1 Introduction
Public debate is vital to the correct functioning of a democratic society. With the rise of the Internet, digital platforms increased the opportunity for users to engage in public discussions (Flaxman et al.
2016; Schäfer et al.
2015), making this exchange more immediate and disintermediated (Del Vicario et al.
2016; Quattrociocchi et al.
2014). Online discussions can play a crucial role in the public discourse, influencing policy decisions, and mobilizing action on a variety of issues, such as in the case of political elections (Bovet and Makse
2019; Cinelli et al.
2020). However, the online environment is not a stand-alone entity but is intimately connected with the offline world. Indeed, events such as wars, political elections, epidemic outbreaks, and natural disasters can attract the users’ attention and shape online debates (Chen and Ferrara
2022; Bovet and Makse
2019; Cinelli et al.
2020; Sloggy et al.
2021). The outbreak of the coronavirus generated so much hype in online and traditional media that the World Health Organization used the term ‘infodemic’ to express concern about the excessive amount of information being circulated during the pandemic (Briand et al.
2021).
Vaccines have been the subject of an enduring public discourse that continues to draw widespread attention, as seen recently with the case of Covid-19 (Burki
2019). Vaccine hesitancy and the raise of anti-vax movements may become a public health issue, especially during times of crisis. In some cases, countries strengthened vaccination programs and introduced laws to make certain vaccinations mandatory (Maltezou et al.
2019; MacDonald et al.
2018; Siciliani et al.
2020). The Covid-19 outbreak represents a unique scenario in vaccination history. The unprecedented impact of the pandemic prompted research to accelerate to such an extent that vaccines were developed in an exceptionally short time. The announcements of the first vaccines against Covid-19—first Pfizer and Moderna and then AstraZeneca—generated much debate on online platforms. The European Medical Agency’s (EMA) decision to temporarily suspend the use of a specific batch of the AstraZeneca vaccine as a precautionary measure to evaluate potential issues and side effects has garnered additional attention.
The online debate on vaccines has been intensively studied in correspondence with the Covid-19 outbreak. The authors (Yousefinaghani et al.
2021) analyze 4 million tweets about the vaccine debate over 1 year, studying the prevalence and evolution of the sentiments and opinions. They found that positive sentiment was slightly dominating and attracted higher engagement, but the volume of discussion on vaccine rejection and hesitancy was higher than the one on the interest in vaccines. However, when focusing only on ‘AstraZeneca,’ negative information was the most retweeted content and they often pointed to sources known to be misinformation spreaders, as shown in (Jemielniak and Krempovych
2021). Additionally, the authors emphasize the existence of coordination networks playing a role in political astroturfing and vaccine diplomacy. By utilizing sentiment analysis, the authors of (Aljedaani et al.
2022) analyzed the attitudes and apprehensions toward vaccination among the Arab population on Twitter, revealing variations in their vaccine preferences. The authors of (Mittal et al.
2021) conducted a study to investigate the relationship between online sentiment and disease outbreaks in terms of deaths, infections, and recoveries. By bridging online and offline data, they found a positive association between global rates of infections, deaths, and recoveries and the prevalence of tweets expressing negative sentiment.
In this paper, we analyze how the online public debate evolves in conjunction with significant external events. In particular, here we consider two major events:
1.
The announcement of the first Covid-19 vaccine by Pfizer
1;
2.
The suspension of the AstraZeneca (AZ) vaccine by the European Medicines Agency .
2
We analyzed tweets from five countries: France, Germany, the UK, Italy, and the USA. Each country had its own unique societal context but faced challenges with vaccine hesitancy before the Covid-19 pandemic. For instance, Italy witnessed a negative trend in vaccination coverage, which led to the implementation of compulsory vaccination in July 2017 (Gualano et al.
2018). Prior to the pandemic, France had one of the highest rates of vaccine hesitancy globally (Ward et al.
2019). Similarly, Germany has faced a relatively high level of vaccine skepticism, and surveys indicate a decline in enthusiasm for Covid-19 vaccines throughout the pandemic, despite the population’s strong trust in institutions and health experts (Fiske et al.
