A cross-sectional study exploring the Covid-19 vaccination landscape in Malta through social media: An insight into...

Covid-19 vaccines were disseminated across Europe from the end of 2020. Malta had one of the fastest vaccination rollouts in Europe and by March 2022 most adults had their booster dose. The aim was to investigate adult's perspectives, experiences, and attitudes regarding vaccination in Malta.

An anonymous online survey targeting adult social media users living in Malta was disseminated through social media, with a snowball technique. Demographic information, vaccination uptake, side-effects, perceptions, and experiences were gathered through quantitative and qualitative means. Participants were sub-grouped according to their vaccination status and descriptive analysis through frequency was performed. χ ²/Fisher test testing followed by logistic regressions were performed to assess the vaccination perspectives according to vaccination status.

Out of 611 participants 79.87% had the booster, 4.91% had two doses awaiting booster, 6.55% refused booster while, 8.67% refused any dose. Booster sub-group when compared to vaccine hesitant sub-group exhibited an association with the perception for the need to "continue wearing masks, maintaining physical distance and hand washing following vaccination" (odds ratio [OR]: 5.97 confidence interval [CI] 95%: 1.09-32.36 p = 0.04). Those waiting for the booster dose when compared to those refusing booster, exhibited an association with the perspective that "COVID-19 vaccine is the solution to returning to normality" (OR: 5.00 CI 95%: 1.12-22.35 p = 0.04). The commonest reason for inoculation was to protect against severe disease (63.08% CI 95%: 58.91-67.07). More pronounced booster adverse effects raised concern about future booster doses uptake. Unwillingness among anti-booster and vaccine hesitant arose among high socioeconomic background participants, with concern for vaccine safety and adverse effects.

Vaccine hesitancy is low yet, vaccination unwillingness even among highly educated may act as a barrier to control the pandemic. Clear, transparent public health communication which targets concerns is crucial, with unified messages from governing bodies optimizing population safety.