"COVID is a huge jigsaw puzzle that I am trying to make sense of myself": Exploring the perceptions towards the COVID-19 vaccine communication strategy in Australia amongst unvaccinated Australian adults

The COVID-19 pandemic and the associated introduction of a novel vaccine has provided researchers with the opportunity to investigate how to support vaccine acceptance and reduce hesitancy using novel approaches. This study aimed to understand the perceptions of COVID-19 unvaccinated Australian adults towards the COVID-19 vaccines and the factors influencing their vaccine decision-making. We also explored their attitudes towards vaccine communication strategies and the availability and quality of resources to support decision-making and preferences during future public health emergencies. In-depth interviews were undertaken with 35 members of the Australian community who self-identified as being unvaccinated against COVID-19 from September to December 2021 and did not intend to vaccinate. Key themes that emerged focused on past experiences of vaccination, feelings of being coerced or pushed into vaccination, concerns about transparency around the development processes used for the COVID-19 vaccines, the value of getting vaccinated and issues regarding the mandates being used. Participants acknowledged that they would be open to talking to peers but held some reservations about the process. Requirements for vaccination have now been lifted in many countries. While governments should continue to strive to promote COVID-19 primary and booster vaccines going forward, this research suggests that there will be a small proportion of the community who continue to actively decline the vaccine. Further work is needed to understand the strategies that can support decision-making during pandemics amongst people who remain uncertain about the need for the vaccines or are concerned about vaccine safety. This includes innovatively exploring the role of peer-to-peer communication and the influence it may have on correcting misunderstandings and supporting confidence.

'Getting the vaccine makes me a champion of it': Exploring perceptions towards peer-to-peer communication about the COVID-19 vaccines amongst Australian adults

OBJECTIVES

Peer-to-peer communication approaches have been previously described as the 'power of personal referral'. Rather than relying on official channels of information, peer-to-peer communication may have a role in supporting changes in understanding and possibly behaviours. However, in emergency or pandemic situations, there is currently limited understanding of whether community members feel comfortable speaking about their vaccine experiences or advocating to others. This study explored the perceptions of COVID-19 vaccinated and unvaccinated Australian adults regarding their preferences and opinions about peer-peer communication and other vaccine communication strategies.

STUDY DESIGN

Qualitative interview research.

METHODS

In-depth interviews were conducted in September 2021 with 41 members of the Australian community. Thirty-three participants self-identified as being vaccinated against COVID-19, while the remainder were not vaccinated at the time or did not intend on receiving a COVID vaccine.

RESULTS

Amongst those who were vaccinated, participants spoke about being willing to promote the vaccine and correct misinformation and felt empowered following their vaccination. They highlighted the importance of peer-to-peer communication and community messaging, expressing the need for both strategies in an immunisation promotional campaign, with a slight emphasis on the persuasive power of communication between family and friends. However, those who were unvaccinated tended to dismiss the role of community messaging, commenting on a desire not to be like one of the many who listened to the advice of others.

CONCLUSION

During emergency situations, governments and other relevant community organisations should consider harnessing peer-to-peer communication amongst motivated individuals as a health communication intervention. However further work is needed to understand the support that this constituent-involving strategy requires.

PATIENT OR PUBLIC CONTRIBUTION

Participants were invited to participate through a series of online promotional pathways including emails and social media posts. Those who completed the expression of interest and met the study criteria were contacted and sent the full study participant information documentation. A time for a 30 min semi-structured interview was set and provided with a $50 gift voucher at the conclusion.

Inhibition of STAT3 signaling leads to apoptosis of leukemic large granular lymphocytes and decreased Mcl-1 expression

Large granular lymphocyte (LGL) leukemia is characterized by the expansion of antigen-activated cytotoxic T lymphocytes. These leukemic cells are resistant to Fas-mediated apoptosis despite expressing high levels of Fas. We found that leukemic LGL from 19 patients displayed high levels of activated STAT3. Treatment of leukemic LGL with the JAK-selective tyrosine kinase inhibitor AG-490 induced apoptosis with a corresponding decrease in STAT-DNA binding activity. Moreover, using an antisense oligonucleotide approach to diminish STAT3 expression, we found that Fas sensitivity was restored in leukemic LGL. AG-490-induced apoptosis in leukemic LGL was independent of Bcl-xL or Bcl-2 expression. However, we found that the Bcl-2-family protein Mcl-1 was significantly reduced by AG-490 treatment. Activated STAT3 was shown to bind an SIE-related element in the murine mcl-1 promoter. Using a luciferase reporter assay, we demonstrated that v-src overexpression in NIH3T3 induced STAT3-dependent transcriptional activity from the mcl-1 promoter and increased endogenous Mcl-1 protein levels. We conclude that STAT3 activation contributed to accumulation of the leukemic LGL clones. These findings suggest that investigation should focus on novel strategies targeting STAT3 in the treatment of LGL leukemia.

The distribution of omega-conotoxin MVIICnle-binding sites in rat brain measured by autoradiography

An analogue of omega-conotoxin MVIIC, [125I]omega-MVIICnle, has been employed in an autoradiographic assay to define the distribution of binding sites in rat brain of this neuronal calcium channel antagonist. In comparison with N-type channels (labeled by [125I]omega conotoxin GVIA), omega-MVIICnle sites are much denser in cerebellum (molecular layer) than in forebrain. Binding in thalamus is also comparatively high for omega-MVIICnle. Under these conditions, [125I]omega-MVIICnle binding to rat brain sections is not displaceable by the N-channel antagonist, omega-conotoxin GVIA. The calcium channel blocker [125I]omega-conotoxin MVIICnle labels a unique set of binding sites in mammalian brain.

Determination of canrenone, the major metabolite of spironolactone, in plasma and urine by high-performance liquid chromatography

An assay procedure for measuring plasma and urine levels of canrenone is described. The drug is extracted with n-hexane-toluene (1:1, v/v) after adding spirorenone as internal standard, and is then separated from plasma constituents and metabolites by high-performance liquid chromatography followed by UV detection at 285 nm. The limit of detection is less than 5 ng/ml. Interference with a series of spironolactone and canrenone metabolites was not observed. Plasma levels and renal excretion of canrenone after oral administration of 200 mg of spironolactone and intravenous injection of 200 mg of potassium canrenoate to a healthy male volunteer were measured.

Pharmacokinetics of canrenone after oral administration of spironolactone and intravenous injection of canrenoate-K in healthy man

Five healthy male volunteers received canrenoate-K 200 mg (Sincomen pro injectione) by intravenous injection and one week later spironolactone 200 mg (Sincomen-100) orally. Plasma levels and urinary excretion of unchanged canrenone were determined up to 24 h by a specific HPLC method. Following intravenous administration, the maximum plasma level of 2066 +/- 876 ng/ml was found after 29 +/- 15 min and thereafter the concentration declined with a half-life of 3.7 +/- 1.2 h. Total clearance was 4.2 +/- 1.7 ml/min . kg. After oral ingestion, the maximum concentration of 177 +/- 33 ng/ml was observed at 4.4 +/- 0.9 h. The absolute bioavailability of canrenone was 25 +/- 9%. Within 24 h, respectively 0.4 and 0.6 mg, canrenone were excreted by the kidney after intravenous and oral administration. The half-life of elimination was 4.9 +/- 1.8 h (i.v.) and 3.9 +/- 1.2 h (p.o.).