Monitoring vaccine-related online discourse in Italy: findings from the RISP project

Abstract Background Effective communication is critical in public health emergencies. In 2023, WHO and UNICEF issued a framework to guide infodemic insight reporting. The RISP project (Report Infodemico per la Sanità Pubblica) applied this methodology in Italy to detect vaccine-related narratives and support institutional communication. It aimed to test a replicable model for future emergencies. Methods From October 2023 to September 2024, a multidisciplinary team from the University of Pisa and Bambino Gesù Children's Hospital produced 12 monthly reports based on the infodemic reporting framework. Each report focused on a specific vaccine (COVID-19, influenza, measles, pertussis, mpox, dengue); one report focused on RSV monoclonal antibodies. Using the Pulsar platform and complementary tools (AnswerThePublic, manual searches on Instagram and TikTok), content was collected across platforms (X, Facebook, Instagram, TikTok, YouTube, news). Posts were analysed for stance, narratives, disinformation, and user information needs. Biweekly team meetings generated specific and general recommendations. Results Over 750,000 items were analysed. X hosted most disinformation, while TikTok and Instagram revealed user questions and doubts. Negative narratives were most common on COVID-19, mpox, and dengue. Measles, pertussis, and RSV showed more neutral or positive content. For flu, institutional presence in late 2023 was associated with a more positive stance; as that presence declined in 2024, negative content increased. Institutional messaging across the monitoring period was often inconsistent or generic. Key unmet information needs included practical information on eligibility and vaccine access. Conclusions RISP showed that WHO's framework can be applied nationally to produce timely, actionable insights. Recommendations include continuous social listening, platform-specific communication, and stronger institutional presence in routine and low-attention phases. Key messages • RISP shows how real-time infodemic reporting can support vaccine communication by identifying narratives, disinformation, and user needs across platforms. • Social listening must be continuous and multidisciplinary to build trust, tailor public health messaging, and counter disinformation beyond crisis phases.