10 terms within topic
Sick, signed, shared, petition, AMA, stomach, count, Tylenol, likes, sickening, signing,
signatures, sadly, twisted, perfect, petitions, commented, legit, provaxers, flue,
object, exactly, counting, repeal, referendum
Missed, homeopathy, double, terrible, placebo, figures, Abbott, midwife, style, shocked,
hiding, tony, amen, midwives, Sweden, transparency, max, Denmark, meningococcal,
plot, speed, tall, triple, saline, prozac
News, link, gates, surprised, shedding, Canada, fake, click, India, china, button, strange,
rotavirus, blocked, ads, chart, edgy, pushers, thread, fox, Reply, Disney, Melinda,
unlike, horrific
Land, jail, crime, Nazi, Germany, experiment, crimes, tyranny, assault, criminals, prison,
Hitler, murdered, mafia, Washington, flag, amendment, discrimination, powers,
democracy, Nuremberg, owned, genocide, suicide, experiments
Disturbing, jenny, finally, three, brazil, Florida, accident, shocking
West, Texas, looks, error, McCarthy, brown, microcephaly, mosquitoes, hoax, privacy,
poisonous, precious, absolutely, rats, spears, horror, messed
Poison, follow, evil, sue, total, sounds, pure, lying, gene, fire, eugenics, greed, dirty,
greedy, recall, suit, roll, bastards, violation, gross, unethical, abortions, bullies, pays,
madness
Sad, horrible, glad, omg, shame, heartbreaking, tragic, terrible, incredibly, tragedy,
liked, frightening, wth, terribly, frustrating, shameful, unfortunate, sadly, shell, ugh,
Shill, outrageous, unreal, definitely, guard
Man, word, Gardasil, corruption, brilliant, speaks, google, careful, cholesterol,
acceptable, wise, greed, episode, English, England, causation, dream, indeed, usual,
bird, everywhere, king, arrogant, perspective, abusive
Oil, coconut, sunscreen, butter, coffee, dentist, eggs, soda, tap, vit, raw, Cannabis, burn,
bottled, honey, olive, green, silver, tea, fish, taste, corn, fillings, cook, apple
Stupid, smart, Monsanto, idiot, dumb, chemical, fucking, brainwashed, uneducated,
stupidity, plain, damn, ban, chemtrails, kidding, fix, everywhere, depopulation,
morons, Russian, roulette, fools, moron, talks, ass
 14 N. SMITH AND T. GRAHAM

Discussion and conclusion

The findings demonstrate that analysing the online networks of anti-vaccination social
media sites can provide us with important context information about these movements.
As demonstrated in the literature, online information and communication is clearly
important within the anti-vaccination community (see Davies, Chapman, & Leask
2002; Kata, 2010, 2012). These activities are fostered through social media, which focuses
as an effective hub of distributing anti-vaccination information, designed to encourage
grass roots resistance.
Our analysis suggests that anti-vaccination networks, despite their relative size and high
levels of activity, are relatively sparse or ‘loose’, that is, they do not necessarily function as
close-knit communities of support with participants interacting with each other in a sus-
tained way over time. However, this does not necessarily mean that anti-vaccination net-
works provide no support. Simply participating in a community of like-minded others
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may reinforce and cement anti-vaccination beliefs. Our data also suggest that participants
are moderately active across several anti-vaccination Facebook pages, suggesting that
users’ activity on anti-vaccination is more than just a product of Facebook’s recommender
system. Liking and actively commenting on a number of anti-vaccination pages across
Facebook suggests that those who are involved in this network may develop a pattern
of activity and involvement across multiple pages, creating a filter bubble effect that
reinforces anti-vaccination sentiment and practice. However, it is difficult to discern
from the data to what extent the filter bubble is created through users’ own agency and
activity, and how much is influenced by the algorithmic structure of Facebook, whereby
Facebook actively targets users with content they would be more likely to click on and
relate to. As discussed later in this paper, further research is needed to fully address this
question, and understand how health information and communities on social media
both shape, and are shaped by, day-to-day practice.
Further to this, the network structure of anti-vaccination Facebook pages has impli-
cations when considering how ‘robust’ or open to change this social movement might
be. As detailed previously, anti-vaccination Facebook pages exhibit the signature charac-
teristics of a ‘small world’ network structure. In small world networks, information dif-
fuses quickly and easily through the network, in this instance through user-generated
comments. As with other aspects of this analysis, we argue that it is difficult to say whether
the ‘small world’ characteristics of the networks examined in this paper are due to the
nature of the anti-vaccination movement itself, or are an artefact of Facebook as a plat-
form. Both outcomes are equally interesting. The former suggests that social movements
(like anti-vaccination) may inevitably develop as ‘small world’ networks structure that is
further amplified and made visible online. If it is the latter, this demonstrates that Face-
book as a platform has important implications for the dynamics, spread, and durability
of social movements outside of the specific case examined here. Indeed, if the materiality
or architecture of Facebook shapes networks towards ‘small-worldness’, this suggests that
such platforms may be instrumental for the anti-vaccination movement and social move-
ments more broadly to blossom, flourish, and resist being dismantled or disrupted by
outside influences.
The large numbers of ‘likes’ and posts on the anti-vaccination sites examined suggest a
popular and active community. In addition to like, and commenting on a post, posts are
 INFORMATION, COMMUNICATION & SOCIETY 15

