Framing messages to combat potential COVID-19 vaccine hesitancy in Western Balkans

Euro Health Foundation
Bosnia and Herzegovina
Macedonia, the Former Yugoslav Republic of

In collaboration with the Faculty of Medicine at University of Belgrade, Serbia, Euro Health Group has been granted funding by the Euro Health Foundation to conduct original research on COVID-19 vaccine hesitancy. The project runs between April 2021 and October 2021.

The objective of the project is two-fold:

1) To assess the extent of COVID-19 vaccine hesitancy in western Balkans countries by exploring knowledge, attitudes and willingness to take the COVID-19 vaccine as well as factors that may influence vaccine hesitancy and

2) To assess the effects of different message framing on attitudes and intention to change.

The project is conducted among 5,000 respondents in Albania, Bosnia and Herzegovina, North Macedonia, Montenegro, and Serbia.

To explore objective 1, a cross-sectional design including an online distributed questionnaire is used. The questionnaire subjects and items are derived from previous similar studies. Information about socio-demographics, knowledge about COVID-19 vaccines, health literacy, attitudes towards COVID-19 vaccines, behavior, general confidence in science and general confidence in institutions are collected and analysed.

To explore objective 2, a randomized controlled trial is conducted using an intervention including video messages, which are based on published content from neutral organizations and contained messages promoting vaccination. Respondents are randomly assigned to either the control group or one of four intervention groups. The four different interventions consist of four different video messages: a medical doctor sharing a hard decision/initial suspicion narrative, a medical doctor sharing an easy decision/no suspicion narrative, a lay person sharing a hard decision/initial suspicion narrative and a lay person sharing an easy decision/no suspicion narrative. All video messages are concluded by an encouragement to accept the COVID-19 vaccine.

In order to assess the effect of the four interventions on vaccine acceptance and attitudes towards vaccines, respondents are asked to complete the questionnaire assessing their attitudes towards COVID-19 vaccine and behavior before and after watching the video message. Furthermore, respondents are also asked to complete questions on how they regarded the credibility of the source of the message after they have viewed the video.

Findings from the baseline survey are compared to findings from the follow-up survey, and analyses are conducted to examine the effect of the different video messages on respondents’ attitudes towards COVID-19 vaccine as well as their intention to accept it.