Exploring COVID-19 Vaccine Misinformation Exposure,Beliefs,Fear,and Information Avoidance via the Stimulus–Organism

Abstract

Empirical evidence generated from theory-driven research addressing the relationship between misinformation and vaccine information avoidance during a pandemic remains lacking. Using the Stimulus-Organism-Response (S-O-R) framework, this study examined the influence of vaccine misinformation exposure and information overload on cognitive and affective responses as well as vaccine information avoidance behaviors. Findings showed that misinformation exposure predicted cognitive health beliefs (perceived vaccination barriers and benefits) and negative emotions (fear) toward the vaccines; health beliefs in turn predicted information avoidance. Information overload moderated (a) the relationship between misinformation exposure and health beliefs and (b) the relation between misinformation exposure and fear.

Keywords

COVID-19 vaccines vaccine misinformation exposure vaccine information avoidance perceived vaccination benefits and barriers fear of vaccination

Get full access to this article

View all access options for this article.

References

Al-Metwali

B. Z.

Al-Jumaili

A. A.

Al-Alag

Z. A.

Sorofman

(2021). Exploring the acceptance of COVID-19 vaccine among healthcare workers and general population using health belief model. Journal of Evaluation in Clinical Practice, 27(5), 1112–1122. https://doi.org/10.1111/jep.13581

Associated Press-University of Chicago National Opinion Research Center. (2020). Expectations for a COVID-19 vaccine. https://apnorc.org/projects/expectations-for-a-covid-19-vaccine/

Bok

Martin

Acosta

Shum

Harvie

Lee

(2023). Psychometric development of the COVID-19 vaccine misinformation scale and effects on vaccine hesitancy. Preventive Medicine Reports, 31, Article 102087. https://doi.org/10.1016/j.pmedr.2022.102087

Brashers

D. E.

(2001). Communication and uncertainty management. Journal of Communication, 51(3), 477–497. https://doi.org/10.1111/j.1460-2466.2001.tb02892.x

Carpenter

C. J.

(2010). A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Communication, 25(8), 661–669. https://doi.org/10.1080/10410236.2010.521906

Catellier

J. R. A.

Yang

Z. J.

(2012). Trust and affect: How do they impact risk information seeking in a health context? Journal of Risk Research, 15(8), 897–911. https://doi.org/10.1080/13669877.2012.686048

CDC. (2022a, March 22). COVID-19 Vaccine Effectiveness Research CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/effectiveness-research/protocols.html

CDC. (2022b, August 11). COVID-19 and Your Health. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

Chae

(2016). Who avoids cancer information? Examining a psychological process leading to cancer information avoidance. Journal of Health Communication, 21(7), 837–844. https://doi.org/10.1080/10810730.2016.1177144

10.

Chou

W.-Y. S.

Budenz

(2020). Considering emotion in covid-19 vaccine communication: Addressing vaccine hesitancy and fostering vaccine confidence. Health Communication, 35(14), 1718–1722. https://doi.org/10.1080/10410236.2020.1838096

11.

Cohen

Aiken

L. S.

West

S. H.

(Eds.). (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Lawrence Erlbaum.

12.

Cooke

N. A.

(2017). Posttruth, truthiness, and alternative facts: Information behavior and critical information consumption for a new age. The Library Quarterly, 87(3), 211–221. https://doi.org/10.1086/692298

13.

Cuesta-Cambra

Martínez-Martínez

Niño-González

J.-I.

(2019). An analysis of pro-vaccine and anti-vaccine information on social networks and the internet: Visual and emotional patterns. Profesional de la Información, 28(2), Article 2. https://doi.org/10.3145/epi.2019.mar.17

14.

Cutler

S. J.

Hodgson

L. G.

(2003). To test or not to test: Interest in genetic testing for Alzheimer’s disease among middle-aged adults. American Journal of Alzheimer’s Disease & Other Dementias®, 18(1), 9–20. https://doi.org/10.1177/153331750301800106

15.

Dam

Basaran

A.-M. B.

Lin

C. A.

Rogers

(2023). Exploring the influence of cultural and health beliefs on intentions to adopt COVID-19 prevention measures. Atlantic Journal of Communication, 31(3), 189–206. https://doi.org/10.1080/15456870.2022.2049269

16.

