Attitudes toward COVID-19 vaccines during pregnancy and breastfeeding.

Background: Although vaccination is one of the most effective means of controlling the spread of COVID-19, public concerns and indecision about vaccination still continue. Because pregnant and breastfeeding individuals are at high risk for severe outcomes in case of infections, determining their level of hesitation and attitude toward COVID-19 vaccines will guide the management of the disease. This study aimed to determine pregnant and breastfeeding women's levels of hesitation and attitude toward COVID-19 vaccines as well as their related factors. Methods: The sample of this descriptive research consisted of 103 pregnant or breastfeeding individuals who were seen at the obstetrics and gynecology outpatients clinic of a state hospital in Istanbul, Turkey. The data were collected using a 'demographic data form', the 'Vaccine Hesitancy Scale in Pandemic', and the 'Attitudes toward COVID-19 Vaccine Scale'. The research data were analyzed with appropriate statistical methods. Results: The mean age of the participants was 29.71 ± 4.75, 51% were pregnant, and 74.8% had received the COVID-19 vaccine. The mean score of the 'Vaccination Hesitancy Scale in Pandemic' was 30.83 ± 6.91, and the mean score for the 'Attitude Scale toward the COVID-19 Vaccine' was 25.50 ± 5.20. A significant difference was found between the total score of the 'Vaccine Hesitation Scale in the Pandemic' and the mean score of the 'Lack of Confidence' sub-dimension between the 'working status' and the 'influenza vaccination' status. In terms of the mean score of the 'Risk' sub-dimension, a significant difference was found between the 'period of vaccination' (p < 0.05). According to the mean total score of the 'Attitude Towards COVID-19 Vaccine Scale', there was a significant difference between the 'smoking' status. There was a significant difference in the 'Positive Attitude' sub-dimension in terms of the 'flu vaccination' status. There was a significant difference in the 'Negative Attitude' sub-dimension in terms of the 'chronic disease' status. A positive correlation was found between the total scores of the scales. Conclusion: It was concluded that although the participants had a high level of hesitation toward the COVID-19 vaccine, they had a positive attitude. The results obtained will be guided in determining the strategies to be developed for these specific groups in future pandemics.

Cobertura vacinal e o movimento antivacina: o impacto na saúde pública no Brasil / Vaccination coverage and anti-vaccine movement: the impact on public health in Brazil / Cobertura de vacunación y movimiento antivacuna: el impacto en la salud pública en Brasil

A vacina constitui um dos principais métodos de prevenção contra doenças. Em 1973, o Brasil criou o Programa Nacional de Imunizações a fim de promover a imunização gratuita para a população, o que mais tarde tornou o país em referência mundial em vacinação. No entanto, a recusa vacinal ainda é um grande problema de saúde pública, sendo o movimento antivacina um dos destaques dessa realidade. Dessa forma, o objetivo deste artigo é avaliar como o movimento antivacina impacta na saúde pública no Brasil através da diminuição da cobertura vacinal. Trata-se de uma pesquisa de metodologia mista, com uma primeira etapa qualitativa, composta de uma revisão integrativa nas plataformas PubMed, LILACS e SciELO, no período de 2010 a 2020, e uma pesquisa documental em portais de movimentos antivacina; e uma segunda etapa quantitativa, em que foi realizado um estudo epidemiológico do tipo ecológico, com consulta nas bases eletrônicas do Datasus e no Sistema de Informações do Programa Nacional de Imunizações (SI-PNI), no período de 2010 a 2022. No período investigado, apenas em 2015 o Brasil alcançou a meta preconizada de cobertura vacinal, diferentemente dos anos seguintes, que apresentaram oscilações preocupantes. As publicações apresentam argumentos utilizados pelos grupos antivacina, evidenciados entre 2015 e 2019, período em que os dados de cobertura vacinal oscilaram. Assim, conclui-se que a ascensão do movimento antivacina é um dos fatores que influenciaram na queda da vacinação no Brasil, a exemplo do sarampo e da febre amarela.

