White House Working With Facebook and Twitter to Tackle Antivaxxers

WASHINGTON (Reuters) – The White House has been reaching out to social media companies including Facebook, Twitter and Alphabet Inc’s Google about clamping down on COVID misinformation and getting their help to stop it from going viral, a senior administration official said.

President Joe Biden, who has raced to curb the pandemic since taking office, has made inoculating Americans one of his top priorities and called the move “a wartime effort.” But tackling public fear about taking the vaccine has emerged as a major impediment for the administration.

Since the onset of the pandemic, calls from lawmakers asking the companies to tackle the spread of COVID misinformation on their platforms have grown.

The White House’s direct engagement with the companies to mitigate the challenge has not been previously reported. Biden’s chief of staff Ron Klain has previously said the administration will try to work with Silicon Valley on the issue.

“Disinformation that causes vaccine hesitancy is going to be a huge obstacle to getting everyone vaccinated and there are no larger players in that than the social media platforms,” said the source, who has direct knowledge of the White House’s efforts.

“We are talking to them … so they understand the importance of misinformation and disinformation and how they can get rid of it quickly.”

The Biden White House is especially trying to make sure such material “does not start trending on such platforms and become a broader movement,” the source said.

The source cited the example of the anti-vaccine protests at Dodger Stadium in Los Angeles in early February, and said the White House wants to stop events like that from happening again.

The protest, organized on Facebook through a page that promotes debunked claims about the coronavirus pandemic, masks and immunization, briefly blocked public access to the stadium – one of the largest vaccination sites in the country, where health authorities are administering more than 8,000 vaccines a day.

The event illustrated the extent to which social media platforms have become a critical organizing tool for movements such as the anti-vaccine drive, that spread misinformation and disinformation.

A growing number of anti-vaccine activists, emboldened by their rising social media following, have helped the movement gain strength in the United States. A report by the Center for Countering Digital Health in July 2020 found social media accounts held by anti-vaxxers have increased their following by at least 7·8 million people since 2019.

The companies have repeatedly vowed to get rid of such material on their platforms but gaps remain in their enforcement efforts.

On Thursday, Senator Richard Blumenthal criticized the platforms in a tweet for carrying ads that he said funds and promotes “dangerous conspiracy theories, COVID-19 disinformation and malign foreign propaganda.”

A Facebook spokeswoman said that the company has reached out to the White House to offer “any assistance we can provide” and has recently announced a new policy to remove COVID and vaccine misinformation along with pages, groups, and accounts that repeatedly spread such material.

A Twitter spokesman said the company is “in regular communication with the White House on a number of critical issues including COVID-19 misinformation.”

Alphabet Inc’s Google did not comment on engagement with the White House, instead pointing to a company blog on and how it stops misinformation.

The source said the companies “were receptive” as they engaged with the White House. “But it is too soon to say whether or not it translates into lessening the spread of misinformation.”

There will be more details on how the White House is engaging with the social media companies on this issue in the “next ten days or so”, the source added.

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National experts stress importance of COVID-19 vaccination for Black community

Importance of COVID-19 Vaccination for Black Community Stressed by National Experts including Dr. Cato T. Laurencin

This week in the New York Times a national group of leading Black health experts shined a light on the critical importance of the Black community receiving the COVID-19 vaccination. Amongst the 60 elected members of the National Academy of Medicine were UConn Health Surgeon-Scientist Dr. Cato T. Laurencin and other top experts bringing the critical issue to the national forefront urging the Black community to protect themselves and get vaccinated once available.

Read UConn Today’s Q & A on this important awareness topic with Laurencin who chairs the National Academies Roundtable on Black Men and Black Women in Science, Engineering and Medicine, and serves as the Albert and Wilda Van Dusen Distinguished Endowed Professor of Orthopaedic Surgery at UConn Health and University Professor at UConn.

Q: Are Blacks contracting the COVID-19 virus at higher rates?

A: Our research data show that yes, Blacks not only have higher rates of contracting COVID-19, but also are dying of COVID-19 at high rates. Our team at the University of Connecticut published the first paper in the peer-reviewed literature presenting data showing higher rates of cases and deaths involving COVID-19 in Blacks. Our paper is entitled The COVID-19 Pandemic: A Call to Action to Identify and Address Racial and Ethnic Health Disparities. Since the latest data show that Blacks are continuing to die from high rates of COVID-19, a team of Black members of the National Academy of Medicine are hoping as trusted, reputable medical faces in the community we have a positive impact on the Black community making the choice to get vaccinated.

Q: How may racism in the healthcare system influence medical mistrust in the Black Community?

