Minor Consent for Vaccination: Ethically Justified, Politically Fraught.

Policies allowing some minors to consent to receive recommended vaccines are ethically defensible. However, a policy change at the federal level expanding minor consent for vaccinations nationwide risks triggering a political backlash. Such a move may be perceived as infringing on the rights of parents to make decisions about their children's health care. In the current post-COVID environment of heightened anti-vaccination activism, changes to minor consent laws may be unadvisable, and policy makers should proceed with caution.

On the determinants of anti-COVID restriction and anti-vaccine movements: the case of IoApro in Italy.

Following restrictions to control the spread of COVID-19, and subsequent vaccination campaigns, sentiments against such policies were quick to arise. While individual-level determinants that led to such attitudes have drawn much attention, there are also reasons to believe that the macro context in which these movements arose may contribute to their evolution. In this study, exploiting data on business activities which supported a major Italian anti-restriction and anti-vaccine movement, IoApro, using quantitative analysis that employs both a fractional response probit and logit model and a beta regression model, we investigate the relationship between socio-economic characteristics, institutional quality, and the flourishing of this movement. Our results suggest a U-shaped relationship between income and the proliferation of the movement, meaning that support for these movements increases the greater the degree of economic decline. Our results further indicate that the share of the population between 40 and 60 years old is positively related to support for such movements, as is institutional corruption.

Vacinas e desinformação: uma análise de conteúdo sobre fake newsapuradas por plataformas de debunkingem redes sociais / Vaccines and disinformation: a content analysis on fake news verified by debunking platforms on social networks / Vacunas y desinformación: un análisis de contenidos sobre fake news verificadas por las plataformas de debunking en las redes sociales

O impacto das fake news chegou à área da saúde e a desconfiança em relação às vacinas trouxe de volta doenças até então erradicadas. Mas como os discursos antivacinasão construídos nas redes sociais? Neste trabalho, 80fake news com foco nas vacinas foram coletadas de sites brasileiros que realizam debunking, uma estratégia de detecção e desmascaramento de desinformação e fake news. A partir da aplicação de um protocolo analítico, mapeamos as principais características presentes na elaboração dessas publicações. A análise de conteúdo revelou que o Facebook e o WhatsApp são as redes preferidas para esse tipo de compartilhamento. Cerca de 59% dos conteúdos são totalmente falsos e a maioria dos discursos destaca possíveis riscos das vacinas como estratégias de convencimento. As fontes mais referenciadas são supostamente médicos e cientistas, para criar confiabilidade. O levantamento aponta ainda que 60% das publicações apresentaram erros gramaticais e ortográficos na elaboração dos textos

The impact of fake news reached the health area and distrust in relation to vaccines brought back diseases that had been eradicated. But how are these anti-vaccine discourses constructed in social medias? In this paper, 80 fake news stories focusing on vaccines were collected through Brazilian websites that perform debunking, a strategy for detecting and unmasking misinformation and fake news. From the application of an analytical protocol, the main characteristics present in the elaboration of these publications were mapped. Content analysis revealed that Facebook and WhatsApp are the preferred medias for this type of sharing. About 59% of the contents are totally false and most of the speeches highlight the risks of vaccines as a convincing strategy. The most referenced sources are supposedly doctors and scientists to create re-liability. The survey also points out that 60% of publications have grammatical and spelling errors in the preparation of texts

El impacto de las fake news llegó al área de la salud y la desconfianza en las vacunas trajo de vuelta enfermedades erradicadas. Pero, ¿cómo se construyen los discursos antivacunas en las redes sociales? En este trabajo, se recopilaron 80 noticias falsas centradas en vacunas a través de sitios web brasileños que realizan debunking, una estrategia para detectar y desenmascarar información errónea y noticias falsas. A partir de la aplicación de un protocolo analítico, mapeamos las principales características presentes en la elaboración de estas publicaciones. El análisis de contenido reveló que Facebook y WhatsApp son las redes preferidas para este tipo de intercambio. Alrededor del 59% del contenido es completamente falso y la mayoría destaca los posibles riesgos de las vacunas como estrategias convincentes. Las fuentes más referenciadas son supuestamente médicos y científicos para crear confiabilidad. La encuesta señala que el 60% de las publicaciones tenían errores gramaticales y ortográficos

Responses to a COVID-19 vaccination intervention: Qualitative analysis of 17K unsolicited SMS replies.

