The Mismatch Between Professionally Produced Vaccine Content and Audience Demand on Chinese Short-Form Video...

Background: Short-form video platforms have become important channels for vaccine science communication, yet whether professionally produced vaccine content aligns with audience demand remains underexplored. Methods: We conducted a cross-sectional quantitative content analysis of 3752 publicly available vaccine-related videos retrieved from three major Chinese short-form video platforms between 21 November and 13 December 2024. A coding framework based on the Health Belief Model (HBM) and the World Health Organization (WHO) Behavioral and Social Drivers (BeSD) framework was used to identify key content themes. Multivariate Bayesian negative binomial regression and demand-avoidance analysis were used to examine engagement patterns and supply-demand alignment across account types. Results: Individual users produced the majority of videos (53.17%), whereas medical professionals received the highest level of engagement. Engagement was positively associated with themes related to disease severity (β ≈ 0.19-0.25) and side effects and management (β ≈ 0.31-0.67), but negatively associated with vaccine effectiveness (β ≈ -0.28 to -0.14) and vaccination precautions (β ≈ -0.28 to -0.27). Professional sources showed broader thematic coverage but also the greatest supply-demand mismatch, with mismatch indices of 0.377 for medical institution official media and 0.304 for medical professionals, primarily driven by overrepresentation of themes associated with audience avoidance. Conclusions: Significant structural mismatch exists between professionally produced vaccine content and audience engagement-based demand on short-form video platforms. Optimizing vaccine communication may require prioritizing audience-concerned risk-related information and dynamically adjusting content strategies based on engagement feedback to enhance the effectiveness of vaccine education.