A: Racism in the healthcare system, whether it be called conscious bias, unconscious bias, stereotyping, or prejudice, contributes to healthcare disparities and high rates of morbidity and deaths among the Black population, and is a driver of mistrust. In order to build trust within the Black community, The National Academies Roundtable on Black Men and Black Women in Science, Engineering and Medicine suggests increasing the number of Black men and women in Medicine and Science. In 2018, the National Academies produced the landmark proceedings entitled An American Crisis: The Growing Absence of Black Men in Medicine and Science.

Q: How do we address medical mistrust right now and urge the Black community to get vaccinated?

A: Established in 2019, the Roundtable on Black Men and Black Women in Science, Engineering and Medicine convenes a broad array of stakeholders to tackle various issues facing the Black community. As a trusted source of information, Roundtable leadership and the COVID-19 Action Group of the Roundtable recorded an informational webinar video focused on addressing common questions and concerns around vaccine hesitation in the Black community. The hope is that this video will be a key resource for the Black community to learn more about the importance of being vaccinated.

Q: Where do we go from here?

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Israel expands vaccination campaign to teens


Israel began administering COVID-19 vaccines to teenagers Saturday as it pushed ahead with its inoculation drive, with a quarter of the population now vaccinated, health officials said.

Since the rollout of vaccinations one month ago, more than 2.5 million of Israel’s nine-million-strong population have been vaccinated already, the health ministry said on Friday.

Expanding the campaign to include teens came days after Israel extended on Tuesday till the end of the month its third national coronavirus lockdown due to a surge in coronavirus infections.

The health ministry had on Thursday announced it was allowing the inoculation of high school students aged 16-18, subject to parental approval.

The country’s largest health fund, Clalit, was already giving teens shots as of Saturday morning, its website said, while the three smaller funds were due to kick off their campaign later.

Israel began administering vaccines on December 20, beginning with health professionals and quickly proceeding to the elderly, sick and at-risk groups, continuously lowering the minimum age of those entitled to the shot.

From Saturday, people aged 40 and up are also allowed to get the vaccine.

According to the health ministry, as of Friday nearly 2.5 million people had received the first of two doses, with 900,000 of them getting the second as well.

The country secured a huge stock of the Pfizer-BioNTech vaccine and has pledged to share the impact data quickly with the US-German manufacturer.

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Encouraging COVID-19 vaccination in a politically polarized country


COVID-19 vaccination rates must reach 80% to achieve herd immunity, but only about 60% of Americans are willing to be vaccinated, according to the Pew Research Center. Stanford physician and economist Kevin Schulman suggests marketing tactics to boost compliance.

More than 300,000 Americans have died of COVID-19—about 1 in every 1,000 people in this country. But will people agree to be vaccinated against the virus that causes the disease?

In November, only about 60% of Americans were willing—far short of the 80% believed necessary to stop the disease from spreading, according to a survey from the Pew Research Center. On Dec. 31, the Los Angeles Timesreported that about 50% of Riverside County’s frontline workers declined the injection.

In an article published Jan. 6 in the New England Journal of Medicine, Kevin Schulman, MD, MBA, professor of medicine, and Stacy Wood, Ph.D., professor of marketing at Duke University, note the strong correlation that has been observed between a person’s political views and his or her willingness to comply with social distancing, mask wearing and other efforts to keep the virus in check. This correlation, they suggest, calls for different communication strategies in upcoming vaccine launches and coronavirus vaccination campaigns. They also explore principles of marketing that could help health care professionals and policymakers frame their messaging to encourage vaccine participation. Recently, science writer Krista Conger spoke with Schulman about their recommendations.

Why is it important to consider lessons from marketing when framing important public health messages?

Schulman: Encouraging 80% to 90% of people in this country of over 300 million people to be vaccinated with not one but two doses of vaccine is one of the largest communications challenges any of us have seen in our lifetimes. We need people across the political spectrum to pull together and get vaccinated. But we learned early in the pandemic that our communications strategies about prevention weren’t working. In many cases, masks haven’t been used effectively, for example. So how do we learn from that and adopt new strategies now?

As clinicians, we’re comfortable dealing with patients in front of us in the exam room, but populationwide questions, like who should be vaccinated, require us to pivot from one-to-one conversations to one-to-many. That’s where marketing and good messaging come in.

We all want this pandemic to end. We want the economy back and functioning well. We want everyone’s lives to be back to normal. Some piece of this message should resonate with everyone, regardless of who you voted for.

What can health care providers do to encourage vaccination?

