Medical and public health professionals recommend wearing face masks to combat the spread of the coronavirus disease of 2019 (COVID-19). While the majority of people in the United States support wearing face masks as an effective tool to combat COVID-19, a smaller percentage declared the recommendation by public health agencies as a government imposition and an infringement on personal liberty. Social media play a significant role in amplifying public health issues, whereby a minority against the imposition can speak loudly, perhaps using tactics of verbal aggression taking the form of toxic language. We investigated the role that toxicity plays in the online discourse around wearing face masks. Overall, we found tweets including anti-mask hashtags were significantly more likely to use toxic language, while tweets with pro-mask hashtags were somewhat less toxic with the exception of #WearADamnMask. We conclude that the tensions between these two positions raise doubt and uncertainty around the issue, which make it difficult for health communicators to break through the clutter in order to combat the infodemic. Public health agencies and other governmental institutions should monitor toxicity trends on social media in order to better ascertain prevailing sentiment toward their recommendations and then apply these data-driven insights to refine and adapt their risk communication messaging toward mask wearing, vaccine uptake, and other interventions.

Objective: The aim of this study was to test the appearance of negative dominance in coronavirus disease (COVID-19) vaccine-related information and activity online. We hypothesized that if negative dominance appeared, it would be a reflection of peaks in adverse events related to the vaccine, that negative content would attract more engagement on social media than other vaccine-related posts, and posts referencing adverse events related to COVID-19 vaccination would have a higher average toxicity score.Methods: We collected data using Google Trends for search behavior, CrowdTangle for social media data, and Media Cloud for media stories, and compared them against the dates of key adverse events related to COVID-19. We used Communalytic to analyze the toxicity of social media posts by platform and topic.Results: While our first hypothesis was partially supported, with peaks in search behavior for image and YouTube videos driven by adverse events, we did not find negative dominance in other types of searches or patterns of attention by news media or on social media.Conclusion: We did not find evidence in our data to prove the negative dominance of adverse events related to COVID-19 vaccination on social media. Future studies should corroborate these findings and, if consistent, focus on explaining why this may be the case.

Based on ethnographic research, this article describes and interprets the verbal content of television advertising as it circulates in everyday life. The research approaches the use of advertising content as play, an integral part of social discourse. The verbal play described in the article considers the individual's desire to entertain, to play for no gain, but also goes beyond, to consider how individuals take the literal meaning of commercial content and transform it in an effort to impact social relationships.

Background: During an infodemic, timely, reliable, and accessible information is crucial to combat the proliferation of health misinformation. While message testing can provide vital information to make data-informed decisions, traditional methods tend to be time- and resource-intensive. Recognizing this need, we developed the rapid message testing at scale (RMTS) approach to allow communicators to repurpose existing social media advertising tools and understand the full spectrum of audience engagement. Objective: We had two main objectives: (1) to demonstrate the use of the RMTS approach for message testing, especially when resources and time are limited, and (2) to propose and test the efficacy of an outcome variable that measures engagement along a continuum of viewing experience. Methods: We developed 12 versions of a single video created for a vaccine confidence project in India. We manipulated video length, aspect ratio, and use of subtitles. The videos were tested across 4 demographic groups (women or men, younger or older). We assessed user engagement along a continuum of viewing experience: obtaining attention, sustaining attention, conveying the message, and inspiring action. These were measured by the percentage of video watched and clicks on the call-to-action link. Results: The video advertisements were placed on Facebook for over 4 consecutive days at the cost of US $450 and garnered a total of 3.34 million impressions. Overall, we found that the best-performing video was the shorter version in portrait aspect ratio and without subtitles. There was a significant but small association between the length of the video and users’ level of engagement at key points along the continuum of viewing experience (N=1,032,888; χ24=48,261.97; P<.001; V=.22). We found that for the longer video, those with subtitles held viewers longer after 25% video watch time than those without subtitles (n=15,597; χ21=7.33; P=.007; V=.02). While we found some significant associations between the aspect ratio, the use of subtitles, and the number of users watching the video and clicking on the call-to-action link, the effect size for those were extremely small. Conclusions: This test served as a proof of concept for the RMTS approach. We obtained rapid feedback on formal message attributes from a very large sample. The results of this test reinforce the need for platform-specific tailoring of communications. While our data showed a general preference for a short video in portrait orientation and without subtitles among our target audiences on Facebook, that may not necessarily be the case in other social media platforms such as YouTube or TikTok, where users go primarily to watch videos. RMTS testing highlights nuances that communication professionals can address instead of being limited to a “one size fits all” approach.