Choosing COVID-19 treatment over prevention through vaccination: A U.S. social media case study

Background: This study examined anti-vaccination social media posts that favored COVID-19 treatment (monoclonal antibodies (mAbs)) rather than prevention through vaccination, both of which were under Emergency Use Authorization rather than full approval from the U.S. Food and Drug Administration at the time of this study. Our research stemmed from participation in a U.S. public health education campaign led by a coalition of government agencies to expand provider and health system use of mAbs with high-risk COVID-19 positive patients. Aim: Inform real world communication strategies for treatment over prevention therapies. Methods: We analyzed the most-engaged tweets that mentioned mAbs and vaccines from March 1 to August 31, 2021. Results: Our qualitative analysis identified the following themes: distrust in science, individualism, and politically oriented or partisan sentiment. Discussion: Countering anti-vaccine messages and reducing the susceptibility of vaccine-hesitant individuals to these messages must involve message design that considers the individualism and distrust revealed in this study. We recommend two approaches: (1) unmasking anti-vaccine messaging techniques; (2) using colloquial and values-driven language. Conclusions: Our findings reinforce the need for public health practitioners to monitor public and social media discourse, adopt messaging that navigates anti-vaccine sentiment, and engage with the preference for treatment over prevention