Medical knowledge, political tension, and social relevance: a content and framing analysis of vaccine-related TV broadcasts in the Philippines.

Introduction: Mass media plays a key role in shaping medical discourses on a societal level, and understanding this role could inform context-specific approaches to address current health challenges. However, public health scholarship that focuses on low- and middle-income countries, draws on media analytic approaches established in other fields, or utilises the potential of digital platforms for understanding non-print mass media remains limited. One context meriting a better understanding of media communication is vaccination in the Philippines, where large-scale discourses have repeatedly challenged vaccine confidence. Methods: To understand how vaccine information has been communicated on Philippine TV broadcasts, we systematically searched and extracted n=108 broadcasts using YouTube API queries. Our approach covered 16 years of broadcasting throughout three major waves of vaccination reporting including routine communication, the Dengvaxia controversy and its fallout, and the COVID-19 pandemic. We conducted a content analysis of the full dataset, followed by an in-depth qualitative framing analysis of 16 purposively selected broadcasts. Results: Our results highlight how broadcasts across periods of varying discourse intensity were generally pro-vaccine leaning. However, key vaccine information, such as regarding the safety and efficacy of immunisation, was often lacking. Framing of vaccination varied within and across broadcasts and over time as communication stakeholders (including broadcasters, medical or scientific professionals, political actors, and lay individuals) employed medical (eg, providing explanations of disease risks or vaccine functioning), political (eg, suggesting accountability and highlighting actions taken) and social frames (eg, emphasising belonging and community-level relevance). Conclusion: Vaccine messaging changes based on shifting societal discourses, stakeholders and communication objectives. Training health professionals to emphasise under-represented information and to purposively engage with prominent message frames could improve vaccination communication. Beyond vaccine hesitancy, our results also highlight how methodological advances can guide public health stakeholders analysing societal discourses and seeking to convey medical information to the broader population.