Characterization of COVID-19 Vaccine Clinical Trial Discussions on the Social Question-and-Answer Site Quora

Abstract

Abstract Introduction: 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. Methodology: 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 populations to capture their experiences, attitudes, topics, and barriers to COVID-19 vaccine trials. Result A total of 1,073 questions and 7,479 answers were collected based on structured automated keyword queries and data mining. A total of 763 questions and 2,548 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 register for a trial; and (iv) whether participants could withdraw from a trial to receive a more rapidly approved COVID-19 vaccine. Conclusions Our study found active user discussions related to COVID-19 vaccine clinical trials on Quora, including those specific to minority health topics and posted by self-identified racial and ethnic minority online users. Results from this study can help identify near real-time barriers to participation among underrepresented groups and support the design of future outreach strategies to help with recruitment and inclusive participation.