The development of effective interventions for COVID-19 vaccination has proven challenging given the unique and evolving determinants of that behavior. A tailored intervention to drive vaccination uptake through machine learning-enabled personalization of behavior change messages unexpectedly yielded a high volume of real-time short message service (SMS) feedback from recipients. A qualitative analysis of those replies contributes to a better understanding of the barriers to COVID-19 vaccination and demographic variations in determinants, supporting design improvements for vaccination interventions. OBJECTIVE: The purpose of this study was to examine unsolicited replies to a text message intervention for COVID-19 vaccination to understand the types of barriers experienced and any relationships between recipient demographics, intervention content, and reply type. METHOD: We categorized SMS replies into 22 overall themes. Interrater agreement was very good (all κpooled > 0.62). Chi-square analyses were used to understand demographic variations in reply types and which messaging types were most related to reply types. RESULTS: In total, 10,948 people receiving intervention text messages sent 17,090 replies. Most frequent reply types were "already vaccinated" (31.1%), attempts to unsubscribe (25.4%), and "will not get vaccinated" (12.7%). Within "already vaccinated" and "will not get vaccinated" replies, significant differences were observed in the demographics of those replying against expected base rates, all p > .001. Of those stating they would not vaccinate, 34% of the replies involved mis-/disinformation, suggesting that a determinant of vaccination involves nonvalidated COVID-19 beliefs. CONCLUSIONS: Insights from unsolicited replies can enhance our ability to identify appropriate intervention techniques to influence COVID-19 vaccination behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The emergence and persistence of the anti-vaccination movement.

Vaccine hesitancy is a significant threat to public health and the anti-vaccination movement has played a significant role in communicable disease outbreaks. This commentary discusses the history and tactics of vaccine denialists and anti-vaccination groups. Anti-vaccination rhetoric is robust on social media platforms, and vaccine hesitancy has proven to impede the uptake of both established and new vaccines. Effective counter-messaging is needed to preemptively discredit vaccine denialists and reduce their influence on vaccine uptake. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How to Respond to Misinformation From the Anti-Vaccine Movement.

Vaccines are doubtlessly one of the most crucial life-saving medical interventions to date. However, perplexingly, they court more public controversy than their objectively excellent safety profile warrants. While doubts about the safety of vaccines, as well as opposition to vaccine policies, can be traced back at least to the mid-19th century, the modern anti-vaccine movement has come in 3 distinct waves, or generations, each precipitating around distinct key events. Here, we describe the first 2 generations and trace the origins of an emerging third generation anti-vaccine movement. Currently, this third generation is an integral part of the larger anti-COVID movement and in this more libertarian environment propagates the idea of individualism superseding the responsibility for community health. We highlight the need for a better science education of the young, as well as the general public to further enhance overall science literacy and suggests strategies to achieve these goals.

Social Media and Vaccine Hesitancy: Help Us Move the Needle.

With more than 75% of parents and pediatric caregivers getting their health-related information online, reaching families on social media is a powerful way to leverage the trust built in the examination room to address vaccine hesitancy. This article first reviews the ways the antivaccine movement has leveraged social media to expand its considerable influence, and why social media companies have failed to reduce antivaccine misinformation and disinformation. Next, it reviews the barriers to adoption of social media-based communication by pediatric health-care providers and concludes with action-oriented items to increase the adoption of this powerful tool.

On Antiscience and Antisemitism.

Recent surges in antivaccine activism and other antiscience trends now converge with rising antisemitism. During the COVID-19 pandemic, authoritarian elements from the far right in North America and Europe often invoked Nazi imagery to describe vaccinations or at times even blame the Jewish people for COVID-19 origins and vaccine profiteering. Such tropes represent throwbacks to the 14th century, when European Jews were persecuted during the time of the bubonic plague. This article provides both historical and recent perspectives on the links between antiscience and antisemitism, together with the author's personal experience as a Jewish vaccine scientist targeted by both dark forces. New approaches to uncoupling antisemitism from antiscience, while combating both, are essential for saving lives and preserving democratic values.

Influence of online opinions and interactions on the Covid-19 vaccination in Chile.

We analyze 6 months of Twitter conversations related to the Chilean Covid-19 vaccination process, in order to understand the online forces that argue for or against it and suggest effective digital communication strategies. Using AI, we classify accounts into four categories that emerge from the data as a result of the type of language used. This classification naturally distinguishes pro- and anti-vaccine activists from moderates that promote or inhibit vaccination in discussions, which also play a key role that should be addressed by public policies. We find that all categories display relatively constant opinions, but that the number of tweeting accounts grows in each category during controversial periods. We also find that accounts disfavoring vaccination tend to appear in the periphery of the interaction network, which is consistent with Chile's high immunization levels. However, these are more active in addressing those favoring vaccination than vice-versa, revealing a potential communication problem even in a society where the antivaccine movement has no central role. Our results highlight the importance of social network analysis to understand public discussions and suggest online interventions that can help achieve successful immunization campaigns.

