Understanding the Barriers to COVID-19 Vaccine Among Hispanic/Latinx Communities.

OBJECTIVE: COVID-19 disproportionally affected Hispanic/Latinx populations exacerbating systemic health inequities. The pilot study aimed to explore barriers to COVID-19 vaccination across Hispanic/Latinx communities in Southern California. METHODS: Cross-sectional survey of 200 participants to identify common barriers to vaccine hesitancy among Hispanics/Latinx individuals in Southern California utilizing a 14-item survey and questionnaire in English and Spanish. RESULTS: Of the 200 participants that completed questionnaires, 37% identified a knowledge deficit, 8% identified misinformation, and 15% identified additional barriers such as awaiting appointments, immigration status, transportation issues, or religious reasons as barriers to not receiving the COVID-19 vaccine. Wald statistics denoted that household members with COVID-19 infection within the past 3 months saw a medical provider within the last year, wearing a mask in public often, and barriers to vaccination (not knowing enough about the vaccine) predicted vaccine. These variables indicated changes in the likelihood of obtaining vaccination. CONCLUSION: The most crucial factor for increasing vaccination rates was directly reaching out to the community and actively conducting surveys to address the barriers and concerns encountered by Hispanic/Latinx participants.

User agency–based versus machine agency–based misinformation interventions: The effects of commenting and AI fact-checking labeling on attitudes toward the COVID-19 vaccination

This study aimed to examine the effects of commenting on a Facebook misinformation post by comparing a user agency–based intervention and machine agency–based intervention in the form of artificial intelligence (AI) fact-checking labeling on attitudes toward the COVID-19 vaccination. We found that both interventions were effective at promoting positive attitudes toward vaccination compared to the misinformation-only condition. However, the intervention effects manifested differently depending on participants' residential locations, such that the commenting intervention emerged as a promising tool for suburban participants. The effectiveness of the AI fact-checking labeling intervention was pronounced for urban populations. Neither of the fact-checking interventions showed salient effects with the rural population. These findings suggest that although user agency- and machine agency–based interventions might have potential against misinformation, these interventions should be developed in a more sophisticated way to address the unequal effects among populations in different geographic locations. [ FROM AUTHOR] Copyright of New Media & Society is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Negative COVID-19 Vaccine Information on Twitter: Content Analysis.

Background: Social media platforms, such as Facebook, Instagram, Twitter, and YouTube, have a role in spreading anti-vaccine opinion and misinformation. Vaccines have been an important component of managing the COVID-19 pandemic, so content that discourages vaccination is generally seen as a concern to public health. However, not all negative information about vaccines is explicitly anti-vaccine, and some of it may be an important part of open communication between public health experts and the community. Objective: This research aimed to determine the frequency of negative COVID-19 vaccine information on Twitter in the first 4 months of 2021. Methods: We manually coded 7306 tweets sampled from a large sampling frame of tweets related to COVID-19 and vaccination collected in early 2021. We also coded the geographic location and mentions of specific vaccine producers. We compared the prevalence of anti-vaccine and negative vaccine information over time by author type, geography (United States, United Kingdom, and Canada), and vaccine developer. Results: We found that 1.8% (131/7306) of tweets were anti-vaccine, but 21% (1533/7306) contained negative vaccine information. The media and government were common sources of negative vaccine information but not anti-vaccine content. Twitter users from the United States generated the plurality of negative vaccine information; however, Twitter users in the United Kingdom were more likely to generate negative vaccine information. Negative vaccine information related to the Oxford/AstraZeneca vaccine was the most common, particularly in March and April 2021. Conclusions: Overall, the volume of explicit anti-vaccine content on Twitter was small, but negative vaccine information was relatively common and authored by a breadth of Twitter users (including government, medical, and media sources). Negative vaccine information should be distinguished from anti-vaccine content, and its presence on social media could be promoted as evidence of an effective communication system that is honest about the potential negative effects of vaccines while promoting the overall health benefits. However, this content could still contribute to vaccine hesitancy if it is not properly contextualized.

Psychometric development of the COVID-19 vaccine misinformation scale and effects on vaccine hesitancy.

