Attitudes toward COVID-19 vaccines during pregnancy and breastfeeding.

Background: Although vaccination is one of the most effective means of controlling the spread of COVID-19, public concerns and indecision about vaccination still continue. Because pregnant and breastfeeding individuals are at high risk for severe outcomes in case of infections, determining their level of hesitation and attitude toward COVID-19 vaccines will guide the management of the disease. This study aimed to determine pregnant and breastfeeding women's levels of hesitation and attitude toward COVID-19 vaccines as well as their related factors. Methods: The sample of this descriptive research consisted of 103 pregnant or breastfeeding individuals who were seen at the obstetrics and gynecology outpatients clinic of a state hospital in Istanbul, Turkey. The data were collected using a 'demographic data form', the 'Vaccine Hesitancy Scale in Pandemic', and the 'Attitudes toward COVID-19 Vaccine Scale'. The research data were analyzed with appropriate statistical methods. Results: The mean age of the participants was 29.71 ± 4.75, 51% were pregnant, and 74.8% had received the COVID-19 vaccine. The mean score of the 'Vaccination Hesitancy Scale in Pandemic' was 30.83 ± 6.91, and the mean score for the 'Attitude Scale toward the COVID-19 Vaccine' was 25.50 ± 5.20. A significant difference was found between the total score of the 'Vaccine Hesitation Scale in the Pandemic' and the mean score of the 'Lack of Confidence' sub-dimension between the 'working status' and the 'influenza vaccination' status. In terms of the mean score of the 'Risk' sub-dimension, a significant difference was found between the 'period of vaccination' (p < 0.05). According to the mean total score of the 'Attitude Towards COVID-19 Vaccine Scale', there was a significant difference between the 'smoking' status. There was a significant difference in the 'Positive Attitude' sub-dimension in terms of the 'flu vaccination' status. There was a significant difference in the 'Negative Attitude' sub-dimension in terms of the 'chronic disease' status. A positive correlation was found between the total scores of the scales. Conclusion: It was concluded that although the participants had a high level of hesitation toward the COVID-19 vaccine, they had a positive attitude. The results obtained will be guided in determining the strategies to be developed for these specific groups in future pandemics.

Personal rights over public Health: Anti-vaccine rhetoric in the Texas Legislature.

During the COVID-19 pandemic, there was an observed increase in anti-vaccine sentiment linked with requirements for the vaccines. But how did these ideas impact the politics of vaccines? In this paper, the authors analyze witness statements from the 2021 Texas Legislative Session during vaccine-related hearings. Specifically, the research focused on five hearings for bills that related to vaccine requirements or vaccine transparency laws filed during the 2021Texas Legislative Session and witnesses who opposed these measures. From the 128 witnesses cataloged and analyzed, we found 84 witnesses opposed to vaccines. Medical freedom and the right to opt-out of a medical procedure as well as concerns about vaccine safety and effectiveness were most frequently used by witnesses to justify their stance against vaccine requirements or vaccines. While some witnesses were opposed to all vaccines, most focused their objections on the COVID-19 vaccine specifically.

Examining the Dynamics of COVID-19 Misinformation: Social Media Trends, Vaccine Discourse, and Public Sentiment.

INTRODUCTION: COVID-19, known as coronavirus disease, has prompted a global reevaluation of societal norms. The World Health Organization (WHO) declared it a worldwide Public Health Emergency on January 30, 2020. Subsequently, governments and pharmaceutical firms developed vaccines, such as mRNA options from Pfizer and Moderna, alongside viral vector alternatives to combat the escalating COVID-19 case tally. Extensive inquiry was directed toward assessing vaccine efficiency. Nonetheless, vaccine discourse has surged across social media, prominently involving the anti-vaxxer community. This faction's hesitancy, rooted in reservations about efficacy, potential side effects, and conspiracy notions, contributes to an ongoing dialogue. OBJECTIVE: This investigation delves into social media's role in proliferating COVID-19 misinformation, utilizing tools like Python, Excel, and external resources to craft data visuals that elucidate trends influencing misinformation dissemination and its hypothetical ties to elevated COVID-19 cases. Scrutiny of Twitter trends illuminates the prevalence of the hashtag #covidvaccine, although the platform curbs anti-vaccine hashtags. RESULT: Analysis of sentiment across 207,006 tweets reveals a prevailing positive sentiment toward COVID-19 vaccines, coexisting with lingering skepticism. Google trends reflect increased anti-vaccine ideology queries, notably post-FDA vaccine approval in December 2020, indicating public doubt. CONCLUSION: While limitations encompass data granularity, geographic origins of false tweets, bot account quantification on Twitter, and comprehensive digital resources, this study pioneers reference for forthcoming investigations. Its objective is to mitigate the diffusion of misinformation.

