The impact of social media on people acceptance e

Of the COVID-19 vaccine in Egypt

An applied study on social media’s users in Egypt

19- ‫تأثري وسائل التواصل الاجامتعى عىل املوافقة عىل اخذ لقاح كوفيد‬
‫ىف مرص‬

Presented by
Table of Contents

Introduction 3
Chapter (1): The Research Framework 5
1.1 Research Background 5

1.2 Previous studies 7

1.3 pilot study 12

1.4 Research problem 13
1.5 Research Questions 13

1.6 Research Objectives 13

1.7 Research Hypotheses 13

1.8 The Conceptual Framework of the Research 14

1.9 Research Variables 15

1.10 Research Methodology 15

1.11 Study Limitation 17
1.12 Structure of the Thesis 17
1.13 Conclusion 18

Reference 18

Introduction

2
The pandemic of COVID-19 is considered a global challenge for all countries worldwide
to contain its spread. Efforts and campaigns of prevention, early diagnosis, and medical
management are being led by the World Health Organization (WHO) and numerous
research teams and clinical experts worldwide. There are no specific antiviral
medications for COVID-19, and among the used drugs, a few have shown potential to
reduce mortality among patients with COVID-19. Also, compliance of humans with
social distancing and using face masks for an extended period is unguaranteed. Thus,
the best strategy to control and gradually silencing this pandemic is to develop an
effective vaccine.
A remarkable effort has been made in the eleven months since discovering the SARS-
CoV-2 virus and its genome. The scientific community has contributed to the creation of
more than 300 vaccine projects. More than 40 new vaccines are currently undergoing
clinical evaluation, a few of them obtained the Food and Drug Administration's (FDA)
Emergency Use Authorization (EUA), and are now used in many countries, for example,
Pfizer BioNTech and Moderna vaccines, but coverage rate is an essential factor that
decides successful vaccination. Vaccine development was typically taking years. So, the
public acceptance for a new vaccine of COVID-19 developed within a short period
remains uncertain despite the availability.6, 7 Lessons learned from the previous
pandemics of influenza when the vaccine was introduced, and the acceptance rate was
variably low in many countries urges proper understanding of the vaccine hesitancy
problem.
This means to delay accepting or refusing vaccination although the vaccination services
are made available, that is, no demand for offered and available vaccines. It is a
continuum between those who accept vaccines without a doubt to complete refusal
without a doubt. Vaccine hesitancy affects the hesitant individual and, consequently,
the whole community as a high coverage rate is necessary to confer herd immunity
needed to flatten the epidemic curve.
Several determinants modify vaccination decisions and determine whether to refuse,
delay, or accept some or all vaccines. These include contextual influences that arise
from historical, socioeconomic, cultural, ecological, health system/institutional, and
political factors. Concerns about the efficacy or safety, the country of manufacture of
the vaccine, the ant vaccine movements, and the belief of rushed vaccine development
and production, besides rumors and misinformation, were important COVID-19
vaccination hesitancy causes.

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Social media platforms are amongst the most widely used sources of information in the
World, the easy and inexpensive access to the internet and a large number of registered
users in these platforms make them one of the easiest and most effective ways to
disseminate information. During major events, the overall response is usually a greater
search for information be it a sports event, a disease, or a natural disaster.
A good example can be seen with the peak of searches for information on the Internet
and social media platforms in China preceding the peak of incidence in COVID-19 cases
by 10-14 days, with which Internet and social media networks searches have a
demonstrated correlation with the incidence of disease.
Social media platforms have also become helpful for the lay public to maintain
communication with friends and family to reduce isolation and boredom which have
been associated with anxiety and long-term distress, therefore becoming an important
recommendation for isolation at home to help to reduce the psychological impact.
Some of the most relevant characteristics of social media platforms in this pandemic
has been the rapid dissemination of protocols at regional, national, and international
levels. Sharing protocols about treatment, personal protection equipment, or even
proposals for fair allocation in scarce medical resource settings have now become the
new normal.
This allows centers with less capacity to develop protocols at sufficient speed to be able
to implement or adapt other's protocols to their particular situation or resources in
minimal time, something unthinkable 20 years ago when most social media platforms
had not yet been born.
Social media platforms have become an essential source of information for many users.
The purpose of the current study is to explore Egyptian social media users’ acceptance
of COVID-19 vaccine.

