Testing the Efficacy of Attitudinal Inoculation Videos to Enhance COVID-19 Vaccine Acceptance: Quasi-Experimental Intervention Trial.

BACKGROUND: Over the course of the COVID-19 pandemic, a variety of COVID-19-related misinformation has spread and been amplified online. The spread of misinformation can influence COVID-19 beliefs and protective actions, including vaccine hesitancy. Belief in vaccine misinformation is associated with lower vaccination rates and higher vaccine resistance. Attitudinal inoculation is a preventative approach to combating misinformation and disinformation, which leverages the power of narrative, rhetoric, values, and emotion. OBJECTIVE: This study seeks to test inoculation messages in the form of short video messages to promote resistance against persuasion by COVID-19 vaccine misinformation. METHODS: We designed a series of 30-second inoculation videos and conducted a quasi-experimental study to test the use of attitudinal inoculation in a population of individuals who were unvaccinated (N=1991). The 3 intervention videos were distinguished by their script design, with intervention video 1 focusing on narrative/rhetorical ("Narrative") presentation of information, intervention video 2 focusing on delivering a fact-based information ("Fact"), and intervention video 3 using a hybrid design ("Hybrid"). Analysis of covariance (ANCOVA) models were used to compare the main effect of the intervention on the 3 outcome variables: ability to recognize misinformation tactics ("Recognize"), willingness to share misinformation ("Share"), and willingness to take the COVID-19 vaccine ("Willingness"). RESULTS: There were significant effects across all 3 outcome variables comparing inoculation intervention groups to controls. For the Recognize outcome, the ability to recognize rhetorical strategies, there was a significant intervention group effect (P<.001). For the Share outcome, support for sharing the mis- and disinformation, the intervention group main effect was statistically significant (P=.02). For the Willingness outcome, there was a significant intervention group effect; intervention groups were more willing to get the COVID-19 vaccine compared to controls (P=.01). CONCLUSIONS: Across all intervention groups, inoculated individuals showed greater resistance to misinformation than their noninoculated counterparts. Relative to those who were not inoculated, inoculated participants showed significantly greater ability to recognize and identify rhetorical strategies used in misinformation, were less likely to share false information, and had greater willingness to get the COVID-19 vaccine. Attitudinal inoculation delivered through short video messages should be tested in public health messaging campaigns to counter mis- and disinformation.

Development of a Codebook of Online Anti-Vaccination Rhetoric to Manage COVID-19 Vaccine Misinformation.

Vaccine hesitancy (delay in obtaining a vaccine, despite availability) represents a significant hurdle to managing the COVID-19 pandemic. Vaccine hesitancy is in part related to the prevalence of anti-vaccine misinformation and disinformation, which are spread through social media and user-generated content platforms. This study uses qualitative coding methodology to identify salient narratives and rhetorical styles common to anti-vaccine and COVID-denialist media. It organizes these narratives and rhetorics according to theme, imagined antagonist, and frequency. Most frequent were narratives centered on "corrupt elites" and rhetorics appealing to the vulnerability of children. The identification of these narratives and rhetorics may assist in developing effective public health messaging campaigns, since narrative and emotion have demonstrated persuasive effectiveness in other public health communication settings.

Predictors of COVID-19 Vaccine Hesitancy: Socio-Demographics, Co-Morbidity, and Past Experience of Racial Discrimination.

The goal of this study is to explore predictors of COVID-19 vaccine hesitancy, including socio-demographic factors, comorbidity, risk perception, and experience of discrimination, in a sample of the U.S. population. We used a cross-sectional online survey study design, implemented between 13-23 December 2020. The survey was limited to respondents residing in the USA, belonging to priority groups for vaccine distribution. Responses were received from 2650 individuals (response rate 84%) from all 50 states and Puerto Rico, American Samoa, and Guam. The five most represented states were California (13%), New York (10%), Texas (7%), Florida (6%), and Pennsylvania (4%). The majority of respondents were in the age category 25-44 years (66%), male (53%), and working in the healthcare sector (61%). Most were White and non-Hispanic (66%), followed by Black and non-Hispanic (14%) and Hispanic (8%) respondents. Experience with racial discrimination was a predictor of vaccine hesitancy. Those reporting racial discrimination had 21% increased odds of being at a higher level of hesitancy compared to those who did not report such experience (OR = 1.21, 95% C.I. 1.01-1.45). Communication and logistical aspects during the COVID-19 vaccination campaign need to be sensitive to individuals' past-experience of racial discrimination in order to increase vaccine coverage.

Examining the effect of information channel on COVID-19 vaccine acceptance.

Hesitancy towards the COVID-19 vaccine remains high among the US population. Now that the vaccine is available to priority populations, it is critical to convince those that are hesitant to take the vaccine. Public health communication about the vaccine as well as misinformation on the vaccine occurs through a variety of different information channels. Some channels of information are more commonly found to spread misinformation. Given the expansive information environment, we sought to characterize the use of different media channels for COVID-19 vaccine information and determine the relationship between information channel and vaccine acceptance. We used quota sampling of vaccine priority groups [N = 2,650] between December 13 and 23, 2020 and conducted bivariate chi-squared tests and multivariable multinomial logistic regression analyses to determine the relative impact of channels of information on vaccine acceptance. We found traditional channels of information, especially National TV, National newspapers, and local newspapers increased the likelihood of vaccine acceptance. Individuals who received information from traditional media compared to social media or both traditional and social media were most likely to accept the vaccine. The implications of this study suggest social media channels have a role to play in educating the hesitant to accept the vaccine, while traditional media channels should continue to promote data-driven and informed vaccine content to their viewers.

COVID-19, nationalism, and the politics of crisis: A scholarly exchange.

In this article, several scholars of nationalism discuss the potential for the COVID-19 pandemic to impact the development of nationalism and world politics. To structure the discussion, the contributors respond to three questions: (1) how should we understand the relationship between nationalism and COVID-19; (2) will COVID-19 fuel ethnic and nationalist conflict; and (3) will COVID-19 reinforce or erode the nation-state in the long run? The contributors formulated their responses to these questions near to the outset of the pandemic, amid intense uncertainty. This made it acutely difficult, if not impossible, to make predictions. Nevertheless, it was felt that a historically and theoretically informed discussion would shed light on the types of political processes that could be triggered by the COVID-19 pandemic. In doing so, the aim is to help orient researchers and policy-makers as they grapple with what has rapidly become the most urgent issue of our times.