Intentions to use a novel Zika vaccine: the effects of misbeliefs about the MMR vaccine and perceptions about Zika

Impact of COVID-19 pandemic on influenza vaccination rate among health care workers

Vaccinations against influenza are critical in mitigating the severity of the disease, preventing its transmission, and restricting its dissemination. Concerns about vaccination hesitancy among healthcare workers (HCWs) have been duly recognized during and following the COVID-19 pandemic. To examine the extent to which the COVID-19 pandemic has influenced the adoption of vaccinations among HCWs. A cross-sectional online survey was conducted four years after the COVID-19 pandemic among HCWs in Saudi Arabia. We performed a logistic regression analysis using influenza vaccination uptake as the dependent variable and perceived COVID-19 pandemic's impact, age, gender, marital status, employment status, education level, monthly income, respondent's overall health, doctor visits, tobacco use, number of adults in the household, and number of children in the household as independent variables. The study included 574 participants, an 86% response rate. Of the sample, 47% reported they had the influenza vaccination. HCWs who reported a greater negative impact due to the COVID-19 pandemic were 40% more likely to acquire the influenza vaccine (OR = 1.4, 95% CI [1.24, 1.58]). Compared to HCWs without children, HCWs with a child had a 44% lower likelihood of taking the influenza vaccination (OR = 0.34, 95% CI [0.16, 0.69]). The odds of HCWs obtaining the influenza vaccine were 4.5 times higher for those who reported one yearly medical visit, 2.6 times higher for two, and 1.4 times higher for three or more. HCWs who experienced more severe COVID-19 outcomes were more likely to get vaccinated against the virus. However, long-term monitoring of this inclination is necessary.

An exploration of the role of trust and rapport in enhancing vaccine uptake among Anishinaabe in rural northern Ontario

This article examines the complicated terrain of immunization acceptance and access among Indigenous peoples in northern Ontario by drawing on conversations held prior to 2019 that explored knowledge about Haemophilus influenzae type a (Hia) infection specifically and attitudes toward vaccines more broadly. In the decade preceding COVID-19, Hia emerged as a leading cause of morbidity and mortality in Indigenous communities in northern Canada. Before developing new vaccines, it is imperative to hold conversations with the communities most affected and to learn more about Indigenous peoples' perceptions of and knowledge about vaccines, both generally and Hia specifically. We conducted focus groups and one-on-one conversations with Anishinaabe Peoples in northwestern Ontario. Our findings illustrate that decisions to vaccinate are informed by a host of social, institutional, and ideological factors and historical and contemporary relationships with government institutions and health practitioners. In particular, Indigenous community members perceived their relationships with social and health services and education institutions as coercive. Thus, public health approaches cannot continue to operate in ways that prioritize interventions for Indigenous peoples and communities so that they "do the right thing." More emphasis is needed on health service and social service provider knowledge, skills, attitudes and practices-redirecting the onus onto those within the health care system. Solutions must respect Indigenous nationhood and the right of self-determination. Finally, we suggest the term vaccine hesitancy may not entirely capture the breadth of experiences that many Indigenous Peoples and communities have and continue to have within the health care system in Canada.

Trust Matters: The Effects of Social Media Use on the Public's Health Policy Support Through (mis)beliefs in the Context of HPV Vaccination

This study examines whether social media exposure is associated with the public's beliefs and misbeliefs about human papillomavirus (HPV) vaccination and how those (mis)beliefs are associated with the public's support for HPV vaccination-related policies. This study also explores whether trust in HPV vaccination-related regulatory organizations moderates the associations between social media exposure and public policy support through (mis)beliefs. We found that social media exposure was positively associated with misbeliefs about HPV vaccination. The findings also indicated that while beliefs about benefits were positively associated with policy support for HPV vaccination, misbeliefs were negatively associated with this support. More interestingly, our analysis revealed that the negative association of HPV-related misbeliefs with vaccination policy support was larger for those who had low levels of trust, compared to their high-trust counterparts.