2022). In Germany and Italy, concerns regarding the AstraZeneca vaccine, which was ultimately suspended by EMA, contributed to erode trust in scientific and political authorities (Zimmermann et al.
2023). However, the UK, while also facing declining vaccination rates (Kennedy
2020), was not under the jurisdiction of the EMA when it suspended the AstraZeneca vaccine. Moreover, the UK had one of the fastest vaccine roll-outs in Europe (Gallardo
2021). Lastly, the USA, being geographically distant and independent from the other countries considered, was less likely to be affected by the EMA’s decision. However, vaccine hesitancy in the USA has been growing in recent times to the extent that diseases preventable through vaccination, such as measles, have experienced repeated outbreaks due to reduced immunity (Yasmin et al.
2021). Moreover, there has been a decline in childhood vaccination rates, particularly in states where legislation permits personal choice exemptions, indicating a growing vaccine hesitancy in those areas (Lo and Hotez
2017).
First, we compare the interaction structure, content volume, and the most debated topics in five countries (France, Germany, UK, Italy, and the USA) distinguishing between questionable and reliable content. Then, we analyze the temporal evolution of the debate around vaccines and fit auto-regressive models to study how the online public discourse developed in response to significant external events. Our study makes a threefold contribution and addresses the following research questions: (1) What user communities emerge in each country, and how do they compare across countries? (2) What are the characteristics of questionable and reliable narratives in each country, and how do they compare across countries? (3) How has the public debate on vaccination evolved over time in each country?
Our results indicate that the shares of reliable and questionable content can fluctuate based on the country under consideration. Topic modeling reveals different narratives of the debate for content pointing to questionable and reliable sources, although a certain level of similarity across the countries can be found. The temporal analysis shows that the first event (vaccine announcement) influenced the consumption of both questionable and reliable content more than the EMA’s suspension of the AZ vaccine batch, although some differences can be found across countries. Finally, we found that users split into two communities rather stable over time based on their attitude toward vaccines, with a small fraction of users changing their beliefs.
This paper contributes to understanding the users’ news consumption and reactions to external events in different countries and thus, on the one hand, it provides useful insight into how to communicate negative events during a crisis, on the other hand, it highlights the need for specific communication policy based on the audience characteristics.
4 Conclusions
In this study, we used Twitter data to examine the debate surrounding Covid-19 vaccines. Our analysis proceeded in two main directions, investigating cross-country variations and tracing the evolution of the conversation in response to major events, such as the announcement of the Pfizer vaccine and the EMA’s suspension of a batch of the AstraZeneca vaccine. Moreover, we incorporated third-party data to explore the presence of misinformation over time and employed topic modeling to uncover emergent narratives. Finally, we aimed to shed light on the structure and dynamics of the vaccine debate on Twitter.
Our findings show that while reliable sources dominate the discussion, communities of users who consume questionable content are present to varying degrees across different countries. Moreover, the narratives from reliable and questionable sources diverge, although some similarities exist across countries. The analysis of the response to the Pfizer vaccine announcement and the AstraZeneca suspension revealed that both reliable and questionable content increased following these events, though the volume increase after the latter was typically lower and not statistically significant. Finally, our community detection analysis revealed a relatively stable scenario, with only a few shifts between communities.
Taken together, our results confirm the polarized nature of the Covid-19 vaccine debate on Twitter, with stable communities and differences across countries. Furthermore, we show that significant external events can be associated with changes in the production and consumption of online information, though we found no evidence of increased misinformation after the EMA’s suspension of the AstraZeneca vaccine. These findings may be relevant for policy and decision makers involved in risk and crisis communication. To maximize the effectiveness of public health policy strategies, it is essential to consider the social and cultural environment in which they are implemented (Cascini et al.
2022). To this aim, the dynamic monitoring of public response through online data may prove extremely helpful in adjusting public health measures. This study shows how social media and network analysis can be used to reveal differences and similarities across countries, thereby highlighting its potential to facilitate the development of tailored plans of action and interventions suited to the population’s unique context. Further, enhancing our understanding of the narratives prevalent within distinct communities and countries can assist public organizations in delivering more impactful communication, particularly during times of crisis. Expanding our research to include other social media platforms and socially significant topics such as climate change could provide further insights.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.