Using social media surveys and interventions to address vaccine hesitancy in Saudi Arabia

Background: Countering COVID-19 vaccine hesitancy has been a challenge in Saudi Arabia, one of the countries affected most by the pandemic in the Eastern Mediterranean Region. Aims: To identify information needs, perceived benefits, concerns, trusted information sources, social norms, and predictors for COVID-19 vaccine uptake in Saudi Arabia and identify effective messaging strategies to increase vaccination intentions among the unvaccinated. Method: Between March and April 2021, we conducted an online cross-sectional survey (N = 2883), and in part, a randomized experiment for unvaccinated participants (n = 675) in Saudi Arabia using Facebook Ads and Messenger. Unvaccinated participants were randomly assigned to 1 of 5 message conditions and after message exposure, participants were asked if they planned to take the COVID-19 vaccine. Results: In total, 2883 adults participated in the survey. All message framings worked equally well, with no statistically significant difference between the arms. Approximately 80% of the participants across all message conditions said they intended to vaccinate. However, participants wanted to know more about the vaccines; about 35% wanted to know more about vaccine efficacy, 31.5% about safety, 26.8% about health authority's recommendation, and 3.7% about where to get the vaccines. Health workers (61.4%) and scientists and epidemiologists (25.7%) were the most trusted sources. Others were family members (7.5%), community leaders (2.2%), religious leaders (1.6%), friends (1.4%), and celebrities and social media influencers (0.2%). Conclusion: Vaccine hesitancy can be overcome by understanding individuals' decision -making processes and using effective risk communication targeted to their needs.