key: cord-0926184-d3j0uqmh authors: Storey, Doug title: COVID-19 Vaccine Hesitancy date: 2022-02-28 journal: Glob Health Sci Pract DOI: 10.9745/ghsp-d-22-00043 sha: b60c481a45794855e73eb3d274c4e3d0c5f24ec6 doc_id: 926184 cord_uid: d3j0uqmh Improving access to accurate information on vaccines and vaccination, increasing trust in reliable information sources, and counteracting misinformation can go a long way toward improving vaccination decision making. common in many places, they are also shaped by local culture and social conditions and must be studied locally to develop tailored approaches to vaccine communication. For example, patterns of social interaction differ resulting in localized normative perceptions, real and perceived risk of COVID-19 transmission vary, and sources of information differ in their trustworthiness. In this issue of GHSP, Kulkarni et al. 7 examine the roles that different information sources have in uptake of the third dose of diphtheria-pertussis-tetanushepatitis B-Haemophilus influenzae type-b-pentavalent vaccine. Such variations in these factors indicate a need for continued analysis of how people think about vaccines and vaccination and the social influences that affect their decisions about getting vaccinated. Where and how people get COVID-19 information affects what they think about the disease and how to respond. Formative research to inform COVID-19 vaccination communication efforts should be asking people who have been vaccinated questions such as: What made you decide to get the vaccine? What do you consider to be the benefits of getting vaccinated? Was there anything that made it hard for you to get vaccinated? How did you overcome that challenge? Where did you get the information that helped you make the decision and get vaccinated? People who have not yet been vaccinated should be asked the following questions: What are some of the reasons you have not been vaccinated yet? How likely do you think it is that you might become infected with COVID-19? How serious do you think it would be if you did become infected with COVID-19? What proportion of your friends and family has been vaccinated? Where do you get information that helps you decide whether to get vaccinated or not? The COVID-19 pandemic is global and has connected us in ways we have rarely if ever seen before. Although still not universal, rapidly expanding access to mobile technologies in all parts of the world makes it easier to access information and connect with others across time and distance at unprecedented speeds. As a result, we vicariously share experiences (and trauma) with people who are otherwise quite different from us. Sadly, the same technologies can also spread misinformation and enable close-minded echo chambers and discriminatory communities to form and persist. 8 People develop attitudes and beliefs through interaction with others and through what they see and hear in the media, increasingly through online and social media, even in more remote parts of the world. Furthermore, they make choices based in part on what they see their peers and other community members doing and on what they a Johns Hopkins Center for Communication Programs, Baltimore, MD, USA. Correspondence to Doug Storey (dstorey@jhu.edu). Global Health: Science and Practice 2022 | Volume 10 | Number 1 perceive to be approved or disapproved by people around them, so the symbolic environment that surrounds them can be very influential. The COVID Behaviors Dashboard also opens a window on these dynamics of trust and information use. Information sources that are trusted generally exert more persuasive influence over people who rely on them, but trust does not necessarily result in better health outcomes. Trusting in a source that contains misinformation may pose real danger to personal and public health. According to the Dashboard data, patterns of media use and trust vary somewhat from country to country, but globally the sources of information people report relying on the most are government health authorities and journalists. However, those 2 sources differ considerably in terms of reported trustworthiness. 5 The least trusted sources of information tend to be journalists, religious leaders, and politicians, while scientists and health experts, including international agencies like the U.S. Centers for Disease Control and Prevention and the World Health Organization, and local health workers and government health authorities, enjoy higher levels of trust. Fortunately, sources that engender low levels of trust tend to have lower levels of exposure, but people who do trust those sources are more susceptible to the misinformation they carry. Communication planners seeking to promulgate accurate information about COVID-19 should carefully analyze the relationship between trustworthiness and exposure to identify the communication channels that are both trusted and reach the greatest numbers of people. From a public health perspective, managing the symbolic environment to improve access to accurate information, to improve trust in trustworthy information sources, and to counteract misinformation can go a long way toward improving vaccination decision making. Dealing with vaccine hesitancy in Africa: the prospective COVID-19 vaccine context COVID-19 vaccine hesitancy in South Africa: how can we maximize uptake of COVID-19 vaccines? Factors of parental COVID-19 vaccine hesitancy: a cross sectional study in Japan COVID-19 vaccine acceptance among Bangladeshi adults: understanding predictors of vaccine intention to inform vaccine policy Johns Hopkins Center for Communication Programs in collaboration with Facebook Data for Good Implementation approaches for introducing and overcoming barriers to hepatitis B birth-dose vaccine in sub-Saharan Africa Role of information sources in vaccination uptake: insights from a cross-sectional household survey in Sierra Leone Building trust while influencing online COVID-19 content in the social media world