COVID-19 pediatric vaccine Hesitancy: Themes and interactions with verified twitter accounts.

Background: Though vaccine hesitancy and misinformation has been pervasive online, via platforms such as Twitter, little is known about the characteristics of pediatric-specific vaccine hesitancy and how online users interact with verified user accounts that may hold larger influence. Identifying specific COVID-19 pediatric vaccine hesitancy themes and online user interaction and sentiment may help inform health promotion that addresses vaccine hesitancy more effectively among parents and caregivers of pediatric populations.

Methods: Keywords were used to query the public streaming twitter application programming interface to collect tweets associated with COVID-19 pediatric vaccines. From this corpus of tweets, we used topic modeling to output 20 topic clusters of tweet content and examined the 10 most retweeted tweets from each cluster to classify for relevance to pediatric COVID-19 vaccine hesitancy topics. Tweets were inductively coded to identify specific themes. Publicly available user metadata were assessed to identify verified accounts and self-reporting of racial or ethnic identity, and parental status. Replies to tweets were coded for user sentiment. A chi-squared test was used to determine the proportion of users agreeing with misinformation tweets RESULTS: 863,007 tweets were collected between October 2020-October 2021. The 230 top tweets reviewed after outputting topic clusters accounted for 236,121 tweets and retweets. 84 unique tweets were identified as related to pediatric COVID-19 vaccine topics by verified users. Twenty three tweets (generating 44,509 retweets) contained misinformation-related themes. Seventy-one percent (n = 742) of user replies agreed with misinformation sentiment of the parent tweet. Main themes identified included vaccine development conspiracy, vaccine is experimental, and vaccine as a control tactic discussions. This study found that users who interacted with misinformation posted by verified accounts were more likely to agree than disagree with misinformation sentiment.