Behavioural intention of receiving COVID-19 vaccination, social media exposures and peer discussions in China

Factors Influencing the Intention of Chinese Adults to Recommend COVID-19 Vaccination for Specific or Non-Specific Groups

The widespread availability of vaccines has profound implications for sustainable public health. Positive recommendation on vaccination is one of the most effective ways to increase the willingness to vaccinate against COVID-19. This study aims to investigate the factors influencing the intentions to recommend COVID-19 vaccination for specific groups (IRCVSG) and the intentions to recommend COVID-19 vaccination for non-specific groups (IRCVNSG) in China and explore the mediating role of vaccine hesitancy and perception of vaccination information. This study conducted a cross-sectional anonymous online survey of adults (N = 903) in 28 provincial-level administrative regions in China in May 2022. The prevalence of IRCVSG and IRCVNSG was 60.5% and 93.0%, respectively. Health information literacy has a significant direct and indirect impact on IRCVSG through safety hesitancy and the perceived adequacy and usefulness of vaccination information. The relationship between health information literacy and IRCVNSG is entirely mediated via hesitation about the effectiveness and perceived usefulness of vaccination information. Special attention should be paid to the safety hesitation of COVID-19 vaccination for specific groups. This study tests these effects from both theoretical and practical perspectives, helping to address barriers to promoting the vaccination of specific groups for COVID-19 in clinical practice, improving health and sustainability.

Promoter or barrier? Assessing how social media predicts Covid-19 vaccine acceptance and hesitancy: A systematic review of primary series and booster vaccine investigations

RATIONALE

Prior research indicates that social media is primarily a negative contributor to Covid-19 vaccine outcomes.

OBJECTIVE

The current systematic review of Covid-19 primary series and booster vaccine investigations provides a more nuanced and comprehensive assessment of this association by exploring a) how distinct social media judgments and actions predict different vaccine-related outcomes - perceptions and intentions/uptake, b) both primary series and booster findings, c) types of social media, and d) comparisons across different populations.

METHOD

We conducted a systematic review of published research examining the link between social media and COVID-19 vaccine outcomes - judgments, intentions, and uptake. Overall, we identified 113 published articles.

RESULTS

The findings reveal complex associations between distinct social media predictors and these outcomes. The most consistent negative relationships emerge within studies looking at 'social media as an information source,' 'trust', and 'general social media use/passive exposure' as predictors of less favorable vaccine judgments and intentions/uptake. Conversely, studies focused on 'information seeking' indicate more mixed results. Among the few booster investigations, there are more positive than negative associations between social media predictors and Covid-19 vaccine intentions. Across different social media platforms and sample populations, social media was a less robust/consistent negative predictor of COVID-19 judgments and intentions.

CONCLUSIONS

While social media can contribute to more negative COVID-19 vaccine judgments and motivations, the consistency of this relationship may vary across populations, the platforms users access, and the nature of exposure. Overall, social media campaigns promoting COVID-19 vaccines should employ distinct strategies to target those individuals that value social media as an information resource.

Is Covid-19 "vaccine uptake" in postsecondary education a "problem"? A critical policy inquiry

Since the launch of the Covid-19 global vaccination campaign, postsecondary institutions have strongly promoted vaccination, often through mandates, and the academic literature has identified "vaccine uptake" among postsecondary students as a problem deserving monitoring, research, and intervention. However, with the admission that vaccines do not stop viral spread, that older-age and co-morbidities are major determinants of poor outcomes, and that many vaccine side effects disproportionately affect the young, it cannot be assumed that a risk-benefit analysis favors vaccinating postsecondary students. Drawing from critical policy studies, I appraise the literature on Covid-19 vaccine uptake in postsecondary education. I find that this literature reflects the "scientific consensus," hardly acknowledging contradictory medical evidence, ignoring coercive elements underlying "vaccine acceptance," and neglecting ethical tensions built into the very design of vaccination policies. I discuss potential explanations for my findings, and their implications for academia's role in society in the COVID-19 era and beyond.

The Relationship Between Social Media Use and Negative Emotions Among Chinese Medical College Students: The Mediating Role of Fear of Missing Out and the Moderating Role of Resilience

Objective

This study aimed to examine the mediating role of fear of missing out (FoMO) and the moderating role of resilience in the association between social media use and negative emotions among medical college students in China during the COVID-19 pandemic.

Participants and Methods

A cross-sectional study design was conducted, medical college students from Qiqihar Medical University, China participated in the study. A total of 470 medical college students were recruited voluntarily to complete questionnaires on social media use, FoMO, resilience, and negative emotions.

