Politicizing COVID-19 Vaccines in the Press: A Critical Discourse Analysis

Assessment of Covid-19 vaccine confidence among healthcare personnel in the safety-net sector in the United States and Puerto Rico

BACKGROUND

This study aimed to assess COVID-19 vaccine confidence among healthcare personnel in the safety net sector of the United States and Puerto Rico. This study aimed to examine the extent to which increased knowledge and positive attitudes toward COVID-19 vaccine safety and efficacy were associated with healthcare workers' COVID-19 vaccination status and their recommendation of the vaccine to all patients.

METHODS

Online survey data were collected from health care workers working in Free and Charitable Clinics across the United States and Federally Qualified Health Centers in Puerto Rico. The survey consisted of 62 questions covering various demographic measures and constructs related to healthcare workers' vaccination status, beliefs, and recommendations for COVID-19 vaccination. Statistical analyses, including multivariate analysis, were conducted to identify the factors associated with the COVID-19 vaccine status and recommendations among healthcare personnel.

RESULTS

Among the 2273 respondents, 93% reported being vaccinated against COVID-19. The analysis revealed that respondents who believed that COVID-19 vaccines were efficacious and safe were three times more likely to be vaccinated and twice as likely to recommend them to all their patients. Respondents who believed they had received adequate information about COVID-19 vaccination were 10 times more likely to be vaccinated and four times more likely to recommend it to all their patients.

CONCLUSIONS

The study results indicate that healthcare workers' confidence in COVID-19 vaccines is closely tied to their level of knowledge, positive beliefs, and attitudes about vaccine safety and efficacy. The study emphasizes the significance of healthcare workers feeling well informed and confident in their knowledge to recommend the vaccine to their patients. These findings have important implications for the development of strategies to boost COVID-19 vaccine confidence among healthcare workers and increase vaccine uptake among patients.

Public Opinion Through Art: Exploring Chinese University Students' Perspectives on COVID-19 Mass Nucleic Acid Testing

In the context of the global COVID-19 pandemic, this study focuses on Chinese university students, employing graphic elicitation as a qualitative research method to analyze their hand-drawn paintings and related descriptions. Augmented by A/r/tography and metacognitive methods, the research aims to unveil the participants' collective memory, as well as the perspectives and responses of these students to policies related to the pandemic. By specifically examining this particular demographic, the study incorporates Fairclough's ethical theory, applying deontological ethics, consequentialist ethics, and virtue ethics to establish a comprehensive framework for evaluating adjustments to pandemic response policies. This research not only enhances our understanding of how these university students perceive and adapt to COVID-19 policies but also provides valuable insights for decision-makers. The particular methodology, combining graphic elicitation and metacognitive research, contributes to policy assessment and ethical analysis, offering a nuanced perspective on the interplay between individual perceptions, policy responses, and ethical considerations amid the complexities of a public health crisis.

One size doesn't fit all: methodological reflections in conducting community-based behavioural science research to tailor COVID-19 vaccination initiatives for public health priority populations

BACKGROUND

Promoting the uptake of vaccination for infectious diseases such as COVID-19 remains a global challenge, necessitating collaborative efforts between public health units (PHUs) and communities. Applied behavioural science can play a crucial role in supporting PHUs' response by providing insights into human behaviour and informing tailored strategies to enhance vaccination uptake. Community engagement can help broaden the reach of behavioural science research by involving a more diverse range of populations and ensuring that strategies better represent the needs of specific communities. We developed and applied an approach to conducting community-based behavioural science research with ethnically and socioeconomically diverse populations to guide PHUs in tailoring their strategies to promote COVID-19 vaccination. This paper presents the community engagement methodology and the lessons learned in applying the methodology.

METHODS

The community engagement methodology was developed based on integrated knowledge translation (iKT) and community-based participatory research (CBPR) principles. The study involved collaboration with PHUs and local communities in Ontario, Canada to identify priority groups for COVID-19 vaccination, understand factors influencing vaccine uptake and co-design strategies tailored to each community to promote vaccination. Community engagement was conducted across three large urban regions with individuals from Eastern European communities, African, Black, and Caribbean communities and low socioeconomic neighbourhoods.

RESULTS

We developed and applied a seven-step methodology for conducting community-based behavioural science research: (1) aligning goals with system-level partners; (2) engaging with PHUs to understand priorities; (3) understanding community strengths and dynamics; (4) building relationships with each community; (5) establishing partnerships (community advisory groups); (6) involving community members in the research process; and (7) feeding back and interpreting research findings. Research partnerships were successfully established with members of prioritized communities, enabling recruitment of participants for theory-informed behavioural science interviews, interpretation of findings, and co-design of targeted recommendations for each PHU to improve COVID-19 vaccination uptake. Lessons learned include the importance of cultural sensitivity and awareness of sociopolitical context in tailoring community engagement, being agile to address the diverse and evolving priorities of PHUs, and building trust to achieve effective community engagement.

CONCLUSION

Effective community engagement in behavioural science research can lead to more inclusive and representative research. The community engagement approach developed and applied in this study acknowledges the diversity of communities, recognizes the central role of PHUs, and can help in addressing complex public health challenges.