The vaccine is one of the main methods of preventing diseases. Since 1973, Brazil created the National Immunization Program to ensure free immunization to the population, which later made the country a world reference in vaccination. However, vaccine refusal is still a great public health issue, and the anti-vaccine movement stand out in this reality. Thus, the purpose of this article is to evaluate how the anti-vaccine movement affects public health in Brazil with vaccination coverage reduction. This is a mixed methodology study, with first a qualitative step, composed of an integrative review in the platforms PubMed, LILACS, and SciELO, in the period from 2010 to 2020,and a documental research in portals of anti-vaccination movements; and a second quantitative step, where an epidemiological study of the ecological type was carried out, with consultation in the electronic databases of DATASUS and in the Information System of the National Immunization Program (SI-PNI) in the period of 2010 to 2022. In the investigative period, only in 2015 Brazil managed to reach the recommended vaccination coverage goal, unlike in the following years, which showed worrying fluctuations. The publications summarize arguments used by the anti-vaccination groups, evidenced between 2015 and 2019, a period in which the vaccination coverage data fluctuated. Therefore, it is clear that the rise of the anti-vaccination movement is a factor that influenced the drop in vaccination numbers in Brazil, with yellow fever and measles as examples.

La vacuna es uno de los principales métodos de prevención de enfermedades. En 1973, Brasil creó el Programa Nacional de Inmunización con el fin de promover la inmunización gratuita para la población, lo que luego convirtió al país en un referente mundial en vacunación. Sin embargo, la negativa de la vacuna sigue siendo un problema importante en la salud pública, y el movimiento antivacunas es uno de los aspectos más destacados de esta realidad. Así, el objetivo de este artículo es evaluar cómo el movimiento antivacunas impacta en la salud pública en Brasil mediante la disminución de la cobertura de vacunación. Se trata de un estudio epidemiológico mixto, con una primera etapa cualitativa, consistente en una revisión integradora en las plataformas PubMed, Lilacs y SciELO, en el período de 2010 a 2020, y una investigación documental en portales de movimientos antivacunas; y una segunda etapa cuantitativa, en la que se realizó un estudio epidemiológico de tipo ecológico, con consulta en las bases de datos electrónicas de DATASUS y en el Sistema de Información del Programa Nacional de Inmunización (SI-PNI), en el período de 2010 a 2022. Entre eses años, solo el año 2015 logró alcanzar la meta recomendada, a diferencia de los años siguientes, que mostraron fluctuaciones preocupantes en la cobertura de vacunación. Las publicaciones mostraron los argumentos utilizados por los grupos antivacina, evidenciados entre 2015 y 2019, período en que los datos de cobertura de la vacuna fluctuaron. Así, se concluye que la asunción del movimiento antivacunación es uno de los factores que influye en la caída de la vacunación en Brasil, como en el sarampión y la fiebre amarilla.

VACCINATION CARD: IMPORTANT INSTRUMENT TO STIMULATE THE VACCINATION AUTONOMY OF STUDENTS / CARTILLA DE VACUNACIÓN: UNA HERRAMIENTA IMPORTANTE PARA PROMOVER LA AUTONOMÍA DE VACUNACIÓN DE LOS ESTUDIANTES / CARTÃO DE VACINAÇÃO: IMPORTANTE INSTRUMENTO PARA INCENTIVAR A AUTONOMIA VACINAL DE ESTUDANTES

Due to the decrease in adherence to vaccination and strengthened by the anti-vaccination movement, world vaccination coverage is at a low level and there is a recirculation of once eradicated diseases. In Brazil, recognized for its successful campaigns to vaccinate childrenand adolescents, the valid document for measuring vaccination coverage is the vaccination card (VC). However, there is a gap between subjects and their VCs, in which deterioration and misplacement of this document are recurrent. Thus, the present study proposed the application of a didactic sequence involving aspects of vaccination, in order to stimulate the vaccinal autonomy of students in a public school. Theoretical classes were taught; exhibition of the animation "Cells at Work!"; and carried out practices with the VC of the students themselves. Among the participants, 88.24% and 82.35% showed, respectively, understanding that the cells of the immune system act through phagocytosis and the production of antibodies. 76.47% understood that vaccines provide individual and collective protection and 64.71% that the VC allows monitoring the individual's vaccination status. Among the vaccines consulted, most were vaccinated against polio, measles and Covid-19, and for this last vaccine, everyone had taken at least the first dose. Surprisingly, 78.57% stated that they had already had access to their VV, however only 28.57% had considered the information contained therein. Finally, 92.86% stated that they needed to check and update the VC and felt compelled to keep the VC in accordance with the national vaccination schedule, showing the awareness of these students' vaccinal autonomy.