Results

Social media use was positively associated with FoMO and negative emotions among medical students (p < 0.01). The total effect of social media use on negative emotions was significant (β = 1.101, SE = 0.079, p < 0.001). Social media use had no significant direct effect on negative emotions (β = 0.168, SE = 0.096, p > 0.05), but it had an indirect effect on negative emotions via mediation of FoMO (β = 0.933, SE = 0.106, 95% CI: 0.731 to 1.149). Moreover, resilience had a significant moderating effect on the relationship between FoMO and negative emotions (β = -0.021, SE = 0.005, 95% CI: -0.032 to -0.012). FoMO had a significant positive predictive effect on negative emotions at both levels of resilience (low resilience individuals: β = 1.079, SE = 0.076, p < 0.001; high resilience individuals: β = 0.212, SE = 0.094, p < 0.05).

Conclusion

Social media use and FoMO may be risk factors for increased negative emotions, and resilience should be considered in prevention and intervention strategies designed to mitigate negative emotions among medical college students.

Social Media and Anxiety in Youth: A Narrative Review and Clinical Update

Social media use and related research on psychiatric symptoms continue to increase and evolve rapidly. The potential bidirectional relationships and correlations between social media use and anxiety seem to be understudied. We examine prior research focused on social media use and anxiety disorders, and thus far, correlations have been weak. Nevertheless, these associations may be poorly understood but important. Fear of missing out has been considered a moderator in earlier research. We discuss the limitations of previous research, guidance for clinicians and caregivers, and challenges for future studies in this area.

College students in China during initial COVID-19 pandemic: Role of social media on attitudes toward preventive measures

Objective: To examine the direct and indirect associations (through risk perceptions) between college students' social media use and their perceived importance of COVID-19 preventive measures. Participants and Method: 1,353 undergraduate students in China completed an online survey in 2020 Spring. Results: Participants reported high reliance on social media for COVID-19 updates, which was positively associated with perceived importance of preventive measures. Information-oriented social media use was associated with higher perceived importance of preventive measures not only directly but also indirectly via increased cognitive and emotional risk perceptions. Social-oriented media use, on the other hand, had a negative direct association with perceived importance of preventive measure as well as a positive indirect association via emotional risk perception. Conclusions: This study shows that social media are important information sources for college students during the early stage of the pandemic and their response to the pandemic was related to social media use.

Social media and attitudes towards a COVID-19 vaccination: A systematic review of the literature

BACKGROUND

Vaccine hesitancy continues to limit global efforts in combatting the COVID-19 pandemic. Emerging research demonstrates the role of social media in disseminating information and potentially influencing people's attitudes towards public health campaigns. This systematic review sought to synthesize the current evidence regarding the potential role of social media in shaping COVID-19 vaccination attitudes, and to explore its potential for shaping public health interventions to address the issue of vaccine hesitancy.

METHODS

We performed a systematic review of the studies published from inception to 13 of March2022 by searching PubMed, Web of Science, Embase, PsychNET, Scopus, CINAHL, and MEDLINE. Studies that reported outcomes related to coronavirus disease 2019 (COVID-19) vaccine (attitudes, opinion, etc.) gathered from the social media platforms, and those analyzing the relationship between social media use and COVID-19 hesitancy/acceptance were included. Studies that reported no outcome of interest or analyzed data from sources other than social media (websites, newspapers, etc.) will be excluded. The Newcastle Ottawa Scale (NOS) was used to assess the quality of all cross-sectional studies included in this review. This study is registered with PROSPERO (CRD42021283219).

FINDINGS

Of the 2539 records identified, a total of 156 articles fully met the inclusion criteria. Overall, the quality of the cross-sectional studies was moderate - 2 studies received 10 stars, 5 studies received 9 stars, 9 studies were evaluated with 8, 12 studies with 7,16 studies with 6, 11 studies with 5, and 6 studies with 4 stars. The included studies were categorized into four categories. Cross-sectional studies reporting the association between reliance on social media and vaccine intentions mainly observed a negative relationship. Studies that performed thematic analyses of extracted social media data, mainly observed a domination of vaccine hesitant topics. Studies that explored the degree of polarization of specific social media contents related to COVID-19 vaccines observed a similar degree of content for both positive and negative tone posted on different social media platforms. Finally, studies that explored the fluctuations of vaccination attitudes/opinions gathered from social media identified specific events as significant cofactors that affect and shape vaccination intentions of individuals.

INTERPRETATION

This thorough examination of the various roles social media can play in disseminating information to the public, as well as how individuals behave on social media in the context of public health events, articulates the potential of social media as a platform of public health intervention to address vaccine hesitancy.

