Confronting the evolution and expansion of anti-vaccine activism in the USA in the COVID-19 era

Peer education as a strategy to promote vaccine acceptance: A randomized controlled trial within New York community healthcare practices

BACKGROUND

Effective strategies are needed to improve vaccine acceptance. This study sought to determine if a peer-led vaccine education intervention embedded within community medical practices increases parental acceptance of pediatric pneumococcal conjugate vaccination.

METHODS

From March 2022-July 2023, we conducted a randomized trial at three pediatric health practices in predominantly Hasidic Jewish neighborhoods in New York, where vaccine deferral is common. Parents of children up to 18 months due/overdue for routine pneumococcal vaccination were randomized (1:1) to receive routine care alone or routine care plus a peer educational intervention. Peer educators trained in motivational interviewing and vaccine science provided counseling at enrollment and follow-up telephone engagement in the intervention arm at day 30 and 60. Primary outcome was child's pneumococcal immunization status by allocation arm expressed as at least one dose received between enrollment and 90 days post-enrollment.

RESULTS

144 parent-child dyads were eligible for outcome analysis. Participants in the group receiving routine care along with peer-led vaccine counseling were significantly more likely to have their child receive at least 1 vaccine dose between enrollment and 90 days compared to the group who received routine care alone (28.4 % vs 12.9 %, risk ratio [RR] 2.21, confidence interval [CI] 1.09-4.49, p = 0.022). The effect of peer education was greatest in dyads with children less than 1 year old at enrollment (34 % vs 12.7 %, RR 2.67, CI (1.22-5.86), p = 0.009).

CONCLUSIONS

Peer vaccine education can increase vaccine acceptance compared to routine care alone and may be particularly valuable in decreasing vaccination delays for younger infants. (Funded by EGL Charitable Foundation, ClinicalTrials.gov NCT05875779).

School-Entry Vaccine Policies: States' Responses To Federal Recommendations Varied From Swift To Substantially Delayed

School-entry immunization requirements are a valuable strategy to reduce the spread of vaccine-preventable diseases. This research examined the temporal relationship between recommendations issued by the federal Advisory Committee on Immunization Practices (ACIP) and corresponding school-entry requirements adopted by states for adolescent meningococcal ACWY (MenACWY) and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines. A legal epidemiological review of statutes, regulations, and state agency guidance identified school-entry policies across fifty states and Washington, D.C. Researchers measured the number of months between the date of an ACIP recommendation and the effective dates for state policies that were in place through the 2023-24 school year. All fifty-one jurisdictions had school-entry requirement policies for Tdap vaccination, and thirty-six had school-entry requirements for MenACWY vaccination. The average period between ACIP's recommendations and state policy adoption was 4.94, 9.61, and 8.24 years for Tdap and for MenACWY first and booster doses, respectively. This analysis found diverse timelines and notable delays for both Tdap and MenACWY school-entry requirement policies. This heterogeneity and patchwork of state requirements underscores the need for ACIP to evaluate the role of these policies in reducing vaccine-preventable diseases across the United States.

Quantifiable Cross-cultural Research on Medical Mistrust is Necessary for Effective and Equitable Vaccination in Low- and Middle-income Countries

Perceptions of healthcare personnel and institutions substantially impact healthcare behaviors. In the US, minority experiences with racist events like the Tuskegee study, alongside everyday experiences of marginalization and discrimination, drive medical mistrust in populations that are already burdened with health inequalities. However, the concept of medical mistrust is rarely applied outside of industrialized contexts. Histories of colonialism, underfunded healthcare institutions, and the enormous cultural and ethnolinguistic diversity present in low- and middle-income countries (LMICs) make medical mistrust a likely contributor to health behavior in these contexts. In the era of COVID-19 and emergent malaria vaccines, there is an urgent need to mitigate factors leading to medical mistrust, which impedes interest in novel vaccines. Doing so requires substantial investment in research that examines the causes of medical mistrust across diverse communities, develops methodological tools that can effectively measure medical mistrust across diverse cultural and ethno-linguistic contexts, and applies this data to policy and public health messaging. This commentary highlights the role of medical mistrust in vaccination and argues for its utility in addressing vaccine decision-making in LMICs.