Diamond-Smith

Campbell

Madan

(2012). Misinformation and fear of side-effects of family planning. Culture, Health & Sexuality, 14(4), 421–433. https://doi.org/10.1080/13691058.2012.664659

17.

Dobson

G. P.

(2022). Wired to doubt: Why people fear vaccines and climate change and mistrust science. Frontiers in Medicine, 8, Article 809395. https://www.frontiersin.org/articles/10.3389/fmed.2021.809395

18.

Ebrahim

A. H.

Saif

Z. Q.

Buheji

AlBasri

Al-Husaini

F. A.

Jahrami

(2020). COVID-19 information-seeking behavior and anxiety symptoms among parents. OSP Journal of Health Care and Medicine, 1(1), 1–9.

19.

Emami

Ghahramanian

Rahmani

Mirza Aghazadeh

Onyeka

T. C.

Nabighadim

(2021). Beliefs, fear and awareness of women about breast cancer: Effects on mammography screening practices. Nursing Open, 8(2), 890–899. https://doi.org/10.1002/nop2.696

20.

Featherstone

J. D.

Zhang

(2020). Feeling angry: The effects of vaccine misinformation and refutational messages on negative emotions and vaccination attitude. Journal of Health Communication, 25(9), 692–702. https://doi.org/10.1080/10810730.2020.1838671

21.

Forster

A. S.

McBride

K. A.

Davies

Stoney

Marshall

McGeechan

Cooper

S. C.

Skinner

S. R.

(2017). Development and validation of measures to evaluate adolescents’ knowledge about human papillomavirus (HPV), involvement in HPV vaccine decision-making, self-efficacy to receive the vaccine and fear and anxiety. Public Health, 147, 77–83. https://doi.org/10.1016/j.puhe.2017.02.006

22.

Fox

J. R.

Park

Lang

(2007). When available resources become negative resources: The effects of cognitive overload on memory sensitivity and criterion bias. Communication Research, 34(3), 277–296. https://doi.org/10.1177/0093650207300429

23.

Funk

Tyson

(2021, March 5). Growing share of Americans say they plan to get a covid-19 vaccine—Or already have. Pew Research Center Science & Society. https://www.pewresearch.org/science/2021/03/05/growing-share-of-americans-say-they-plan-to-get-a-covid-19-vaccine-or-already-have/

24.

Gao

Zheng

Jia

Chen

Mao

Chen

Wang

Dai

(2020). Mental health problems and social media exposure during COVID-19 outbreak. PLOS ONE, 15(4), Article e0231924. https://doi.org/10.1371/journal.pone.0231924

25.

Griffin

R. J.

Dunwoody

Yang

Z. J.

(2012). Linking risk messages to information seeking and processing. Communication Yearbook, 36, 323–362. https://doi.org/doi:10.13140/2.1.3856.0960

26.

Guo

Kuang

Wang

(2020). Information avoidance behavior on social network sites: Information irrelevance, overload, and the moderating role of time pressure. International Journal of Information Management, 52, 102067. https://doi.org/10.1016/j.ijinfomgt.2020.102067

27.

Hidayana

Amir

Pelupessy

D. C.

Rahvenia

(2022). Using a health belief model to assess COVID-19 vaccine intention and hesitancy in Jakarta, Indonesia. PLOS Global Public Health, 2(10), Article e0000934. https://doi.org/10.1371/journal.pgph.0000934

28.

Hoq

K. M. G.

(2016). Information overload: Causes, consequences and remedies—A study. Philosophy and Progress, 55, 49–68. https://doi.org/10.3329/pp.v55i1-2.26390

29.

Hornik

Kikut

Jesch

Woko

Siegel

Kim

(2021). Association of covid-19 misinformation with face mask wearing and social distancing in a nationally representative US sample. Health Communication, 36(1), 6–14. https://doi.org/10.1080/10410236.2020.1847437

30.

Bentler

P. M.

(1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118

31.

Huang

Lei

(2022). Perceived information overload and unverified information sharing on WeChat amid the COVID-19 pandemic: A moderated mediation model of anxiety and perceived herd. Frontiers in Psychology, 13, Article 837820. https://doi.org/10.3389/fpsyg.2022.837820

32.

John Hopkins Medicine. (2021, August 4). COVID-19 Vaccines: Myth Versus Fact. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-19-vaccines-myth-versus-fact

33.

Kim

H. K.

Ahn

Atkinson

Kahlor

L. A.

(2020). Effects of covid-19 misinformation on information seeking, avoidance, and processing: A multicountry comparative study. Science Communication, 42(5), 586–615. https://doi.org/10.1177/1075547020959670

34.

Kim

Lee

Ihm

Kim

(2022). A comprehensive examination of association between belief in vaccine misinformation and vaccination intention in the COVID-19 context. Journal of Health Communication, 27(7), 495–509. https://doi.org/10.1080/10810730.2022.2130479

35.

Klepac

R. K.

Dowling

Hauge

(1982). Characteristics of clients seeking therapy for the reduction of dental avoidance: Reactions to pain. Journal of Behavior Therapy and Experimental Psychiatry, 13(4), 293–300. https://doi.org/10.1016/0005-7916(82)90073-8

36.

Kricorian

Civen

Equils

(2022). COVID-19 vaccine hesitancy: Misinformation and perceptions of vaccine safety. Human Vaccines & Immunotherapeutics, 18(1), Article 1950504. https://doi.org/10.1080/21645515.2021.1950504

37.

Lazarus

R. S.

(1991). Emotion and adaptation. Oxford University Press.

38.

Lee

J. J.

Kang

K.-A.

Wang

M. P.

Zhao

S. Z.

Wong

J. Y. H.

O’Connor

Yang

S. C.

Shin

(2020). Associations between COVID-19 misinformation exposure and belief with COVID-19 knowledge and preventive behaviors: Cross-sectional online study. Journal of Medical Internet Research, 22(11), Article e22205. https://doi.org/10.2196/22205

39.

(2023). Information avoidance in the age of COVID-19: A meta-analysis. Information Processing & Management, 60(1), Article 103163. https://doi.org/10.1016/j.ipm.2022.103163

40.

Lin

C. A.

(2020). A year like no other: A call to curb the infodemic and depoliticize a pandemic crisis. Journal of Broadcasting & Electronic Media, 64(5), 661–671. https://doi.org/10.1080/08838151.2020.1871185

41.

Lin

C. A.

Lagoe

(2013). Effects of news media and interpersonal interactions on H1N1 risk perception and vaccination intent. Communication Research Reports, 30(2), 127–136. https://doi.org/10.1080/08824096.2012.762907

42.

Lin

C. A.

Roy

Dam

Coman

E. N.

(2017). College students and HIV testing: Cognitive, emotional self-efficacy, motivational and communication factors. Journal of Communication in Healthcare, 10(4), 250–259. https://doi.org/10.1080/17538068.2017.1385575

43.

Lin

Zhao

Alias

Danaee

Wong

L. P.

(2020). Understanding COVID-19 vaccine demand and hesitancy: A nationwide online survey in China. PLOS Neglected Tropical Diseases, 14(12), Article e0008961. https://doi.org/10.1371/journal.pntd.0008961

44.

Link

(2021). Information avoidance during health crises: Predictors of avoiding information about the COVID-19 pandemic among german news consumers. Information Processing & Management, 58(6), Article 102714. https://doi.org/10.1016/j.ipm.2021.102714

45.

Loomba

de Figueiredo

Piatek

S. J.

de Graaf

Larson

H. J.

(2020). Measuring the impact of exposure to COVID-19 vaccine misinformation on vaccine intent in the UK and US [Preprint]. Public and Global Health. https://doi.org/10.1101/2020.10.22.20217513

46.

, APPC 2018–2019 ASK Group, Winneg

Jamieson

K. H.

Albarracín

. (2020). Intentions to seek information about the influenza vaccine: The role of informational subjective norms, anticipated and experienced affect, and information insufficiency among vaccinated and unvaccinated people. Risk Analysis, 40(10), 2040–2056. https://doi.org/10.1111/risa.13459

47.

Liu

Kim

S. J.

Tao

Shah

D. V.

McLeod

D. M.

(2023). The effects of vaccine efficacy information on vaccination intentions through perceived response efficacy and hope. Journal of Health Communication, 28(2), 121–129. https://doi.org/10.1080/10810730.2023.2186545

48.

Marsh

H. W.

Hocevar

(1985). Application of confirmatory factor analysis to the study of self-concept: First- and higher order factor models and their invariance across groups. Psychological Bulletin, 97(3), 562–582. https://doi.org/10.1037/0033-2909.97.3.562

49.

Mehrabian

Russell

J. A.

(1974). An approach to environmental psychology (pp. xii, 266). The MIT Press.

50.

Miller

C. A.

Guidry

J. P. D.

Dahman

Thomson

M. D.

(2020). A tale of two diverse qualtrics samples: Information for online survey researchers. Cancer Epidemiology, Biomarkers & Prevention, 29(4), 731–735. https://doi.org/10.1158/1055-9965.EPI-19-0846

51.

Mohammed

Alanzi

Alanezi

Alhodaib

AlShammari

(2021). Usage of social media for health awareness purposes among health educators and students in Saudi Arabia. Informatics in Medicine Unlocked, 23, Article 100553. https://doi.org/10.1016/j.imu.2021.100553

52.

Motta

Stecula

Farhart

(2020). How right-leaning media coverage of COVID-19 facilitated the spread of misinformation in the early stages of the pandemic in the U.S. Canadian Journal of Political Science/Revue Canadienne de Science Politique, 53(2), 335–342. https://doi.org/10.1017/S0008423920000396

53.

Nabi

R. L.

Prestin

(2016). Unrealistic hope and unnecessary fear: Exploring how sensationalistic news stories influence health behavior motivation. Health Communication, 31(9), 1115–1126. https://doi.org/10.1080/10410236.2015.1045237

54.

Roseman

I. J.

Spindel

M. S.

Jose

P. E.

(1990). Appraisals of emotion-eliciting events: Testing a theory of discrete emotions. Journal of Personality and Social Psychology, 59, 899–915. https://doi.org/10.1037/0022-3514.59.5.899

55.

Rosenstock

I. M.

(1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403

56.

Rosenstock

I. M.

(2000). Health belief model. In Kazdin

A. E.

(Ed.), Encyclopedia of psychology (Vol. 4, pp. 78–80). Oxford University Press. https://doi.org/10.1037/10519-035

57.

Sherman

S. M.

Smith

L. E.

Sim

Amlôt

Cutts

Dasch

Rubin

G. J.

Sevdalis

(2021). COVID-19 vaccination intention in the UK: Results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Human Vaccines & Immunotherapeutics, 17, 1612–1621. https://doi.org/10.1080/21645515.2020.1846397

58.

Siebenhaar

K. U.

Köther

A. K.

Alpers

G. W.

(2020). Dealing with the COVID-19 infodemic: Distress by information, information avoidance, and compliance with preventive measures. Frontiers in Psychology, 11, Article 567905. https://www.frontiersin.org/articles/10.3389/fpsyg.2020.567905

59.

Kuang

Cho

(2019). Information seeking upon exposure to risk messages: Predictors, outcomes, and mediating roles of health information seeking. Communication Research, 46(5), 663–687. https://doi.org/10.1177/0093650216679536

60.

Song

Yao

Wen

(2021). What motivates Chinese consumers to avoid information about the COVID-19 pandemic? The perspective of the stimulus-organism-response model. Information Processing & Management, 58(1), Article 102407. https://doi.org/10.1016/j.ipm.2020.102407

61.

Soroya

S. H.

Farooq

Mahmood

Isoaho

Zara

(2021). From information seeking to information avoidance: Understanding the health information behavior during a global health crisis. Information Processing & Management, 58(2), Article 102440. https://doi.org/10.1016/j.ipm.2020.102440

62.

Sultana

Dhillon

Oliveira

(2023). The effect of fear and situational motivation on online information avoidance: The case of COVID-19. International Journal of Information Management, 69, Article 102596. https://doi.org/10.1016/j.ijinfomgt.2022.102596

63.

Swar

Hameed

Reychav

(2017). Information overload, psychological ill-being, and behavioral intention to continue online healthcare information search. Computers in Human Behavior, 70, 416–425. https://doi.org/10.1016/j.chb.2016.12.068

64.

Sweeny

Melnyk

Miller

Shepperd

J. A.

(2010). Information avoidance: Who, what, when, and why. Review of General Psychology, 14(4), 340–353. https://doi.org/10.1037/a0021288

65.

