Numerical findings
A total of 663,377 tweets were extracted and analysed. Figure 2 depicts the results of sentiment analysis of tweets from each country in terms of positive, negative as well as neutral tweets. While the maximum number of neutral tweets (have very little subjectivity linked to them) are from South Africa (63.88%), the minimum number of positive tweets (7.40%), as well as negative tweets (28.88%), were also extracted from South Africa only. India had highest percentage of negative tweets (58.48%) as compared to South Africa (28.88%). United Kingdom reported highest percentage of positive tweets (21.09%) as opposed to South Africa (7.40%).
Graphical representation of percentage of negative, positive and neutral attitudes.
The word cloud reflects the most frequently reported terms. In India, the words “government”, “Patients”, “Stay Safe”, “Second Wave”, “Hospital”, “Situation”, and “Help” were most frequently observed. In contrary, in Australia “Fully vaccinated”, “get vaccinated”, “variants”, “public health”, “support” etc. were most frequent words. Figure 3 outlines the word clouds from the four countries studied.
Word cloud generated by analysing the tweets. Footnotes: (1) India; (2) South Africa; (3) United Kingdom; (4) Australia.
Qualitative findings
Several key themes emerged from the analysis of tweets sampled (Fig. 4). It was observed that the twitter served as a platform for advocacy, community engagement, information sharing, myth busting, awareness building, and reporting COVID-19 vaccination shortcomings. The themes reflected on the positive/negative attitudes of individuals towards COVID-19 Vaccines. Figure 4 outlines the themes emerged from the analysis of the tweets.
Figure outlining the themes identified across the polarity.
Theme 1: awareness about vaccines
One of the commonly observed positive sentiment towards vaccination was spreading awareness about the COVID-19 vaccines, their availability and vaccination drives. Specifically, the twitter handles of national and local government machineries, civil society bodies and celebrities focused on sharing the information on vaccination, which were actively retweeted by other individuals. Such awareness about COVID-19 vaccines was observed alike for initial and booster doses of vaccines. One of the tweets from UK a country with a high vaccination rate said the following:
“Time to take up your #COVID19 booster jabs or your first or second vaccinations if you have not had them. If you have just become eligible for you #boosterjab wait to be contacted to invite you for vaccination. See below for current walk in vaccination sites. https://t.co/lLIkNlhlfx” (UK 05).
While countries like India faced vaccine shortages initially, the vaccination programmes amped as time progressed. Technology such as CoWIN platform was leveraged to aid the vaccination drive and develop awareness about vaccination.
“Book your vaccination on the given link, https://t.co/VkLfexCFiO, Current availability slot #Mumbai”(India 79583)
The information shared using the twitter handles served in better transmission & awareness about COVID-19 vaccination, positively contributing to vaccine coverage.
Theme 2: vaccines work
A commonly observed positive tweets among twitter users is concerning the effectiveness of vaccines. The idiom “Vaccines Work” was a common catchphrase used by the national and regional governments, politicians, bureaucrats, health workers and celebrities across the countries. The users shared posters, web links, videos, statistics and research articles reporting efficacy and effectiveness of vaccines contributing to spreading a positive word about COVID-19 vaccines. Individuals even shared their real-life experiences touting that being unvaccinated increases the risk of COVID-19.
“I was shocked at the proportion of unvaccinated pregnant women now in ICU..….. Remember the vaccines work and are safer than encountering COVID19 first” (UK 7142).
“Half a million lives saved because of the COVID-19 vaccine. Vaccines work!” (Australia 108693).
As the COVID-19 pandemic progressed and new variants emerged the tweets were also observed to be reporting the effectiveness of vaccines on the multiple variants of COVID. Some of the tweets reporting effectiveness of vaccines towards new COVID-19 variants said the following.
“Good news! “Two doses of Pfizer jab are 90% effective against Covid-19 hospital admission for all variants for at least six months, according to a study”.”(UK 4670)
“Before anyone jumps to conclusion that @Pfizer-BioNTech #vaccine doesn't work against #COVID19 #DeltaVariant 3rd wave in #SouthAfrica. Data from #Israel show that it does. Spread the word. https://t.co/NbJ4XvJwNK” (UK 11971).