Direct Support Professionals and COVID-19 Vaccination: A Comparison of Vaccinated Early Adopters and In-Betweeners

Direct support professionals (DSPs) are at increased risk of contracting COVID-19. A four-wave survey series was conducted, in part, to understand DSPs' COVID-19 vaccination experiences. Fourth wave data were used to compare those vaccinated against COVID-19 when they became eligible (early adopters) and those waiting at least three months before vaccination (in-betweeners). Findings indicated that in-betweeners were more likely to be female, younger, and people of color with lower education levels and annual incomes, with employers requiring COVID-19 vaccination to remain employed. COVID-19 vaccination motivators included protection for self, family, or people supported; an employer who mandated COVID-19 vaccination; and having had COVID-19 or knowing someone who did.

Media Reporting Relating to COVID-19 Vaccination as a Driver of Vaccine Hesitancy Prior to the Second Wave of the COVID-19 Pandemic in India: A Content Analysis of Newspaper and Digital Media Reports

Background Over 2,40,000 deaths were attributed to the SARS-CoV-2 Delta (B.1.617.2) variant in India during the second wave of the pandemic from April to June 2021 with most deaths occurring in the unvaccinated population. High levels of coronavirus disease 2019 (COVID-19) vaccine hesitancy contributed to significantly reduced vaccination coverage in the eligible population especially among healthcare workers, comorbid and older people. The existing global evidence suggests misinformation through social media to accentuate, while newspaper and mainstream media reporting to be protective against vaccine hesitancy during the COVID-19 pandemic. Content analysis of regular press coverage of COVID-19 vaccination in India during the period of initial deployment and until the onset of the second wave of the pandemic can provide useful learnings and strengthen preparedness for addressing potential vaccine hesitancy concerns during future pandemics. Therefore, we conducted this inductive content analysis of press coverage related to the COVID-19 vaccine hesitancy in India prior to the second (Delta) wave of the COVID-19 pandemic. Methods We examined news reports related to COVID-19 vaccination in India for the period from 1st January 2021 to 28 February 2021 from a high circulation English language daily (Hindustan Times), Hindi (vernacular) language daily (Dainik Jagran), and English language news reports from selected digital news portals. The inclusion criterion was any news report related to COVID-19 vaccination including editorials and guest opinion pieces that could potentially generate COVID-19-related vaccine hesitancy. The news items were classified depending on their potential to drive vaccine hesitancy by either avoiding reporting of positive information related to COVID-19 vaccines, or attributing directly or indirectly, negative or misleading commentary relating to vaccine safety or efficacy. Reports with possible risk of increasing vaccine hesitancy were further analyzed based on content, source of information, and the extent of fact-checking. Results Most of the published newspaper reports examined in this study echoed official news sources and views from government health agencies promoting COVID-19 vaccine acceptance and dispelling doubts on concerns regarding vaccine safety. There were eight unique newspaper reports after excluding duplicated bilingual entries and four news items from online digital Indian news sources that met our criterion of reports with possible contribution to vaccine hesitancy. The reports possibly contributed to vaccine hesitancy were grouped into two themes: (i) Doubts on the safety and efficacy of local manufactured vaccines: most of these reports focused on the granting of emergency use authorization for Covaxin (BBV152) in 'clinical trial mode' without the completion and publication of Phase-3 efficacy data (ii). Doubts on vaccine requirement considering high seroprevalence and reduced virus transmission.  Conclusions Concerns about the efficacy and safety of Covaxin (BBV152), safety of the Covishield vaccine, and questioning the necessity of immunizing all adults with COVID-19 vaccines were observed in multiple press reports with attempts at politicization of vaccination-related decisions. The press reporting with potential for contributing to significant COVID-19 vaccine hesitancy since launch and until the Delta wave of the pandemic in India has important lessons in future pandemic preparedness.

Understanding underlying moral values and language use of COVID-19 vaccine attitudes on twitter

Public sentiment toward the COVID-19 vaccine as expressed on social media can interfere with communication by public health agencies on the importance of getting vaccinated. We investigated Twitter data to understand differences in sentiment, moral values, and language use between political ideologies on the COVID-19 vaccine. We estimated political ideology, conducted a sentiment analysis, and guided by the tenets of moral foundations theory (MFT), we analyzed 262,267 English language tweets from the United States containing COVID-19 vaccine-related keywords between May 2020 and October 2021. We applied the Moral Foundations Dictionary and used topic modeling and Word2Vec to understand moral values and the context of words central to the discussion of the vaccine debate. A quadratic trend showed that extreme ideologies of both Liberals and Conservatives expressed a higher negative sentiment than Moderates, with Conservatives expressing more negative sentiment than Liberals. Compared to Conservative tweets, we found the expression of Liberal tweets to be rooted in a wider set of moral values, associated with moral foundations of care (getting the vaccine for protection), fairness (having access to the vaccine), liberty (related to the vaccine mandate), and authority (trusting the vaccine mandate imposed by the government). Conservative tweets were found to be associated with harm (around safety of the vaccine) and oppression (around the government mandate). Furthermore, political ideology was associated with the expression of different meanings for the same words, e.g. "science" and "death." Our results inform public health outreach communication strategies to best tailor vaccine information to different groups.

