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The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.

Effectiveness of message tactics in social marketing projects often varies across groups of individuals, which suggests the importance of tailoring communication approaches to maximize the success of promotional strategies. This study aims to contribute in this direction by using an innovative approach to promote targeted human papillomavirus vaccination, applying conjoint analysis to understand parental preferences for social media content features.

An online purpose-built quantitative survey was administered to a group of parents meeting eligibility criteria. The survey questions were designed based on inputs from formative qualitative research conducted in a previous phase of the study.

In the overall sample of 285 parents, responses show that image was the most important feature of social media posts overall, followed by source and text. Cluster analysis identified eight segments in the sample based on parental preferences for content features. Significant differences across segments were identified in terms of need for cognition, vaccine hesitancy, parental gender, concerns around side effects, trust in medical providers, information sharing behaviors on social media and information seeking online.

The application of conjoint analysis to promotional content allows to assess which features of the content are most important in persuading different individuals and provide insights on how people process the information, ultimately to inform targeted promotion based on preferences. Conjoint analysis has been widely used in consumer research to explore audience preferences for products or services, but only a few applications of conjoint analysis to the design and testing of promotional content are found in the literature.

As public health professionals strive to promote vaccines for inoculation efforts, fervent anti-vaccination movements are marshaling against it. This study is motived by a need to better understand the online discussion around vaccination. The authors identified the sentiments, emotions and topics of pro- and anti-vaxxers’ tweets, investigated their change since the pandemic started and further examined the associations between these content features and audiences’ engagement.

Utilizing a snowball sampling method, data were collected from the Twitter accounts of 100 pro-vaxxers (266,680 tweets) and 100 anti-vaxxers (248,425 tweets). The authors are adopting a zero-shot machine learning algorithm with a pre-trained transformer-based model for sentiment analysis and structural topic modeling to extract the topics. And the authors use the hurdle negative binomial model to test the relationships among sentiment/emotion, topics and engagement.

In general, pro-vaxxers used more positive tones and more emotions of joy in their tweets, while anti-vaxxers utilized more negative terms. The cues of sadness predominantly encourage retweets across the pro- and anti-vaccine corpus, while tweets amplifying the emotion of surprise are more attention-grabbing and getting more likes. Topic modeling of tweets yields the top 15 topics for pro- and anti-vaxxers separately. Among the pro-vaxxers’ tweets, the topics of “Child protection” and “COVID-19 situation” are positively predicting audiences’ engagement. For anti-vaxxers, the topics of “Supporting Trump,” “Injured children,” “COVID-19 situation,” “Media propaganda” and “Community building” are more appealing to audiences.

This study utilizes social media data and a state-of-art machine learning algorithm to generate insights into the development of emotionally appealing content and effective vaccine promotion strategies while combating coronavirus disease 2019 and moving toward a global recovery.

The peer review history for this article is available at https://publons.com/publon/10.1108/OIR-03-2022-0186

Vaccination is widely conceded as a pivotal measure to achieve community immunization and eradicate COVID-19. The purpose of this paper is to understand vaccination behavior based on the association between the theory of planned behavior (TPB) and health belief model (HBM).

A self-administered questionnaire was designed to collect data from 438 participants through social media in Vietnam and later analyzed using SPSS and AMOS to examine the research model.

The results indicated that attitude toward vaccination is positively influenced by perceived risk and perceived benefits. Additionally, background constructs of TPB (i.e. social norms, attitude and perceived behavioral control) and HBM (i.e. perceived risk, response efficacy, perceived benefits and knowledge about COVID-19) are underlying motivations for individual intention to receive vaccine. Moreover, age is a demographic predictor of vaccination intention. Finally, vaccination intention facilitates COVID-19 vaccination.

The findings will assist health-care bodies and authorities to understand public perceptions, attitude and behaviors and encourage their participation in vaccination campaigns.

To date, this is the first investigation of how disease knowledge and perceived benefits drive vaccination intention in Vietnam. Moreover, this study may be initially successful in adding current health-care behavior literature by combining TPB with HBM. With most studies on vaccination intention at the early stage of COVID-19 outbreak in developed nations, this work provides new insights by testing vaccination behavior in the fourth wave of COVID-19 outbreak and in a developing nation.

Successful social marketing campaign to promote COVID-19 vaccination for the unvaccinated relies on increasing positive reactions but also reducing negative responses to persuasive messages. This study aims to investigate the relative effects of narrative vs non-narrative public service announcements (PSAs) promoting COVID-19 vaccination on both positive and negative reactions. Using social media as a tool for disseminating marketing campaigns provides a great opportunity to examine the effectiveness of narrative PSAs on vaccination intention, especially among unvaccinated young adults, who were the target audience of the social marketing. This study explores the role of empathy and psychological reactance as underlying mechanisms.

An experiment involving unvaccinated young adults was conducted with a one-factor, two-condition (message type: narrative vs non-narrative) design.

Results indicated that the narrative (vs non-narrative) PSAs led to greater empathy. While no direct effects of message type emerged on psychological reactance or vaccination intention, results of a serial multi-mediator model confirmed that empathy and psychological reactance mediated the effects of message type on vaccination intention.

