Reasons for Taking the COVID-19 Vaccine by US Social Media Users

Mapping global public perspectives on mRNA vaccines and therapeutics

The development and rollout of mRNA vaccines during COVID-19 marked a significant advancement in vaccinology, yet public hesitation to vaccination was prevalent, indicating the potential risk that future mRNA-based medical innovations will fail to be adopted. Utilizing a combined approach of large language models with manual validation and unsupervised machine learning, we conducted a social listening analysis to assess attitudes towards mRNA vaccines and therapeutics on Twitter from June 2022 to May 2023, contrasting online perspectives with data from the Vaccine Adverse Event Reporting System. Our findings reveal widespread negative sentiment and a global lack of confidence in the safety, effectiveness, and trustworthiness of mRNA vaccines and therapeutics, with frequent discussions of severe vaccine side effects, rumors, and misinformation. This underscores the need for targeted communication strategies to foster acceptance of medical treatments and strengthen public trust in order to enhance societal resilience to future health challenges.

Usage of social media and Covid 19 vaccine hesitancy among medical students in Kericho County

The recent Covid 19 pandemic revealed the global challenge posed by infectious diseases. Vaccines are a crucial tool in preventing pandemics, as evidenced by their success in controlling past outbreaks. The rise of information and communication technology has introduced social media platforms as potential game-changers in both preventing and managing future pandemics. However, these same platforms can also be a double-edged sword, hindering the uptake of essential vaccination services. This study investigated the association between social media use and vaccine hesitancy among medical students. The study was designed as an institution based cross sectional study of 423 medical students in Kenya Medical Training College and University of Kabianga in Kericho County. Stratified sampling was used to decide on the two institutions and systematic random sampling was used to select the study participants. Research administered questionnaires were used to collect data on the socio-demographic characteristics, use of social media platforms, social media campaigns, and uptake of Covid 19 vaccines. The collected data was analyzed using Statistical Package for Social Sciences version 25. Chi square was used to establish the association between the independent variables and uptake of Covid 19 vaccines. The variables that were significantly associated with hesitancy to Covid 19 vaccines were further analyzed using binary logistic regression. The confidence interval (CI) was set at 95% and statistical significance was considered at p < 0.05. The study found significant associations between vaccine hesitancy and several factors, including academic level, preferred social media platform, the influence of social media on attitudes towards vaccines, concerns about vaccine safety and efficacy, and confidence in vaccines. The findings present social media as a potential platform for promotion of vaccines utilization during pandemics when used well.

Gendered (SDG5) and other perspectives on COVID-19 vaccination status: a focus on South Africa's Limpopo province

One of the key issues embedded in the 2030 Agenda for Sustainable Development is the need for disaggregated data. Given the nature of the Coronavirus disease 2019 (COVID-19), studies on such should respond to this call. This paper investigates gendered and other perspectives on COVID-19 vaccination status in South Africa's Limpopo Province. The work utilises a household survey (n = 4,571), data from Our World in Data and Johns Hopkins University, as well as policy documents and academic literature. The findings are that the government moved away from a goal to attain 67% herd immunity, to the containment strategy. While the country attained 35% of population fully vaccinated, the current study reveals 72.84% of the respondents fully vaccinated in Limpopo (including those receiving a booster). Noteworthy findings include 7.1% of the respondents reporting partial vaccination and 19.8% expressing vaccine hesitancy. Gender differences were significant, with females exhibiting higher vaccination rates than males, and age-related variations were observed, particularly among the youngest participants. Further analysis stratified by gender and age groups unveiled substantial disparities, emphasizing the need for targeted interventions. Additionally, the study highlights patterns in COVID-19 vaccine uptake based on education levels, with higher education associating with increased vaccination rates. Significant gender-based differences in vaccine uptake across education levels indicate potential areas for focused public health efforts. The findings emphasise the complexity of factors influencing vaccination behaviour, providing valuable insights for policymakers, public health practitioners, and researchers aiming to enhance vaccine uptake and address disparities in diverse demographic groups.

Path analysis of perceived disease vulnerability, COVID-19 fear, and lower vaccine hesitancy within the context of protection motivation theory

COVID-19 vaccinations have demonstrated effectiveness in reducing severe infections. However, vaccine hesitancy posed a major public health hurdle to combat the COVID-19 pandemic. Online spread of vaccine conspiracy beliefs generated unwarranted mistrust and resistance to vaccines. While numerous studies have explored the factors influencing vaccine hesitancy, there remains a lack of comprehensive understanding regarding the interplay between perceived disease vulnerability, COVID-19 fear, and vaccine hesitancy. Protection motivation theory posits citizens will evaluate perceived threats and take actions to mitigate potential harm. With a large U.S. sample, path analysis demonstrated individuals' perceived disease vulnerability was associated with lower vaccine hesitancy. Greater perceived disease vulnerability was associated with higher COVID-19 fear. Greater COVID-19 fear was associated with lower vaccine hesitancy. Greater vaccine conspiracy beliefs associated with higher vaccine hesitancy. However, in the presence of perceived vulnerability to disease, vaccine conspiracy beliefs associated with higher fear of COVID-19 and thereby lower vaccine hesitancy. We found under circumstances of higher perceived vulnerability to disease and fear of COVID-19, vaccine conspiratorial believers were less vaccine hesitant. We discuss how public health messaging can highlight personal risks to contracting COVID-19 to appeal to those who self-identify as disease prone, but may have reservations about vaccines because of misinformation. Successfully combating diseases entails reaching and gaining cooperation from misbelievers because misinformation is expected to continue in the digital age. By understand individual differences to vaccine hesitancy, it can help increase vaccinations and prevent severe illnesses in the post COVID-19 pandemic era.

Pandemic fatigue, behavioral intention and predictors of COVID-19 vaccination among individuals living with HIV in Bench Sheko Zone, in Southern Ethiopia, application of TBP: a facility based cross sectional study

Introduction

People living with HIV often face inequalities and negative outcomes, which make them vulnerable. To protect this population and achieve herd immunity, it is crucial for COVID-19 vaccination efforts to prioritize and encourage vaccination among people living with HIV (PLWH). However, in Ethiopia, there is a lack of motivation in this regard. To tackle this issue, a study was conducted in the Bench Sheko Zone of Southwest Ethiopia. The study aimed to assess pandemic fatigue, behavioral intention to get vaccinated, and factors influencing COVID-19 vaccine acceptance among PLWH in that region.

Methods

A facility-based cross-sectional study was conducted among individuals living with HIV who were over 18 years old in Bench-Sheko Zone, located in Southwest Ethiopia. The study included a total of 590 participants from four ART healthcare facilities within the zone. The researchers utilized the Theory of Planned Behavior to examine the predictors of intention to use preconception care. Multiple linear regression analysis was employed to determine these predictors, with a p-value of less than 0.05 considered as indicative of a significant association. The final analysis of the study involved the use of linear regression analysis, and the measure of association was presented as the standardized B coefficient following a multivariable logistic regression analysis.

Result

In the conducted study, the response rate was an impressive 98%. The researchers aimed to investigate the behavioral intention toward the COVID-19 vaccine, which was found to be 55.7%. The average age of the participants in the study was 34.65 ± 6.67. The study was the assessment of pandemic fatigue, which had a mean value of 17.22 ± 5.28. During the multivariate linear regression analysis, four predictor variables were identified. Among these, three variables, namely subjective norm, pandemic fatigue, and age, positively influenced the behavioral intention toward the COVID-19 vaccine. Comprehending these factors can assist healthcare professionals and policymakers in formulating precise interventions and strategies aimed at enhancing the acceptance and adoption of vaccines.

