Abstract Background In 2024, 62% of world’s population actively use social media (SM), with people aged 16 to 64 spending an average of 2 hours and 23 minutes daily across 6,7 SM platforms - most people use Facebook but spend more time on TikTok. While these platforms are essential for disseminating public health information, this study aims to explore their use by public health institutions in European countries. Methods We analysed the SM engagement of 32 health institutions recognized by ECDC across 29 European countries. Data collected focused on Facebook, Instagram, X, LinkedIn, TikTok, and YouTube, including SM presence on official websites, number of followers, and posts from January to March 2024. Additional data included followers per 100.000 residents, with population statistics from Worldometer and SM usage from DataReportal. Results Most institutions (30) are active on SM, particularly on Facebook (28), X (23), Instagram (22), YouTube (22), and LinkedIn (21). Spain and Slovenia’s institutions are active on all analysed platforms, while only four institutions are on TikTok. The most used platforms were Facebook and X, with averages of 59,7 and 58,1 publications, respectively. There are disparities in engagement across platforms, with Facebook having the highest average followers (177.241) and TikTok the lowest (1.961) among all platforms. Notably, the most followed platform within ten institutions did not match country’s most popular platform, indicating a misalignment in SM platforms’ strategy. There was an average of 2.756 followers per 100.000 residents among analysed countries. Conclusions Public health institutions in Europe are actively using SM platforms to disseminate health information, mainly Facebook, X, LinkedIn, and Instagram. Despite high engagement on Facebook and X, there is a need for strategic alignment with audience’s preferences, particularly in underutilized platforms like TikTok, to optimize the effectiveness of public health communication. Key messages • The majority of European public health institutions actively use social media, with Facebook leading; however, newer platforms like TikTok are underutilized. • There is a need for public health institutions to realign their social media strategies to better match the platforms preferred by their audiences to maximize the effectiveness of their communication.
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