Addressing Antivaccine Sentiment on Public Social Media Forums Through Web-Based Conversations Based on Motivational Interviewing Techniques: Observational Study.

BACKGROUND: Health misinformation shared on social media can have negative health consequences; yet, there is a dearth of field research testing interventions to address health misinformation in real time, digitally, and in situ on social media. OBJECTIVE: We describe a field study of a pilot program of "infodemiologists" trained with evidence-informed intervention techniques heavily influenced by principles of motivational interviewing. Here we provide a detailed description of the nature of infodemiologists' interventions on posts sharing misinformation about COVID-19 vaccines, present an initial evaluation framework for such field research, and use available engagement metrics to quantify the impact of these in-group messengers on the web-based threads on which they are intervening. METHODS: We monitored Facebook (Meta Platforms, Inc) profiles of news organizations marketing to 3 geographic regions (Newark, New Jersey; Chicago, Illinois; and central Texas). Between December 2020 and April 2021, infodemiologists intervened in 145 Facebook news posts that generated comments containing either false or misleading information about vaccines or overt antivaccine sentiment. Engagement (emojis plus replies) data were collected on Facebook news posts, the initial comment containing misinformation (level 1 comment), and the infodemiologist's reply (level 2 reply comment). A comparison-group evaluation design was used, with numbers of replies, emoji reactions, and engagements for level 1 comments compared with the median metrics of matched comments using the Wilcoxon signed rank test. Level 2 reply comments (intervention) were also benchmarked against the corresponding metric of matched reply comments (control) using the Wilcoxon signed rank test (paired at the level 1 comment level). Infodemiologists' level 2 reply comments (intervention) and matched reply comments (control) were further compared using 3 Poisson regression models. RESULTS: In total, 145 interventions were conducted on 132 Facebook news posts. The level 1 comments received a median of 3 replies, 3 reactions, and 7 engagements. The matched comments received a median of 1.5 (median of IQRs 3.75) engagements. Infodemiologists made 322 level 2 reply comments, precipitating 189 emoji reactions and a median of 0.5 (median of IQRs IQR 0) engagements. The matched reply comments received a median of 1 (median of IQRs 2.5) engagement. Compared to matched comments, level 1 comments received more replies, emoji reactions, and engagements. Compared to matched reply comments, level 2 reply comments received fewer and narrower ranges of replies, reactions, and engagements, except for the median comparison for replies. CONCLUSIONS: Overall, empathy-first communication strategies based on motivational interviewing garnered less engagement relative to matched controls. One possible explanation is that our interventions quieted contentious, misinformation-laden threads about vaccines on social media. This work reinforces research on accuracy nudges and cyberbullying interventions that also reduce engagement. More research leveraging field studies of real-time interventions is needed, yet data transparency by technology platforms will be essential to facilitate such experiments.

Cobertura vacinal e o movimento antivacina: o impacto na saúde pública no Brasil / Vaccination coverage and anti-vaccine movement: the impact on public health in Brazil / Cobertura de vacunación y movimiento antivacuna: el impacto en la salud pública en Brasil

A vacina constitui um dos principais métodos de prevenção contra doenças. Em 1973, o Brasil criou o Programa Nacional de Imunizações a fim de promover a imunização gratuita para a população, o que mais tarde tornou o país em referência mundial em vacinação. No entanto, a recusa vacinal ainda é um grande problema de saúde pública, sendo o movimento antivacina um dos destaques dessa realidade. Dessa forma, o objetivo deste artigo é avaliar como o movimento antivacina impacta na saúde pública no Brasil através da diminuição da cobertura vacinal. Trata-se de uma pesquisa de metodologia mista, com uma primeira etapa qualitativa, composta de uma revisão integrativa nas plataformas PubMed, LILACS e SciELO, no período de 2010 a 2020, e uma pesquisa documental em portais de movimentos antivacina; e uma segunda etapa quantitativa, em que foi realizado um estudo epidemiológico do tipo ecológico, com consulta nas bases eletrônicas do Datasus e no Sistema de Informações do Programa Nacional de Imunizações (SI-PNI), no período de 2010 a 2022. No período investigado, apenas em 2015 o Brasil alcançou a meta preconizada de cobertura vacinal, diferentemente dos anos seguintes, que apresentaram oscilações preocupantes. As publicações apresentam argumentos utilizados pelos grupos antivacina, evidenciados entre 2015 e 2019, período em que os dados de cobertura vacinal oscilaram. Assim, conclui-se que a ascensão do movimento antivacina é um dos fatores que influenciaram na queda da vacinação no Brasil, a exemplo do sarampo e da febre amarela.