Panic in the Pandemic: Determinants of Vaccine Hesitancy and the Dilemma of Public Health Information Sharing during the COVID-19 Pandemic in Sri Lanka

Vaccine hesitancy, a pressing global challenge in vaccination programs, was significantly amplified during the COVID-19 pandemic. The proliferation of misinformation, including false claims and rumours, and the influence of anti-vaccine movements fuelled hesitancy. This study aims to explore the socio-economic determinants that influenced vaccine hesitancy and the impact of public health information sharing in Sri Lanka during the pandemic. The study employed a comprehensive mixed-method approach for data collection, administrating a household survey (n = 3330) and 206 semi-structured interviews. The survey results indicated that 37.8% (n = 3113) of respondents delayed or rejected vaccines for various reasons, the leading cause being the fear of side effects of the vaccine. Although fear of side effects was the prime reason for rejection (n = 1176, 46.29%), respondents demonstrated an extremely poor understanding of the potential side effects of vaccines, which was 55.39% (n = 3113). Notably, 84.60% (n = 3113) were unaware of the vaccine development process. Multivariate logistic regression analysis showed that middle-income people (AOR-0.42) and females (0.65) were less likely not to make decisions based on scientific information compared to underprivileged people and males. The survey also revealed that strong belief in the use of traditional medicines and remedies and religious beliefs (n = 1176, 3.95%) were among the main reasons for hesitancy. The findings illustrate that misinformation, lack of health knowledge, and lack of understanding to seek scientific information have fuelled vaccine hesitancy in Sri Lanka.

"I Thought It Was Better to Be Safe Than Sorry": Factors Influencing Parental Decisions on HPV and Other Adolescent Vaccinations for Students with Intellectual Disability and/or Autism in New South Wales, Australia

The uptake of human papilloma virus (HPV) and other adolescent vaccinations in special schools for young people with disability is significantly lower than in mainstream settings. This study explored the factors believed to influence parental decision making regarding vaccine uptake for students with intellectual disability and/or on the autism spectrum attending special schools in New South Wales, Australia, from the perspective of all stakeholders involved in the program. Focus groups and interviews were conducted with 40 participants, including parents, school staff, and immunisation providers. The thematic analysis identified two themes: (1) appreciating diverse parental attitudes towards vaccination and (2) educating parents and managing vaccination questions and concerns. While most parents were described as pro-vaccination, others were anti-vaccination or vaccination-hesitant, articulating a marked protectiveness regarding their child's health. Reasons for vaccine hesitancy included beliefs that vaccines cause autism, concerns that the vaccination may be traumatic for the child, vaccination fatigue following COVID-19, and assumptions that children with disability will not be sexually active. Special school staff regarded the vaccination information pack as inadequate for families, and nurses described limited educational impact resulting from minimal direct communication with parents. More effective communication strategies are needed to address vaccine hesitancy among parents with children with disability.

Vaccine Science Diplomacy and "The Phenomenon of Man"

The central tenets of international scientific collaborations leading to the development, testing, and the equitable distribution vaccines to combat poliomyelitis, smallpox, COVID-19, and other devasting infections, first accelerated in the mid-twentieth century. The genesis of vaccine science diplomacy also coincides with the publication of Le Phénomène Humain (The Phenomenon of Man) shortly after the death of its author, the French Jesuit priest and scientist, Dr. Teilhard de Jardin. Several tenets of Teilhard's posthumous essay, including our collective consciousness, and the "conjugated faces" of science and religion, are relevant to a modern vaccine diplomacy framework, even if Teilhard may not have specifically addressed vaccines in his writings. This could also include the potential for arriving at an "omega point" through international scientific collaboration and joint vaccine development, while simultaneously avoiding the destructive forces of anti-vaccine or anti-science activism. Collaborations between the Vatican, Catholic research universities and institutions; and leaders of the Catholic-majority nations in Africa, Asia, and Latin America in an integrated framework might accelerate these activities as they apply to both pandemic threats and neglected diseases of poverty.

