Background COVID-19 has had a devastating impact and efforts are being made to speed up vaccinations. The growing problem of vaccine hesitancy may affect the uptake of COVID-19 vaccine. We examined the individual, communication and social determinants associated with vaccines uptake. Methods Data come from a nationwide online probability-based panel of 1012 representative adults in the United States and the survey was conducted before the vaccines were available. People under the federal poverty level and racial and ethnic minorities were oversampled. Our outcome variables of interest were likelihood of vaccinating self and likelihood of vaccinating people under one’s care (such as children) measuring behavioral intentions. Independent variables included perceptions of risk, exposure to different media for COVID-19 news, political party identification, confidence in scientists and social determinants of health. Logistic regression analysis was used to ascertain the effects of independent variables on the two outcome variables. Results The results indicated that 68 and 65% agreed to get the vaccine for themselves and people under their care, respectively. Risk perceptions (severity of and susceptibility to COVID-19) were significantly associated with vaccine uptake. People who relied on “conservative” news outlets, Republicans, and who had low confidence in scientists are least likely to vaccinate self or children. Non-Hispanic Blacks and those with least schooling were also less likely to receive vaccine for themselves or people in their care. Conclusions Our study identified race/ethnicity, risk perceptions, exposure to different media for COVID-19 news, party identification and confidence in scientists as factors that would be affecting COVID-19 vaccine uptake. The good news is that these are addressable through strategic public health communications, but a lot of work remains to be done with some urgency.

The ongoing COVID-19 pandemic has brought forward the centrality of public communication as a force for information, and in highlighting the differential impact on diverse segments of the society. Information and communication technologies-led developments including social media have previously been discussed as instruments of democratization of knowledge. However, the evidence so far shows that the promise remains unfulfilled as upper socioeconomic groups acquire information at a faster rate than others. The communication inequalities have only reinforced the existing societal fault lines of race, class and place.

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ObjectiveTo generate evidence for the association between different types of mass media and antenatal care (ANC) visits in India.DesignA cross-sectional study design, analysing data from India’s National Family Health Survey 4 (NFHS-4), 2015–2016.SettingRural and urban India.ParticipantsFrom NFHS-4, women who had given birth in the last 5 years before survey administration were included in this study. Women with missing information about their number of ANC visits and their caste were excluded, leaving 187 894 women in the final analytical sample.Primary outcome measuresLogistic regression analysis was conducted to determine the association of ANC utilisation with mass media exposure.ResultsOverall, our study showed that high exposure to all four types of mass media was positively associated with making at least eight ANC visits. In rural India, women who had high exposure to newspaper/magazine (adjusted OR (aOR), 1.43; 95% CI, 1.31 to 1.57), radio (aOR, 1.22; 95% CI, 1.09 to 1.37), television (aOR, 2.07; 95% CI, 1.94 to 2.2) and movies (aOR, 1.33; 95% CI, 1.2 to 1.47) were more likely to make at least eight ANC visits. In urban India, women who had high exposure to newspaper/magazine (aOR, 1.12; 95% CI, 1.02 to 1.24), radio (aOR, 1.37; 95% CI, 1.13 to 1.65), television (aOR, 1.39; 95% CI, 1.24 to 1.55) and movies (aOR, 1.23; 95% CI, 1.09 to 1.38) were more likely to make at least eight ANC visits.ConclusionsOur findings emphasise the need for increased awareness about adequate ANC visits in India, to improve maternal, neonatal and child health outcomes. Our study highlights that television penetration is broader than other forms of media and has the potential to create awareness about health in both urban and rural populations. These findings can inform ANC-related health awareness campaigns in the country to allocate resources to appropriate media sources to encourage healthy behaviours.