Reasons for not getting COVID-19 vaccine in Ardabil, a Northwestern province in Iran: Based on an ecological approach

BACKGROUND

Understanding the reasons for not getting the COVID-19 vaccine can help to increase acceptability and tackle vaccine hesitancy and consequently reach high coverage for this new vaccine. Using an ecological approach, the reasons for not getting the vaccine in the Iranian population was investigated.

METHODS AND MATERIAL

This study was conducted from October to December 2021 on 426 participants who had not received the COVID-19 vaccine. The following subsets of questions were included in the questionnaire: intrapersonal level factors, interpersonal level factors, group and organization, and society and policy-making. Multivariable logistic regression was used, and the odds ratio (OR) and 95% confidence intervals (CIs) were estimated for vaccine hesitancy (dependent variable) according to the reasons for not getting COVID vaccine scores (independent variable) using multivariable logistic regression in 3 different models, including Model 0: unadjusted, Model 1: adjusted for age, gender, and underlying disease, and Model 2: adjustment for age, gender, underlying disease, education, place of living, income, marital status, and employment.

RESULTS

A significant difference was found regarding gender between likely and not likely groups (P = 0.016). A significant association was observed between the vaccine hesitancy and interpersonal (unadjusted model: OR = 0.833 (CI: 0.738-0.942), P for trend = 0.003; model 1: OR = 0.820 (CI: 0.724-0.930), P for trend = 0.002; model 2: OR = 0.799 (CI: 0.703-0.909), P for trend = 0.001) and group and organization (unadjusted model: OR = 0.861 (CI: 0.783-0.948), P for trend = 0.002; model 1: OR = 0.864 (CI: 0.784-0.952, P for trend = 0.003; model 2:OR = 0.862 (CI: 0.781-0.951, P for trend = 0.003). There was no significant association between vaccine hesitancy and intrapersonal and society and policy-making (P > 0.05).

CONCLUSIONS

We found that a high score of "interpersonal" and "group and organization" factors were associated with lower intention to COVID vaccine. Moreover, women had higher vaccination intentions than men.

Taking a Shot: The Impact of Information Frames and Channels on Vaccination Willingness in a Pandemic

The reluctance of people to receive safe and recommended available vaccines is a well-documented public health challenge. As information and communication technologies evolve, this challenge gets more complex and even harder to manage during complex public health situations. In this experimental study, we examine the relationship between vaccine information frames (with scientific information vs. without scientific information) and channels (through government vs. religious organizations) and vaccination willingness in the U.S. in the context of a pandemic. Additionally, we evaluate the interaction between vaccine skepticism, vaccine information frames, and vaccine information channels on vaccination willingness. This experimental study uses data from Amazon Mechanical Turk (MTURK) to evaluate the relationships between vaccine skepticism, vaccine information frames, and channels on vaccination willingness. We find that contrary to our hypothesis, a vaccine advisory framed with scientific information decreases people's vaccination willingness compared to one framed without scientific information. Additionally, the impact of framing on vaccination willingness is conditioned on participants' skepticism-participants who hold skepticism toward the vaccine but received information framed with scientific information score significantly higher in vaccination willingness compared to participants who do not hold skepticism toward a vaccine. The results suggest that the factors impacting vaccination willingness are complex and nuanced. Thus, policymakers should be more strategic with the delivery of vaccination information, especially during complex health crises.

Misrepresentation and Nonadherence Regarding COVID-19 Public Health Measures

Importance

The effectiveness of public health measures implemented to mitigate the spread and impact of SARS-CoV-2 relies heavily on honesty and adherence from the general public.

Objective

To examine the frequency of, reasons for, and factors associated with misrepresentation and nonadherence regarding COVID-19 public health measures.

Design, Setting, and Participants

This survey study recruited a national, nonprobability sample of US adults to participate in an online survey using Qualtrics online panels (participation rate, 1811 of 2260 [80.1%]) from December 8 to 23, 2021. The survey contained screening questions to allow for a targeted sample of one-third who had had COVID-19, one-third who had not had COVID-19 and were vaccinated, and one-third who had not had COVID-19 and were unvaccinated.

