  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.
