Public health in the age of TikTok: A content analysis of measles narratives

Abstract

Objectives: This cross-sectional study aimed to analyze TikTok content related to measles.

Methods: TikTok videos tagged #measles were sampled by selecting the first 100 results. Using a structured codebook, videos were classified by source, tone, vaccination stance, content focus, target audience, and Vitamin A mention. Engagement metrics were analyzed using t-tests or Wilcoxon rank-sum tests for binary predictors and two-way ANOVA for source-tone interactions. Analyses were conducted in Excel and RStudio.

Results: The 100 TikTok videos tagged with #measles in this sample garnered over 30 million views, with experts producing 44% of them. Expert-created videos received significantly more views, likes, favorites, and comments than non-expert ones, and tone was linked to differences in saves, with an expertise-tone interaction affecting comments. Most coded content features, such as conspiracy theories, policy mentions, side effects, or Vitamin A, appeared in fewer than 5% of videos and showed no significant relationship to engagement. Two-way ANOVAs confirmed that comments were the only metric significantly influenced by the interplay between expertise and tone, with no other meaningful interactions observed.

Conclusions: These results highlight the importance of credible messengers and carefully chosen tone to maximize audience engagement with measles-related content on TikTok. Future research is needed to determine whether such engagement translates into changes in vaccine attitudes or behaviors.

Keywords: Measles; Social media; TikTok. Health communication.