This paper discusses the theoretical and methodological approaches to the study of the use or non-use of expert-based information in policy-making. Special attention is paid to the Narrative Policy Framework introduced by Jones & McBeth in 2010. This theory of the policy process adopts a quantitative, structuralist and positivist approach to the study of policy narratives. The Narrative Policy Framework is useful for the analysis of the use of expert-based information to resolve so-called wicked problems, which are characterized by intense (...) value-based conflict between policy coalitions. The methodological approach of the Narrative Policy Framework is illustrated using the policy issue of mandatory vaccination. (shrink)

This article theorizes the connection between political distrust and conspiracy theories through a post-political framework. Following Luc Boltanski’s focus on the critical capacities of ordinary actors, it builds on interviews with participants of the Yellow Vest Movement in France who hold conspiratorial views of Covid-19 and the vaccine. The article explores how the interviewees’ critique mirrors that of post-political theorists. In particular, I use Rancière’s notion of subjectification and politics to theorize how conspiracy theories function as a means of (...) dissent in the interviewees’ understanding of their experiences as well as in their own critique of and disillusionment with politics in France. As such, this article explores how political trust affected reactions to the pandemic, how political trust is interconnected with conspiracy theories and finally how such conspiracy theories can be viewed as biproducts of the post-political order. (shrink)

Research on the reasons for vaccine hesitancy has largely focused on factors directly related to vaccines. In contrast, the present study focused on cognitive factors that are not conceptually related to vaccines but that have been linked to other epistemically suspect beliefs such as conspiracy theories and belief in fake news. This survey was conducted before the Covid-19 pandemic (N = 356). The results showed that anti-vaccination attitudes decreased slightly with cognitive abilities and analytic thinking styles, and strongly (...) with scientific literacy. In addition, anti-vaccination attitudes increased slightly with teleological bias and strongly with an intuitive thinking style, ontological biases, and religious and paranormal beliefs. The results suggest that the same cognitive mechanisms that predispose to other epistemically suspect beliefs may predispose to anti-vaccination attitudes as well. The findings also indicate that pro-vaccination communication should focus on early prevention and that interventions against vaccine hesitancy should strive to be intuitively appealing. (shrink)

A recent study dealing with Western European countries suggests a connection between vaccine skepticism and support for populist parties (Kennedy 2019). Of all countries in the study, Italy scored highest on both counts, with 44% of the electorate voting for populists in 2014 and 14% of the population not deeming vaccinations important. The study concludes that both phenomena have a common root in the distrust of elite and experts. While that seems plausible, this paper establishes that there is much (...) more to be said about the relation between populism and the anti-vaccination movement. Using the case study of the Italian anti-vaxxers, I spell out how populists have reinforced an echo chamber in an effort to mobilize it. I argue that besides the common root cause, in this instance there is also indication of a causal relation between populism and anti-vaccination. Moreover, I show that populism and echo chambers in general are conceptually linked through their dichotomous division of society and rejection of legitimate opposition. (shrink)

A culture war has been brewing in Singapore since 2009 when a conservative Christian group conducted a reverse takeover of a feminist civil society organization and was subsequently expelled from the organization in a publicized meeting between the two groups. Since then, the state has mediated the contestation of values between religious conservatives and liberal groups allied around issues of gender and sexuality. The culture war between the two sides has revolved around creative protests that have evaded state prohibitions against (...) public contestations over what is legally considered private beliefs and affairs. They involve innovative hybridizations of American discourses on values and rights mixed with Asian emphases on family traditions and sentiments. The COVID-19 pandemic has, however, laid bare the adaptation of the American culture war into the Singaporean public sphere. This article looks at and analyzes COVID-19 vaccine hesitancy among conservative Christians in Singapore and their incorporation of anti-vaccination views from American Christian nationalism into secular framings, invoking legal rights and responsibilities aligned with the state’s nationalist discourse. I argue that this represents a new phase of contestation by conservatives, refashioning their religious views into secular frames of public good and morality serving the secular nation. By doing so, they implicitly challenge the state’s regulation of religion as private interests and beliefs. This altered religious activism has shifted the terms of secularism and loosened the hegemony of the state in defining these terms. (shrink)

