Despite the good news emanating from COVID-19 vaccine trials, governments should understand hesitancy concerns to ensure a successful roll-out plan.

  • The analysis identified 243,000 tweets from the UK and US that referred to a possible COVID-19 vaccine
  • Hesitancy tweets were not just a more significant portion of the vaccine conversation, they also created greater traction than advocacy tweets
  • By analyzing online conversation, public health institutions and governments can strengthen their understanding of vaccine hesitancy in specific regions

In recent weeks, news coming out of COVID-19 vaccine trials has been hugely encouraging. The preliminary data from Pfizer and Moderna’s vaccine show 95 percent and 94.5 percent efficacy, respectively. With more vaccines expected to report preliminary data in the coming months, it appears that we can start to be hopeful about some kind of return to normality.

But the discovery of the vaccine is only the first challenge to overcome. The next challenge for governments will be convincing citizens to accept a vaccine. To do this, governments and public health institutions must first get to grips with the problem’s scope and scale. They will need to find out how many people are hesitant, which countries have the biggest challenge, and the specific issues that drive hesitancy. 

Vaccine hesitancy is prevalent on social media

Social media is a valuable source of public feedback that, if analyzed accurately, provides a real-time and granular view of public opinion. BrandsEye recently concluded an analysis of vaccine hesitancy on social media from 28 July to 28 August to assess the problem’s scale and identify what was driving the conversation. The results are worrying. 

The analysis identified 243,000 tweets from the UK and US that referred to a possible COVID-19 vaccine. BrandsEye’s distributed crowd of human contributors analyzed the sentiment (positive, negative, or neutral) in 8,392 tweets and coded a further 1,505 tweets for nine possible hesitancy themes. 

We found that vaccine hesitancy tweets made up 28.2 percent of COVID-19 vaccine conversation, compared to 8.4 percent for advocacy tweets. 

Classification themes
ConspiracyThe user believes that the COVID-19 vaccine is part of a conspiracy (not just money-making). E.g., mark of the beast, tracking chips, etc. 
No dangerThe user accepts COVID-19 is real but does not think it is very dangerous or harmful.
HoaxThe user states that COVID-19 is a hoax, conspiracy, or simply not real. Includes “plandemic” mentions.
Health & safetyThe user references health safety issues, side effects of a COVID-19 vaccine, or concerns about the vaccine’s ingredients.
MandatoryThe user is against making the vaccine mandatory or believes it should be optional.
PharmaceuticalThe user doesn’t trust the pharmaceutical industry. E.g., they think they are tricking people, trying to make money, etc.
Vaccine efficacyThe user is doubtful or skeptical about how effective a vaccine will be.
Scientific processThe user thinks that the vaccine’s development is being rushed, has been poorly tested, or is otherwise scientifically flawed.
PoliticsThe user believes the vaccine is political in nature or mistrusts the government about the vaccine.

Hesitancy tweets were not just a more significant portion of the vaccine conversation, they also created greater traction than advocacy tweets, generating an average of 4.8 engagements per post, tripling the engagement generated by advocacy mentions. In both the UK and the US, the public is concerned about being forced to take the vaccine and possible side effects.

Advocates of a vaccine used Twitter to share news and developments about vaccine trials. They are generally concerned about the equitable and fair distribution of a vaccine once it becomes available.

Institutional distrust is a critical issue in vaccine discourse. This emerged as a central theme that underpinned the COVID-19 vaccine conversation and was evident in tweets from both hesitancy and advocacy Twitter users. 

In the US, hesitancy was driven by health and safety concerns

The United States had a marginally higher percentage of hesitancy mentions than the United Kingdom. Health and safety was the top driver of hesitancy conversation. Users shared Dr. Fauci’s warnings about the premature release of a vaccine and highlighted concerns around unknown side-effects and adverse reactions. 

Libertarian views were prevalent in hesitancy conversations related to mandatory vaccines. US House Representative Thomas Massie drove engagement with a tweet stating that vaccines should be voluntary rather than mandatory. 



Conspiracy theories and tweets about pharmaceutical companies were more prevalent in United States conversation compared to the United Kingdom. 

In the UK, government-mandated vaccines drove over a quarter of hesitancy conversation

Most of the tweets about a vaccine being mandatorily included users petitioning the UK Parliament not to place restrictions on those that refuse vaccination.  

Health & safety also drove hesitancy in the UK. Previous medical failures, such as thalidomide, were cited by Twitter users who cautioned against rushing out a vaccine without sufficient testing. Some people called on the government to hold pharmaceutical companies liable for harm caused by a COVID-19 vaccine.  

Twitter users in the UK more frequently referred to the pandemic as a hoax generated by media hype than the US, who were more likely to attribute the pandemic to conspiracy theories linked to Bill Gates. 

Governments and public health organizations ought to pay close attention to hesitancy sentiment online and the themes driving it. Unlike other survey methods, social media provides an unprompted and volunteered view of public opinion. By analyzing online conversations, public health institutions and governments can strengthen their understanding of vaccine hesitancy in specific regions. By understanding the specific topic themes driving hesitation, governments can develop communications strategies that combat misinformation and the most pressing public concerns.

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