Spanish Healthcare Institutions and Their Role in Social Media-Driven Influenza Vaccination Campaigns: A Comprehensive Analysis of X

Social media plays a crucial role in health information dissemination, yet it also raises concerns about misinformation. This study examines the role of Spanish health centers in promoting influenza vaccination on social networks, particularly X (formerly Twitter), during the 2023–2024 campaign. An observational, retrospective study analyzed the activity of 832 Spanish health centers on X. Data collection focused on the existence of official accounts, follower engagement and the nature of messages posted. Metrics were obtained using X Analytics, and statistical analysis was performed using JAMOVI v2.4 software. Of the 832 centers, 607 had readable X accounts. Collective accounts were more prevalent (351) than individual ones (239). Collective accounts had significantly more followers and posts but showed less engagement compared to individual accounts. The most followed accounts belonged to public entities, like the Community of Madrid and private organizations, such as Sanitas. An analysis of the vaccination campaign revealed that most posts had a political focus with limited health information, resulting in minimal interaction with the public. As a conclusion, the study highlights the fragmented nature of health communication through social networks in Spain. Despite the higher visibility of collective accounts, their engagement with the public is low, often due to the political nature of posts. A unified national strategy is essential for enhancing public health communication, focusing on interactive and relevant content.