Analysis of public concerns about influenza vaccinations by mining a massive online question dataset in Japan

Exploring public attitudes toward live-streaming fitness in China: A sentiment and content analysis of China's social media Weibo

Objectives

Live-streaming fitness is perceived by the Chinese government as an invaluable means to reduce the prevalence of physical inactivity amid the COVID-19 pandemic. This study aims to investigate the public altitudes of the Chinese people toward live-streaming fitness and provide future health communication strategies on the public promotion of live-streaming fitness accordingly.

Methods

This study collected live-streaming fitness-related microblog posts from July 2021 to June 2022 in Weibo, the Chinese equivalent to Twitter. We used the BiLSTM-CNN model to carry out the sentiment analysis, and the structured topic modeling (STM) method to conduct content analysis.

Results

This study extracted 114,397 live-streaming fitness-related Weibo posts. Over 80% of the Weibo posts were positive during the period of the study, and over 85% were positive in half of the period. This study finds 8 topics through content analysis, which are fitness during quarantine; cost reduction; online community; celebrity effect; Industry; fitness injuries; live commerce and Zero Covid strategy.

Conclusions

It is discovered that the public attitudes toward live-streaming fitness were largely positive. Topics related to celebrity effect (5-11%), fitness injuries (8-16%), live commerce (5-9%) and Zero Covid strategy (16-26%) showed upward trends in negative views of the Chinese people. Specific health communication strategy suggestions are given to target each of the negative topics.

Spatiotemporal evolution of online attention to vaccines since 2011: An empirical study in China

Since the outbreak of Coronavirus Disease 2019 (COVID-19), the Chinese government has taken a number of measures to effectively control the pandemic. By the end of 2021, China achieved a full vaccination rate higher than 85%. The Chinese Plan provides an important model for the global fight against COVID-19. Internet search reflects the public's attention toward and potential demand for a particular thing. Research on the spatiotemporal characteristics of online attention to vaccines can determine the spatiotemporal distribution of vaccine demand in China and provides a basis for global public health policy making. This study analyzes the spatiotemporal characteristics of online attention to vaccines and their influencing factors in 31 provinces/municipalities in mainland China with Baidu Index as the data source by using geographic concentration index, coefficient of variation, GeoDetector, and other methods. The following findings are presented. First, online attention to vaccines showed an overall upward trend in China since 2011, especially after 2016. Significant seasonal differences and an unbalanced monthly distribution were observed. Second, there was an obvious geographical imbalance in online attention to vaccines among the provinces/municipalities, generally exhibiting a spatial pattern of “high in the east and low in the west.” Low aggregation and obvious spatial dispersion among the provinces/municipalities were also observed. The geographic distribution of hot and cold spots of online attention to vaccines has clear boundaries. The hot spots are mainly distributed in the central-eastern provinces and the cold spots are in the western provinces. Third, the spatiotemporal differences in online attention to vaccines are the combined result of socioeconomic level, socio-demographic characteristics, and disease control level.

Willingness to Receive the COVID-19 Vaccination and the Psychological State of Japanese University Students: A Cross-Sectional Study

Vaccinations may be one of the solutions to end the COVID-19 pandemic. One’s psychological state may be strongly related to one’s willingness to be vaccinated. This study investigated the relationship between the psychological state of Japanese university students and their willingness to be vaccinated. A self-report questionnaire on COVID-19, its vaccines (vaccination status, and perceived efficacy and safety), and psychological state (anxiety and depressive mood) was administered online, and 560 valid responses were obtained. The unvaccinated group reported significantly lower perceived vaccine effectiveness and importance than the vaccinated group. However, there were no differences in anxiety and depressive mood symptoms between the two groups. Multivariate logistic regression analysis was performed on the unvaccinated participants to identify the factors associated with their unwillingness to be vaccinated; there was a significant association between anxiety and unwillingness to receive the vaccine (p < 0.05). However, there was no significant association between depressive mood and unwillingness to receive the vaccine. The results suggest that timely psychological support for Japanese university students experiencing high levels of anxiety is important in accelerating vaccination programs.

Changes of the Public Attitudes of China to Domestic COVID-19 Vaccination After the Vaccines Were Approved: A Semantic Network and Sentiment Analysis Based on Sina Weibo Texts

Introduction: On December 31, 2020, the Chinese government announced that the domestic coronavirus disease-2019 (COVID-19) vaccines have obtained approval for conditional marketing and are free for vaccination. This release drove the attention of the public and intense debates on social media, which reflected public attitudes to the domestic vaccine. This study examines whether the public concerns and public attitudes to domestic COVID-19 vaccines changed after the official announcement.

