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The public has voiced concern over the adverse effects of vaccines from the moment Dr. Edward Jenner introduced the first smallpox vaccine in 1796. The controversy over childhood immunization intensified in 1998, when Dr. Andrew Wakefield linked the MMR vaccine to autism. Although Wakefield’s findings were later discredited and retracted, and medical and scientific evidence suggests routine immunizations have significantly reduced life-threatening conditions like measles, whooping cough, and polio, vaccine refusal and vaccine-preventable outbreaks are on the rise. This book explores vaccine hesitancy and refusal among parents in the industrialized North. Although biomedical, public health, and popular science literature has focused on a scientifically ignorant public, the real problem, Maya J. Goldenberg argues, lies not in misunderstanding, but in mistrust. Public confidence in scientific institutions and government bodies has been shaken by fraud, research scandals, and misconduct. Her book reveals how vaccine studies sponsored by the pharmaceutical industry, compelling rhetorics from the anti-vaccine movement, and the spread of populist knowledge on social media have all contributed to a public mistrust of the scientific consensus. Importantly, it also emphasizes how historical and current discrimination in health care against marginalized communities continues to shape public perception of institutional trustworthiness. Goldenberg ultimately reframes vaccine hesitancy as a crisis of public trust rather than a war on science, arguing that having good scientific support of vaccine efficacy and safety is not enough. In a fraught communications landscape, Vaccine Hesitancy advocates for trust-building measures that focus on relationships, transparency, and justice.
Vaccine reluctance and refusal are no longer limited to the margins of society. Debates around vaccines' necessity -- along with quesitons around their side effects -- have gone mainstream, blending with geopolitical conflicts, political campaigns, celebrity causes, and "natural" lifestyles to win a growing number of hearts and minds. Today's anti-vaccine positions find audiences where they've never existed previously. Stuck examines how the issues surrounding vaccine hesitancy are, more than anything, about people feeling left out of the conversation. A new dialogue is long overdue, one that addresses the many types of vaccine hesitancy and the social factors that perpetuate them. To do this, Stuck provides a clear-eyed examination of the social vectors that transmit vaccine rumors, their manifestations around the globe, and how these individual threads are all connected.
Immunization against disease is among the most successful global health efforts of the modern era, and substantial gains in vaccination coverage rates have been achieved worldwide. However, that progress has stagnated in recent years, leaving an estimated 20 million children worldwide either undervaccinated or completely unvaccinated. The determinants of vaccination uptake are complex, mutable, and context specific. A primary driver is vaccine hesitancy - defined as a "delay in acceptance or refusal of vaccines despite availability of vaccination services". The majority of vaccine-hesitant people fall somewhere on a spectrum from vaccine acceptance to vaccine denial. Vaccine uptake is also hampered by socioeconomic or structural barriers to access. On August 17-20, 2020, the Forum on Microbial Threats at the National Academies of Sciences, Engineering, and Medicine held a 4-day virtual workshop titled The Critical Public Health Value of Vaccines: Tackling Issues of Access and Hesitancy. The workshop focused on two main areas (vaccine access and vaccine confidence) and gave particular consideration to health systems, research opportunities, communication strategies, and policies that could be considered to address access, perception, attitudes, and behaviors toward vaccination. This publication summarizes the presentations and discussion of the workshop.
Quick vaccine rollouts are crucial for a strong economic recovery, but vaccine hesitancy could prolong the pandemic and the need for social distancing and lockdowns. We use individual-level data from nationally representative surveys developed by YouGov and Imperial College London to empirically examine the determinants of vaccine hesitancy across 17 countries and over time. Vaccine demand depends on demographic features such as age and gender, but also on perceptions about the severity of COVID-19 and side effects of the vaccine, vaccine access, compliance with protective behaviors, overall trust in government, and how information is shared with peers. We then introduce vaccine hesitancy into an extended SIR model to assess its impact on pandemic dynamics. We find that hesitancy can increase COVID-19 infections and deaths significantly if it slows down vaccine rollouts, but has a smaller impact if all willing adults can be immunized rapidly.
