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analytics, anti-vaxxers, COVID-19, social media, vaccines


This study aimed to identify and assess the prevalence of vaccine-hesitancy-related topics on Twitter in the periods before and after the Coronavirus Disease 2019 (COVID-19) outbreak. Using a search query, 272,780 tweets associated with anti-vaccine topics and posted between 1 January 2011, and 15 January 2021, were collected. The tweets were classified into a list of 11 topics and analyzed for trends during the periods before and after the onset of COVID-19. Since the beginning of COVID-19, the percentage of anti-vaccine tweets has increased for two topics, “government and politics” and “conspiracy theories,” and decreased for “developmental disabilities.” Compared to tweets regarding flu and measles, mumps, and rubella vaccines, those concerning COVID-19 vaccines showed larger percentages for the topics of conspiracy theories and alternative treatments, and a lower percentage for developmental disabilities. The results support existing anti-vaccine literature and the assertion that anti-vaccine sentiments are an important public-health issue.

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Originally published as: Nasralah T, Elnoshokaty A, El-Gayar O, Al-Ramahi M, Wahbeh A. A comparative analysis of anti-vax discourse on twitter before and after COVID-19 onset. Health Informatics Journal. 2022;28(4). doi:10.1177/14604582221135831 © The Author(s) 2022. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (