The Impact of Social Media on CoViD-19 Vaccination Hesitancy
A Thesis presented to the Faculty of College of Arts and Sciences in partial fulfillment of the requirements for the degree in Bachelor of Arts in Communication 2nd Semester, SY 2021-2022
Acknowledgement
The researchers would like to take this opportunity to thank those people who served as a guide in the completion of this study. The researchers would like to express our sincere gratitude and appreciation to Prof. Nenita Santos, our dear Thesis Writing I and II Adviser, who provided us challenging yet memorable experience in conducting this study. We appreciate his comments and suggestions that give us the motivation to make this study possible.
We also want to thank the Respondents who helped us conduct our research by filling out a questionnaire that will be used in the study. To our friends and classmates who gave us motivation and support on how to improve our research study.
The researchers would like to express our greatest appreciation to our beloved family members who have given us their moral and financial support in conducting our study. We appreciate all of your patience and understanding. Above all, we would like to extend everlasting gratitude to our Almighty Father for giving countless blessings, knowledge, and strength for us to come up with a successful research study.
– J.K.A.C
Abstract
Effective and safe COVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus and prevent hospitalizations and deaths. However, COVID-19 vaccine uptake is challenged by vaccine hesitancy. In this paper, we explored vaccination narratives and challenges experienced and observed by Manileños during the early vaccination period. We surveyed 30 respondents in Manila. The survey form was conducted in Filipino and English via online platforms such as Google Forms. To highlight the complex reasons for delaying or refusing COVID-19 vaccines, we embedded our findings within the social-ecological model. Our analysis showed that individual perceptions play a significant role in vaccinating. Such perceptions are shaped by exposure to (mis)information amplified by the media, the community, and the health system. Social networks may positively or
negatively impact vaccination uptake, depending on their views on vaccines. Political issues contribute to vaccine brand hesitancy, resulting in vaccination delays and refusals. Perceptions about the inefficiency and inflexibility of the system also create additional barriers to the vaccine rollout in the country, especially among vulnerable and marginalized groups. Recognizing and addressing concerns at all levels are needed to improve COVID-19 vaccination uptake and reach. Strengthening health literacy is a critical tool to combat misinformation that undermines vaccine confidence. Vaccination systems must also consider the needs of marginalized and vulnerable groups to ensure their access to vaccines. In all these efforts to improve vaccine uptake, governments will need to engage with communities to ‘co-create’ solutions.
Approval
This thesis of John Kevin A. Centeno is approved by the panelists and faculty members of the Universidad De Manila. Namely, Prof. Ronald Zamora (Panel), Prof. Nenita O. Santos (Adviser), and Dr. Noami D. Solano (UDM Dean of Arts and Sciences).
Chapter I
INTRODUCTION
COVID-19 is a deadly respiratory illness, caused by SARs-CoV-2. The virus caused a crisis affecting our economy and society. Establishments are closing or rotating their manpower to reduce the spread of the COVID-19. After a lot of research, Scientists around the world discovered a chemical composition that will suppress the virus. Free vaccinations are now happening around the world. But some people are not happy with what the governments doing. The COVID-19 vaccine has been met with a mix of excitement and apprehension. A significant portion of Manila’s population continues to have hesitancy toward a COVID-19 vaccine, as of July 4, 2021, only 166,391 out of 1,846,531 citizens of Manila are recorded to be fully vaccinated. Since late June, the Philippines has greenlighted the vaccination of five priority groups, namely health workers (A1), senior citizens (A2), persons with comorbidities (A3), economic frontline workers (A4), and indigent Filipinos (A5). The government’s strategy was to kickstart inoculations in places with high infections and significant economic impact. These include Metro Manila, six provinces in Luzon, Metro Cebu, and Metro Davao (Rappler, 2021). But due to the misinformation scatter over social media, the government’s goals are bound to be impossible.