To help inform post-COVID-19 pandemic practical health policies, the researchers created the COVID-19 vaccine misinformation scale (CVMS). During the COVID-19 pandemic, falsehoods spread online which casted doubt and concerns about the vaccine. Example misconceptions included vaccination leads to greater vulnerability to other illness and would alter someone's DNA. The researchers performed two large surveys with U.S. participants. The researchers reviewed debunked COVID-19 vaccine falsehoods online. Construction of the CVMS followed standard psychometric scale development steps. Statistical analysis provided support for the 10-item CVMS with satisfactory reliability, discriminant validity, and convergent validity. Predictive validity regression analysis demonstrated the CVMS associated with higher vaccine hesitancy. The prevalence of vaccine misbeliefs broadened pandemic healthcare challenges. On top of existing duties, healthcare workers had to explain vaccine efficacy and safety to dispel fallacies. The researchers discuss implications for the CVMS within the context of motivated reasoning theory.

The race that stopped a nation: lessons from Australia's Covid vaccine failures

Australia handled many aspects of the Covid-19 pandemic very well. The international border was closed early, contract tracing regimes were implemented quickly, and targeted lockdowns helped keep case and death rates per capita to relatively low levels. Yet in mid-2021, Australia's vaccine rollout was the slowest in the OECD. We estimate that an optimal vaccine rollout could have saved lives and averted at least A$31 billion in economic damage. The policy errors reflected a failure to heed basic economic concepts of portfolio diversification, option value, and dynamic optimization. We conclude with some policy lessons concerning pandemic preparedness for Australia and other countries.

Collective Value Promotes the Willingness to Share Provaccination Messages on Social Media in China: Randomized Controlled Trial.

BACKGROUND: The proliferation of vaccine misinformation on social media has seriously corrupted the public's confidence in vaccination. Proactively sharing provaccination messages on social media is a cost-effective way to enhance global vaccination rates and resist vaccine misinformation. However, few strategies for encouraging the public to proactively share vaccine-related knowledge on social media have been developed. OBJECTIVE: This research examines the effect of value type (individual vs collective) and message framing (gain vs loss) on influenza vaccination intention (experiment 1) and the willingness to share provaccination messages (experiment 2) among Chinese adults during the COVID-19 pandemic. The primary aim was to evaluate whether messages that emphasized collective value were more effective in increasing the willingness to share than messages that emphasized individual value. METHODS: We enrolled 450 Chinese adults for experiment 1 (n=250, 55.6%) and experiment 2 (n=200, 44.4%). Participants were randomly assigned to individual-gain, individual-loss, collective-gain, or collective-loss conditions with regard to the message in each experiment using the online survey platform's randomization function. Experiment 1 also included a control group. The primary outcome was influenza vaccination intention in experiment 1 and the willingness to share provaccination messages in experiment 2. RESULTS: The valid sample included 213 adults in experiment 1 (females: n=151, 70.9%; mean age 29 [SD 9] years; at least some college education: n=202, 94.8%; single: n=131, 61.5%) and 171 adults in experiment 2 (females: n=106, 62.0%; mean age 28 [SD 7] years; at least some college education: n=163, 95.3%; single: n=95, 55.6%). Influenza vaccination intention was stronger in the individual-value conditions than in the collective-value conditions (F3,166=4.96, P=.03, η2=0.03). The reverse result was found for the willingness to share provaccination messages (F3,165=6.87, P=.01, η2=0.04). Specifically, participants who received a message emphasizing collective value had a higher intention to share the message than participants who read a message emphasizing individual value (F3,165=6.87, P=.01, η2=0.04), and the perceived responsibility for message sharing played a mediating role (indirect effect=0.23, 95% lower limit confidence interval [LLCI] 0.41, 95% upper limit confidence interval [ULCI] 0.07). In addition, gain framing facilitated influenza vaccination intention more than loss framing (F3,166=5.96, P=.02, η2=0.04). However, experiment 2 did not find that message framing affected message-sharing willingness. Neither experiment found an interaction between value type and message framing. CONCLUSIONS: Strengthened individual value rather than collective value is more likely to persuade Chinese adults to vaccinate. However, these adults are more likely to share a message that emphasizes collective rather than individual value, and the perceived responsibility for message sharing plays a mediating role.