The study extends the understanding of narrative persuasion by examining an underlying mechanism behind narrative persuasion in a COVID-19 PSA. This study provides empirical evidence of the important role of empathy in processing narrative PSAs. Moreover, the current study expands narrative persuasion’s applicability to COVID-19 vaccination intervention messages for unvaccinated young adults, highlighting the effectiveness of narrative persuasion as a social marketing communication tool.

Social media have been playing a critical role in seeking and sharing health related information and consequently shaping individuals’ health behaviors. This study investigates how information seeking about Covid-19 vaccine on social media is related to vaccine receiving intentions. The study furthers explores the association of trust in social media and uncertainty about Covid-19 with information seeking and the moderating role of prior social media experience on this association.

We developed a questionnaire and collected data from 525 educated social media users through “Google Forms.” Further, we applied ordinary least squares (OLS) regress to test the study hypothesis.

We noted that trust in social media and uncertainty about Covid-19 vaccine positively influenced information seeking which further positively affected vaccine receiving intentions. However, the moderating effect of prior social media experience was not only noted as weak but also found negatively affecting the associations of trust in social media and uncertainty about Covid-19 vaccine with information seeking.

The findings provide insights into understanding of public perceptions regarding Covid-19 vaccine in the cultural contexts of a developing country. Further, it informs about the public patterns of seeking information related to health issues on social media, an understanding which may likely benefit policymakers, health care providers and researchers to understand the antecedents and behavioral outcomes of seeking information through social media during health crisis. The study also elucidates the leveraging power of social media to motivate the public to accept the Covid-19 vaccines.

The study uniquely combines the antecedents and behavioral outcomes of information seeking through social media in the particular context of Covid-19. It further extends the literature by introducing the conditional role of prior social media experience.

This study proposes and validates an integrated theoretical model involving the theory of planned behavior (TPB), health belief model (HBM), personal norms and information privacy to understand determinants of acceptance and resistance to the use of mobile contact tracing app (MCTA) in a pandemic situation.

This study draws on online surveys of 194 research respondents and uses partial least squares structural equation modeling (PL-SEM) to test the proposed theoretical model.

The study establishes that a positive attitude towards MCTA is the most important predictor of individuals' willingness to use MCTA and resistance to use MCTA. Furthermore, barriers to taking action positively influence resistance to the use of MCTA. Personal norms negatively influence resistance to the use of MCTA. Information privacy showed a negative and positive influence on willingness to use MCTA and use the resistance of MCTA, respectively, but neither was statistically significant. The authors found no significant influence of perceived vulnerability, severity, subjective norms and perceived behavioral control on either acceptance or use resistance of MCTA.

The study has been one of the first in the literature to propose an integrated theoretical model in the investigation of the determinants of acceptance and resistance to the use of MCTA in a single study, thereby increasing the scientific understanding of the factors that can facilitate or inhibit individuals from engaging in the use of a protection technology during a pandemic situation.

The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-10-2021-0533

This study aims to examine how different hospitals utilize social media to communicate risk information about COVID-19 with the communities they serve, and how hospitals' social media messaging (firm-generated content and their local community's responses (user-generated content) evolved with the COVID-19 outbreak progression.

This research proposes a healthcare-specific social media analytics framework and studied 68,136 tweets posted from November 2019 to November 2020 from a geographically diverse set of ten leading hospitals' social media messaging on COVID-19 and the public responses by using social media analytics techniques and the health belief model (HBM).

The study found correlations between some of the HBM variables and COVID-19 outbreak progression. The findings provide actionable insight for hospitals regarding risk communication, decision making, pandemic awareness and education campaigns and social media messaging strategy during a pandemic and help the public to be more prepared for information seeking in the case of future pandemics.

For hospitals, the results provide valuable insights for risk communication practitioners and inform the way hospitals or health agencies manage crisis communication during the pandemic For patients and local community members, they are recommended to check out local hospital's social media sites for updates and advice.

The study demonstrates the role of social media analytics and health behavior models, such as the HBM, in identifying important and useful data and knowledge for public health risk communication, emergency responses and planning during a pandemic.

This study aims to explain the factors associated with receiving a specific brand of COVID-19 vaccine within the framework of the theory of reasoned action (TRA). This study extends the TRA with the country-of-origin image (COI), brand image and electronic word of mouth variables.

This study is based on a cross-sectional survey conducted among 460 people who received the Sinofarm vaccine. Participants were selected using an online convenience sampling method. The structural equation modeling technique tests the proposed hypotheses.

The results showed that the essential factor associated with the intent to get the Chinese Sinopharm vaccine is the attitude toward the Signopharm vaccine. Also, word of mouth, subjective norms and brand image are the most critical factors that play a role in forming a favorable attitude toward the Sinopharm vaccine. Finally, the country-of-origin image does not affect attitudes toward the Sinopharm vaccine.

The area of vaccine marketing has been given limited attention in academic literature. This study addresses this area with little research and is greatly attractive to many brands targeting the consumer market. The study results can form a foundation for creating the branding strategy for this product category and assessing its demand in various markets.