The Research Framework:

4
 1.1 Research Background
Vaccination is one of the most successful public health interventions and a cornerstone
for the prevention of communicable infectious diseases. Notwithstanding vaccine
progress, ongoing public acceptance is required to maintain herd immunity, prevent
outbreaks of vaccine preventable illnesses, and ensure adoption of novel vaccines.
Unfortunately, uptake of many vaccines continues to be suboptimal. The ongoing
resurgence of vaccine-preventable illnesses has led the World Health Organization
(WHO) to name vaccine hesitancy as one of the top ten threats to global health in 2019.
Vaccine hesitancy, defined as patient-level reluctance to receive vaccines, may be
fueled by a spectrum of held views regarding vaccination spanning from cautious
acceptors to outright deniers. Amongst the barriers to universal vaccination,
misinformation regarding the benefits, medicinal composition, and adverse effects of
vaccination limits patient understanding and overall buy-in. As patients increasingly
consult the Internet and peer networks, such as those generated on social media, for
health information, growing interest has emerged in the role of interactive social media
in public health promotion. However, there is also substantial potential for harmful
misinformation to spread across networks which may be propagated via the
contemporary anti-vaccination movement, fueling vaccine hesitancy.
These worries may be magnified in the face of the current COVID-19 pandemic, as the
ongoing development and subsequent deployment of a vaccine is expected to play a
critical role in downstream global control efforts. Further, intensive global efforts for
physical distancing and isolation to curb the spread of SARS-CoV-2 may intensify the use
of social media as individuals try to remain connected while apart. Concerningly,
misinformation and unsubstantiated rumors regarding COVID-19 and potential
vaccination against SARSCoV-2 have already begun emerging on social media platforms,
threatening to erode public confidence well before the release of an effective vaccine.
We thus sought we sought to review the state of anti-vaccination messaging on social
media platforms, examine their role in propagating vaccine hesitancy, and to explore
next steps in how social media may be used to improve health literacy and build public
trust in vaccination.
Social media platforms are internet-based applications that enable communities of
users to create, interact, and share with others, with multiple platforms for different
content-types They allow for real-time communication amongst queasier networks,
allowing users to actively participate in public discourse. In contrast to traditional
media, content posted need not undergo editorial curation nor scientific vetting, and
may represent a more complex mixture of evidence and personal opinion. Further,

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users frequently maintain anonymity, allowing individuals to express their views
unadulterated. Social media is also characterized by its potential to reach large
audiences and propagate information very rapidly. Social media allow users to
“follow” or “like” other users or groups to keep updated with their postings and self-
select streams of content relevant to their interests, whilst simultaneously rejecting
content with which they do not agree. As a result, each user develops a unique
network of content and interactions within the broader network. Such self-selection
may allow individuals to aggregate and cluster within ideologically distinct sub-
communities commonly known as “echo chambers”.
Vaccine content is widely present across social media platforms, with several studies
characterizing how vaccine content is portrayed on these platforms and, more
broadly, the Internet.