Using Deep Learning to Identify Linguistic Features that Facilitate or Inhibit the Propagation of Anti- and Pro-Vaccine Content on Social Media

Anti-vaccine content is rapidly propagated via social media, fostering vaccine hesitancy, while pro-vaccine content has not replicated the opponent's successes. Despite this dis-parity in the dissemination of anti- and pro-vaccine posts, linguistic features that facilitate or inhibit the propagation of vaccine-related content remain less known. Moreover, most prior machine-learning algorithms classified social-media posts into binary categories (e.g., misinformation or not) and have rarely tackled a higher-order classification task based on divergent perspectives about vaccines (e.g., anti-vaccine, pro-vaccine, and neutral). Our objectives are (1) to identify sets of linguistic features that facilitate and inhibit the propagation of vaccine-related content and (2) to compare whether anti-vaccine, pro-vaccine, and neutral tweets contain either set more frequently than the others. To achieve these goals, we collected a large set of social media posts (over 120 million tweets) between Nov. 15 and Dec. 15, 2021, coinciding with the Omicron variant surge. A two-stage framework was developed using a fine-tuned BERT classifier, demonstrating over 99 and 80 percent accuracy for binary and ternary classification. Finally, the Linguistic Inquiry Word Count text analysis tool was used to count linguistic features in each classified tweet. Our regression results show that anti-vaccine tweets are propagated (i.e., retweeted), while pro-vaccine tweets garner passive endorsements (i.e., favorited). Our results also yielded the two sets of linguistic features as facilitators and inhibitors of the propagation of vaccine-related tweets. Finally, our regression results show that anti-vaccine tweets tend to use the facilitators, while pro-vaccine counterparts employ the inhibitors. These findings and algorithms from this study will aid public health officials' efforts to counteract vaccine misinformation, thereby facilitating the delivery of preventive measures during pandemics and epidemics. © 2022 IEEE.

"Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA": Author correction

Reports an error in "Measuring the impact of COVID-19 vaccine misinformation on vaccination intent in the UK and USA" by Sahil Loomba, Alexandre de Figueiredo, Simon J. Piatek, Kristen de Graaf and Heidi J. Larson (Nature Human Behaviour, 2021[Mar], Vol 5[3], 337-348). In the original article, reference number of the ethics application approved by the London School of Hygiene and Tropical Medicine ethics committee was incorrectly quoted. The correct number is 22647. Also, debriefing information was originally only provided in Supplementary Information. The following sentence has been added for clarification to the Methods section in the updated article: "All respondents exposed to misinformation were debriefed after the survey;debriefing information can be found in the questionnaire included in Supplementary Information." These errors have been corrected in the PDF and HTML versions of this article. (The following of the original article appeared in record 2021-29746-012). [Correction Notice: An Erratum for this article was reported in Vol 5(7) of Nature Human Behaviour (see record 2021-69306-024). In the original article, the subscript for the gamma element in equation (7) should have been k rather than j;i.e., it should read as given in erratum. The error has been corrected in the PDF and HTML versions of this article.] Widespread acceptance of a vaccine for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will be the next major step in fighting the coronavirus disease 2019 (COVID-19) pandemic, but achieving high uptake will be a challenge and may be impeded by online misinformation. To inform successful vaccination campaigns, we conducted a randomized controlled trial in the UK and the USA to quantify how exposure to online misinformation around COVID-19 vaccines affects intent to vaccinate to protect oneself or others. Here we show that in both countries-as of September 2020-fewer people would 'definitely' take a vaccine than is likely required for herd immunity, and that, relative to factual information, recent misinformation induced a decline in intent of 6.2 percentage points (95th percentile interval 3.9 to 8.5) in the UK and 6.4 percentage points (95th percentile interval 4.0 to 8.8) in the USA among those who stated that they would definitely accept a vaccine. We also find that some sociodemographic groups are differentially impacted by exposure to misinformation. Finally, we show that scientific-sounding misinformation is more strongly associated with declines in vaccination intent. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Professional Discipline for Vaccine Misinformation Posts on Social Media: Issues and Controversies for the Legal Profession.