"Do not inject our babies": a social listening analysis of public opinion about authorizing pediatric COVID-19 vaccines

Designing effective childhood vaccination counseling guidelines, public health campaigns, and school-entry mandates requires a nuanced understanding of the information ecology in which parents make vaccination decisions. However, evidence is lacking on how best to "catch the signal" about the public's attitudes, beliefs, and misperceptions. In this study, we characterize public sentiment and discourse about vaccinating children against SARS-CoV-2 with mRNA vaccines to identify prevalent concerns about the vaccine and to understand anti-vaccine rhetorical strategies. We applied computational topic modeling to 149 897 comments submitted to regulations.gov in October 2021 and February 2022 regarding the Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee's emergency use authorization of the COVID-19 vaccines for children. We used a latent Dirichlet allocation topic modeling algorithm to generate topics and then used iterative thematic and discursive analysis to identify relevant domains, themes, and rhetorical strategies. Three domains emerged: (1) specific concerns about the COVID-19 vaccines; (2) foundational beliefs shaping vaccine attitudes; and (3) rhetorical strategies deployed in anti-vaccine arguments. Computational social listening approaches can contribute to misinformation surveillance and evidence-based guidelines for vaccine counseling and public health promotion campaigns.

Vaccine Confidence as Critical to Pandemic Preparedness and Response

Vaccine confidence is a belief that vaccines work, are safe, and are part of a trustworthy medical system. The COVID-19 pandemic exposed the fragility of the public's confidence in vaccines and the vaccine enterprise, limiting the public health impact of vaccination. In this review, we examine the critical nature of vaccine confidence to pandemic preparedness and response.

Systematic documentation of the introduction of COVID-19 vaccines in Latin America and the Caribbean

Objective

To document the process of introducing COVID-19 vaccines in a selection of Latin American and Caribbean countries, including the lessons learned and the strengths and weaknesses, and similarities and differences among programs.

Methods

This descriptive study is based on a systematic evaluation of the process of introducing COVID-19 vaccines in Argentina, Belize, Brazil, Costa Rica, Panama and Peru. Data were collected through a questionnaire distributed to key stakeholders. Six informants from each of the included countries participated in this study. The period of the study was from December 2021 through September 2022.

Results

The main strengths reported by countries were health workers' commitment to delivering vaccinations, evidence-based decision-making, the development of plans for vaccine introduction, the participation of national immunization technical advisory groups, the availability of economic resources and positive actions from the respective Ministry of Health. The main challenges were the actions of antivaccination groups, problems with electronic immunization registries, a lack of vaccines, delays in the delivery of vaccines and the scarcity of health personnel at the local level.

Conclusions

Commitment, the participation of multiple sectors, the availability of resources and preparedness planning were some of the many strengths shown by countries introducing COVID-19 vaccines. Weaknesses included third parties' interests, the lack of information systems and difficulty in accessing vaccines and vaccine services. There is a window of opportunity for countries to maintain the good practices that allowed for the processes' strengths and to assess the identified weaknesses to invigorate immunization programs and prepare for future health crises.

Vaccination against COVID-19: the view of Brazilian federal judges

The aim was to analyze the perception of Brazilian federal judges on the implications of COVID-19 vaccination. A study was carried out with Brazilian federal judges, who received a survey designed with multiple-choice questions on COVID-19 vaccination, covering topics such as its mandatory aspect, the application of coercive measures, hesitation to vaccinate, priority groups, the duties of Brazilian Health Regulatory Agency (Anvisa, acronym in Portuguese), the role of the Judiciary branch, and immunity passports. A total of 254 out of 1,300 federal judges from all states responded to the survey. Most respondents have a Bachelor's degree or a specialization (59.1%) and have been judges for more than 10 years (63.8%). A great majority of the judges (87.7%) agree with vaccine mandates for adults and for children and adolescents (66.1%). Over 75% of judges believe that all levels of government can impose sanctions on those who refuse to get vaccinated. The judges trust vaccination 93% of the time, 56.1% reject anti-vaccination movements, and 75.2% believe that Anvisa duties should be respected. The Judiciary branch actions concerning the COVID-19 pandemic are approved by 62.6% of judges, and 88.2% support immunity passports. There is a direct connection among mandatory vaccination, trust in the vaccine, and the adoption of immunity passports. Most federal judges agree with vaccine mandates for children and adults, support the application of sanctions for vaccination refusal, disapprove of anti-vaccination movements, agree with Anvisa's duties, and support judicial intervention in relation to the COVID-19 pandemic.