https://datareportal.com/reports/digital-2021-egypt

1.2 Previous Studies

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 Marwa O. Elgendy (2020): studied Public awareness in Egypt about COVID-19 spread
in the early phase of the pandemic and she found that participants had good
knowledge about coronavirus. With recent outbreaks of this pandemic disease in the
world, there is a need for the Ministry of Information to increase the knowledge and
awareness of coronavirus, but Continuous training is needed by the Ministry of Health
to the healthcare teams to support their important role in educating and spreading
awareness about the coronavirus infection to the public.
Janmejaya Samal (2021): studied the Impact of COVID-19 infodemic on psychological
wellbeing and vaccine hesitancy and concluded that The infodemic is as serious as the
pandemics and can spread at higher speed than that of the pandemic. Hence, it
becomes significant and imperative that the infodemic is encountered appropriately
and timely in order to promote health and wellbeing and aid in the prevention,
vaccination, and management of pandemic of COVID-19. Given the context, the
media, both traditional and social, should play a robust role in creating awareness,
promoting healthy habits, making people exposed to accurate information, and
improving psychosocial wellbeing. Above all, the government should play an active
role in regulatory roles, bringing polices that would govern the media in mitigating the
menace of the infodemic.
Ahmed shehata &metwaly eldakar(2021): this study the Exploration of Egyptian
Facebook Users’ Perceptions and Behavior of COVID-19 Misinformation and The study
was conducted on a sample of Egyptian participants and Egyptian social media pages
on Facebook, hence, the types of misinformation and the results may differ in other
countries, depending on the social media platform and other factors that may play a
role in the spread of misinformation. And the study showed that there are four main
types of misinformation shared on social media. The first type is false claims about the
virus or treatment of the virus; the second is false information about the government;
the third is false content in general or manipulated content, and the last type is
conspiracy theories. The findings also revealed that gender and education affect how
people deal with and accept misinformation. Additionally, it was found that the
spread of COVID-19 misinformation has caused negative feelings among the
participants.
Chiara Reno (2021): studied the enhancing of COVID-19 Vaccines Acceptance: Results
from a Survey on Vaccine Hesitancy in Northern Italy and found that The need to
promote COVID-19 vaccination at a global level could offer opportunities for countries
to join forces and build a solid culture of trust towards COVID-19 vaccination, as well
as other vaccines, and to restore faith in this fundamental preventive measure for
infectious diseases.
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It is important to keep in mind that different geographical and cultural contexts may
play an important role: thinking globally, but acting locally can be the turning point for
effective and efficient strategies. Evidence produced at different levels is needed to
inform policy makers and public health professionals in their efforts to target
information and communication campaigns to counteract vaccine hesitancy. Given the
regional contribution in Italy to the organization of the COVID-19 vaccination
campaign, this survey may represent an important piece of knowledge to enforce the
need of ongoing surveys conducted at different levels and time points.

Malik Sallam(2021): COVID-19 Vaccine Hesitancy Worldwide: A Concise Systematic

Review of Vaccine Acceptance Rates and the study showed that Large variability in
COVID-19 vaccine acceptance rates was reported in different countries and regions of
the world. A sizable number of studies reported COVID-19 acceptance rates below
60%, which would pose a serious problem for efforts to control the current COVID-19
pandemic. Low COVID-19 vaccine acceptance rates were more pronounced in the
Middle East, Eastern Europe and Russia. High acceptance rates in East and South East
Asia would help to achieve proper control of the pandemic. More studies are
recommended to assess the attitude of general public and healthcare workers in
Africa, Central Asia and the Middle East besides Central and South America. Such
studies would help to evaluate COVID-19 vaccine hesitancy and its potential
consequences in these regions, and around the globe. The major challenges that could
face successful implementation of COVID-19 vaccination programs to fight the
unprecedented pandemic include mass manufacturing of vaccines, its fair distribution
across the world and the uncertainty regarding its long-term efficacy. However,
vaccine hesitancy can be the major hindrance of the control efforts to lessen the
negative consequences of COVID-19 pandemic, at least in certain countries/regions.
The widespread prevalence of COVID-19 vaccine hesitancy mandates collaborative
efforts of governments, health policy makers, and media sources, including social
media companies. It is recommended to build COVID-19 vaccination trust among the
general public, via the spread of timely and clear messages through trusted channels
advocating the safety and efficacy of currently available COVID-19 vaccines.

Samar Fares(2021): COVID-19 Vaccination Perception and Attitude among Healthcare

Workers in Egypt the study aimed to assess the perception and attitude of healthcare
workers in Egypt toward COVID-19 vaccines, acknowledge the determinants of their
attitude, and the factors that could increase the acceptance of the vaccine and the
results was regarding vaccination decision, 51% of the participants were undecided,

8
28% refused, and 21% accepted vaccination. Reasons for vaccine acceptance mainly
were risks of COVID-19 (93%), safety (57.5%), and effectiveness (56.25%) of the
vaccine. Simultaneously, the reasons for vaccine hesitancy were the absence of
enough clinical trials (92.4%) and fear of side effects of the vaccine (91.4%). The
leading factor that could increase vaccination acceptance among the participants was
to get sufficient and accurate information about the available vaccines, despite the
COVID-19 pandemic, only approximately 21% of Egyptian healthcare workers in our
study accepted the COVID-19 vaccination. Vaccine hesitancy represents a major
barrier to implementing vaccination programs.