The vaccine is one of the main methods of preventing diseases. Since 1973, Brazil created the National Immunization Program to ensure free immunization to the population, which later made the country a world reference in vaccination. However, vaccine refusal is still a great public health issue, and the anti-vaccine movement stand out in this reality. Thus, the purpose of this article is to evaluate how the anti-vaccine movement affects public health in Brazil with vaccination coverage reduction. This is a mixed methodology study, with first a qualitative step, composed of an integrative review in the platforms PubMed, LILACS, and SciELO, in the period from 2010 to 2020,and a documental research in portals of anti-vaccination movements; and a second quantitative step, where an epidemiological study of the ecological type was carried out, with consultation in the electronic databases of DATASUS and in the Information System of the National Immunization Program (SI-PNI) in the period of 2010 to 2022. In the investigative period, only in 2015 Brazil managed to reach the recommended vaccination coverage goal, unlike in the following years, which showed worrying fluctuations. The publications summarize arguments used by the anti-vaccination groups, evidenced between 2015 and 2019, a period in which the vaccination coverage data fluctuated. Therefore, it is clear that the rise of the anti-vaccination movement is a factor that influenced the drop in vaccination numbers in Brazil, with yellow fever and measles as examples.

La vacuna es uno de los principales métodos de prevención de enfermedades. En 1973, Brasil creó el Programa Nacional de Inmunización con el fin de promover la inmunización gratuita para la población, lo que luego convirtió al país en un referente mundial en vacunación. Sin embargo, la negativa de la vacuna sigue siendo un problema importante en la salud pública, y el movimiento antivacunas es uno de los aspectos más destacados de esta realidad. Así, el objetivo de este artículo es evaluar cómo el movimiento antivacunas impacta en la salud pública en Brasil mediante la disminución de la cobertura de vacunación. Se trata de un estudio epidemiológico mixto, con una primera etapa cualitativa, consistente en una revisión integradora en las plataformas PubMed, Lilacs y SciELO, en el período de 2010 a 2020, y una investigación documental en portales de movimientos antivacunas; y una segunda etapa cuantitativa, en la que se realizó un estudio epidemiológico de tipo ecológico, con consulta en las bases de datos electrónicas de DATASUS y en el Sistema de Información del Programa Nacional de Inmunización (SI-PNI), en el período de 2010 a 2022. Entre eses años, solo el año 2015 logró alcanzar la meta recomendada, a diferencia de los años siguientes, que mostraron fluctuaciones preocupantes en la cobertura de vacunación. Las publicaciones mostraron los argumentos utilizados por los grupos antivacina, evidenciados entre 2015 y 2019, período en que los datos de cobertura de la vacuna fluctuaron. Así, se concluye que la asunción del movimiento antivacunación es uno de los factores que influye en la caída de la vacunación en Brasil, como en el sarampión y la fiebre amarilla.

Coordinated inauthentic behavior: An innovative manipulation tactic to amplify COVID-19 anti-vaccine communication outreach via social media.

Coordinated inauthentic behavior (CIB) is a manipulative communication tactic that uses a mix of authentic, fake, and duplicated social media accounts to operate as an adversarial network (AN) across multiple social media platforms. The article aims to clarify how CIB's emerging communication tactic "secretly" exploits technology to massively harass, harm, or mislead the online debate around crucial issues for society, like the COVID-19 vaccination. CIB's manipulative operations could be one of the greatest threats to freedom of expression and democracy in our society. CIB campaigns mislead others by acting with pre-arranged exceptional similarity and "secret" operations. Previous theoretical frameworks failed to evaluate the role of CIB on vaccination attitudes and behavior. In light of recent international and interdisciplinary CIB research, this study critically analyzes the case of a COVID-19 anti-vaccine adversarial network removed from Meta at the end of 2021 for brigading. A violent and harmful attempt to tactically manipulate the COVID-19 vaccine debate in Italy, France, and Germany. The following focal issues are discussed: (1) CIB manipulative operations, (2) their extensions, and (3) challenges in CIB's identification. The article shows that CIB acts in three domains: (i) structuring inauthentic online communities, (ii) exploiting social media technology, and (iii) deceiving algorithms to extend communication outreach to unaware social media users, a matter of concern for the general audience of CIB-illiterates. Upcoming threats, open issues, and future research directions are discussed.