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the (...) specific issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

This article examines the rise of the anti-vaccination movement, the proliferation of laws allowing parental exemptions to mandatory school vaccines, and the impact of the movement on immunization rates for all vaccines. It uses the ongoing debate about the Human Papillomavirus vaccine as an example to highlight the ripple effect and consequences of the anti-vaccine movement despite robust evidence of the vaccine's safety and efficacy. The article scrutinizes how state legislatures ironically promote vaccination while simultaneously (...) deferring to the opposition by promulgating broad opt-outs from mandatory vaccine laws. This article concludes by offering an alternative legislative approach to specifically combat the anti-vaccine movement's impact on HPV vaccination rates. Lowering the age of consent has not been widely attempted or proposed and provides an alternative statutory mechanism to push back against vaccine resistance. (shrink)

This text aims to offer a epistemic-normative reading of madness in Kant's work and its different developments throughout his work. This to maintain that madness arises from rationality itself when understood it as a force that exceeds the limits that reason imposes on itself. By outlining normality or mental sanity as the restriction of reason to sensibility, Kant intends -I maintain- to outline the minimum subjective and epistemic conditions for a republican political conformation, which is based on the agreement between (...) subjects about the rules that will regulate their actions and interactions. This reading will allow us to outline an understanding of the anti-vaccine protest that took place during the pandemic. Showing that those who promote and follow them break with this minimum agreement on the restrictions of reason, thus reaching selfish excesses that harm democratic dynamics. I concluded that these people can be understood as madness people who represent a danger to the republican and democratic political organization. (shrink)

Since the outbreak of COVID-19, many conspiracy theories have spread widely, which has the potential to reduce adherence to recommended preventive measures. Specifically, anti-vaccine conspiracy beliefs can have a strong negative impact on COVID-19 vaccination attitude and intention. The present study aimed to clarify how such beliefs can reduce vaccination intention, exploring the possible mediating roles of attitude toward vaccination, trust in science, and trust in government, among a sample of 822 unvaccinated Italian adults. Path analysis showed that (...) anti-vaccine conspiracy beliefs influenced intention to get vaccinated both directly and indirectly through the mediating effects of attitude, trust in science, and trust in government. In particular, the simple mediating effect of attitude was the strongest one, followed by the serial mediating effect of trust in science and attitude itself. Findings provide insights into the design of interventions aimed at reducing misinformation and subsequent vaccine hesitancy. (shrink)

This article discusses the debate about vaccination as a case of public scientific technological controversy. In the vaccination controversy there is a scientific question, the effectiveness of vaccines in the elimination of diseases; a question of risk assessment, possible adverse effects and the possibility that immunization causes idiopathic diseases; an ethical question, the balance of rights between the two groups and the limits of the freedom of choice of treatment; and a political issue, who must take decisions about immunization and (...) whether immunization should be mandatory. The results of the analysis of the controversy suggest that the attitudes of the anti-vaccination groups towards vaccination are largely explained by their worldview which comes majorly from New Age beliefs. This worldview causes differences in the interpretation of evidence, law, risk and science. (shrink)

Here, an epidemiological model considering pro and anti-vaccination groups is proposed and analyzed. In this model, susceptible individuals can migrate between these two groups due to the influence of false and true news about safety and efficacy of vaccines. From this model, written as a set of three ordinary differential equations, analytical expressions for the disease-free steady state, the endemic steady state, and the basic reproduction number are derived. It is analytically shown that low vaccination rate and no influx (...) to the pro-vaccination group have similar impacts on the long-term amount of infected individuals. Numerical simulations are performed with parameter values of the COVID-19 pandemic to illustrate the analytical results. The possible relevance of this work is discussed from a public health perspective. (shrink)