Ahmed Samir Abdelhafiz & zeinb mohammed(2020):they studied knowledge,

Perceptions, and Attitude of Egyptians Towards the Novel Coronavirus
Disease (COVID-19) and they figured out that people participated in the survey had
good knowledge about COVID-19, and a positive attitude towards using protective
measures, which is important to limit the spread of the disease. This knowledge is
mainly acquired through social media platforms and the internet, which has pros and
cons. However, knowledge was lower among older, rural, less educated, and lower
income groups. This may necessitate more efforts or using different tools to
communicate with these groups. Although the government has taken major steps to
limit the spread of the disease, more effort is needed to support the most affected
groups from the economic sequel of the disease. If a vaccine or a treatment is
approved for the disease, we recommend that it should be available for developing
countries for affordable prices and government control over the use of the vaccine
and/or treatment to preserve the rights of the vulnerable and needy groups.

Arriel Benis & Abraham Seidmann & and Shai Ashkenazi (2021): Reasons for Taking
the COVID-19 Vaccine by US Social Media Users and concluded that Vaccination
adherence and hesitancy against COVID-19 are mainly affected by individual opinions
and health literacy.
- Implications for Healthcare Practice Healthcare policymakers must consider
communication on social media as a strategic task. Therefore, they should
contemplate making use of social media advertising campaigns. They must target the
vaccination hesitancy groups (18.5% or 304/1644 in this study) to stimulate the civic
motivation for vaccination (62.8% or 191/304 of the hesitant participants denying this
reason) and to counter mistrust in healthcare providers (57.2% or 174/304) and the
pharmaceutical industry (74.3% or 226/304). Additional campaigns should target the
vaccination adherence group (81.5% or 1340/1644) as a retention program and

9
 reminder to act. Public health communication with a specific audience must employ
adapted and personalized language that considers personal opinions and fears and
addresses concerns about the risks and benefits of the COVID-19 vaccine. Improving
adherence to COVID-19 vaccination must start, in this era of social media based
knowledge, by building trust. Healthcare policymakers should use community
influencers to effectively promulgate trustworthy vaccination messages and dismantle
dangerous false claims. This approach should have a powerful impact on about 10%
(23.5 million people) of the overall US population using social media (recall that 8.9%
of this study’s participants declare that they may take the COVID-19 vaccine).
Policymakers can also use our results in their reinforcement advertising to publicly
reassure younger people that they have done the right thing in opting for vaccination.
- Current and Potential Future Research Directions The overall population is becoming
more and more accustomed to using social media to get information and enhance
their knowledge. Analyzing, on a few specific social media platforms, concerns voiced
about COVID-19 vaccination (or any other vaccine) can help policymakers to
understand how other aspects of daily life are considered related to it in specific
population segments. This understanding can help to improve the targeting of
communication campaigns aimed at increasing vaccination compliance or at least
professional and scientifically based tools for taking the vaccination decision.
Additionally, the content of the communication campaign must use personalized
content such as buzzwords, and pictures fitting with the target population specificities
and non-vaccination related interests.

Neha Puri , Eric A. Coomes , Hourmazd Haghbayan & Keith Gunaratne(2020): Social
media and vaccine hesitancy: new updates for the era of COVID-19 and globalized
infectious diseases this study show that ongoing resurgence of vaccine-preventable
illnesses has led the WHO to identify vaccine hesitancy as a major threat to global
health. In the digital era, patients have access to health information from a variety of
sources including the Internet and social media platforms. As social media platforms
gain increasing popularity globally, there has been growing public health concerns
regarding the impact of anti-vaccination content on downstream vaccine denial. This
further threatens the uptake of emerging vaccines, such as ongoing efforts to develop
an effective vaccine against SARS-CoV-2. Future work in this field should focus on
developing and analyzing effective strategies to foster vaccine uptake and promote
evidence-based health literacy.

