Aug 2026· Vaccine· Vol 89, pp.
128998
· 0 citations· 44 references
Medicine
TL;DR
Emotional support showed a modest positive association with willingness, suggesting supportive social ties may help promote vaccination willingness, and vaccine willingness in this rural setting was shaped by both individual factors and network dynamics.
Abstract
Background
Trust in vaccines and those who deliver them is often shaped by personal social networks, yet empirical data on these dynamics remain limited in low-and middle-income settings. Social networks shape exposure to information, norms, and reinforcement processes that influence vaccine decision-making. We examined how rural South Africans' social network composition and content influence their willingness to receive a COVID-19 vaccine.
Methods
We analysed 2022-23 data from the Sixhumene social network study conducted primarily among young adults in three rural KwaZulu-Natal communities. Our primary outcome was a six-level ordinal measure combining past vaccination and hypothetical willingness. Using multivariable ordinal logistic regression, we evaluated associations between vaccine willingness and social network size, kinship composition, geographic proximity, gender homophily, support received, and respondent characteristics.
Results
Respondents were predominantly female with median age 21 years (IQR 18-28) and identified a median of three key social contacts, with networks characterised by strong kinship and local ties. Vaccine willingness varied by the geographic composition of networks. Compared with urban respondents whose networks were concentrated within the household, willingness was higher among those with more geographically dispersed networks, including urban respondents with alters in the same village (aOR 2.54, 95% CI 2.40-2.70) or outside the village (aOR 3.26, 95% CI 2.04-5.20). Similarly, among rural respondents, willingness was higher among those with household-based networks (aOR 1.95, 95% CI 1.57-2.41), village-based networks (aOR 1.63, 95% CI 1.40-1.90), and networks extending beyond the village (aOR 1.64, 95% CI 1.50-1.79). Emotional support was positively associated with willingness (per 30 contact-days: aOR 1.15, 95% CI 1.01-1.32), while physical support was inversely associated (aOR 0.84, 95% CI 0.72-0.98).
Discussion
Vaccine willingness in this rural setting was shaped by both individual factors and network dynamics. Emotional support showed a modest positive association with willingness, suggesting supportive social ties may help promote vaccination willingness.
Older adults are at increased risk for complications from vaccine-preventable diseases, yet many remain undervaccinated. This study examined demographic variability in vaccination hesitancy among older adults in a rural state and the potentially mediating role of trust uncertainty. A cross-sectional survey of a random sample of 739 adults aged 65+ in North Dakota was conducted from May to July 2022. Using bootstrapped mediation analyses, we assessed whether trust uncertainty mediated the relationships between demographic characteristics and vaccine hesitancy and acceptance. Results showed uncertainty about whom to trust was a significant predictor of both higher vaccine hesitancy and lower vaccine acceptance. Uncertainty about whom to trust fully mediated the relationship between rurality and vaccine hesitancy, and between education and vaccine acceptance. Political leaning and physical health were also partially mediated through uncertainty about whom to trust. These findings highlight the role of trust in shaping vaccine attitudes and the need for tailored communication strategies that address information uncertainty.
Unknown authors· The International Journal of...· 0 citations
Heat-related illnesses (HRIs) are a growing public health concern, particularly in the context of global climate change. Vulnerable populations, such as agricultural and outdoor workers, face disproportionate risks of HRIs. This study investigates associations between social determinants of health (SDOH) profiles and prevention behaviors, trust in information sources, and frequency of information-seeking related to extreme heat among Florida residents. Using a Bayesian Profile Regression (BPR) approach, we identified four clusters based on six sociodemographic and contextual variables from an online survey administered to 500 Florida residents, including income, education, race/ethnicity, occupation, political orientation, and urban/rural status. Logistic regression models were then used to examine associations between these clusters and key HRI-related outcomes. Cluster 3, characterized by low income, low education, rural residency, agricultural work, and high proportions of Hispanic and Black people, showed elevated odds of low prevention and distrust in institutional information sources. Clusters 2 and 4 demonstrated more selective distrust of government-affiliated platforms. These findings underscore the need for targeted, culturally responsive health communication strategies tailored to the diverse SDOH profiles influencing heat-related vulnerability.
Social determinants of health profiles are associated with differences in prevention behaviors and trust in information sources during extreme heat. Populations characterized by lower income, lower education, and rural/agricultural backgrounds may experience greater heat-related vulnerability, highlighting the need for culturally responsive and targeted communication strategies.
Alejandro Mena, Andres Manrique, Ashley McLeod-Morin· Frontiers in Communication· 0 citations
OBJECTIVE
This study aimed to identify latent classes of social networks among rural left-behind older adults in China, examine their influencing factors, and explore their associations with different dimensions of intergenerational support.
