FINAL PR-Qualitative - Emperador CHPT 1-5

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Examining Social Media’s Influence to Vaccine Acceptance in Davao Region

Amidst the COVID-19 Pandemic: A Qualitative Study

______________________________________________________________________

A Research Project Submitted to the Rogationist Academy-Davao

Practical Research
Terryl Angelo M. Emperador

S.Y 2021-2022

CHAPTER 1

Introduction

As the world continues to fight the COVID-19 epidemic, vaccination will become

increasingly more important in helping civilization achieve herd immunity and return to

normalcy. Vaccines are substances that promote antibody formation and offer protection

against one or more illnesses. They are made from the disease's causative agent, its

products, or a synthetic equivalent that has been processed to behave as an antigen

without causing the disease. To tackle the lethal threat posed by the COVID-19

pandemic, the World Health Organization (WHO) is working diligently with partners to

design, manufacture, and distribute safe and effective vaccines. Equitable access to

safe and effective vaccines is critical to ending the COVID-19 pandemic, encouraging

the public to embrace vaccines is a critical public health issue. With vaccine debate

dominating government conferences, news stories, and social media discussions,

urgent demands must be made to promote vaccine literacy, address vaccination

reluctance, and combat disinformation specific to the COVID-19 vaccine.


Inaccessibility to vaccinations is a major factor in low vaccination rates; however,

when vaccines are readily available, vaccine acceptance becomes the primary barrier.

Vaccine literacy necessitates the involvement of a wider number of advocacy

stakeholders, and the misunderstanding of public health makes enforcing vaccine

literacy more difficult. Vaccine literacy is described as "not just understanding about

vaccinations, but also building a system with reduced complexity to communicate and

deliver vaccines as a sine qua non of a working health system," and it is based on the

same notion as health literacy.

For decades, social media has played a significant role in the dissemination of

news and information. The dissemination of disinformation, aided by social media and

other digital platforms, is proving to be a greater threat to global public health than the

virus itself, as the COVID-19 epidemic has proved. The study's aim is to assess and

investigate the influence of social media on vaccine acceptance among Davao

residents.

Statement of the Problem

The general problem addressed in this study is that few residents from Davao

City lack knowledge about the COVID-19 vaccines which affects vaccine hesitancy

among the residents. One of the key causes for Davao's low vaccination literacy is the

widespread dissemination of false information and news about the COVID-19 vaccine
on social media. The objective of this study is to investigate and assess the influence of

social media on vaccine acceptance among Davaoeños.

1. What is vaccine and vaccine acceptance?

2. How does social media influence vaccine acceptance in Davao region?

3. What causes the vaccine impediment among residents in Davao region?

Significance of the Study

This qualitative research ought to be conducted prior to understanding the

Vaccine acceptance in Davao Region. The result of the study could contribute

significantly to the following:

To the Individuals

This study, which heightens the Vaccine Acceptance in Davao region, may serve

as an awareness of one's knowledge about COVID-19, especially the importance of

getting vaccinated.

To the Families
This study would benefit families, specifically the parents, since they will be able

to acquire enough knowledge about Vaccine Literacy to fairly educate their children

about the positive effect of COVID-19 Vaccines.

To the Local Communities

Since Health Literacy and accepting COVID-19 Vaccines are undoubtedly

beneficial to everyone, this study is hoped to vastly influence communities in Davao

Region. Adapting knowledge about these vaccines will increase communities’

willingness to accept vaccines and follow health protocols as well. Moreover, getting

vaccinated will be substantial not just for a person alone but for all the people around a

certain community. It lessens the spread of the virus and the number of the affected

individuals in a community.

To the Government Agencies

This research will then be used by government agencies to investigate the

relevance of vaccine acceptance in the Davao Region in order to raise public

knowledge about COVID-19 vaccinations and therefore enhance vaccine acceptance

rates.

To the Medical Professionals

This study will support the health care practitioners by adapting the health

communications strategies for improved vaccine literacy and vaccine acceptance rates.
Scope and Limitation

The general objective of this qualitative research is to determine how social

media influence vaccine acceptance in Davao region amidst the Covid-19 pandemic.

The residents of Davao will be the respondents of this study. Furthermore, this study

aims to investigate and examine different factors that can affect vaccine acceptance in

Davao region through conducting focus group interviews online.