VACCINATION CARD: IMPORTANT INSTRUMENT TO STIMULATE THE VACCINATION AUTONOMY OF STUDENTS / CARTILLA DE VACUNACIÓN: UNA HERRAMIENTA IMPORTANTE PARA PROMOVER LA AUTONOMÍA DE VACUNACIÓN DE LOS ESTUDIANTES / CARTÃO DE VACINAÇÃO: IMPORTANTE INSTRUMENTO PARA INCENTIVAR A AUTONOMIA VACINAL DE ESTUDANTES

Due to the decrease in adherence to vaccination and strengthened by the anti-vaccination movement, world vaccination coverage is at a low level and there is a recirculation of once eradicated diseases. In Brazil, recognized for its successful campaigns to vaccinate childrenand adolescents, the valid document for measuring vaccination coverage is the vaccination card (VC). However, there is a gap between subjects and their VCs, in which deterioration and misplacement of this document are recurrent. Thus, the present study proposed the application of a didactic sequence involving aspects of vaccination, in order to stimulate the vaccinal autonomy of students in a public school. Theoretical classes were taught; exhibition of the animation "Cells at Work!"; and carried out practices with the VC of the students themselves. Among the participants, 88.24% and 82.35% showed, respectively, understanding that the cells of the immune system act through phagocytosis and the production of antibodies. 76.47% understood that vaccines provide individual and collective protection and 64.71% that the VC allows monitoring the individual's vaccination status. Among the vaccines consulted, most were vaccinated against polio, measles and Covid-19, and for this last vaccine, everyone had taken at least the first dose. Surprisingly, 78.57% stated that they had already had access to their VV, however only 28.57% had considered the information contained therein. Finally, 92.86% stated that they needed to check and update the VC and felt compelled to keep the VC in accordance with the national vaccination schedule, showing the awareness of these students' vaccinal autonomy.

Debido a la disminución de la adherencia a la vacunación y fortalecida por el movimiento antivacunación, la cobertura mundial de vacunación se encuentra en un nivel bajo y existe una recirculación de enfermedades erradicadas. En Brasil, reconocido por sus exitosas campañas de vacunación de niños y adolescentes, el documento válido para medir las coberturas de vacunación es la cartilla de vacunación (CV). El presente estudio propuso la aplicación de una secuencia didáctica que involucra aspectos de vacunación, con el fin de estimular la autonomía vacunal de los alumnos. Se impartieron clases teóricas; se mostró la animación "Cells at Work!"; y las prácticas se realizaron con las CVs de los propios alumnos. Entre los participantes, el 88,24% y el 82,35% mostraron, respectivamente, comprender que las células inmunitarias actúan por fagocitosis y la producción de anticuerpos. El 76,47% entendió que las vacunas brindan protección individual y colectiva y el 64,71% que la CV permite monitorear el estado vacunal del individuo. Entre las vacunas, la mayoría estaban vacunadas contra la poliomielitis, el sarampión y el Covid-19 (en las que todos habían tomado al menos la primera dosis). Sorprendentemente, el 78,57% afirmó que ya había tenido acceso a su CV, sin embargo, solo el 28,57% había considerado la información contenida en la CV. Finalmente, el 92,86% afirmó que necesitaba revisar y actualizar la CV y se sintió obligado a mantener la CV de acuerdo con el calendario nacional de vacunación, lo que demuestra la conciencia de la autonomía vacunal de estos estudiantes.

Devido à diminuição da adesão à vacinação e fortalecidos pelo movimento antivacina, a cobertura vacinal mundial encontra-se em baixa e observa-se a recirculação de doenças outrora erradicadas. No Brasil, reconhecido por suas campanhas bem-sucedidas para vacinação de crianças e adolescentes, o documento válido para aferimento da cobertura vacinal é o cartão de vacinação (CV). Todavia, observa-se um distanciamento entre sujeitos e seus CVs, em que deterioração e extravios desse documento são recorrentes. Assim, o presente estudo propôs a aplicação de uma sequência didática envolvendo aspectos da vacinação, a fim de estimular a autonomia vacinal de estudantes de uma escola pública. Foram lecionadas aulas teóricas; exibidos episódios da animação "Cells at Work!"; e realizadas práticas com CVs dos próprios estudantes. Dentre os participantes, 88,24% e 82,35% mostraram, respectivamente, compreender que as células do sistema imunológico atuam por meio da fagocitose e da produção de anticorpos. 76,47% compreenderam que as vacinas conferem proteção individual e coletiva e 64,71% que o CV permite acompanhar o estado vacinal do indivíduo. Dentre as vacinas consultadas, a maioria era vacinada contra poliomielite, sarampo e Covid-19, sendo que para essa última vacina, todos haviam tomado pelo menos a primeira dose. Surpreendentemente, 78,57% afirmaram que já tinham tido acesso a seu CV, entretanto apenas 28,57% havia atentado às informações ali contidas. Por fim, 92,86% afirmaram que necessitam checar e atualizar o CV bem como se sentem impelidos a manter o CV em acordo com o calendário nacional de vacinação, evidenciando o despertar quanto à autonomia vacinal desses estudantes.

