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

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.

The Impact of Social Media on Vaccination: A Narrative Review

Vaccine hesitancy poses a significant global health challenge, fueled by misinformation and anti-vaccination campaigns on social media platforms (SMPs). This study examines the influence of social media on coronavirus disease 2019 (COVID-19) and non-COVID-19 vaccination in Asia during the peri-pandemic period. Through a comprehensive analysis of available literature, we aim to elucidate the role of SMPs in shaping vaccination attitudes and behaviors. The findings highlight the detrimental impact of social media on vaccination efforts and provide insights into addressing vaccine hesitancy during this critical period. A narrative review was conducted by searching the PubMed, Scopus, and Google Scholar databases from inception to May 26, 2022. Only English-language articles involving human participants from Asian countries were included in this review. Out of the 228 articles identified through the database search, 14 articles were included in the final analysis. The prevalence of COVID-19 vaccine hesitancy or negative attitudes towards COVID-19 vaccines in Asian countries was found to be high, ranging from 20% to 55% across countries. Notably, reliance on SMPs for vaccine-related information was associated with a higher likelihood of COVID-19 vaccine hesitancy. This trend coincided with the proliferation of misinformation and conspiracy theories that portrayed COVID-19 vaccines as harmful during the pandemic. Similar patterns were observed for other types of vaccines, including polio, measles mumps and rubella, and diphtheria-tetanus-pertussis vaccines. The use of SMPs was also found to be associated with increased fear among caregivers in Asian countries, as well as a 3-4 times higher likelihood of delayed immunization. SMPs negatively impact vaccine intent in Asia due to misinformation and anti-vaccination campaigns during the pandemic. However, they can be a powerful tool for healthcare providers and policymakers to promote informed decision-making. Efforts should focus on leveraging SMPs to disseminate reliable information and combat hesitancy, fostering a well-informed and vaccinated population in Asia.

Sociotechnical Challenges of Digital Health in Nursing Practice During the COVID-19 Pandemic: National Study

BACKGROUND

The COVID-19 pandemic has accelerated the use of digital health innovations, which has greatly impacted nursing practice. However, little is known about the use of digital health services by nurses and how this has changed during the pandemic.

OBJECTIVE

This study explored the sociotechnical challenges that nurses encountered in using digital health services implemented during the pandemic and, accordingly, what digital health capabilities they expect from the emerging workforce.

METHODS

Five groups of nurses, including chief nursing information officers, nurses, clinical educators, nurse representatives at digital health vendor companies, and nurse representatives in government bodies across Australia were interviewed. They were asked about their experience of digital health during the pandemic, their sociotechnical challenges, and their expectations of the digital health capabilities of emerging nurses to overcome these challenges. Interviews were deductively analyzed based on 8 sociotechnical themes, including technical challenges, nurse-technology interaction, clinical content management, training and human resources, communication and workflow, internal policies and guidelines, external factors, and effectiveness assessment of digital health for postpandemic use.

RESULTS

Sixteen participants were interviewed. Human factors and clinical workflow challenges were highly mentioned. Nurses' lack of knowledge and involvement in digital health implementation and evaluation led to inefficient use of these technologies during the pandemic. They expected the emerging workforce to be digitally literate and actively engaged in digital health interventions beyond documentation, such as data analytics and decision-making.

CONCLUSIONS

Nurses should be involved in digital health interventions to efficiently use these technologies and provide safe and quality care. Collaborative efforts among policy makers, vendors, and clinical and academic industries can leverage digital health capabilities in the nursing workforce.