Background. To inform their health decisions, patients may seek narratives describing other patients' evaluations of their treatment experiences. Narratives can provide anti-treatment or pro-treatment evaluative meaning that low-numerate patients may especially struggle to derive from statistical information. Here, we examined whether anti-vaccine narratives had relatively stronger effects on the perceived informativeness and judged vaccination probabilities reported among recipients with lower numeracy. Methods. Participants from a nationally representative US internet panel were randomly assigned to an anti-vaccine (...) or pro-vaccine narrative, as presented by a patient discussing a personal experience, a physician discussing a patient's experience, or a physician discussing the experiences of 50 patients. Anti-vaccine narratives described flu experiences of patients who got the flu after getting vaccinated; pro-vaccine narratives described flu experiences of patients who got the flu after not getting vaccinated. Participants indicated their probability of getting vaccinated and rated the informativeness of the narratives. Results. Participants with lower numeracy generally perceived narratives as more informative. By comparison, participants with higher numeracy rated especially anti-vaccine narratives as less informative. Anti-vaccine narratives reduced the judged vaccination probabilities as compared with pro-vaccine narratives, especially among participants with lower numeracy. Mediation analyses suggested that low-numerate individuals' vaccination probabilities were reduced by anti-vaccine narratives - and, to a lesser extent, boosted by pro-vaccine narratives - because they perceived narratives to be more informative. These findings were similar for narratives provided by patients and physicians. Conclusions. Patients with lower numeracy may rely more on narrative information when making their decisions. These findings have implications for the development of health communications and decision AIDS. (shrink)

Vaccine refusal harms and risks harming innocent bystanders. People are not entitled to harm innocents or to impose deadly risks on others, so in these cases there is nothing to be said for the right to refuse vaccination. Compulsory vaccination is therefore justified because non-vaccination can rightly be prohibited, just as other kinds of harmful and risky conduct are rightly prohibited. I develop an analogy to random gunfire to illustrate this point. Vaccine refusal, I argue, is morally similar (...) to firing a weapon into the air and endangering innocent bystanders. By re-framing vaccine refusal as harmful and reckless conduct my aim is to shift the focus of the vaccine debate from non-vaccinators’ religious and refusal rights to everyone else’s rights against being infected with contagious illnesses. Religious freedom and rights of informed consent do not entitle non-vaccinators to harm innocent bystanders, and so coercive vaccination requirements are permissible for the sake of the potential victims of the anti-vaccine movement. (shrink)

ArgumentUsing the example of the anti-tuberculosis vaccine BCG during the 1920s and 1930s, this article asks how a labile laboratory-modified bacteria was transformed into a genuine standard vaccine packaged and commercialized as a pharmaceutical product. At the center of the analysis lies the notion of standardization inquiring why and how a local laboratory process with standard operating procedures (SOPs) reached its limits and was transformed when the product faced international distribution. Moving from Paul Ehrlich's initial technological notion (...) ofWertbestimmungreferring to a practice physiologically testing the effects of ill-defined antitoxins, the concept of standardization is extended to pharmaceutical and economical meanings implying quality control for biological therapeutic agents produced by a variety of industrial entrepreneurs. Following the request for product uniformity, two ways to maintain levels of compatibility and commonality are depicted opposing SOPs and end-product control. Furthermore, standardization is understood as a spiral, never ending process where progressive transformation of the vaccine in its production and medical uses periodically recreated the necessity of standardization. Developments analyzed are thus understood as a stabilization process aligning laboratory settings, products, and practices with medical theories and practices through technical, bureaucratic, and organizational systems. A paradox of the analysis is that standardization as a historical phenomenon and moment in the history of drug development was initially linked to a problem of under-determination of what was to be standardized and to a knowledge gap before it could become a central concept for quality control. (shrink)