Schulman: It’s important to understand human nature. When faced with three choices—like three possible cup sizes at your favorite coffee shop—most people will choose the one that is less extreme. Moderation feels safe. Framing a health care decision in similar terms can make people feel more comfortable. For example, rather than asking whether someone will get the vaccine, ask whether they are going to get it today, next week or wait until summer, emphasizing that summer is a less recommended option. Make getting the vaccination the normal, rather than an extreme, choice.

Another critically important piece is the power of personal stories to demonstrate the safety and importance of vaccination. If someone feels the vaccine is unsafe, tell them about someone in a similar situation who took the vaccine and is doing well. Frame the availability of the vaccination to certain groups as a mark of respect for their service to society, and use visible badges or bracelets to indicate to the public that you’ve been vaccinated because you’re a first responder, or a patient-facing employee, or an essential worker. Celebrate and normalize vaccination.

A former student of mine was the leader of the polio eradication efforts in Nigeria. To build confidence in rural villages, he would first take the vaccine himself in front of everyone. Then the village elders would take it, and then the elders’ children. Only then would the rest of the villagers take it. Our personal stories and examples are really important.

What are other things to keep in mind when speaking with someone who isn’t planning to be vaccinated?

Schulman: Be careful with numbers and statistics. It can be very challenging for many people to truly understand risks, odds ratios and other statistics that physicians are taught throughout medical school. Instead of talking about the rare risk of side effects, for example, convey concepts with analogies. If they want a guarantee that the vaccination will protect them from the disease, describe how the risk of contracting and dying from COVID-19 after receiving the vaccine is about the same as dying in a car crash. It’s not zero, but it’s very unlikely.

Another strategy in framing the need for vaccination is to find a common enemy, such as poverty, unemployment or the lockdowns we are now experiencing. Regardless of our political views or our beliefs about the virus, we all want those to end. Don’t talk down to them, or belittle them. Try to find a common ground.

Finally, it’s important to realize, as medical care providers, that we can’t be falsely reassured that everyone out there feels the way we do about the availability of vaccination. There are a lot of people who say they probably won’t or definitely won’t get the vaccine. But we need these people too. How can we reach and reassure these folks as well?

What can medical institutions like Stanford Medicine do to help in this effort?

Schulman: Creating a visible symbol of vaccination, like a wearable badge or a digital stamp for social media or Zoom meetings, can help spread awareness and excitement about the vaccine. It’s also important to gather and spread success stories on websites and across social media promoting the relief and increased freedom experienced by vaccine recipients. It’s clear that misinformation and reports of adverse events spread rapidly over platforms like Twitter and Facebook, so it’s important to actively combat those with positive, personal stories.

Finally, we also need to be aware of the many different communities we serve, and choose analogies and stories that are statistically appropriate and resonate with each audience and their cultural background. Taking note of what is most successful for each group, and sharing that information among our physicians, would provide a valuable resource when speaking to patients about vaccination.

Are efforts to achieve adequate vaccination rates for COVID-19 likely to be an ongoing challenge?

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Experts tap into behavioral research to promote COVID-19 vaccination in the US


As the first doses of COVID-19 vaccines are being rolled out, it is still unclear whether enough Americans are willing to be vaccinated to allow the nation to return to normalcy. Many believe a key part of the equation lies in how effective vaccine communication teams are at convincing the public to get vaccinated. And the key to effective communication tactics in promoting the vaccines may lie in demonstrated behavioral economics and consumer behavior theory, experts say.

“The country has made an incredible investment in fast-tracking SARS-CoV-2 vaccines from conception to market, which would make it even more tragic if we fail to curtail the virus simply because Americans are hesitant to be vaccinated,” says Stacy Wood, an expert on how consumers respond to change and innovation, and first author of a paper published in the New England Journal of Medicine titled “Beyond Politics—Promoting COVID-19 Vaccination in the U.S.” Wood is a professor of marketing and executive director of the Consumer Innovation Collaborative at the NC State Poole College of Management

Recent surveys indicate that the proportion of the U.S. population willing to be vaccinated has fluctuated in recent months—from a high of 72 percent in May, to 51 percent in September and increasing slightly to 60 percent in November. Of those respondents who indicated that they probably or definitely would not get the vaccine, less than half said they might be open to vaccination once others start getting it and more information becomes available.

Since Anthony Fauci has said that at least 80% of the population will need to be vaccinated to get the country back to normalcy, Wood notes that this means it will be necessary to get 100% follow-through from those who are more likely to get the vaccine and 100% conversion of those who are unlikely now but willing to keep an open mind. That’s a daunting prospect.

To address this challenge, Wood and her colleague Kevin Schulman of Stanford drew on their expertise in behavioral economics and consumer research to develop 12 strategies that could, collectively, create an effective vaccine-promotion effort.

