Improving Public Health Policy by Comparing the Public Response during the Start of COVID-19 and Monkeypox on Twitter in Germany: A Mixed Methods Study

Little is known about monkeypox public concerns since its widespread emergence in many countries. Tweets in Germany were examined in the first three months of COVID-19 and monkeypox to examine concerns and issues raised by the public. Understanding views and positions of the public could help to shape future public health campaigns. Few qualitative studies reviewed large datasets, and the results provide the first instance of the public thinking comparing COVID-19 and monkeypox. We retrieved 15,936 tweets from Germany using query words related to both epidemics in the first three months of each one. A sequential explanatory mixed methods research joined a machine learning approach with thematic analysis using a novel rapid tweet analysis protocol. In COVID-19 tweets, there was the selfing construct or feeling part of the emerging narrative of the spread and response. In contrast, during monkeypox, the public considered othering after the fatigue of the COVID-19 response, or an impersonal feeling toward the disease. During monkeypox, coherence and reconceptualization of new and competing information produced a customer rather than a consumer/producer model. Public healthcare policy should reconsider a one-size-fits-all model during information campaigns and produce a strategic approach embedded within a customer model to educate the public about preventative measures and updates. A multidisciplinary approach could prevent and minimize mis/disinformation.