These messages enabled a positive discourse on the effectiveness of the COVID-19 vaccines, despite of the fears of new variants.
Theme 3: vaccines are safe
The safety of the vaccines was another important domain found to be repetitive across the countries studied. Given the apprehensions surrounding the safety of COVID-19 vaccines, the twitter users largely advocated that the vaccines are safe to use. As the science of COVID-19 vaccines evolved the specific information concerning the safety of vaccines (among younger age groups, pregnant women etc.) was also reported. Twitter handles from India and South Africa tweeted the following.
“in South Africa, 71 k people have died of Covid-19, 7 million are Vaccinated and are fine a few with some side effects. It’s not rocket science, vaccinate.”(South Africa 42666).
“The fourth and the biggest phase of #COVID19 vaccination in India has commenced & according to #WHO, vaccines are safe to be administered to women on their periods. Don't delay your vaccinations.
Don't fall for myths.#VaccineForAll #VaccinationForAll https://t.co/r05KsgLpRg” (India 81029).
In India specifically, while initial concerns on vaccines such as “Covi-shield” were observed, the discourse gradually shifted to safety and efficacy of the vaccines. Twitter handles of popular leaders also facilitated in developing a positive discourse towards safety and efficacy of vaccines.
“There have been rumors about #vaccines made in India being unreliable. I would like to request all of you to stay aware and know that our vaccines are safe and effective: #PMModi”(India 71370).
Twitter served as a platform of advocacy for vaccine safety. Particularly the twitter handles of popular leaders and cultural icons vouching for vaccine safety improved trust and acceptance of vaccines in the community.
Theme 4: voices for vaccine equity
The twitter users also advocated for vaccine sharing and vaccine equity to better control COVID-19 at a global scale. Specifically, the tweets were found to be advocating for vaccine equity by tagging the policy makers to share their stockpiles of vaccines with low-income countries through COVAX initiatives. One of the several tweets concerning vaccine equity tagging world leaders reads as follows.
“@BorisJohnson@JustinTrudeau@POTUS@EUCouncil@RegSprecher @ScottMorrisonMP the world needs #COVID19 vaccine access now. The #G7 must step up to #EndThePandemic for all by sharing 1 billion doses through #COVAX by September. https://t.co/ha2zi5IJEH” (UK 14594).
After emergence of new variants such as Omicron, the dialogue for vaccine equity was more strongly observed in the twitter discourse. The users voiced for vaccine sharing and vaccine equity for the developing countries to prevent emergence of newer variants of the virus.
One of the key lessons from the emergence of the new B.1.1.159 variant in Southern Africa is that if we don’t address the enormous global inequity in access to Covid-19 vaccines, other variants may emerge that are highly infectious or against which vaccines work less well. (Australia 89403).
Theme 5: myth busters
A large proportion of positive tweets on vaccines were concerned with busting popular myths on COVID-19 vaccines. Specifically, in both developed and developing country settings, popular vaccine myths on conspiracy around COVID-19 vaccines, viability of COVID-19 vaccines for specific population groups, timing of vaccines and disease status etc. were debunked. Some of the popular tweets debunking COVID-19 vaccine myths are as follows.
“Covid-19 vaccines do not contain microchips https://t.co/kyWSAeqzDf via @harakahdailyHD” (India 980).
“MYTH: The vaccine alters your DNA.
FACT: Vaccines do not change a person’s DNA. Vaccines work by stimulating the body the same way the virus would if someone was infected.”(Australia 98087).
Debunking COVID-19 vaccine myths was also actively done by the Government agencies across the countries. For example, the Government of India as part of its COVID-19 prevention campaign, launched “Jan Andolan” to bust myths and spread awareness about COVID-19 vaccines.
“Mythbusters on #COVID19Vaccines.
Myth: Vaccine not needed for #COVID19 recovered persons.