Proposed strategies include:

  • Use Analogy: Many attitudes toward the current pandemic are responses to complex medical information. Analogies are short-cuts to conceptual understanding. Saying “the war against COVID” is a term rich in meaning-coming together, making sacrifices, doing tough things, and emerging on the other side with new improvements and inventions in hand. Or one can explain that mRNA vaccines are not weak doses of the virus, but instead are “instruction manuals” that teach the immune system how to defend itself.
  • Increase Observability: Studies have shown consumers’ ability to observe others’ choices can increase an innovation’s rate of adoption. Distributing tokens, such as Livestrong-style bracelets or stickers, or digital badges, such as social media profile frames, may prove to be effective in increasing consumer buy-in. They can even be specific to different populations (e.g. stickers that say “COVID-19 Frontline Hero—I’m Vaccinated!” or “America Honors Her Veterans—I’m Vaccinated!”)
  • Leverage Natural Scarcity: In consumer markets, scarcity often signals exclusivity and prompts greater interest or desirability. Communicators should frame early access to vaccines as a mark of honor or respect for people we want to protect, such as the elderly, teachers or essential workers. Leveraging scarcity, especially as the vaccine is slowly rolled out, may help to counteract many individuals’ natural hesitancy to “go first.”
  • Promote Compromise Options: Consider coffee shops that offer three serving sizes and typically sell more of the middle option. This decision rule-of-thumb is based on choice preferences for “compromise” or middle options. When it comes to the vaccine, communicators should not make vaccination seem like an either-or decision, but rather should frame it as three options where vaccination is in the middle. For instance, options could include allowing people to get the shot now, signing up for a later date, or not getting it at all. Or all three options could include the vaccine—such as get the shot now and donate plasma, simply get the shot now, or get the shot later. The key is to avoid depicting vaccination as the most extreme action in a range of choices.

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Vaccination drive enters new phase in US and Britain

The first Americans inoculated against COVID-19 began rolling up their sleeves for their second and final dose Monday, while Britain introduced another vaccine on the same day it imposed a new nationwide lockdown against the rapidly surging virus.

New York State, meanwhile, announced its first known case of the new and seemingly more contagious variant, detected in a man in his 60s in Saratoga Springs. Colorado, California and Florida previously reported infections involving the mutant version that has been circulating in England.

The emergence of the variant has added even more urgency to the worldwide race to vaccinate people against the scourge.

In Southern California, intensive care nurse Helen Cordova got her second dose of the Pfizer vaccine at Kaiser Permanente Los Angeles Medical Center along with other doctors and nurses, who bared their arms the prescribed three weeks after they received their first shot. The second round of shots began in various locations around the country as the U.S. death toll surpassed 352,000.

“I’m really excited because that means I’m just that much closer to having the immunity and being a little safer when I come to work and, you know, just being around my family,” Cordova said.

Over the weekend, U.S. government officials reported that vaccinations had accelerated significantly. As of Monday, the Centers for Disease Control and Prevention said nearly 4.6 million shots had been dispensed in the U.S., after a slow and uneven start to the campaign, marked by confusion, logistical hurdles and a patchwork of approaches by state and local authorities.

Britain, meanwhile, became the first nation to start using the COVID-19 vaccine developed by AstraZeneca and Oxford University, ramping up its nationwide inoculation campaign amid soaring infection rates blamed on the new variant. Britain’s vaccination program began Dec. 8 with the shot developed by Pfizer and its German partner BioNTech.

Brian Pinker, an 82-year-old dialysis patient, received the first Oxford-AstraZeneca shot at Oxford University Hospital, saying in a statement: “I can now really look forward to celebrating my 48th wedding anniversary.”

The rollout came the same day Prime Minister Boris Johnson announced a new lockdown for England until at least mid-February. Britain has recorded more than 50,000 new coronavirus infections a day over the past six days, and deaths have climbed past 75,000, one of the worst tolls in Europe.

Schools and colleges will generally be closed for face-to-face instruction. Nonessential stores and services like hairdressers will be shut down, and restaurants can offer only takeout.

“As I speak to you tonight, our hospitals are under more pressure from COVID than at any time since the start of the pandemic,” Johnson said.

Elsewhere around the world, France and other parts of Europe have come under fire over slow vaccine rollouts and delays.

France’s cautious approach appears to have backfired, leaving just a few hundred people vaccinated after the first week and rekindling anger over the government’s handling of the pandemic. The slow rollout has been blamed on mismanagement, staffing shortages over the holidays and a complex consent policy designed to accommodate vaccine skepticism among the French.

“It’s a state scandal,” Jean Rottner, president of the Grand-Est region of eastern France, said on France-2 television. “Getting vaccinated is becoming more complicated than buying a car.”

