"This is not any of your business so stop your bulls**t": An abductive thematic analysis of antagonism towards others in a vaccination study.

Abstract

Vaccine hesitancy hinders some older adults from receiving immunization against potentially life-threatening and serious diseases such as pneumonia, influenza, COVID-19, and shingles. However, vaccine hesitancy can escalate from mere reluctance to hostility and paranoia. To examine such reluctance, data were drawn from the North Dakota Older Adults' Vaccine Use Study which surveyed 901 community-dwelling older adults about their vaccination perceptions and behaviors. We identified a subset of 59 participants who expressed antagonism towards researchers, healthcare workers, and vaccination topics by their use of explicit language, criticism, and fear. The current study investigates the qualitative content of antagonism via open-ended survey responses and comments provided in survey margins. Data were coded using abductive thematic analysis, with hostile emotions as a framework. We found that antagonistic participants directed anger, resentment, and indignation towards four sources: political agendas, duplicitous officials, inept researchers, and reckless anti-vaxxers. Though antagonism was more frequently expressed by vaccine hesitant participants, antagonism was evident on both ends of the anti- and pro- vaccination spectrum. Findings from this study offer unique perspectives of vaccination from a distrusting and hard-to-reach population and provide specific beliefs that interventionists can seek to combat. Additionally, these findings also highlight potential conflict between pro- and anti-vaccine patients. Overall, these findings highlight an understudied emotional component of vaccine refusal and hesitancy. Practitioners should target emotions related to vaccine hesitancy in addition to combatting vaccine myths and misinformation.