Use of a language intervention to reduce vaccine hesitancy

Vaccine hesitancy is a major global challenge facing COVID-19 immunization programs. Its main source is low public trust in the safety and effectiveness of the vaccine. In a preregistered experimental study, we investigated how using a foreign language when communicating COVID-19 vaccine information influences vaccine acceptance. Hong Kong Chinese residents (N = 611) received COVID-19 vaccine information either in their native Chinese or in English. English increased trust in the safety and effectiveness of the vaccine and, as a result, reduced vaccine hesitancy. This indicates that language can impact vaccine attitudes and demonstrate the potential of language interventions for a low cost, actionable strategy to curtail vaccine hesitancy amongst bilingual populations. Language interventions could contribute towards achieving the United Nations Sustainable Development Goal of health and well-being.

COVID-19 Vaccine Perceptions in the Initial Phases of US Vaccine Roll-out: An Observational Study on Reddit

Background: Open online forums like Reddit provide an opportunity to quantitatively examine COVID-19 vaccine perceptions early in the vaccine timeline. We examine COVID-19 misinformation on Reddit following vaccine scientific announcements, in the initial phases of the vaccine timeline. Methods: We collected all posts on Reddit from January 1 2020 - December 14 2020 (n=266,840) that contained both COVID-19 and vaccine-related keywords. We used topic modeling to understand changes in word prevalence within topics after the release of vaccine trial data. Social network analysis was also conducted to determine the relationship between Reddit communities (subreddits) that shared COVID-19 vaccine posts, and the movement of posts between subreddits. Results: There was an association between a Pfizer press release reporting 90\% efficacy and increased discussion on vaccine misinformation. We observed an association between Johnson and Johnson temporarily halting its vaccine trials and reduced misinformation. We found that information skeptical of vaccination was first posted in a subreddit (r/Coronavirus) which favored accurate information and then reposted in subreddits associated with antivaccine beliefs and conspiracy theories (e.g. conspiracy, NoNewNormal). Conclusions: Our findings can inform the development of interventions where individuals determine the accuracy of vaccine information, and communications campaigns to improve COVID-19 vaccine perceptions, early in the vaccine timeline. Such efforts can increase individual- and population-level awareness of accurate and scientifically sound information regarding vaccines and thereby improve attitudes about vaccines, especially in the early phases of vaccine roll-out. Further research is needed to understand how social media can contribute to COVID-19 vaccination services.

Growing Need for Alternative Covid-19 Vaccination Strategy in the Face of Vaccination Uptake Hesitancy in the United States

There has been accelerated effort geared towards the swift creation of COVID-19 vaccines; however, this fast pace poses a negative impact on vaccine acceptance. The current US COVID vaccine hesitancy of 23-33% has a ripple effect and makes it impossible to attain community immunity. The primary aim of this study was to assess the current COVID vaccine hesitancy rates and to argue for the need of more effective strategies to improve its uptake in the US. This paper reviewed quantitative peer-reviewed publications assessing COVID vaccine hesitancy in the US. It was revealed that COVID-19 vaccine hesitancy was influenced by myriad factors like gender, education, political affiliation, race and location. Transparency and a mix of communication, local partnerships, incentives and arguably legal strategies can be adopted to attenuate US COVID vaccine hesitancy. Lastly, vulnerable demographics (black Americans and conservatives) need targeted COVID vaccine information. Keywords: Covid 19 Vaccines, Herd Immunity, Vaccine Uptake, Hesitancy and Vaccine Education

The News of the Covid-19 Vaccine in the Media and Public Resistance in Indonesia: A Study of Islamic Law

This article aims to examine media coverage of COVID-19 and the resistance of the Indonesian people. This research is a legal sociology study that discusses the public's response to government policies regarding the Covid-19 vaccine with an Islamic legal approach. The data is analyzed using critical discourse analysis. This study concludes that community resistance to vaccines has a relationship with online media content. News content of victims who died after the vaccine, information about vaccines that impact the human body to become sick in the long term, and information about raw materials or contents of the Covid-19 vaccine that are not halal, indirectly have implications for the community resistance. This refusal was mainly due to information about victims who had been vaccinated experienced vaccine failures, especially from social media such as YouTube, WhatsApp, and Facebook, which are sometimes difficult to justify. According to Islamic law, people should be careful about content and news regarding Covid-19 because it may not be accurate. Therefore, the government needs to provide solutions in various ways. First, the government oversees all social media in conveying information so that all news related to the COVID-19 vaccine needs to be more careful and wisely not to worry the public. Second, the government needs to re-strengthen media regulations or news coverage that doesn’t seem to work optimally. Moreover, the government's vaccine policy aims to prevent the danger of the virus, which guarantees the safety of people's lives, and it is part of maqâshid al-syarī'ah. Likewise, the government has involved the MUI, which has authority in the field of religious fatwas, so that the certainty that the vaccine is halal can be accounted for in Islamic law.

