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    Association between Covid-19 sources of information, beliefs, and vaccination rates: an EU-wide survey.
    (Oxford University Press, 2023-07-14) De la Cruz Sánchez, Ernesto; Moreno Llamas, Antonio; Mendiola Olivares, Jaime; García Mayor, Jesús; Torres Cantero, Alberto; Devine, Emily Beth; Ciencias Sociosanitarias
    Background: Misinformation hampers vaccine uptake. The European Union (EU) employed a coordinated effort to curb misinformation during the Covid-19 pandemic. In this context, we investigated relationships between sources of information, vaccine safety/effectiveness, satisfaction with government vaccination strategy, and vaccination intent. Methods: We used cross-sectional survey data (May 2021) from Flash Eurobarometer 494, a populationadjusted dataset comprised of a representative sample of those  15 years from 27 EU nations. We employed a latent class analysis to create clusters of information sources as the independent variable and beliefs in vaccine safety/efficacy, satisfaction with government vaccination strategy, and vaccine intent as four outcome variables. We first estimated the association between source clusters and each of the first three outcomes separately. Then, using these three as intermediate variables, we employed structural equation modeling to estimate the relationship between sources and vaccine intent. We adjusted for individual and country-level variables. Results: Among 23 012 respondents, four clusters of information sources emerged: (1) national authorities/health professionals (n¼9602; 42%), (2) mostly health professionals (6184; 27%), (3) mixed (n¼1705; 17%) and (4) social media/family/ friends (n¼5524; 24%). Using cluster (3) as the referent, we found decreasing odds of beliefs in vaccine safety/effectiveness, satisfaction and vaccine intent across clusters (1), (2) and (4), respectively. Demographics played a role. Conclusion: In the context of the Covid pandemic, these results provide the first EU-wide estimates of the association between sources of information about vaccine safety/effectiveness, satisfaction and vaccine intent. The coordinated approach promulgated by the EU to minimize misinformation provides a model for managing future pandemics.