The fear factor: examining the impact of fear on vaccine hesitancy and anti-vaccine conspiracy beliefs.

OBJECTIVES: While anti-vaccine conspiracy beliefs can reduce vaccine intentions, longitudinal research shows that vaccine hesitancy can increase conspiracy beliefs. In three experiments (N = 949), we examined the effect of fear about a vaccine on vaccine hesitancy and anti-vaccine conspiracy beliefs. METHOD AND MEASURES: In Studies 1a (N = 221) and 1b (N = 508), participants were exposed to high fear (vs low fear) about a (fictional) vaccine before reporting vaccine hesitancy and anti-vaccine conspiracy beliefs. In Study 2, all participants were exposed to high fear before being asked to think about not getting vaccinated (vs vaccinated) against the (fictional) disease. Participants then reported their vaccine hesitancy, anti-vaccine conspiracy beliefs, and closeness to others who distrust official narratives. RESULTS: In Studies 1a and 1b, exposure to high fear (vs low fear) increased vaccine hesitancy, which was positively correlated with anti-vaccine conspiracy beliefs. The reverse model's effect was either smaller (Study 1a) or non-significant (Study 1b). In Study 2, fear and not wanting to vaccinate resulted in vaccine hesitancy, which then predicted anti-vaccine conspiracy beliefs and feeling closer to those distrusting official narratives. CONCLUSION: Therefore, fear creates a response not to get vaccinated. A conspiracy belief may then justify this response.

Comparison of Frailty Screening Instruments in the Emergency Department.

Early identification of frailty through targeted screening can facilitate the delivery of comprehensive geriatric assessment (CGA) and may improve outcomes for older inpatients. As several instruments are available, we aimed to investigate which is the most accurate and reliable in the Emergency Department (ED). We compared the ability of three validated, short, frailty screening instruments to identify frailty in a large University Hospital ED. Consecutive patients aged ≥70 attending ED were screened using the Clinical Frailty Scale (CFS), Identification of Seniors at Risk Tool (ISAR), and the Programme on Research for Integrating Services for the Maintenance of Autonomy 7 item questionnaire (PRISMA-7). An independent CGA using a battery of assessments determined each patient's frailty status. Of the 280 patients screened, complete data were available for 265, with a median age of 79 (interquartile ±9); 54% were female. The median CFS score was 4/9 (±2), ISAR 3/6 (±2), and PRISMA-7 was 3/7 (±3). Based upon the CGA, 58% were frail and the most accurate instrument for separating frail from non-frail was the PRISMA-7 (AUC 0.88; 95% CI:0.83-0.93) followed by the CFS (AUC 0.83; 95% CI:0.77-0.88), and the ISAR (AUC 0.78; 95% CI:0.71-0.84). The PRISMA-7 was statistically significantly more accurate than the ISAR (p = 0.008) but not the CFS (p = 0.15). Screening for frailty in the ED with a selection of short screening instruments, but particularly the PRISMA-7, is reliable and accurate.