also shared widely as detailed previously in Table 2. This finding suggests that the anti-vac-
cination community has scope and reach outside of those who immediately engage with
the public Facebook pages examined in this study. For the period of data collection, the
total number of shares across all pages sampled in this research was 2,024,672.6 The num-
ber of shares also far out-paces the number of comments for this same period, suggesting
that sharing is a more common mode of participation than commenting or liking posts.
Sharing also suggests that the anti-vaccination network extends further than is apparent
from the Facebook pages analysed in this research. However, the research conducted
here is limited by the combined public/private nature of Facebook. While public Facebook
pages do provide a wealth of network information, we are unable to gather information
about how information shared from anti-vaccination pages disseminates through private
Facebook pages or personal social media networks. Nonetheless, the data suggests that
sharing may be an important function in spreading anti-vaccination information and
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potentially growing anti-vaccination networks.

The gender composition of anti-vaccination movement reflects dominant cultural
understandings of parenting. That is, that the parenting and care of children is primarily
a maternal concern. Women are still more likely to stay at home and care for children
(Medved, 2016), and this care includes making decisions about healthcare choices.
Historically, vaccination was seen to be ‘a mother’s question’ (Durbach, 2005, p. 60),
women’s maternal instincts were to the privileged as forms of knowledge as mothers
were argued to be best placed to tell if their children were healthy or not. In the contem-
porary anti-vaccination movement, our analysis suggests that anti-vaccination, is now,
more than ever, ‘a mother’s question’. The anti-vaccination movement is now primarily
lead by women. Notably, one of the most popular anti-vaccination pages on Facebook
‘Vaccine Info’ is run by Dr Sherri Tenpenny. Given the gendered nature of participants
on anti-vaccination pages, we can conclude that the anti-vaccination movement is a signifi-
cantly ‘feminised’ social phenomena, although the issue it addresses is not gender specific.
Until recently, a large-scale analysis of anti-vaccination discourse has been beyond the
scope of social science methods papers (e.g., Davies et al., 2002; Grant et al., 2015; Kata,
2010) that have investigated the content of anti-vaccination websites, rather than social
media. These studies have also had a relatively small sample size due to the limitations
of human qualitative analysis. The LDA topic modelling approach used previously
addresses some of these problems, as this quali-quantitative, computational approach
facilitates a large-scale analysis of comments on anti-vaccination pages. Through this
method we can understand the content of discourse in anti-vaccination Facebook
pages, including the latent factors or ‘topics’ that help to explain what is driving and gen-
erating this discourse. The first 10 topics, and the top 25 terms associated with these topics,
were provided previously in Table 10.
The qualitatively labelled topics point towards several key pre-occupations of the anti-
vaccination communities, constitutive of the Facebook pages examined. Primarily, the
results of the topic modelling suggest that the anti-vaccination community is very con-
cerned with the institutional arrangements that are perceived to be perpetuating the harm-
ful practice of vaccination. The sentiment across all topic models (with the exception of
Topic 9) is quite negative in tone, suggesting that users of the anti-vaccination pages
feel not only morally outraged about the practice of vaccination, but structurally oppressed
by seemingly tyrannical and conspiratorial government and media. Topics 2, 3, 4, 5, 7, and
 16 N. SMITH AND T. GRAHAM