Effects of the COVID-19 Pandemic on the Decision and Doubts About Vaccination in Catalonia: Online Cross-sectional Questionnaire.

BACKGROUND: Hesitancy to get vaccinated during the COVID-19 pandemic may decrease vaccination coverage and facilitate the occurrence of local or global outbreaks. OBJECTIVE: The objective of this study was to analyze the impact of the COVID-19 pandemic in Catalonia on 3 aspects: the decision to get vaccinated against COVID-19, changes in opinion about vaccination in general, and the decision to get vaccinated against other diseases. METHODS: We performed an observational study with the population of Catalonia aged 18 years or over, obtaining information through a self-completed questionnaire in electronic format. Differences between groups were determined using the chi-square test, Mann-Whitney U test, or the Student t test. RESULTS: We analyzed the answers from 1188 respondents, of which 870 were women, 47.0% (558/1187) had sons or daughters under the age of 14 years, and 71.7% (852/1188) had studied at university. Regarding vaccination, 16.3% (193/1187) stated that they had refused a vaccine on some occasion, 76.3% (907/1188) totally agreed with vaccines, 1.9% (23/1188) were indifferent, and 3.5% (41/1188) and 1.2% (14/1188) slightly or totally disagreed with vaccination, respectively. As a result of the pandemic, 90.8% (1069/1177) stated that they would get vaccinated against COVID-19 when they are asked, while 9.2% (108/1177) stated the opposite. A greater intention to get vaccinated was observed among women; people older than 50 years; people without children under 15 years of age; people with beliefs, culture, or family in favor of vaccination; respondents who had not previously rejected other vaccines, were totally in favor of vaccines, or had not increased their doubts about vaccination; and respondents who had not changed their decision about vaccines as a result of the pandemic. Finally, 30.3% (359/1183) reported an increase in their doubts regarding vaccination, and 13.0% (154/1182) stated that they had changed their decision about routinely recommended vaccines as a result of the pandemic. CONCLUSIONS: The population studied was predominantly in favor of vaccination; however, the percentage of people specifically rejecting vaccination against COVID-19 was high. As a result of the pandemic, we detected an increase in doubts about vaccines. Although the final decision about vaccination did not primarily change, some of the respondents did change their opinion about routine vaccinations. This seed of doubt about vaccines may be worrisome as we aim to maintain high vaccination coverage.

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.

Accuracy-sensitisation promotes the sharing of pro- (but not anti-) vaccine information.

OBJECTIVE: This study investigated (i) factors predicting the seeking and sharing of vaccinerelated information, and (ii) the effect of an accuracy-sensitisation prime on sharing intentions. Design:This was a preregistered online survey with 213 participants. Participants were randomly assigned to an intervention group (who were exposed to an accuracy-sensitisation prime) or a control group. DESIGN: This was a preregistered online survey with 213 participants. Participants were randomly assigned to an intervention group (who were exposed to an accuracy-sensitisation prime) or a control group. MAIN OUTCOME MEASURES: Measures included decision-making style, COVID-19 anxiety, and percentages of pro and anti-vaccine friends. We also measured preferences to seek pro or anti-vaccine-related information and sharing intentions with respect to this information. RESULTS: Compared with those seeking both pro and anti-vaccine information, participants seeking only pro-vaccine information had lower hypervigilance and buck-passing and higher COVID-19 anxiety. The likelihood of sharing anti-vaccine information was positively predicted by the percentage of one's anti-vaccine friends, the size of one's social network, and conservative political orientation. Conversely, the likelihood of sharing pro-vaccine information was positively predicted by the percentage of one's pro-vaccine friends, and liberal political orientation. Participants sensitised to accuracy were significantly more likely to share provaccine information; however, accuracy-sensitisation had no effect on anti-vaccine information sharing. CONCLUSIONS: Individuals who seek anti-vaccine information have a tendency towards disorganised and impulsive decision-making. Accuracy-sensitisation may prime people to internalise a norm promoting truth-sharing.

The Prevalence, Features, Influencing Factors, and Solutions for COVID-19 Vaccine Misinformation: Systematic Review.