Background of the Study
Most of us would see that vaccination programs could help the economy and society come back from the nearly graved situation. Records show that the Philippine economy suffered a big loss due to the lockdowns and ECQs implemented by the government, some laborers have lost their jobs and started to think about where they could find money to support their needs. However, the government has come up with assistance, the social amelioration programs helped the people to survive lockdowns. Vaccination programs also are being implemented and fast running through the help of LGUs.
Though the government helped people survive the crisis and vaccination programs are undergone, but after giving, the government is now running out of funds, and people are hesitating to get vaccinated due to the misinformation from the social media, therefore this study aims to what is the influence of social media covid-19 vaccine hesitancy.
Few citizens of Manila are hesitant to get vaccinated, as used in this study is to know the sources of anti-vaccination campaigns, and their relationship to people’s vaccine hesitancy to help the Manila LGU to plan a strategy to pursue people to get vaccinated and reach the goal of vaccinating 100% of the population.
Statement of the Problem
This study aimed to know the impact of social media on covid-19 vaccine
hesitancy.
Specifically, the study attempted to answer the following questions:
- What social media platforms are most likely to influence the people to be
unvaccinated? - What are the effects of anti-vaccination campaigns on the respondents?
- What are the reasons of the respondents for being unvaccinated?
Objectives of the Study
The primary objectives of this research are:
- to identify the social media platforms that influence the respondents to hesitate about vaccination;
- to find out the effects of anti-vaccination campaigns on social media on the respondents;
- to find the reasons of the respondents for being unvaccinated;
Significance of the Study
This section provides various reasons as to the essence of the study. This study aimed to benefit the following:
The Manila LGU, this study ensures that the local government of Manila can prepare a lot of new strategies to continue the CoViD-19 vaccination project, to be able to ensure the mission to vaccinate the 100 percent of the population.
Future Researchers may benefit from this study as a source for conducting the same research. Their research may lead to
Scope and Limitation
The study specifically focused on the people who are hesitant of being vaccinated. Although there are other factors affecting the decision of the people, the researchers choose only anti-vaccination campaigns that are spread on social media. To obtain the influence of social media on CoVid-19 vaccine hesitancy.
The researcher will give a self-evaluation questionnaire that is required to answer by the chosen vaccine-hesitant, regarding the anti-vaccination campaigns on social media. This study is largely dependent on the respondent’s honesty,
sincerity, and integrity.
Regarding the sources of anti-vaccination campaigns, the result will depend on the respondents’ answers as they rank the platforms that are most likely to contain sources of the anti-vaccination campaigns. If there are people involved, the researcher will respect their privacy and will not expose their identities to the public.
Definition of Terms
Social Media. This refers to interactive technologies that allow the creation or sharing/exchange of information, ideas, interests, and other forms of expression via virtual communities and networks. While challenges to the definition of social media arise due to the broad variety of stand-alone and built in social media services currently available (Dollarhide, 2021).
LGU. This refers to a local government unit which is a political subdivision of the Republic of the Philippines at the provincial, city, municipal, or Barangay level, and “LGUs” means, collectively, the plural thereof (International Bank for Reconstruction and Development, 2005).
CoVid-19. This refers to an acute respiratory illness in humans caused by a coronavirus, capable of producing severe symptoms and in some cases death, especially in older people and those with underlying health conditions. It was originally identified in China in 2019 and became a pandemic in 2020 (Oxford Languages, 2020).
ECQ. This Refers to enhanced community quarantine which is a series of stay-at-home orders and cordon sanitaire measures implemented by the
Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID) in the island of Luzon and its associated islands. It is part of the COVID-19 community quarantines in the Philippines, a larger scale of COVID-19 containment measures with varying degrees of strictness. The “enhanced community quarantine” (ECQ) is the strictest of these measures and is effectively a total lockdown (Wikipedia, 2020).
Chapter II
REVIEW OF RELATED STUDIES
This chapter presents the related literature and studies of both local and foreign from various scholars relevant to support the discussion throughout. Due to scarcity of materials, most of the review of related literature was obtained from the internet.
