Moffett Kenneth W, Marshall Michael C, Kim Jae-Eun C, Dahlen Heather, Denison Benjamin, Kranzler Elissa C, Meaney Morgan, Hoffman Blake, Pavisic Ivica, Hoffman Leah
Fors Marsh, Arlington, VA, United States.
Online J Public Health Inform. 2024 Jul 29;16:e55422. doi: 10.2196/55422.
Factors such as anxiety, worry, and perceptions of insufficient knowledge about a topic motivate individuals to seek web-based health information to guide their health-related decision-making. These factors converged during the COVID-19 pandemic and were linked to COVID-19 vaccination decision-making. While research shows that web-based search relevant to COVID-19 was associated with subsequent vaccine uptake, less is known about COVID-19 vaccine intent search (which assesses vaccine availability, accessibility, and eligibility) as a signal of vaccine readiness.
To increase knowledge about vaccine intent search as a signal of vaccine readiness, we investigated the relationship between COVID-19 vaccine readiness and COVID-19 vaccine intent relative search volume on Google.
We compiled panel data from several data sources in all US counties between January 2021 and April 2023, a time during which those with primary COVID-19 vaccinations increased from <57,000 to >230 million adults. We estimated a random effects generalized least squares regression model with time-fixed effects to assess the relationship between county-level COVID-19 vaccine readiness and COVID-19 vaccine intent relative search volume. We controlled for health care capacity, per capita COVID-19 cases and vaccination doses administered, and sociodemographic indicators.
The county-level proportions of unvaccinated adults who reported that they would wait and see before getting a COVID-19 vaccine were positively associated with COVID-19 vaccine intent relative search volume (β=9.123; Z=3.59; P<.001). The county-level proportions of vaccine-enthusiast adults, adults who indicated they were either already vaccinated with a primary COVID-19 vaccine series or planned to complete the vaccine series soon, were negatively associated with COVID-19 vaccine intent relative search volume (β=-10.232; Z=-7.94; P<.001). However, vaccine intent search was higher in counties with high proportions of people who decided to wait and see and lower in counties with high proportions of vaccine enthusiasts.
During this period of steep increase in COVID-19 vaccination, web-based search may have signaled differences in county-level COVID-19 vaccine readiness. More vaccine intent searches occurred in high wait-and-see counties, whereas fewer vaccine intent searches occurred in high vaccine-enthusiast counties. Considering previous research that identified a relationship between vaccine intent search and subsequent vaccine uptake, these findings suggest that vaccine intent search aligned with people's transition from the wait-and-see stage to the vaccine-enthusiast stage. The findings also suggest that web-based search trends may signal localized changes in information seeking and decision-making antecedent to vaccine uptake. Changes in web-based search trends illuminate opportunities for governments and other organizations to strategically allocate resources to increase vaccine uptake. Resource use is part of the larger public policy decisions that influence vaccine uptake, such as efforts to educate the public during evolving public health crises, including future pandemics.
焦虑、担忧以及对某一主题知识不足的认知等因素，促使个体寻求基于网络的健康信息，以指导其与健康相关的决策。在新冠疫情期间，这些因素同时出现，并与新冠疫苗接种决策相关联。虽然研究表明，与新冠相关的网络搜索与后续的疫苗接种有关，但对于作为疫苗接种准备信号的新冠疫苗意向搜索（评估疫苗的可获得性、可及性和资格）了解较少。
为了增加对作为疫苗接种准备信号的疫苗意向搜索的了解，我们调查了新冠疫苗接种准备情况与谷歌上新冠疫苗意向相对搜索量之间的关系。
我们收集了2021年1月至2023年4月期间美国所有县几个数据源的面板数据，在此期间，完成新冠疫苗基础接种的人数从不到5.7万成年人增加到超过2.3亿成年人。我们估计了一个具有时间固定效应的随机效应广义最小二乘回归模型，以评估县级新冠疫苗接种准备情况与新冠疫苗意向相对搜索量之间的关系。我们控制了医疗保健能力、人均新冠病例数和接种剂量以及社会人口学指标。
报告在接种新冠疫苗前会观望的未接种成年人的县级比例与新冠疫苗意向相对搜索量呈正相关（β=9.123；Z=3.59；P<0.001）。热衷于接种疫苗的成年人（即表示已完成新冠疫苗基础接种系列或计划很快完成该系列接种的成年人）的县级比例与新冠疫苗意向相对搜索量呈负相关（β=-10.232；Z=-7.94；P<0.001）。然而，在观望人群比例高的县，疫苗意向搜索量更高；在热衷于接种疫苗人群比例高的县，疫苗意向搜索量更低。
在新冠疫苗接种急剧增加的这段时期，基于网络的搜索可能反映了县级新冠疫苗接种准备情况的差异。在观望人群比例高的县，疫苗意向搜索更多；而在热衷于接种疫苗人群比例高的县，疫苗意向搜索更少。鉴于之前的研究发现疫苗意向搜索与后续疫苗接种之间存在关系，这些发现表明疫苗意向搜索与人们从观望阶段到热衷于接种疫苗阶段的转变相一致。这些发现还表明，基于网络的搜索趋势可能预示着在疫苗接种之前信息寻求和决策方面的局部变化。网络搜索趋势的变化为政府和其他组织战略性地分配资源以提高疫苗接种率提供了机会。资源利用是影响疫苗接种率的更大公共政策决策的一部分，例如在不断演变的公共卫生危机（包括未来的大流行）期间对公众进行教育的努力。