10 all appear to accord with conspiracy-style beliefs in which the government and media
are key actors in underplaying, denying, or perpetuating the perceived harms caused by
vaccinations. These include: media cover-up or denial of the extent of vaccination injury
and death (Topic 3); Bill Gates’ involvement in the spread of Zika virus within Brazil and
beyond its borders (Topic 5); and chemtrails (Topic 10), which is a belief that the vapour
trails emitted by aircraft are chemical compounds sprayed by the government and
designed to subdue the population and/or control the weather (Oliver & Wood, 2014).
The prevalence of conspiracy-style thinking is unsurprising. Survey research under-
taken by the Cooperative Congressional Election Studies indicates that 55% of respon-
dents in 2011 agreed with at least two of the conspiracy theories they were presented
with. This suggests that conspiracy-style thinking is relatively prevalent in the general
population, and perhaps particularly pronounced among those who hold anti-vaccination
beliefs (Oliver & Wood, 2014). Sitting alongside these conspiracy-style beliefs are concerns
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about state-sanctioned harm or interference with citizens’ bodily autonomy through the
administration of vaccination. In particular, Topic 4 demonstrates how anti-vaccination
Facebook pages commonly compare vaccination to the Holocaust, illustrating a strong
sense of persecution within the anti-vaccination communities examined in this study.
While Topic 9 appears to be an ‘outlier’ in relation to the other topics shown previously
in Table 10, it is also suggestive of a distrust of authority. Anti-vaccination communities
tend to advocate natural remedies for maintaining health or curing illness. These include
avoiding fluoridated tap water, avoiding sunscreen, using coconut oil to improve mouth
health, and generally prescribing food as medicine. The emphasis on natural remedies
is in keeping with the anti-vaccination movement’s distrust of the broader medical and
scientific community, which they regard as irrevocably corrupt.
While this research analysed a large volume of empirical data, our findings are limited
by the number of Facebook pages sampled. This study has also focussed on analysing anti-
vaccination on Facebook, limiting our ability to generalise about anti-vaccination activity
across social media platforms. However, it is not the goal of this research to account for all
anti-vaccination content online – although more comprehensive study is warranted – but
to provide a foundational, empirically informed account of the anti-vaccination move-
ment in a social media context. The results of this investigation suggest a robust and highly
gendered network structure that has a strong sense of moral outrage associated with the
practice of vaccination. This ‘righteous indignation’, in combination with the network
characteristics identified in this study, indicates that anti-vaccination communities are
likely to be persistent across time and global in scope as they utilise the affordances of
social media platforms to disseminate anti-vaccination information. Concerns about vac-
cination reveal a community that feels persecuted and is suspicious of mainstream medical
practice and government-sanctioned methods to prevent disease. In a generation that has
rarely seen these diseases first hand, the risk of adverse reaction seems more immediate
and pressing than disease prevention (Davies et al., 2002).

Notes
1. Countries such as France issue fines for non-compliance. Similar legislation removing per-
sonal belief exemption has also been passed in California and Australia (Klapdor & Grove,
2015).
 INFORMATION, COMMUNICATION & SOCIETY 17

2. Doxing is the publication of private and/or identifying information of a particular individ-

ual on the Internet. Typically doxing is a malicious act design to threaten, intimidate, or
harass.
3. The limit of 1000 was set by the Facebook API specifications at the time of data collection.
4. The graph theory literature often uses the term ‘vertex’, but we will use the less formal term
‘node’.
5. In this study, we used a binary classification of gender, namely, male and female. The primary
rationale for such an approach was due to the limited capacities of gender modelling tools
and existing data.
6. Currently the Facebook API does not provide data for individual post ‘shares’, but does pro-
vide a total sum of shares for public posts.

Disclosure statement
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No potential conflict of interest was reported by the authors.

Notes on contributors
Naomi Smith is a Lecturer in Sociology in the School of Arts, Humanities and Social Sciences at
Federation University Australia (Gippsland). She received her PhD in Sociology of The University
of Queensland. Her current research projects examine intersection of health and wellness practices,
physical spaces and social media [email: n.smith@federation.edu.au].
Tim Graham is Postdoctoral Research Fellow at the Australian National University, Australia, with
a joint appointment in the Research School of Social Science and the Research School of Computer
Science. His research combines social theory and computationally-intensive approaches to analys-
ing, understanding, and predicting social phenomena. The holds a PhD in Sociology from the Uni-
versity of Queensland [email: Timothy.Graham@anu.edu.au].

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