The COVID-19 pandemic prompted a global effort to develop and distribute vaccines. However, vaccine hesitancy significantly hampered vaccination efforts across various populations. This study addresses the critical issue of vaccine hesitancy in the UK, aiming to understand its underlying causes and contributing factors. The context of the pandemic, characterized by the rapid spread of the virus and the urgent need for effective treatments, is crucial. Early in the pandemic, a lack of proven treatments led to containment strategies such as lockdowns, quarantines, and social distancing. The race to develop vaccines represented a significant turning point, yet this sense of urgency wasn't universally shared. The spread of misinformation and anti-vaccine sentiments, often amplified through social media and political discourse, further complicated the situation. Vaccine hesitancy, defined as the delay in acceptance or refusal of vaccination despite availability, is a complex, context-specific issue influenced by factors such as complacency, convenience, and confidence. Previous research highlights various factors influencing vaccine hesitancy, including concerns about vaccine safety and side effects, mistrust in the efficacy of certain vaccines, and demographic factors like age, education, and political ideology. The UK's experience, with its early vaccine approval and rollout, offers a unique context to study vaccine hesitancy. This research seeks to explore the relationship between knowledge about vaccines and willingness to be vaccinated within a representative UK sample, paying particular attention to the role of social media and trust in different vaccine sources.

Existing research indicates lower vaccine acceptance among specific demographics such as Black/African individuals, unemployed people, and those with lower income, education, and age. Religious affiliation and political support also correlate with vaccine acceptance. Common reasons cited for vaccine refusal include general opposition to vaccines, safety concerns, distrust, and doubts about efficacy. Studies across various countries have identified concerns about vaccine safety and side effects as major drivers of hesitancy. Anxiety regarding vaccine efficacy and safety also predicts hesitancy. In the US, factors such as younger age, lower education, conservative political ideology, and lack of trust contribute to vaccine hesitancy. A study in Ireland and the UK found associations between hesitancy and age, gender, and income, with women, younger individuals, and those with lower incomes showing greater hesitancy. While the UK was among the first countries to approve a COVID-19 vaccine, vaccine hesitancy persisted even among those already vaccinated, with concerns about safety and efficacy being frequently cited.

This study employed a nationally representative survey of 537 UK adults. Participants completed questionnaires assessing their religious and political beliefs, knowledge of various global COVID-19 vaccines (including two fictitious ones: 'Theranos' and 'Medicare'), and willingness to be vaccinated. The survey involved a soft launch on social media followed by recruitment via the Prolific platform. Participants provided informed consent and were compensated for their participation. The questionnaire encompassed demographic information (age, gender, race/ethnicity, education, region, political beliefs, religious/spiritual identity, social media usage, risk status for COVID-19), vaccination status, anxiety levels concerning vaccination, attitudes toward vaccines, and willingness to take different vaccines (including those from different countries). The survey also assessed the influence of community and religious leaders on vaccination decisions. Data analysis was conducted using OLS regression techniques in R, investigating the effects of demographic factors on vaccine knowledge and the relationship between vaccine knowledge and willingness to be vaccinated.

The study found that 89.22% of participants would take the Oxford-AstraZeneca vaccine, and 88.24% would take the Pfizer-BioNTech vaccine. Regression analyses revealed that Twitter usage positively correlated with reported knowledge about Janssen-J&J and Moderna vaccines. Economic conservatism positively correlated with knowledge about Oxford-AstraZeneca, while social conservatism had a negative effect on knowledge about Moderna and Oxford-AstraZeneca. For unavailable vaccines, Twitter usage correlated with greater knowledge about Sputnik. Regarding willingness to be vaccinated, Twitter usage positively affected willingness to take Janssen-J&J, Moderna, and Novavax, while Instagram usage had a negative effect on willingness to take most approved vaccines. Social conservatism negatively impacted willingness to take the Pfizer-BioNTech vaccine. Interestingly, Twitter usage positively correlated with willingness to take unavailable (Sputnik, Sinovac) and fictitious vaccines (Medicare, Theranos).

The key finding is the significant impact of social media, particularly Twitter, on perceived vaccine knowledge and hesitancy. Twitter usage was associated with both increased knowledge and increased willingness to take fictitious or foreign vaccines. This suggests that while Twitter may enhance knowledge, it might also contribute to the spread of misinformation, impacting trust and acceptance of specific vaccines. The lack of effect from Facebook and Reddit, despite their efforts to combat misinformation, suggests that the platform's approach to content moderation may play a crucial role in shaping attitudes toward vaccination. The higher acceptance rate of fictitious vaccines compared to real ones from Russia and China suggests that concerns about the trustworthiness of foreign vaccine production protocols are significant factors in vaccine hesitancy. The anxiety surrounding the pandemic may have led some individuals to be more willing to take vaccines about which they know little, while simultaneously being wary of vaccines produced outside the US or Europe.

This study highlights the complex interplay between social media, misinformation, and vaccine hesitancy. Twitter’s influence on both knowledge and acceptance of vaccines, including fictitious ones, is noteworthy. Future research should investigate the specific mechanisms through which social media impacts vaccine acceptance and explore targeted interventions to address misinformation. Further exploration of the role of trust, anxiety, and perceptions of vaccine origin is also crucial.

The study relied on self-reported survey data, limiting the ability to cross-check information such as social media usage. The use of pre-existing vaccine names in the study might have influenced responses. Future research could employ a randomized design with varied vaccine names and utilize multi-dimensional measures of political beliefs to gain a more comprehensive understanding of the underlying factors contributing to vaccine hesitancy.