BACKGROUND: During the COVID-19 pandemic, infodemic spread even more rapidly than the pandemic itself. The COVID-19 vaccine hesitancy has been prevalent worldwide and hindered pandemic exiting strategies. Misinformation around COVID-19 vaccines is a vital contributor to vaccine hesitancy. However, no evidence systematically summarized COVID-19 vaccine misinformation. OBJECTIVE: This review aims to synthesize the global evidence on misinformation related to COVID-19 vaccines, including its prevalence, features, influencing factors, impacts, and solutions for combating misinformation. METHODS: We performed a systematic review by searching 5 peer-reviewed databases (PubMed, Embase, Web of Science, Scopus, and EBSCO). We included original articles that investigated misinformation related to COVID-19 vaccines and were published in English from January 1, 2020, to August 18, 2022. We excluded publications that did not cover or focus on COVID-19 vaccine misinformation. The Appraisal tool for Cross-Sectional Studies, version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2), and Critical Appraisal Skills Programme Checklist were used to assess the study quality. The review was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and registered with PROSPERO (CRD42021288929). RESULTS: Of the 8864 studies identified, 91 observational studies and 11 interventional studies met the inclusion criteria. Misinformation around COVID-19 vaccines covered conspiracy, concerns on vaccine safety and efficacy, no need for vaccines, morality, liberty, and humor. Conspiracy and safety concerns were the most prevalent misinformation. There was a great variation in misinformation prevalence, noted among 2.5%-55.4% in the general population and 6.0%-96.7% in the antivaccine/vaccine hesitant groups from survey-based studies, and in 0.1%-41.3% on general online data and 0.5%-56% on antivaccine/vaccine hesitant data from internet-based studies. Younger age, lower education and economic status, right-wing and conservative ideology, and having psychological problems enhanced beliefs in misinformation. The content, format, and source of misinformation influenced its spread. A 5-step framework was proposed to address vaccine-related misinformation, including identifying misinformation, regulating producers and distributors, cutting production and distribution, supporting target audiences, and disseminating trustworthy information. The debunking messages/videos were found to be effective in several experimental studies. CONCLUSIONS: Our review provides comprehensive and up-to-date evidence on COVID-19 vaccine misinformation and helps responses to vaccine infodemic in future pandemics. TRIAL REGISTRATION: PROSPERO CRD42021288929; https://tinyurl.com/2prejtfa.

The evil corporation master frame: The cases of vaccines and genetic modification.

Employing a qualitative content analysis of online comments made on YouTube and letters to the editor published in US newspapers, we examine the deployment and neutralization of the evil corporation master frame in debates on two distinct biotechnologies, vaccines and genetically modified organisms. This study builds on previous research by outlining three diagnostic components of the evil corporation master frame: dishonesty, greed, and the contamination of authority. It also finds that supporters of vaccines and genetically modified organisms seek to neutralize the evil corporation master frame through aggressive, defensive, endurance, and redemptive framings. This study provides ideational detail for the ways that controversial biotechnology is constructed. The particularly vexing anti-vaccine movement is not dissimilar from other challenges to mainstream science as disparate movements draw on the same master frame. It also demonstrates how defenses of genetically modified organisms and vaccines tend to reify the anti-corporate stigma that sustains challenges to scientific authority.

Prediction and reasons for COVID-19 second dose vaccine hesitation: a cross-sectional study in a municipality of Brazil

ABSTRACT BACKGROUND: Hesitation and refusal to take a second dose of the vaccine for coronavirus disease 19 (COVID-19) are prevalent. OBJECTIVES: We aimed to identify predictive factors for hesitation or refusal and describe groups with higher rates of vaccine hesitancy. DESIGN AND SETTING: A cross-sectional study in Assis City, Brazil. METHODS: The study included adults who passed the due date for taking the COVID-19 second dose vaccine. Participants were recruited in December 2021 using a mobile-based text message. Sociodemographic and clinical data and reasons for hesitance were collected. The outcome was the attitude towards completing the recommended second dose of the vaccine. Bivariate and multivariate Poisson analyses were performed to determine the adjusted predictors. RESULTS: Participants between 30-44 years of age had a 2.41 times higher prevalence of hesitation than those aged 18-29 years. In addition, people who had adverse events or previously had COVID-19 had 4.7 and 5.4 times higher prevalences of hesitation, respectively (P value < 0.05). CONCLUSION: We found a significant group of adults aged between 30-44 years who refused the second dose of the COVID-19 vaccine. Furthermore, those who reported adverse effects after the first dose and those who had COVID-19 previously were a significant group for refusal.

Correlation between Parental Vaccine Hesitancy, Socio-demographic Factors, and Novel SARS-CoV-2 Vaccination in Puerto Rico.