Health Minister Olivier Veran promised that by the end of Monday, several thousand people would be vaccinated, with the tempo picking up through the week. But that would still leave France well behind its neighbors.

French media broadcast charts comparing vaccine figures in various countries: In France, a nation of 67 million people, just 516 people were vaccinated in the first six days, according to the French Health Ministry. Germany’s first-week total surpassed 200,000, and Italy’s was over 100,000. Millions have been vaccinated in the U.S. and China.

The European Union likewise faced growing criticism about the slow rollout of COVID-19 shots across the 27-nation bloc of 450 million inhabitants. EU Commission spokesman Eric Mamer said the main problem “is an issue of production capacity, an issue that everybody is facing.”

The EU has sealed six vaccine contracts with a variety of manufacturers. But only the Pfizer-BioNTech vaccine has been approved for use so far across the EU. The EU’s drug regulators are expected to decide on Wednesday whether to recommend authorizing the Moderna vaccine.

In the U.S., Dr. Mysheika Roberts, health commissioner in Columbus, Ohio, said demand has been lower than expected among the people given top priority for the vaccine. For example, the city’s 2,000 emergency medical workers are all eligible, but the health department has vaccinated only 850 of them.

She said some people were hesitant to get the vaccine and wanted to see how others handled it. The vaccine also arrived the week of Christmas, and a lot of people were on vacation and didn’t want to be bothered during the holiday, she said.

“I think we all assumed that people would want this vaccine so badly, that when it became available, people would just come get it,” Roberts said.

Roberts noted there has been no effective mass marketing campaign explaining why people should get vaccinated.

“From the president on down, so many people have been touting the fact that we’re going to have a vaccine and get this vaccine out. But so many of those same people who were talking about it now have gone silent,” she said. “That could help if those same people would be more vocal about it.”

Elsewhere around the globe, Israel appears to be among the world leaders in the vaccination campaign, inoculating over 1 million people, or roughly 12% of its population, in just over two weeks. The effort has been boosted by a high-quality, centralized health system and the country’s small size and concentrated population.

Hoping to spur a halting vaccination effort that has only given about 44,000 shots since the third week of December, Mexico approved the Oxford-AstraZeneca vaccine for emergency use Monday. Previously, the Pfizer vaccine was the only one approved for use in Mexico.

On Sunday, India, the world’s second-most populous country, authorized its first two COVID-19 vaccines—the Oxford-AstraZeneca one and another developed by an Indian company. The move paves the way for a huge inoculation program in the desperately poor nation of 1.4 billion people.

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What will Australia’s COVID vaccination program look like? 4 key questions answered

The Pfizer/BioNTech, Moderna and AstraZeneca/University of Oxford groups have all recently announced their COVID vaccine candidates have demonstrated high levels of efficacy in phase 3 trials. These developments have focused attention on how a COVID vaccine might be rolled out in Australia.

It’s important to emphasize these trials have not yet been completed, and we only have a few headline results. But the information we do have is promising, and pending scrutiny from the Therapeutic Goods Administration (TGA), it’s looking increasingly hopeful we’ll have several COVID vaccines available in Australia during 2021.

To make this happen, a lot goes on behind the scenes. Australia’s national strategy for the delivery of a COVID vaccine encompasses the whole process: from research and development, to purchase and manufacturing, to international partnerships, to regulation and safety, to administration and monitoring.

Here’s a summary of some of the things you might be wondering about how this all works.

1. Which vaccines will we get?

Currently, there are more than 200 vaccine candidates around the world, 48 of which are in clinical trials.

To ensure Australians will have access to COVID-19 vaccines, the federal government has established agreements with suppliers of four of the most promising vaccine candidates. The vaccines have been carefully assessed on advice from a Science and Industry Technical Advisory Group.

So far, the vaccines we’ve signed up to include the AstraZeneca/University of Oxford vaccine, the CSL/University of Queensland vaccine, the Novavax vaccine, and the Pfizer/BioNTech vaccine.

These agreements will only progress should the vaccines prove safe and effective, as assessed by the TGA, which will look at the quality of the vaccine, the degree of protection it offers, and its safety.

In addition to the four pre-purchase agreements, the federal government has signed up to the global vaccine initiative COVAX, which supports vaccines for all participating countries and grants us access to a range of additional leading candidates.

2. Once we get a vaccine, who will receive it first?

The intent is that a vaccine will eventually be available for anyone who wants to be vaccinated. But it’s likely the initial supply will be limited, so we’ll need to make decisions around which groups will receive the vaccine first.

This will depend on the characteristics of the available vaccines as well as principles we use to define priority populations. These include using vaccines in those who will benefit the most, ensuring equitable access, and reciprocity (the obligation to those who bear additional risks as part of the COVID-19 response).