Methodology

This chapter will go through the methods that will be utilized to conduct the

analytical research. This chapter will address the research design, the research site and

participants, data collecting procedures, data analysis, the study's reliability, the

researchers' viewpoint, and ethical problems.

In order to create comprehensive plot profiles and case studies, the researcher

will conduct a self-administrated online survey with the participants, learning about their

lives in a practical setting.The researcher will then evaluate data from the

self-administered surveys conducted online. Inductive reasoning can reveal trends and

themes, which are the result of qualitative research.


The researcher will choose thirty (30) respondents from the Davao region to take

part in the study. The researcher will conduct the survey using the guiding questions

they developed and had authorized by the research adviser through Google Form. The

survey questionnaires will be sent through Email. The researcher advises respondents

to sit in a quiet area throughout the survey to avoid being disturbed; the response of the

respondents will be saved to preserve the information provided by the researcher and to

ensure that it is kept secret.

Review of the Related Literature

This chapter presents the related literature and studies after the thorough and

in-depth search done by the researcher.

Vaccine Acceptance

A study by Haque et. al (2021) aimed to investigate the acceptance level of the

COVID-19 vaccine and its determinants among the adult Bangladeshi population. This

cross-sectional study was conducted in eight divisions of Bangladesh. There were 7,357

adult respondents who used a self-administered semi-structured questionnaire. The

statistical tool used was Statistical software STATA (Version 16.1). The majority of the

people (79.85%) had positive vaccine perceptions, believing that vaccines should be

made mandatory for everyone. Most respondents (67%) believed that the vaccine would

work against COVID-19 infection. People who had the education level of graduation or
above, age ≥50 years, students, monthly income ≥41,000 BDT, being resident of rural

area, respondents from Khulna division were more likely to receive a COVID-19

vaccine. Those who had family members diagnosed with COVID-19, presence of

chronic disease, and those who were vaccinated in the last few years were also more

likely to accept the COVID-19 vaccine. The majority of the respondents showed a

willingness to be vaccinated based on the belief that the vaccine will work against

COVID-19. With rumors circulating every day, a need for policy-level initiative and

evidence-based mass media promotion is required to make the general Bangladeshi

people keep accepting the COVID-19 vaccine whenever available at an individual level

(Haque & Rahman, 2021).

Vaccines are effective interventions that can reduce the world's great burden of

disease. However, public doubt about vaccines is an urgent problem facing public

health authorities. With the advent of the COVID19 vaccine, there is little information on

the acceptance and attitude of the Jordanian public towards the COVID19 vaccine. This

study aims to investigate the acceptability of the COVID19 vaccine and its predictive

factors, as well as the attitude of the Jordanian public towards these vaccines. An

online, cross-sectional, and self-administered questionnaire was used to investigate the

acceptability of the COVID19 vaccine for adult participants from Jordan. Logistic

regression analysis was used to find predictors of the acceptability of the COVID19

vaccine. A total of 3,100 participants completed the survey. In Jordan, public

acceptance of the COVID19 vaccine is very low. Men and people vaccinated with

seasonal influenza are more likely to receive the COVID19 vaccine.

The same Participants who believe that the vaccine is generally safe and
participants who are willing to pay for the vaccine once available, are more likely to

receive the COVID19 vaccine. However, people over 35 years old and employed

participants have a lower chance of receiving the COVID19 vaccine. In addition,

participants who believe that there is a conspiracy behind COVID19 and participants

who do not trust any source of information about the COVID19 vaccine, are unlikely to

accept them. The most reliable source of information on the COVID19 vaccine is the

healthcare provider. Public health authorities need systematic interventions to reduce

the swing level of vaccines and increase vaccine acceptance. We believe that these

results, especially the low acceptance rate, shocked the Jordanian health authorities,

and that more research on the root cause and the need for awareness-raising

campaigns should be promoted. These interventions should be in the form of rekindling

trust in national health authorities and carrying out structured publicity campaigns to

provide transparent information about the safety and effectiveness of vaccines and their

production techniques. (Tamam El-Elimat et al., 2021)