Parents in the US and other societies are increasingly refusing to vaccinate their children, even though popular anti-vaccine myths – e.g. ‘vaccines cause autism’ – have been debunked. This book explains the epistemic and moral failures that lead some parents to refuse to vaccinate their children. First, some parents have good reasons not to defer to the expertise of physicians, and to rely instead upon their own judgments about how to care for their children. Unfortunately, epistemic self-reliance systematically (...) distorts beliefs in areas of inquiry in which expertise is required. Second, vaccine refusers and mainstream medical authorities are often committed to different values surrounding health and safety. For example, while vaccine advocates stress that vaccines have low rates of serious complications, vaccine refusers often resist vaccination because it is ‘unnatural’ and because they view vaccine-preventable diseases as a ‘natural’ part of childhood. Finally, parents who refuse vaccines rightly resist the utilitarian moral arguments – ‘for the greater good’ – that vaccine advocates sometimes make. Unfortunately, vaccine refusers also sometimes embrace a pernicious hyper-individualism that sanctions free-riding on herd immunity and that cultivates indifference to the interpersonal and social harms that unvaccinated persons may cause. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S12-S17, March‐April 2022.

The 2015 Disneyland outbreak of measles in the US unequivocally brought to light what had been brewing below the surface for a while: a slow but steady decline in vaccination rates resulting in a rising number of outbreaks. This can be traced back to an increasing public questioning of vaccines by an emerging anti-vaccination movement. This article argues that, in the face of diminishing vaccination rates, childhood vaccinations should not be seen as part of the domain of parental choice (...) but, instead, as a non-negotiable legal obligation. The first part of the article formulates and defends two arguments in favour of unqualified mandatory childhood vaccination laws. First, government should not permit parents to put their children at avoidable risk of death and suffering; second, government should guard the common good of herd immunity to protect vulnerable persons. The second part rejects legal and pragmatic objections against such mandatory vaccination laws. (shrink)

Times of uncertainty and fear were brought on by Covid-19. The ongoing pandemic is a fruitful ground for fake news, as citizens try to find explanations that fit into their worldviews. This process polarizes society and creates echo chambers amplified by recommender systems. Our main goal is to detect anti-vaxxer echo chambers in Serbia by analyzing online reactions to the recent detention of prominent anti-vaxxer Dr. Jovana Stojkovic. A content analysis of online comments is deployed in anti-regime (...) left-leaning, anti-regime right-leaning, and pro-government media to explore attitudes towards a vaccination conspiracy theory, police action towards anti-vaxxers, and the government crisis response team. We clearly identify the anti-vaccine echo chamber among commentators of anti-regime right-leaning media (YouTube podcasts). Additionally, we describe attitudes expressed around issues related to vaccination. Limitations and implications for future research are discussed. (shrink)

Comme tous les autres projets humains, les politiques de santé publique sont souvent affectées par des imperfections et des erreurs. Cependant, elles sont mieux ancrées dans les résultats de la recherche scientifique que d’autres actions humaines en général, et politiques gouvernementales en particulier. D’une manière générale, les données sur lesquelles reposent les politiques de santé publique remplissent les conditions suivantes : méthodes de recherche rigoureuses, tests indépendants et précis, reproductibilité des résultats, mesure du taux d’erreur, capacité à écarter des hypothèses (...) rivales et un degré d’acceptation satisfaisant au sein de la communauté scientifique. Les politiques de santé publique comprennent des campagnes de vaccination de la population, en particulier des enfants. Ces actions de vaccination sont considérées comme sûres et efficaces par les institutions publiques, les organisations de santé, les médecins et les chercheurs en santé. Malgré cela, un nombre croissant de parents choisit de ne pas vacciner leurs enfants. Les fausse nouvelles sur les vaccins publiées dans les médias, en particulier dans les nouveaux médias, par les influenceurs, ont contribué certainement à cette tendance. Ces influenceurs sont insuffisamment qualifiés ou totalement non qualifiés pour commenter l’innocuité et l’efficacité des vaccins dans les médias. Par conséquent, ils ne peuvent pas produire des données fiables et des opinions qualifiées, c’est-à-dire des informations indépendantes, précises, pertinentes, fiables et complètes. Cependant, ces influenceurs parviennent à influencer, dans une large mesure, le comportement des parents en matière de vaccination. La stratégie de lutte contre les fausses nouvelles en publiant des preuves contraires est évidemment nécessaire, mais pas suffisante parce que beaucoup de fausses infos sur les vaccins fonctionnent comme des mythes. Etant fixées d’une manière partiellement irrationnelle, les mythes anti-vaccination ne peuvent être démystifiés seulement avec les dernières preuves scientifiques. C’est pourquoi il est nécessaire d’envisager des stratégies de relations publiques capables d’influencer des opinions collectives irrationnelles. (shrink)