Foreign Literature
Puri et al. (2020) said, it is not easy to understand why social media is disproportionately successful in promoting hesitation to get immunized rather than adoption. Social media users can be a biased population sample with basic misconceptions about the benefits and side effects of vaccination, while not being well versed in the consequences of vaccine preventable diseases. Moreover, when evaluating the risks and benefits of vaccination in general, the risks may be overestimated and may seem more immediate and tangible as compared to the more abstract potential benefits of disease prevention.
Jennings et al. (2021) said, as COVID-19 vaccines are rolled out across the world, there are growing concerns about the roles that trust, belief in conspiracy theories, and spread of misinformation through social media play in impacting vaccine hesitancy. We use a nationally representative survey of 1476 adults in the UK between December 12 and 18, 2020, as well as 5 focus groups conducted over the same period. Trust is a fundamental predictor, mistrust of vaccines in general, and mistrust of government increase vaccine hesitation. Trust in health
institutions and experts and perceived personal threat is vital, with focus groups revealing that COVID-19 vaccine hesitancy is driven by a misunderstanding of herd immunity as providing protection, fear of rapid vaccine development and side effects, and beliefs that the virus is man-made and used for population control. In particular, those who obtain information from relatively unregulated social media sources—such as YouTube—that have recommendations tailored by watch history, and who hold general conspiratorial beliefs, are less willing to be vaccinated. With an increasing number of people using social media to gather health information, interventions require action from government, health officials, and social media companies. More attention needs to be given to helping people understand their own risks, unpacking complex concepts and closing knowledge gaps.
Vaccine hesitancy is a long-standing problem, but it has now assumed great urgency. The widespread mortality and economic disruption caused by the Covid19 pandemic present acute challenges. The long-term decline of trust in UK collective and public institutions compounds the uncertainty (Devine et al., 2020).
Local Literature
Cordero (2021) said that as the world welcomes the availability and distribution of COVID-19 vaccines, coupled with it is the ‘hesitant’ predicament of some Filipinos to get vaccinated because of the confusing information regarding its efficacy. In doing so, the government must gain public confidence to ensure a successful vaccination program. A recent study has suggested that more “localized” public education and a role model of public and health authorities can help strengthen public trust. However, it does require a lot of clarification if it applies in the current situation where education is fully performed online. The problem now lies in the country’s low Internet connectivity, which greatly affects on-line configuration. This study, then proposes that a house-to-house massive information campaign by local health care personnel which is led by a medical doctor to ensure a credible explanation of the entire procedure. Likewise, the idea of public servants as models seemed ineffective since there were already victims linked to the vaccine. A coherent and transparent approach is suggested rather than that, which can prepare the country for a more defensive strategy to combat the pandemic.
Gotinga (2021) said hesitation to vaccinate among Filipinos is a major concern in the country’s COVID-19 vaccination campaign, already hampered by the slowness of vaccine shipments. Only 4 percent of the Philippines’ roughly 110 million people has received at least one dose of a COVID-19 vaccine as of June 6, and only 1.4 percent have received a second dose.
Westerman (2021) says hesitation to vaccinate is a national issue in the Philippines, despite the archipelago having one of the worst COVID-19 infection rates in South East Asia. Cases exceeded 1.1 million, primarily in the Manila metropolitan area; more than 19,200 people died.
Alfonso et al. (2021) said, as the Dengvaxia controversy raged and received broad public and social media coverage, vaccine confidence among Filipinos has precipitated catastrophically. By 2015, 93 percent of Filipinos were strongly convinced of the importance of vaccines. This percentage went down to 32% in 2018. The compliance rate for childhood vaccines such as measles vaccine fell from 88% in 2014 to 55% in 2018. Measles cases have increased nearly 2,000% from 2017 to 2019, with 632 measles-related deaths reported in 2019 alone.
