Elsevier

Vaccine

Volume 38, Issue 3, 16 January 2020, Pages 512-520
Vaccine

Vaccine-related advertising in the Facebook Ad Archive

https://doi.org/10.1016/j.vaccine.2019.10.066 Get rights and content

Highlights

  • First assessment of vaccine-related advertisements on Facebook Ad Archive.

  • Top pro-vaccine ad themes: vaccine promotion, philanthropy, news.

  • Top anti-vaccine ad themes: vaccine harm, promoting choice, uncovering “fraud”.

  • Two buyers accounted for majority (54%) of anti-vaccine advertising content.

  • Facebook policies negatively impact first time ad buyers, largely pro-vaccine.

Abstract

Background

In 2018, Facebook introduced Ad Archive as a platform to improve transparency in advertisements related to politics and “issues of national importance.” Vaccine-related Facebook advertising is publicly available for the first time. After measles outbreaks in the US brought renewed attention to the possible role of Facebook advertising in the spread of vaccine-related misinformation, Facebook announced steps to limit vaccine-related misinformation. This study serves as a baseline of advertising before new policies went into effect.

Methods

Using the keyword ‘vaccine’, we searched Ad Archive on December 13, 2018 and again on February 22, 2019. We exported data for 505 advertisements. A team of annotators sorted advertisements by content: pro-vaccine, anti-vaccine, not relevant. We also conducted a thematic analysis of major advertising themes. We ran Mann-Whitney U tests to compare ad performance metrics.

Results

309 advertisements were included in analysis with 163 (53%) pro-vaccine advertisements and 145 (47%) anti-vaccine advertisements. Despite a similar number of advertisements, the median number of ads per buyer was significantly higher for anti-vaccine ads. First time buyers are less likely to complete disclosure information and risk ad removal. Thematically, anti-vaccine advertising messages are relatively uniform and emphasize vaccine harms (55%). In contrast, pro-vaccine advertisements come from a diverse set of buyers (83 unique) with varied goals including promoting vaccination (49%), vaccine related philanthropy (15%), and vaccine related policy (14%).

Conclusions

A small set of anti-vaccine advertisement buyers have leveraged Facebook advertisements to reach targeted audiences. By deeming all vaccine-related content an issue of “national importance,” Facebook has further the politicized vaccines. The implementation of a blanket disclosure policy also limits which ads can successfully run on Facebook. Improving transparency and limiting misinformation should not be separate goals. Public health communication efforts should consider the potential impact on Facebook users’ vaccine attitudes and behaviors.

Introduction

Facebook has over two billion active users, making it one of the largest communities in the world [1]. In the United States, 68% percent of adults use the platform and more Americans get news from Facebook than any other website or single news outlet [2], [3]. On Facebook, users engage with a personalized News Feed, where posts shared by friends appear alongside sponsored advertising content [4]. While public health researchers have frequently studied marketing strategies used to promote harmful products in print and broadcast media [5], [6], there is a critical lack of public health research on social media advertising [7], [8], [9]. Social media sites like Facebook offer advertisers an easy and inexpensive channel to reach narrowly-defined audiences in a relatively unregulated setting [10]. Each user sees advertisements tailored to their interests, habits, and online behaviors. This highly personalized tailoring makes Facebook advertising enormously successful, but also has limited opportunities for research.

We turned our attention to vaccine-related Facebook advertisements as the World Health Organization (WHO) listed vaccine hesitancy -- due, in part, to online misinformation -- among the top ten global health threats of 2019 [11]. As parents delay or forgo recommended childhood vaccines, scholars have implicated the widespread circulation of misleading vaccine information online [12], [13], [14]. The Facebook platform, in particular, has been used to disseminate highly polarized user-generated content [15], [16], [17]. In early 2019, measles outbreaks across the U.S. drew media attention to the possible influence of vaccine-related Facebook advertising, but no academic studies have yet examined this issue [18], [19], [20]. These measles outbreaks only underscored the potential risks posed to global health by misleading health-related Facebook advertisements [21]. Whereas traditional advertising techniques might have failed to find a coherent audience of vaccine-hesitant individuals [22], sophisticated algorithms can be used to micro-target individuals who are susceptible to vaccine opposition.

