PONE-D-23-15997Outcomes of a social media campaign to promote COVID-19 vaccination in NigeriaPLOS ONE

Dear Dr. Evans,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Aug 02 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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Kind regards,

Naeem Mubarak, PhD

Academic Editor

PLOS ONE

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2. We note that the grant information you provided in the ‘Funding Information’ and ‘Financial Disclosure’ sections do not match. 

When you resubmit, please ensure that you provide the correct grant numbers for the awards you received for your study in the ‘Funding Information’ section.

3. Thank you for stating the following financial disclosure: 

"Yes, Sohail Agha was a project officer and participated in meetings to design the study and provided input to the manuscript. The Principal Investigator, W. Douglas Evans, made all final study decisions."

Please state what role the funders took in the study.  If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." 

If this statement is not correct you must amend it as needed. 

Please include this amended Role of Funder statement in your cover letter; we will change the online submission form on your behalf.

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"This study was funded by the Bill & Melinda Gates Foundation (BMGF) grant INV-033413. We thank the foundation for its support of this study."

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Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: 

"Yes, Sohail Agha was a project officer and participated in meetings to design the study and provided input to the manuscript. The Principal Investigator, W. Douglas Evans, made all final study decisions."

Please include your amended statements within your cover letter; we will change the online submission form on your behalf.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for providing the opportunity to review this interesting study

The study focused on the impact of a social media campaign on COVID-19 vaccination that was premised on the principal of the theory of change (diffusion of innovations, social norm theory, and MOA framework model) among healthcare providers and the general population in Nigeria. The research evaluated the outcomes of the status of COVID-19 vaccine uptake, vaccine hesitancy, and pro-vaccination social norms among the participants recruited at 3 different time points over 10 months.

The study holds a good deal of merit for publication with following recommendations:

The introduction section does not sufficiently cover the topic mentioned in hand. Many studies can be cited from other LMIC, for instance:

1. https://doi.org/10.37723/jumdc.v12i2.624

2. https://doi.org/10.37723/jumdc.v13i3.762

The authors have targeted Facebook and Instagram to propagate social media campaigns. How this selection will ensure the generalizability of responses in the Nigerian context and not create a demographic bias? Please clarify what you mean by “the persuadable middle”

The authors have chosen a mixed method study design. However, no detail or mention of the qualitative part of the survey. No mention of the stakeholders involved. How will you justify Line 99-101: “The evaluation employed mixed methods and comprised of a quantitative study conducted through social media-based surveys, a qualitative study of stakeholders, and a cost-effectiveness study”?

The study mentions a quasi-experimental design with non-equivalent control and treatment groups. How will you justify the 6 states that you have chosen for treatment interventions? What was the rationale for not including the federal capital of Nigeria in the treatment group? Also, the terminology for mentioning the comparison or control group keeps on changing throughout the manuscript. Would have been better to keep it consistent for a better understanding

Can the authors provide explicit detail on the social media campaign content that was used to assess the outcomes? Can they provide details on the interventional strategies used? How have they ensured that the findings obtained were merely based on the impact of social media campaigns and not on the other competing exposures?

The study mentions attrition bias as the limitation. However, can the authors provide a compelling rationale for the large loss of participants after the first follow-up?

To assess the primary outcome of COVID-19 vaccine status, please clarify does the fully vaccinated status was given with or without booster shots. How have you differentiated the 5Cs of vaccine hesitancy among participants with or without booster shots?

The discussion section lacks depth. Would have been better to draw comparisons of social media influence on COVID-19 vaccine hesitancy with other LMICs. The study demands a holistic explanation of the impact of social media campaigns in terms of the primary and secondary outcomes of your study.

Reviewer #2: In this manuscript, Evans and colleagues conducted a national-level quasi-experimental evaluation of a social media based COVID-19 vaccination promotion campaign across Nigeria's 36 states and the Federal Capital Territory. The authors purposively chose 6 States in the south-south, south-east, south-west, north-east, north-west and north-central region of Nigeria as "intervention" states where they ran online campaigns and compared them to Nigeria's other 30 States and the Federal Capital Territory as "comparator States".

The study used a potentially novel methodology for data collection. It is also evident that a lot of work and collbaorative effort has gone in to ensure this study was succesfully completed. That being said, there are some important issues that I strongly recommend that the authors address to improve the overall quality of the manuscript. Ihave lsited below as major and minor issues.

