How the Italian Twitter Conversation on Vaccines Changed During the First Phase of the Pandemic: A Mixed-Method Analysis

Stakeholders' Understanding of European Medicine Agency's COVID-19 Vaccine Information Materials in EU and Regional Contexts

The COVID-19 pandemic posed challenges to communicating accurate information about vaccines because of the spread of misinformation. The European Medicines Agency (EMA) tried to reassure the public by communicating early on about the development and approval of COVID-19 vaccines. The EMA surveyed patients/consumers, healthcare professional organizations, and individual stakeholders, both at the EU level and in an Italian regional context. The objectives of the study were to see if the EMA's core information materials were informative and well-understood and which communication channels were preferred by the public. The main findings showed that individual patients/consumers generally prefer to obtain information about COVID-19 vaccines from the internet or mass media, while organizations and individual healthcare professionals prefer to obtain information from national and international health authorities. Both at EU and local levels, participants had a good understanding of the key messages from regulators and found the materials useful and relevant. However, some improvements were recommended to the visual, text, and dissemination formats, including publishing more information on safety and using a more public-friendly language. Also, it was recommended to maintain the EMA's approach of using media, stakeholder engagement, and web-based formats to communicate about COVID-19 vaccines. In conclusion, user-testing of proactive communication materials aimed to prebunk misinformation during a public health crisis helps to ensure that users understand the development and safety of novel vaccine technologies. This information can then be used as a basis for further evidence-based communication activities by regulators and public health bodies in an emergency context.

Exploring the vaccine conversation on TikTok in Italy: beyond classic vaccine stances

TikTok, a social media platform for creating and sharing short videos, has seen a surge in popularity during the COVID-19 pandemic. To analyse the Italian vaccine conversation on TikTok, we downloaded a sample of videos with a high play count (Top Videos), identified through an unofficial Application Programming Interface (consistent with TikTok's Terms of Service), and collected public videos from vaccine sceptic users through snowball sampling (Vaccine Sceptics' videos). The videos were analysed using qualitative and quantitative methods, in terms of vaccine stance, tone of voice, topic, conformity with TikTok style, and other characteristics. The final datasets consisted of 754 Top Videos (by 510 single users) plus 180 Vaccine Sceptics' videos (by 29 single users), posted between January 2020 and March 2021. In 40.5% of the Top Videos the stance was promotional, 33.9% were indefinite-ironic, 11.3% were neutral, 9.7% were discouraging, and 3.1% were ambiguous (i.e. expressing an ambivalent stance towards vaccines); 43% of promotional videos were from healthcare professionals. More than 95% of the Vaccine Sceptic videos were discouraging. Multiple correspondence analysis showed that, compared to other stances, promotional videos were more frequently created by healthcare professionals and by females, and their most frequent topic was herd immunity. Discouraging videos were associated with a polemical tone of voice and their topics were conspiracy and freedom of choice. Our analysis shows that Italian vaccine-sceptic users on TikTok are limited in number and vocality, and the large proportion of videos with an indefinite-ironic stance might imply that the incidence of affective polarisation could be lower on TikTok, compared to other social media, in the Italian context. Safety is the most frequent concern of users, and we recorded an interesting presence of healthcare professionals among the creators. TikTok should be considered as a medium for vaccine communication and for vaccine promotion campaigns.

Lexicon-based sentiment analysis to detect opinions and attitude towards COVID-19 vaccines on Twitter in Italy

The paper proposes a methodology based on Natural Language Processing (NLP) and Sentiment Analysis (SA) to get insights into sentiments and opinions toward COVID-19 vaccination in Italy. The studied dataset consists of vaccine-related tweets published in Italy from January 2021 to February 2022. In the considered period, 353,217 tweets have been analyzed, obtained after filtering 1,602,940 tweets with the word "vaccin". A main novelty of the approach is the categorization of opinion holders in four classes, Common users, Media, Medicine, Politics, obtained by applying NLP tools, enhanced with large-scale domain-specific lexicons, on the short bios published by users themselves. Feature-based sentiment analysis is enriched with an Italian sentiment lexicon containing polarized words, expressing semantic orientation, and intensive words which give cues to identify the tone of voice of each user category. The results of the analysis highlighted an overall negative sentiment along all the considered periods, especially for the Common users, and a different attitude of opinion holders towards specific important events, such as deaths after vaccination, occurring in some days of the examined 14 months.

The deployment of social media by political authorities and health experts to enhance public information during the COVID-19 pandemic

Social media have increasingly been used by political bodies and experts to disseminate health information to the public. However, we still know little about how the communication of these actors on social media is received by other users and how it reflects trends in public trust. We examined social media dynamics in the communication of information by major actors (n = 188) involved in COVID-19 online discussions in Switzerland. These actors are scientists (experts), policymakers (government officials, cantonal executives, and other parties), and representatives of mass media. We found little correlation between Twitter features (other users' engagement and negativity in other users' replies) and the level of public trust found in representative opinion surveys. We used topic modelling in combination with correspondence analysis, and including additional variables for actor types and the period of the public debate further enabled us to detect salient episodes related to the pandemic on social media. In particular, we found that differing roles were played by the (health) experts and political authorities in terms of both topics and influence on the specific timing of the pandemic. The results of this study provide helpful conclusions for communication among political authorities, health experts, and the public.

Ten Actions to Counteract Vaccine Hesitancy Suggested by the Italian Society of Hygiene, Preventive Medicine, and Public Health

Vaccine hesitancy (VH) is one of the main causes of the widespread decline in vaccination coverage and has become the subject of ongoing debate among public health professionals. The present commentary is a “decalogue” of strategic actions to counteract vaccine hesitancy for public health professionals that comes from the cognitive and formative path put in place by the “Communication in Public Health” working group (WG) of the Italian Society of Hygiene, Preventive Medicine, and Public Health. From the establishment of a national, multidisciplinary WG on VH to the activation of a national monitoring/surveillance system on vaccine hesitancy, several proposals are discussed. The identification and dissemination of good practices and tools to counteract and understand vaccine hesitancy, interdisciplinary training on vaccine hesitancy and on risk communication, community engagement and infodemiology, the inclusion of effective interventions to counteract vaccine hesitancy within the National Immunization Plan (NIP), the promotion and growth of a community of practice and research in the field of vaccine hesitancy, collaborations between scientific societies, and knowledge from the behavioral sciences represent other actions recommended in the present commentary. The present document suggests ten undeferrable strategies that could be implemented at the national and local levels in Italy, and that could be borrowed by other European countries in order to counteract vaccines hesitancy with a systematic and organic approach.