Vaccine Hesitancy and COVID-19 Risk Behaviors Associated with Social Media Use in Japan.

We examined the associations between the use of different types of media and COVID-19 vaccine hesitancy, as well as risk behaviors of COVID-19 infection, in Japan in late 2021. Cross-sectional surveys were conducted using rapid online surveys of residents in Iwate Prefecture from February 5 to 7, 2021, and from October 1 to 3, 2021. Each individual's risk of acquiring SARS-CoV-2 infection was calculated using a quantitative assessment tool (the microCOVID). Intention to get vaccinated for COVID-19 was assessed by self-report. Usage of five types of media for obtaining COVID-related information was assessed: (1) newspapers, (2) television or radio, (3) internet or news apps, (4) social network services (SNS) (excluding LINE, a popular messaging app), and (5) other. Reliance on SNS did not show significant associations with either intention to get vaccinated or engaging in risky behavior for acquiring COVID-19. Although users of the internet or news apps were marginally significantly less likely to engage in high-risk behavior, significant associations between vaccine hesitancy and the usage of the internet or news apps were found in the middle age and elderly groups (OR [95% confidence interval (CI)] in middle age: 1.55 [1.07-2.23]; in elderly; 9.24 [3.28-26.02]). The differential associations between different types of media use and COVID-19 prevention behaviors may assist in preparing for future pandemic outbreaks. One implication for public health risk communication is audience segmentation, such as emphasizing vaccine safety and effectiveness for older audiences.