Understanding factors influencing healthcare workers' intention towards the COVID-19 vaccine

Globally, healthcare workers (HCWs) are at high risk of acquiring Coronavirus infection. In addition, they are role models for the general public concerning attitudes towards the COVID-19 vaccine. In addition, they play a critical role in successfully promoting practices aiming to reduce the transmission of COVID-19 infection. Therefore, this study broadly based on the theory of planned behavior (TPB) explores the factors influencing HCWs' intention to be vaccinated. An online survey was administered using Google Form to collect data from HCWs working in the public health sector of Pakistan. The sample included 813 participants, two-thirds were female, and one-third were male. In addition, 41.5% of them were aged between 26-35 years, 32.6% had master's level education, 25% were nurses, and 57.7% of them were living in urban areas. Data analysis was run using Partial Least Squares Structural Equation Modeling (PLS-SEM). The research findings reveal the positive and significant effect of the TPB factors (attitude, subjective norms, and perceived behavioral control) and the extended factor of vaccine confidence on HCWs' intention to be vaccinated. This study's model explains 66.4% of variations in HCWs' intention to be vaccinated.

Indicators of Mental Health Disorder, COVID-19 Prevention Compliance and Vaccination Intentions among Refugees in Kenya

Background and Objectives: COVID-19 remains a major development challenge in many developing countries. This study analysed the effect of mental health disorder and indicators of COVID-19 preventive practices on vaccination intentions among refugees in Kenya. Materials and Methods: The data were the fourth and fifth waves of the High Frequency Phone Surveys on the impacts of COVID-19 that were collected by the Kenyan National Bureau of Statistics (KNBS) between May 2020 and June 2021. The data were collected from Kakuma, Kalobeyei, Dadaab and Shona camps using the stratified random sampling method. The data were analysed with random effects instrumental variable Probit regression model. Results: The results showed that 69.32% and 93.16% of the refugees were willing to be vaccinated during the 4th and 5th waves, respectively. The fear of dying was reported by 85.89% and 74.19% during the 4th and 5th waves, respectively. COVID-19 contact prevention and immune boosting indicators were differently influenced by some demographic and anxiety index variables, while being endogenous influenced vaccine hesitancy along with urban residence, age, knowing infected persons, days of depression, days of anxiety, days of physical reactions, members losing job, searching for jobs, accepting job offers and being employed. Conclusions: It was concluded that efforts to promote COVID-19 vaccination should address mental health disorder and compliance with existing COVID-19 contact and immune boosting behaviour with a focus on urban residents and youths.

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.

Confidence in a Vaccine against COVID-19 among Registered Nurses in Barcelona, Spain across Two Time Periods

OBJECTIVE

To report the vaccine hesitancy (VH) for a vaccine against COVID-19 in registered nurses in Barcelona, with measurements taken at two stages, prior to the vaccination campaign and once 75% vaccination coverage had been reached.

METHODS

A self-completed online survey was administered in December 2020 and again in July 2021 through the College of Nurses of Barcelona. It measured the prevalence of VH against a government-approved vaccine recommended by their employer, their intention to be vaccinated, perceptions of disease risk and vaccine protection, attitudes and beliefs to vaccination and social norm. Bivariate analysis according to VH and application time are presented.

RESULTS

2430 valid responses were obtained in the first measurement and 2027 in the second. At both times, 86% were women and 69% worked mainly in the public sector. Prior to the vaccine availability, VH was 34.2%, decreasing to 17.9%. Risk perceptions were significantly lower in those with VH compared to non-VH, in all groups studied and at both times, while safety and efficacy perceptions increased in all groups, significantly less in VH. The greatest benefit of the COVID-19 vaccine is perceived by pharmaceutical companies. VH nurses perceived a more hesitant social environment.

CONCLUSION

As the vaccination was rolled out, VH in nurses declined, with time improving the confidence in the safety and efficacy of the vaccines. Risk perceptions also decreased over time, except for the perception of severity in HCW where it increased. Trust in institutions impacts trust in vaccines.