OBJECTIVE: Accurate and inaccurate vaccination information is readily accessible. Unfortunately, the information found by parents may be wrong. Due to the limited studies on this issue in Puerto Rico, we aim to correlate Puerto Rican parents' sociodemographic characteristics to their vaccine hesitancy level. METHODS: We quantified vaccine hesitancy in Puerto Rican parents and legal guardians who were at least 18 years old using the Parent Attitudes about Childhood Vaccines survey, their attitudes towards a possible SARS-CoV-2 vaccine, and the correlation between vaccine hesitancy and socio-demographic factors. The subjects were recruited through social networks and by distributing the online survey among pediatricians in Puerto Rico. RESULTS: We identified a vaccine hesitancy prevalence of 38.3%, higher than has been found by other similar studies. The results also demonstrated a significant association between vaccine hesitancy, income, and the type of legal guardian. Participants with a household income less than $75,000 and a legal guardian were more likely to be vaccine-hesitant. Most participants surveyed (80.8%) would not immediately vaccinate their children against SARS-CoV-2, independent of vaccine-hesitancy status, citing general worries of vaccine safety and side effects. CONCLUSION: Our results demonstrate the need for better vaccine-education campaigns in Puerto Rico and the challenges that SARS- CoV-2 vaccine fears pose to the proper control of the COVID-19 pandemic. It should be noted that at the time of the survey described herein, a COVID-19 vaccine had yet been developed.

Vaccine Hesitancy: Contemporary Issues and Historical Background.

Vaccination, despite being recognized as one of the most effective primary public health measures, is viewed as unsafe and unnecessary by an increasing number of individuals. Anxiety about vaccines and vaccination programs leading to vaccine hesitancy results from a complex mix of social and political influences, cultural and religious beliefs, the availability of and ability to interpret health and scientific information, and personal and population experiences of health systems and government policies. Vaccine hesitancy is becoming a serious threat to vaccination programs, and was identified as one of the World Health Organization's top ten global health threats in 2019. The negative impact of anti-vaccination movements is frequently cited as one of the major reasons for rising vaccine hesitancy amongst the general public world-wide. This review discusses the various issues surrounding vaccine hesitancy and the anti-vaccine movement, starting with the definitions of vaccine hesitancy and the anti-vaccine movement in their early history and in the modern era, before discussing the key drivers of vaccine hesitancy, particularly across different regions of the world, with a focus on various countries with low-, middle-, or high-income economies with different socio-economic populations. The review concludes with the impact of vaccine hesitancy on herd immunity and social, psychological, and public health measures to counter vaccine hesitancy.

Adherencia a la campaña de vacunación de la gripe 2020/21 en el contexto de la pandemia de SARS-CoV-2. Análisis de los cambios en la gestión: un estudio piloto / Adherence to influenza vaccination campaign 2020/21 in the pandemic SARS-CoV-2. Context analysis in management changes: A pilot study

Introducción Las campañas de vacunación contra la gripe alcanzan coberturas por debajo de lo deseado y recomendado. Lo que en el contexto actual de pandemia por SARS-CoV-2 cobra mayor relevancia. Nuestro objetivo consiste en evaluar el impacto en la cobertura vacunal alcanzada de una serie de estrategias de implementación vacunal llevadas a cabo. Material y métodos Se introdujo una serie de estrategias de implementación de la vacunación en nuestra zona básica de salud como la captación activa y la ampliación horaria entre otras, se evaluó y comparó la cobertura vacunal alcanzada en la campaña actual con las previas, tanto a las 8 semanas como al final de la campaña. Además, se llevó a cabo un estudio transversal mediante una encuesta para valorar el impacto que habían tenido las medidas. Resultados En la semana 8 de la campaña detectamos diferencias significativas en cuanto al incremento de la cobertura vacunal alcanzada respecto a años previos, resultado que se confirmó al finalizar la campaña alcanzándose diferencias significativas (p<0,05) de cobertura vacunal en todos los centros estudiados, datos que fueron a favor de la efectividad de las estrategias empleadas. Conclusiones Las estrategias de implementación vacunal empleadas se han mostrado efectivas, logrando un incremento de hasta un 74% en las dosis totales administradas respecto a campañas previas y de hasta un 15% en la cobertura vacunal alcanzada en mayores de 64 años; pese al contexto de pandemia y al aumento de los movimientos antivacunas (AU)

Introduction Vaccination campaigns against influenza virus achieve coverages under recommended and desired values. In current context of SARS-CoV-2 pandemic it becomes more relevant. Our objective is to evaluate the impact on vaccination coverage of a set of implementation strategies carried out. Material and method Vaccine implementation strategies were introduced in our basic health zone as active caption of patients and schedule extension. Then the vaccination coverage achieved in the current campaign was evaluated and compared with previous in the 8th week and at the end of the campaign. Besides, a transversal study through a survey was carried out to measure the impact of the applied strategies. Result In the 8th week of the campaign significant differences were detected in the increase of vaccination coverage compared with previous years. These results were confirmed at the end of the campaign, getting a significant difference (<.05) of vaccination coverage in all the studied centers, these data support the effectivity of the applied strategies. Conclusions The vaccine implementation strategies applied have shown effectivity, achieving an increase of until 74% in the total administered doses compared to previous campaigns and even a 15% of vaccination coverage increased in the group of patients older than 64 years; even in a pandemic context and the increasing of anti-vaccine movements (AU)

The Mediating Roles of Attitude Toward COVID-19 Vaccination, Trust in Science and Trust in Government in the Relationship Between Anti-vaccine Conspiracy Beliefs and Vaccination Intention.