Fact: Advisable to receive a complete schedule of vaccine despite recovery from COVID-19, to enhance the immune response. #JanAndolan @SpokespersonMoD @diprjk @PIB_India @rajnathsingh https://t.co/hkWDXoJOFZ” (India 120860).
The active participation of individuals, government and civil society bodies, prevented fear & panic and contributed to the positive discourse on COVID-19 vaccines.
Theme 6: vaccine shortages
Experiences of shortage of vaccines were among the common negative discourse observed in developing countries. In Indian context, the tweets on vaccine shortages raised exponentially during the April-June 2021 quarter. One tweet concerning suspension of vaccination drive read as follows.
“COVID-19 vaccination drive in Mumbai suspended for two days due to vaccine shortage https://t.co/K6eSNlssJx” (India 52738).
In developed countries like UK while the vaccine shortages are substantially less visible, the tweets reflected the user’s advocacy to tackle vaccine shortages in developing countries, specifically in Africa.
“Everyone vaccinated on an remote island in Scotland that had no #COVID19 cases… instead of giving the vaccine to individuals in #COVID19 UK hotspots or sharing vaccine with other countries? There is a global vaccine shortage! This is #vaccinenationalism at its finest! https://t.co/HxZyhvOf09” (UK 19740).
The tweets concerning vaccine shortages also reflected on the supply chain & health system issues within the countries and larger vaccine inequity between the developed and developing countries. One twitter handle from South Africa said.
“WHO warns lack of COVID-19 vaccine supply in Africa could make it breeding ground for new variants and send the whole world back to square one” (South Africa 29430).
Theme 7: distrust on vaccines
The negative discourse on COVID-19 vaccines also reflected the general distrust of COVID-19 vaccines in the communities. The distrust of vaccines is largely reported in the developed country settings, quoting concerns around expedited process of vaccine development, capitalism and big pharma lobbying. The twitter discourse reflected the user’s skepticism on COVID-19 vaccines and their development process. Some tweets from Australia and the UK read as follows.
“So it seems people are finally realizing the covid 19 vaccines aren’t vaccines. They just call these shots vaccine so people who get serious side effects can’t sue the gov. Covid19 is just a shot people.#shots#vaccines#thanksgivingconvos https://t.co/lRhqrOW9gu” (Australia 46606).
“People are not linking a drug and vaccine. They're linking what can happen if pharmaceutical companies don't trial and test a product adequately. AIDS has been around for 50 years but no vaccine whereas COVID-19 about a year. Public have a right to be concerned” (UK 86542).
“There are no vaccines available for most of NTDs, Malaria, HIV and others, but there are many vaccines developed and manufactured in less than one year time against #COVID19. #RuleOf3Ps Fact speaks itself” https://t.co/01C0kFaQju” (UK 20113).
In developing countries, the vaccine distrust was largely observed in villages and areas with limited awareness. In rural India, distrust was mainly surrounded by the myths that COVID-19 vaccines will cause infertility and impotency.
“We are hearing the rural population is scared of the vaccine—they think it will make women infertile and men impotent. Children are being sent away when there is a vaccine campaign in villages.#COVID19 #VaccineHesitancy #mythbusting” (India 79298).
Theme 8: vaccine side-effects
The distrust on vaccines was seen to be largely linked to the fear of vaccine side-effects. In this regard it was observed that twitter also served as platform to share reliable information and updates on rare events such as vaccine side-effects. The platform served to communicate any recommendation, report, news concerning vaccine side-effects such as allergic reactions, bell’s palsy, and even death in the countries studied. Some of the tweets studied are as follows.
“2 people have experienced allergic reactions and 4 people have developed Bells' palsy to Pfizer's COVID19 Vaccine so far”. (UK 70882).
“Covid Has A 99% Survival Rate.
Now I personally know of at least two otherwise healthy people who died of blood clots after getting the vaccine & three others who developed Bells Palsy.
https://t.co/40z6yv39n3″ (Australia 116251).
“#COVID19 | Government’s review of side effects confirms 1 death after vaccine dose” (India 68330).
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