Misinformation has challenged the rollout of COVID-19 vaccination around the world. In 2021, professional bodies for several regulated occupations (including doctors and lawyers) initiated investigations into the conduct of members who engaged in vaccine misinformation, including on social media. This commentary discusses key controversies surrounding this novel disciplinary issue, with the focus on the legal profession in New Zealand and Australia. We consider the difficulties of defining "vaccine misinformation", differentiating between public and private social media use, giving proper scope to rights of free speech, and challenges in identifying financial conflicts of interest and unethical client solicitation practices (eg, profiting from spreading vaccine misinformation). The chilling effect upon freedom of expression when lawyers are disciplined for their social media posts that are deemed unscientific is discussed.

Side effects of COVID-19 vaccines and perceptions about COVID-19 and its vaccines in Bangladesh: A Cross-sectional study.

Objective: One of the primary reasons for hesitancy in taking COVID-19 vaccines is the fear of side effects. This study primarily aimed to inspect the potential side effects of the COVID-19 vaccines circulated in Bangladesh.Design and Settings.The study was based on a cross-sectional anonymous online survey conducted in December 2021 across Bangladesh.Participants.The study included consenting Bangladeshi individuals aged 12 and above who had received at least one dose of the COVID-19 vaccines.Main Outcome.Analyses were carried out through exploratory analysis, Chi-square test, and logistic regression to investigate potential side effects of the COVID-19 vaccines. Results: A total of 1,180 vaccinated people participated in the study. Only 39.48% of the participants reported at least one side effect after receiving their COVID-19 vaccine. Injection-site pain, fever, headache, redness/swelling at the injection site, and lethargy were the most commonly reported adverse effects, all of which were mild and lasted 1-3 days. Side effects were most prevalent (about 80%) among individuals who received Pfizer-BioNTech and Moderna vaccines and were least common among those who received Sinopharm and Sinovac vaccines (21%-28%). When compared to the Sinopharm vaccines, the OxfordAstraZeneca, Pfizer-BioNTech, and Moderna vaccines were 4.51 times (95% CI: 2.53-8.04), 5.37 times (95% CI: 2.57-11.22), and 4.28 times (95% CI: 2.28-8.05) likelier to produce side effects. Furthermore, males, those over 50 years old, urban dwellers, smokers, and those with underlying health issues had a considerably increased risk of developing side effects. A lack of confidence in vaccines' efficacy and a substantial level of hesitancy in allowing children (age five years or over) and older people (70 years or over) to receive COVID-19 vaccines were also observed. Conclusion: Side effects of COVID-19 vaccines are minimal, demonstrating their safety. Efforts should be made to disseminate such findings worldwide to increase vaccine uptake.

Understanding the Role of Misinformation in COVID-19 Vaccine Hesitancy in a Rural State.

OBJECTIVE: to identify factors associated with COVID19 vaccine hesitancy, including sources of information among residents of Maine. METHODS: 148 study participants, recruited through community partners and primary care offices in Maine, completed an anonymous 15 item online survey. Recruitment and data collection occurred from May to September, 2021. Hesitancy was determined through a single question, "Will you get one of the COVID vaccines when it is offered to you?" RESULTS: vaccine hesitant respondents were younger than not hesitant respondents (p = 0.01). Hesitant individuals were significantly more likely to report concerns regarding the speed of COVID-19 vaccine production, vaccine efficacy, and potential vaccine side effects (p < 0.05 for each). Hesitant individuals were also significantly more likely to have discussed vaccination with their primary physician (p = 0.04). CONCLUSIONS: overall, hesitant individuals are more likely to be younger and had less trust in information from government sources, but they sought input from primary care. They were also more concerned about efficacy, side effects, and the rapid development of COVID-19 vaccines. Primary care physicians are in key positions to address these concerns due to contact with individuals who need accurate information.

