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ObjectiveWe sought to examine reasons for vaccine hesitancy among online communities of US-based Black and Latinx communities to understand the role of historical racism, present-day structural racism, medical mistrust and individual concerns about vaccine safety and efficacy.DesignA qualitative study using narrative and interpretive phenomenological analysis of online bulletin board focus groups.SettingBulletin boards with a focus-group-like setting in an online, private, chat-room-like environment.ParticipantsSelf-described vaccine hesitant participants from US-based Black (30) and Latinx (30) communities designed to reflect various axes of diversity within these respective communities in the US context.ResultsBulletin board discussions covered a range of topics related to COVID-19 vaccination. COVID-19 vaccine hesitant participants expressed fears about vaccine safety and doubts about vaccine efficacy. Elements of structural racism were cited in both groups as affecting populations but not playing a role in individual vaccine decisions. Historical racism was infrequently cited as a reason for vaccine hesitancy. Individualised fears and doubts about COVID-19 (short-term and long-term) safety and efficacy dominated these bulletin board discussions. Community benefits of vaccination were not commonly raised among participants.ConclusionsWhile this suggests that addressing individually focused fear and doubts are central to overcoming COVID-19 vaccine hesitancy in Black and Latinx groups, addressing the effects of present-day structural racism through a focus on community protection may also be important.

UNSTRUCTURED Research has shown that health misinformation in online social media spaces has real, negative health consequences. Despite a proliferation of research evaluating individual intervention tactics, usually in controlled experimental environments, there remains a dearth of field research testing interventions to address health misinformation in real-time, online, in situ on social media platforms. Here we describe the results of a pilot program of infodemiologists trained to intervene on anti-vaccine sentiment in Facebook comments sections of news article postings using various evidence-informed intervention techniques. Benchmarking our interventions to matched comments, we found that empathy-first communication strategies garner less engagement (defined as comments + emoji reactions) relative to matched controls. This work reinforces research on accuracy nudges and cyberbullying interventions that also reduce engagement. In addition to more research leveraging real-time interventions in real-world social media settings, more data transparency by technology platforms will be essential to finding effective counterspeech remedies to the problem of medical misinformation in digital environments.

Research has shown that health misinformation in online social media spaces has real, negative health consequences. Despite a proliferation of research evaluating individual intervention tactics, usually in controlled experimental environments, there remains a dearth of field research testing interventions to address health misinformation in real-time, online, in situ on social media platforms. Here we describe the results of a pilot program of infodemiologists trained to intervene on anti-vaccine sentiment in Facebook comments sections of news article postings using various evidence-informed intervention techniques. Benchmarking our interventions to matched comments, we found that empathy-first communication strategies garner less engagement (defined as comments + emoji reactions) relative to matched controls. This work reinforces research on accuracy nudges and cyberbullying interventions that also reduce engagement. In addition to more research leveraging real-time interventions in real-world social media settings, more data transparency by technology platforms will be essential to finding effective counterspeech remedies to the problem of medical misinformation in digital environments.