Main Outcomes and Measures

The survey assessed 9 different types of misrepresentation and nonadherence related to COVID-19 public health measures and the reasons underlying such behaviors. Additional questions measured COVID-19-related beliefs and behaviors and demographic characteristics.

Results

The final sample included 1733 participants. The mean (SD) participant age was 41 (15) years and the sample predominantly identified as female (1143 of 1732 [66.0%]) and non-Hispanic White (1151 of 1733 [66.4%]). Seven hundred twenty-one participants (41.6%) reported misrepresentation and/or nonadherence in at least 1 of the 9 items; telling someone they were with or about to be with in person that they were taking more COVID-19 preventive measures than they actually were (420 of 1726 [24.3%]) and breaking quarantine rules (190 of 845 [22.5%]) were the most common manifestations. The most commonly endorsed reasons included wanting life to feel normal and wanting to exercise personal freedom. All age groups younger than 60 years (eg, odds ratio for those aged 18-29 years, 4.87 [95% CI, 3.27-7.34]) and those who had greater distrust in science (odds ratio, 1.14 [95% CI, 1.05-1.23]) had significantly higher odds of misrepresentation and/or nonadherence for at least 1 of the 9 items.

Conclusions and Relevance

In this survey study of US adults, nearly half of participants reported misrepresentation and/or nonadherence regarding public health measures against COVID-19. Future work is needed to examine strategies for communicating the consequences of misrepresentation and nonadherence and to address contributing factors.

The level and determinants of COVID-19 vaccine acceptance in Ghana

Objective

As part of the efforts to curb the COVID-19 pandemic, the government of Ghana has received several shipments of approved vaccines, and administration has begun in the country. Studies examining the determinants of COVID-19 vaccine acceptance in Ghana were mostly conducted before the vaccination exercise. Vaccine acceptance decisions however vary with time and hence, peoples’ decisions may have changed once vaccines became accessible. This study examines the level and determinants of COVID-19 vaccine acceptance among adult Ghanaians during the vaccination exercise.

Methods

The study was a cross-sectional online survey involving Ghanaian adults (18 years and above) eligible to take the COVID-19 vaccine. The study was conducted from 18th May 2021 to 14th July 2021 and the questionnaire was answered by 362 respondents. Snowball sampling technique was utilized to obtain the respondents. Probit regression analysis was used to identify factors influencing COVID-19 vaccine acceptance.

Key findings

Only 62.7% of the respondents indicated that they will accept the COVID-19 vaccine if provided. The regression results revealed that the decision to accept the COVID-19 vaccine was influenced by occupation, perceived susceptibility, perceived benefits and attitudes towards the vaccines.

Conclusion

The findings suggest that government must implement strategies to enhance positive attitudes toward vaccines, increase the risk perception of contracting the virus and also educate the populace about the benefits of the vaccine.

A randomized controlled trial of a video intervention shows evidence of increasing COVID-19 vaccination intention

Increasing acceptance of COVID-19 vaccines is imperative for public health. Previous research on educational interventions to overcome vaccine hesitancy have shown mixed effects in increasing vaccination intention, although much of this work has focused on parental attitudes toward childhood vaccination. In this study, we conducted a randomized controlled trial to investigate whether vaccination intention changes after viewing an animated YouTube video explaining how COVID-19 mRNA vaccines work. We exposed participants to one of four interventions–watching the video with a male narrator, watching the same video with a female narrator, reading the text of the transcript of the video, or receiving no information (control group). We found that participants who watched the version of the video with a male narrator expressed statistically significant increased vaccination intention compared to the control group. The video with a female narrator had more variation in results. As a whole, there was a non-significant increased vaccination intention when analyzing all participants who saw the video with a female narrator; however, for politically conservative participants there was decreased vaccination intention for this intervention compared to the control group at a threshold between being currently undecided and expressing probable interest. These results are encouraging for the ability of interventions as simple as YouTube videos to increase vaccination propensity, although the inconsistent response to the video with a female narrator demonstrates the potential for bias to affect how certain groups respond to different messengers.