COVID-19

The term "crisis" is everywhere. The current coronavirus pandemic is considered

the most recent example. However, the concept of crisis is increasingly used as a

signifier of relevance rather than as an analytical concept. In addition, so far, human

geography has made little contribution to the field of interdisciplinary crisis research,

which is obsessed with the temporal aspect of crisis and neglects its spatiality. In this

case, the first goal of this work is to demonstrate the value of analyzing and thinking

about crises. Therefore, we present the theoretical insights developed in the recent
literature on crisis management. Second, we have more systematically demonstrated

the relevance of incorporating geographic thinking into crisis research. Based on the

TPSN framework of Jessop et al., We explain the spatial dimension of the "crown

crisis", its perception and processing in Germany. The empirical reference is based on

media reports. (Verena Brinks and Oliver Ibert, 2020)

In December 2019, pneumonia caused by the new coronavirus (SARSCoV2)

emerged in Wuhan, China, and it spread rapidly around the world. This study aims to

understand the research gaps related to COVID19 and make recommendations for

future research. We reviewed the scope of COVID19 and exhaustively searched

databases and other sources to identify the literature on COVID19 between December

1, 2019 and February 6, 2020. We analyzed the source, publication date, type and

subject of the retrieved articles/studies. 249 articles were included in this scope review.

More than half (59.0%) took place in China. Guidelines / guidelines and consensus

statements (n = 56; 22.5%) are the most common. The majority (n = 192; 77.1%) of the

articles were published in peer-reviewed journals, 35 (14.1%) were published on the

preprint server, and 22 (8.8%) were published online. Ten genetic studies (4.0%)

focused on the origin of SARSCoV2, and the topics of the molecular studies were

different. Nine of the 22 epidemiological studies focused on estimating the basic

reproduction number (R0) of COVID19 infection. Of all the guidelines/guidelines

identified (n = 35), only 10 comply with strict evidence-based practice principles. The

number of articles published every day increased rapidly until the end of January.

As of February 6, 2020, the number of articles on COVID19 has steadily

increased. However, they lack diversity and hardly exist in some research fields (such
as clinical research). Research results indicate that when more clinical research results

become available, the evidence for the development of clinical practice guidelines and

public health policies will improve. (Meng Lv et al., 2020)

What social media told us in the time of COVID-19

With the onset of the COVID-19 pandemic, social media has rapidly become a

crucial communication tool for information generation, dissemination, and consumption.

In this scoping review, we selected and examined peer reviewed empirical studies

relating to COVID-19 and social media during the first outbreak from November, 2019,

to November, 2020. From an analysis of 81 studies, we identified five overarching public

health themes concerning the role of online social media platforms and COVID-19.

These themes focused on: surveying public attitudes, identifying infodemics, assessing

mental health, detecting or predicting COVID-19 cases, analyzing government

responses to the pandemic, and evaluating quality of health information in prevention

education videos. Furthermore, our Review emphasizes the paucity of studies on the

application of machine learning on data from COVID-19-related social media and a

scarcity of studies documenting real-time surveillance that was developed with data

from social media on COVID-19. For COVID-19, social media can have a crucial role in

disseminating health information and tackling infodemics and misinformation.

The Impact of Social Media on the Acceptance of the COVID-19 Vaccine

Social media are also used efficiently to notify the general population about the

consequences of the pandemic. In addition, emerging infectious diseases like


COVID-19 lead to enhanced public use and desire for all types of information from

media. Social media thus has an important impact on perception of disease outbreaks,

decision-making, and risk behavior.10–12 As people share information on social media,

such information can be accurate or inaccurate. Accurate and timely reporting on

emerging risks such as SARS-CoV-2 is therefore essential to the public.13,14 In

reaction to a global public health crisis, social media users generally develop and share

information on healthcare available from local and international sources. Meanwhile,

professionals and governments in the health sector have adopted social media to

control and manage negative health crises.15–17 However, various age groups prefer

various social media sites, whereas the present study utilized Twitter, WhatsApp, and

Facebook for data collection regarding the impact of social media on the vaccine. The

World Health Organization (WHO) has declared that most of the social media platforms

are sources of misinformation regarding the COVID-19 which may lead to significant

risk to the public health.18 In Saudi Arabia, the Ministry of Health has launched a

vaccine campaign using a mobile application entitled Sehaty, which makes it easier to

register for COVID-19 vaccination. Several vaccination centers have also been built in

various cities throughout the country. The Pfizer-BioNTech COVID-19 Vaccine campaign

started on 17 December 2020 to supply all residents of Saudi Arabia with free

vaccines.19 This study aims to understand the influence of social media on the attitudes

and willingness of the general public of the Aseer region of Saudi Arabia to receive

vaccination against COVID-19.