Charles E Basch&  Corey H Basch& Grace C Hillyer(2021): YouTube Videos and Informed
Decision-Making About COVID-19 Vaccination: Successive Sampling Study and concluded

10
that the data potentially inaccurate and negative influence social media can have on
population-wide vaccine uptake, which should be urgently addressed by agencies of the
United States Public Health Service as well as its global counterparts.

Rachael Piltch-Loeb &Elena Savoia& Beth Goldberg& Brian Hughes (2021): Examining
the effect of information channel on COVID-19 vaccine acceptance and they found that
the COVID-19 vaccine rollout is already underway. Anecdotal reports suggest some of
those who are eligible for the vaccine are refusing to get vaccinated. this study
demonstrates that in the United States it is useful to draw on traditional media sources to
discuss the COVID-19 vaccine. and also show that because vaccine-hesitant individuals are
more likely to identify social media as their sole source of information, social media
platforms have a particularly important role to play in addressing vaccine hesitancy.

User’s Perception
Social media
about vaccine
platform Vaccine hesitancy

Infodemic

Accept to take
√

Gap Refuse to take

ꓫ

After studying the previous studies, we found many studies addressed the relation
between social media and vaccine hesitancy, others addressed the relation

11
between infodemic and vaccine hesitancy but there is lack of studies in the
relationship between social media impact and vaccine acceptance.
This situation represents one of the empirical gaps in the present literature
between social media platform and people accepting the vaccine.
Therefore, this study attempts to bridge this gap by shedding the light on
the role of the social media on acceptance of vaccine by people.

1.3 Pilot Study

Since the current study aims to explore the Impact of Social Media on the decision
to take covid 19 vaccine, the pilot study was designed to:
- Explore the relationship between variables.
- Investigate how social media effect the decision of taking covid 19 vaccine.
- investigate the positive or negative impact of social media on decision taking.

A sample of 30 students of Ain Shams University was randomly

interviewed. The participants of the sample were both males and females
with a percentage of 50% males and 50% females. Their ages range
from 29 to 38 years old and the data were collected during June 2021. All
participants were asked to answer the following questions
regarding:
a) what is your favorite social media?
b) what is your opinion about covid- 19 vaccine?
c) do you trust the information about covid – 19 vaccines from social media?
c) do you intended to take covid – 19 vaccines?

The Results of the Pilot Study:

The majority of the participants had negative attitudes toward the covid -19
vaccine.
The majority of the participant’s relay on information from social media.
The majority of the participants refuse to take covid -19 vaccine because they
don’t trust in it.

1.4 Research Problem

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 From pilot study run in Egyptian society that touch the base of 30 respondents with
different age, background and education it was found that there is lack of
information of the importance of vaccine.
As identified through literature reviews, there is lack of studies on the impact of
social media on vaccine acceptance.
There is lack of the source of information on social media platform and if it is right
or wrong.
There is lack of information about the cause of vaccine refuse and the trust in it.
So this study focusses on the measure the impact of social media platform on the
vaccine acceptance in Egypt.

1.5 Research Questions

Based on pilot study conduct in Egypt for 30 respondents as well as literature

reviews, try to extract the following questions:
- what is the relationship between social media and vaccine acceptance in Egypt.
- what is the social media platform which has the major impact on vaccine
acceptance.
-what is the social media platform which users rely on to have their information.

1.6 Research Objectives

This research aims to achieve the following objectives:

- to investigate the relationship between social media platform and vaccine
acceptance by internet users.

-to investigate the which social media platform has the major impact on users.

Objectives are accomplished through studying on population of social media users.

1.7 Research Hypotheses

The research hypotheses were formulated considering previous studies which

were stated as follows:

H0: there is a significant relation between social media and vaccine acceptance.
H1: there is no significant relation between social media and vaccine acceptance.

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 1.8 The Conceptual Framework of the Research

Facebook YouTube

User’s Perception
Social media about vaccine Vaccine hesitancy
platform Infodemic

WhatsApp
Twitter
Accept to take
√

Relationship Refuse to take

ꓫ

Hypotheses framework developed by the researcher

- Social media being independent variable in this research.

- acceptance of COVID-19 vaccine is dependent variable measure by approval to
take the vaccine.