Foreign Studies
Piltch-Loeb et at. (2021) according to their research, anecdotal reports indicate that some people who qualify for the vaccine refuse to receive the vaccine. Their article shows that in the US, it is helpful to use traditional media to discuss the COVID-19 vaccine. It also shows that because the vaccine-hesitant individuals are more likely to identify social media as their sole source of information, social media platforms have a particularly important role to play in addressing vaccine hesitancy.
The study conducted by Hermani and Biller-Andorno (2021) stated the anti-vaccination group scored the highest number of retweets per Tweet, highlighting that the vast majority of anti-vaccination supporters act as an echo chamber for the pool of content generated by a small fraction of users. Behavioral outliers, which were excluded with 0.1% confidence interval, suggest that a small fraction of users belonging to this group are producing the majority of the content, which is then shared by the community at large. The data also suggest that individuals and pro-vaccine groups are more likely to generate new content and are not very engaged with a larger community with similar interests.
According to the research of Wilson and Wiysonge (2020), The use of social media to organize offline action to be highly predictive of the belief that vaccinations are unsafe, with such beliefs mounting as more organization occurs on social media. Furthermore, the prevalence of foreign misinformation is very statistically significant and substantial in predicting a decline in average immunization coverage over time. A 1-point increase in the 5-point disinformation scale is associated with a 2-percentage-point decrease in annual average immunization coverage. We also found support for the relationship between foreign misinformation and negative social media activity regarding vaccination. The significant impact of foreign misinformation is to increase the number of negative tweets on vaccines by 15 percent for the median country.
Hou et al. (2021) found out that among social media users 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 were more concerned about vaccine production and supply, while the tweeters from New York and London were more concerned about vaccine distribution and inequity. Negative tweets expressing a lack of confidence in the vaccine and disinformation, or rumors had more followers and attracted more public participation online.
The study of Thaker and Subramanian (2021) there was no significant difference in gender, age, education or ethnicity between the three conditions. Similarly, there was no significant difference between the three conditions on pre – test measures of intention to vaccinate against COVID-19 to protect self and intention to vaccinate against COVID-19 to protect others. These results show that the composition of the three groups was similar with respect to demographic characteristics and vaccination intentions prior to exposure to COVID-19.
As a manipulation check, respondents were asked, “Which of the following statements best represents information in the image?” The response options were, “Information is supportive of getting vaccinated for COVID-19” and “Information is opposed to getting vaccinated against COVID-19.” There was a significant difference between the two experimental conditions and control on correctly identifying if the information in the image was supportive or opposed to getting vaccinated against COVID-19. A large majority of respondents in both the misinformation and hesitancy condition said that the information is opposed to getting vaccinated, whereas almost all respondents in the factual information control said the information was supportive of getting vaccinated against COVID19.
Local Studies
The study of Migriño et al. (2020) found that out of 110 respondents, there were mostly mothers 20 to 39 years old. Most respondents felt that vaccines were protective, but vaccine hesitancy rates among respondents were 36.4%. Respondents who believed in the protective nature of vaccines were less likely to report vaccine hesitancy and were nine times less likely to refuse vaccination for their children because of negative media exposure. The main reasons identified for vaccine hesitation or exposure to negative media information and concerns regarding vaccine safety. The major negative media identified by respondents concerned the dengue vaccine, Dengvaxia. Health care workers and political leaders were the primary defenders of vaccination in the community.
According to the study of Landicho-Guevarra et al. (2021), out of 55 VHCs of children under 5 who participated in 44 interviews, 11 respondents refused to participate. The reasons included busy schedules and the fact that the husband or other relatives did not allow participation, and some did not provide a specific reason. The majority of respondents were women, under the age of 40, with a minimum high school diploma.
Mason and Smith (2020) indicated in their study that there was significant duplication between Facebook and Twitter data. For example, the same spikes in posts occurred around Dengvaxia during similar time periods for both platforms, just as some of the same individuals were controlling the overall narrative and driving much of the debate on Facebook and Twitter.
Analysis from both platforms also revealed some differences and nuances. Francis Cruz and Persida Acosta, two key politicians responsible for most of the reactions against the Department of Health, are relatively invisible on Facebook. However, on Twitter, they appear to be major actors in the Dengvaxia online debate.
