Randomized controlled trial of a social media campaign to promote COVID-19 vaccination in Nigeria

Background: The COVID-19 pandemic has challenged public health and behavior change programs and has also led to innovative interventions and research. In low -and middle-income countries (LMICs) such as Nigeria, new strategies to promote vaccination, increase pro-vaccination social norms, and reduce vaccine hesitancy have been deployed through social media campaigns and evaluated using digital media platforms. Methods: The aim of this study was to conduct two randomized controlled evaluations of social media content designed to promote COVID-19 vaccination and to complement research on a nationwide vaccination promotion campaign in Nigeria run in 2022. We conducted two studies in March and August 2022 among Nigerians drawn from 31 states that were not the target of the nationwide campaign. Participants were randomized to receive the pro-vaccination social media campaign or not and data were collected at pre- and post-test to evaluate psychosocial predictors of vaccination and vaccination outcomes following a theory of change based on Diffusion of Innovations, Social Norms Theory, and the Motivation, Opportunity, Ability (MOA) Framework. Data were collected through a novel intervention delivery and data collection platform through social media, and this study demonstrates the capability and potential of new social media-based data collection techniques. Results: The study found that pro-vaccination social norms and vaccination rates increased, and vaccine hesitancy decreased, among participants randomized to the social media intervention study arm. Conclusion: Social media campaigns are a promising approach to increasing vaccination at scale in LMICs, and social norms are an important factor in promoting vaccination, which is consistent with the Social Norms Theory. We describe implications for future vaccination campaigns and identify future research priorities in this area. The study was conducted in accordance with the Declaration of Helsinki, and approved by t