Debido a la disminución de la adherencia a la vacunación y fortalecida por el movimiento antivacunación, la cobertura mundial de vacunación se encuentra en un nivel bajo y existe una recirculación de enfermedades erradicadas. En Brasil, reconocido por sus exitosas campañas de vacunación de niños y adolescentes, el documento válido para medir las coberturas de vacunación es la cartilla de vacunación (CV). El presente estudio propuso la aplicación de una secuencia didáctica que involucra aspectos de vacunación, con el fin de estimular la autonomía vacunal de los alumnos. Se impartieron clases teóricas; se mostró la animación "Cells at Work!"; y las prácticas se realizaron con las CVs de los propios alumnos. Entre los participantes, el 88,24% y el 82,35% mostraron, respectivamente, comprender que las células inmunitarias actúan por fagocitosis y la producción de anticuerpos. El 76,47% entendió que las vacunas brindan protección individual y colectiva y el 64,71% que la CV permite monitorear el estado vacunal del individuo. Entre las vacunas, la mayoría estaban vacunadas contra la poliomielitis, el sarampión y el Covid-19 (en las que todos habían tomado al menos la primera dosis). Sorprendentemente, el 78,57% afirmó que ya había tenido acceso a su CV, sin embargo, solo el 28,57% había considerado la información contenida en la CV. Finalmente, el 92,86% afirmó que necesitaba revisar y actualizar la CV y se sintió obligado a mantener la CV de acuerdo con el calendario nacional de vacunación, lo que demuestra la conciencia de la autonomía vacunal de estos estudiantes.

Devido à diminuição da adesão à vacinação e fortalecidos pelo movimento antivacina, a cobertura vacinal mundial encontra-se em baixa e observa-se a recirculação de doenças outrora erradicadas. No Brasil, reconhecido por suas campanhas bem-sucedidas para vacinação de crianças e adolescentes, o documento válido para aferimento da cobertura vacinal é o cartão de vacinação (CV). Todavia, observa-se um distanciamento entre sujeitos e seus CVs, em que deterioração e extravios desse documento são recorrentes. Assim, o presente estudo propôs a aplicação de uma sequência didática envolvendo aspectos da vacinação, a fim de estimular a autonomia vacinal de estudantes de uma escola pública. Foram lecionadas aulas teóricas; exibidos episódios da animação "Cells at Work!"; e realizadas práticas com CVs dos próprios estudantes. Dentre os participantes, 88,24% e 82,35% mostraram, respectivamente, compreender que as células do sistema imunológico atuam por meio da fagocitose e da produção de anticorpos. 76,47% compreenderam que as vacinas conferem proteção individual e coletiva e 64,71% que o CV permite acompanhar o estado vacinal do indivíduo. Dentre as vacinas consultadas, a maioria era vacinada contra poliomielite, sarampo e Covid-19, sendo que para essa última vacina, todos haviam tomado pelo menos a primeira dose. Surpreendentemente, 78,57% afirmaram que já tinham tido acesso a seu CV, entretanto apenas 28,57% havia atentado às informações ali contidas. Por fim, 92,86% afirmaram que necessitam checar e atualizar o CV bem como se sentem impelidos a manter o CV em acordo com o calendário nacional de vacinação, evidenciando o despertar quanto à autonomia vacinal desses estudantes.

How to Respond to Misinformation From the Anti-Vaccine Movement.

Vaccines are doubtlessly one of the most crucial life-saving medical interventions to date. However, perplexingly, they court more public controversy than their objectively excellent safety profile warrants. While doubts about the safety of vaccines, as well as opposition to vaccine policies, can be traced back at least to the mid-19th century, the modern anti-vaccine movement has come in 3 distinct waves, or generations, each precipitating around distinct key events. Here, we describe the first 2 generations and trace the origins of an emerging third generation anti-vaccine movement. Currently, this third generation is an integral part of the larger anti-COVID movement and in this more libertarian environment propagates the idea of individualism superseding the responsibility for community health. We highlight the need for a better science education of the young, as well as the general public to further enhance overall science literacy and suggests strategies to achieve these goals.