FUNDING

None.

Prevalence and Predictors of Intention to be Vaccinated Against COVID-19 in Thirteen Latin American and Caribbean Countries

The presence of a significant number of people who do not intend to be vaccinated could negatively impact efforts to control the COVID-19 pandemic. Therefore, this study sought to determine the prevalence of intention to be vaccinated against COVID-19 and associated sociodemographic and psychosocial factors in thirteen countries in Latin America and the Caribbean (LAC). A total of 5510 people from 13 LAC countries participated. Frequencies, percentages, bivariate analyses using chi-square tests, and Poisson regression analysis with robust variance were used. The countries with the highest prevalence of intention to be vaccinated were Brazil (96.94%), Cuba (89.59%), Chile (84.59%), and Mexico (78.33%). On the other hand, the countries with the lowest prevalence were El Salvador (54.01%), Paraguay (55.87%), and Uruguay (56.40%). Prevalence is also reported according to some sociodemographic and health variables. It was found that country, male sex, hours exposed to information about COVID-19, university education, living in an urban area, belief in the animal origin of the virus, perceived likelihood of contracting COVID-19, perceived severity of COVID-19, and concern about infecting others significantly predicted intention to be vaccinated in the 13 LAC countries. While most countries had a high prevalence of intention to be vaccinated, there are still subgroups that have levels of intention that may be insufficient to predict the presence of community immunity. In this sense, knowing the estimates of vaccination intention rates, as well as the associated sociodemographic and psychological factors, can be used to plan actions and interventions that will inform about the safety and benefits of vaccines, as well as strengthen trust in health authorities.

Exposure to "Vaccination Selfies" Relate to Readers' Vaccination Intention: The Moderating Role of Partisan Media Use and the Mediating Role of Affective Responses

As vaccines for COVID-19 become accessible to the U.S. public, vaccinated individuals often post "vaccination selfies" on social media to encourage unvaccinated others to be inoculated. This study explores the relationship between exposure to these vaccination posts and post readers' vaccination intention. Drawn upon the functional affect theories, the authors proposed integral affective responses to the vaccination posts to explain readers' vaccination intention. Social media users' partisan media use was proposed to explain readers' different affective responses. Results from a cross-sectional survey (N = 343) showed that only exposure to proximal others' (e.g., friends), not distal others' (e.g., celebrities), vaccination posts was significantly associated with vaccination intention through positive affective responses. Conservative media use enhanced readers' negative affective response to vaccination posts whereas liberal media use was associated with positive affective responses. The findings highlighted the importance of social norms and positive affection appeals in pro-vaccination campaigns.

Willingness to Vaccinate Against COVID-19: The Role of Health Locus of Control and Conspiracy Theories

Understanding the predictors of the willingness to get vaccinated against COVID-19 may aid in the resolution of current and future pandemics. We investigate how the readiness to believe conspiracy theories and the three dimensions of health locus of control (HLOC) affect the attitude toward vaccination. A cross-sectional study was conducted based on the data from an online survey of a sample of Czech university students (n = 866) collected in January 2021, using the multivariate linear regression models and moderation analysis. The results found that 60% of Czech students wanted to get vaccinated against COVID-19. In addition, 40% of the variance of willingness to get vaccinated was explained by the belief in the COVID-19-related conspiracy theories and the powerful others dimension of HLOC. One-sixth of the variance of the willingness to get vaccinated was explained by HLOC, cognitive reflection, and digital health literacy [eHealth Literacy Scale (EHEALS)]. HLOC and conspiracy mentality (CM) and its predictors are valid predictors of a hesitancy to get vaccinated against COVID-19. The campaigns promoting vaccination should target the groups specifically vulnerable to the conspiracy theories and lacking HLOC related to powerful others.

Positive Association between Individualism and Vaccination Resistance against COVID-19 Vaccination among Chinese Adults: Mediations via Perceived Personal and Societal Benefits

Background: Vaccination resistance is the key hurdle against herd immunity as it limits the final vaccination coverage. This study investigated the prevalence and factors of COVID-19 vaccination resistance (i.e., those indicating definitely not taking up COVID-19 vaccination), including individualism, perceived personal benefits (PPB) and perceived societal benefits (PSB) of COVID-19 vaccination, and related mechanisms of the association. Methods: A random telephone survey interviewed 395 unvaccinated adults aged 18–75 not having scheduled for COVID-19 vaccination in May 2021 in Hong Kong, China (response rate = 56.8%). Results: The prevalence of vaccination resistance was 56.5%. Adjusted for background factors, individualism, PPB, and PSB were significantly associated with vaccination resistance. Path analysis showed that individualism exhibited a direct effect on vaccination resistance and a 3-step indirect effect (individualism → PSB → PPB→ vaccination resistance) that explained 46.8% of the total effect. The two 2-step indirect paths via PPB only and via PSB only were non-significant. Conclusion: High prevalence of vaccination resistance was observed. Individualism increased vaccination resistance via its direct and indirect effects. Health promotion may emphasize collective good to reduce the impact of individualism and promote PPB/PSB, which may reduce vaccination resistance directly and alleviate the impact of individualism on vaccination resistance indirectly.