Bautista, Bleza, Balibrea, Equiza (2021) In their study, the majority of respondents are willing to be vaccinated, regardless of their place of residence, gender, education and monthly family income. The perceived risk to the safety and effectiveness of COVID-19 vaccines has been shown to be important factors affecting respondents’ willingness to obtain a COVID-19 vaccine. Similarly, many respondents have preferred brands in mind, which may affect the government’s immunization program. Health education and vaccine promotion should be developed to improve vaccine acceptance during COVID-19 inoculation programs, especially since not all preferred brands are available. The government must also target family leaders, doctors and church figures as primary influences to encourage more people to get vaccinated.
Theoretical Framework
The Health Belief Model (HBM) is a theoretical model that can be used to guide health promotions and disease prevention programs. It is used to explain and predict individual changes in health behaviors. It is one of the most widely used models for understanding health behaviors.
HBM focuses on individual beliefs about health conditions, which predict individual health-related behaviors. The model defines the key factors that influence health behaviors as an individual’s perceived threat to sickness or disease (perceived susceptibility), belief of consequence (perceived severity), potential positive benefits of action (perceived benefits), perceived barriers to action, exposure to factors that prompt action (cue action), and confidence in ability to succeed (self-efficacy). (Rural Health Promotion and Disease Prevention Toolkit Rural Health Information Hub, 2018).
Thus, Health Belief Model is found to be appropriate for this study as it is the most widely applied for understanding health behaviors.
Another, the “Magic Bullet” or “Hypodermic Needle Theory” of direct influence effects was based on early observations of the effect of mass media, as used by Nazi propaganda and the effects of Hollywood in the 1930s and 1940s. People were assumed to be “uniformly controlled by their biologically based ‘instincts’ and that they react more or less uniformly to whatever ‘stimuli’ came along”. The “Magic Bullet” theory graphically assumes that the media’s message is a bullet fired from the “media gun” into the viewer’s “head”. Similarly, the “Hypodermic Needle Model” uses the same idea of the “shooting” paradigm. It suggests that the media injects its messages straight into the passive audience. This passive audience is immediately affected by these messages. The public essentially cannot escape from the media’s influence, and is therefore considered a “sitting duck”. Both models suggest that the public is vulnerable to the messages shot at them because of the limited communication tools and the studies of the media’s effects on the masses at the time. It means the media explores information in such a way that it injects in the mind of audiences as bullets.
The “magic bullet” and “hypodermic needle” models originate from Harold Lasswell’s 1927 book, Propaganda Technique in the World War. Recent work in the history of communication studies have documented how the two models may have served as strawman theory or fallacy or even a “myth”. Others have documented the possible medical origins of the metaphor of the magic bullet model. (Communication Theory; Mass Communication: Magic Bullet or Hypodermic Needle Theory of Communication).
This theory is used by the people to spread propagandas in the internet to influence the decision making of individuals regarding the CoVid-19 vaccination.
Conceptual Framework
This section provides particular variables which are included in the study. As shown in the figure, the conceptual framework represents paradigm wherein variables were grouped into the dependent and independent variables. This section also provides the application of the following theories: health belief model, and magic bullet or hypodermic needle theory.
The conceptual framework in the study attempts to investigate the possible relationships between social media and CoVid-19 vaccine hesitancy.
Figure 1. Paradigm of the Study
In the figure, which consists of major variables and their possible pattern of influence toward each other, and the influence on covid-19 vaccine hesitancy. The effect between the independent variable namely: social media towards covid-19 vaccine hesitancy to produce either low vaccination rate or high vaccination rate.
Base on the theories namely: health belief model, and magic bullet or hypodermic needle theory, conducting an online survey on vaccine hesitant is a must. The questions are made based on the statement of the problem.
With the hesitant, the researchers will find people with vaccine hesitancy and conduct survey for their reasons of being they unvaccinated.