JMIR Publications

ABSTRACT

Background:

The battle against the 2019 novel coronavirus (COVID-19) has not concluded. Although vaccines are available, the high prevalence of vaccine hesitancy represents a significant challenge to public health and raising vaccine acceptance among the public is critical. While social media has become an increasingly popular source of COVID-19 information, the question of whether and how social media use can influence the public’s vaccine hesitancy warrants exploration.

Objective:

This study aimed to (1) examine the level of COVID-19 vaccine hesitancy, (2) identify influencing factors of COVID-19 vaccine hesitancy, and (3) investigate the direct and the indirect effect of social media use on vaccine hesitancy.

Methods:

A cross-sectional online survey took place over six days (January 20–25, 2021), a month ago before vaccination was initiated in South Korea. This study included 1016 subjects, and a logit model for regression analyzed associations between socio-demographic factors, health-related factors, psychological factors, and media use toward one’s COVID-19 vaccine hesitancy. Additionally, the indirect effects of social media use on vaccine hesitancy via psychological factors (i.e., perceived risk, perceived benefits, and perceived barriers) were examined.

Results:

Among the respondents (n=1,016), 37.5% (n= 381) reported that they were undecided, 1.8% (n= 110) would probably not get vaccinated. Out of the sociodemographic factors, female (OR, 2.056; 95% CI, 1.40-3.03; P < .001), age in 50s (OR, .40; 95% CI, .19-.86; P= .020), and over 60s (OR, .43; 95% CI, .20 – .92; P= .029) were significant individual predictors of COVID-19 vaccine hesitancy. When it comes to psychological factors, perceived susceptibility (OR, .70; 95% CI, .53 – .94; P= .017) and perceived benefits (OR, .07; 95% CI, .04 – .10; P < .001) were related to vaccine acceptance, while perceived barriers (OR, 1.72; 95% CI, 1.35 – 2.19; P < .001) were related to vaccine hesitancy. Social media use to obtain vaccine-related information was related to higher tendency of vaccine hesitancy directly (OR, 1.43; 95% CI, 1.08-1.90; P= .014). Moreover, perceived benefits mediated the indirect effect of social media on vaccine hesitancy in a negative direction while perceived barriers mediated the effect in a positive direction.

Conclusions:

Findings revealed a considerable level of COVID-19 vaccine hesitancy in South Korea. Perceived barriers (i.e., concerns about side effects caused by vaccination) had a significant and robust influence on vaccine hesitancy. Obtaining vaccine-related information via social media was related to vaccine hesitancy both positively and negatively. Social media is a double-edged sword; that is, efforts should be made to disseminate reliable and timely information while monitoring misinformation or rumors for successive implementation of vaccine programs during pandemics.