Vaccine hesitancy
The Italian childhood vaccination coverage rates for various vaccine-preventable

diseases have been decreasing since 2013. In 2016, the vaccination coverage rate for

poliomyelitis in children at 24 months of age was 93,3% compared to 95,7 of 2013.

Moreover, in the same year, the vaccination coverage rate for measles in children at

24 months of age was dangerously low, accounting only for 87.3%.7,8 In Sicily,

vaccination coverage rates both for mandatory and recommended are often under the

national average.9 The hazard is highlighted by the recent outbreaks of

vaccine-preventable diseases (VPDs), including measles,10 poliomyelitis and

pertussis.11,12 In Italy, a large measles outbreak occurred in 2017, with more than

4,885 cases reported from January to December 2017.13 Sicily was one of the more

affected Italian regions with 410 reported cases at December 2017. In particular, the

whole territory of Messina reported 63 cases (10% of Sicilian cases). Vaccine hesitancy

refers to delay in acceptance or refusal of vaccines despite availability of vaccination

services and it is an individual behaviour influenced by a range of factors, such as

knowledge or past experiences. This refusal is also linked to historical, political and

socio-cultural contexts. Vaccine-hesitant individuals are a rather heterogeneous group,

some refuse certain vaccines (i.e. influenza vaccination) but agree to others.14

Particularly, newer vaccines, usually generate more hesitancy.17,18 Many scientific

studies have highlighted the negative influence of traditional (i.e. TV and newspapers)

and newest (i.e. internet and social) media misinformation on vaccine acceptance.19-21

On the other hand, an important role is played by healthcare professionals. Several

studies have demonstrated the importance of health professionals’ knowledge and

attitudes about vaccines, particularly their intention to recommend the vaccinations to


their patients, in the decision-making process regarding vaccination.

YouTube Videos and Informed Decision-Making About COVID-19 Vaccination

Social media platforms have become a dominant communication channel

through which people seek and share health-related information [18,19]. Research

suggests that this is no less the case for information on COVID-19 [20]. Although

different age cohorts tend to prefer different social media platforms, overall, YouTube is

extremely popular, with nearly three-quarters of the US adult population known to have

used the platform [21]. Founded in 2005, YouTube has over 2 billion users [22].

YouTube videos can be accessed in 80 different languages, and over a billion hours of

video are streamed every day [22]. As with social media platforms in general,

health-related content shared on YouTube is often not empirically grounded and yet can

easily be accessed [23]. Research on coronavirus-related videos on YouTube is

nascent but the results thus far are mixed, with some studies finding that the majority of

video content is reliable [24,25], whereas other studies, including those previously

undertaken by authors of this study group [26], demonstrate otherwise. At the time of

this study, there is little published research on COVID-19 vaccination content on

YouTube, with the exception of our previous study that revealed that the majority of

videos were uploaded by news outlets and did not contain misinformation [27]. Our prior

investigation was conducted relatively early in the pandemic (early-April 2020).

Continued monitoring and analysis of social media coverage of COVID-19 vaccine

messages is vital to improve its understanding among public health officials about

responding to questions and concerns that may produce vaccine hesitance and impede
community mitigation. The purpose of this study was, therefore, to build on and update

the findings of our previous investigation and add to the repository of scientific

knowledge on COVID-19 social media content.

Deciphering Vaccine Hesitancy in the Time of COVID-19

Since the COVID-19 pandemic first hit Wuhan, China, in December 2019,

scientists have been racing to develop and test novel vaccines to protect against severe

acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The speed of scientific

discovery related to COVID-19 is unprecedented. With several vaccine candidates

already being tested in clinical trials, we pose the question: what will the vaccine

hesitant do in the face of this pandemic?

