Mining Social Media Data to Assess the Risk of Skin and Soft Tissue Infections from Allergen Immunotherapy

Abstract

Allergen immunotherapy (AIT) treatment for allergic rhinitis and asthma is used by 2.6 million Americans annually. Clinical and sterility testing studies identify no risk of contamination or infection from extracts prepared using recommended aseptic techniques. Regulatory changes to extract preparation are under consideration. Social media can be used to investigate rare adverse effects not captured by traditional studies. We investigated large social media databases for suggestion of AIT infection risk. We analyzed USA-restricted data from over 10 common text-based social media platforms including Facebook, Twitter and Reddit between 2012-2016. We employed natural language processing (NLP) to identify posts related to AIT, or influenza vaccination, a comparator procedure with a sterile pharmaceutical. NLP was followed by manual review to identify posts suggesting skin and soft tissue infections (SSTI) associated with either AIT or influenza vaccination. SSTI frequencies with 95% confidence intervals (CI) were compared. We identified 25,126 AIT related posts, which were matched by social media platform to 25,126 influenza vaccination related posts. NLP identified 4,088 AIT posts that required manual review, with 6 posts (0.02%, 95% CI 0.018, 0.022) indicative of possible AIT related SSTI. NLP identified 2,689 influenza posts that required manual review, with 7 posts (0.03%, 95% CI 0.028, 0.032) indicative possible influenza vaccination related SSTI. Social media data suggest that SSTI from AIT and influenza vaccination are equally rare events. Given that AIT’s SSTI risk appears comparable to the risk using a sterile pharmaceutical based on social media data, current aseptic technique procedures seem safe.