A mixed methods study exploring requests for unproven COVID therapies such as ivermectin and healthcare distrust in the rural South

The COVID-19 pandemic has led to contentious discourse regarding unproven COVID-19 therapies (UCTs),(e.g. ivermectin). Despite recommendations against it, ivermectin remains, in some areas, highly demanded. The goal of this study is to understand patient and provider perspectives about UCTs (e.g., ivermectin) and how responses to requests for UCTs impact healthcare distrust. This mixed methods observational study was conducted in a rural healthcare system in the Southern United States. Adults (n = 26) with a history of COVID-19 or clinicians (n = 8) from the same system were interviewed using questionnaires assessing healthcare distrust and qualitatively interviewed exploring perceptions about UCTs. Patient themes were: 1) Importance of anecdotal stories for decision-making; 2) Use of haphazard approaches to 'research'; 3) Strong distrust of government and healthcare organizations; 4) Inherent trust in local healthcare; 5) Decision-making as weighing pros/cons; and 6) Feeling a right to try medications. High survey medians indicated high distrust with differences of 8.5 points for those who requested/used ivermectin versus those who did not (p = 0.027). Clinician themes were: 1) Frustration when patients trust social media over clinicians; 2) Acceptance of community beliefs about UCTs; 3) Distrust originating outside of the healthcare system; 4) Feeling torn about prescribing UCTs to build trust; and 5) Variable educational strategies. When clinicians are perceived as aligned with government, this may void patients' trust of clinicians. Clinicians should leverage trust in local healthcare and distance themselves from distrusted information sources. Ethical questions arise regarding appropriateness of acquiescing to patient requests for ivermectin for building trust.

Stereotyping of the Russian Orthodox Church in Fake News in the Context of the COVID-19 Pandemic: Semiotic and Legal Analysis

Fake news is created as ordinary news stylistically but it consists of deliberate disinformation or hoaxes (aimed at misinforming or deceiving people). The text is generally constructed to cause negative emotions and feelings in readers: fear, panic, distrust, and paranoia. It is done to manipulate the opinion and consciousness of a large number of people and eventually leads to changes in the values, ideas and attitudes that already exist in the public awareness. The result is a schism that has already gone beyond the usual spiritual strife. Moreover, its expansion has weakened the defining feature of Russian Orthodoxy which lies in trust and support of the state and authorities. The Russian Orthodox Church has to deal not only with public health crisis but also with profound differences within its ranks over the churchgoers' behavior in the conditions of a pandemic. The article analyzes legal regulations and mechanisms for countering fake news about the Russian Orthodox Church, and provides examples from the judicial practice. It also determines the mechanisms of the worshippers' reaction to the fake news involving the Russian Orthodox Church. Using semiotic methodology, the author reveals re-encoding of the symbolic meaning of such signs as "Russian Orthodox cross" and "red cross". The connotative meaning of these signs leads to contradictions in the conditions of the COVID-19 pandemic.

Politicization and COVID-19 vaccine resistance in the U.S

Science is frequently used and distorted to advance political, economic, or cultural agendas. The politicization of science can limit the positive impacts that scientific advances can offer when people reject sound and beneficial scientific advice. Politicization has undoubtedly contributed to hesitancy toward uptake of the COVID-19 vaccine. It is urgent for scientists and clinicians to better understand: (1) the roots of politicization as related to COVID-19 vaccines; (2) the factors that influence people's receptivity to scientific misinformation in politicized contexts; and (3) how to combat the politicization of science to increase the use of life-saving vaccines. This chapter explores these issues in the context of COVID-19 vaccine resistance in the United States. After briefly describing the development of the vaccines, we describe the ways in which the disease itself became politicized because of statements by political leaders and also by media accounts including social media. We then review the politicization of the vaccine at both national and international scales, variability in public acceptance of the vaccines in the United States, and response to the emergence of variants. The next section summarizes social science findings on overcoming vaccine resistance, and the concluding section outlines some of the lessons of the politicization of the disease and the vaccine for health practitioners and life scientists.

Redeeming by Unlearning: A Critical Discourse Analysis of COVID-19 Vaccine Hesitancy on Facebook

As false and debunked claims about the COVID-19 virus and vaccines were pervasively disseminated across online social networks, their detrimental effects necessitated that social media companies track down and remove the disinformation. To explore the lingering vaccine hesitancy and resistance within a vaccine discussion group on Facebook, this study applies a nascent framework called Information Acts in three communication styles. Employing critical discourse analysis methodology, this study showed that the dominant communication styles of vaccine hesitant participants (VHPs) are locutionary and perlocutionary acts. Those VHPs can reduce and eventually end their vaccine hesitancy and resistance in the process of informative and rational communication and interactive and ad-hoc support for informed decision-making. The results pose challenges and opportunities for public health communication and information provision to cultivate information resilience and interventions targeting VHPs.