The evil corporation master frame: The cases of vaccines and genetic modification.

Employing a qualitative content analysis of online comments made on YouTube and letters to the editor published in US newspapers, we examine the deployment and neutralization of the evil corporation master frame in debates on two distinct biotechnologies, vaccines and genetically modified organisms. This study builds on previous research by outlining three diagnostic components of the evil corporation master frame: dishonesty, greed, and the contamination of authority. It also finds that supporters of vaccines and genetically modified organisms seek to neutralize the evil corporation master frame through aggressive, defensive, endurance, and redemptive framings. This study provides ideational detail for the ways that controversial biotechnology is constructed. The particularly vexing anti-vaccine movement is not dissimilar from other challenges to mainstream science as disparate movements draw on the same master frame. It also demonstrates how defenses of genetically modified organisms and vaccines tend to reify the anti-corporate stigma that sustains challenges to scientific authority.

Correlation between Parental Vaccine Hesitancy, Socio-demographic Factors, and Novel SARS-CoV-2 Vaccination in Puerto Rico.

OBJECTIVE: Accurate and inaccurate vaccination information is readily accessible. Unfortunately, the information found by parents may be wrong. Due to the limited studies on this issue in Puerto Rico, we aim to correlate Puerto Rican parents' sociodemographic characteristics to their vaccine hesitancy level. METHODS: We quantified vaccine hesitancy in Puerto Rican parents and legal guardians who were at least 18 years old using the Parent Attitudes about Childhood Vaccines survey, their attitudes towards a possible SARS-CoV-2 vaccine, and the correlation between vaccine hesitancy and socio-demographic factors. The subjects were recruited through social networks and by distributing the online survey among pediatricians in Puerto Rico. RESULTS: We identified a vaccine hesitancy prevalence of 38.3%, higher than has been found by other similar studies. The results also demonstrated a significant association between vaccine hesitancy, income, and the type of legal guardian. Participants with a household income less than $75,000 and a legal guardian were more likely to be vaccine-hesitant. Most participants surveyed (80.8%) would not immediately vaccinate their children against SARS-CoV-2, independent of vaccine-hesitancy status, citing general worries of vaccine safety and side effects. CONCLUSION: Our results demonstrate the need for better vaccine-education campaigns in Puerto Rico and the challenges that SARS- CoV-2 vaccine fears pose to the proper control of the COVID-19 pandemic. It should be noted that at the time of the survey described herein, a COVID-19 vaccine had yet been developed.

Vaccine Hesitancy: Contemporary Issues and Historical Background.

Vaccination, despite being recognized as one of the most effective primary public health measures, is viewed as unsafe and unnecessary by an increasing number of individuals. Anxiety about vaccines and vaccination programs leading to vaccine hesitancy results from a complex mix of social and political influences, cultural and religious beliefs, the availability of and ability to interpret health and scientific information, and personal and population experiences of health systems and government policies. Vaccine hesitancy is becoming a serious threat to vaccination programs, and was identified as one of the World Health Organization's top ten global health threats in 2019. The negative impact of anti-vaccination movements is frequently cited as one of the major reasons for rising vaccine hesitancy amongst the general public world-wide. This review discusses the various issues surrounding vaccine hesitancy and the anti-vaccine movement, starting with the definitions of vaccine hesitancy and the anti-vaccine movement in their early history and in the modern era, before discussing the key drivers of vaccine hesitancy, particularly across different regions of the world, with a focus on various countries with low-, middle-, or high-income economies with different socio-economic populations. The review concludes with the impact of vaccine hesitancy on herd immunity and social, psychological, and public health measures to counter vaccine hesitancy.

Hashtag as a new weapon to resist the COVID-19 vaccination policy: a qualitative study of the anti-vaccine movement in Brazil, USA, and Indonesia.