Australia’s COVID-19 vaccination policy sets out target groups including people who are at higher risk of severe disease and death from COVID-19 (especially older people), those at greater risk of exposure and transmission (health-care and aged-care workers) and other essential workers required to maintain the functioning of society (such as police).

The exact priority order may depend on whether the vaccine works as well in older people, whether it protects against infection (and therefore transmission) or only severe disease, and where infections are occurring when vaccines become available.

3. How will people get it?

We’re likely to need a range of vaccination providers and sites to ensure timely access for the population.

Distribution may be complicated by different storage requirements—for example, the Pfizer vaccine needs to be stored at -70℃. While this might sound like a major hurdle, the Ebola vaccine required similar storage conditions and was successfully delivered in West Africa. But this is something we need to take into account.

People involved in vaccine distribution and administration will need additional training in the specifics of these new vaccines. This workforce will be crucial to a successful COVID-19 vaccine program, particularly if we need to set up additional clinics.

As it’s likely we’ll need two vaccine doses, keeping records on who has received a vaccine so reminders can be sent for the second dose will be important.

4. How will we know if it’s safe?

Current clinical trials are including up to 30,000-40,000 participants, of which roughly half receive the vaccine.

Studies of this size are sufficient to identify common adverse events (like a sore arm or fever, which we’re seeing reported in some patients). But to pick up serious but very rare side effects, ongoing monitoring of vaccine safety will be important.

Existing national and state-based surveillance programs will monitor the safety of COVID-19 vaccines. For example, the AusVaxSafety system sends text messages to those who have received vaccines to check on side effects, and SAFEVAC is a network of experts who assess reports of adverse events and can provide clinical advice.

Using the Australian Immunization Register to record COVID vaccinations will also be crucial to monitoring safety and effectiveness.

Finally, we’ll need to communicate with the public about what we know, as well as the uncertainties, as a vaccine is rolled out. This involves identifying which groups need information, developing and disseminating evidence-based resources, and supporting health-care providers to facilitate discussions with patients. We’ll also need strategies to manage negative messaging and misinformation.

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Delayed vaccination: How it may impact your child

A delay in vaccination should be avoided. When families get behind schedule, it means a child does not have the full potential immunity to the disease, thereby making them susceptible to infections

By Dr Deepti T. Nair

Savitha (name changed), a new mom is postponing vaccinations for her 10-week-old daughter because she fears her family could contract COVID 19 or another infection if they visit a hospital. She says she typically has her children vaccinated but is being ultra-cautious about interactions outside of their home during the ongoing pandemic. Many parents like Savitha across the country are fearful and anxious of exposure to the pandemic and other illnesses and hence are delaying vaccinations for their children that they would typically pursue on time.

Frequently asked questions by parents

We are often asked by parents if they can delay the vaccination. For how long can they delay the vaccination? Are missed vaccines still required or has the baby outgrown the same? Should we follow the schedule as per age or take the missed ones? Can we resume with the vaccination once back from their hometown? Do we need these vaccinations now, when everyone is at home? Is this vaccine optional or mandatory? Is it safe to visit the hospital and what precautions need to be taken during the visit?

My simple answer to all these questions is: A delay in vaccination should be avoided. When families get behind schedule, it means a child does not have the full potential immunity to the disease until they are caught up, thereby making them susceptible to these infections for longer periods of time. Having said that, it is important to administer deferred doses as soon as it is feasible.

Immunisation is crucial in protecting your child from infectious diseases such as polio, mumps, rubella, measles, etc. Babies have underdeveloped immune systems, and need vaccinations along with breast milk and a balanced diet (when they are weaned onto solids) for appropriate and uncompromised mental and physical growth. Each disease has a separate vaccination, and each of these vaccines has a schedule that needs to be followed, to be able to give your little one the immunity to fight the diseases.

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Why is it important to follow the recommended vaccination schedule?

Missed vaccination puts the child at risk of contracting the disease the vaccine was meant to protect against. Young children can be exposed to vaccine preventable diseases from almost anyone, ranging from parents, siblings and visitors, to people at the grocery store and play area. They are at risk to catch diseases from people who don’t have any symptoms. Children less than five years are especially susceptible as their immune systems have not built up the necessary defences to fight infection. Vaccine preventable diseases can range from mild to severe and life-threatening. Some of them can cause large outbreaks as well. Measles, for example, is highly contagious and can spread quickly among people who are not immune.