Conclusion

The study indicates that individuals living with HIV have shown lower vaccine intention compared to previous research. The study identifies subjective norm, pandemic control measures, income, and age as predictors of individuals' intention to receive the COVID-19 vaccine.

Comparison of SARS-CoV-2 Vaccination Skepticism, Reasons, and Concerns Between Mass Vaccination Centers and General Practices in Germany 2021

Introduction

The reluctance to be vaccinated against COVID-19 has significantly curbed vaccine uptake. Unlike mass vaccination centers, general practitioners (GPs) might be able to address some of the patients' concerns through their long-term doctor-patient relationship. This study compared vaccination reasons, concerns and skepticism about vaccination, and perceived importance of the vaccine and its hypothetical value between vaccination centers and GP practices.

Methods

A survey was distributed (07/2021-10/2021) among newly vaccinated individuals in ten GP practices (n = 364) and two vaccine centers (n = 474).

Results

Participants in vaccine centers stated more prosocial and benefit-oriented reasons for vaccination, whereas participants in GP practices more often stated the GP's recommendation as the reason. Perceived importance of the vaccine in combating the pandemic was rated higher among individuals at vaccine centers and with higher health awareness and self-efficacy. Participants at both types of sites who preferred a GP for vaccination expressed more vaccination skepticism, which was also related to older age, more health risk concerns related to COVID-19 vaccines, and lower perceived importance of the vaccine.

Conclusion

Our results indicate opportunities for framing future vaccination campaigns that include vaccination centers. Additionally, a rapid GP involvement in future mass vaccinations might be crucial for overcoming attitudinal barriers and achieving higher vaccine uptake.

Topic and Trend Analysis of Weibo Discussions About COVID-19 Medications Before and After China's Exit from the Zero-COVID Policy: Retrospective Infoveillance Study

BACKGROUND

After 3 years of its zero-COVID policy, China lifted its stringent pandemic control measures with the announcement of the 10 new measures on December 7, 2022. Existing estimates suggest 90%-97% of the total population was infected during December. This change created a massive demand for COVID-19 medications and treatments, either modern medicines or traditional Chinese medicine (TCM).

OBJECTIVE

This study aimed to explore (1) how China's exit from the zero-COVID policy impacted media and the public's attention to COVID-19 medications; (2) how social COVID-19 medication discussions were related to existing model estimates of daily cases during that period; (3) what the diversified themes and topics were and how they changed and developed from November 1 to December 31, 2022; and (4) which topics about COVID-19 medications were focused on by mainstream and self-media accounts during the exit. The answers to these questions could help us better understand the consequences of exit strategies and explore the utilities of Sina Weibo data for future infoveillance studies.

METHODS

Using a scrapper for data retrieval and the structural topic modeling (STM) algorithm for analysis, this study built 3 topic models (all data, before a policy change, and after a policy change) of relevant discussions on the Chinese social media platform Weibo. We compared topic distributions against existing estimates of daily cases and between models before and after the change. We also compared proportions of weibos published by mainstream versus self-media accounts over time on different topics.

RESULTS

We found that Weibo discussions shifted sharply from concerns of social risks (case tracking, governmental regulations, etc) to those of personal risks (symptoms, purchases, etc) surrounding COVID-19 infection after the exit from the zero-COVID policy. Weibo topics of "symptom sharing" and "purchase and shortage" of modern medicines correlated more strongly with existing susceptible-exposed-infected-recovered (SEIR) model estimates compared to "TCM formulae" and other topics. During the exit, mainstream accounts showed efforts to specifically engage in topics related to worldwide pandemic control policy comparison and regulations about import and reimbursement of medications.

CONCLUSIONS

The exit from the zero-COVID policy in China was accompanied by a sudden increase in social media discussions about COVID-19 medications, the demand for which substantially increased after the exit. A large proportion of Weibo discussions were emotional and expressed increased risk concerns over medication shortage, unavailability, and delay in delivery. Topic keywords showed that self-medication was sometimes practiced alone or with unprofessional help from others, while mainstream accounts also tried to provide certain medication instructions. Of the 16 topics identified in all 3 STM models, only "symptom sharing" and "purchase and shortage" showed a considerable correlation with SEIR model estimates of daily cases. Future studies could consider topic exploration before conducting predictive infoveillance analysis, even with narrowly defined search criteria with Weibo data.

Acceptance of COVID-19 vaccination and vaccine confidence levels in Thailand: A cross-sectional study

BACKGROUND

Vaccination is considered effective for minimising the impact of COVID-19. Pandemic control depends on high vaccination rates and confidence levels among the population. This study determined COVID-19 vaccine acceptance and confidence levels among vaccinated Thai participants.

METHODS

An online cross-sectional study was conducted between 13 September 2021 and 14 January 2022 among individuals ≥ 18 years. An online questionnaire was distributed via social media platforms and posters in public places in Thailand. It included four components (demographic characteristics, COVID-19 vaccine regimens, vaccine acceptance, and confidence). Statistical analyses included a chi-squared test, Wilcoxon signed-rank test, and multivariate logistic regressions.

RESULTS

Approximately 88.4% of the participants accepted the vaccine. Almost half had confidence in 'unconcerned about vaccine side effects' (48.2%), 'trust in vaccine effectiveness' (44.3%) and 'trust in government vaccine policy' (43.4%). Multiple logistic regression indicated that males and high education significantly correlated with vaccine acceptance. Higher age (45-59 years and ≥ 60 years) and low monthly income (≤5,000 THB) were significantly associated with trust in government vaccine policy. The 1stCoronaVac/2ndCoronaVac/3rdBNT162b2 regimen group was significantly associated with unconcern about vaccine side effects compared to the 1stAZD1222/2ndAZD1222 regimen group.

CONCLUSIONS

Over half of vaccinated participants indicated concern about COVID-19 vaccine side effects and distrust in vaccine effectiveness and government policy; nonetheless, almost all took the COVID-19 vaccine. Participants who received the 1stCoronaVac/2ndCoronaVac/3rdBNT162b2 regimen were unconcerned about vaccine side effects. Some socio-demographic factors were associated with vaccine acceptance and high confidence, which should be sought while designing interventions to improve COVID-19 vaccination rates.

COVID-19 disease and vaccination in pregnancy: understanding knowledge, perceptions and experiences among pregnant women and community leaders in Uganda

BACKGROUND

We investigated pregnant women and community leaders' knowledge, perceptions and experiences of the coronavirus disease 2019 (COVID-19) vaccination program during pregnancy in Uganda and how this changed over the course of the pandemic.

METHODS

We conducted 20 in-depth interviews (IDIs) and two group discussions (GDs) with pregnant women and four GDs with community leaders in Kawempe division of Kampala, Uganda. The first round of IDIs/GDs were carried out in March 2021. In July 2021, telephone IDIs were conducted with 7 pregnant women and 10 community leaders randomly selected from first-round interview participants. Themes were analysed deductively drawing codes from the topic guides.

RESULTS

In the first round, the majority of participants thought COVID-19 was not real because of misconceptions around government messaging/motivation and beliefs that Africans would not be affected. In the second round, participants recognised COVID-19 disease, because of rising case numbers and fatalities. There was increased awareness of the benefits of the vaccine. However, pregnant women remained unsure of vaccine safety and quality, citing side effects like fevers and general body weakness. Role models and coherent public health messaging and healthcare workers were key enablers of vaccine uptake.

CONCLUSIONS

Targeted and sustained COVID-19 communication and engagement strategies are needed, especially for pregnant women and others in their communities, to improve vaccine confidence during outbreaks.

Anti-stigma narratives and emotional comfort against health crisis: a context analysis of UGC short videos from patients with COVID-19 infections

Patients narratives are being recorded increasingly frequently and spontaneously in short user produced content (UGC) films, which may have an impact on the vlogger's health as well as the public's comprehension of the relevant health concerns. This paper addressed three research questions regarding the population characteristics of UGC video publishers, the narrative theme of the videos, and the emotional orientation of the commenters. This study aimed to deepen our understanding of COVID-19 patients' narrative intentions and emotional needs through the theoretical frameworks of theory of planned behavior (TPB) and negative dominance theory (NDT). We collected 335 videos from 28 COVID-19 patients and 572,052 comments as samples on Douyin platform, the largest short-video website in China. Using Latent Semantic Analysis, we analyzed the descriptive information of the video blogs, the narrative textual information of the videos, and the emotional orientation of the comments. Our findings revealled seven categories of narrative themes, with 52.1% of video comments exhibiting a positive emotional orientation. Within a framework integrating TPB and NDT theories, we analyzed the behavioral intentions of vloggers and viewers during COVID-19 epidemic, and interpreted the persistent posting of videos and the active posting of comments as positive actions that counteracted the multiple effects of negative messages. This study contributes to the understanding of individual narratives in macro-risk communication, both theoretically and empirically, and offers policy recommendations in relevant fields.

Unveiling Vaccine Hesitancy on Twitter: Analyzing Trends and Reasons during the Emergence of COVID-19 Delta and Omicron Variants

Given the high amount of information available on social media, the paper explores the degree of vaccine hesitancy expressed in English tweets posted worldwide during two different one-month periods of time following the announcement regarding the discovery of new and highly contagious variants of COVID-19-Delta and Omicron. A total of 5,305,802 COVID-19 vaccine-related tweets have been extracted and analyzed using a transformer-based language model in order to detect tweets expressing vaccine hesitancy. The reasons behind vaccine hesitancy have been analyzed using a Latent Dirichlet Allocation approach. A comparison in terms of number of tweets and discussion topics is provided between the considered periods with the purpose of observing the differences both in quantity of tweets and the discussed discussion topics. Based on the extracted data, an increase in the proportion of hesitant tweets has been observed, from 4.31% during the period in which the Delta variant occurred to 11.22% in the Omicron case, accompanied by a diminishing in the number of reasons for not taking the vaccine, which calls into question the efficiency of the vaccination information campaigns. Considering the proposed approach, proper real-time monitoring can be conducted to better observe the evolution of the hesitant tweets and the COVID-19 vaccine hesitation reasons, allowing the decision-makers to conduct more appropriate information campaigns that better address the COVID-19 vaccine hesitancy.

Digital Emergency Management for a Complex One Health Landscape: the Need for Standardization, Integration, and Interoperability

OBJECTIVE

Planning reliable long-term planning actions to handle disruptive events requires a timely development of technological infrastructures, as well as the set-up of focused strategies for emergency management. The paper aims to highlight the needs for standardization, integration, and interoperability between Accident & Emergency Informatics (A&EI) and One Digital Health (ODH), as fields capable of dealing with peculiar dynamics for a technology-boosted management of emergencies under an overarching One Health panorama.

METHODS

An integrative analysis of the literature was conducted to draw attention to specific foci on the correlation between ODH and A&EI, in particular: (i) the management of disruptive events from private smart spaces to diseases spreading, and (ii) the concepts of (health-related) quality of life and well-being.

RESULTS

A digitally-focused management of emergency events that tackles the inextricable interconnectedness between humans, animals, and surrounding environment, demands standardization, integration, and systems interoperability. A consistent and finalized process of adoption and implementation of methods and tools from the International Standard Accident Number (ISAN), via findability, accessibility, interoperability, and reusability (FAIR) data principles, to Medical Informatics and Digital Health Multilingual Ontology (MIMO) - capable of looking at different approaches to encourage the integration between the ODH framework and the A&EI vision, provides a first answer to these needs.

CONCLUSIONS

ODH and A&EI look at different scales but with similar goals for converging health and environmental-related data management standards to enable multi-sources, interdisciplinary, and real-time data integration and interoperability. This allows holistic digital health both in routine and emergency events.

One Digital Health Intervention for Monitoring Human and Animal Welfare in Smart Cities: Viewpoint and Use Case

Smart cities and digital public health are closely related. Managing digital transformation in urbanization and living spaces is challenging. It is critical to prioritize the emotional and physical health and well-being of humans and their animals in the dynamic and ever-changing environment they share. Human-animal bonds are continuous as they live together or share urban spaces and have a mutual impact on each other's health as well as the surrounding environment. In addition, sensors embedded in the Internet of Things are everywhere in smart cities. They monitor events and provide appropriate responses. In this regard, accident and emergency informatics (A&EI) offers tools to identify and manage overtime hazards and disruptive events. Such manifold focuses fit with One Digital Health (ODH), which aims to transform health ecosystems with digital technology by proposing a comprehensive framework to manage data and support health-oriented policies. We showed and discussed how, by developing the concept of ODH intervention, the ODH framework can support the comprehensive monitoring and analysis of daily life events of humans and animals in technologically integrated environments such as smart homes and smart cities. We developed an ODH intervention use case in which A&EI mechanisms run in the background. The ODH framework structures the related data collection and analysis to enhance the understanding of human, animal, and environment interactions and associated outcomes. The use case looks at the daily journey of Tracy, a healthy woman aged 27 years, and her dog Mego. Using medical Internet of Things, their activities are continuously monitored and analyzed to prevent or manage any kind of health-related abnormality. We reported and commented on an ODH intervention as an example of a real-life ODH implementation. We gave the reader examples of a "how-to" analysis of Tracy and Mego's daily life activities as part of a timely implementation of the ODH framework. For each activity, relationships to the ODH dimensions were scored, and relevant technical fields were evaluated in light of the Findable, Accessible, Interoperable, and Reusable principles. This "how-to" can be used as a template for further analyses. An ODH intervention is based on Findable, Accessible, Interoperable, and Reusable data and real-time processing for global health monitoring, emergency management, and research. The data should be collected and analyzed continuously in a spatial-temporal domain to detect changes in behavior, trends, and emergencies. The information periodically gathered should serve human, animal, and environmental health interventions by providing professionals and caregivers with inputs and "how-to's" to improve health, welfare, and risk prevention at the individual and population levels. Thus, ODH complementarily combined with A&EI is meant to enhance policies and systems and modernize emergency management.

Patterns of diverse and changing sentiments towards COVID-19 vaccines: a sentiment analysis study integrating 11 million tweets and surveillance data across over 180 countries

OBJECTIVES

Vaccines are crucial components of pandemic responses. Over 12 billion coronavirus disease 2019 (COVID-19) vaccines were administered at the time of writing. However, public perceptions of vaccines have been complex. We integrated social media and surveillance data to unravel the evolving perceptions of COVID-19 vaccines.

MATERIALS AND METHODS

Applying human-in-the-loop deep learning models, we analyzed sentiments towards COVID-19 vaccines in 11 211 672 tweets of 2 203 681 users from 2020 to 2022. The diverse sentiment patterns were juxtaposed against user demographics, public health surveillance data of over 180 countries, and worldwide event timelines. A subanalysis was performed targeting the subpopulation of pregnant people. Additional feature analyses based on user-generated content suggested possible sources of vaccine hesitancy.

RESULTS

Our trained deep learning model demonstrated performances comparable to educated humans, yielding an accuracy of 0.92 in sentiment analysis against our manually curated dataset. Albeit fluctuations, sentiments were found more positive over time, followed by a subsequence upswing in population-level vaccine uptake. Distinguishable patterns were revealed among subgroups stratified by demographic variables. Encouraging news or events were detected surrounding positive sentiments crests. Sentiments in pregnancy-related tweets demonstrated a lagged pattern compared with the general population, with delayed vaccine uptake trends. Feature analysis detected hesitancies stemmed from clinical trial logics, risks and complications, and urgency of scientific evidence.

