dc.description.abstract | Background. Vaccinations help prevent the spread of diseases
and save healthcare costs. Herd immunity exists at a high level
of vaccine coverage and improves individual and community
health and can be jeopardized by anti-vaccination movements.
According to literature, anti-vaccination proponents generally
base their arguments on beliefs and mistrust while provaccination proponents rely on science. Both pro- and antivaccination movements impact the online vaccination discourse
and can influence vaccine-related decisions. Understanding the
arguments used by Twitter users can combat the online antivaccination movement and increase willingness to vaccinate,
resulting in herd immunity and improved health outcomes.
Methodology. A vaccination decision-making framework is
created to visualize various arguments used in vaccination
debates. This framework is based on qualitative studies from
literature and used as a coding scheme for vaccination tweets.
Prior to this research, a selection of 2,000 tweets was gleaned
from database containing 85,000 tweets. These selected tweets
were coded manually in Excel by six coders in various categories
including pro-vaccination, anti-vaccination and hesitant. Any
doubts were discussed among the coders. Then, these pro-,
anti- and hesitant vaccination tweets were coded top-down on
content, substantiated by bottom-up codes. Solely the pro- and
anti-vaccination tweets were coded in NVivo based on the
aforementioned vaccination decision-making framework.
Finally, in data analysis the pro- and anti-vaccination arguments
were compared to each other.
Results. In pro-vaccination, the most mentioned themes were
preventive health beliefs, risk, health freedom, media,
reliability, vaccine effectiveness and social experiences. In anti-
vaccination, the most mentioned themes were vaccine safety,
trust in government and social experiences As expected, provaccination arguments are more based on science while antivaccination arguments are more focused on beliefs and
mistrust. Several themes were unmentioned, implying that
Twitter users value them less than expected in literature
studies.
Discussion. Differences in outcomes between this research and
the literature can be explained by country, tweet selection, the
time period of the tweets and study population. Strengths of
this research include the representation of reality, inter-coder
reliability in Excel, an interdisciplinary approach and the jointly
analysis of pro- and anti-vaccination tweets. Limitations of this
research include the lack of inter-coder reliability in NVivo, little
variation and validity in the (amount of) tweets, the difficulty of
interpretation of tweets and the fact that the current COVID-19
pandemic might have changed the attention, willingness and
hesitancy towards vaccines. Further research would include a
more explorative analysis on the influence of Twitter on vaccine
decision-making.
Conclusion. In line with the literature, the arguments in provaccination tweets are majorly based on science and the antivaccination tweets are more based on beliefs, attitudes and
mistrust. | |
dc.subject.keywords | Vaccine, vaccination, anti-vaccination, anti-vaxx, pro-vaccination, pro-vaxx, proponent, vaccine hesitancy, herd immunity, vaccine damage, Twitter, tweets, belief, attitude, health, freedom | |