Utilizing Google trends to monitor coronavirus vaccine interest and hesitancies.

INTRODUCTION: Vaccine hesitancy remains a serious challenge for ending the coronavirus disease 2019 (COVID-19) pandemic. Digital media has played an immense role in the spread of information during the pandemic. One method to gauge public interest in COVID-19 related information is to examine patterns of online search queries. METHODS: Google Trends (GT) was used to analyze results for search terms relating to COVID-19 vaccine misinformation, information, and accessibility from October 1st, 2020 to May 27th, 2021. GT allows you to compare multiple queries at one time. The resultant relative search volumes (RSVs)range from 0 to 100. The search term andpoint in time on the graph that has the greatest search volume is given a score of 100 and all other terms and times are given values relative to that maximum. Search interest peaks were analyzed by subgroups (misinformation, information seeking, and access seeking) and across key time points throughout the pandemic. RESULTS: GT analysis revealed that search interest related to vaccine misinformation, general information, and access seeking changed in relation to events taking place throughout the pandemic. The most commonly searched terms in each subgroup were: "Covid vaccine infertility", "Covid vaccine side effects", and "Covid vaccine appointment". Searches related to misinformation peaked in December 2020. Search terms in the general information category peaked in April 2021. RSVs for access seeking terms peaked in March 2021 and have decreased since April 2021. CONCLUSION: Misinformation RSVs were highest after FDA authorization and have multiple repeated spikes after subsequent vaccine announcements. General information seeking terms peaked concurrently with increased vaccination uptake in the United States. Search interest has decreased with wider vaccine availability, despite many individuals in the United States remaining unvaccinated. GT can be used to monitor trends in public attitudes and misinformation regarding COVID-19 vaccines and further target education.

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.

COVID-19 health misinformation: using design-based research to develop a theoretical framework for intervention

Purpose Because health misinformation pertaining to COVID-19 is a serious threat to public health, the purpose of this study is to develop a framework to guide an online intervention into some of the drivers of health misinformation online. This framework can be iterated upon through the use of design-based research to continue to develop further interventions as needed. Design/methodology/approach Using design-based research methods, in this paper, the authors develop a theoretical framework for addressing COVID-19 misinformation. Using a heuristic analysis of research on vaccine misinformation and hesitancy, the authors propose a framework for education interventions that use the narrative effect of transportation as a means to increase knowledge of the drivers of misinformation online. Findings This heuristic analysis determined that a key element of narrative transportation includes orientation towards particular audiences. Research indicates that mothers are the most significant household decision-makers with respect to vaccines and family health in general;the authors suggest narrative interventions should be tailored specifically to meet their interests and tastes, and that this may be different for mothers of different backgrounds and cultural communities. Originality/value While there is a significant body of literature on vaccine hesitancy and vaccine misinformation, more research is needed that helps people understand the ways in which misinformation works upon social media users. The framework developed in this research guided the development of an education intervention meant to facilitate this understanding.

Characterizing initial COVID-19 vaccine attitudes among pregnancy-capable healthcare workers.

