Impact of behavioral insights-informed social media campaigns on HPV vaccination in Bangladesh

Cervical cancer remains a leading cause of cancer-related deaths among women in Bangladesh. In 2024, the government introduced the single-dose HPV vaccine across six divisions of Bangladesh through a school-based vaccination campaign. This study evaluates the impact of targeted and population-wide social media interventions designed to boost HPV vaccine uptake. A pre-test/post-test quasi-experimental study was conducted across six divisions of Bangladesh with four intervention groups and one control group. Caregivers of adolescent girls aged 9-17 were recruited for baseline (n = 3,823) and follow-up (n = 7,004) online surveys. Interventions included: (T1) targeted social media plus school awareness, (T2) targeted social media only, (T3) school awareness only, and (T4) population-wide social media. Logistic regression models with interaction terms were used to assess intervention effects. HPV vaccination coverage increased from 10.1% to 32.9% in the control group, consistent with the national campaign being implemented across all study areas. Adjusted odds ratios showed significant additional effects for T1 (OR = 1.52, 95% CI: 1.30-1.77), T2 (OR = 1.92, 95% CI: 1.40-2.65), T3 (OR = 1.08, 95% CI: 1.01-1.16), and T4 (OR = 1.36, 95% CI: 1.28-1.45). Adjusted marginal effects indicated that, relative to the control group, the probability of vaccination increased by 11.8 percentage points for the targeted social media intervention and 5.3 percentage points for the population-wide social media intervention. The school-awareness intervention was associated with a 1.3 percentage point increase. Each behavioral insights-informed social media intervention was associated with a measurable impact on HPV vaccination beyond that of the national campaign. The targeted social media intervention was associated with twice as large an increase in coverage as the population-wide social media intervention (11.8 versus 5.3 percentage points). Insights-informed social media interventions can play an important role in national vaccine introductions in low- and middle-income countries.