Sweller

(2011). Chapter two—Cognitive load theory. In Mestre

J. P.

Ross

B. H.

(Eds.), Psychology of learning and motivation (Vol. 55, pp. 37–76). Academic Press. https://doi.org/10.1016/B978-0-12-387691-1.00002-8

66.

Talbert

(2008). The relationship of fear and fatalism with breast cancer screening among a selected target population of African American middle class women. Journal of Social, Behavioral, and Health Sciences, 2, 96–110.

67.

Tandoc

E. C.

Lee

J. C. B.

(2022). When viruses and misinformation spread: How young Singaporeans navigated uncertainty in the early stages of the COVID-19 outbreak. New Media & Society, 24(3), 778–796. https://doi.org/10.1177/1461444820968212

68.

U.S. Census Bureau. (2021, September 14). Income and poverty in the United States: 2020. Census.Gov. https://www.census.gov/library/publications/2021/demo/p60-273.html

69.

U.S. Food & Drug Administration. (2021, April 26). FDA and CDC lift recommended pause on Johnson & Johnson (Janssen) covid-19 vaccine use following thorough safety review. U.S. Food & Drug Administration (FDA). https://www.fda.gov/news-events/press-announcements/fda-and-cdc-lift-recommended-pause-johnson-johnson-janssen-covid-19-vaccine-use-following-thorough

70.

van ‘t Riet

Ruiter

R. A. C

. (2013). Defensive reactions to health-promoting information: An overview and implications for future research. Health Psychology Review, 7(Suppl. 1), S104–S136. https://doi.org/10.1080/17437199.2011.606782

71.

Volkman

J. E.

Day

A. M.

McManus

T. G.

Hokeness

K. L.

Morse

C. R.

(2022). PRISM and emotions: Understanding the role of fear and hope toward vaccine information seeking intentions. Health Communication, 1–12. https://doi.org/10.1080/10410236.2022.2119689

72.

Vrinten

Boniface

S. H.

Kobayashi

L. C.

von Wagner

Waller

(2018). Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England. Psychology & Health, 33(1), 117–129. https://doi.org/10.1080/08870446.2017.1314475

73.

World Health Organization. (2020). Novel Coronavirus(2019-nCoV) (Situation report-13). https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200202-sitrep-13-ncov-v3.pdf

74.

Guo

(2018). Using text mining to compare online pro- and anti-vaccine headlines: Word usage, sentiments, and online popularity. Communication Studies, 69(1), 103–122. https://doi.org/10.1080/10510974.2017.1414068

75.

Yıldırım

Geçer

Akgül

. (2021). The impacts of vulnerability, perceived risk, and fear on preventive behaviours against COVID-19. Psychology, Health & Medicine, 26(1), 35–43. https://doi.org/10.1080/13548506.2020.1776891

76.

Yang

Z. J.

(2012). Too scared or too capable? Why do college students stay away from the H1N1 vaccine? Risk Analysis, 32(10), 1703–1716. https://doi.org/10.1111/j.1539-6924.2012.01799.x

77.

Zampetakis

L. A.

Melas

(2021). The health belief model predicts vaccination intentions against COVID-19: A survey experiment approach. Applied Psychology: Health and Well-being, 13(2), 469–484. https://doi.org/10.1111/aphw.12262

78.

Zhao

Cai

(2009). The role of risk, efficacy, and anxiety in smokers’ cancer information seeking. Health Communication, 24(3), 259–269. https://doi.org/10.1080/10410230902805932

79.

Zheng

Jiang

(2022). Linking the pathway from exposure to online vaccine information to cyberchondria during the COVID-19 pandemic: A moderated mediation model. Cyberpsychology, Behavior, and Social Networking, 25(10), 625–633. https://doi.org/10.1089/cyber.2022.0045

80.

Zhou

Ampon-Wireko

Quansah

P. E.

Larnyo

(2022). Media attention and vaccine hesitancy: Examining the mediating effects of fear of COVID-19 and the moderating role of trust in leadership. PLOS ONE, 17(2), Article e0263610. https://doi.org/10.1371/journal.pone.0263610

Exploring COVID-19 Vaccine Misinformation Exposure,Beliefs,Fear,and Information Avoidance via the Stimulus–Organism–Response Framework

Abstract

Keywords

Get full access to this article

References