Methods: This article used big data analytics in the research, including semantic network and sentiment analysis. The purpose of the semantic network is to obtain the public concerns about domestic vaccines. Sentiment analysis reflects the sentiments of the public to the domestic vaccines and the emotional changes by comparing the specific sentiments shown on the posts before and after the official announcement.

Results: There exists a correlation between the public concerns about domestic vaccines before and after the official announcement. According to the semantic network analysis, the public concerns about vaccines have changed after the official announcement. The public focused on the performance issues of the vaccines before the official approval, but they cared more about the practical issues of vaccination after that. The sentiment analysis showed that both positive and negative emotions increased among the public after the official announcement. “Good” was the most increased positive emotion and indicated great public appreciation for the production capacity and free vaccination. “Fear” was the significantly increased negative emotion and reflected the public concern about the safety of the vaccines.

Conclusion: The official announcement of the approval for marketing improved the Chinese public acceptance of the domestic COVID-19 vaccines. In addition, safety and effectiveness are vital factors influencing public vaccine hesitancy.

Methods for Social Media Monitoring Related to Vaccination: Systematic Scoping Review

BACKGROUND

Social media has changed the communication landscape, exposing individuals to an ever-growing amount of information while also allowing them to create and share content. Although vaccine skepticism is not new, social media has amplified public concerns and facilitated their spread globally. Multiple studies have been conducted to monitor vaccination discussions on social media. However, there is currently insufficient evidence on the best methods to perform social media monitoring.

OBJECTIVE

The aim of this study was to identify the methods most commonly used for monitoring vaccination-related topics on different social media platforms, along with their effectiveness and limitations.

METHODS

A systematic scoping review was conducted by applying a comprehensive search strategy to multiple databases in December 2018. The articles' titles, abstracts, and full texts were screened by two reviewers using inclusion and exclusion criteria. After data extraction, a descriptive analysis was performed to summarize the methods used to monitor and analyze social media, including data extraction tools; ethical considerations; search strategies; periods monitored; geolocalization of content; and sentiments, content, and reach analyses.

RESULTS

This review identified 86 articles on social media monitoring of vaccination, most of which were published after 2015. Although 35 out of the 86 studies used manual browser search tools to collect data from social media, this was time-consuming and only allowed for the analysis of small samples compared to social media application program interfaces or automated monitoring tools. Although simple search strategies were considered less precise, only 10 out of the 86 studies used comprehensive lists of keywords (eg, with hashtags or words related to specific events or concerns). Partly due to privacy settings, geolocalization of data was extremely difficult to obtain, limiting the possibility of performing country-specific analyses. Finally, 20 out of the 86 studies performed trend or content analyses, whereas most of the studies (70%, 60/86) analyzed sentiments toward vaccination. Automated sentiment analyses, performed using leverage, supervised machine learning, or automated software, were fast and provided strong and accurate results. Most studies focused on negative (n=33) and positive (n=31) sentiments toward vaccination, and may have failed to capture the nuances and complexity of emotions around vaccination. Finally, 49 out of the 86 studies determined the reach of social media posts by looking at numbers of followers and engagement (eg, retweets, shares, likes).

CONCLUSIONS

Social media monitoring still constitutes a new means to research and understand public sentiments around vaccination. A wide range of methods are currently used by researchers. Future research should focus on evaluating these methods to offer more evidence and support the development of social media monitoring as a valuable research design.

Willingness to Receive COVID-19 Vaccination in Japan

In the wake of the COVID-19 pandemic, vaccines are being developed by many countries for the safety of their population. However, people of various nations have revealed hesitancy towards being vaccinated, citing reasons such as side effects, safety, a lack of trust in vaccine effectiveness, etc. This study aimed to explore the willingness of people in Japan to be vaccinated or not be vaccinated and the reasons for either decision. A sample of 1100 respondents was drawn from an internet research panel, and a questionnaire survey was administered to evaluate their willingness to be vaccinated by gender, age group, place of living, and underlying illness history. After using descriptive statistics and the chi-squared test to evaluate categorical variables, 65.7% of the participants indicated a willingness to be vaccinated; among them were older age groups, those in rural areas, and those with underlying medical conditions. In addition, males showed less hesitancy towards being vaccinated. Although selectivity bias exists, this study is the first to examine the willingness of Japanese people to be vaccinated. Since vaccine hesitancy and refusal ratio were found to be higher in Japan than in other countries, policy efforts are needed to make the country’s vaccination program viable.