  • The recommended schedule was created to protect infants and young children early in life, when they are most vulnerable, and before they are potentially exposed to vaccine-preventable diseases. It usually takes weeks for a vaccine to help your baby make protective disease fighting antibodies and some vaccines might require multiple doses to provide the best protection. If you wait until your child could be exposed to serious illness, there might not be enough time for the vaccine to work. The recommended immunisation schedule is safe and based on science. Age prevalence of disease decides appropriate age of vaccination as per the standard schedule. Vaccines are scheduled to provide immunity at the right age to your child and also to protect the people around.

  • Following the recommended schedule minimises the number of visits to your child’s health care provider. Unimmunised children are at high risk of infectious diseases during the time the shots are delayed. More so for young children who need protection at an early age, as diseases like H. Influenza B, Pneumococcal pneumonia and whooping cough could be life threatening at less than 2 years of life. Polio can cause permanent paralysis, measles can lead to brain damage or death, and mumps can affect hearing and cause brain damage. Delayed vaccination in children can also put other family members at risk, especially the elderly and those with compromised immunity, chronic health conditions and infants who are too young to be vaccinated.

  • In order to handle the current scenario of delayed vaccination effectively, we prioritise completing the primary series of vaccination. Also, we combine vaccinations mentioned at different ages as possible so that the number of hospital visits is reduced. The parents who are not comfortable visiting the hospital for vaccination can avail for home vaccination services that are available in their city through their hospital. Hospitals also send regular reminders to parents for the pending vaccines.

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  • I would recommend following regular precautions while visiting the hospital. Take an early appointment through a digital platform to avoid staying longer at the hospital.

  • Ensure not more than one attendant accompanies the baby.

  • Toddlers can use a mask and/or face shield, practice safe social distancing, avoid touching surfaces and take good care of hand hygiene.

(The writer is Consultant Paediatrician & Neonatologist, Cloudnine Group of Hospitals, Bangalore – Bellandur)

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Q&A: Tips to prepare children for a flu vaccination

DEAR MAYO CLINIC: My 5-year-old son is afraid of needles. He cries and fusses anytime we have to visit the doctor. When it’s time for an immunization or vaccination, he squirms and screams, and he has to be held down. Afterward he admits that it wasn’t so bad, but he never seems to get over his fear. Does my son need a flu shot? Can we do anything else to minimize his risk for the flu?

ANSWER: It can be hard for any child to visit a health care provider, but it can be especially hard if he or she fears needles. Vaccinations are a childhood rite of passage, but they are important, as they can prevent and limit the spread of illness.

The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend flu shots for children 6 months and older to protect them, as well as their friends and family members, from the flu.

Influenza is a respiratory infection that can cause serious complications, particularly in young children. Getting a flu vaccination is the best way to prevent the flu and its complications. Even when the vaccination doesn’t completely prevent the flu, it will help to prevent complications from the flu, such as pneumonia and bronchiolitis. Recent research shows that getting a flu vaccination significantly reduces the risk of dying of the flu for all children.

Flu can spread by kissing, touching and holding the hands of other infected people. The germs can stay on surfaces for many hours or spread through the air when a person coughs or sneezes.

The flu strain can change from year to year. Therefore, people do not stay immunized for more than a season. It is important for people to get the flu shot each year to stay vaccinated for each flu season, which runs approximately from November to April. Getting a flu vaccination is especially important this season because the flu and COVID-19 cause similar common signs and symptoms. The flu vaccination may reduce symptoms that might be confused with those caused by COVID-19.

The good news for your son is that there are two options available: a shot and a nasal mist. In your case, the nasal mist may be the best option for your son. Like the injection, the mist does not cause the flu, but side effects can occur in the initial few days after receiving the vaccination. Your son might experience a runny or stuffy nose, a mild fever, or a headache.

It can be scary for any child to visit a health care provider, particularly if he or she thinks there will be something painful involved. Be honest with your child that an appointment will include a shot. Do your best to explain what will happen in advance so he knows what to expect.

You also may want to prepare your son for any changes that he could see during the vaccination visit. Safety is a priority for your health care provider, so there may be significant changes to spaces and processes, including temperature screening at entrances, masking requirements and limiting the number of people in the building. Take time to explain to your son that these changes are made to create safe environments for him and all in-person visitors, just like the vaccination is meant to protect him from illness.

Before the appointment, check in with your health care provider to confirm if the flu mist is available, as not all providers offer it. If a flu shot is the only option, ask about different options to help with discomfort, including a using an ice pack to numb the skin. Other options include pain-ease spray, numbing cream and oral sugar solution for infants. Most nursing staff should be skilled at making kids feel secure and having parents part of the process.

In addition to being honest with your son about what to expect, consider bringing something to distract him, such as a favorite video or a game that you can pull up on your phone. And while I don’t always recommend a treat after a flu vaccination appointment, depending on the age of the child, an incentive—like ice cream after an appointment—can work.