Influence of Social Media Platforms on Public Health Protection Against the

COVID-19 Pandemic via the Mediating Effects of Public Health Awareness and

Behavioral Changes

Despite the growing body of literature examining social media in health contexts,

including public health communication, promotion, and surveillance, limited insight has

been provided into how the utility of social media may vary depending on the particular

public health objectives governing an intervention. For example, the extent to which

social media platforms contribute to enhancing public health awareness and prevention

during epidemic disease transmission is currently unknown. Doubtlessly, coronavirus

disease (COVID-19) represents a great challenge at the global level, aggressively

affecting large cities and public gatherings and thereby having substantial impacts on
many health care systems worldwide as a result of its rapid spread. Each country has

its capacity and reacts according to its perception of threat, economy, health care policy,

and the health care system structure. Furthermore, we noted a lack of research

focusing on the role of social media campaigns in public health awareness and public

protection against the COVID-19 pandemic in Jordan as a developing country.

The causes and consequences of COVID-19 misperceptions

We investigate the relationship between media consumption, misinformation, and

important attitudes and behaviours during the coronavirus disease 2019 (COVID-19)

pandemic. We find that comparatively more misinformation circulates on Twitter, while

news media tends to reinforce public health recommendations like social distancing. We

find that exposure to social media is associated with misperceptions regarding basic

facts about COVID-19 while the inverse is true for news media. These misperceptions

are in turn associated with lower compliance with social distancing measures. We thus

draw a clear link from misinformation circulating on social media, notably Twitter, to

behaviors and attitudes that potentially magnify the scale and lethality of COVID-19.

Associations Between COVID-19 Misinformation Exposure and Belief With

COVID-19 Knowledge and Preventive Behaviors

Online misinformation proliferation during the COVID-19 pandemic has become a

major public health concern. We aimed to assess the prevalence of COVID-19

misinformation exposure and beliefs, associated factors including psychological distress

with misinformation exposure, and the associations between COVID-19 knowledge and
number of preventive behaviors. COVID-19 misinformation exposure was associated

with misinformation belief, while misinformation belief was associated with fewer

preventive behaviors. Given the potential of misinformation to undermine global efforts

in COVID-19 disease control, up-to-date public health strategies are required to counter

the proliferation of misinformation.

CHAPTER 2

What is vaccine and vaccine acceptance?

COVID-19 vaccinations aid in the development of immunity to the virus that

causes COVID-19 without the need for us to become unwell. Different types of

vaccinations provide protection in different ways. However, all vaccinations leave the

body with a supply of "memory" T-lymphocytes and B-lymphocytes that remember how

to fight that virus in the future. The body normally produces T-lymphocytes and

B-lymphocytes a few weeks following immunization. As a result, a person might become

infected with the virus that causes COVID-19 either before or shortly after immunization

and become ill as a result of the vaccine failing to give adequate protection. The

process of establishing immunity following vaccination can sometimes induce symptoms

such as fever. These symptoms are typical and indicate that the body is strengthening

its defenses.
Notwithstanding proof showing vaccination is one of the most life-saving public

health measures of the previous century, an increasing percentage of people remain

hesitant to be vaccinated. Vaccine acceptance is described as "the extent to which

individuals embrace, question, or oppose immunization," and it is a factor in vaccine

uptake and, as a result, vaccine distribution success. Vaccine hesitancy, or the refusal

to get recommended vaccinations due to concerns and uncertainties about vaccines,

was considered one of the world ten dangers to world health by the World Health

Organization in 2019.

Overall, 96.7% of respondents willingly accepted COVID-19 vaccination without

hesitation, while the remaining 3.3% of respondents are still uncertain about the

COVID-19 vaccine but got vaccinated anyway due to tight workplace protocol. The

study provides that there was a high degree of awareness indicated among Davaoeños

regarding the advantages COVID-19 vaccination has.


CHAPTER 3

How does social media influence vaccine acceptance in Davao region?

Many people use social media platforms to find and share health-related

information that might influence their choice to be vaccinated against COVID-19. In

developing countries, one of the most prevalent methods to hear about news and

updates on infectious illnesses was through social media. During the COVID-19

pandemic, social media was critical in disseminating accurate or false information. In

addition to the COVID-19 pandemic, there have been widespread false claims or

information, posing a serious public health risk by altering infection patterns and the

scope and depth of the pandemic.