Forming and updating vaccination beliefs: does the continued effect of misinformation depend on what we think we know?

People may cling to false facts even in the face of updated and correct information. The present study confronted misconceptions about the measles, mumps and rubella vaccine and a novel, fictitious Zika vaccine. Two experiments are reported, examining misconceptions as motivated by a poor risk understanding (Experiment 1, N = 130) or the exposure to conspiracy theories (Experiment 2, N = 130). Each experiment featured a Misinformation condition, wherein participants were presented with fictitious stories containing some misinformation (Experiment 1) and rumours focused on conspiracy theories (Experiment 2) that were later retracted by public health experts and a No misinformation condition, containing no reference to misinformation and rumours. Across experiments, participants were more hesitant towards vaccines when exposed to stories including vaccine misinformation. Notwithstanding, our results suggest a positive impact of a trusted source communicating the scientific consensus about vaccines. Zika virus represents a particular case showing how missing information can easily evolve into misinformation. Implications for effective dissemination of information are discussed.

Vaccine Hesitancy Under the Magnifying Glass: A Systematic Review of the Uses and Misuses of an Increasingly Popular Construct

Resistance to vaccines has hindered attempts to contain and prevent outbreaks of infectious diseases for centuries. More recently, however, the term "vaccine hesitancy" has been used to describe not necessarily outright resistance but also a delay in acceptance or uncertainty regarding vaccines. Given concerns about hesitancy and its impact on vaccine uptake rates, researchers increasingly shifted the focus from resistance to vaccines toward vaccine hesitancy. Acknowledging the urgency to accurately assess the phenomenon, it is critical to understand the state of the literature, focusing on issues of conceptualization and operationalization. To carry out this systematic review, we collected and analyzed all published empirical articles from 2000 to 2021 that explicitly included quantitative self-report measures of vaccine hesitancy (k = 86). Using a mixed-method approach, the review demonstrates and quantifies crucial inconsistencies in the measurement of the construct, lack of clarity in regard to the determination of who should or should not be defined as hesitant, and overreliance on unrepresentative samples. Crucially, our analysis points to a potential systematic bias toward exaggerating the level of hesitancy in the population. Modeling a vaccine hesitancy co-citation network, the analysis also points to the existence of insular academic silos that make it harder to achieve a unified measurement tool. Theoretical and practical implications for academics, practitioners, and policymakers are discussed.

Vaccine discourse in white nationalist online communication: A mixed-methods computational approach

INTRODUCTION

Research has indicated a growing resistance to vaccines among U.S. conservatives and Republicans. Following past successes of the far-right in mainstreaming health misinformation, this study tracks almost two decades of vaccine discourse on the extremist, white nationalist (WN) online message-board Stormfront. We examine the argumentative repertoire around vaccines on the forum, and whether it assimilated to or challenged common arguments for and against vaccines, or extended it in ways unique to the racist WN agenda.

METHODS

We use a mixed-methods approach, combining unsupervised machine learning of 8892 posts including the term "vaccin*", published on Stormfront between 2001 and 2017. We supplemented the computational analysis with a manual coding of randomly sampled 500 posts, evaluating the prevalence of pro- and anti-vaccine sentiment, previously identified pro- and anti-vaccine arguments, and WN-specific arguments.

RESULTS

Discourse was dynamic, increasing around specific events, such as outbreaks and following legal debates about vaccine mandates. We identified four themes: conspiracies, science, race and white innovation. The prominence of themes over time was relatively stable. Our manual coding identified levels of anti-vaccine sentiment that were much higher than found in the past on mainstream social media. Most anti-vaccine posts relied on common anti-vaccine tropes and not on WN conspiracy theories. Pro-vaccination posts, however, were supported by unique race-based arguments.

