To the Editor: In their Research Letter study, Dr Keelan and colleagues1 evaluated YouTube as a source of information on immunization. Previous reports have indicated an increasing use and inconsistency in the quality of online sources of information about vaccination.2 - 4 However, we are concerned that the application of a formal appraisal to a freeware Web site that is unregulated, uncensored, and designed more for entertainment than the dissemination of evidence-based medical advice may lend false gravitas to an unstructured, unvalidated online rating system as well as medical credence to a conduit of popular culture.
Furthermore, the authors' assignment of the content of each message as either positive or negative and their consequent conclusions may not be valid. By restricting the search criteria to vaccination and immunization, the authors limited their findings and analysis to only 153 videos mainly pertaining to childhood and human papillomavirus vaccines. They concluded that half of these videos were not explicitly supportive of immunization. However, inclusion of the term flu shot in their search criteria would likely have identified many more videos: the study was conducted during the winter season, and flu shot may have been more frequently used in common parlance than either immunization or vaccination. It seems likely that the majority of flu shot videos would be judged as positive, potentially changing the study conclusion.
Finally, we believe that the recommendation that YouTube be considered as a means of communication by health professionals should not be endorsed without a critical evaluation of the Web site's rating criteria and some uniformity of quality and content. In the implementation of public health communication strategies to positively affect health behavior, caution should be taken to ensure that this information is useful, scientific, and conveyed from a source whose veracity and accountability can be both determined and ensured.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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