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Background: COVID-19 vaccine hesitancy seems to be universal across countries and subgroups, and so are its determinants. We studied the willingness and factors associated with the decision to be vaccinated against COVID-19 in healthcare workers (HCW) in a Spanish tertiary hospital. Furthermore, we compared the percentage of willingness to vaccinate against COVID with actual vaccination rates among HCW in our hospital., Methods: From December 21, 2020 to January 4, 2021, before initiation of the COVID-19 HCW vaccination campaign at Germans Trias i Pujol University Hospital (HUGTiP), an anonymous self-administered questionnaire was administered to HCW. Univariate and multivariate logistic regression of the association of variables with the outcome "intention to receive the COVID-19 vaccine as soon as possible" was conducted. Vaccination rates were extracted from the hospital information systems., Results: Forty-four percent of HCW included in the study declared a willingness to be vaccinated against COVID-19 as soon as possible. This was associated with male sex [1.66 (95%CI 1.13-2.43); p = 0.009], older age [1.02 (95%CI 1.00-1.03); p = 0.014], belonging to the occupational groups "physician" or "other" [5.76 (95%CI 3.44-9.63) and 2.15 (95%CI 1.25-3.70); p<0.001], respectively, and reporting influenza vaccination during the last three seasons or at least one of the last three seasons [3.84 (95%CI 2.56-5.75) and 2.49 (95%CI 1.71-3.63); p<0.001]. One in ten hospital workers reported they were unwilling to receive COVID-19 vaccination. Actual COVID-19 vaccination uptake among HCW was higher (80.4%) than the percentage of willingness to vaccinate estimated from the questionnaire. Physicians not only had the highest vaccination rate, but also the highest correlation between the reported intention to vaccinate and the final decision to receive COVID-19 vaccination., Conclusions: COVID-19 vaccination uptake was higher than previously estimated according to the stated intentions of HCW. Doubts and fears must be addressed, particularly in persons less inclined to be vaccinated: females, younger people and those not vaccinated against influenza in recent seasons. The study of barriers and strategies aimed at promoting COVID-19 vaccination must be adapted in relation to occupational groups' attitudes, understanding their idiosyncrasies with respect to this and other vaccines., Competing Interests: The authors have declared that no competing interests exist.

Purpose: This study investigates the communication behavior of public health organizations on Twitter during the COVID-19 vaccination campaign in Brazil. It contributes to the understanding of the organizational framing of health communication by showcasing several instances of framing devices that borrow from (Brazilian) internet culture. The investigation of this case extends the knowledge by providing a rich description of the organizational framing of health communication to combat misinformation in a politically charged environment. Design/methodology/approach: The authors collected a Twitter dataset of 77,527 tweets and analyzed a purposeful subsample of 536 tweets that contained information provided by Brazilian public health organizations about COVID-19 vaccination campaigns. The data analysis was carried out quantitatively and qualitatively by combining social media analytics techniques and frame analysis. Findings: The analysis showed that Brazilian health organizations used several framing devices that have been identified by previous literature such as hashtags, links, emojis or images. However, the analysis also unearthed hitherto unknown visual framing devices for misinformation prevention and debunking that borrow from internet culture such as "infographics," "pop culture references" and "internet-native symbolism." Research limitations/implications: First, the identification of framing devices relating to internet culture add to our understanding of the so far little addressed framing of misinformation combat messages. The case of Brazilian health organizations provides a novel perspective to knowledge by offering a notion of internet-native symbols (e.g. humor, memes) and popular culture references for misinformation combat, including misinformation prevention. Second, this study introduces a frontier of political contextualization to misinformation research that does not relate to the partisanship of the spreaders but that relates to the political dilemmas of public organizations with a commitment to provide accurate information to citizens. Practical implications: The findings inform decision-makers and public health organizations about framing devices that are tailored to internet-native audiences and can guide strategies to carry out information campaigns in misinformation-laden social media environments. Social implications: The findings of this case study expose the often-overlooked cultural peculiarities of framing information campaigns on social media. The report of this study from a country in the Global South helps to contrast several assumptions and strategies that are prevalent in (health) discourses in Western societies and scholarship. Originality/value: This study uncovers unconventional and barely addressed framing devices of health organizations operating in Brazil, which provides a novel perspective to the body of research on misinformation. It contributes to existing knowledge about frame analysis and broadens the understanding of frame devices borrowing from internet culture. It is a call for a frontier in misinformation research that deals with internet culture as part of organizational strategies for successful misinformation combat. [ABSTRACT FROM AUTHOR]