The combat against COVID-19 can only be successful if the vaccination rollout is successful on a global level. While the aim is to make the COVID-19 vaccine available and accessible to all, convincing people to vaccinate themselves is another matter. Vaccination behaviors are influenced by multiple social and psychological factors. These may include one's thoughts, feelings, social norms, experiences, moral values and worldviews. The emergence of misinformation and disinformation surrounding COVID-19 vaccination creates another challenge in fighting the pandemic. This study examined exposure to misinformation, risk perception and public confidence in the government and their relationships to negative attitudes toward the COVID-19 vaccine among Malaysians. An online cross-sectional survey involving 775 respondents in Malaysia was conducted between June and August 2021. The results of this study indicate that increased exposure to misinformation was associated with an increase in four domains of negative attitudes toward the vaccine: i) mistrust of vaccine benefits, ii) worries about the unforeseen future effects of the vaccine, iii) concerns about commercial profiteering; and iv) preference for natural immunity. Additionally, it was found that high perceived risk of COVID-19 resulted in low mistrust of vaccine benefits and high worries about the future effects of the vaccine. High confidence in the government was also associated with lower negative attitudes towards vaccines. The results have helped us to understand factors related to negative attitudes toward vaccines among the Malaysian population and demonstrated the need for increased efforts to combat misinformation surrounding vaccinations.

Vaccine hesitancy is a significant challenge for COVID-19 vaccination campaigns. Traditionally, videos promoting vaccines have narrowly focused on facts and less on emotional and narrative communication elements that can be equally, if not more, persuasive. The role of humor, for example, has remained largely unexplored, as has the effects of the vaccine advocate's gender. We filmed eight brief videos to explore how collectivistic and individualistic appeals, humor, and protagonist gender individually and jointly affect vaccination attitudes, beliefs, and intentions. We adopted a 2 (appeal: individualistic or collectivistic) x 2 (tone: humor or non-humor) x 2 (protagonist gender: male or female) between-subjects design approach. Odia-speaking participants between ages 18–35 were randomly assigned to watch one of the eight study videos. An online survey questionnaire assessed people's reactions to the videos and assessed vaccine attitudes. After watching the videos, 32% of participants became more accepting of COVID-19 vaccines, 47% did not change in their acceptance, and 21% became more skeptical. Being a male (p< .05), not having a skeptical attitude before watching the video (p< .001), watching the video more often (p< .05), and watching the humorous video (p< .001) significantly increased vaccine acceptance. A humorous appeal may be an effective strategy for reducing skepticism. This study can inform future messaging on vaccines and guide public health professionals in creating and sharing health promotion videos on the internet. We will discuss the importance of and strategies for not exacerbating negative attitudes that can produce boomerang effects among certain populations. 

During the COVID-19 pandemic, global vaccine hesitancy and misinformation were on the rise. With restrictions on organizations' ability to conduct vaccine education and awareness raising in-person, CARE and Meta launched a partnership to leverage social media for this purpose in 2021. CARE selected 20 countries for participation and collected data in each of them on motivations and reasons for vaccine hesitancy. Using this data to contextualize content and approaches, CARE developed 45 social and behaviour change communication campaigns aimed at reducing COVID-19 vaccine hesitancy and launched them online via Facebook and Instagram in 20 countries. Campaign success was measured using metrics on reach, engagement, conversion, and brand lift. CARE's campaigns reached 476 million people 1.3 billion times. Over eight million people reported positive perceptions of the COVID-19 vaccine following their interaction with a CARE campaign. 
CARE's demonstrated evidence of outcomes of this online SBCC work provides insights on how digital and social media are expanding the landscape of possibilities related to leveraging technologies for health. As more of the world comes online, social media platforms provide an opportunity for connection with and accessibility for otherwise hard-to-reach or vulnerable populations. To further this work, CARE is currently in a new phase of partnership with Meta aimed at expanding online SBCC campaigns to include health topics other than COVID, and at exploring measurement and evaluation methods that track offline health behaviours resulting from online programming. 

Liberia received its first COVID-19 vaccine in March 2021. However, as of February 2022, COVID-19 vaccine coverage remains abysmally low at 21%. To build trust and enthusiasm for the COVID-19 vaccine, Breakthrough ACTION enlisted the help of a new cadre of Vaccine Ambassadors, a group of 180 influential leaders from within the subnational health sector from six counties in Liberia. Breakthrough ACTION trained Vaccine Ambassadors on the COVID-19 disease, prevention behaviors, vaccines, and interpersonal communication and counseling approaches to address concerns. As a final component of the training, Vaccine Ambassadors created an action plan outlining the community engagement events they would conduct. Though Vaccine Ambassadors did not receive financial incentive, they were publicly recognized and awarded a certificate if they completed and documented at least three engagement events. As of February 2022, 86 Vaccine Ambassadors conducted 425 community engagement events, which resulted in 1,788 additional people getting vaccinated. The Vaccine Ambassadors program will continue to be scaled up in Liberia, building on its initial success. The success of this program highlights the importance of integrating respected and well-known community figures-especially local health workers-in interventions designed to build vaccine acceptance. It also highlights the importance of allowing for ongoing conversations between community members and health workers that incorporates sharing personal experience. The Vaccine Ambassadors project in Liberia illustrates the promise of similar grassroots interventions in other countries that are struggling to build vaccine acceptance, including increasing trust and acceptance for previously accepted routine immunization.