CONCLUSION

We find a high volume of anti-vaccine sentiment among WN on Stormfront, but also identify unique pro-vaccine arguments that echo the group's racist ideology.

PUBLIC HEALTH IMPLICATION

As with past health-related conspiracy theories, high levels of anti-vaccine sentiment in online far-right sociotechnical information systems could threaten public health, especially if it 'spills-over' to mainstream media. Many pro-vaccine arguments on the forum relied on racist, WN reasoning, thus preventing the authors from recommending the use of these unethical arguments in future public health communications.

The role of non-COVID-specific and COVID-specific factors in predicting a shift in willingness to vaccinate: A panel study

In communities that remain below the immunity threshold needed to blunt COVID-19’s spread, SARS-CoV-2 has a greater chance of mutating to evade vaccines. This study underscores the central role of trust and knowledge in increasing the likelihood of vaccinating. Trust in scientific institutions and spokespersons anchors time 1 vaccination intentions and knowledge affects them at both times 1 and 2. These background (non–COVID-specific) factors as well as flu vaccination history and patterns of media reliance played a more prominent role in shifting individuals from vaccination hesitance to acceptance than did COVID-specific ones. The study underscores the need for ongoing community engagement and trust building, proactive communication about vaccination, motivating vaccination against seasonal flu, and deploying science-consistent, provaccination voices across media.

Although declines in intent to vaccinate had been identified in international surveys conducted between June and October 2020, including in the United States, some individuals in the United States who previously expressed reluctance said, in spring 2021, that they were willing to vaccinate. That change raised the following questions: What factors predicted an increased willingness to inoculate against COVID-19? And, to what extent was the change driven by COVID-specific factors, such as personal worry about the disease and COVID-specific misinformation, and to what extent by background (non–COVID-specific) factors, such as trust in medical authorities, accurate/inaccurate information about vaccination, vaccination history, and patterns of media reliance? This panel study of more than 8,000 individuals found that trust in health authorities anchored acceptance of vaccination and that knowledge about vaccination, flu vaccination history, and patterns of media reliance played a more prominent role in shifting individuals from vaccination hesitance to acceptance than COVID-specific factors. COVID-specific conspiracy beliefs did play a role, although a lesser one. These findings underscore the need to reinforce trust in health experts, facilitate community engagement with them, and preemptively communicate the benefits and safety record of authorized vaccines. The findings suggest, as well, the need to identify and deploy messaging able to undercut health-related conspiracy beliefs when they begin circulating.

Content and Dynamics of Websites Shared Over Vaccine-Related Tweets in COVID-19 Conversations: Computational Analysis

BACKGROUND

The onset of the COVID-19 pandemic and the consequent "infodemic" increased concerns about Twitter's role in advancing antivaccination messages, even before a vaccine became available to the public. New computational methods allow for analysis of cross-platform use by tracking links to websites shared over Twitter, which, in turn, can uncover some of the content and dynamics of information sources and agenda-setting processes. Such understanding can advance theory and efforts to reduce misinformation.

OBJECTIVE

Informed by agenda-setting theory, this study aimed to identify the content and temporal patterns of websites shared in vaccine-related tweets posted to COVID-19 conversations on Twitter between February and June 2020.

METHODS

We used triangulation of data analysis methods. Data mining consisted of the screening of around 5 million tweets posted to COVID-19 conversations to identify tweets that related to vaccination and including links to websites shared within these tweets. We further analyzed the content the 20 most-shared external websites using a mixed methods approach.

RESULTS

Of 841,896 vaccination-related tweets identified, 185,994 (22.1%) contained links to specific websites. A wide range of websites were shared, with the 20 most-tweeted websites constituting 14.5% (27,060/185,994) of the shared websites and typically being shared for only 2 to 3 days. Traditional media constituted the majority of these 20 websites, along with other social media and governmental sources. We identified markers of inauthentic propagation for some of these links.

