---
title: "Media Campaigns, Social Media Use, and Immunization Awareness in Rural Muzaffarabad"
id: "pubmed-42759247"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42759247"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42759247/"
doi: "10.1016/j.vaccine.2026.129173"
published_at: "2026-10-24T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Media Campaigns, Social Media Use, and Immunization Awareness in Rural Muzaffarabad
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42759247
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42759247/)
- **DOI:** [10.1016/j.vaccine.2026.129173](https://doi.org/10.1016%2Fj.vaccine.2026.129173)
- **Published At:** 2026-10-24T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- A cross-sectional WhatsApp-based survey of 300 caregivers in rural Muzaffarabad used a WHO 30 × 10 cluster approach to assess media influence on **immunization** awareness. - Households were located in person by Lady Health Workers (LHWs); questionnaires were then administered via WhatsApp. - Respondents ranked **social media** as the top source of health information (mean = 4.08). - Awareness scores were moderately high (mean = 3.72) and perceived campaign effectiveness was similarly elevated (mean = 3.76). - Media exposure correlated positively with awareness (r = 0.363, p < .001); awareness correlated strongly with perceived effectiveness (r = 0.720, p < .001). - The sample reported a vaccination rate of 98.67%, higher than the district's official baseline of 82%; the authors interpret this discrepancy cautiously and link it to potential selection bias from digital survey administration. - The study lacked a non-digital comparison arm; investigators described the design as cross-sectional and therefore unable to establish causality. - Authors proposed a **Hybrid Communication Model** combining social media, religious networks, and community health workers to improve rural immunization communication, though implementation details were not reported in the abstract.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 18. # Perceived influence of media campaigns and immunization awareness in rural Muzaffarabad, Azad Jammu and Kashmir: A cross-sectional evaluation of selection Bias in digital survey methodology [Syed Mubashar Hussain Shah](https://pubmed.ncbi.nlm.nih.gov/?term=Shah+SMH&cauthor_id=42759247)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42759247/#full-view-affiliation-1 "Department of PR & Media, Institution: University of Azad Jammu and Kashmir, Pakistan. Electronic address: mubashar.hussain@uajk.edu.pk."), [Tehleel Fatima](https://pubmed.ncbi.nlm.nih.gov/?term=Fatima+T&cauthor_id=42759247)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42759247/#full-view-affiliation-2 "Department: Student at the Public Health Department, Institution: University of Azad Jammu and Kashmir, Pakistan."), [Amjid Assad Ullah](https://pubmed.ncbi.nlm.nih.gov/?term=Ullah+AA&cauthor_id=42759247)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42759247/#full-view-affiliation-2 "Department: Student at the Public Health Department, Institution: University of Azad Jammu and Kashmir, Pakistan.") Affiliations Expand ### Affiliations * 1 Department of PR & Media, Institution: University of Azad Jammu and Kashmir, Pakistan. Electronic address: mubashar.hussain@uajk.edu.pk. * 2 Department: Student at the Public Health Department, Institution: University of Azad Jammu and Kashmir, Pakistan. * PMID: **42759247** * DOI: [ 10.1016/j.vaccine.2026.129173 ](https://doi.org/10.1016/j.vaccine.2026.129173) Item in Clipboard # Perceived influence of media campaigns and immunization awareness in rural Muzaffarabad, Azad Jammu and Kashmir: A cross-sectional evaluation of selection Bias in digital survey methodology Syed Mubashar Hussain Shah et al. Vaccine. 2026. Show details Display options Display options Format Abstract PubMed PMID Vaccine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Vaccine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Vaccine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42759247/) . 2026 Oct 24:92:129173. doi: 10.1016/j.vaccine.2026.129173. Epub 2026 Sep 18. ### Authors [Syed Mubashar Hussain Shah](https://pubmed.ncbi.nlm.nih.gov/?term=Shah+SMH&cauthor_id=42759247)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42759247/#short-view-affiliation-1 "Department of PR & Media, Institution: University of Azad Jammu and Kashmir, Pakistan. Electronic address: mubashar.hussain@uajk.edu.pk."), [Tehleel Fatima](https://pubmed.ncbi.nlm.nih.gov/?term=Fatima+T&cauthor_id=42759247)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42759247/#short-view-affiliation-2 "Department: Student at the Public Health Department, Institution: University of Azad Jammu and Kashmir, Pakistan."), [Amjid Assad