Since the outbreak of COVID-19, many conspiracy theories have spread widely, which has the potential to reduce adherence to recommended preventive measures. Specifically, anti-vaccine conspiracy beliefs can have a strong negative impact on COVID-19 vaccination attitude and intention. The present study aimed to clarify how such beliefs can reduce vaccination intention, exploring the possible mediating roles of attitude toward vaccination, trust in science, and trust in government, among a sample of 822 unvaccinated Italian adults (Women = 67.4%; M age = 38.1). Path analysis showed that anti-vaccine conspiracy beliefs influenced intention to get vaccinated both directly and indirectly through the mediating effects of attitude, trust in science, and trust in government. In particular, the simple mediating effect of attitude was the strongest one, followed by the serial mediating effect of trust in science and attitude itself. Findings provide insights into the design of interventions aimed at reducing misinformation and subsequent vaccine hesitancy.

Viruela: de la primera vacuna al nacimiento del primer movimiento antivacunas / Smallpox: from the first vaccine to the birth of the first anti-vaccine movement

El último caso de viruela, la peor plaga que ha enfrentado la humanidad, fue diagnosticado hace 45 años y con él la enfermedad fue erradicada del planeta. Una hazaña épica iniciada a finales del siglo XVIII por Edward Jenner, el hombre que inoculó a su propio hijo con el pus de las lesiones de una ordeñadora que sufría viruela bovina, una enfermedad benigna antigénicamente relacionada con la viruela y que le confería inmunidad. Pocos años más tarde, en 1803, partía de España la "Real expedición filantrópica de la vacuna", llevando la vacuna a América y Asia, transportándola de brazo en brazo. A pesar del éxito de la vacuna, Jenner y la sociedad victoriana sufrieron los primeros movimientos antivacunas que hoy, en el contexto de la pandemia del COVID-19, son catapultados por los sitios de noticias falsas que socaban el conocimiento científico.

The last case of smallpox, the worst plague that humanity has faced, was diagnosed 45 years ago, marking the end of this disease in our world. It is a fascinating story that started in the late 18th century with a man called Edward Jenner. He made a name for himself by inoculating his son with the secretion of pus from the hand of a milkmaid sick with cowpox, a benign disease antigenically related to smallpox, and his inoculum conferred immunity. A few years later, in 1803, the "Royal Philanthropic Vaccine Expedition" left Spain, carrying the vaccine to the Americas and the Orient and passing the inoculum from arm to arm. Despite the vaccine's success, Jenner and Victorian society found themselves up against the first anti-vaccine backlash. In today's COVID-19 pandemic, these movements are now being super-charged by fake news websites, undermining scientific knowledge.

Anti-Vaccine Attitudes among Adults in the U.S. during the COVID-19 Pandemic after Vaccine Rollout.

Even though vaccination is the most effective measure against COVID-19 infections, vaccine rollout efforts have been hampered by growing anti-vaccine attitudes. Based on current knowledge, we identified three domains (beliefs, discrimination, and news) as our correlates of primary interest to examine the association with anti-vaccine attitudes. This is one of the first studies to examine key correlates of anti-vaccine attitudes during the critical early stages of vaccine implementation in the United States. An online survey was administered in May 2021 to a non-representative, nationally based sample of adults (N = 789). Using multivariable logistic regression analysis, we found that individuals who expressed worry about COVID-19 (OR = 0.34, 95% CI 0.21, 0.55) and had greater knowledge of COVID-19 (OR = 0.50, 95% CI 0.25, 0.99) were less likely to hold anti-vaccine attitudes. Conversely, individuals who held stigmatizing views of COVID-19 (OR = 2.47, 95% CI 1.53, 3.99), had experienced racial discrimination (OR = 2.14, 95% CI 1.25, 3.67) and discrimination related to COVID-19 (OR = 2.84, 95% CI 1.54, 5.24), and who had been watching Fox News (OR = 3.95, 95% CI 2.61, 5.97) were more likely to hold anti-vaccine attitudes. These findings suggest COVID-19 beliefs, experiences of discrimination, and news sources should be considered when designing targeted approaches to address the anti-vaccine movement.