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Purpose

COVID-19 vaccinations face a backdrop of widespread mistrust in their safety and effectiveness, specifically via social media platforms which constitute major barriers for the public health sector to manage COVID-19 (and future) pandemics. This study provides a more nuanced understanding of the public's engagement behavior toward COVID-19 vaccinations.

Design/methodology/approach

Using Netnography, this study explores the public's interactions with vaccine communications by the WHO via Facebook. From WHO posts about the COVID-19 vaccination 23,726 public comments on Facebook were extracted and analyzed.

Findings

Building on crisis communication, health and engagement literature, this paper identifies and conceptualizes seven patterns of engagement behavior toward the COVID-19 vaccination and develops the first framework of relationships between these patterns and the extant vaccine attitudes: vaccine acceptance, hesitancy and refusal.

Practical implications

This paper helps policymakers identify and adapt interventions that increase vaccine confidence and tailor public health services communications accordingly.

Originality/value

This research offers the first typology of patterns of engagement behavior toward COVID-19 vaccinations and develops a framework of relationships between these patterns and the existing understanding in health literature. Finally, the study provides data-driven communication recommendations to public health service organizations.

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