Vaccine attributes and vaccine uptake in Hungary: evidence from a conjoint experiment.

BACKGROUND: In an ongoing public health crisis, the question of why some people are unwilling to take vaccines with particular attributes is an especially pertinent one, since low rates of vaccination mean that it will take longer for many nations to exit the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In this article, we conduct a pre-registered conjoint experiment in Hungary (N = 2512), where respondents were asked about their attitudes towards hypothetical COVID-19 vaccines whose characteristics varied across a number of attributes. RESULTS: Results indicate that vaccine attributes matter for the likelihood of uptake when it comes to the prevalence of severe side effects, efficacy and country of origin. Moreover, we find that our pre-treatment measure of institutional trust moderates the effect of our treatment, as differences in vaccine attributes are larger for those with robust levels of institutional trust compared to those with weaker levels. CONCLUSION: Our findings suggest that institutional trust matters when it comes to understanding the relationship between vaccine attributes and likelihood of uptake.

Lessons learned by thoracic surgeons during the COVID-19 pandemic.

Background: The scale of the coronavirus disease 2019 (COVID-19) pandemic has necessitated healthcare systems to adapt and evolve, altering physician roles and expectations. Thoracic surgeons have seen practice changes from new COVID-19 consults to necessary delay and triage of elective care. The goal of this study was to understand the impact of COVID-19 on thoracic surgeon experiences in order to anticipate roles and changes in practice in future such circumstances. Methods: Semi-structured, qualitative individual telephone interviews were conducted with thoracic surgeons. Interviews were structured to understand how surgeons were impacted by the COVID-19 pandemic and to record lessons learned. Interviews were conducted until thematic saturation was achieved. Data were analyzed using matrix analysis. Results: Eleven board-certified general thoracic surgeons from nine institutions were interviewed. Thoracic surgeon roles in COVID-19 care included critical care delivery, performing tracheostomies and establishing related protocols, and interventions for long-term airway complications. Attention was called to the impact of the pandemic on thoracic cancer: patients avoided hospitals because of concern over COVID-19, delaying care. Conclusions: Thoracic surgeons played a critical role in the COVID-19 pandemic response in both technical patient care and administrative capacities. Primary care responsibilities included the development, administration and delivery of tracheostomy protocols, and the care of down-stream airway complications. Thoracic surgeons were critical in triage decisions to minimize the impact of COVID-19 on thoracic cancer care. Lessons learned during the COVID-19 pandemic may provide insight into opportunities to promote collaboration in thoracic surgery and facilitate improved care delivery in future settings of resource limitation.

Minimal effects from injunctive norm and contentiousness treatments on COVID-19 vaccine intentions: evidence from 3 countries.

Does information about how other people feel about COVID-19 vaccination affect immunization intentions? We conducted preregistered survey experiments in Great Britain (5,456 respondents across 3 survey waves from September 2020 to February 2021), Canada (1,315 respondents in February 2021), and the state of New Hampshire in the United States (1,315 respondents in January 2021). The experiments examine the effects of providing accurate public opinion information to people about either public support for COVID-19 vaccination (an injunctive norm) or public beliefs that the issue is contentious. Across all 3 countries, exposure to this information had minimal effects on vaccination intentions even among people who previously held inaccurate beliefs about support for COVID-19 vaccination or its perceived contentiousness. These results suggest that providing information on public opinion about COVID vaccination has limited additional effect on people's behavioral intentions when public discussion of vaccine uptake and intentions is highly salient.

Leading the World: A Review of Household Recycling in Wales

Wales is one of the world leaders in household waste recycling with a steady recent recycling rate of ~65%. The Welsh Assembly Government (WAG) set a statutory target of achieving a 70% recycling rate by 2024/25. We reviewed historical trends in waste management in Wales from 2006 to 2020, with a focus on recycling. Authoritative, official data were obtained from WasteDataFlow, an Internet system for municipal waste data reporting by UK local authorities to government. Data are collected quarterly allowing the generation of time series plots, trendlines and like-for-like comparisons between groupings of various characteristics, such as number of separate kerbside collections, income, political preference, and impact of policy changes. Results showed that the approach taken by the WAG to politically prioritise and encourage participation in household recycling has achieved impressive results that contrast starkly with the recycling performance of other UK countries. In Wales, household waste disposed annually per person via landfill decreased from ~410 kg to <50 kg and household waste recycled increased from to ~150 kg to ~310 kg, with a recent increase in incineration with energy recovery to ~135 kg as infrastructure has come online. Recycling rates show a seasonal variation due to increases in garden waste sent for composting in the summer. There are variations in local authority performance across Wales, mainly caused by variations in the number of separate collections. Co-mingled collections tend to lead to higher contamination of recyclates that are then not able to be sold for recycling. Deprivation, as indicated by differences in income, also influences total waste arisings and recycling rates. A plateau of ~65% recycling rate was reached in 2020, with incineration reaching a rate of >25%. The recycling rate plateaus at exactly the same time as incineration comes on stream. Evidence demonstrates that improvements to recycling rates can become more difficult when incineration becomes available. Whilst further reductions and improvements to recycling in Wales will be more challenging, the WAG’s track record of focused proactive political and policy support shows what can be achieved when there is suitable political will. The WAG has demonstrated that it tends to deliver on its waste-related plans, and it clearly has the best chance of any of the UK’s four countries of achieving its aims.