CONCLUSIONS

The topic of vaccination was prevalent in tweets about COVID-19 early in the pandemic. Sharing websites was a common communication strategy, and its "bursty" pattern and inauthentic propagation strategies pose challenges for health promotion efforts. Future studies should consider cross-platform use in dissemination of health information and in counteracting misinformation.

The Role of Twitter in the WHO's Fight against the Infodemic

The COVID-19 pandemic has far-reaching consequences in various fields. In addition to its health and economic impact, there are also social, cultural and informational impacts. Regarding the latter, the World Health Organization (WHO) flagged concerns about the infodemic at the beginning of 2020. The main objective of this paper is to explore how the WHO uses its Twitter profile to inform the population on vaccines against the coronavirus, thus preventing or mitigating misleading or false information both in the media and on social networks. This study analyzed 849 vaccine-related tweets posted by the WHO on its Twitter account from 9 November 2020 (when the 73rd World Health Assembly resumed) to 14 March 2021 (three months after the start of vaccination). In order to understand the data collected, these results were compared with the actions carried out by the WHO and with the information and debates throughout this period. The analysis shows that the WHO is decidedly committed to the use of these tools as a means to disseminate messages that provide the population with accurate and scientific information, as well as to combat mis- and disinformation about the SARS-CoV-2 vaccination process.

Quantifying the effect of Wakefield et al. (1998) on skepticism about MMR vaccine safety in the U.S

BACKGROUND

Efforts to trace the rise of childhood vaccine safety concerns in the US often suggest Andrew Wakefield and colleagues' retracted 1998 Lancet study (AW98)-which alleged that the MMR vaccine can cause children to develop autism-as a primary cause of US vaccine skepticism. However, a lack of public opinion data on MMR safety collected before/after AW98's publication obscures whether anecdotal accounts are indicative of a potentially-causal effect.

METHODS

We address this problem using a regression discontinuity framework to study change in monthly MMR injury claims (N = 74,850; from 1990-2019) from the Vaccine Adverse Events Reporting System (VAERS) to proxy concern about vaccine safety. Additionally, we suggest a potential mechanism for the effect of AW98 on vaccine skepticism, via automated sentiment analyses of MMR-related news stories (N = 674; from 1996-2000) in major television and newspaper outlets.

RESULTS

AW98 led to an immediate increase of about 70 MMR injury claims cases per month, averaging across six estimation strategies (meta-analytic effect = 70.44 [52.19, 88.75], p < 0.01). Preliminary evidence suggests that the volume of negative media attention to MMR increased in the weeks following AW98's publication, across four estimation strategies (meta-analytic effect = 9.59% [3.66, 15.51], p < 0.01).

CONCLUSIONS

Vaccine skepticism increased following the publication of AW98, which was potentially made possible by increased negative media coverage of MMR.

SIGNIFICANCE

Childhood vaccine skepticism presents an important challenge to widespread vaccine uptake, and undermines support for pro-vaccine health policies. In addition to advancing our understanding of the previously-obscured origins of US vaccine skepticism, our work cautions that high-profile media attention to inaccurate scientific studies can undermine public confidence in vaccines. We conclude by offering several recommendations that researchers and health communicators might consider to detect and address future threats to vaccine confidence.

Fearing the disease or the vaccine: The case of COVID-19

As studies indicate that people perceive COVID-19 as a threatening disease, the demand for a vaccine against the disease could be expected to be high. Vaccine safety concerns might nevertheless outweigh the perceived disease risks when an individual decides whether or not to accept the vaccine. We investigated the role of perceived risk of COVID-19 (i.e., perceived likelihood of infection, perceived disease severity, and disease-related worry) and perceived safety of a prospective vaccine against COVID-19 in predicting intentions to accept a COVID-19 vaccine. Three Finnish samples were surveyed: 825 parents of small children, 205 individuals living in an area with suboptimal vaccination coverage, and 1325 Facebook users nationwide. As points of reference, we compared the perceptions of COVID-19 to those of influenza and measles. COVID-19 was perceived as a threatening disease-more so than influenza and measles. The strongest predictor of COVID-19 vaccination intentions was trusting the safety of the potential vaccine. Those perceiving COVID-19 as a severe disease were also slightly more intent on taking a COVID-19 vaccine. Informing the public about the safety of a forthcoming COVID-19 vaccine should be the focus for health authorities aiming to achieve a high vaccine uptake.

