Introduction: The global spread of the COVID-19 pandemic was rapid and devastating to humanity. The public health response to the pandemic was rapid too. Completion of COVID-19 vaccine development was achieved in under a year. The USA and the UK were the first countries to rollout COVID-19 vaccines to contain the pandemic. Successful rollout of the vaccines hinges on many factors, among which is public trust.   Aim: To investigate the sentiments towards COVID-19 vaccines in the USA and UK prior to vaccination rollout.  Methods: Neuro-linguistic programming with human validation was used to analyse a sample of 243,883 COVID-19 vaccine related social media posts from the USA and the UK in the period 28 July to 28 August 2020. The sentiment analysis measured polarity (positive, neutral, negative), and the themes present in negative comments.   Results: In the sample of 243,883 social media posts, both the USA and the UK had a net sentiment profile of approximately 28% positive, 8% negative and 63% neutral sentiment. On further analysis, there were distinct differences between the two country’s social media sentiment towards COVID-19 vaccines. The differences were seen in the themes behind the negative sentiment. In the USA, the negative sentiments were mainly due to health and safety concerns, the fear of making a vaccine mandatory, and the role that pharmaceutical companies would play with the release of vaccines. In the UK the main driver of negative sentiment was the fear of making the vaccine mandatory (almost double the size of the sentiment in the USA).  Conclusions: Negative sentiments towards COVID-19 vaccines were prevalent in the third quarter of 2020 in the USA and the UK. Reasons behind the negative sentiments can be used by authorities in the two countries to design evidence-based interventions to address the refusal of vaccination against COVID-19.

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