In 2019, the World Health Organization (WHO) named the anti-vaccine movement one of the top 10 global health threats. This trend has shown that it can diminish public faith in government and increase public distrust of scientific results in the health sector, including the use of the COVID-19 vaccine. The purpose of this study is to examine the anti-vaccine movement on Twitter social media platform, which uses Hashtag to protest vaccination regulations in the COVID-19 pandemic. The content analysis, relationship analysis, and word cloud analysis models were used in this study, which used a descriptive qualitative approach. The primary data source for this study is Hashtag, which are used to focus on three aspects. First, establish which information in Brazil, the United States, and Indonesia leads the anti-vaccine COVID-19 narrative. Second, how does the Hashtag link between each country work? Third, which narrative dominates the use of Hashtag in each of the three countries? According to the findings of this study, in Brazil, 69.2% of Twitter Hashtag associated to the COVID-19 vaccination were negative, compared to 59.4% in the USA and 62.8% in Indonesia. In general, the Hashtag used in the three countries to oppose COVID-19 vaccination policies have a clear and significant relationship. In Brazil, the Hashtag #covidiots was the most popular, while in the United States, #covivaccine was the most popular, and in Indonesia, #antivaccine was the most popular.

Parents' Opinions and Knowledge About Vaccination in Poland - A Cross-Sectional Observational Study.

BACKGROUND AND OBJECTIVES: Despite the fact that vaccines save many lives worldwide, in many countries, including Poland, the percentage of unvaccinated children is constantly growing. The main reasons for low immunisation coverage include parents' concerns about the safety of vaccines, their fears related to possible adverse events following vaccination, and the increasingly powerful activity of anti-vaccine movements. It is necessary to monitor the public's attitudes to vaccination in order to implement appropriate solutions to prevent a resurgence of epidemics. The aim of the study was to assess Polish parents' opinions about and awareness of immunisation-related issues. METHODS: The study, based on an online survey, investigated Polish mothers' attitudes towards the use of vaccines, their opinions regarding the sanctions for a failure to vaccinate a child, and the correlations between the result and the socio-demographic characteristics. RESULTS: A total of 646 responses were collected, including 593 from mothers from general-interest groups and 53 from anti-vax groups. Differences were identified in vaccination coverage among children of respondents from general-interest groups and anti-vax groups. The findings show that the respondents from anti-vax groups stopped vaccinating more often due to vaccine adverse events and inadequate response from doctors. CONCLUSION: Most of the respondents are aware of anti-vaccine movements and have a negative attitude to them, but these movements still influence the public. Also, the findings show a correlation between the level of education and a general attitude to immunisation - people with higher education more often have a negative opinion on this matter.

Covid-19, the anti-vaccine movement and immunization challenges in Brazil: a review / Covid-19, o movimento anti-vacina e os desafios da imunização no Brasil: uma revisão

AIMS: The COVID-19 pandemic suddenly and significantly increased hospitalizations for pneumonia with systemic inflammatory disease. Since its appearance, COVID-19 has affected more than 200 countries, with more than 90 million cases and almost 2 million deaths. So far, there is no quality evidence regarding the specific pharmacological therapy for COVID-19; most treatments usually involve off-label use of existing drugs and have unproven efficacy. The global effort converges on the development of a vaccine; however, the greatest challenge is to achieve collective immunization in the face of increasing vaccination hesitancy. METHODS: This study investigated the impact of vaccine hesitancy movements on the goal of COVID-19 immunization in Brazil. An integrative bibliographic review was performed with an electronic search on PubMed and SciELO that yielded 13.535 articles. Inclusion and exclusion criteria were applied which included 29 interventional and descriptive studies. RESULTS: The results of the 29 studies revealed that the most frequent reasons for hesitation is skepticism about the true interests of the industry and politicians, the lack of trust in research, and inaccurate information on social media. CONCLUSION: The main factors that lead the population not to believe in vaccines were the real interests of industry and politicians, lack of confidence in research, and the amount of false information that circulates massively on social media and because of that it is possible that Brazil will face some challenges in achieving collective immunity due to the anti-vaccine movement.

