Identifying factors influencing COVID-19 vaccine uptake in Finland - a qualitative study using social media data

A thematic analysis of UK COVID-19 vaccine hesitancy discussions on Twitter

BACKGROUND

Following UK approval of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on 2/12/20 and 30/12/20 respectively, discussions about them emerged on the social media platform Twitter, (now 'X'). Previous research has shown that Twitter/ X is used by the UK public to engage with public health announcements and that social media influences public opinions of vaccines, including COVID-19 vaccines, globally. This study explored discussions on Twitter posted in response to the UK government's posts introducing the Pfizer-BioNTech and Oxford-AstraZeneca vaccines. The aim was to investigate vaccine hesitant views, and thereby identify barriers and facilitators to COVID-19 vaccine uptake in the UK.

METHODS

Online ethnography was used to collect responses ('tweet replies') to 14 Twitter posts published by officials or departments of the UK government on the dates the Pfizer-BioNTech and Oxford-AstraZeneca vaccines received approval from the Medicines and Healthcare products Regulatory Agency (2/12/20 and 30/12/20, respectively). 16,508 responses were collected and those expressing vaccine hesitancy were analysed using reflexive thematic analysis.

RESULTS

Three themes that underpinned Twitter posters' vaccine hesitancy were identified: (1) Concerns about vaccine development and safety, (2) Information, misinformation and disinformation, (3) Distrust: Politics and 'Big Pharma'. From these themes, eight barriers and eight facilitators to UK COVID-19 vaccine uptake were identified.

CONCLUSION

This paper highlights key obstacles to COVID-19 vaccine acceptance in the UK based on views from Twitter and contributes to the emerging literature on the relationship between social media and the public response to COVID-19 vaccines. In so doing, this analysis offers insights that are useful for the development of vaccine communication strategies more broadly, both in and beyond future pandemics, to ensure that public concerns are addressed, and misinformation and disinformation are appropriately countered.

Quantitative Synthesis of Factors Associated with COVID-19 Vaccine Acceptance and Vaccine Hesitancy in 185 Countries

Mass vaccination against COVID-19 is the best method to ensure herd immunity in order to curb the effect of the pandemic on the global economy. It is therefore important to assess the determinants of COVID-19 vaccine acceptance and hesitancy on a global scale. Factors were recorded from cross-sectional studies analyzed with t-Test, ANOVA, correlation, and meta-regression analyses and synthesized to identify global trends in order to inform policy. We registered the protocol (ID: CRD42022350418) and used standard Cochrane methods and PRISMA guidelines to collect and synthesize cross-sectional articles published between January 2020 and August 2023. A total of 67 articles with 576 studies from 185 countries involving 3081,766 participants were included in this synthesis. Global COVID-19 vaccine acceptance was 65.27% (95% CI; 62.72-67.84%), while global vaccine hesitancy stood at 32.1% (95% CI; 29.05-35.17%). One-Way ANOVA showed that there was no significant difference in the percentage Gross Domestic Product spent on vaccine procurement across the World Bank income levels (p < 0.187). There was a significant difference of vaccine acceptance (p < 0.001) and vaccine hesitancy (p < 0.005) across the different World Bank Income levels. World Bank income level had a strong influence on COVID-19 vaccine acceptance (p < 0.0004) and hesitancy (p < 0.003) but percentage Gross Domestic Product spent on vaccine procurement did not. There was no correlation between percentage Gross Domestic Product spent on vaccine procurement and COVID-19 vaccine acceptance (r = -0.11, p < 0.164) or vaccine hesitancy (r = -0.09, p < 0.234). Meta-regression analysis showed that living in an urban setting (OR = 4.83, 95% CI; 0.67-212.8), rural setting (OR = 2.53, 95% CI; 0.29-119.33), older (OR = 1.98, 95% CI; 0.99-4.07), higher education (OR = 1.76, 95% CI; 0.85-3.81), and being a low income earner (OR = 2.85, 95% CI; 0.45-30.63) increased the odds of high COVID-19 vaccine acceptance. Factors that increased the odds of high COVID-19 vaccine hesitancy were no influenza vaccine (OR = 33.06, 95% CI; 5.03-1395.01), mistrust for vaccines (OR = 3.91, 95% CI; 1.92-8.24), complacency (OR = 2.86, 95% CI; 1.02-8.83), pregnancy (OR = 2.3, 95% CI; 0.12-141.76), taking traditional herbs (OR = 2.15, 95% CI; 0.52-10.42), being female (OR = 1.53, 95% CI; 0.78-3.01), and safety concerns (OR = 1.29, 95% CI; 0.67-2.51). We proposed a number of recommendations to increase vaccine acceptance and ensure global herd immunity against COVID-19.

COVID-19 Vaccine Hesitancy Among Parents: A Qualitative Study

OBJECTIVES

Addressing parental/caregivers' coronavirus disease 2019 (COVID-19) vaccine hesitancy is critical to improving vaccine uptake in children. Common concerns have been previously reported through online surveys, but qualitative data from KII and focus groups may add much-needed context. Our objective was to examine factors impacting pediatric COVID-19 vaccine decision-making in Black, Spanish-speaking, and rural white parents/caregivers to inform the content design of a mobile application to improve pediatric COVID-19 vaccine uptake.

METHODS

Parents/caregivers of children aged 2 to 17 years from groups disproportionately affected by COVID-19-related vaccine hesitancy (rural-dwelling persons of any race/ethnicity, urban Black persons, and Spanish-speaking persons) were included on the basis of their self-reported vaccine hesitancy and stratified by race/ethnicity. Those expressing vaccine acceptance or refusal participated in KII, and those expressing hesitancy in focus groups. Deidentified transcripts underwent discourse analysis and thematic analysis, both individually and as a collection. Themes were revised until coders reached consensus.

RESULTS

Overall, 36 participants completed the study: 4 vaccine acceptors and 4 refusers via KIIs, and the remaining 28 participated in focus groups. Participants from all focus groups expressed that they would listen to their doctor for information about COVID-19 vaccines. Infertility was a common concern, along with general concerns about vaccines. Vaccine decision-making was informed by the amount of information available to parents/caregivers, including scientific research; possible positive and negative long-term effects; and potential impacts of vaccination on preexisting medical conditions.

CONCLUSIONS

Parents/caregivers report numerous addressable vaccine concerns. Our results will inform specific, targeted interventions for improving COVID-19 vaccine confidence.