A Qualitative Inquiry in Understanding Trusted Media Sources to Reduce Vaccine Hesitancy among Kenyans

"The importance of the media cannot be ignored while addressing COVID-19 vaccine hesitancy."

The COVID-19 vaccine rollout in Kenya has been challenged by both the supply of and demand for vaccines. With a third of the adult population classifying as vaccine hesitant, reaching vaccination targets requires an understanding of how people make decisions regarding vaccines. One key decision-making factor is access to trusted sources of information. Pregnant and lactating women have been disproportionately impacted by misinformation, uncertainty, and changing guidance. Given the fact that low vaccine uptake among pregnant and lactating women is hindering Kenya's COVID-19 vaccination goals, this study examines the relationship between the media and the vaccine decision-making process among pregnant and lactating women and those who are likely to influence the vaccine decision-making process.

The researchers note that, with the widespread global use of smartphones, access to different media channels allows for more convenient access to health information that may influence vaccine decision-making. However, the media can act as a catalyst for the spread of misinformation and mistrust related to vaccination and has been found to be a central factor in settings with high levels of vaccine hesitancy. People look to media sources for reputable information and use it to shape their own attitudes and behaviours. Therefore, correctly harnessing the power of media on vaccine decision-making is crucial in improving uptake.

The researchers conducted 94 in-depth interviews with: 29 pregnant and lactating women, 35 community members (male family members or neighbours of those women, as well as community gatekeepers such as community leaders and faith-based leaders), 20 healthcare workers, and 10 policymakers. Participants were recruited from 3 diverse counties in Kenya: Garissa (rural), Kakamega (rural and urban), and Nairobi (urban).

While healthcare workers were the most frequently cited information source for pregnant and lactating women, other healthcare workers, and community members, findings show that the media (traditional, social, and the internet) is an important source for obtaining COVID-19 information for these groups. Policymakers obtained their information most frequently from traditional media. More specifically:

• Traditional media was one of the top information sources for pregnant and lactating women, followed by social media and the internet more broadly. Across the 31 interviews with pregnant and lactating women, traditional media was mentioned 63 times, while social media and the internet were cited 22 and 9 times, respectively.
• Among community members, across the 33 interviews conducted, traditional media was mentioned 67 times, while social media 41 times and the internet 15 times. Many community members heard about COVID-19 vaccines through the radio, TV, or the newspaper. Social media also helped community members access information from global organisations, like the United Nations Children's Fund (UNICEF).
• Across the 20 interviews conducted with healthcare workers, traditional media was mentioned 45 times, while social media and the internet were mentioned 24 and 12 times, respectively.
• Among the 10 interviews conducted with policymakers, traditional media was the most cited source, with 21 mentions, followed by social media and internet with 11 and 3 mentions, respectively.

The information received from media sources consisted mainly of COVID-19 vaccine availability and eligibility.

Per the researchers, given that many participants received their information through multiple channels, circulating only accurate information through all media types may promote positive vaccine attitudes. Government bodies and public health agencies could work with the media to reduce the presence of misinformation on platforms and to ensure that accurate and reliable information is always available. Increased presence and engagement of public health professionals and policymakers throughout media, especially social media, may also assist in reducing misinformation. Kenya has been working to reduce misinformation on social media platforms with investments in fact-checking organisations that locate and mitigate circulating false information.

Beyond ensuring the accuracy and accessibility of information, the researchers suggest that presenting positive and truthful messages is paramount. Positive COVID-19 media coverage has been shown to increase vaccine acceptance, while negative coverage can lead to decreased acceptance.

"The potential influence of other individuals on vaccine uptake of pregnant and lactating women should also be considered when understanding how vaccine attitudes and beliefs are shaped. Male family members, community gatekeepers, policymakers, and healthcare workers were all identified as key stakeholders in the vaccine decision-making process of pregnant and lactating women. Ensuring that these groups are also receiving accurate information from trusted sources, especially the media, should be of interest....Moreover, encouraging healthcare worker engagement in the media could act as the bridge between these two central information sources."

In conclusion: "The key to addressing vaccine hesitancy in vulnerable groups, such as pregnant and lactating women, may lie in ensuring that...media channels share up-to-date and accurate information..., along with developing effective communication strategies....The findings from our study will inform the development of such communication strategies to improve trust in media sources and vaccine uptake."