Examining an Altruism-Eliciting Video Intervention to Increase COVID-19 Vaccine Intentions in Younger Adults: A Qualitative Assessment Using the Realistic Evaluation Framework

Patricia Zhu, Ovidiu Tatar, Ben Haward, Veronica Steck, Gabrielle Griffin-Mathieu, Samara Perez, Ève Dubé, Gregory Zimet, Zeev Rosberger, Patricia Zhu, Ovidiu Tatar, Ben Haward, Veronica Steck, Gabrielle Griffin-Mathieu, Samara Perez, Ève Dubé, Gregory Zimet, Zeev Rosberger

Abstract

COVID-19 vaccine-induced immunity wanes over time, and with the emergence of new variants, additional "booster" doses have been recommended in Canada. However, booster vaccination uptake has remained low, particularly amongst younger adults aged 18-39. A previous study by our research team found that an altruism-eliciting video increased COVID-19 vaccination intentions. Using qualitative methods, the present study aims to: (1) identify the factors that influence vaccine decision-making in Canadian younger adults; (2) understand younger adults' perceptions of an altruism-eliciting video designed to increase COVID-19 vaccine intentions; and (3) explore how the video can be improved and adapted to the current pandemic context. We conducted three focus groups online with participants who: (1) received at least one booster vaccine, (2) received the primary series without any boosters, or (3) were unvaccinated. We used deductive and inductive approaches to analyze data. Deductively, informed by the realist evaluation framework, we synthesized data around three main themes: context, mechanism, and intervention-specific suggestions. Within each main theme, we deductively created subthemes based on the health belief model (HBM). For quotes that could not be captured by these subthemes, additional themes were created inductively. We found multiple factors that could be important considerations in future messaging to increase vaccine acceptance, such as feeling empowered, fostering confidence in government and institutions, providing diverse (such as both altruism and individualism) messaging, and including concrete data (such as the prevalence of vulnerable individuals). These findings suggest targeted messaging tailored to these themes would be helpful to increase COVID-19 booster vaccination amongst younger adults.

Keywords: COVID-19 vaccination; altruism; booster vaccination; health promotion; public health; qualitative; young adults.

Conflict of interest statement

G.Z. has served as a consultant and advisory board member at Merck and as an advisory board member at Moderna and Pfizer. He has also received investigator-initiated research funding from Merck, which was administered through Indiana University.

Figures

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Figure 1
CMO Thematic Structure.

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