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Yaoan Leng

Dr. Qian

Capstone

27 March 2022

Vaccines-related Health Communication in the Covid-19 Pandemic

Coronavirus Disease 2019 (COVID-19) has affected over 4.7 billion people

worldwide (JHU CSSE COVID-19 Data) since the first documented case was published by

the local government of Wuhan, the capital city of Hebei Province, China, on 31 December

2019. The pathogenic virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),

has high infectious rates and different levels of symptoms. Scientific research on effective

vaccines and proper regulation protocols are urgently needed to appease the severe pandemic.

In the form of news on televisions, posts on social media, and publicities, public

communication has increased people’s awareness of certain diseases and imparts scientific

knowledge varied in different levels. Individuals who merely had any background knowledge

may present a tendency to follow medical authorities’ instructions and advice, and individuals

who have had basic disease-control knowledge may be willing to correct others’ misbehaviors

and take the leading role during the pandemic. However, individuals who are exposed to

misleading information, including but not limited to oral information and news from biased

media, may present implementations against proper ways of disease control. Also, some

people’s actions may distract communities’ attention from valuable information about Covid-

19, impeding available implements for controlling the disease. For example, anti-vaxxers (in

the context, a new component word which is defined as people perceive the Covid-19 pandemic

as a make-up falsity and refuse to be vaccinated) launch campaigns that propagandize

pseudoscientific data and the harmful effects of vaccines. Moreover, debates about human

rights, democracy, social and personal freedom arise from regulations mandating vaccinations
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and other public health actions. The severity of these phenomena may vary among different

countries. Therefore, to win the race against the pandemic, it is still of great importance to

develop proper and effective health communication between authoritative institutions or public

relations figures and the public for all countries.

Health communication, a blossoming concept in health promotion, is significant in

achieving health “empowerment” (Nutbeam 259). In the forepart of health promotion, a study

of social behaviors and education about health covered this field. Dr. Wallerstein, N. and Dr.

Bernstein, E. published Empowerment Education: Freire’s Ideas Adapted to Health

Education in 1988 to investigate how educations and prevention models contributed to

society and individuals. This study started emphasizing modeling strategies of health

promotions and policies (Wallerstein and Bernstein). Dr. Don Nutbeam analyzed how health

communication strategies should be applied into the 21st century. He established a “health

outcome model” which reveals interactive health literacy is more than just transmitting

information (Nutbeam 265).

This status is based on combined positive outcomes of health education, which turns

out to be an underestimated problem in addressing the mass determinants of health under the

contemporary Covid-19 pandemic. In the past, as communication and medical technologies

were limited, public health actions were mainly focused on changing people’s harmful living

and working conditions, which followed the initial focus “on the social and environmental

determinants of the health of the population.” However, after the 20th century, as people’s

conventional or misled information contradicted technology development, public health

action shifted toward modifying inappropriate individual behaviors (Nutbeam 260; Paakkari

and Okan e249). Most profitable communications are provided in a simple way that gives

straightforward and practical arrangements, such as washing hands, maintaining social

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distances, and where to find the newest information about scientific terms that the public may

encounter during daily life.

As facing the global Covid-19 pandemic, public health actions have gained a rich

array of attention. However, implements of health control seem to keep constant on a

universal routine. Scholars are focusing on the easy and general way to implement. They may

ignore the possibility that there might be an increase in the efficiency of health

communication, as they are achieved under the designed national- and cultural-based health

actions. In different areas, because of varied cultures and customs, people’s acceptance of

characterized health actions varies; therefore, methods to address health literacy need to be

diverse and merged with countries’ specialties (Ramos and Hynes).

Collectively, health communication has collected the outcomes of all approaches

made in the past. Its essence should have enough contents to repackage into balanced ideas

addressing the relationship between health communication and “empowerment.” By

implementing past templates, the correct way to produce reformative efforts is to spend more

effort supporting the development of such actions. More actions should be done combining

modern internet technologies.

An already confirmed point is that vaccination would be the most effective way to

prevent Covid-19 and related causes of severe diseases and death. Therefore, the public’s

opinions on vaccines would be a key factor controlling the death rate and spread of the

disease. Since the pandemic is declared a high emergency by the World Health Organization

(WHO), plenty of research papers and data about vaccination developments and clinic

experiments are open to public access. Vaccine developments have achieved enormous

success throughout history; to increase available solutions on immunologic issues, prevent

additional side effects, and trigger functional responses to pathogens, the complexity of

vaccine development is increasing (Plotkin). Besides, different individuals may have different
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responses to the same vaccine due to age, genetics, relevant environmental variants, and other

personalized factors (Mascola and Haynes).

