JMIR Publications

ABSTRACT

Background:

In the fall of 2020, the COVID-19 infodemic began to affect public confidence in and demand for COVID-19 vaccines in the United States. While national polls and surveys indicated what Americans felt about COVID-19 vaccines, they did not provide an understanding of why they felt that way nor the social and informational influences that factored into vaccine uptake. It was essential for U.S. Centers for Disease Control and Prevention (CDC) to gain a better understanding of the information environment and how it affected Americans’ confidence in and demand for COVID-19 vaccines.

Objective:

CDC established an Insights Unit within its COVID-19 Response Vaccine Task Force in January 2021 to assist CDC in acting more swiftly to address the questions, concerns, perceptions, information voids, and circulating mis- and disinformation that affected people’s health decision-making, particularly around COVID-19 vaccines. The Insights Unit established a novel approach and methodology to rapidly detect and report on the trends in vaccine confidence and demand. The goal was to guide communication efforts and improve programmatic quality in near real-time through a continual and iterative listening and feedback process.

Methods:

To inform the first COVID-19 State of Vaccine Confidence (SoVC) Insights Report, we identified and assessed available data sources. CDC’s Vaccinate with Confidence framework and the World Health Organization’s (WHO) Behavioral and Social Drivers for vaccine decision-making framework (BeSD) were selected as guiding principles for interpreting the impacts of findings on vaccine confidence and uptake. The Insights Unit established qualitative thematic analysis methods and a consensus-building approach to identify prevailing and emerging themes, assess their potential threat to vaccine confidence, and propose actions to increase confidence and demand.

Results:

As of August 2022, the Insights Unit produced and distributed 34 reports to over 950 recipients within CDC and externally. State and local health departments, nonprofit organizations, professional associations, and congressional committees have referenced and used the reports as resources for learning about COVID-19 vaccine confidence and demand, developing communication strategies to address low vaccine acceptance, and demonstrating how CDC monitored and responded to COVID-19 vaccine mis- and disinformation. Our methodology underwent continuous process improvement as workforce capacity and contextual changed to increase the rigor of the research process, the validity of the findings, and the usability of the reports.

Conclusions:

While not a solution alone for infodemics, this methodology is a first step in managing an infodemic and can serve as a diagnostic technique for rapidly identifying opportunities for intervention and prevention. The methodology could be adapted and scaled for use in a variety of public health settings. It can be applied beyond acute public health crises to support adherence to guidance and recommendations and could be considered within routine monitoring and surveillance systems.