Os efeitos da pandemia de covid-19 no discurso antivacinação infantil no Facebook / The effects of covid-19 pandemic on children's antivaccination discourse in Facebook / Los efectos de la pandemia de covid-19 sobre el discurso antivacunación infantil en Facebook

Este trabalho pretende analisar como o discurso antivacina sobre a covid-19 impactou o discurso sobre vacinação infantil no contexto da mídia social, a partir das estratégias e narrativas de legitimação construídas. Para isso, realizamos uma análise de mais de 260 mil publicações sobre vacinação infantil no Facebook (Meta) entre os anos de 2019 e 2022, com o objetivo de compreender: quais foram as estratégias discursivas utilizadas para legitimar o discurso antivacina e pró-vacina nesses anos; quais as principais narrativas construídas; e como a pandemia de covid-19 impactou nessa discussão. Os resultados indicam um crescimento e uma polarização do debate sobre vacinação infantil na mídia social, com a circulação de discursos desinformativos e conspiratórios. No contexto da pandemia, observamos que o discurso antivacina saiu da vacinação infantil contra a covid-19 e se espalhou para o debate sobre a vacinação infantil para outras doenças. Essas mudanças têm um impacto no discurso pró-vacina que se modifica para tentar responder ao movimento antivacinação.

This work intends to analyze how the anti-vaccination discourse on covid-19 impacted the discourse on childhood vaccination in the context of social media, based on the strategies and narratives of legitimation constructed. In order to do this, we carried out an analysis of more than 260 thousand publications about childhood vaccination on Facebook (Meta) between 2019 and 2022, focusing on understanding: what dis-cursive strategies were used to legitimize the anti-vaccine and pro-vaccine discourse during this period; what are the main narratives constructed; and how the covid-19 pandemic impacted this discussion. The results indicate a growth and polarization of the debate about childhood vaccination on social media, with the circulation of misinformative and conspiratorial discourses. In the context of the pandemic, we noted that the anti-vaccine discourse spread from childhood vaccination against covid-19 and started a debate on childhood vaccination for other diseases. These changes have an impact on the pro-vaccine discourse, that changes itself to try to respond to the anti-vaccination movement.

Este trabajo pretende analizar cómo el discurso antivacunas sobre la covid-19 impactó en el discurso sobre la vacunación infantil en el contexto de las redes sociales, a partir de las estrategias y narrativas de legiti-mación construidas. Para ello, realizamos un análisis de más de 260 mil publicaciones sobre vacunación infantil en Facebook (Meta) entre 2019 y 2022, con los objetivos de comprender qué estrategias discursivas se utilizaron para legitimar el discurso antivacunas y provacunas sobre los años; cuáles fueron las prin-cipales narrativas construidas; y cómo la pandemia de covid-19 impactó esta discusión. Los resultados indican un crecimiento y una polarización del debate sobre la vacunación infantil en las redes sociales, con la circulación de discursos desinformativos y conspirativos. En el contexto de la pandemia, observamos que el discurso antivacunas dejó la vacunación infantil contra el covid-19 y se extendió al debate sobre la vacunación infantil para otras enfermedades. Estos cambios tienen un impacto en el discurso provacunas, que cambia para responder al movimiento antivacunación.

Hesitant and anti-vaccination groups: A qualitative study on their perceptions and attitudes regarding vaccinations and their reluctance to participate in academic research- an example during a measles outbreak among a group of Jewish parents in Israel.