DISCUSSION

Integrating social media and public health surveillance data, we associated the sentiments at individual level with observed populational-level vaccination patterns. By unraveling the distinctive patterns across subpopulations, the findings provided evidence-based strategies for improving vaccine promotion during pandemics.

EU Member States’ Institutional Twitter Campaigns on COVID-19 Vaccination: Analyses of Germany, Spain, France and Italy

The development of an effective vaccine against the SARS-CoV-2 coronavirus became the hope for halting the spread of the disease. In recent years, social networks have become important tools for political and strategic communication in the dialogue with citizens. Therefore, the messages emitted through them were important to address vaccine hesitancy and achieve collective immunity. This paper analyses the use of Twitter by politicians and institutions in EU Member States during the first fifty days after the Commission’s marketing authorisation of the first COVID-19 vaccine (21 December 2020 to 8 February 2021). To do so, a triple approach content analysis was carried out (quantitative, qualitative and discursive on feelings) applied to 1913 tweets published by the official profiles of the prime ministers, health ministers, governments and health ministries of Germany, Spain, France and Italy, the four most populous EU countries. The results point out that politicians and institutions gave preference to other issues on their political agenda over vaccine-related issues. Moreover, previous research hypotheses, such as those related to the underutilization of the Twitter tool as a two-way communication channel with citizens, are validated.

Implications for COVID-19 vaccine uptake: A systematic review

BACKGROUND

Globally, increasing coronavirus disease (COVID-19) vaccination coverage remains a major public health concern in the face of high rates of COVID-19 hesitancy among the general population. We must understand the impact of the determinants of COVID-19 vaccine uptake when designing national vaccination programmes. We aimed to synthesise nationwide evidence regarding COVID-19 infodemics and the demographic, psychological, and social predictors of COVID-19 vaccination uptake.

METHODS

We systematically searched seven databases between July 2021 and March 2022 to retrieve relevant articles published since COVID-19 was first reported on 31 December 2019 in Wuhan, China. Of the 12,502 peer-reviewed articles retrieved from the databases, 57 met the selection criteria and were included in this systematic review. We explored COVID-19 vaccine uptake determinants before and after the first COVID-19 vaccine roll-out by the Food and Drug Authority (FDA).

RESULTS

Increased COVID-19 vaccine uptake rates were associated with decreased hesitancy. Concerns about COVID-19 vaccine safety, negative side effects, rapid development of the COVID-19 vaccine, and uncertainty about vaccine effectiveness were associated with reluctance to be vaccinated. After the US FDA approval of COVID-19 vaccines, phobia of medical procedures such as vaccine injection and inadequate information about vaccines were the main determinants of COVID-19 vaccine hesitancy.

CONCLUSION

Addressing effectiveness and safety concerns regarding COVID-19 vaccines, as well as providing adequate information about vaccines and the impacts of pandemics, should be considered before implementation of any vaccination programme. Reassuring people about the safety of medical vaccination and using alternative procedures such as needle-free vaccination may help further increase vaccination uptake.

The Role of Information and Knowledge in COVID-19 Vaccination Among People With Intellectual and Developmental Disabilities and Their Families

People with intellectual and developmental disabilities (IDD) may be at an increased risk of severe illness and death from COVID-19. This article examines the role of information and knowledge in COVID-19 vaccine uptake for people with IDD and their families. We developed a survey about COVID-19 vaccine uptake, confidence, and knowledge for people with IDD and their families. COVID-19 vaccine uptake was associated with higher self-reported knowledge about the vaccine, learning about the vaccine from one's doctor, and social media use. Qualitative results reflected the importance of trusted relationships with medical providers in vaccination.

Remembering and forgetting information about the COVID-19 vaccine on Twitter

Social media exposes people to selective information of what they have previously known. We conducted two laboratory studies to examine in a simulated online context the phenomenon of retrieval-induced forgetting, where information reposted on social media is likely to be later remembered and relevant but not reposted information may be forgotten. Specifically, we examined how exposure to selective information about the COVID-19 vaccine via tweets affected subsequent memory and whether people's attitudes towards vaccination played a role in their memory for the information. Young adults (N = 119; Study 1) and community members (N = 92; Study 2) were presented with information about the COVID-19 vaccine that included both pro- and anti-vaccine arguments, organised in four categories (i.e., science, children, religion, morality). They then read tweets that repeated half of the arguments from two of the categories. In a subsequent memory test, participants remembered best the statements repeated in the tweets and remembered worst the statements from the same category but not repeated in the tweets, thus exhibiting retrieval-induced forgetting. This pattern of results was similar across pro- and anti-vaccine arguments, regardless of the participants' level of support for vaccination. We discussed the findings in light of remembering and forgetting in the context of the pandemic and social media.

Knowledge, attitude, and practices of front line health workers after receiving a COVID-19 vaccine: a cross-sectional study in Pakistan

Background

Globally, there is an increased risk of COVID-19 infection among front-line health workers (FHW). This study aimed to evaluate the knowledge, attitude, and practices of FHW of Pakistan after receiving the COVID-19 vaccine.

Methods

A population web-based survey on COVID-19 vaccine was conducted on 635 FHW in Pakistan between April 15, 2021, and July 15, 2021. The survey focused on four main sections consisting of socio-demographic data, knowledge, attitude, and practices after receiving the COVID-19 vaccine. The data was analyzed on SPSS. p < 0.05 was considered significant.

Results

Overall, 60% of FHW were nervous before getting vaccinated, with the leading reason to get vaccinated being their concern to protect themselves and their community (53.4%). A majority of FHW had fear about the unseen side effects of the COVID-19 vaccine (59.7%) used in Pakistan, with the most common side effect reported as soreness at the injection site (39%). It has been noted that almost all of the FHW observed preventive practices after getting vaccinated. The results showed that married respondents had favorable practices towards COVID-19 vaccines (B = 0.53, p < 0.01) (B, unstandardized regression coefficient). It was also found that more informational sources (B = 0.19, p < 0.01), higher knowledge of vaccination (B = 0.15, p < 0.001), and favorable attitude toward vaccine (B = 0.12, p < 0.001) significantly predicted favorable practices toward COVID-19 vaccination.

Conclusion

The findings reflect that FHW, though they were worried about its side effects, have good knowledge and a positive attitude after getting the COVID-19 vaccine. This study is significant as the FHWs are a symbol for guidance, a reliable source of information, and an encouraging means of receiving COVID-19 vaccine for the general public. This study also reported that post-vaccination side effects were mild which will aid in reducing the vaccine hesitancy among the general Pakistani population.

Early Detection and Control of the Next Epidemic Wave Using Health Communications: Development of an Artificial Intelligence-Based Tool and Its Validation on COVID-19 Data from the US

Social media networks highly influence on a broad range of global social life, especially in the context of a pandemic. We developed a mathematical model with a computational tool, called EMIT (Epidemic and Media Impact Tool), to detect and control pandemic waves, using mainly topics of relevance on social media networks and pandemic spread. Using EMIT, we analyzed health-related communications on social media networks for early prediction, detection, and control of an outbreak. EMIT is an artificial intelligence-based tool supporting health communication and policy makers decisions. Thus, EMIT, based on historical data, social media trends and disease spread, offers an predictive estimation of the influence of public health interventions such as social media-based communication campaigns. We have validated the EMIT mathematical model on real world data combining COVID-19 pandemic data in the US and social media data from Twitter. EMIT demonstrated a high level of performance in predicting the next epidemiological wave (AUC = 0.909, F₁ = 0.899).