In the Covid-19 pandemic, there are four general types of vaccines in use

worldwide—inactivated vaccines, mRNA vaccines, protein subunit vaccines, and viral vector

vaccines. Inactivated vaccines usually carry dead viruses, and the pathogen is cultivated to

produce a large number of antigens (Nunnally et al.). mRNA vaccines, a newly-developing

technology in recent years, generate spike proteins that appear on pathogens in human bodies

and make humans’ immune system recognize and learn the virus and protect against future

infection ([Link]). Protein subunit vaccines contain safe and filtered pieces (proteins) of the

pathogens, which have been particularly chosen for their capacity to trigger resistance (Pardi

et al.). Viral vector vaccines use a modified viral vector to deliver genetic messages to the

recipient’s cells for producing the desired antigen to resist the virus ([Link]). The

importance of having various types of vaccines is to make sure that enough vaccines can be

produced for worldwide use. In addition, a mixed vaccination of multiple types of vaccines,

in the case of an applied booster dose, can trigger more effective and endurable immune

responses to the Covid-19 virus and some varients that may randomly mutate in the future

(Kunal et al.).

This paper will explore how health communication shapes people’s perception and

knowledge of the current Covid-19 vaccines. The geographic location where the research data

come from is China. China is currently considered the place where the first Covid-19

breakout happened, but now the average daily confirmed cases have already dropped below

500 (the data is released before March 2022; [Link]) since strict disease control

protocols and enhanced health communication has applied. Due to some limitations of this

project, considering the relatively small amount of accessible data and research and restricted

conditions to conduct large-scale information collection, a small sample size of interviews

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has been collected to analyze the purpose of the paper. By comparing and contrasting

subjects’ uses of vaccines, measures of public communication and governments’

interventions, and discussions about the knowledge of vaccines will be carried out.

Furthermore, elevated research orientations and suggestions will be proposed based on well-

developed arguments and authorities’ opinions.

Data were collected by asking 12 randomly chosen participants from my social

media’s (Tencent QQ) contact lists with a total number of 158. Considering the limitations of

this collection, the sex, age, geological information of all possible participants have been

categorized for random selection to maximize the conclusiveness of the final result. Firstly,

two groups of people are categorized by their sex (73 males and 85 females). Sex is not a

variable measuring the effects of health communications. In this research, this category is just

for sampling purposes. Secondly, all possible participants’ age is scaled into three levels

within the first category. In the male category, 26 people fit into the scale of 12 to 16 years

old level, 38 people fit into the 18 to 25 years old level, and 19 people fit into the 38 to 65

years old level). The interval of the three levels is adjusted to fit the largest population,

considering the existence of missing ages among all my contacts. Thirdly, all possible

participants within three categories of the second step are grouped by their geographic

locations. All possible participants with the exact geographic locations (measured to their

city) are given a number. Using a random number generator, the first person who meets the

first generated number will be put into the final sampling pool. Ultimately, twelve

participants with different geographic locations, grouped in 6-6 by sex and 2-2 by each age

level within the two sex groups, are selected (Table.1). Participants’ names are presented as

aliases in the data table to protect their privacy.

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Table 1

The name, sex, age, and geographic locations of the twelve randomly selected participants.

Name Sex Age Geographic

locations

K. Li Male 13 Shanghai

O. Wang Male 16 Chendu

Z. Li Male 18 Danyang

LP Xiao Male 21 Yihua

JG Zhang Male 41 Shenyang

PJ Xin Male 56 Suzhou

YY Liang Female 16 Mianyang

NJ Qiu Female 16 Yilan

H. Shu Female 19 Zhijiang

JJ Jian Female 25 Hangzhou

W. Jiang Female 38 Shantou

ZH Ran Female 40 Mianzhu

For all the twelve participants, questions about their vaccination status, attitude to

public communication and governments’ interventions, and knowledge of vaccines will be

carried out by asking each individual the exact same question. Data are recorded and mapped

(Table.2-Table.4)
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Table.2

Vaccination status of each participant

Name Have you been vaccinated? (Y/N)

K. Li N

O. Wang Y

Z. Li Y

LP Xiao Y

JG Zhang Y

PJ Xin Y

YY Liang Y

NJ Qiu Y

H. Shu Y

JJ Jian Y

W. Jiang Y

ZH Ran Y

Table.3

Each participant’s attitude to public communication and governments interventions (graded

on a scale from 1 to 10)

Name\Question Grade

K. Li 6

O. Wang 10

Z. Li 9.5
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LP Xiao 9

JG Zhang 8

PJ Xin 7.5

YY Liang 8

NJ Qiu 7

H. Shu 9

JJ Jian 3.5

W. Jiang 5

ZH Ran 9

Table.4

Each participant’s knowledge of vaccines, answers to three questions

Name How many types Do you know Do you know

of vaccines are there for the differences which type of

the Covid-19 virus? between each type of vaccine have you

(Correct/Incorrect) vaccine? been vaccinated?

