The Rashōmon Effect and COVID-19 vaccine decision-making: A qualitative study

Objectives This qualitative study captured the perspectives of patients and healthcare professionals to better understand COVID-19 vaccine decision-making among South Asians in London. Design In-depth semi-structured telephone and virtual interviews were conducted using convenience and purposive sampling to explore narratives about COVID-19 decision-making processes, pandemic experiences, and perceptions of living through a period of unprecedented uncertainty and turbulence. Setting UK. Participants 12 London-based individuals including patients, clinicians, and a medical receptionist. Main Outcome Measures Respondents were categorised as either COVID-19 vaccine compliant or non-compliant based on their vaccination status. Results The variation and dynamic nature of the vaccination trajectories described in this study suggest that the decision to vaccinate or not against COVID-19 comprises a fluid, continually evolving process shaped by personal experiences and ongoing risk assessments. This study examines the possibility that some individuals form an ‘epistemic community of uncertainty,’ influenced by the pervasive ‘infodemic’ surrounding COVID-19 vaccines, which has created substantial ambiguity about truth and trust, reminiscent of the Rashōmon effect. Developing a nuanced understanding of this effect in the context of the COVID-19 era is a critical step towards addressing such ambiguity and fostering deeper critical thinking about vaccine decision-making. Conclusions This research highlights the need for more flexible and innovative strategies to navigate the complex factors influencing decision-making. Furthermore, the study advocates for a more refined and discerning personalised approach to engagement, which is vital for improving scientific and health literacy within society and overcoming common barriers to making informed and autonomous choices.