Characterization of Vaccine Tweets During the Early Stage of the COVID-19 Outbreak in the United States: Topic Modeling Analysis

BACKGROUND

During the early stages of the COVID-19 pandemic, developing safe and effective coronavirus vaccines was considered critical to arresting the spread of the disease. News and social media discussions have extensively covered the issue of coronavirus vaccines, with a mixture of vaccine advocacies, concerns, and oppositions.

OBJECTIVE

This study aimed to uncover the emerging themes in Twitter users' perceptions and attitudes toward vaccines during the early stages of the COVID-19 outbreak.

METHODS

This study employed topic modeling to analyze tweets related to coronavirus vaccines at the start of the COVID-19 outbreak in the United States (February 21 to March 20, 2020). We created a predefined query (eg, "COVID" AND "vaccine") to extract the tweet text and metadata (number of followers of the Twitter account and engagement metrics based on likes, comments, and retweeting) from the Meltwater database. After preprocessing the data, we tested Latent Dirichlet Allocation models to identify topics associated with these tweets. The model specifying 20 topics provided the best overall coherence, and each topic was interpreted based on its top associated terms.

RESULTS

In total, we analyzed 100,209 tweets containing keywords related to coronavirus and vaccines. The 20 topics were further collapsed based on shared similarities, thereby generating 7 major themes. Our analysis characterized 26.3% (26,234/100,209) of the tweets as News Related to Coronavirus and Vaccine Development, 25.4% (25,425/100,209) as General Discussion and Seeking of Information on Coronavirus, 12.9% (12,882/100,209) as Financial Concerns, 12.7% (12,696/100,209) as Venting Negative Emotions, 9.9% (9908/100,209) as Prayers and Calls for Positivity, 8.1% (8155/100,209) as Efficacy of Vaccine and Treatment, and 4.9% (4909/100,209) as Conspiracies about Coronavirus and Its Vaccines. Different themes demonstrated some changes over time, mostly in close association with news or events related to vaccine developments. Twitter users who discussed conspiracy theories, the efficacy of vaccines and treatments, and financial concerns had more followers than those focused on other vaccine themes. The engagement level-the extent to which a tweet being retweeted, quoted, liked, or replied by other users-was similar among different themes, but tweets venting negative emotions yielded the lowest engagement.

CONCLUSIONS

This study enriches our understanding of public concerns over new vaccines or vaccine development at early stages of the outbreak, bearing implications for influencing vaccine attitudes and guiding public health efforts to cope with infectious disease outbreaks in the future. This study concluded that public concerns centered on general policy issues related to coronavirus vaccines and that the discussions were considerably mixed with political views when vaccines were not made available. Only a small proportion of tweets focused on conspiracy theories, but these tweets demonstrated high engagement levels and were often contributed by Twitter users with more influence.

Qualitative evidence synthesis of values and preferences to inform infant feeding in the context of non-HIV transmission risk

Background

Breastfeeding is recommended by many organisations, but feeding choices can take on complexity against a backdrop of a transmissible infection risk. The aim of this synthesis is to explore what is known about the values and preferences of pregnant women, mothers, family members and health practitioners, policy makers and providers (midwives) concerning feeding when there is a risk of Mother-to-Child transmission [MTCT] of an infectious disease (other than HIV/AIDS) to infants (0–2 years of age).

Methods

A qualitative evidence synthesis and GRADE CERQual assessment of relevant studies of values and preferences regarding infant feeding options in the context of non-HIV MTCT risk.

Results

The synthesis included eight qualitative studies. Four studies focussed on human T-cell lymphotropic virus type 1 (HTLV-1), three studies on Ebola, and one study on influenza vaccination. Mothers reported feeling sadness and guilt at not breastfeeding, while recognising that it was important for the health of their baby not to breastfeed. Mothers were reportedly appreciative of the provision of appropriate facilities, and the advice of those health professionals who knew about the diseases, but felt other professionals lacked knowledge about the transmission risk of conditions such as HTLV-1. All groups expressed concerns about social perceptions of not breastfeeding, as well as the alternatives. The evidence was coherent and relevant, but there were serious concerns about adequacy and methodological limitations, such as potential social desirability bias in some studies.

Conclusions

This synthesis describes the reported values and preferences of pregnant women, mothers, and others concerning feeding when there is a risk of Mother-to-Child transmission (MTCT) of an infectious disease (other than HIV/AIDS) to an infant when breastfeeding. However, the evidence in the peer-reviewed literature is limited both in quality and quantity.

