Abstract

Social media have played an important role in shaping COVID-19 vaccine choices during the pandemic. Understanding people's attitudes toward the vaccine as expressed on social media can help address the concerns of vaccine-hesitant individuals. The aim of this study was to understand the attitudes of Swedish-speaking Twitter users toward COVID-19 vaccines. This was an exploratory qualitative study that used a social media-listening approach. Between January and March 2022, a total of 2877 publicly available tweets in Swedish were systematically extracted from Twitter. A deductive thematic analysis was conducted using the World Health Organization's 3C model (confidence, complacency, and convenience). Confidence in the safety and effectiveness of the COVID-19 vaccine appeared to be a major concern expressed on Twitter. Unclear governmental strategies in managing the pandemic in Sweden and the belief in conspiracy theories have further influenced negative attitudes toward vaccines. Complacency-the perceived risk of COVID-19 was low and booster vaccination was unnecessary; many expressed trust in natural immunity. Convenience-in terms of accessing the right information and the vaccine-highlighted a knowledge gap about the benefits and necessity of the vaccine, as well as complaints about the quality of vaccination services. Swedish-speaking Twitter users in this study had negative attitudes toward COVID-19 vaccines, particularly booster vaccines. We identified attitudes toward vaccines and misinformation, indicating that social media monitoring can help policy makers respond by developing proactive health communication interventions.

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