MAJOR

1. I would like to address a significant concern regarding the absence of local authors in the list of authors. In recent years, the global health community has increasingly emphasized the importance of equitable and inclusive collaborations, particularly in research conducted in low- and middle-income countries. It is crucial to ensure that local researchers, scientists, and collaborators from the host country are included as authors, as their perspectives, insights, and expertise are vital in conducting research that accurately reflects the local context and addresses the specific health needs of the population. I note that in line 104, the authors state that were invloved in designing the campaign. I also note that the study has IRB from Nigeria's national primary health care agency (not "public health agency" as stated by the authors") which I assume was led by local collaborators too. To make matthers worse, your acknowledgment section only mentioned the study funder and not even a mention of a lcoal collaborator whom have been referred to in the body of the manuscript as creators of the campaign and delivered the campaigns.

Therefore, I strongly recommend that you consider including local authors who have contributed significantly to the study design, data collection, analysis, interpretation, or manuscript preparation. This would enhance the credibility and relevance of the research findings, foster meaningful partnerships, and support the broader goal of promoting local ownership and sustainability in research endeavors. I understand that there may be various reasons for the absence of local authors in the current version of the manuscript. If there are limitations or challenges in involving local authors, I encourage you to provide a clear and transparent explanation in the manuscript, outlining the efforts made to engage local collaborators and the reasons for their exclusion as authors. By addressing this issue, your study will not only comply with emerging guidelines and expectations in global health research but also contribute to the advancement of ethical research practices, respectful collaborations, and knowledge co-creation in LMIC settings.

2. The manuscript methods sections lacked information on the local context in Nigeria which would be useful in contextualizing the findings. For example, there is no information on the rate of internet penetration in Nigeria, no information on the demographic that utilize social media in Nigeria and there is no information on how these vary across States in Nigeria as the country has a wide gap in access to many social amenities, education, etc which can impact impact these and your findings.

3. One wonders how the authors were able to confirm that a study participant was a healthcare worker during the survey. It is important to transparently mention the extra checks that was put in place for this. This is critical as your study comapred the outcome among health workers and others.

4. Likewise, how were the authors able to confirm that a participant was 18 years or above. It is important to state was was done clearly or note this as a limitation of the study, as it will impact the interpretation of the study.

MINOR

1. There are several sentences in the manuscript that needs referencing. Please check the sentences starting in lines 70, 72, 110, 111 among others.

2. The authors states that NPHCDA is Nigeria "public health agency". The NCDC is Nigeria's puplic health agency while NPHCDA is the national primary healthcare agency. Please revise.

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: No

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PONE-D-23-15997R1Outcomes of a social media campaign to promote COVID-19 vaccination in NigeriaPLOS ONE

 Dear Dr. Evans,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please ensure that your decision is justified on PLOS ONE’s publication criteria and not, for example, on novelty or perceived impact.

Please submit your revised manuscript by Aug 26 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

We look forward to receiving your revised manuscript.

Kind regards,

Naeem Mubarak, PhD

Academic Editor

PLOS ONE

Additional Editor Comments:

The study merits publication with improvements as advised in the reviewer's comments

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for providing the opportunity to review the revised manuscript

The comments have not been completely addressed

It is necessary to update the introduction section. No changes suggested previously were made. You may use the following studies to cover the insufficient details of the topic in hand.

1. https://doi.org/10.37723/jumdc.v12i2.624

2. https://doi.org/10.37723/jumdc.v13i3.762

The discussion section was edited but with no details on the comparison of your findings with other countries as recommended previously.

Can the authors explicitly mention the sample size calculation separately for both the HCP and the general population? What population size you used to reach your target sample size for both? Is your survey response sufficient to meet your target sample size for both populations? Please clarify.

Reviewer #2: I have no further comments. All required questions have been answered. I have no concerns with publication ethics

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

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[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Outcomes of a social media campaign to promote COVID-19 vaccination in Nigeria

PONE-D-23-15997R2

Dear Dr. W. Douglas Evans,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Comments from PLOS Editorial Office: We note that during previous rounds of peer review one or more reviewers has recommended that you cite specific previously published works. As always, we recommend that you please review and evaluate the requested works to determine whether they are relevant and should be cited. It is not a requirement to cite these works, and if you assess that any such requested citations are not sufficiently relevant to this study, you may remove them during preparation of the final manuscript files. We appreciate your attention to this request.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Naeem Mubarak, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

The manuscript holds a good deal of merit for publication with no further revisions required and may be accepted.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #3: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thankyou for providing me the opportunity to review this revised manuscript. I have no further concerns. All the comments have been addressed fully. The study now holds a good deal of merit for publication with improved quality.

Reviewer #3: All the queries have been addressed by the author. I do not have any further concerns regarding publication of this article. Good Luck!

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #3: No

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