Potential protective factors against negative interpersonal influence regarding COVID-19 vaccination - A cross-sectional study on Covid-19 vaccine discussion networks

Illnesses or their threat are experienced in the context of people with whom we discuss health-related issues, who also influence vaccine related decisions. As people may talk about vaccination with others who are not vaccinated, it is important to explore the protective factors against negative interpersonal influence so as to decrease vaccine hesitancy and help achieve herd immunity. Self-reported survey data came from an observational, cross-sectional survey collected online in November 2022. Our analysis involved those respondents who discussed COVID-19 vaccine matters with at least one person (n = 858). Binomial logistic Least Absolute Shrinkage and Selection Operator (LASSO) regression and average marginal effects (AMEs) were calculated. Our multivariate analysis identified four correlates of COVID-19 vaccination refusal: at least one influenza inoculation in the past, the ratio of vaccinated alters in COVID-19 vaccine discussion networks, health knowledge level and social-norm espousal. These effects were also confirmed in the subsample of those who had at least one unvaccinated alter in their COVID-19 vaccine discussion network. Our study indicates that health knowledge and social-norm espousal are in a negative associative relationship with COVID-19 vaccine refusal among those as well, who discussed COVID-19 vaccine matters with at least one unvaccinated alter. We propose that basic health knowledge and social-norm espousal are likely to be protective factors against negative interpersonal influence regarding COVID-19 vaccination. There is an urge for policy makers and influencers to promote health literacy and values for social responsibility over personal choice regarding vaccination while also acknowledging and building on interpersonal health communication. • It is important to learn about relevant peers who influence vaccine related decisions in order to help achieve herd immunity. • COVID-19 vaccine discussion networks are characterized by vaccination homophily. • Basic health knowledge and social-norm espousal are associated with vaccination intentions. • Health literacy, social responsibility and interpersonal health communication could be utilized to enhance vaccination.