The effects of scientific messages and narratives about vaccination

A fundamental challenge complicates news decisions about covering vaccine side effects: although serious vaccine side effects are rare, less severe ones do occur occasionally. The study was designed to test whether a side effect message could induce vaccine hesitancy and whether that could be countered by pro-vaccine messages about vaccine safety. A large (N = 2,345), nationally representative experiment was conducted by randomly exposing participants to one of six videos about the measles, mumps, and rubella (MMR) vaccine edited from news programs produced during the 2019 measles outbreak in the United States. The design was a 2x3 factorial crossing the presence or absence of a hesitancy-inducing narrative message with a pro-vaccine science-supporting message (i.e., no message, science-supporting expert message, or pro-vaccine narrative message), leading to a total of six conditions. A general linear model was used to assess the effects of these videos on respondents’ (1) vaccine risk perceptions, (2) policy views on vaccination, (3) willingness to encourage others to vaccinate their children, and (4) intention to send a pro-vaccine letter to their state representative. Findings indicated that the science-supporting expert message about vaccine safety led to higher pro-vaccine evaluations relative to other conditions [e.g., b = -0.17, p < .001, a reduction in vaccine risk perceptions of 0.17 as compared to the control]. There was also suggestive evidence that the hesitancy-inducing narrative may limit the effectiveness of a science-supporting expert message, although this finding was not consistent across different outcomes. When shown alone the hesitancy-inducing narrative did not shift views and intentions, but more research is needed to ascertain whether exposure to such messages can undercut the pro-vaccine influence of science-supporting (expert) ones. All in all, however, it is clear that science-supporting messages are effective and therefore worthwhile in combating vaccine misinformation.

Acceptability of a Hypothetical Zika Vaccine among Women from Colombia and Spain Exposed to ZIKV: A Qualitative Study

Zika virus (ZIKV) can cause pregnancy loss and congenital Zika syndrome, among other poor health outcomes. The ZIKV epidemic in 2015-2017 disproportionately affected pregnant women in poor-resource settings. We aimed to understand perceptions and attitudes towards a hypothetical ZIKV vaccine, women's willingness to be vaccinated, and potential barriers and facilitators for vaccine acceptance in 1) migrant women living in Spain who travelled to their countries of origin and were diagnosed with ZIKV infection during pregnancy, and their healthcare providers, and 2) women living in Colombia who delivered a child with microcephaly. An exploratory qualitative study based on phenomenology and grounded theory was conducted. Data were collected through in-depth, paired and semi-structured interviews. Overall, women from both sites were willing to receive a hypothetical ZIKV vaccine. However, some expressed concerns of being vaccinated during pregnancy, yet they would accept it if the vaccine was recommended by a healthcare professional they trust. Main fears towards vaccination were related to vaccine safety and potential adverse effects on child's health. Women reported feeling hesitant to participate in a ZIKV vaccine trial. These results may contribute to guiding the effective delivery of future ZIKV vaccines among populations most at risk and particularly vulnerable.

Brazil's Missing Infants: Zika Risk Changes Reproductive Behavior

Zika virus epidemics have potential large-scale population effects. Controlled studies of mice and nonhuman primates indicate that Zika affects fecundity, raising concerns about miscarriage in human populations. In regions of Brazil, Zika risk peaked months before residents learned about the epidemic and its relation to congenital anomalies. This spatiotemporal variation supports analysis of both biological effects of Zika infection on fertility and the effects of learning about Zika risk on reproductive behavior. Causal inference techniques used with vital statistics indicate that the epidemic caused reductions in birth cohort size of approximately one-quarter 18 months after Zika infection risk peaked but 10 months after public health messages advocated childbearing delay. The evidence is consistent with small but not statistically detectable biological reductions in fecundity, as well as large strategic changes in reproductive behavior to temporally align childbearing with reduced risk to infant health. The behavioral effects are larger for more-educated and older women, which may reflect facilitated access to information and to family planning services within high-risk, mosquito-infested urban locations as well as perceptions about the opportunity costs of risks to pregnancy and infant survival.