Maternal influenza vaccination relates to receiving relevant information among pregnant women in Japan

Maternal vaccination for seasonal influenza is currently not listed as a routine vaccination in the national vaccination schedule of Japan. However, many pregnant women voluntarily receive an influenza vaccination. We explored the factors related to influenza vaccine uptake. We particularly focused on factors related to any recommendation, such as advice or suggestions from another individual. We conducted a cross-sectional web-based questionnaire survey in Japan among pregnant women or mothers who had recently given birth in March 2017 and 2018. Logistic regression models were used to determine the factors influencing vaccination uptake. Key individuals regarding maternal vaccination were examined using the network visualization software Gephi. The total number of valid responses was 2204 in 2017 and 3580 in 2018. Over 40% of respondents had been vaccinated with the seasonal influenza vaccine at some point in both years. Of the vaccinated respondents, over 80% received advice regarding the influenza vaccination. Obstetricians were the most common source of advice in both years. Among respondents who chose more than two sources, the largest link in the network of sources was found between the obstetrician and family members. Attention to public concern or potential recommenders, by public health authorities, not just pregnant women, about the benefits of maternal influenza vaccination is important.

Syndromic surveillance using web data: a systematic review

During the recent years, a lot of debate is taken place about the evolution of Smart Healthcare systems. Particularly, how these systems can help people improve human conditions of health, by taking advantages of the new Information and Communication Technologies (ICT), regarding early prediction and efficient treatment. The purpose of this study is to provide a systematic review of the current literature available that focuses on information systems on syndromic surveillance using web data. All published items concern articles, books, reviews, reports, conference announcements, and dissertations. We used a variation of PRISMA Statements methodology to conduct a systematic review. The review identifies the relevant published papers from the year 2004 to 2018, systematically includes and explores them to extract similarities, gaps, and conclusions on the research that has been done so far. The results presented concern the year, the examined disease, the web data source, the geographic location/country, and the data analysis method used. The results show that influenza is the most examined infectious disease. The internet tools most used are Twitter and Google. Regarding the geographical areas explored in the published papers, the most examined country is the United States, since many scientists come from this country. There is a significant growth of articles since 2009. There are also various statistical methods used to correlate the data retrieved from the internet to the data from national authorities. The conclusion of all researches is that the Web can be a useful tool for the detection of serious epidemics and for a creation of a syndromic surveillance system using the Web, since we can predict epidemics from web data before they are officially detected in population. With the advance of ICT, Smart Healthcare can benefit from the monitoring of epidemics and the early prediction of such a system, improving national or international health strategies and policy decision. This can be achieved through the provision of new technology tools to enhance health monitoring systems toward the new innovations of Smart Health or eHealth, even with the emerging technologies of Internet of Things. The challenges and impacts of an electronic system based on internet data include the social, medical, and technological disciplines. These can be further extended to Smart Healthcare, as the data streaming can provide with real-time information, awareness on epidemics and alerts for both patients or medical scientists. Finally, these new systems can help improve the standards of human life.

Factors associated with influenza vaccination in Japanese elderly outpatients

BACKGROUND

Elderly patients benefit from influenza vaccination, but the number of Japanese elderly patients who are vaccinated is insufficient. Several factors are associated with influenza vaccination acceptance, but little is known about Japanese elderly outpatients. The purpose of this study was to examine factors associated with influenza vaccination in elderly outpatients in Japan.

METHODS

During the 2017-2018 influenza season, outpatients from one hospital and one clinic in Kitaibaraki City, Ibaraki, Japan, participated in this study. Patients answered a self-report questionnaire exploring factors such as their vaccination status during the 2017-2018 season, past influenza vaccination, perceived susceptibility to influenza and adverse events of the vaccine, perceived vaccine efficacy, physician recommendations. Multivariable logistic regression analyses were conducted to identify factors associated with vaccination.

RESULTS

Of 377 patients, 316 (83.8%) responded, and the vaccination rate was 57%. Eighty-three patients (27.0%) reported that their physician recommended the influenza vaccine. In multivariate analysis, influenza vaccination was associated with higher age (odds ratio (OR) 1.09, 95% confidence interval (CI) 1.03-1.14), physician recommendations (OR 2.49, 95% CI 1.18-5.25), low perceived susceptibility to vaccine-related adverse events (OR 0.33, 95% CI 0.15-0.74), and belief in vaccine efficacy (OR 4.73, 95% CI 2.08-10.8).