(Y/N) (Y/N)

K. Li Incorrect N N/A

O. Incorrect N N

Wang

Z. Li Incorrect N N

LP Xiao Correct Y Y

JG Correct N Y

Zhang
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PJ Xin Incorrect N N

YY Incorrect N N

Liang

NJ Qiu Incorrect N N

H. Shu Correct Y Y

JJ Jian Correct Y Y

W. Incorrect N Y

Jiang

ZH Ran Incorrect N Y

The result shows that other participants have all been vaccinated except for K. Li,

who has not reached a safe age for vaccination. In addition, the average grade for disease

control communication and governmental interventions is 7.625, with the lowest grade of 3.5

and the highest grade of 10. In the last data collection, four participants can correctly answer

the types of Covid-19 vaccines, three can correctly tell the differences between each type of

vaccine, and six participants know which type of vaccine they were vaccinated. The result

interprets that most participants have a relatively satisfied or positive impression about the

progress of health communication and disease control policies so far. A relatively low grade

may relate to the participant’s geographic location and age, considering the way of public

communication and governmental interventions may impede a normal and active daily life.

Although most participants’ grades are above the average, the correctness and responsiveness

of questions in the third data set may not be able to conclude that current health

communication in China is effective in sharing more scientific and professional information.

To conduct further research on the inconsistent relationship between the second and

the third data collection, the connection between participants’ information sources and the
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authenticity of the information may need to be analyzed. In the interview, data about the two

potential factors have been collected (Table.5 and Table.6). The result shows that, regarding

the twelve participants’ sources of Covid-19 information, the most frequent (7) media source

is community prints (for instance, booklets, bulletins, and flyers). Sources followed after in

descending order of total counts are BiliBili (6), Tiktok (5), Television Programs (3), Weibo

(4), Zhihu (2), QQ Official Account (1), WeChat Official Account (1), News App (1). The

result can be categorized into traditional and modern media (App). In addition, when

participants were asked for their opinions on the authenticity of the Covid-19 information,

eight of them thought the information was “completely true,” three of them selected the

“mixed” option, one of them answered, “I do not know.” However, none of them thinks the

information is “untrue” (Appendix A). When answering the reason of the twelve participants’

options, those who chose “completely true” provide a general reason that governmental or

authoritative credits are included in the information. Participants who chose the “mixed”

option provide a general reason that much exaggerated information is written merely for eye-

catching. The only participant who chose “I do not know” provides the reason that he has a

slight symptom of decidophobia.

Table.5

Answers to questions related to the commonly-used media source from the twelve

participants.

Name\Question Media Source

K. Li Tiktok, Weibo, QQ Official Account, Community Prints

O. Wang Tiktok, BiliBili, Community Prints

Z. Li Zhihu, BiliBili

LP Xiao WeChat Official Account, BiliBili

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JG Zhang TikTok, Television Programs, Community Prints

PJ Xin Television Programs, Community Prints

YY Liang Tiktok, Weibo

NJ Qiu Tiktok, Weibo, BiliBili, Community Prints

H. Shu Weibo, BiliBili

JJ Jian BiliBili, Community Prints

W. Jiang Zhihu, News App

ZH Ran Television Programs, Community Prints

Table.6

Answers to questions related to the attitude to the authenticity of the information they

commonly access from the twelve participants.

Name\Question Authenticity of information

K. Li Completely True

O. Wang Completely True

Z. Li Mixed

LP Xiao I do not know

JG Zhang Completely True

PJ Xin Completely True

YY Liang Completely True

NJ Qiu Completely True

H. Shu Mixed

JJ Jian Completely True

W. Jiang Completely True

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ZH Ran Mixed

The question raised from these two statistics is how the category of media and

authenticity of the information is interrelated. Also, because all participants’ attitudes to the

authenticity present a similar tendency with the grade to the public communication and

governmental interventions, it is still worth considering whether some social or political

factors influence participants’ overall perception of the Covid-19 pandemics.

In conclusion, vaccine plays a significant role in controlling the Covid-19 pandemics;

therefore, health communication should be comprehensively done to enhance the public’s

awareness and understanding of the functionality of different types of vaccines in order to get

a great quality of self-protection. Nonetheless, in the interview with twelve randomly selected

participants, subjects’ positive attitudes and awareness are inconsistent with the knowledge

that they are supposed to know under a functional and comprehensive health communication

system. Further research is needed to conclude whether such an inconsistency is a universal

rule within the context of China or some other possible factors influencing the public’s

perception.
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Figure.1

Percentage of media source category and the total number of selection

10, 33%

20, 67%

Traditional Media (Television programs and community prints)

Modern Media (Bilibili, Tiktok, Weibo, Zhihu, QQ Official Account, WeChat

Official Account, and News App)
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Figure. 2

Percentage of different attitudes on the authenticity of Covid-19 information

1, 8% 0, 0%

3, 25%

8, 67%

Completely true Mixed I do not know Untrue

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