The ultimate guide for anyone wondering how President Joe Biden will respond to the COVID-19 pandemic—all his plans, goals, and executive orders in response to the coronavirus crisis. Shortly after being inaugurated as the 46th President of the United States, Joe Biden and his administration released this 200 page guide detailing his plans to respond to the coronavirus pandemic. The National Strategy for the COVID-19 Response and Pandemic Preparedness breaks down seven crucial goals of President Joe Biden's administration with regards to the coronavirus pandemic: 1. Restore trust with the American people. 2. Mount a safe, effective, and comprehensive vaccination campaign. 3. Mitigate spread through expanding masking, testing, data, treatments, health care workforce, and clear public health standards. 4. Immediately expand emergency relief and exercise the Defense Production Act. 5. Safely reopen schools, businesses, and travel while protecting workers. 6. Protect those most at risk and advance equity, including across racial, ethnic and rural/urban lines. 7. Restore U.S. leadership globally and build better preparedness for future threats. Each of these goals are explained and detailed in the book, with evidence about the current circumstances and how we got here, as well as plans and concrete steps to achieve each goal. Also included is the full text of the many Executive Orders that will be issued by President Biden to achieve each of these goals. The National Strategy for the COVID-19 Response and Pandemic Preparedness is required reading for anyone interested in or concerned about the COVID-19 pandemic and its effects on American society.
COVID-19 is a threat to university reopening. Universities are sites of dense human contact, congregate living, and heterogenous mixing patterns that may increase risk of viral transmission within and between social groups. Understanding attitudes toward vaccine uptake is critical to strategic reopening. At the University of Washington, we conducted a prospective observational study of SARS-CoV-2 surveillance in faculty, staff, and students (n=17,994) between 09-Sep-2020 and 27-Jan-2021. Demographic characteristics and attitudes toward vaccination were collected at baseline and followed-up among the same cohort. Participants were asked to complete daily electronic check-ins (email or text) to assess symptoms and risk factors. At baseline, 14,353 (79.8%) were vaccine receptive and 3,641 (20.2%) were vaccine hesitant (responded that when the COVID-19 vaccine becomes available to them, they would not plan to get vaccinated, or were uncertain).Of the 3,641 who were vaccine hesitant at baseline, 2,360 (64.8%) participants were followed-up to reassess attitudes in the time period after FDA Emergency Use Authorization (EUA) of two SARS-CoV-2 vaccines using mRNA formulations (Pfizer, Moderna). Among the 2,360 who were followed-up, 649 (27.5%) were hesitant at follow-up (continued hesitancy). In an analysis using multivariate regression, we observed that continued hesitancy was relatively more common among Black (PR 1.97, 95% CI 1.52-2.54) and Asian (PR 1.56, 95%CI 1.31-1.85) respondents than among Whites; persons who reported non-receipt of prior year’s influenza vaccine (PR 1.73, 95%CI 1.49-2.01); and residence outside Seattle city limits (PR 1.52, 95%CI 1.27-1.84). Faculty status was associated with a lower likelihood of continued hesitancy (PR 0.45, 95%CI 0.25-0.82, compared to students). Students in Greek congregate living were somewhat more likely to remain hesitant than those living off-campus (PR 1.29, 95%CI 0.99-1.78). In this cohort of university staff, students, and faculty, continued vaccine hesitancy after vaccine EUA was relatively more common in persons at higher risk for COVID-19 infection and transmission. Understanding hesitancy patterns is important for university reopening and campus public health planning.
Paediatric Rheumatology is an indispensible resource for the identification and management of specific rheumatological disorders. As well as covering common and rare rheumatological problems, there are also chapters on investigations and emergencies, designed for quick reference. The handbook includes dedicated topics on systemic diseases affecting rheumatology; the relevant clinical guidelines and information needed for a rheumatologist to successfully management a young patient; and, a coloured section for guidance on rash-related investigations. Paediatric Rheumatology is also fully endorsed by the British Society for Paediatric and Adolescent Rheumatology and the UK Paediatric Rheumatology Clinical Studies Group.
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