Social media-based interventions for improving vaccine uptake, reducing hesitancy, and combating misinformation: a comprehensive systematic review and meta-analysis of RCT

The widespread use of social media plays a complex role in vaccination efforts. While it can spread misinformation that causes people to hesitate, it also provides a valuable platform for promoting accurate health information. This study systematically reviewed how strategies used on social media can help reduce false beliefs, encourage more people to get vaccinated, and support positive mental health outcomes. Following PRISMA guidelines, we conducted a systematic review and meta-analysis. We systematically searched PubMed, Scopus, and Web of Science for randomized controlled trials (RCTs) evaluating social media–based interventions aimed at increasing vaccination uptake, reducing vaccine hesitancy, or correcting vaccine-related misinformation, from inception through June 2025. Studies were eligible if they involved human participants, employed a randomized controlled design, and assessed vaccination-related outcomes. Non-randomized studies, conference abstracts, protocols, reviews, and studies not published in English were excluded. We used the Cochrane ROB-2 tool to figure out how likely it was that there was bias. We used random-effects models to find the pooled risk ratios (RR) and standardized mean differences (SMD). We also looked into heterogeneity by doing subgroup and meta-regression analyses. There were a total of 28 RCTs. There was no statistically significant difference in the number of people who got vaccinated between social media-based interventions and control conditions (RR = 1.04; 95% CI: 0.96 to 1.14; I² = 66.2%). But these interventions always made small but statistically significant changes in positive factors like attitudes, knowledge, intention, and confidence (SMD = 0.21; 95% CI: 0.09 to 0.34; I² = 88.0%). They also made people less hesitant, resistant, delayed, and wrong about vaccines (RR = 0.27; 95% CI: 0.19 to 0.38; I² = 56.5%). The follow-up period didn’t change the results much, but subgroup analyses showed that the results were less consistent when things like country, platform, and length of the intervention were taken into account. The publication didn’t show any signs of bias. In conclusion, social media–based health promotion interventions are effective in enhancing vaccine-related knowledge and attitudes, and in reducing hesitancy, resistance, delays, and misinformation; however, their effect on actual vaccination uptake was not statistically significant, highlighting the need for integrated, multi-component strategies to optimize real-world vaccine coverage.