gms | German Medical Science

Background and status of (inter)national research: Vaccination against Covid-19 has been available in Germany since December 2020. The willingness of the population to be vaccinated has been changing in the course of the pandemic. There is limited knowledge about why people hesitate to get a Covid-19 vaccine. In order to further increase vaccination rates, knowledge is needed regarding the factors affecting the acceptance of vaccination. Because of the new experiences encountered in the pandemic as well as the novelty of and perceived uncertainty associated with the available Covid-19 vaccines, existing evidence on vaccine hesitancy is only partly applicable to Covid-19 vaccines.

Question and objective: Using posts on three social media sites, the aim of this study was to investigate the reasons why individuals are hesitant to receive a Covid-19 vaccine.

Method or hypothesis: The German-language versions of Instagram, Twitter and YouTube were searched regarding negative attitudes towards the Covid-19 vaccination. The data search was conducted in February 2021 with posts covering a period from 29/12/2020 to 09/02/2021. The search combined the terms ‘corona’, ‘Covid-19’ and ‘SARS-Cov-2’ with ‘vaccination’. It was conducted in German language. The evaluation of the data was inductive, based on structured qualitative content analysis according to Kuckartz.

Results: A total of 226 posts have been examined. Based on the data, 7 main categories with a different number of subcategories could be identified: attitudes regarding vaccines (mistrust of the vaccination mechanism, mistrust due to the rapid development and vaccine approval process, rejection of certain manufacturers), natural immunity, refusal for health reasons (side effects, rejection due to pre-existing conditions and allergies, adverse reaction to previous vaccinations), lack of education, no perceived added value of the vaccination (low benefit assessment of vaccination, low perceived risk associated with Covid-19, reliance on own immune system and own preventive behaviour, rejection on esoteric or religious grounds), attitudes due to misinformation.

Discussion: The results indicate that a lack of information and the spread of misinformation related to Covid-19 and vaccines are drivers of hesitancy towards the Covid-19 vaccination. For example, information on Covid-19 and vaccination is seldom provided in simple language and is often not multilingual. It is therefore necessary to develop tailored information addressing hesitancy and promoting the awareness towards the relevance of the Covid-19 vaccination in the target group.

Practical implications: The results emphasize the need for strengthening the Covid-19-related health literacy and promoting informed decision making across all population groups. Using social media sites in addition to other media sources could allow reaching a broader range of the population.

Appeal for practice (science and/or care) in one sentence: Strategies promoting Covid-19-related health literacy and informed decision making should be developed, evaluated and transferred from research into practice.