Ivermectin for treatment of COVID-19: A systematic review and meta-analysis

The effect of ivermectin (IVM) in treating coronavirus disease 2019 (COVID-19) is still controversial, yet the drug has been widely used in the world. The aim of this review was to systematically evaluate the clinical outcomes of IVM in patients with COVID-19. From inception to June 22, 2023, the PubMed, EMBASE, Web of Science (WOS), and scopus databases were searched for relevant observational studies on the risk of RA in migraineurs. We searched PubMed/Medline, EMBASE, the Cochrane Library, Web of Science, medRxiv, and bioRxiv to collect all relevant publications from inception to June 22, 2023. Primary outcomes were all-cause mortality rate, mechanical ventilation (MV) requirement, PCR negative conversion, and adverse events (AEs). Revman 5.4 was used to assess the risk of bias (RoB) and quality of evidence. Thirty-three RCTs (n = 10,489) were included. No significant difference in all-cause mortality rates or PCR negative conversion between IVM and controls. There were significant differences in MV requirement (RR 0.67, 95% CI 0.47-0.96) and AEs (RR 0.87, 95% CI 0.80-0.95) between the two groups. Ivermectin could reduce the risk of MV requirement and AEs in patients with COVID-19, without increasing other risks. In the absence of a better alternative, clinicians could use it with caution.

COVID Vaccine Hesitancy and Long-Term Traffic Risks

BACKGROUND

COVID vaccine hesitancy identifies a discrepancy between personal decisions and public guidelines. We tested whether COVID vaccine hesitancy was associated with the long-term risks of a traffic crash.

METHODS

We conducted a population-based longitudinal cohort analysis of adults by determining COVID vaccination status through linkages to electronic medical records. Traffic crashes requiring emergency medical care were defined by multicenter outcome ascertainment of all hospitals throughout the region over the subsequent year.

RESULTS

We identified 11,598,549 total individuals, of whom 1,210,754 had not received a COVID vaccine. A total of 54,558 were subsequently injured in traffic crashes during the 1-year follow-up interval, equal to a risk of 4704 per million. Those who had not received a COVID vaccine had a 58% higher risk than those who had received a COVID vaccine (6983 vs 4438 per million, P < .001). The increased traffic risks among unvaccinated individuals included diverse subgroups, were accentuated for single-vehicle crashes, extended to fatal outcomes, exceeded the risks associated with sleep apnea, and persisted after adjustment for baseline characteristics. The increased risks were validated in analyses using Artificial Intelligence techniques and generally larger than the risks of other adverse events frequently ascribed to COVID vaccination.

CONCLUSIONS

COVID vaccine hesitancy is associated with significant increased long-term risks of a traffic crash. A greater awareness of traffic risks might encourage patients to take protective actions for personal safety.

Perceived experts are prevalent and influential within an antivaccine community on Twitter

Perceived experts (i.e. medical professionals and biomedical scientists) are trusted sources of medical information who are especially effective at encouraging vaccine uptake. The role of perceived experts acting as potential antivaccine influencers has not been characterized systematically. We describe the prevalence and importance of antivaccine perceived experts by constructing a coengagement network of 7,720 accounts based on a Twitter data set containing over 4.2 million posts from April 2021. The coengagement network primarily broke into two large communities that differed in their stance toward COVID-19 vaccines, and misinformation was predominantly shared by the antivaccine community. Perceived experts had a sizable presence across the coengagement network, including within the antivaccine community where they were 9.8% of individual, English-language users. Perceived experts within the antivaccine community shared low-quality (misinformation) sources at similar rates and academic sources at higher rates compared to perceived nonexperts in that community. Perceived experts occupied important network positions as central antivaccine users and bridges between the antivaccine and provaccine communities. Using propensity score matching, we found that perceived expertise brought an influence boost, as perceived experts were significantly more likely to receive likes and retweets in both the antivaccine and provaccine communities. There was no significant difference in the magnitude of the influence boost for perceived experts between the two communities. Social media platforms, scientific communications, and biomedical organizations may focus on more systemic interventions to reduce the impact of perceived experts in spreading antivaccine misinformation.