OBJETIVOS: A pandemia de COVID-19 aumentou repentina e significativamente as hospitalizações por pneumonia com doença inflamatória sistêmica. Desde o seu surgimento, a COVID-19 afetou mais de 200 países, com mais de 90 milhões de casos e quase 2 milhões de mortes. Até o momento, não há evidências de qualidade em relação à terapia farmacológica específica para COVID-19; a maioria dos tratamentos geralmente envolve o uso off-label de medicamentos existentes e sem eficácia comprovada. O esforço global converge para o desenvolvimento de uma vacina; entretanto, o maior desafio é conseguir a imunização coletiva diante do aumento da recusa à vacinação. MÉTODOS: Este estudo investigou o impacto dos movimentos de recusa à vacina no objetivo de imunização com COVID-19 no Brasil. Foi realizada uma revisão bibliográfica integrativa com busca eletrônica no PubMed e SciELO que resultou em 13.535 artigos. Foram aplicados os critérios de inclusão e exclusão que incluíram 29 estudos de intervenção e descritivos. RESULTADOS: Os resultados dos 29 estudos revelaram que os motivos de hesitação mais frequentes são o ceticismo sobre os verdadeiros interesses da indústria e dos políticos, a falta de confiança em pesquisas e informações imprecisas nas redes sociais. CONCLUSÃO: Os principais fatores que levaram a população a não acreditar nas vacinas foram os reais interesses da indústria e dos políticos, a falta de confiança nas pesquisas e a quantidade de informações falsas que circulam massivamente nas redes sociais e por isso é possível que o Brasil enfrente alguns desafios para alcançar a imunidade coletiva devido ao movimento anti-vacinas.

Estrategias de aceptabilidad de la vacunación contra el virus del papiloma humano: una revisión sistemática / Acceptability of strategies for human papillomavirus vaccination: A systematic review

Resumen El cáncer de cuello uterino es la cuarta causa de cáncer en mujeres, siendo el virus del papiloma humano (VPH) su mayor factor de riesgo. Este virus produce, además, otros tipos de cáncer e infecciones que afectan a hombres y a mujeres. La vacuna del VPH ha mostrado eficacia y seguridad en su prevención, sin embargo, se han evidenciado barreras que disminuyen su aceptación en las comunidades. El objetivo de este estudio es identificar las estrategias más efectivas en la intervención comunitaria con el fin de mejorar la aceptabilidad de la vacunación contra el VPH. Se realizó una revisión sistemática en Cochrane, Scopus, Embase, Medline y Google Académico de junio a julio de 2019, sin restricciones temporales, en idioma inglés y español. Se incluyeron ensayos clínicos que evaluaran estrategias para mejorar la vacunación contra el VPH. Se revisaron 22 estudios que evaluaban estrategias de intervención comunitaria y se identificaron, principalmente tres: el uso de información y formación de tipo virtual, el involucramiento tanto de padres, madres o cuidadores como del personal sanitario, así como el involucramiento de los hombres y de las personas de orientación sexual diversa como población objetivo.

Abstract Cervical cancer is the fourth leading cause of cancer in women, with the human papillomavirus (HPV) being its major risk factor. This virus also produces other types of cancer and infections that affect men and women. The HPV vaccine has shown efficacy and safety in its prevention, however, barriers have been evident that decrease its acceptance in communities. The objective of this study is to identify the most effective strategies in community intervention to improve the acceptability of HPV vaccination. A systematic review was conducted in Cochrane, Scopus, Embase, Medline, and Google Scholar from June to July 2019, without time constraints, in English and Spanish. We included clinical trials evaluating strategies to improve HPV vaccination. We reviewed 22 studies evaluating community intervention strategies, and identified mainly three: the use of virtual information and training, involvement of parents and/or caregivers as well as health personnel, and involvement of men and people of diverse sexual orientation as a target population.

Social media and vaccine hesitancy: new updates for the era of COVID-19 and globalized infectious diseases.

