Cultural Nuances in COVID-19 Vaccine Uptake: A Comparative Analysis of English and Spanish Facebook Posts in Tarrant County, Texas (Preprint)
Authors: Aleksandric Ana , Dangal Anisha , Nilizadeh Shirin , Mustata Wilson Gabriela 
Published: February 2025

BACKGROUND

Prior studies have identified key factors contributing to COVID-19 vaccine hesitancy, including concerns over vaccine safety, potential side effects, and mistrust in the healthcare system. According to the World Health Organization, vaccine hesitancy is among the top ten threats to global public health. Previous research suggests that vaccine hesitancy is a significant barrier within the Hispanic population, particularly in Texas.

OBJECTIVE

This longitudinal study examines the relationship between daily stances, misinformation, and topics in vaccine-related English and Spanish social media posts and daily vaccination rates in Tarrant County, Texas, throughout 2021 and 2022. The study seeks to identify predictors positively associated with vaccination uptake to inform potential social media interventions aimed at reducing vaccine hesitancy, focusing on the Hispanic population in Tarrant County.

METHODS

COVID-19 vaccine-related English and Spanish posts were collected from Facebook in Tarrant County for 2021 and 2022. Posts were annotated by GPT-4, labeling each post’s stance toward the vaccine, the presence of misinformation, and relevant topics such as vaccine availability, safety, and side effects. The prevalence of each category was compared across English and Spanish posts to explore major vaccine-related concerns and potential cultural influences on vaccination uptake. Regression analysis was then conducted to assess associations between post-related variables and vaccination rates over time.

RESULTS

Regression analysis identified distinct predictors of Hispanic vaccination uptake within the Spanish dataset, including encouraging posts (P = .02) and posts related to religious beliefs (P = .007), which did not emerge as significant predictors for the general population uptake (P = .065). A substantial proportion of discouraging Spanish posts focused on vaccine side effects (~19%) and health system distrust (~34%), highlighting areas where targeted interventions may address specific concerns within the Hispanic community. Some predictors are common for both higher Hispanic and general population vaccination uptake, including posts regarding vaccine availability (P = .01), safety (P = .006), and misinformation debunking (P < .001).

CONCLUSIONS

This study investigates the correlation between daily stances, misinformation, and topics shared in Facebook COVID-19 vaccine-related English and Spanish posts with new daily vaccination uptake in Tarrant County, Texas, during 2021 and 2022. Findings suggest that posts emphasizing vaccine availability, safety, and debunking misinformation are associated with increased vaccination rates. Additionally, encouraging posts and those related to religious beliefs correlate with higher vaccination uptake among Hispanics, suggesting cultural nuances. These insights highlight the need for targeted social media messaging that may effectively boost vaccination rates when tailored as part of targeted public health campaigns.