CONCLUSIONS

Influenza vaccination was associated with belief in vaccine efficacy, perceived susceptibility to vaccine-related adverse events, physician recommendations, and older age. Increasing the frequency of physician recommendations may lead to increased vaccination coverage.

Are social inequalities in influenza vaccination coverage in Japan reduced by health policy?

Influenza vaccination is effective to prevent influenza infection. However, findings about association between socioeconomic status and influenza vaccination coverage are controversial. Online survey was conducted among 4995 participants between 20 and 69 years of age throughout Japan, January 2017. We asked about history of receiving vaccination in previous year and socioeconomic status, with their reasons for having vaccination or not. Age stratified multivariable logistic regression model was conducted to estimate the odds ratio (ORs) and 95% confidence intervals (CIs) of receiving vaccine for each educational level and income. Sex, self-reported health status, marital status and income were included as covariates. The rate for receiving influenza vaccine among ≤64 year-olds and ≥65 year-olds was 32.9% and 35.4%, respectively. Among younger adults, vaccination varied by each education: junior high school, 23.6%; senior high school, 27.2%; college, 32.6%; university, 36.2%; and graduate school, 39.8%. Compared to junior high school, those from graduate school tended to be more vaccinated (OR1.88, 95%CI 1.07–3.24). On the contrary, those aged above ≥65 years old received vaccination with no significant differences across education. Likewise, among respondents aged ≤64 year-olds, income was significantly associated with influenza vaccination. Despite being “Managed by school or company” (32.5%), having “No particular reason” was the frequent reason for both receiving influenza vaccination (23.8%) or not (34.3%). Adults with higher educational level were significantly more likely to receive vaccination. Subsidizing influenza vaccination may reduce inequality in receiving vaccination for adults. Strengthening vaccination through various approaches is necessary, such as managing by school or company.

An infodemiological investigation of the so-called "Fluad effect" during the 2014/2015 influenza vaccination campaign in Italy: Ethical and historical implications

Influenza vaccines represent a major tool to contain the clinical and epidemiological burden generated by influenza. However, in spite of their effectiveness, vaccines are victims of prejudices and false myths, which contribute to the increasing phenomenon of vaccine hesitancy and loss of confidence. Media and, mainly, new media, and information and communication technologies play a major role in disseminating health-related information. While, on the one hand, they can be extremely promising in promoting disease prevention, on the other hand, they can also have a negative impact on population's health attitudes and behaviors when delivering information not based on scientific evidences. The "Fluad-case" is an excellent example of the crucial role of an adequate information campaign. Following the cluster of deaths allegedly related to the administration of the adjuvanted influenza vaccine "Fluad" during the 2014-2015 influenza campaign, the Italian health authorities and regulatory bodies decided the withdrawal of two potentially contaminated Fluad batches. This fostered a huge media coverage, with resulted in negatively impacting on influenza vaccination coverage. Monitoring and tracking the Fluad-related web searches, we showed that Liguria resulted the Italian region with the highest number of Fluad-related website searches and that, interestingly, Fluad was searched also in Regions in which this vaccine was not distributed. A positive moderate correlation between accessing Fluad-related websites and overall influenza vaccination coverage was found (r = 0.66 ([95%CI 0.29-0.86], p = 0.0026). Considering subjects ≥65 years, who are the subjects for which the Fluad vaccination is recommended, the correlation resulted r = 0.49 ([95%CI 0.03-0.78], p = 0.0397). As such, health authorities and decision-makers should promote high-quality communication campaigns in order to raise awareness of vaccination practices.

Analysis of public discourse on heart transplantation in Japan using social network service data

The clarification of public concerns regarding heart transplantation is important for improving low organ donation rates in Japan. In the present study, we used the Twitter data of 4986 tweets (between August 2015 and January 2016) and 1429 tweets (between April 2016 and May 2016) to analyze public discourse on heart transplantation in Japan and identify the reasons for low organ donation rates. We manually categorized all tweets relevant to heart transplantation into nine categories and counted the number of tweets in each category per month. During the study period, the most popular category of tweets was related to the media, followed by money (tweets questioning or even criticizing the high price of fundraising goals to go overseas for heart transplantations), while some tweets were misconceptions. We also conducted a sentiment analysis, which revealed that the most popular negative tweets were related to money, while the most positive tweets were related to reports on the favorable outcomes of recipients. Our results suggest that listening to concerns, providing correct information (particularly for some misconceptions), and emphasizing the outcomes of recipients will facilitate an increase in the number of people contemplating heart transplantation and organ donation.