Health system quality and COVID-19 vaccination: a cross-sectional analysis in 14 countries

The social and behavioural determinants of COVID-19 vaccination have been described previously. However, little is known about how vaccinated people use and rate their health system. We used surveys conducted in 14 countries to study the health system correlates of COVID-19 vaccination. Country-specific logistic regression models were adjusted for respondent age, education, income, chronic illness, history of COVID-19, urban residence, and minority ethnic, racial, or linguistic group. Estimates were summarised across countries using random effects meta-analysis. Vaccination coverage with at least two or three doses ranged from 29% in India to 85% in Peru. Greater health-care use, having a regular and high-quality provider, and receiving other preventive health services were positively associated with vaccination. Confidence in the health system and government also increased the odds of vaccination. By contrast, having unmet health-care needs or experiencing discrimination or a medical mistake decreased the odds of vaccination. Associations between health system predictors and vaccination tended to be stronger in high-income countries and in countries with the most COVID-19-related deaths. Access to quality health systems might affect vaccine decisions. Building strong primary care systems and ensuring a baseline level of quality that is affordable for all should be central to pandemic preparedness strategies.

Effects of SARS-CoV-2 Vaccines on Sperm Quality: Systematic Review

BACKGROUND

The COVID-19 pandemic, caused by SARS-CoV-2, has triggered a global public health crisis of unprecedented proportions. SARS-CoV-2 vaccination is a highly effective strategy for preventing infections and severe COVID-19 outcomes. Although several studies have concluded that COVID-19 vaccines are unlikely to affect fertility, concerns have arisen regarding adverse events, including the potential impact on fertility; these concerns are plagued by limited and inconsistent evidence.

OBJECTIVE

This review aims to provide a recent assessment of the literature on the impact of COVID-19 vaccines on male sperm quality. The possible impact of COVID-19 vaccines on fertility potential was also examined to draw a clearer picture and to evaluate the effects of COVID-19 on male reproductive health.

METHODS

PubMed, Scopus, Web of Science, Embase, and Cochrane databases were searched from their inception to October 2023. Eligible studies included articles reporting SARS-CoV-2 vaccination and human semen quality and fertility, as well as the impact of vaccination on assisted reproductive technology treatment outcomes. The quality of cohort studies was assessed using the Newcastle-Ottawa Scale, and the quality of cross-sectional studies was assessed using the quality evaluation criteria recommended by the Agency for Healthcare Research and Quality. The systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

RESULTS

The initial literature search yielded 4691 records by searching 5 peer-reviewed databases (PubMed, Scopus, Web of Science, Embase, and Cochrane). Finally, 24 relevant studies were selected for our study. There were evident research inequalities at the regional level, with the United States and Western European countries contributing 38% (9/24) of the studies, Middle Eastern countries contributing 38% (9/24), China accounting for 21% (5/24), and Africa and South America accounting for none. Nonetheless, the overall quality of the included studies was generally good. Our results demonstrated that serious side effects of the COVID-19 vaccine are extremely rare, and men experience few problems with sperm parameters or reproductive potential after vaccination.

CONCLUSIONS

On the basis of the studies published so far, the COVID-19 vaccine is safe for male reproductive health. Obviously, vaccination is a wise option rather than experience serious adverse symptoms of viral infections. These instances of evidence may help reduce vaccine hesitancy and increase vaccination coverage, particularly among reproductive-age couples. As new controlled trials and prospective cohort studies with larger sample sizes emerge, the possibility of a negative effect of the COVID-19 vaccine on sperm quality must be further clarified.

