Public health communication and HPV vaccine hesitancy discourse on instagram in Türkiye: A 5C model-based content analysis

Human papillomavirus (HPV) vaccination is an effective strategy for preventing HPV-related cancers; however, communication gaps and barriers to information access remain critical public health concerns. Social media platforms have become vital sources of vaccine-related information and provide a key environment for public discussions about vaccination. This study aimed to examine HPV vaccine-related Instagram posts and comments in Türkiye using the 5 C psychological antecedents of vaccination framework. A total of 2,362 posts and 5,609 associated comments containing HPV-related hashtags were collected during HPV Awareness Month (March) over a three-year period (2021–2023). Data were analyzed using the 5 C psychological antecedents of vaccination model of vaccine hesitancy, including confidence, complacency, constraints, calculation, and collective responsibility. Coding was conducted independently by two researchers. Among the included posts, 64.8% were categorized as irrelevant content and consequently contained no 5 C model categories. Within the assigned 5 C model post codes, confidence in HPV vaccination was the most common dimension (45.6%; 452/991). Associations allocated a higher proportion of their content to HPV vaccine awareness, whereas posts by hospitals and healthcare professionals were more frequently promotional or unrelated. Among comments, 75.1% were unclassifiable, and constraints represented the most common theme among assigned 5 C model comment codes (51.5%; 788/1,529), primarily related to vaccine cost and limited accessibility. Confidence and calculation were also frequently discussed themes. Analysis of 2,362 Instagram posts and 5,609 associated comments revealed distinct patterns between producer-generated content and audience responses, with confidence-related content predominating among posts and constraint-related content prevailing among comments. Instagram serves as an important platform for public discussions about HPV vaccination in Türkiye. The findings highlight the need for accurate, evidence-based, and engaging digital health communication strategies. Healthcare institutions and professionals should take a more active role in addressing vaccine hesitancy through social media platforms and developing digital public health strategies that address online concerns, strengthen communication accuracy, and foster an informed decision-making environment.