The sources and correlates of exposure to vaccine-related (mis)information online()

OBJECTIVES: To assess the quantity and type of vaccine-related information Americans consume online and its relationship to social media use and attitudes toward vaccines. METHODS: Analysis of individual-level web browsing data linked with survey responses from representative samples of Americans collected between October 2016 and February 2019. RESULTS: We estimate that approximately 84% of Americans visit a vaccine-related webpage each year. Encounters with vaccine-skeptical content are less frequent; they make up only 7.5% of vaccine-related pageviews and are encountered by only 18.5% of people annually. However, these pages are more likely to be published by untrustworthy sources. Moreover, skeptical content exposure is more common among people with less favorable vaccine attitudes. Finally, usage of online intermediaries is frequently linked to vaccine-related information exposure. Google use is differentially associated with subsequent exposure to non-skeptical content, whereas exposure to vaccine-skeptical webpages is associated with usage of webmail and, to a lesser extent, Facebook. CONCLUSIONS: Online exposure to vaccine-skeptical content is relatively rare, but vigilance is required given the potential for exposure among vulnerable audiences.