Modes of COVID-19 Information and Vaccine Hesitancy Among Asian Americans: The Moderating Role of Exposure to Cyberbullying.

Introduction:: COVID-19 vaccination is an important public health intervention to curb the pandemic's magnitude and spread, and racial discrimination is a key predictor of COVID-19 preventive behavior, vaccine hesitancy, and uptake. This study evaluated the association of vaccine hesitancy with various modes of information on COVID-19 (i.e., online, social media) and the moderating role of cyberbullying among Asian Americans. Methods:: We used population-weighted data from the nationwide Asian American & Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Survey, which was conducted from January to April 2021 (unweighted n=3,127). We examined the association of various modes of COVID-19 information and vaccine hesitancy, moderated by exposure to cyberbullying. Results:: In general, 16% of Asian Americans reported vaccine hesitancy; 26% reported experiencing cyberbullying. Asian Americans reported receiving the majority of COVID-19 information from online sources (75%) and social media (52%). In unadjusted models, receiving information online (OR=0.46, 95%CI=0.33, 0.62, p<.001), via social media (OR=0.80, 95%CI=0.52, 0.93, p<.05), and via broadcast (OR=0.60, 95%CI=0.44, 0.81, p<.001) were significantly associated with a lower vaccine hesitancy. However, reporting any cyberbullying was associated with increased vaccine hesitancy (OR=1.39, 95%CI=1.02, 1.90, p<.05). The protective effects for COVID-19 information modes remained when accounting for health and sociodemographic factors, while the effect of cyberbullying was no longer statistically significant. Cyberbullying moderated the protective effect of broadcast information only, so those who received information via broadcast and reported experiencing cyberbullying had similar odds of vaccine hesitancy compared to those who did not receive information via broadcast. Conclusions:: Online, social media, and broadcast remain important sources of information about COVID-19 for Asian Americans; however, experiencing cyberbullying can reduce the effectiveness of these sources in the uptake of the vaccine. COVID-19 information promotion strategies for Asian Americans must account for the role of cyberbullying in social media campaigns.