COVID-19 Vaccine Hesitancy in Three Latin American Countries: Reasons Given for Not Becoming Vaccinated in Colombia, Ecuador, and Venezuela

Although vaccines have been developed to prevent COVID-19, vaccine hesitancy is a significant barrier for vaccination programs. Most research on COVID-19 vaccine hesitancy has blamed misinformation and misstated concerns about effectiveness, safety, and side effects of these vaccines. The preponderance of these studies has been performed in the Global North. Although Latin American has been substantially and negatively impacted by COVID-19, few studies have examined COVID-19 vaccine hesitancy there. We explored reasons volunteered for COVID-19 vaccine hesitancy from a sample of 1,173 Colombians, Ecuadorians, and Venezuelans. Overall, COVID-19 vaccine hesitancy in these three countries is higher than desirable, but most people who are COVID-19 vaccine hesitant offered one reason or fewer. The reasons offered are diverse, including myths and exaggerations, but also individual-level contraindications for vaccination and structural barriers. Because of the diversity of reasons, single-issue mass campaigns are unlikely to bring about large shifts in COVID-19 vaccine hesitancy in Colombia, Ecuador, and Venezuela. Our data suggest that interpersonal communication, particularly in Ecuador, and addressing structural concerns, particularly in Venezuela, are likely to have the greatest impact on vaccine uptake.

A social ecological approach to identify the barriers and facilitators to COVID-19 vaccination acceptance: A scoping review

BACKGROUND

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that has caused substantial impact on population health, healthcare, and social and economic systems around the world. Several vaccines have been developed to control the pandemic with varying effectiveness and safety profiles. One of the biggest obstacles to implementing successful vaccination programmes is vaccine hesitancy stemming from concerns about effectiveness and safety. This review aims to identify the factors influencing COVID-19 vaccine hesitancy and acceptance and to organize the factors using the social ecological framework.

METHODS

We adopted the five-stage methodological framework developed by Arksey and O'Malley to guide this scoping review. Selection criteria was based on the PICo (Population, Phenomenon of interest and Context) framework. Factors associated with acceptance and hesitancy were grouped into the following: intrapersonal, interpersonal, institutional, community, and public policy factors using the social ecological framework.

RESULTS

Fifty-one studies fulfilled this review's inclusion criteria. Most studies were conducted in Europe and North America, followed by Asia and the Middle East. COVID-19 vaccine acceptance and hesitancy rates varied across countries. Some common demographic factors associated with hesitancy were younger age, being female, having lower than college education, and having a lower income level. Most of the barriers and facilitators to acceptance of the COVID-19 vaccines were intrapersonal factors, such as personal characteristics and preferences, concerns with COVID-19 vaccines, history/perception of general vaccination, and knowledge of COVID-19 and health. The remaining interpersonal, institution, community, and public policy factors were grouped into factors identified as barriers and facilitators.

CONCLUSION

Our review identified barriers and facilitators of vaccine acceptance and hesitancy and organised them using the social ecological framework. While some barriers and facilitators such as vaccine safety are universal, differentiated barriers might exist for different target groups, which need to be understood if they are to be addressed to maximize vaccine acceptance.

Spatial and sentiment analysis of public opinion toward COVID-19 pandemic using twitter data: At the early stage of vaccination

During the crisis of Coronavirus pandemic, social media, like Twitter, have been the platforms on which people have been able to share their opinions and obtain information. The present study provides a detailed spatial-temporal analysis of the Twitter online discourse (approximately 280 thousand tweets) in Ohio and Michigan at the early stage of vaccination rollout (January 2021, till March 2021). This work aims to explore how people were feeling about the pandemic, the most frequent topics people were talking about, and how the topics spatially were distributed. Moreover, state government responses and important news were gathered to analyze their impacts on public opinion based on the temporal analysis of the tweets. In this project, Natural Language Processing using the LDA method was employed to identify 11 topics and 8 sub-topics in the Twitter data. The temporal analysis of topics shows the sensitivity of the online discourse to the significant state news and the local government's reactions to the pandemic. Moreover, the spatial distribution of Coronavirus-related tweets and sentiments demonstrates concentrations in the more populated urban areas with a high rate of COVID-19 cases in Ohio and Michigan. The government's economic and financial policies taken during this time, the vaccination timeline phases specified by each state, and the pandemic-related information can contribute to public opinion and sentiment trends. The findings of this study can help explore public demands, and reactions, follow the impacts of the local authorities' policies at the county level and manage their future responses to such a pandemic.

The acceptance of COVID-19 vaccine at early stage of development and approval: A global systematic review and meta-analysis

Background

Vaccination seems to be the most effective way to prevent and control the spread of COVID-19, a disease that has adversely impacted the lives of over 7 billion people across the globe. Vaccine hesitancy represents an important threat to combat infectious diseases worldwide. This study aims to inspect the COVID-19 vaccine acceptance rate worldwide and the regional variation of the acceptance rates among the general population and healthcare workers across different territories of the world. In addition, it compares the vaccine acceptance rates between the pre- and post-vaccine approval periods.

Method

A comprehensive systematic review was conducted using PRISMA statements. After quality evaluation, the data from eligible studies were analyzed using the random effect model. Q-test andI 2 statistics were used to search for heterogeneity. The publication bias was assessed by using Egger's test and funnel plot.

Results

The combined COVID-19 vaccine acceptance rate among the general population and healthcare workers (n = 1,581,562) was estimated at 62.79% (95% CI: 58.98-66.60). The acceptance rate substantially decreased from 66.29% (95% CI: 61.24-71.35) to 56.69% (95% CI: 48.68-64.71) among the general population from the pre-to post-vaccine approval periods but remained almost constant at 58.25% (95% CI: 46.52-69.97) among healthcare workers. The acceptance rates also varied in different regions of the world. The highest acceptance rate was found in the South-East Asia region at 70.18% (95% CI: 58.12-82.25) and the lowest was found in African Region at 39.51% (95% CI: 23.42-55.59).

Conclusion

Low COVID-19 vaccine acceptance rate might be a massive barrier to controlling the pandemic. More research is needed to address the responsible factors influencing the low global rate of COVID-19 vaccine acceptance. Integrated global efforts are required to remove the barriers.

Acceptance Rates of COVID-19 Vaccine Highlight the Need for Targeted Public Health Interventions

We aimed to examine rates of COVID-19 vaccination to elucidate the need for targeted public health interventions. We retrospectively reviewed the electronic medical files of all adults registered in a central district in Israel from 1 January 2021 to 31 March 2022. The population was characterized by vaccination status against COVID-19 and the number of doses received. Univariate and multivariable analyses were used to identify predictors of low vaccination rates that required targeted interventions. Of the 246,543 subjects included in the study, 207,911 (84.3%) were vaccinated. The minority groups of ultra-Orthodox Jews and Arabs had lower vaccination rates than the non-ultra-Orthodox Jews (68.7%, 80.5% and 87.7%, respectively, p < 0.001). Adults of low socioeconomic status (SES) had lower vaccination rates compared to those of high SES (74.4% vs. 90.8%, p < 0.001). Adults aged 20−59 years had a lower vaccination rate than those ≥60 years (80.0% vs. 92.1%, p < 0.0001). Multivariate analysis identified five independent variables that were significantly (p < 0.001) associated with low vaccination rates: minority groups of the ultra-Orthodox sector and Arab population, and underlying conditions of asthma, smoking and diabetes mellitus (odds ratios: 0.484, 0.453, 0.843, 0.901 and 0.929, respectively). Specific targeted public health interventions towards these subpopulations with significantly lower rates of vaccination are suggested.

The Role of COVID-19 Vaccine Perception, Hope, and Fear on the Travel Bubble Program

The travel bubble program presented an appealing strategy for reopening international travel safely. However, a full vaccination regime is the foremost prerequisite of the program. Therefore, vaccination and the travel bubble are inextricably linked. This study investigated the roles of perceived vaccine efficacy, attitude towards the COVID-19 vaccine, and attitude toward the travel bubble on travel bubble intention. More importantly, the study also examined the mediating role of hope and fear among unvaccinated Korean adults between 20 and 29 years old. A total of 535 samples were collected to test the proposed conceptual model using structural equation modeling. In general, the results supported the proposed hypotheses. Notably, the intention to travel to a bubble destination was explained by 57% of the variance. Furthermore, hope mediated the relationship between vaccine attitude and travel bubble intention. Whereas fear mediated the relationship between perceived vaccine efficacy and intention. Hence, the findings suggest doubts around the vaccine efficacy and that a positive attitude towards the vaccine also install hope among the research samples.

New Wave of COVID-19 Vaccine Opinions in the Month the 3rd Booster Dose Arrived

Vaccination has been proposed as one of the most effective methods to combat the COVID-19 pandemic. Since the day the first vaccine, with an efficiency of more than 90%, was announced, the entire vaccination process and its possible consequences in large populations have generated a series of discussions on social media. Whereas the opinions triggered by the administration of the initial COVID-19 vaccine doses have been discussed in depth in the scientific literature, the approval of the so-called 3rd booster dose has only been analyzed in country-specific studies, primarily using questionnaires. In this context, the present paper conducts a stance analysis using a transformer-based deep learning model on a dataset containing 3,841,594 tweets in English collected between 12 July 2021 and 11 August 2021 (the month in which the 3rd dose arrived) and compares the opinions (in favor, neutral and against) with the ones extracted at the beginning of the vaccination process. In terms of COVID-19 vaccination hesitance, an analysis based on hashtags, n-grams and latent Dirichlet allocation is performed that highlights the main reasons behind the reluctance to vaccinate. The proposed approach can be useful in the context of the campaigns related to COVID-19 vaccination as it provides insights related to the public opinion and can be useful in creating communication messages to support the vaccination campaign.

Could Social Bots’ Sentiment Engagement Shape Humans’ Sentiment on COVID-19 Vaccine Discussion on Twitter?

During the COVID-19 pandemic, social media has become an emerging platform for the public to find information, share opinions, and seek coping strategies. Vaccination, one of the most effective public health interventions to control the COVID-19 pandemic, has become the focus of public online discussions. Several studies have demonstrated that social bots actively involved in topic discussions on social media and expressed their sentiments and emotions, which affected human users. However, it is unclear whether social bots’ sentiments affect human users’ sentiments of COVID-19 vaccines. This study seeks to scrutinize whether the sentiments of social bots affect human users’ sentiments of COVID-19 vaccines. The work identified social bots and built an innovative computational framework, i.e., the BERT-CNN sentiment analysis framework, to classify tweet sentiments at the three most discussed stages of COVID-19 vaccines on Twitter from December 2020 to August 2021, thus exploring the impacts of social bots on online vaccine sentiments of humans. Then, the Granger causality test was used to analyze whether there was a time-series causality between the sentiments of social bots and humans. The findings revealed that social bots can influence human sentiments about COVID-19 vaccines. Their ability to transmit the sentiments on social media, whether in the spread of positive or negative tweets, will have a corresponding impact on human sentiments.

Prevalence and Drivers of COVID-19 Vaccine Booster Hesitancy Among German University Students and Employees

COVID-19 booster hesitancy (VBH) is a serious public health challenge which acts simultaneously with the waning vaccine-elicited immunity and the emerging viral variants to prolong the pandemic interval. Therefore, this study aimed to evaluate the prevalence of COVID-19 VBH among a highly educated subset of the German population and to explore the potential demographic, anamnestic, and psychosocial determinants of this problem. A cross-sectional survey-based study was conducted in December 2021 among German university students and employees to evaluate their attitudes toward COVID-19 vaccine booster (VB) doses. The study used a self-administered questionnaire that was developed and disseminated digitally, and the questionnaire inquired about participants' demographic characteristics, COVID-19-related anamnesis, COVID-19 vaccine-related anamnesis, and psychosocial predictors of COVID-19 VBH. A total of 930 participants were recruited, of which 608 (65.4%) were students, 682 (73.3%) were females, and their mean age was 29.08 ± 10.93 years. Fifty-five participants (5.9%) had been previously infected by COVID-19 and the vast majority of infections happened before the first vaccine dose. Over 95% of the participants had received at least one vaccine dose, and the most commonly administered vaccine was BNT162b2. The overall COVID-19 VB acceptance was satisfactory (87.8%) and induced by various altruistic promoters, e.g., family health protection, community health protection, and patients' health protection. The students (86.3%), the previously infected participants (76.4%), the participants who did not receive primer doses of COVID-19 vaccines (2.5 %), and those who were hospitalized (40%) and sought medical care/treatment after receiving primer doses (86.8%) were less likely to accept COVID-19 VB compared to the employees (90.7%), the participants who were not previously infected (88.6%) and those who received primer dose (91.7%), and the participants who were not hospitalized (92%) nor sought medical care/treatment after primer doses (92.9%), respectively. The perceived effectiveness of COVID-19 VB against severe illness (adjusted odds ratio "AOR": 47.65-95% confidence interval "CI": 23.65-96.49), symptomatic infection (AOR: 9.87-95% CI: 5.20-18.71), community transmission (AOR: 5.34-95% CI: 3.00-9.49) and emerging variants (AOR: 19.12-95% CI: 10.57-34.55) were key predictors for COVID-19 VB acceptance; therefore, it needs to be highlighted in vaccine messaging. In addition, the perceived safety of COVID-19 VB and ethical dilemmas of vaccine justice need to be addressed publicly.

Multilevel determinants of COVID-19 vaccination hesitancy in the United States: A rapid systematic review

Vaccine hesitancy is a challenge for the success and optimal implementation of COVID-19 immunization programs in the US. The objective of this study was to summarize multilevel determinants of COVID-19 vaccination intention in the US to inform future intervention opportunities. To this end, we conducted a rapid systematic review by searching published articles via PubMed published by October 5, 2021, following the PRISMA guidelines. One hundred and six articles were included. According to nationally representative studies, the overall COVID-19 acceptance rate ranges from 53.6% to 84.4%. Individual (demographics, health history, behaviors and health beliefs), interpersonal (having a close friend/family member impacted by COVID-19), healthcare and societal level factors (healthcare provider recommendations, source/credential of COVID-19 related information, and COVID-19 related conspiracy theories) all contributed to COVID-19 vaccine hesitancy in the US. This study demonstrates that the acceptance to COVID-19 vaccines is influenced by various factors, particularly the role of healthcare providers in enhancing public intent to vaccination. Potential interventions to mitigate people's concerns over the vaccines and address vaccine-related conspiracy/misinformation from social media are also critical to encourage vaccine uptake in the US.

Social Bots' Involvement in the COVID-19 Vaccine Discussions on Twitter

During the COVID-19 pandemic, social media served as an important channel for the public to obtain health information and disseminate opinions when offline communication was severely hindered. Yet the emergence of social bots influencing social media conversations about public health threats will require researchers and practitioners to develop new communication strategies considering their influence. So far, little is known as to what extent social bots have been involved in COVID-19 vaccine-related discussions and debates on social media. This work selected a period of nearly 9 months after the approval of the first COVID-19 vaccines to detect social bots and performed high-frequency word analysis for both social bot-generated and human-generated tweets, thus working out the extent to which social bots participated in the discussion on the COVID-19 vaccine on Twitter and their participation features. Then, a textual analysis was performed on the content of tweets. The findings revealed that 8.87% of the users were social bots, with 11% of tweets in the corpus. Besides, social bots remained active over three periods. High-frequency words in the discussions of social bots and human users on vaccine topics were similar within the three peaks of discourse.

