Keywords and their explanations.

Vaccine hesitancy remains a significant barrier to the success of global vaccination campaigns and vaccine programs. Understanding people’s perceptions of vaccines on social media during disease outbreaks can aid in reducing socially induced vaccine hesitancy and improve program implementation. Social media is an increasingly valuable tool for assessing public perceptions on critical issues, including vaccine adoption. This study examines perceptions surrounding the COVID-19 vaccine among Twitter users in the United States, Brazil, and India within a few weeks post-vaccine release. These countries are associated with anti-vaccine movements and outbreaks of vaccine-preventable diseases. We identified and analyzed key themes related to vaccine perception in 2,858 Twitter posts. Using a qualitative interpretive approach to analyze tweets, we found that mistrust in vaccine science, politics of vaccination, and religious pushbacks were the main themes that emerged from the analysis. Perceptions harbored by individuals and communicated frequently via mass communication platforms may erode public trust and disarticulate avenues of communication between public health officials and communities. Thus, we suggest that harnessing vaccine hesitancy-related information on social media can enhance understanding of public perceptions about vaccines while providing opportunities for interventional communications to educate the public.