Amanda Forr, Daniel A Salmon, Shaniya H Markalanda, Ann Joseph, Rachel Aeschliman, Jacqueline Lawler, Lynelle Phillips, Jamie Moore, Janesse Brewer, Michelle Goryn, Matthew Z Dudley
Vaccine hesitancy is a major public health problem, with social media playing a crucial role in the spread of reliable vaccine information, as well as misinformation and disinformation. LetsTalkShots is a website that offers tailored, evidence-based vaccine information including personal narratives, credible sources, and animation. We compared the cost of promoting LetsTalkShots through outreach efforts of five local public health departments versus a paid social media campaign targeting the same five communities. Social media ads drove traffic at a low cost per click, though local outreach efforts achieved a lower cost per completed question set at LetsTalkShots.org. Content engagement was particularly low for COVID-related topics, perhaps due to pandemic fatigue or negative perceptions of the COVID vaccine. Engagement was highest for RSV content, perhaps because it was a new vaccine about which people were seeking credible, relevant information. Social media and localized outreach can aid vaccine communication efforts, especially when content is relevant and timely.