Objective: The aims of the study were to examine the association between social media sentiments surrounding COVID-19 vaccination and the effects on vaccination rates in the United States (US), as well as other contributing factors to the COVID-19 vaccine hesitancy.

Method: The dataset used in this study consists of vaccine-related English tweets collected in real-time from January 4 - May 11, 2021, posted within the US, as well as health literacy (HL), social vulnerability index (SVI), and vaccination rates at the state level.

Results: The findings presented in this study demonstrate a significant correlation between the sentiments of the tweets and the vaccination rate in the US. The results also suggest a significant negative association between HL and SVI and that the state demographics correlate with both HL and SVI.

Discussion: Social media activity provides insights into public opinion about vaccinations and helps determine the required public health interventions to increase the vaccination rate in the US.

Conclusion: Health literacy, social vulnerability index and monitoring of social media sentiments need to be considered in public health interventions as part of vaccination campaigns.

Keywords: COVID–19, Health Literacy, COVID–19 Vaccine Hesitancy, Social Vulnerability Index, Social Media, Social Determinants of Health

Abbreviations: Health Literacy (HL), Social Vulnerability Index (SVI), Social Determinants of Health (SDOH), United States (US)

Correspondence: gabriela.wilson@uta.edu