Vaccine misinformation among Arabic-speakers in Australia and the audience and appetite for a game-based intervention

Vaccine misinformation has been increasingly pervasive since the COVID-19 pandemic. It was a particular challenge among Arabic-speaking communities during vaccine roll-out. This study explored the content, context and mechanisms of vaccine misinformation beliefs and dissemination among the Arabic-speaking community in Victoria, to inform the adaptation of the Cranky Uncle - Vaccine (Arabic) online misinformation inoculation game.

This qualitative study involved exploratory community focus groups and intervention adaptation workshops. Using convenience sampling, the project's Advisory Group disseminated flyers to Arabic-speaking communities through their networks, in-person and online. Semi-structured discussions used the transcendental (descriptive) phenomenological approach to explore the 'who, 'what', 'where', 'when' of vaccine misinformation dissemination to inform intervention adaptation and utility. Data were combined and inductively thematically analysed.

Four online focus group discussions were held with 16 women (16-70+ years) in total. Sixty-five participants (n = 45 female, 16-70+ years) attended one of two face-to-face workshops. Arabic translators assisted in three focus groups and both workshops. Misinformation about COVID-19 vaccines (but not other vaccines) was easily recalled, and the content aligned with misinformation topics identified elsewhere, e.g. vaccine concerns and conspiracy theories. Regarding context, the information context theme reflected an information gap that encouraged individuals to seek out vaccine information via unofficial sources. The personal context theme was of fear and uncertainty of the vaccine's side effects, and secondarily of mistrust in authorities. In terms of dissemination mechanisms, misinformation was shared through friends and family and was image-based, making it accessible regardless of written or social media literacy. Misinformation was believed when it filled information gaps, was emotive and reinforced fears and beliefs.

The findings support the utility of the Cranky Uncle - Vaccine (Arabic) game in inoculating key audiences. The community-centred approach to game adaptation makes it relatable and directly relevant to audiences' vaccine beliefs and concerns.