Background: Vaccination is widespread in Western countries and, overall, there is a high vaccination rate. However, immunization is still an enduring challenge. In recent years, the number of parents who choose to delay or refuse vaccines has risen. Objectives: (1) to identify the perceptions and attitudes of hesitant and anti-vaccination parents regarding vaccination in general, and vaccinating their children in particular and; (2) to describe the responses of potential participants to the request to participate in academic research regarding their perceptions and attitudes on the subject of vaccines. Methods: The research employs the qualitative hermeneutic phenomenological method using two research tools: (1) in-depth interviews with 7 hesitant and 11 anti-vaccination Jewish parents in Israel; and (2) the researchers' field notes from this study process, which describe the responses of 32 potential participants to the request to participate in this academic research. Results: The main findings indicate that while most of the interviewees admit to the efficacy of vaccines in preventing diseases, they oppose the way in which vaccines are promoted-based on providing partial information and disregarding parents' concerns and questions. Therefore, they demand transparency about the efficacy and safety of vaccines. The findings also point to a paradoxical finding. On the one hand, these groups claim that health organizations do not understand their position, referring to them as "science-deniers", even though they are not. On the other hand, these parents choose to refrain from participating in scientific studies and voicing their opinions, thereby perpetuating the situation of being misunderstood. Conclusion: Hesitant and anti-vaccination groups express mistrust in academic institutions and health organizations. Therefore, an effective dialogue that would include hesitant and anti-vaccination groups, the academy, and health organizations may contribute to a better understanding of the barriers that prevent these groups from getting vaccinated or vaccinating their children and promote public health.

An Epidemic Model with Pro and Anti-vaccine Groups.

Here, an epidemiological model considering pro and anti-vaccination groups is proposed and analyzed. In this model, susceptible individuals can migrate between these two groups due to the influence of false and true news about safety and efficacy of vaccines. From this model, written as a set of three ordinary differential equations, analytical expressions for the disease-free steady state, the endemic steady state, and the basic reproduction number are derived. It is analytically shown that low vaccination rate and no influx to the pro-vaccination group have similar impacts on the long-term amount of infected individuals. Numerical simulations are performed with parameter values of the COVID-19 pandemic to illustrate the analytical results. The possible relevance of this work is discussed from a public health perspective.

Narrativas antivacinas e a crise de confiança em algumas instituições / Anti-vaccine narratives and the crisis of trust in some institutions / Narrativas antivacunas y crisis de confianza en algunas instituciones

As narrativas antivacinas vêm ganhando força ao redor do mundo e têm sido foco de preocupação de autoridades de saúde nacionais e internacionais. Este artigo tem como objetivo principal analisar as narrativas postadas em dois grupos antivacinas no Facebook publicadas em 2020, quando o mundo iniciava o enfrentamento da pandemia de covid-19. A estratégia metodológica utilizada para alcançar o objetivo e ancorar as análises é o Mapa das Mediações, de Martín-Barbero. Os resultados revelam, entre outros pontos, que as narrativas antivacinas estão, em grande parte, relacionadas com uma desconfiança em duas instituições: a ciência e o Estado. Isso permite o desdobramento de novos estudos focados no desenvolvimento de políticas públicas para o combate à desinformação sobre a saúde nos meios de comunicação.

Anti-vaccine narratives have been gaining strength around the world and have been a focus of concern of national and international health authorities. This article has as main objective to analyze the narratives posted in two anti-vaccine groups on Facebook, published in 2020, when the world was starting the fighting against the covid-19 pandemic. The methodological strategy to achieve the objective and anchor the analyzes is the Map of Mediations, produced by Martín-Barbero. The results reveal, among other points, that the antivaccine narratives are connected with a distrust in two institutions: the science and the State, allowing the development of new studies focused on public policies to combat misinformation about health in the media.

Las narrativas contra las vacunas están ganando fuerza en todo el mundo y están siendo un foco de preocupación para las autoridades sanitarias nacionales e internacionales. Este artículo tiene como objetivo principal analizar las narrativas publicadas en dos grupos antivacunas en Facebook, en 2020, cuando el mundo empezó a luchar contra la pandemia de covid-19. La estrategia metodológica utilizada para lograr el objetivo y realizar los análisis es el Mapa de las mediaciones, evidenciado por Martín-Barbero. Los resultados revelan, entre otros puntos, que las narrativas antivacuna están conectadas con la desconfianza en dos instituciones: la ciencia y el Estado, lo que permite el desarrollo de nuevos estudios enfocados en políticas públicas para combatir la desinformación sobre salud en los medios de comunicación.

El pensamiento antivacuna de Alfredo Helsby Hazell: controversias y debates a fines del siglo XIX e inicios del siglo XX en Chile / Alfredo Helsby Hazell's antivaccine view: controversies and debates at the end of the XIX century and the beginning of the XX century in Chile

Resumen El objetivo central de este artículo, es reconstruir los principales argumentos contrarios a la vacunación que circularon en Chile durante fines del siglo XIX e inicios del siglo XX. Para ello, estudiaremos la figura de Alfredo Helsby Hazell, quien fue el principal opositor que tuvo la vacuna en Chile y publicó diversos escritos en los que desarrolló y difundió sus ideas. A través de éstos, observamos que Helsby argumentó su rechazo a la vacunación a partir de la defensa del higienismo y de la desconfianza respecto de las explicaciones de carácter científico que se comenzaron a difundir a partir de la teoría de los gérmenes. Ello se articuló con la defensa de la salud como un ámbito privado de acción, criticando la intervención del Estado en dichas materias.