'A Home to the Lie': The Contemporary (Per)version of Truth

This paper explores the contemporary trend towards relativization and perversion of truth increasingly prominent in American culture, which, in Bion's terminology (1970), has become an ever more hospitable "home to the lie." The anti-COVID vaccine movement emerging in the United States in 2021, and its related network of conspiracy theories, is presented as an example. To make sense of these phenomena the author presents clinical vignettes illustrating (1) Bion's (1970) notions of catastrophic change, the lie/thinker relation, and the messianic idea; (2) Freud's (1921) thinking on group leaders; and (3) Matte-Blanco's (1975) bi-logical theory of mind. According to Bion, the lie is mobilized to avoid the psychological upheaval associated with catastrophic change. The author suggests that developments in American life experienced as threatening catastrophic change provide a hospitable environment for the lie, making the recognition of truth more elusive. In line with Matte-Blanco's bi-logical theory, the author suggests that creation of opportunities for dialogue giving weight to both conscious and unconscious ways of thinking is necessary for re-establishing a culture of truth.

Global Vaccine Access Demands Combating Both Inequity And Hesitancy

The world's population suffered from lack of access to COVID-19 vaccines. Although inequities in vaccine availability for low- and middle-income countries are widely cited as a component of this lack of access, there is a related but less discussed component: vaccine refusal or hesitancy. Regarding the first component (global vaccine inequities), there are multiple dimensions to this topic and its causes, but for low- and middle-income countries, the most glaring one resulted from upstream science policies that prioritized speed and innovation at the expense of technologies that could be produced by low- and middle-income country vaccine producers. Regarding the second component (vaccine refusal or hesitancy), as COVID-19 waves swept across the United States in 2021, thousands of unvaccinated Americans perished from refusing COVID-19 immunizations. These deaths occurred because of an expanding antiscience ecosystem that now extends into low- and middle-income countries and could block the uptake of new vaccines or routine childhood immunizations. Future vaccine policies must address both elements of global access and their political identities. This recommendation reflects the author's experiences as a vaccine scientist who both develops affordable COVID-19 and neglected disease vaccines and lives on the front lines combating vaccine refusal.

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.

Vaccine Preventable Disease and Vaccine Hesitancy

Global immunization programs have saved tens of millions of lives over the last 2 decades. Now, the recent successes of COVID-19 vaccines having saved more than 3 million lives in North America during the pandemic may open the door to accelerate technologies for other emerging infection vaccines. New vaccines for respiratory syncytial virus, norovirus, influenza, herpes simplex virus, shingles, dengue fever, enteric bacterial infections, malaria, and Chagas disease are advancing through clinical development and could become ready for delivery over the next 5 years. The successful delivery of these new vaccines may require expanded advocacy and communications efforts.

How Likes and Retweets Impacted Our Patients During the COVID-19 Pandemic

The growing dependence on social media for health-related information boomed during the COVID-19 pandemic, posing unprecedented challenges in navigating the vast amounts of information available right at our fingertips. Social media had a major impact on clinical decision-making affecting individuals, communities, and societies at large. In this review, we discuss the role of social media in amplifying information and misinformation as well as factors contributing to its reliance and prevalence. We review how medical providers have been impacted by this changing landscape, useful communication strategies to employ with in-office patient encounters, and how we can be active players in using social media as a tool for health promotion, correcting misinformation, and preparing for future pandemics.

The role and influence of perceived experts in an anti-vaccine misinformation community

The role of perceived experts (i.e., medical professionals and biomedical scientists) as potential anti-vaccine influencers has not been characterized systematically. We describe the prevalence and importance of anti-vaccine perceived experts by constructing a coengagement network based on a Twitter data set containing over 4.2 million posts from April 2021. The coengagement network primarily broke into two large communities that differed in their stance toward COVID-19 vaccines, and misinformation was predominantly shared by the anti-vaccine community. Perceived experts had a sizable presence within the anti-vaccine community and shared academic sources at higher rates compared to others in that community. Perceived experts occupied important network positions as central anti-vaccine nodes and bridges between the anti- and pro-vaccine communities. Perceived experts received significantly more engagements than other individuals within the anti- and pro-vaccine communities and there was no significant difference in the influence boost for perceived experts between the two communities. Interventions designed to reduce the impact of perceived experts who spread anti-vaccine misinformation may be warranted.

Health Communication Science in the Balance

Authors of this Viewpoint discuss the recent “pause” of the NIH Common Fund’s research program that was designed to study the communication of science and the possible detrimental effect of not addressing scientific misinformation and disinformation.