Depending on your health care provider, you may be able to obtain your flu shot at the same time as your son. If you cannot get your vaccination at the same time, consider taking your son with you when you do. But check with your medical clinic to ensure that this will be allowed due to restrictions related to COVID-19.

Though flu season traditionally peaks in February, with December and March being the second and third most common peak months, respectively, it’s important not to delay flu vaccination. It can take up to two weeks for your body to begin to build up immunity.

In addition to flu vaccination, families should maintain healthy habits to stay as healthy as possible. These habits include practicing proper hygiene, getting plenty of sleep and eating well. Remind your son about proper hand-washing. A good rule of thumb is to wash hands for 20 seconds—about as long as it takes to sing the ABCs. Also, teach him to cover a sneeze or cough with the crook of his elbow. And do not send your child to school if he is ill.

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‘Foreign disinformation’ social media campaigns linked to falling vaccination rates

‘Foreign disinformation’ social media campaigns are linked to falling vaccination rates, reveals an international time trends analysis, published in the online journal BMJ Global Health.

Every 1 point increase in effort is tied to an average 2% drop in annual coverage around the globe, and a 15% increase in the number of negative tweets about vaccination, shows the study, which forms part of a BMJ Collection on Democracy and Health published for the World Health Summit this weekend.

Last year, the World Health Organization (WHO) listed vaccine hesitancy—reluctance or refusal to be vaccinated because of safety concerns—-as one of the top 10 threats to world health.

While vaccine hesitancy isn’t new, the proliferation of ‘anti-vaxx’ messaging on social media is of particular public health concern, given that vaccination is seen as a key route out of the current coronavirus pandemic, say the researchers.

Deliberate ‘disinformation’ campaigns by foreign agencies on social media also have their part to play, they add.

To gauge the impact of social media use and foreign disinformation campaigns on vaccine hesitancy around the world, the researchers analysed two different dimensions of social media activity for up to 190 countries.

These were: the public use of Twitter to organise action/resistance; and the amount of tweets expressing negative sentiments about vaccines.

They also drew on national survey data about public attitudes to vaccination safety and annual vaccination rates for the 10 most commonly reported vaccine doses between 2008 and 2018.

They used recognised analytical tools to measure sentiment (Polyglot Python Library); public use of social media to organise (Digital Society Project or DSP); foreign sources of disinformation (Varieties of Democracy Institute expert network + DSP); public attitudes to vaccine safety (2019 Wellcome Global Monitor).

They also logged measures of GDP (gross domestic product) per head of the population for each country and levels of internet usage.

Analysis of all the data revealed that the prevalence of foreign disinformation activity was “highly statistically and substantively significant” in predicting a drop in average vaccination rates.

A one-point shift upwards in the five-point disinformation scale was associated with an average fall in the annual vaccination rate of 2 percentage points, and a cumulative drop of 12 percentage points across the decade.

A belief that vaccines are inherently unsafe was associated with organisation of action/resistance on social media: and the more organisation on social media, the greater was the level of belief that vaccines are unsafe.

Foreign disinformation was also associated with negative social media activity about vaccination, boosting the number of negative vaccine tweets by 15%, on average.

While the study is unique, it wasn’t able to specify the particulars of foreign disinformation campaigns or the prevalence of anti-vacccination propaganda, the researchers acknowledge.

What’s more, Twitter isn’t used in every country, and the survey data were only available at one point in time.

Nevertheless, write the researchers: “Foreign disinformation campaigns are robustly associated with declines in [average] vaccination rates. The use of social media to organise offline action is highly associated with an increase in public belief in vaccines being unsafe.

“Both of these findings suggest that combating disinformation and misinformation regarding vaccines online is critical to reversing the growth in vaccine hesitancy around the world.”

They add: “These findings are especially salient in the context of the COVID-19 pandemic, given that the vaccines under development will require deployment globally to billions of people in the next year.”

Public outreach and education campaigns will, of course, be needed, but they won’t be enough by themselves to counter the tide of mistrust, they emphasise.

“First, governments must mandate that social media companies are responsible for taking down anti-vaccination content (whether originating from genuine domestic actors or foreign propaganda operations),” they advise.

“Second, foreign disinformation campaigns should be addressed at their source. A preponderance of such campaigns amplifying anti-vaccination content originate from within Russia or via pseudo-state actors informally associated with Russia,” they warn.

None of this will be easy, they acknowledge, because it means reconciling the principles of free speech with the policing of social media for “damaging falsehoods,” and persuading Russia to adopt a ceasefire on internet information warfare in the interests of the health of its own people.

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