Mapping Fear and Hope in HPV Vaccine Communication on Sina Weibo: Topic Modeling and Content Analysis

HPV vaccines became available in mainland China in 2016, yet concerns surrounding HPV vaccination have continued to feature prominently in public discourse. Against this background, this study examined how HPV and HPV vaccination are discussed on Sina Weibo and how threat- and efficacy-related message components are represented within this discourse. Drawing on the Extended Parallel Process Model (EPPM), this study analyzed 219,068 posts on Sina Weibo published between 2018 and 2024 using topic modeling and theory-guided content analysis. Topic modeling revealed a substantial increase in HPV-related discussions over the study period and identified five prominent themes: health behaviors, HPV vaccination, cervical cancer prevention, nine-valent HPV vaccine appointment scheduling, and HPV infection. Content analysis further revealed an imbalance between threat and efficacy components in fear-appeal messages. Efficacy information occurred more frequently than threat information, with self-efficacy appearing most frequently, followed by response efficacy, susceptibility, and severity. Spearman correlation analyses showed that severity and self-efficacy were positively associated with the number of user forwards, whereas susceptibility and response efficacy were not significantly associated with forwarding activity in the reported analysis. These findings extend the application of the EPPM to naturally occurring social media communication by demonstrating how threat and efficacy components are unevenly represented and differently associated with observable user engagement. The study also highlights the importance of designing HPV communication that balances information about health threats with clear and actionable efficacy information.