COVID-19 Vaccine Acceptance of Pregnant and Lactating Women (PLW) in Czechia: An Analytical Cross-Sectional Study

Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation could have led to increased COVID-19 vaccine hesitancy levels among PLW; therefore, this study aimed to evaluate the attitudes of Czech PLW towards COVID-19 vaccines and the determinants of their attitudes. An analytical cross-sectional survey-based study was carried out in the University Hospital Brno (South Moravia, Czechia) between August and October 2021. The study utilised a self-administered questionnaire (SAQ) adapted from previous instruments used for the same purpose. The SAQ included closed-ended items covering demographic characteristics, clinical and obstetric characteristics, attitudes towards COVID-19 vaccination, and potential psychosocial predictors of vaccine acceptance. Out of the 362 included participants, 278 were pregnant (PW) and 84 were lactating women (LW). The overall COVID-19 vaccine acceptance (immediate and delayed) level was substantially high (70.2%), with a significant difference between PW (76.6%) and LW (48.8%). Out of the 70.2% who agreed to receive the vaccine, 3.6% indicated immediate acceptance, and 66.6% indicated delayed acceptance. Only 13.3% of the participants indicated their acceptance of their physician's vaccination recommendation during pregnancy or while lactating, and 62.2% were against it. Our results agreed with the recent studies that revealed that PW tended to have a high level of COVID-19 vaccine acceptance, and they were also inclined to resist professional recommendations because they predominantly preferred to delay their vaccination. The pregnancy trimester, education level, employment status, and previous live births were significant determinants for COVID-19 vaccine acceptance. The most commonly preferred vaccine type was mRNA-based vaccines, followed by viral vector-based and inactivated virus vaccines. The first top priority of PLW was vaccine safety for their children, followed by vaccine safety for the PLW and vaccine effectiveness. Regarding psychosocial predictors, media/social media, trust in the government, the pharmaceutical industry, and healthcare professionals, partners, and a positive risk-benefit ratio were significant promoters for COVID-19 vaccine acceptance. Findings from this study suggest that promotional interventions targeting PLW should use web platforms and focus on vaccine safety evidence, the expected benefits of vaccines and potential harms of the infection.

Reasons for Utilizing Telemedicine during and after the COVID-19 Pandemic: An Internet-Based International Study

The COVID-19 pandemic challenges healthcare services. Concomitantly, this pandemic had a stimulating effect on technological expansions related to telehealth and telemedicine. We sought to elucidate the principal patients' reasons for using telemedicine during the COVID-19 pandemic and the propensity to use it thereafter. Our primary objective was to identify the reasons of the survey participants' disparate attitudes toward the use of telemedicine. We performed an online, multilingual 30-question survey for 14 days during March-April 2021, focusing on the perception and usage of telemedicine and their intent to use it after the pandemic. We analyzed the data to identify the attributes influencing the intent to use telemedicine and built decision trees to highlight the most important related variables. We examined 473 answers: 272 from Israel, 87 from Uruguay, and 114 worldwide. Most participants were women (64.6%), married (63.8%) with 1-2 children (52.9%), and living in urban areas (84.6%). Only a third of the participants intended to continue using telemedicine after the COVID-19 pandemic. Our main findings are that an expected substitution effect, technical proficiency, reduced queueing times, and peer experience are the four major factors in the overall adoption of telemedicine. Specifically, (1) for most participants, the major factor influencing their telemedicine usage is the implicit expectation that such a visit will be a full substitute for an in-person appointment; (2) another factor affecting telemedicine usage by patients is their overall technical proficiency and comfort level in the use of common web-based tools, such as social media, while seeking relevant medical information; (3) time saving as telemedicine can allow for asynchronous communications, thereby reducing physical travel and queuing times at the clinic; and finally (4) some participants have also indicated that telemedicine seems more attractive to them after watching family and friends (peer experience) use it successfully.

Data-Driven Decision Making and Proactive Citizen-Scientist Communication: A Cross-Sectional Study on COVID-19 Vaccination Adherence

Due to the severe impact of COVID-19 on public health, rollout of the vaccines must be large-scale. Current solutions are not intended to promote an active collaboration between communities and public health researchers. We aimed to develop a digital platform for communication between scientists and the general population, and to use it for an exploratory study on factors associated with vaccination readiness. The digital platform was developed in Latvia and was equipped with dynamic consent management. During a period of six weeks 467 participants were enrolled in the population-based cross-sectional exploratory study using this platform. We assessed demographics, COVID-19-related behavioral and personal factors, and reasons for vaccination. Logistic regression models adjusted for the level of education, anxiety, factors affecting the motivation to vaccinate, and risk of infection/severe disease were built to investigate their association with vaccination readiness. In the fully adjusted multiple logistic regression model, factors associated with vaccination readiness were anxiety (odds ratio, OR = 3.09 [95% confidence interval 1.88; 5.09]), feelings of social responsibility (OR = 1.61 [1.16; 2.22]), and trust in pharmaceutical companies (OR = 1.53 [1.03; 2.27]). The assessment of a large number of participants in a six-week period show the potential of a digital platform to create a data-driven dialogue on vaccination readiness.

Intention to get COVID-19 vaccines: Exploring the role of attitudes, subjective norms, perceived behavioral control, belief in COVID-19 misinformation, and vaccine confidence in Northern India

This study examines people's intention to get COVID-19 vaccines and some of the psychological factors, that can facilitate the vaccination process. Using the theory of planned behavior (TPB) as a theoretical framework, we hypothesized that the key constructs of TPB (attitudes, subjective norms and perceived behavioral control) would explain people's intention to get COVID-19 vaccines. Belief in COVID-19-related misinformation and vaccine confidence were added to the TPB framework in order to comprehensively assess the predictors of COVID-19 vaccine intentions. Data was collected from 400 Indian respondents electronically during Feb-March, 2021. Hierarchical regression analysis was used to analyze the data. The Three components of TPB collectively explained 41% of the variance in the intention to get COVID-19 vaccines. Belief in COVID-19-related misinformation and vaccine confidence, on the other hand, had no significant impact on the intention to get COVID-19 vaccines. We discuss the theoretical and practical implications of these results.

Change in Threads on Twitter Regarding Influenza, Vaccines, and Vaccination During the COVID-19 Pandemic: Artificial Intelligence-Based Infodemiology Study

Background

Discussions of health issues on social media are a crucial information source reflecting real-world responses regarding events and opinions. They are often important in public health care, since these are influencing pathways that affect vaccination decision-making by hesitant individuals. Artificial intelligence methodologies based on internet search engine queries have been suggested to detect disease outbreaks and population behavior. Among social media, Twitter is a common platform of choice to search and share opinions and (mis)information about health care issues, including vaccination and vaccines.

Objective

Our primary objective was to support the design and implementation of future eHealth strategies and interventions on social media to increase the quality of targeted communication campaigns and therefore increase influenza vaccination rates. Our goal was to define an artificial intelligence–based approach to elucidate how threads in Twitter on influenza vaccination changed during the COVID-19 pandemic. Such findings may support adapted vaccination campaigns and could be generalized to other health-related mass communications.

Methods

The study comprised the following 5 stages: (1) collecting tweets from Twitter related to influenza, vaccines, and vaccination in the United States; (2) data cleansing and storage using machine learning techniques; (3) identifying terms, hashtags, and topics related to influenza, vaccines, and vaccination; (4) building a dynamic folksonomy of the previously defined vocabulary (terms and topics) to support the understanding of its trends; and (5) labeling and evaluating the folksonomy.

