Understanding coronavirus disease 2019 (COVID-19) vaccine hesitancy: Evidence from the community-driven knowledge site Quora

Objective: The present study aims to examine the threshold of coronavirus disease 2019 (COVID-19) vaccine hesitancy over time and public discourse around COVID-19 vaccination hesitancy. Methods: We collected 3,952 questions and 66,820 answers regarding COVID-19 vaccination posted on the social question-and-answer website Quora between June 2020 and June 2021 and employed Word2Vec and Sentiment Analysis to analyze the data. To examine changes in the perceptions and hesitancy about the COVID-19 vaccine, we segmented the data into 25 bi-weekly sections. Results: As positive sentiment about vaccination increased, the number of new vaccinations in the United States also increased until it reached a ceiling point. The vaccine hesitancy phase was identified by the decrease in positive sentiment from its highest peak. Words that occurred only when the positive answer rate peaked (e.g., safe, plan, best, able, help) helped explain factors associated with positive perceptions toward vaccines, and the words that occurred only when the negative answer rate peaked (e.g., early, variant, scientists, mutations, effectiveness) suggested factors associated with vaccine hesitancy. We also identified a period of vaccine resistance, where people who decided not to be vaccinated were unlikely to be vaccinated without further enforcement or incentive. Conclusions: Findings suggest that vaccine hesitancy occurred because concerns about vaccine safety were high due to a perceived lack of scientific evidence and public trust in healthcare authorities has been seriously undermined. Considering that vaccine-related conspiracy theories and fake news prevailed in the absence of reliable information sources, restoring public trust in healthcare leaders will be critical for future vaccination efforts.