Characterization of COVID-19 vaccine clinical trial discussions on the social question-and-answer site Quora.

Publication date: Dec 05, 2023

Throughout the COVID-19 pandemic, underserved populations, such as racial and ethnic minorities, were disproportionately impacted by illness, hospitalization, and death. Equity in clinical trials means that the participants in clinical trials represent the people who are most likely to have the health condition and need the treatment that the trial is testing. Infodemiology approaches examining user conversations on social media platforms have the potential to elucidate specific barriers and challenges related to clinical trial participation, including among racial and ethnic minority populations. The study retrospectively collected and analyzed user question and answer posts from Quora in October 2021 using an inductive content coding approach. We also examined user’s publicly available profile metadata to identify racial and ethnic minority users to capture their experiences, attitudes, topics, and discussions of barriers to COVID-19 vaccine trials. A total of 1073 questions and 7479 answers were collected. A total of 763 questions and 2548 answers were identified as related to COVID-19 vaccine clinical trials. The majority of these online interactions focused on asking questions and sharing knowledge and opinions about COVID-19 vaccine trials, including major topics related to: (a) interpreting whether clinical trial results could be trusted; (b) questions about vaccine efficacy and safety; (c) understanding trial design, regulatory considerations, and vaccine platforms; and (d) questions about trial enrollment, length, and adequate representation. Additionally, four major barriers discussed included: (i) disagreement from users regarding whether clinical trials require representation from different racial and ethnic minorities; (ii) concerns regarding the safety of trials when participating; (iii) lack of knowledge on how to participate in a trial; and (iv) questions of whether participants could withdraw from a trial to access an approved COVID-19 vaccine. Our study found active user discussions related to COVID-19 vaccine clinical trials on Quora, including those specific to minority health topics and those posted by a smaller group of self-identified racial and ethnic minority online users. Results from this study can help identify barriers to participation among the general public and underrepresented groups while also supporting the design of future outreach strategies to help with recruitment and inclusive trial participation.

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Concepts Keywords
Infodemiology Clinical trial
October COVID-19
Pandemic Data mining
Underrepresented Health equity
Vaccine Quora
Retrospective analysis
Social listening


Type Source Name
disease MESH COVID-19
disease VO vaccine clinical trial
disease IDO site
disease MESH death
disease VO Equity
disease VO COVID-19 vaccine
disease VO vaccine efficacy
disease VO vaccine
disease VO LACK
pathway REACTOME Reproduction
disease MESH emergency
disease MESH infection
disease MESH morbidity
disease MESH complications
disease IDO process
disease VO vaccination
drug DRUGBANK Coenzyme M
disease VO report
disease VO volume
disease IDO country
disease VO coronavirus vaccine
disease VO vaccinated
disease VO regulatory agency
drug DRUGBANK Ethionamide
disease VO time
disease VO Canada
disease VO vaccine approval process
drug DRUGBANK Activated charcoal
disease VO company
disease MESH Drug Abuse
disease VO USA
drug DRUGBANK Isosorbide Mononitrate
drug DRUGBANK Carboxyamidotriazole
drug DRUGBANK Gold

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