Stamping the vaccine passport? Public support for lifting COVID-19 related restrictions for vaccinated citizens in France, Germany, and Sweden☆

During the COVID-19 pandemic, many countries implemented restrictions to limit the spread of the SARS-CoV-2 virus (e.g. travel restrictions and lockdowns). One path to loosening restrictions is to do so selectively only for vaccinated individuals (e.g. by implementing vaccine passports domestically or as a prerequisite for international travel). Setting different rules based on people’s vaccination status is however a contentious issue among health policy experts, government officials, and the public. Our analysis focuses on the levels and correlates of public support for the lifting of restrictions for the vaccinated in April 2021, i.e. at a time when restrictions were in place and a selective lifting of these restrictions just for the vaccinated was debated in Europe. We use representative quota samples of the populations of France (N=1,752), Germany (N=1,759), and Sweden (N=1,754). We find that a slight plurality support lifting restrictions for the vaccinated in France and Germany but not in Sweden. Vaccine hesitancy emerges as strong predictor of opposition to such a policy. Additionally, individuals who are already vaccinated (in France and Germany) and who are higher in risk-seeking express more support for the lifting of restrictions for the vaccinated. We discuss implications for the debate on vaccine passports.

Which vaccine attributes foster vaccine uptake? A cross-country conjoint experiment.

Why do people prefer one particular COVID-19 vaccine over another? We conducted a pre-registered conjoint experiment (n = 5,432) in France, Germany, and Sweden in which respondents rated the favorability of and chose between pairs of hypothetical COVID-19 vaccines. Differences in effectiveness and the prevalence of side-effects had the largest effects on vaccine preferences. Factors with smaller effects include country of origin (respondents are less favorable to vaccines of Chinese and Russian origin), and vaccine technology (respondents exhibited a small preference for hypothetical mRNA vaccines). The general public also exhibits sensitivity to additional factors (e.g. how expensive the vaccines are). Our data show that vaccine attributes are more important for vaccine preferences among those with higher vaccine favorability and higher risk tolerance. In our conjoint design, vaccine attributes-including effectiveness and side-effect prevalence-appear to have more muted effects among the most vaccine hesitant respondents. The prevalence of side-effects, effectiveness, country of origin and vaccine technology (e.g., mRNA vaccines) determine vaccine acceptance, but they matter little among the vaccine hesitant. Vaccine hesitant people do not find a vaccine more attractive even if it has the most favorable attributes. While the communication of vaccine attributes is important, it is unlikely to convince those who are most vaccine hesitant to get vaccinated.

Estimating the size of "anti-vax" and vaccine hesitant populations in the US, UK, and Canada: comparative latent class modeling of vaccine attitudes.

Vaccine hesitancy is a significant impediment to global efforts to vaccinate against the SARS-CoV-2 virus at levels that generate herd immunity. In this article, we show the utility of an inductive approach - latent class analysis (LCA) - that allows us to characterize the size and nature of different vaccine attitude groups; and to compare how these groups differ across countries as well as across demographic subgroups within countries. We perform this analysis using original survey data collected in the US, UK, and Canada. We also show that these classes are strongly associated with SARS-CoV-2 vaccination intent and perceptions of the efficacy and safety of the COVID-19 vaccines, suggesting that attitudes about vaccines to fight the novel coronavirus pandemic are well explained by latent vaccine attitudes that precede the pandemic. More specifically, we find four substantive classes of vaccine attitudes: strong supporters, supporters with concerns, vaccine hesitant, and "anti-vax" as well as a fifth measurement error class. The strong "anti-vax" sentiment class is small in all three countries, while the strong supporter class is the largest across all three countries. We observe different distributions of class assignments in different demographic groups - most notably education and political leaning (partisanship and ideology).

The ephemeral effects of fact-checks on COVID-19 misperceptions in the United States, Great Britain and Canada.

Widespread misperceptions about COVID-19 and the novel coronavirus threaten to exacerbate the severity of the pandemic. We conducted preregistered survey experiments in the United States, Great Britain and Canada examining the effectiveness of fact-checks that seek to correct these false or unsupported beliefs. Across three countries with differing levels of political conflict over the pandemic response, we demonstrate that fact-checks reduce targeted misperceptions, especially among the groups who are most vulnerable to these claims, and have minimal spillover effects on the accuracy of related beliefs. However, these reductions in COVID-19 misperception beliefs do not persist over time in panel data even after repeated exposure. These results suggest that fact-checks can successfully change the COVID-19 beliefs of the people who would benefit from them most but that their effects are ephemeral.

COVID-19 Guidance for Triage of Operations for Thoracic Malignancies: A Consensus Statement From Thoracic Surgery Outcomes Research Network.

The extraordinary demands of managing the COVID-19 pandemic has disrupted the world's ability to care for patients with thoracic malignancies. As a hospital's COVID-19 population increases and hospital resources are depleted, the ability to provide surgical care is progressively restricted, forcing surgeons to prioritize among their cancer populations. Representatives from multiple cancer, surgical, and research organizations have come together to provide a guide for triaging patients with thoracic malignancies as the impact of COVID-19 evolves as each hospital.

COVID-19 guidance for triage of operations for thoracic malignancies: A consensus statement from Thoracic Surgery Outcomes Research Network.

The extraordinary demands of managing the COVID-19 pandemic has disrupted the world's ability to care for patients with thoracic malignancies. As a hospital's COVID-19 population increases and hospital resources are depleted, the ability to provide surgical care is progressively restricted, forcing surgeons to prioritize among their cancer populations. Representatives from multiple cancer, surgical, and research organizations have come together to provide a guide for triaging patients with thoracic malignancies as the impact of COVID-19 evolves as each hospital.