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      Assessing COVID-19 Vaccine Hesitancy, Confidence, and Public Engagement: A Global Social Listening Study

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          Abstract

          Background

          Monitoring public confidence and hesitancy is crucial for the COVID-19 vaccine rollout. Social media listening (infoveillance) can not only monitor public attitudes on COVID-19 vaccines but also assess the dissemination of and public engagement with these opinions.

          Objective

          This study aims to assess global hesitancy, confidence, and public engagement toward COVID-19 vaccination.

          Methods

          We collected posts mentioning the COVID-19 vaccine between June and July 2020 on Twitter from New York (United States), London (United Kingdom), Mumbai (India), and Sao Paulo (Brazil), and Sina Weibo posts from Beijing (China). In total, we manually coded 12,886 posts from the five global metropolises with high COVID-19 burdens, and after assessment, 7032 posts were included in the analysis. We manually double-coded these posts using a coding framework developed according to the World Health Organization’s Confidence, Complacency, and Convenience model of vaccine hesitancy, and conducted engagement analysis to investigate public communication about COVID-19 vaccines on social media.

          Results

          Among social media users, 36.4% (571/1568) in New York, 51.3% (738/1440) in London, 67.3% (144/214) in Sao Paulo, 69.8% (726/1040) in Mumbai, and 76.8% (2128/2770) in Beijing indicated that they intended to accept a COVID-19 vaccination. With a high perceived risk of getting COVID-19, more tweeters in New York and London expressed a lack of confidence in vaccine safety, distrust in governments and experts, and widespread misinformation or rumors. Tweeters from Mumbai, Sao Paulo, and Beijing worried more about vaccine production and supply, whereas tweeters from New York and London had more concerns about vaccine distribution and inequity. Negative tweets expressing lack of vaccine confidence and misinformation or rumors had more followers and attracted more public engagement online.

          Conclusions

          COVID-19 vaccine hesitancy is prevalent worldwide, and negative tweets attract higher engagement on social media. It is urgent to develop an effective vaccine campaign that boosts public confidence and addresses hesitancy for COVID-19 vaccine rollouts.

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          Most cited references38

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          Vaccine hesitancy: Definition, scope and determinants.

          The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
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            A global survey of potential acceptance of a COVID-19 vaccine

            Several coronavirus disease 2019 (COVID-19) vaccines are currently in human trials. In June 2020, we surveyed 13,426 people in 19 countries to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 71.5% of participants reported that they would be very or somewhat likely to take a COVID-19 vaccine, and 61.4% reported that they would accept their employer’s recommendation to do so. Differences in acceptance rates ranged from almost 90% (in China) to less than 55% (in Russia). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer’s advice to do so.
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              The spread of true and false news online

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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                June 2021
                11 June 2021
                11 June 2021
                : 23
                : 6
                : e27632
                Affiliations
                [1 ] School of Public Health Fudan University Shanghai China
                [2 ] National Health Commission Key Laboratory of Health Technology Assessment Fudan University Shanghai China
                [3 ] Global Health Institute Fudan University Shanghai China
                [4 ] Department of Infectious Disease Epidemiology London School of Hygiene & Tropical Medicine London United Kingdom
                [5 ] Laboratory of Data Discovery for Health Hong Kong Science Park Hong Kong SAR China
                Author notes
                Corresponding Author: Zhiyuan Hou zyhou@ 123456fudan.edu.cn
                Author information
                https://orcid.org/0000-0003-3413-0076
                https://orcid.org/0000-0002-8188-7031
                https://orcid.org/0000-0001-6108-9123
                https://orcid.org/0000-0001-8849-6626
                https://orcid.org/0000-0001-9832-0843
                https://orcid.org/0000-0003-1951-6157
                https://orcid.org/0000-0003-3321-7022
                https://orcid.org/0000-0002-8477-7583
                https://orcid.org/0000-0003-4123-4762
                Article
                v23i6e27632
                10.2196/27632
                8202656
                34061757
                fcb90fc1-dd54-4bd8-b8f0-1c95a00e6f53
                ©Zhiyuan Hou, Yixin Tong, Fanxing Du, Linyao Lu, Sihong Zhao, Kexin Yu, Simon J Piatek, Heidi J Larson, Leesa Lin. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 11.06.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 1 February 2021
                : 14 April 2021
                : 12 May 2021
                : 17 May 2021
                Categories
                Original Paper
                Original Paper

                Medicine
                covid-19 vaccine,hesitancy,infoveillance,infodemiology,confidence,acceptance,engagement,social media,covid-19

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