Acceptance and Factors Influencing Acceptance of COVID-19 Vaccine in a Romanian Population

COVID-19 vaccination has been recognized as one of the most effective ways to overcome the current SARS-CoV-2 pandemic. However, the success of this effort relies on national vaccination programmes. In May 2021, we surveyed 1552 people from Romania to determine acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 39.2% of participants reported that they were vaccinated and 25.6% desired vaccination; nonetheless, 29.5% expressed opposition to vaccination. Concerning vaccination refusal, the top justification given by respondents is that the vaccine is insufficiently safe and there is a risk of serious side effects (84.4%). A higher rate of vaccination refusal was observed among female gender, younger age, and lower educational level. Refusal was also associated with unemployment, being in a relationship, and having a decrease in income during the pandemic. People who are constantly informed by specialized medical staff have a statistically significant higher vaccination rate, while people who choose to get information from friends, family, and co-workers have the strongest intention of avoiding the vaccine. Current levels of vaccine are insufficient to achieve herd immunity of 67%. It is mandatory to understand the aspects that define and establish confidence and to craft nationwide interventions appropriately.

Physicians' Experience with COVID-19 Vaccination: A Survey Study

BACKGROUND

COVID-19 vaccine hesitancy remains high in the general population and is the main determinant of low vaccination rates and of the fourth pandemic wave severity in Romania. Additional information is needed to raise awareness over vaccine efficiency and the safety profile.

OBJECTIVE

To assess self-reported experience related to COVID-19 vaccination in Romanian physicians.

DESIGN, SETTING, AND PARTICIPANTS

A cross-sectional, self-administered questionnaire-based survey, distributed online in the period 24 March to 24 May 2021. The survey included 30 cascade questions with skip logic filters. All physicians included filled in the questionnaire voluntarily and anonymously. Not all respondents filled in all questions. Main outcome and measure: Primary outcomes addressed were related to the COVID-19 vaccine safety profile.

RESULTS

407/467 (87.15%) of the respondents' physicians were fully vaccinated, mostly with the Pfizer-BioNTech (Comirnaty)-BNT162b2 vaccine, with the peak of immunization in January 2021, with almost four-fifths of the study participants. Regarding COVID-19, almost 20% physicians had the infection and one declared COVID-19 re-infection. A number of 48/420 (11.42%) and 47/419 (11.22%) of the vaccinated physicians did not report any side effects after the first or second vaccine dose. However, most of the side effects reported were minor. Only 50/360 (13.88%) physicians reported the vaccine side effects on the dedicated online national platform. Approximately 40% respondents checked the anti-spike SARS-CoV2 antibodies' titer after complete vaccination, of which two cases reported indeterminate levels. Lower anti-spike SARS-CoV2 antibodies' titer of 100-1000 times the laboratory limit was more frequent in naive physicians (36.95% versus 14.28%, p = 0.012), moderate titers were similar, while very high levels, more than 10,000 times laboratory limit, were more frequent in physicians with previous COVID-19 infection (2.17% versus 42.85%, p < 0.001).

CONCLUSIONS AND RELEVANCE

In this cross-sectional survey study on the COVID-19 vaccination among Romanian physicians, we describe a safety vaccination profile among Romanian physicians.

Effects of Pope Francis' Religious Authority and Media Coverage on Twitter User's Attitudes toward COVID-19 Vaccination

This paper is interdisciplinary and combines the research perspective of medical studies with that of media and social communication studies and theological studies. The main goal of this article is to determine [from arguments on all sides of the issue] whether, and to what extent, statements issued by a religious authority can be used as an argument in the COVID-19 vaccination campaign. The authors also want to find answers to the questions of how the pope's comments affect public opinion when they concern the sphere of secular and everyday life, including issues related to health care. The main method used in this study is desktop research and the analysis of the Roman Catholic Church's teaching on vaccination and on the types and significance of the pope's statements on various topics. The auxiliary methods are sentiment analysis and network analysis made in the open source software Gephi. The authors are strongly interested in the communication and media aspect of the analyzed situation. Pope Francis' voice on the COVID-19 vaccination has certainly been noticed and registered worldwide, but the effectiveness of his message and direct impact on Catholics' decisions to accept or refuse the COVID-19 vaccination is quite questionable and would require further precise research. Comparing this to the regularities known from political marketing, one would think that the pope's statement would not convince the firm opponents of vaccination.