The association between COVID-19 vaccination uptake and Information seeking behaviors using Internet: A nationwide panel study. (Preprint)

BACKGROUND The COVID-19 pandemic, declared in March 2020, profoundly affected global health, societal, and economic frameworks. Vaccination became a crucial tactic in combating the virus. Simultaneously, the pandemic likely underscored the Internet's role as a vital resource for seeking health information. The proliferation of misinformation on social media was observed, potentially influencing vaccination decisions and timing. OBJECTIVE This study sought to explore the relationship between COVID-19 vaccination rates, including the timing of vaccination, and reliance on Internet-based information sources in Japan. METHODS Employing a panel study design, this longitudinal nationwide survey was conducted in seven waves. A total of 10,000 participants were randomly selected via an Internet survey firm, narrowing down to 8,724 after applying inclusion and exclusion criteria. The primary outcome was the COVID-19 vaccination date, divided into vaccinated vs. unvaccinated and early vs. late vaccination groups. The main exposure variable was the use of Internet-based information sources. Control variables included gender, family structure, education level, employment status, household income, eligibility for priority COVID-19 vaccination due to pre-existing medical conditions, and a health literacy scale score. Two regression analyses using generalized estimating equations accounted for prefecture-specific correlations, focusing on vaccination status and timing. Additionally, chi-square tests assessed the relationship between each information source and vaccination rates. RESULTS Representing a cross-section of the Japanese population, the regression analysis found a significant association between Internet information seeking and higher vaccination rates (adjusted Odds Ratio: aOR=1.42 for those under 65; aOR=1.66 for those 65 and older). However, no significant link was found regarding vaccination timing. Chi-square tests showed positive associations with vaccination for television, government web pages, and web news, whereas blogs and some social networking sites were negatively correlated. CONCLUSIONS Internet-based information seeking is positively linked to COVID-19 vaccination rates in Japan, underscoring the significant influence of online information on public health decisions. Nonetheless, certain online information sources, including blogs and some social networks, negatively affected vaccination rates, warranting caution in their use and recognition. The study highlights the critical role of credible online sources in public health communication and the challenge of combating misinformation on less regulated platforms. This research sheds light on how the digital information landscape influences health behaviors, stressing the importance of accurate and trustworthy health information amidst global health emergencies. CLINICALTRIAL Not applicable.