Results

We collected and analyzed 2,782,720 tweets of 420,617 unique users between December 30, 2019, and April 30, 2021. These tweets were in English, were from the United States, and included at least one of the following terms: “flu,” “influenza,” “vaccination,” “vaccine,” and “vaxx.” We noticed that the prevalence of the terms vaccine and vaccination increased over 2020, and that “flu” and “covid” occurrences were inversely correlated as “flu” disappeared over time from the tweets. By combining word embedding and clustering, we then identified a folksonomy built around the following 3 topics dominating the content of the collected tweets: “health and medicine (biological and clinical aspects),” “protection and responsibility,” and “politics.” By analyzing terms frequently appearing together, we noticed that the tweets were related mainly to COVID-19 pandemic events.

Conclusions

This study focused initially on vaccination against influenza and moved to vaccination against COVID-19. Infoveillance supported by machine learning on Twitter and other social media about topics related to vaccines and vaccination against communicable diseases and their trends can lead to the design of personalized messages encouraging targeted subpopulations’ engagement in vaccination. A greater likelihood that a targeted population receives a personalized message is associated with higher response, engagement, and proactiveness of the target population for the vaccination process.

Universal Predictors of Dental Students' Attitudes towards COVID-19 Vaccination: Machine Learning-Based Approach

BACKGROUND

young adults represent a critical target for mass-vaccination strategies of COVID-19 that aim to achieve herd immunity. Healthcare students, including dental students, are perceived as the upper echelon of health literacy; therefore, their health-related beliefs, attitudes and behaviors influence their peers and communities. The main aim of this study was to synthesize a data-driven model for the predictors of COVID-19 vaccine willingness among dental students.

METHODS

a secondary analysis of data extracted from a recently conducted multi-center and multi-national cross-sectional study of dental students' attitudes towards COVID-19 vaccination in 22 countries was carried out utilizing decision tree and regression analyses. Based on previous literature, a proposed conceptual model was developed and tested through a machine learning approach to elicit factors related to dental students' willingness to get the COVID-19 vaccine.

RESULTS

machine learning analysis suggested five important predictors of COVID-19 vaccination willingness among dental students globally, i.e., the economic level of the country where the student lives and studies, the individual's trust of the pharmaceutical industry, the individual's misconception of natural immunity, the individual's belief of vaccines risk-benefit-ratio, and the individual's attitudes toward novel vaccines.

CONCLUSIONS

according to the socio-ecological theory, the country's economic level was the only contextual predictor, while the rest were individual predictors. Future research is recommended to be designed in a longitudinal fashion to facilitate evaluating the proposed model. The interventions of controlling vaccine hesitancy among the youth population may benefit from improving their views of the risk-benefit ratio of COVID-19 vaccines. Moreover, healthcare students, including dental students, will likely benefit from increasing their awareness of immunization and infectious diseases through curricular amendments.

COVID-19 Vaccine Hesitancy in the Month Following the Start of the Vaccination Process

The occurrence of the novel coronavirus has changed a series of aspects related to people's everyday life, the negative effects being felt all around the world. In this context, the production of a vaccine in a short period of time has been of great importance. On the other hand, obtaining a vaccine in such a short time has increased vaccine hesitancy and has activated anti-vaccination speeches. In this context, the aim of the paper is to analyze the dynamics of public opinion on Twitter in the first month after the start of the vaccination process in the UK, with a focus on COVID-19 vaccine hesitancy messages. For this purpose, a dataset containing 5,030,866 tweets in English was collected from Twitter between 8 December 2020-7 January 2021. A stance analysis was conducted after comparing several classical machine learning and deep learning algorithms. The tweets associated to COVID-19 vaccination hesitancy were examined in connection with the major events in the analyzed period, while the main discussion topics were determined using hashtags, n-grams and latent Dirichlet allocation. The results of the study can help the interested parties better address the COVID-19 vaccine hesitancy concerns.

Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review

BACKGROUND

High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide.

METHODS

A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication.

FINDINGS

Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies.Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world.

INTERPRETATION

A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

COVID-19 Vaccine-Related Discussion on Twitter: Topic Modeling and Sentiment Analysis

BACKGROUND

Vaccination is a cornerstone of the prevention of communicable infectious diseases; however, vaccines have traditionally met with public fear and hesitancy, and COVID-19 vaccines are no exception. Social media use has been demonstrated to play a role in the low acceptance of vaccines.

OBJECTIVE

The aim of this study is to identify the topics and sentiments in the public COVID-19 vaccine-related discussion on social media and discern the salient changes in topics and sentiments over time to better understand the public perceptions, concerns, and emotions that may influence the achievement of herd immunity goals.

METHODS

Tweets were downloaded from a large-scale COVID-19 Twitter chatter data set from March 11, 2020, the day the World Health Organization declared COVID-19 a pandemic, to January 31, 2021. We used R software to clean the tweets and retain tweets that contained the keywords vaccination, vaccinations, vaccine, vaccines, immunization, vaccinate, and vaccinated. The final data set included in the analysis consisted of 1,499,421 unique tweets from 583,499 different users. We used R to perform latent Dirichlet allocation for topic modeling as well as sentiment and emotion analysis using the National Research Council of Canada Emotion Lexicon.

RESULTS

Topic modeling of tweets related to COVID-19 vaccines yielded 16 topics, which were grouped into 5 overarching themes. Opinions about vaccination (227,840/1,499,421 tweets, 15.2%) was the most tweeted topic and remained a highly discussed topic during the majority of the period of our examination. Vaccine progress around the world became the most discussed topic around August 11, 2020, when Russia approved the world's first COVID-19 vaccine. With the advancement of vaccine administration, the topic of instruction on getting vaccines gradually became more salient and became the most discussed topic after the first week of January 2021. Weekly mean sentiment scores showed that despite fluctuations, the sentiment was increasingly positive in general. Emotion analysis further showed that trust was the most predominant emotion, followed by anticipation, fear, sadness, etc. The trust emotion reached its peak on November 9, 2020, when Pfizer announced that its vaccine is 90% effective.

CONCLUSIONS

Public COVID-19 vaccine-related discussion on Twitter was largely driven by major events about COVID-19 vaccines and mirrored the active news topics in mainstream media. The discussion also demonstrated a global perspective. The increasingly positive sentiment around COVID-19 vaccines and the dominant emotion of trust shown in the social media discussion may imply higher acceptance of COVID-19 vaccines compared with previous vaccines.

The Impact of Social Media on the Acceptance of the COVID-19 Vaccine: A Cross-Sectional Study from Saudi Arabia

INTRODUCTION

Social media platforms are used by many people to seek and share health-related information that may influence their decision-making about COVID-19 vaccination.

PURPOSE

The objective of this study is to understand the influence of social media on the attitudes and willingness of the general public of the Aseer region of Saudi Arabia to receive COVID-19 vaccination.

MATERIALS AND METHODS

A cross-sectional self-administrated online survey was conducted in Saudi Arabia Aseer region, where 613 persons willingly took part in the survey in April and May 2021. Residents of Aseer in Saudi Arabia, who are over the age of 18 (eligible for COVID-19 vaccination) and willing to participate in the survey, were included in the study.

RESULTS

Overall, 74.6% agreed that the COVID-19 vaccine was misrepresented via social media. However, 37% of those respondents strongly agreed that social media had increased their willingness to get the COVID-19 vaccine. In addition, employees reported (21.8%) or strongly agreed (28%) that the quantity and quality of information on social media has a detrimental impact on their psychological well-being. Additionally, participants also agreed (21.8%) or strongly agreed (28%) that social media had a negative effect on their psychological condition.

CONCLUSION

The study provides that there was a high degree of awareness indicated among Aseer population regarding misleading information about COVID-19 vaccination via social media. Thus, social media that can share up-to-date scientific information about vaccination must be utilized optimally by the government to assist people in making decisions about accepting vaccinations.