The Rashōmon Effect and COVID-19 vaccine decision-making: a qualitative study
Author(s)
Madar, Poonam
Chandok, Raj S
Majeed, Azeem
Type
Journal Article
Abstract
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.
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.
Date Issued
2026-01-01
Date Acceptance
2026-02-01
Citation
JRSM Open, 2026, 17 (1)
ISSN
2054-2704
Publisher
SAGE Publishing
Journal / Book Title
JRSM Open
Volume
17
Issue
1
Copyright Statement
© 2026 The Author(s) CreativeCommonsNonCommercial CCBY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https:// creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41726002
PII: 10.1177_20542704251408587
Subjects
COVID-19 pandemic
qualitative study
rashōmon effect
vaccine decision-making
vaccine hesitancy
Publication Status
Published
Coverage Spatial
England
Article Number
20542704251408587
Date Publish Online
2026-02-18