The Impact of Social Media Exposure and Interpersonal Discussion on Intention of COVID-19 Vaccination among Nurses

COVID-19 vaccine hesitancy among nurses is a global public health concern and it is imperative to understand associated factors. Information environment plays a critical role in shaping health behaviors, while few studies explored such effects in the context of COVID-19 vaccination. A cross-sectional survey was conducted among 1902 nurses in China. The study investigated the effects of social media exposure/interpersonal discussion on intention of COVID-19 vaccination and tested whether perceived effectiveness of COVID-19 vaccines (perceived vaccine efficacy, perceived duration of protection, and perceived effectiveness in preventing resurgences) mediated such associations. Results showed that about 68.0% and 56.5% of the participants had an intention of free and self-paid COVID-19 vaccinations, respectively. Frequent social media exposure and interpersonal discussion were positively associated with vaccination intentions. Perceived vaccine efficacy significantly mediated the effects of frequent social media exposure and interpersonal discussion, whereas perceived effectiveness in preventing resurgences suppressed the effects of frequent social media exposure. In conclusion, the prevalence of intention of COVID-19 vaccination was relatively low among Chinese nurses and health promotion is needed. Frequent social media exposure and interpersonal discussion potentially enhanced vaccination intentions via increased perceived vaccine efficacy. The findings can help inform the development of relevant health communication interventions.

The intention to get a COVID-19 vaccine among the students of health science in Vietnam

This study determines factors related to the intention to vaccinate against COVID-19 for health science students in Ho Chi Minh City (HCMC), using both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model. A cross-sectional survey was considered in April 2021, using a self-administered questionnaire to all health sciences students of the University of Medicine and Pharmacy in Ho Chi Minh City (UMP), Vietnam. The multiple regression was performed to specify the predictable factors of willingness to get a future COVID-19 vaccination.A total of 854 students completed the survey, whose vaccination acceptance was 77.1%. Predictors of intention to receive a COVID-19 vaccination included year of education, knowledge, and the HBM and TPB variables including the perceived benefits, cues to action, perceived behavioral control, and positive attitudes toward the vaccine (all p < .05). The main reasons for hesitancy included being afraid of the side effects (73.0%), vaccine safety (65.3%), and the process of new vaccine development (53.6%). The study examined students' intention toward COVID-19 vaccine and related factors to notify university administrators and policymakers. The findings showed the acceptability of vaccines had differences within the education year of students, besides, knowledge, perception of benefits, cues to action, behavioral control, and attitudes toward the vaccine were positive predictive factors. These may be useful for developing health education messages to promoting vaccination acceptability for students who had hesitancy of a new vaccine and in broader groups.

Understanding a national increase in COVID-19 vaccination intention, the Netherlands, November 2020-March 2021

The intention to get the COVID-19 vaccine increased from 48% (November 2020) to 75% (March 2021) as national campaigning in the Netherlands commenced. Using a mixed method approach we identified six vaccination beliefs and two contextual factors informing this increase. Analysis of a national survey confirmed that shifting intentions were a function of shifting beliefs: people with stronger intention to vaccinate were most motivated by protecting others and reopening society; those reluctant were most concerned about side effects.

COVID-19 Vaccination Strategy in China: A Case Study

The coronavirus disease 2019 (COVID-19) outbreak in China was first reported to the World Health Organization on 31 December 2019, after the first cases were officially identified around 8 December 2019. However, the case of an infected patient of 55 years old can probably be traced back on 17 November. The spreading has been rapid and heterogeneous. Economic, political and social impacts have not been long overdue. This paper, based on English, French and Chinese research in national and international databases, aims to study the COVID-19 situation in China through the management of the outbreak and the Chinese response to vaccination strategy. The coronavirus disease pandemic is under control in China through non-pharmaceutical interventions, and the mass vaccination program has been launched to further prevent the disease and progressed steadily with 483.34 million doses having been administered across the country by 21 May 2021. China is also acting as an important player in the development and production of SARS-CoV-2 vaccines.