BACKGROUND: Healthcare workers were prioritized for COVID-19 vaccination roll-out because of the high occupational risk. Vaccine trials excluded individuals who were trying to conceive and those who are pregnant and lactating, necessitating vaccine decision-making in the absence of data specific to this population. OBJECTIVE: This study aimed to determine the initial attitudes about COVID-19 vaccination in pregnancy-capable healthcare workers by reproductive status and occupational exposure. STUDY DESIGN: We performed a structured survey distributed via social media of US-based healthcare workers involved in patient care since March 2020 who were pregnancy-capable (biologic female sex without history of sterilization or hysterectomy) from January 8, 2021 to January 31, 2021. Participants were asked about their desire to receive the COVID-19 vaccine and their perceived safety of the COVID-19 vaccine using 5-point Likert items with 1 corresponding to "I strongly don't want the vaccine" or "very unsafe for me" and 5 corresponding to "I strongly want the vaccine" or "very safe for me." We categorized participants into the following 2 groups: (1) reproductive intent (preventing pregnancy vs attempting pregnancy, currently pregnant, or currently lactating), and (2) perceived COVID-19 occupational risk (high vs low). We used descriptive statistics to characterize the respondents and their attitudes about the vaccine. Comparisons between reproductive and COVID-19 risk groups were conducted using Mann-Whitney U tests. RESULTS: Our survey included 11,405 pregnancy-capable healthcare workers: 51.3% were preventing pregnancy (n=5846) and 48.7% (n=5559) were attempting pregnancy, currently pregnant, and/or lactating. Most respondents (n=8394, 73.6%) had received a vaccine dose at the time of survey completion. Most participants strongly desired vaccination (75.3%) and very few were strongly averse (1.5%). Although the distribution of responses was significantly different between respondents preventing pregnancy and those attempting conception or were pregnant and/or lactating and also between respondents with a high occupational risk and those with a lower occupational risk of COVID-19, the effect sizes were small and the distribution was the same for each group (median, 5; interquartile range, 4-5). CONCLUSION: Most of the healthcare workers desired vaccination. Negative feelings toward vaccination were uncommon but were significantly higher among those attempting pregnancy and those who are pregnant and lactating and also among those with a lower perceived occupational risk of contracting COVID-19, although the effect size was small. Understanding healthcare workers' attitudes toward vaccination may help guide interventions to improve vaccine education and uptake in the general population.

Automatic detection of COVID-19 vaccine misinformation with graph link prediction.

Enormous hope in the efficacy of vaccines became recently a successful reality in the fight against the COVID-19 pandemic. However, vaccine hesitancy, fueled by exposure to social media misinformation about COVID-19 vaccines became a major hurdle. Therefore, it is essential to automatically detect where misinformation about COVID-19 vaccines on social media is spread and what kind of misinformation is discussed, such that inoculation interventions can be delivered at the right time and in the right place, in addition to interventions designed to address vaccine hesitancy. This paper is addressing the first step in tackling hesitancy against COVID-19 vaccines, namely the automatic detection of known misinformation about the vaccines on Twitter, the social media platform that has the highest volume of conversations about COVID-19 and its vaccines. We present CoVaxLies, a new dataset of tweets judged relevant to several misinformation targets about COVID-19 vaccines on which a novel method of detecting misinformation was developed. Our method organizes CoVaxLies in a Misinformation Knowledge Graph as it casts misinformation detection as a graph link prediction problem. The misinformation detection method detailed in this paper takes advantage of the link scoring functions provided by several knowledge embedding methods. The experimental results demonstrate the superiority of this method when compared with classification-based methods, widely used currently.

Effects of fact-checking social media vaccine misinformation on attitudes toward vaccines.

Social media vaccine misinformation can negatively influence vaccine attitudes. It is urgent to develop communication approaches to reduce the misinformation's impact. This study aimed to test the effects of fact-checking labels for misinformation on attitudes toward vaccines. An online survey experiment with 1198 participants recruited from a U.S. national sample was conducted in 2018. Participants were randomly assigned to six conditions: misinformation control, or fact-checking label conditions attributed to algorithms, news media, health institutions, research universities, or fact-checking organizations. We analyzed differences in vaccine attitudes between the fact-checking label and control conditions. Further, we compared perceived expertise and trustworthiness of the five categories of fact-checking sources. Fact-checking labels attached to misinformation posts made vaccine attitudes more positive compared to the misinformation control condition (P = .003, Cohen's d= 0.21). Conspiracy ideation moderated the effect of the labels on vaccine attitudes (P = .02). Universities and health institutions were rated significantly higher on source expertise than other sources. Mediation analyses showed labels attributed to universities and health institutions indirectly resulted in more positive attitudes than other sources through perceived expertise. Exposure to fact-checking labels on misinformation can generate more positive attitudes toward vaccines in comparison to exposure to misinformation. Incorporating labels from trusted universities and health institutions on social media platforms is a promising direction for addressing the vaccine misinformation problem. This points to the necessity for closer collaboration between public health and research institutions and social media companies to join efforts in addressing the current misinformation threat.