METHODS
A cross-sectional survey was conducted in July-August 2022 across seven counties in Anhui Province, China, using village-based convenience sampling combined with a random-walk household procedure, using a general information questionnaire, the Lubben Social Network Scale, and an intergenerational support scale. Latent profile analysis (LPA) identified network types; multinomial logistic regression examined covariate predictors; and ordinal models including quadratic terms characterized the associations of intergenerational support dimensions with network type, with inflection-point estimation and sensitivity analyses.
RESULTS
LPA revealed three distinct social network profiles: Family-Friend Weak-Tie (56.5%), Family-Friend Moderate-Maintenance (31.3%), and Family-Friend Stable -Active (12.3%). Age, primary economic source, social participation, vision impairment, and intergenerational support were significant influencing factors (all p < 0.05). Emotional support was consistently and positively associated with network level (β = 0.312, p < 0.001), whereas financial support showed a significant inverted-U association (linear β = 1.07, p = 0.002; quadratic β = - 0.105, p = 0.003), with an inflection point at a financial support score of 5.11; instrumental care(daily care) showed no significant association. The inverted-U pattern was robust across sensitivity analyses.
CONCLUSION
The social networks of rural left-behind older adults in China are heterogeneous, with over half characterized by weak ties and a high prevalence of social isolation. Dimensions of intergenerational support are differentially associated with network type: emotional support is consistently positive, financial support follows an inverted-U pattern (suggesting moderate rather than maximal support), and instrumental care shows no significant association. Interventions should prioritize the weak-tie subgroup, emphasize emotional connection, and promote moderate levels of financial support.
BACKGROUND
Few studies have specifically examined the relationship between social media use and uptake of COVID-19 booster. This study examined the association between social media use and COVID-19 booster vaccination uptake in Japan during the pandemic.
METHODS
A series of cross-sectional surveys was conducted using rapid online questionnaires among residents of Iwate Prefecture, Japan, from October 1 to 3, 2021, and from December 11 to 17, 2023 (n = 4,026). Vaccination status was assessed using a single question: "What is your vaccination status?". Respondents were categorized into two groups: individuals with incomplete booster uptake (those who had received one or two doses; n = 226) and booster acceptors (those who had received at least three doses; n = 3,800). Social media use was defined as self-reported use of Twitter, Facebook, Instagram, YouTube, or other social networking services. Logistic regression analyses were conducted to examine the association between social media use and receipt of a COVID-19 booster vaccination.
RESULTS
Social media use was significantly associated with higher odds of incomplete booster uptake of COVID-19 vaccination. This association remained statistically significant after adjustment for relevant covariates (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.21-2.39). Individuals with a history of COVID-19 infection prior to the initiation of booster vaccinations were less likely to receive a booster dose in an exploratory analysis (OR 3.06, 95% CI 1.28-7.32).
CONCLUSION
Differential associations between media use and COVID-19 booster uptake may provide important insights for designing effective communication strategies to improve vaccine acceptance in future pandemics.
Shuko Takahashi, M. Nohara, Satoshi Kanda et al.· Journal of Epidemiology· 0 citations
BACKGROUND AND OBJECTIVES
Social isolation is a significant public health concern, yet trends across diverse demographic groups-including age-differentiated patterns across the adult life course-remain poorly characterized. This study examines the prevalence, temporal trends, and sociodemographic correlates of social isolation among U.S. adults of all ages.
RESEARCH DESIGN AND METHODS
Drawing on 10 waves of the General Social Survey (2006-2024; N = 28,269), this study constructs an adapted three-domain social isolation typology-living arrangement, social contact frequency, and religious attendance-benchmarked against the Berkman-Syme Social Network Index and Cornwell and Waite's (2009) framework. Weighted multinomial logistic regression and a counterfactual decomposition estimated sociodemographic correlates and the contribution of declining religious participation to the overall trend.
RESULTS
An estimated 19.3% of U.S. adults were socially isolated and 2.0% severely isolated. Social integration scores declined from 2006 to a nadir in 2010, with partial recovery by 2024. Young adults (18-34) showed the highest bivariate isolation prevalence (22.5%), but lower or comparable adjusted odds once marital status and living arrangement were accounted for. Male gender, unmarried status, lower income, and non-urban residence were independently associated with higher isolation odds, whereas Black and Hispanic respondents showed lower odds than White respondents. Religious participation declined steadily, accounting for approximately 60% of the overall decline in social integration.
DISCUSSION AND IMPLICATIONS
Spanning two decades-including the 2008-2009 financial crisis, the opioid epidemic, and the COVID-19 pandemic-this study extends the predominantly older-adult focus of prior research and identifies sociodemographic risk profiles for intervention, with implications for public health policy.