The effects of source expertise and trustworthiness on recollection: the case of vaccine misinformation

Designing effective communication strategies for correcting vaccines misinformation requires an understanding of how the target group might react to information from different sources. The present study examined whether erroneous inferences about vaccination could be effectively corrected by a perceived credible (i.e. expert or trustworthy) source. Two experiments are reported using a standard continued influence paradigm, each featuring two correction conditions on vaccine misinformation. Participants were presented with a story containing a piece of information that was later retracted by a perceived credible or not so credible source. Experiment 1 showed that providing a correction reduced participants' use of the original erroneous information, yet the overall reliance on misinformation did not significantly differ between the low- and high-expertise correction groups. Experiment 2 revealed that a correction from a high-trustworthy source decreased participants' reliance on misinformation when making inferences; nonetheless, it did not positively affect the reported intent to vaccinate one's child. Overall, source trustworthiness was more relevant than source expertise.

Effects of Media Exposure to Conflicting Information About Mammography: Results From a Population-based Survey Experiment

BACKGROUND

Although there is growing theoretical and empirical support for the proposition that media exposure to conflicting health information negatively influences public understanding and behavior, few studies have causally linked exposure to conflict with undesirable outcomes. Such outcomes might be particularly likely in the context of mammography, given widespread media attention to conflicting recommendations about the age at and frequency with which average-risk women should be screened for breast cancer.

PURPOSE

The current study tests whether exposure to conflicting information about mammography negatively influences women's affective and cognitive responses and examines whether effects vary by socioeconomic position.

METHODS

We conducted an online survey experiment in 2016 with a population-based sample of U.S. women aged 35-55 (N = 1,474). Participants were randomly assigned to one of four conditions that differed in the level of conflict about mammography presented in a news story (no, low, medium, or high conflict), stratifying by poverty level.

RESULTS

Greater exposure to conflict increased women's negative emotional responses to the story they read, their confusion about and backlash toward cancer prevention recommendations and research, and their ambivalence about mammography and other types of cancer screening, though ambivalence leveled off at high levels of exposure. There was little evidence that effects varied across socioeconomic position.

CONCLUSIONS

Findings add to the growing evidence base documenting undesirable outcomes of exposure to conflicting health information. Future research should examine whether the negative affective and cognitive responses observed translate into behavior, which could have implications for both health campaigns and patient-provider communication.

The Effects of News Coverage of Epidemics on Public Support for and Compliance with the CDC- An Experimental Study

Content analysis identified three dominant themes used by the news media to cover epidemics: the scientific, the pandemic, and the social. This study uses a randomized experimental design to test the effects of common news coverage patterns of epidemics on perceptions of efficacy, certainty, and trust in the CDC, and subsequently on intentions to comply with and support for the CDC during public health crises. The experiment also compares the effects of real-world coverage to that of hypothetical coverage that more closely follows the CDC's recommendations for crisis communication. The results of the experiment (n = 321) demonstrate that exposure to articles from different themes affects perceptions of certainty and self-efficacy, that in turn affect intentions to comply with the CDC. Although organizational-efficacy and trust in the CDC are both correlated with intentions to support, and trust is also correlated with intentions to comply, exposure to different conditions did not affect these perceptions and there was no indirect effect from exposure to intentions. The results reveal the potential effects of real-world coverage on perceptions and intentions, and demonstrate the advantage of the hypothetical coverage that follows the CDC's crisis communication guidelines. Implications for public health organizations and communicators are discussed.