Abstract This article reconstructs the main arguments against vaccination that circulated in Chile during the late nineteenth and early twentieth centuries. For this purpose, we will study the figure of Alfredo Helsby Hazell, who was the primary opponent of vaccination in Chile and published several writings in which he developed and disseminated his ideas. We observe that Helsby argued his rejection of vaccination from the defence of hygienism and distrust of the scientific explanations that began to spread from the germ theory. This was articulated with the defence of health as a private sphere of action, criticizing the intervention of the State in such matters.

Anti-vaccination movements in the world and in Brazil.

Over the years, vaccinations have provided significant advances in public health, because they substantially reduce the morbimortality of vaccine-preventable diseases. Nevertheless, many people are still hesitant to be vaccinated. Brazil is a region of many anti-vaccine movements, and several outbreaks of vaccine-preventable diseases, such as yellow fever and measles, have occurred in the country during the last few years. To avoid new outbreaks, immunization coverage must be high; however, this is a great challenge to achieve due to the countless anti-vaccine movements. The World Health Organization has suggested new actions for the next decade via the Immunization Agenda 2030 to control, reduce, or eradicate vaccine-preventable diseases. Nonetheless, the vaccination coverage has decreased recently. To resolve the anti-vaccine issue, it is necessary to propose a long-term approach that involves innovative education programs on immunization and critical thinking, using different communication channels, including social media. Cooperation among biology and health scientists, ethicists, human scientists, policymakers, journalists, and civil society is essential for an in-depth understanding of the social action of vaccine refusal and planning effective education measures to increase the vaccine coverage.

Vaccine hesitation and the 'pandemic' of the unvaccined: What to do to face the new "Vaccine Revolt"? / Hesitação vacinal e a 'pandemia' dos não vacinados: o que fazer para enfrentar a nova "Revolta da Vacina"?

The frequency of people hesitating to get vaccinated is increasing worldwide and regarding the covid-19 pandemic, this phenomenon has been increasingly noticed at a national level. This article exposes a brief presentation of the historical factors of this phenomenon, approaches its main determinants and conceptual model, in addition to presenting a set of communication strategies in vaccine health that can be implemented to face this problem to raise the credibility and adherence to immunizations (AU)

A frequência da hesitação vacinal está aumentando em todo o mundo e, no contexto da pandemia da Covid-19, esse fenômeno vem sendo cada vez mais percebido no âmbito nacional. No presente trabalho, realizamos uma breve apresentação de fatores históricos desse fenômeno, abordamos seus principais determinantes e modelo conceitual, além de apresentar um conjunto de estratégias de (edu)comunicação em saúde vacinal que podem ser implementadas para enfrentamento dessa problemática com vista a elevar a credibilidade e a adesão às imunizações (AU)

Evaluation of antivaccination movement in Turkey: qualitative reports of family physicians.

Background: In Turkey, childhood vaccination rates are decreasing in the context of increasingly visible antivaccination movements. Aims: To evaluate the antivaccination movement based on communication experiences between family physicians and antivaccine parents in Turkey. Methods: We conducted 39 face-to-face in-depth interviews with family physicians in Sakarya Province who had experiences of communicating with antivaccine parents during October-December 2019. With the permission of the participants, audio recording was obtained in all interviews except one; these were transcribed verbatim and checked. A thematic approach was used to analyse the data. Results: The most common concern about vaccination was the possible side-effects, followed by the origin of the vaccines, religious concerns and distrust of vaccines. The physicians said they assumed an inquisitive, informative and anxiety-relieving attitude towards antivaccine parents.They said they were able to persuade most parents to vaccinate their children and that highly educated parents or those whose attitudes and behaviours were strongly influenced by their religious leaders were the hardest to convince. Physicians emphasized the importance of trust in increasing vaccine acceptance and noted the need to educate religious leaders and families to introduce mandatory vaccination policies. Conclusion: Parents had various reasons for refusing childhood vaccinations, however, the family physicians used persuasive methods to convince them to accept the vaccinations. Strengthening the communication and persuasive skills of health care professionals regarding vaccination may help increase acceptance of childhood vaccinations.