Our research was made possible through a new tool, Facebook Ad Archive (now called Ad Library) [23]. In 2018, Facebook faced a string of high-profile scandals, including the misappropriation of personal data through Cambridge Analytica, and revelations that Russian operatives had weaponized Facebook advertisements, pages, and groups to illegally influence American elections [24]. The company faced calls for increased transparency from lawmakers and the public. In response, Facebook introduced Ad Archive, an effort to increase transparency and regain public confidence. Ad Archive provides users a searchable repository of advertisements related to politics and “issues of national importance” [23]. Ad Archive made it possible to access the set of vaccine-related ads that were posted on Facebook and flagged as politically or nationally important. While Ad Archive does not include every Facebook ad, nor does it give many details about how users see and interact with an ad, it is the most extensive source of information that Facebook has provided about advertisements on its platform.

In the course of our research, rising controversy led Facebook to modify advertising policies related to vaccines [25]. Two of these proposed changes include removing advertisements that contain “misinformation” about vaccines (as defined by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO)), and also removing the ability of advertisers to selectively advertise using criteria like “interest in vaccine controversies” [25]. The changes were announced in March of 2019, and while some appear to have gone into effect, the full impact of these policies remains to be seen. This analysis documents the advertising landscape prior to the implementation of new policies.

We present the first analysis of public health related Facebook advertising using the Ad Archive. We have three aims: 1) document the types of vaccine-related advertisements appearing on Ad Archive; 2) compare the subset of advertisements containing pro-vaccine content to those with anti-vaccine content; and 3) identify the strategies employed by the two largest anti-vaccine ad buyers. Our analysis demonstrates the value of Facebook Ad Archive in understanding advertising campaigns related to vaccines, but also highlights some critical limitations of the platform.

Section snippets

Data source

Facebook’s primary revenue comes from selling advertising to show to users of their platform. The main attraction of Facebook as an advertiser is that they collect information on individual users’ interests, demographic traits, social networks, and online behavior; information that, in turn, can be utilized to develop precise profiles for micro-targeting of advertisements [26]. For every available advertising slot, ad placement is determined through a continuous digital auction process. After

Characterizing the total dataset

Our first search in December 2018 resulted in 374 advertisements, and a second search in February 2019 produced 131 new advertisements, for a total of 505 advertisements. Advertisements ran from May 31, 2017 through February 22, 2019. Twenty-one advertisements were currently active; all others were inactive. After annotation, 197 advertisements were labelled “not relevant” and excluded from further analysis. This included advertisements recruiting for drug trials, promoting livestock and/or pet

Discussion

This is the first academic inquiry to use Ad Archive data to study Facebook advertising focused on a public health issue, like vaccination. While this work describes how vaccine-related advertisements operate on Facebook, it introduces broader questions of Facebook advertising regulations and transparency. This research not only captures the advertising landscape in the lead-up and early days of the 2019 measles outbreak in the U.S., it also can serve as a baseline to assess the impact of

Conclusions

Facebook Ad Archive is a new tool that continues to evolve. For researchers, the current limitations of Ad Archive may hinder some types of analysis, but the data are novel and offer the possibility of identifying major advertising trends for some topics. For vaccine-related advertising, it appears that anti-vaccine advertisers seem better able to navigate Facebook’s advertising requirements and to leverage low cost advertisements into user impressions.

The extent to which Facebook’s

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgement

This research was supported by the National Institute of General Medical Sciences, National Institutes of Health (NIH; award 5R01GM114771). The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.

References (42)

  • K.E. Warner

    Tobacco industry response to public health concern: a content analysis of cigarette ads

    Health Educ Q

    (1985)
  • S.A. Grier et al.

    Targeted marketing and public health

    Annu Rev Public Health

    (2010)
  • A. Richardson et al.

    Tobacco on the web: surveillance and characterisation of online tobacco and e-cigarette advertising

    Tob Control

    (2015)
  • K.-H. Chu et al.

    Electronic cigarette marketing online: a multi-site, multi-product comparison

    JMIR Public Health Surveill

    (2015)
  • A.E. Barry et al.

    Underage access to online alcohol marketing content: a YouTube case study

    Alcohol Alcohol

    (2014)
  • Speicher T, Ali M, Venkatadri G, et al. Potential for Discrimination in Online Targeted Advertising. In: HAL. Vol 81....
  • World Health Organization. Ten Threats to Global Health in 2019....
  • D. Jolley et al.

    The effects of anti-vaccine conspiracy theories on vaccination intentions

    PLoS ONE

    (2014)
  • Pilkington E, Glenza J. Facebook under pressure to halt the rise of anti-vaccine groups. The Guardian....
  • Madrigal AC. The Small, Small World of Facebook’s Anti-vaxxers. The Atlantic. February 20...
  • Telford T. Facebook will consider removing or demoting anti-vaccination recommendatiosn amid backlash. The Washington...
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