Covid-19 vaccine dialogues increase vaccination intentions and attitudes in a vaccine-hesitant UK population

Recently, Altay et al (2020) showed that five minutes of interaction with a chatbot led to increases in Covid-19 vaccination attitudes and intentions in a randomly sampled French population, compared to a brief control condition. Here we replicate and qualify this effect, whilst attempting to isolate what made the chatbot condition so effective. We reduce the chatbot information to several fact-checked and updated dialogues, and introduce strict controls to isolate the effect of choice of information. We control the amount of information provided, the time spent with the information, the trustworthiness of the information, and the level of interactivity. Like Altay et al, our experiment allowed participants to navigate a branching dialogue by choosing questions of interest, eliciting set answers on aspects of the Covid-19 vaccine. Our control condition used the same questions and answers but removed all elements of participant choice. In this way, our experiment isolated the effect of participant choice of information. We also specifically targeted those who were either against or neutral towards Covid-19 vaccinations, screening-out those with already positive attitudes. Replicating Altay et al, we found a similar size increase in positive attitudes towards vaccination, as well as a similar sized increase in intention to get vaccinated, after engaging with vaccine information. Unlike Altay et al, we found no difference between our conditions: choosing the questions did not increase vaccine attitudes or intentions anymore than our control condition. In common with Altay et al, we also found an effect of time spent with the information, across both conditions, in that those who spent between 4 and 16 minutes (above the median) reading the information were more likely to increase their vaccination attitudes (but not their intentions). These results suggest that the attitudes of the vaccine hesitant are modifiable with exposure to in-depth, trustworthy and engaging dialogues.

Exploring the Perceptions of Nurses on Receiving the SARS CoV-2 Vaccine in Palestine: A Qualitative Study

Background Uncertainty about vaccination among nurses are major barriers to managing the ongoing COVID-19 pandemic worldwide. Purpose To explore nurseś perceptions about receiving the SARS CoV-2 vaccine to inform the upcoming Palestinian Ministry of Health (MOH) vaccination efforts. Methods Four focus groups were conducted with nurses between January 18 and 30, 2021, before MOH launched vaccinations in Palestine. Participants working in government and private facilities were invited to participate and completed an online or paper form to provide demographics, review the study purpose, and give consent. Meetings were facilitated in Arabic either online via the Zoom platform or face-to-face using the same interview guide. Transcripts were translated into English and coded using a template analysis approach. Results Forty-six nurses, with a median age of 29.5y (range, 22–57) from across Palestine participated. Three major themes emerged: uncertainty, trust, and the knowledge needed to move forward. Uncertainty related to the evolving nature of COVID-19, the rapidity of vaccine development, the types and timing of available vaccines. The need for trusted experts to share scientific information about the vaccines to counteract the misinformation in social media. Moreover, reliable vaccine information may help vaccine-hesitant nurses move to vaccine-acceptors and to convince others, including their patients. Conclusion The negative perception of nurses towards vaccines is problematic in Palestine and uncertainty about which vaccine(s) will be available adds to the lack of education and mass-media misinformation. Other countries with vaccination efforts that are not wholly planned or implemented and may be struggling with similar concerns.