Respondents' Perceptions:

1
People use social media to encourage people to get vaccinated and with that it

helps me decide to protect myself from the virus. - Repondent

2
I was able to know and learn things regarding vaccines, its side effects as well

as its effectiveness. The consistent reminders that health organizations give through

social media influenced me to get vaccinated. -Respondent

3
I don't think social media influences my views on getting vaccinated, I myself

am willing to get vaccinated in order to protect not just myself but also the people

around me. -Respondent


After a thorough analysis of the responses to the survey questionnaires provided

by the researcher, the majority of respondents noted that social media influenced their

thoughts about COVID-19 vaccinations in some way. They perceive that the information

they acquire on social media helps them to be more knowledgeable about vaccine

literacy since they spend the most time on it. And their decision to be vaccinated or not

was influenced by their usage of social media. 24 of 30 respondents, in particular, think

that social media has affected their opinions and increased their desire to get the

COVID-19 vaccination. The remaining 6 respondents did not agree that social media

had an impact on their choice to be vaccinated since they did not believe it was

essential. They believe it is up to them to determine whether or not to get vaccinated.

CHAPTER 4

What causes the vaccine impediment among residents in Davao region?

Vaccine hesitancy is defined as a delay in accepting or refusing vaccines despite

the availability of vaccination services, and it is a personal choice affected by a variety

of factors such as knowledge and past experiences. This refusal is also influenced by

historical, political, and socio-cultural factors. Many social media platforms, including

Facebook, Twitter, and Instagram, have been utilized to convey information about many

social concerns, including the COVID-19 updates. People have been spreading a range

of information, so we can't be sure whether the material we read or see is accurate.


Majority of the respondents agreed that the lack of sufficient education regarding the

COVID-19 vaccination and the dissemination of misleading information on social media

are the main causes of vaccine hesitancy among certain Davao residents.

Respondents' Perceptions:

1
“Lack of credible sources that explains the purpose of vaccines and other

information about it. And small access to information available.” -Respondent

2
“It might be because people are not well educated about vaccines. Fake news

is also one that prevents people from getting vaccinated.” -Respondent

3
“Personally, I think believing in hoax news and spreading fake information

about vaccines affect the knowledge of the general public the most.” -Respondent

Despite vaccines' generally acceptable safety and efficacy ratings, the methods

that have permitted their fast development have been a source of public worry, with

possible negative consequences for vaccination uptake, leading to vaccine

apprehension. Despite the fact that vaccination hesitancy has a long history, it is

plausible to assert that today's Internet is a source of disinformation. Fear and

misconceptions about vaccine development and licensing are likely to facilitate the

spread of false information.

CHAPTER 5
Summary and Conclusion

This study was undertaken to examine the huge impact of social media in terms

of vaccine hesitancy among Davaoeñoes. The researcher used Google Forms to

conduct a self-administered online survey to the respondents. The data and findings

were then analyzed by the researcher. The researcher discovered that only six (6) out of

every thirty (30) residents believed that social media did not influence their views about

getting the vaccines though they believe that social media has become an effective

medium to disseminate important informations about COVID-19, while the remaining

twenty-four (24) residents agreed that social media influenced their perception and

understanding about getting vaccinated.

This study shows that vaccine literacy is critical in reducing public vaccine

misinformation. This necessitates the expansion of vaccine literacy programs not only in

the Davao region, but around the world, to ensure that everyone is knowledgeable

about vaccines. Everyone should be encouraged to use social media as a means of

disseminating facts and correct information on COVID-19.

Survey Data:
Recommendation

The researcher believes that the survey raises several hypotheses that

merit further research about the influence of social media on the acceptance of the

COVID-19 vaccines and outreach efforts to address concerns about the dangers of

social media usage during the pandemic. In particular, based on the survey results and

its own deliberation, the researcher offers the following recommendations:

Further Research

1. Examine the effectiveness of social media usage in disseminating news and

information to the public and how they can be enhanced to prevent the spreading

of hoax information about COVID-19.

2. Examine how education can be improved to raise everyones’ understanding


about vaccines.

3. Seek to extend and improve educational and awareness raising efforts being

done by small organizations in your community.

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