Despite major advances in vaccination over the past century, resurgence of vaccine-preventable illnesses has led the World Health Organization to identify vaccine hesitancy as a major threat to global health. Vaccine hesitancy may be fueled by health information obtained from a variety of sources, including new media such as the Internet and social media platforms. As access to technology has improved, social media has attained global penetrance. In contrast to traditional media, social media allow individuals to rapidly create and share content globally without editorial oversight. Users may self-select content streams, contributing to ideological isolation. As such, there are considerable public health concerns raised by anti-vaccination messaging on such platforms and the consequent potential for downstream vaccine hesitancy, including the compromise of public confidence in future vaccine development for novel pathogens, such as SARS-CoV-2 for the prevention of COVID-19. In this review, we discuss the current position of social media platforms in propagating vaccine hesitancy and explore next steps in how social media may be used to improve health literacy and foster public trust in vaccination.

How health care providers should address vaccine hesitancy in the clinical setting: Evidence for presumptive language in making a strong recommendation.

Vaccine hesitancy occurs throughout the world and can result in poor vaccine uptake and vaccine-preventable disease-outbreaks. Vaccine hesitancy dates back to the days of Edward Jenner and the smallpox vaccine. It persists despite the preponderance of evidence supporting vaccine safety and effectiveness. Studies show even among parents of well-vaccinated children that 15-35% of those parents are vaccine-hesitant. Studies have failed to show the efficacy of educational interventions, and, indeed, a number of studies of educational interventions show a contrarian effect leaving the vaccine-hesitant more entrenched in their views. Still dozens of studies support health care provider recommendation as a major factor in achieving high rates of vaccine uptake. Furthermore, studies find those recommendations perceived as stronger are more effective than those perceived as weaker. What makes for a stronger recommendation? Several observational studies indicate that presumptive, announcement language as contrasted with participatory, conversational language makes for a stronger more effective recommendation. Several trials now demonstrate that health care providers and practices can implement this language and obtain higher vaccination uptake. The authors recommend the practice be adopted as a routine practice in the clinical setting for all vaccinations.

The anti-vaccine movement in Poland: The socio-cultural conditions of the opposition to vaccination and threats to public health.

The article analyses the cultural and political contexts of the revival of the anti-vaccine movement in Poland. According to the authors, the attempt to institutionalise and politicise anti-vaccine activists is part of the wider phenomenon of political populism in Eastern Europe. The attempt to abolish compulsory vaccinations, which is supported by right-wing populists, shows that the anti-Enlightenment and anti-Western shift in the public sphere in Eastern Europe can also affect the area of health protection. Western pharmaceutical concerns may be the same target of populist attacks as refugees and migrants. The authors claim that, like in the case of political nationalism, a widespread educational campaign and bottom-up social legal and political measures need to be implemented to combat disinformation about vaccination.

The Anti-vaccination Movement: A Regression in Modern Medicine.

There have been recent trends of parents in Western countries refusing to vaccinate their children due to numerous reasons and perceived fears. While opposition to vaccines is as old as the vaccines themselves, there has been a recent surge in the opposition to vaccines in general, specifically against the MMR (measles, mumps, and rubella) vaccine, most notably since the rise in prominence of the notorious British ex-physician, Andrew Wakefield, and his works. This has caused multiple measles outbreaks in Western countries where the measles virus was previously considered eliminated. This paper evaluates and reviews the origins of the anti-vaccination movement, the reasons behind the recent strengthening of the movement, role of the internet in the spread of anti-vaccination ideas, and the repercussions in terms of public health and safety.

Noninvasive vaccination as a casus belli to redeem vaccine value in the face of anti-vaccine movements.

Formidable anti-vaccine movements have been growing as a menace to disrupt beneficial vaccine programs. Although the vaccination-associated adverse effects commonly perceived by vaccine resisters usually represent over-reactions to rare manifestations, converging evidence shows that vaccination-associated health threats could be pervasive when systemic inflammation is considered as a side effect that oozes over time. An anti-vaccine movement thus may not be so unfounded even though the myriad cascades triggered by systemic inflammation have not been brought to a clear focus during any anti-vaccine campaign. Since both pro- and anti-vaccine groups are acting on the same primal impulse - "keep people healthy," reconciliation between the two warring factions should be achievable on a palatable trend that fosters the development of noninvasive vaccines which tend to induce local and transient inflammation along the interface with diminished potential to percolate through internal organs.