Background A global rollout of vaccinations is currently underway to mitigate and protect people from the COVID-19 pandemic. Several individuals have been using social media platforms such as Twitter as an outlet to express their feelings, concerns, and opinions about COVID-19 vaccines and vaccination programs. This study examined COVID-19 vaccine–related tweets from January 1, 2020, to April 30, 2021, to uncover the topics, themes, and variations in sentiments of public Twitter users. Objective The aim of this study was to examine key themes and topics from COVID-19 vaccine–related English tweets posted by individuals, and to explore the trends and variations in public opinions and sentiments. Methods We gathered and assessed a corpus of 2.94 million COVID-19 vaccine–related tweets made by 1.2 million individuals. We used CoreX topic modeling to explore the themes and topics underlying the tweets, and used VADER sentiment analysis to compute sentiment scores and examine weekly trends. We also performed qualitative content analysis of the top three topics pertaining to COVID-19 vaccination. Results Topic modeling yielded 16 topics that were grouped into 6 broader themes underlying the COVID-19 vaccination tweets. The most tweeted topic about COVID-19 vaccination was related to vaccination policy, specifically whether vaccines needed to be mandated or optional (13.94%), followed by vaccine hesitancy (12.63%) and postvaccination symptoms and effects (10.44%) Average compound sentiment scores were negative throughout the 16 weeks for the topics postvaccination symptoms and side effects and hoax/conspiracy. However, consistent positive sentiment scores were observed for the topics vaccination disclosure, vaccine efficacy, clinical trials and approvals, affordability, regulation, distribution and shortage, travel, appointment and scheduling, vaccination sites, advocacy, opinion leaders and endorsement, and gratitude toward health care workers. Reversal in sentiment scores in a few weeks was observed for the topics vaccination eligibility and hesitancy. Conclusions Identification of dominant themes, topics, sentiments, and changing trends about COVID-19 vaccination can aid governments and health care agencies to frame appropriate vaccination programs, policies, and rollouts.

BACKGROUND A global rollout of vaccinations is currently underway to mitigate and protect people from the COVID-19 pandemic. Several individuals have been using social media platforms like Twitter as an outlet to express their feelings, concerns and opinions about COVID-19 vaccines and vaccination programs. This study examines COVID-19 vaccine related tweets from Jan 1, 2020 to April 30, 2021 to uncover the topics, themes and variations in sentiments of public twitter-users. OBJECTIVE To examine key themes and topics from COVID-19 vaccine related English tweets posted by individuals, and to explore the trends and variations in public opinions and sentiments METHODS We gathered and assessed a corpus of 2.94 million COVID-19 vaccine related tweets made by 1.2 million individuals. We used CoreX topic modelling to explore the themes and topics underlying the tweets, and used VADER sentiment analysis to compute sentiment scores and examine weekly trends. We also performed qualitative content analysis of the top three topics pertaining to COVID-19 vaccination. RESULTS Topic modelling yielded 16 topics that were grouped into 6 broader themes underlying the COVID-19 vaccination tweets. The most tweeted topic about COVID-19 vaccination was related to vaccination policy - whether vaccines needed to be mandated or optional (13.94%), followed by vaccine hesitancy (12.63%), and post-vaccination symptoms and effects (10.44%). Average compound sentiment scores were negative throughout the 16 weeks for topics: post-vaccination symptoms and side effects, and hoax/conspiracy. However, consistent positive sentiment scores were observed for the topics: vaccination disclosure, vaccine efficacy, clinical trials and approvals, affordability, policy/regulation,distribution and shortage, travel, appointment and scheduling, vaccination sites, advocacy, opinion leaders and endorsement, and gratitude to healthcare workers. Reversal in sentiment scores in a few weeks were observed for vaccination eligibility and hesitancy. CONCLUSIONS : Identification of dominant themes, topics, sentiments and changing trends about COVID-19 vaccination can aid governments and healthcare agencies to frame appropriate vaccination programs, policies and rollouts.