Ullah](https://pubmed.ncbi.nlm.nih.gov/?term=Ullah+AA&cauthor_id=42759247)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42759247/#short-view-affiliation-2 "Department: Student at the Public Health Department, Institution: University of Azad Jammu and Kashmir, Pakistan.") ### Affiliations * 1 Department of PR & Media, Institution: University of Azad Jammu and Kashmir, Pakistan. Electronic address: mubashar.hussain@uajk.edu.pk. * 2 Department: Student at the Public Health Department, Institution: University of Azad Jammu and Kashmir, Pakistan. * PMID: **42759247** * DOI: [ 10.1016/j.vaccine.2026.129173 ](https://doi.org/10.1016/j.vaccine.2026.129173) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract Despite ongoing Expanded Programme on Immunization (EPI) activities, immunization coverage (IC) in rural areas of Azad Jammu and Kashmir (AJK) remains below the herd-immunity threshold of 95%. This study assessed the perceived influence of media campaigns on immunization awareness among rural caregivers in Muzaffarabad and examined methodological implications of WhatsApp-based data collection in a partially connected population. A cross-sectional survey was conducted with 300 parents/caregivers of children under five, using a WHO 30 × 10 cluster design across 30 rural Union Councils. Households were identified in person by Lady Health Workers (LHWs); the structured questionnaire was then administered via WhatsApp. Descriptive statistics, Pearson correlations, and chi-square tests were computed in IBM SPSS v.25. Social media was the most frequently used source of health information (M = 4.08), and awareness (M = 3.72) and perceived campaign effectiveness (M = 3.76) were moderately high. Media exposure was positively associated with awareness (r = 0.363, p < .001), and awareness was strongly associated with perceived effectiveness (r = 0.720, p < .001). The sample's self-reported vaccination rate (98.67%) was substantially higher than the district's official baseline (82%); we interpret this gap cautiously as consistent with, though not conclusive proof of, selection bias associated with digital survey administration, given the study's cross-sectional design and lack of a non-digital comparison arm. We propose a Hybrid Communication Model integrating social media, religious networks, and community health workers to strengthen immunization communication in rural AJK. **Keywords:** Azad Jammu and Kashmir; Digital divide; Digital selection bias; Health belief model; Health communication; Immunization; Media campaigns; Rural Pakistan; Social cognitive theory; Vaccine hesitancy. Copyright © 2026 Elsevier Ltd. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ HPV vaccine knowledge, attitude, and programme satisfaction among parents and caregivers of vaccine recipients in Ogun state Nigeria. ](https://pubmed.ncbi.nlm.nih.gov/39633371/) Olubodun T, Ogunsola EA, Coker MO, Olayinka SA, Elegbede WÀ, Ojediran JO, Olajide KB, Sanni SB, Oluwadare TO, Inetagbo OT, Balogun MR, Owolabi OO, Anyadiegwu-Bello CC, Runsewe OA, Temitayo-Oboh AO, Soyannwo T, Ogunsiji OB, Banke-Thomas A.Olubodun T, et al.Reprod Health. 2024 Dec 4;21(1):179. doi: 10.1186/s12978-024-01913-y.Reprod Health. 2024.PMID: 39633371Free PMC article. * [ Vaccination coverage and factors associated with routine childhood vaccination uptake in rural Vellore, southern India, 2017. ](https://pubmed.ncbi.nlm.nih.gov/31040085/) Francis MR, Nuorti JP, Kompithra RZ, Larson H, Balraj V, Kang G, Mohan VR.Francis MR, et al.Vaccine. 2019 May 21;37(23):3078-3087. doi: 10.1016/j.vaccine.2019.04.058. Epub 2019 Apr 28.Vaccine. 2019.PMID: 31040085 * [ Demand-side determinants of timely vaccination of oral polio vaccine in social mobilization network areas of CORE Group polio project in Uttar Pradesh, India. ](https://pubmed.ncbi.nlm.nih.gov/29769034/) Choudhary M, Solomon R, Awale J, Dey R.Choudhary M, et al.BMC Infect Dis. 2018 May 16;18(1):222. doi: 10.1186/s12879-018-3129-2.BMC Infect Dis. 2018.PMID: 29769034Free PMC article. * [ Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas. ](https://pubmed.ncbi.nlm.nih.gov/36321557/) Crider K, Williams J, Qi YP, Gutman J, Yeung L, Mai C, Finkelstain J, Mehta S, Pons-Duran C, Menéndez C, Moraleda C, Rogers L, Daniels K, Green P.Crider K, et al.Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217.Cochrane Database Syst Rev. 2022.Update in: [Cochrane Database Syst Rev. 2026 Feb 18;2:CD014217. doi: 10.1002/14651858.CD014217.pub2.](https://pubmed.ncbi.nlm.nih.gov/41705996/)PMID: 36321557Free PMC article.Updated. * [ Media Exposure and Its Association With Vaccine Attitudes, Intentions, and Hesitancy: Systematic Review. ](https://pubmed.ncbi.nlm.nih.gov/42061834/) Leonforte F, Nicosia V, Comite P, Morlino G, Mistretta A.Leonforte F, et al.J Med Internet Res. 2026 Apr 28;28:e74280. doi: 10.2196/74280.J Med Internet Res. 2026.PMID: 42061834Free PMC article. 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