Health Care Providers’ Trusted Sources for Information About COVID-19 Vaccines: Mixed Methods Study

Background Information and opinions shared by health care providers can affect patient vaccination decisions, but little is known about who health care providers themselves trust for information in the context of new COVID-19 vaccines. Objective The purpose of this study is to investigate which sources of information about COVID-19 vaccines are trusted by health care providers and how they communicate this information to patients. Methods This mixed methods study involved a one-time, web-based survey of health care providers and qualitative interviews with a subset of survey respondents. Health care providers (physicians, advanced practice providers, pharmacists, nurses) were recruited from an integrated health system in Southern California using voluntary response sampling, with follow-up interviews with providers who either accepted or declined a COVID-19 vaccine. The outcome was the type of information sources that respondents reported trusting for information about COVID-19 vaccines. Bivariate tests were used to compare trusted information sources by provider type; thematic analysis was used to explore perspectives about vaccine information and communicating with patients about vaccines. Results The survey was completed by 2948 providers, of whom 91% (n=2683) responded that they had received ≥1 dose of a COVID-19 vaccine. The most frequently trusted source of COVID-19 vaccine information was government agencies (n=2513, 84.2%); the least frequently trusted source was social media (n=691, 9.5%). More physicians trusted government agencies (n=1226, 93%) than nurses (n=927, 78%) or pharmacists (n=203, 78%; P<.001), and more physicians trusted their employer (n=1115, 84%) than advanced practice providers (n=95, 67%) and nurses (n=759, 64%; P=.002). Qualitative themes (n=32 participants) about trusted sources of COVID-19 vaccine information were identified: processing new COVID-19 information in a health care work context likened to a “war zone” during the pandemic and communicating information to patients. Some providers were hesitant to recommend vaccines to pregnant people and groups they perceived to be at low risk for COVID-19. Conclusions Physicians have stronger trust in government sources and their employers for information about COVID-19 vaccines compared with nurses, pharmacists, and advanced practice providers. Strategies such as role modeling, tailored messaging, or talking points with standard language may help providers to communicate accurate COVID-19 vaccine information to patients, and these strategies may also be used with providers with lower levels of trust in reputable information sources.

Factors Associated with COVID-19 Vaccine Hesitancy in Mongolia: A Web-Based Cross-Sectional Survey

Vaccine acceptance in the general public is essential in controlling the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to assess the COVID-19 vaccine hesitancy in the adult population of Mongolia, and determine the associated factors. A total of 2875 individuals from urban and rural areas were recruited, and completed an online survey. Older age, urban residence, previous vaccination, high education, good knowledge of side effects, and a personal view of the importance of vaccines were associated with vaccine acceptability, whereas gender and religion were not. Receiving COVID-19 vaccine information from official government pages was related to a higher acceptance rate. Reliance on social media as a source of COVID-19 vaccine information was associated with high level of vaccine hesitancy. The side effects and the type of the COVID-19 vaccine were a major reason for hesitation. Countering false information regarding COVID-19 vaccines on social media, and promoting vaccine importance on general news websites is necessary. Moreover, providing clear and direct educational materials through official communication channels on the safety and efficacy of COVID-19 vaccines alongside information on COVID-19 symptoms, vaccine side effects, and location of vaccine administration centers among the younger populations, rural residents, and those with lower education is needed.

Assessing Acceptability of COVID-19 Vaccine Booster Dose among Adult Americans: A Cross-Sectional Study

Given the emergence of breakthrough infections, new variants, and concerns of waning immunity from the primary COVID-19 vaccines, booster shots emerged as a viable option to shore-up protection against COVID-19. Following the recent authorization of vaccine boosters among vulnerable Americans, this study aims to assess COVID-19 vaccine booster hesitancy and its associated factors in a nationally representative sample. A web-based 48-item psychometric valid survey was used to measure vaccine literacy, vaccine confidence, trust, and general attitudes towards vaccines. Data were analyzed through Chi-square (with a post hoc contingency table analysis) and independent-sample t-/Welch tests. Among 2138 participants, nearly 62% intended to take booster doses and the remaining were COVID-19 vaccine booster hesitant. The vaccine-booster-hesitant group was more likely to be unvaccinated (62.6% vs. 12.9%) and did not intend to have their children vaccinated (86.1% vs. 27.5%) compared to their non-hesitant counterparts. A significantly higher proportion of booster dose hesitant individuals had very little to no trust in the COVID-19 vaccine information given by public health/government agencies (55% vs. 12%) compared to non-hesitant ones. The mean scores of vaccine confidence index and vaccine literacy were lower among the hesitant group compared to the non-hesitant group. Compared to the non-hesitant group, vaccine hesitant participants were single or never married (41.8% vs. 28.7%), less educated, and living in a southern region of the nation (40.9% vs. 33.3%). These findings underscore the need of developing effective communication strategies emphasizing vaccine science in ways that are accessible to individuals with lower levels of education and vaccine literacy to increase vaccination uptake.