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 1.9 Research Variables

Dependent variable is the acceptance of COVID -19 vaccine

independent variable is the social media
Y=Acceptance of COVID -19 vaccine
X=The social media
Y=α+βX+ε
α: constant term
β: the coefficient of regression
ε: the error term

1.10 Research Methodology

In this section, all the steps were applied in this study would be discussed,
starting with the research design, the research method, the methods of data
collection, questionnaire design, then research population, sampling method,
sampling technique, sample size, sample unit selection, reliability and validity,
and statistical analysis techniques

1.11.1 Type of Research Design

The descriptive research was chosen as a research format for this study.

1.11.2 Research Method

This study depended on quantitative research method.

1.11.3 Data Collection

The secondary data and the primary data were used in this study.

a) Secondary Data

The secondary data sources that were used in this study included books, journals
, newspapers, and websites.

b) Primary Data

Primary data can be collected through a structured questionnaire survey. It has

been designed and used as the main method strategy to research because it was
more convenient for the participants to answer; also, it is easy to interpret the
15
respondent’s opinions. The questionnaire was adapted from previous literature
studies to investigate the Impact of Social Media on public Awareness about the COVID-
19 vaccine.

1.11.4 Questionnaire Design

The questionnaire was adapted from several literature reviews; the content
validity and the construct validity were conducted. All the statements in the
questionnaire was measured by using a Five-Point Likert-type scale. Anchored
at (5= strongly agree and 1= strongly disagree).

1.11.5 Research Population

The research population is all internet users in Egypt. The sampling

unit in the current research is the social media users during the research period who
regularly use e-mails, social media such as Facebook, YouTube, and Twitter, TikTok,
Telegram, WhatsApp.

1.11.6 Sampling Method

For the purpose of this research, non-probability sampling was manipulated in

this study, because this study has no sampling frame.

1.11.7 Sampling Technique

Convenience sampling was used in the current study

1.11.8 Sample Size

In non-probability samples, the sample size is usually determined based on the

judgment of the researcher, and the required sample size of the analytical
techniques that are implemented in the research. In this study, 400 samples used as a
sample size.

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1.11.9 Sample Unit Selection

Convenience sampling was used for collecting data from online social media users who
interact with the social media like YouTube, face book, twitter, WhatsApp, telegram, tik
tok and others. The selection of the units was made randomly. The questionnaires were
distributed to participants, who agreed to take the survey.

1.11.10 Reliability and Validity

The Cronbach’s alpha was used to assess the reliability of the selected scale; it
was used to verify the stability of the measuring tool used. In addition, factor
analysis was used to measure the content validity of the research constructs.

1.11.11 Statistical Analysis Techniques

The analyses of the collected data were carried out through various statistical
techniques such as descriptive analysis, Cronbach’s alpha, Correlation analysis,
both exploratory and confirmatory factor analysis, Multiple regressions. The data will be
compiled and analyzed using the Statistical Package for the Social Science (IBM SPSS v22)
for Windows computer software.

1.11 Study Limitations

First this study will be done from audiences online with different background, education
degree and different social classes.

Second this study will be done only from audiences' point of view; the companies’
perspective on this subject will not be studied.

Third the survey will be done limited to only 400 sample size during one-month period.

1.12 Structure of the Thesis

This thesis contains six chapters as flows:

Chapter (1): The Research Framework
Chapter (2): Theoretical Framework
Chapter (3): Conceptual and Theoretical Foundation for the Development of

17
 the Proposed Model
Chapter (4): Research Methodology and Design
Chapter (5): Research Findings
Chapter (6): Conclusion, Implications, and Recommendations

1.13 Conclusion

This chapter discussed the background to the research, which gave an overview
of this thesis. Then, the research terminologies were pointed out; also, the previous
studies were discussed followed by the pilot Study. The results of the pilot study that
were supported by literature studies helped in developing the research problem, the
research questions were formulated to depict the problem of this study, and the study
model that revealed to the impact of social media on public awareness of the COVID-19
vaccine. Next, the Research Hypotheses were designed to investigate the direct,
moderating, and indirect effects among the study variables. Moreover, each of research
constructs, Research Variables, Research Methodology, and Study Limitations were
discussed. Finally, the Structure of the Thesis was explained to show the progress of the
study.

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