Our approach to the epistemology of post-truth is based on the idea that to fully comprehend any post-truth, going back to its origins (i.e., to the moment in which some faulty interpretations start to spread) can be not only relevant but illuminating.One of the most renowned cases of post-truth concerns vaccines and their alleged relationship with autism. It all started in 1998, when The Lancet published a study suggesting a link between the measles, mumps, and rubella vaccine and some (...) symptoms of autism. The case is relevant both because it is at the origins of contemporary anti-vaccinism and because it took twelve years to fully disprove what in 1998 was presented as a scientific truth: this means that the boundary between truth and falsehood has been blurred for a long period of time.For this purpose, we have applied the semiotic methodology to 20 articles from The Independent, 20 from The Telegraph, 20 from The Guardian, and 20 from The Daily Mail, published between 1998 and 2010. Unexpectedly, many elements that can be seen as ‘post-truth seeds’, such as conspiracy theories and the joint presentation of multiple truths, have been found even in the most scientifically accurate newspapers. (shrink)

BackgroundAs opioid use disorder (OUD) incidence and its associated deaths continue to persist at elevated rates, the development of novel treatment modalities is warranted. Recent strides in this therapeutic area include novel anti-opioid vaccine approaches. This work compares logistical and ethical considerations surrounding currently available interventions for opioid use disorder with an anti-opioid vaccine approach.MethodsThe opinions of student pharmacists and practicing pharmacists assessing knowledge, perceptions, and attitudes toward current and future OUD management strategies were characterized using (...) a staged, multi-modal research approach incorporating a focus group, pilot survey development and refinement, and final survey deployment. Survey responses were assessed using one- and two-way parametric and non-parametric analyses where appropriate, and multi-dimensional matrix profiles were compared using z-tests following an exhaustive combinatorial sum of differences calculation between items within each compared matrix.ResultsFocus group content analysis revealed a high level of agreeableness among participants regarding anti-opioid vaccine technology and a sense of shared ownership regarding solutions to the opioid epidemic at large. Pilot survey results demonstrated subject ability to consider both pragmatic and ethical considerations related to current therapeutics and novel interventions in a single instrument, with high endurance amongst engaged subjects. Access inequality was the most concerning ethical consideration identified for anti-opioid vaccines. Support for anti-opioid vaccine implementation across various clinical scenarios was strongest for voluntary use amongst individuals in recovery, and lowest for mandatory use in at-risk individuals.ConclusionsEthical and logistical concerns surrounding anti-opioid vaccines were largely similar to those for current OUD therapeutics overall. Anti-opioid vaccines were endorsed as helpful potential additions to current OUD therapeutic approaches, particularly for voluntary use in the later stages of clinical progression. (shrink)

Policies allowing some minors to consent to receive recommended vaccines are ethically defensible. However, a policy change at the federal level expanding minor consent for vaccinations nationwide risks triggering a political backlash. Such a move may be perceived as infringing on the rights of parents to make decisions about their children’s health care. In the current post-COVID environment of heightened anti-vaccination activism, changes to minor consent laws may be unadvisable, and policy makers should proceed with caution.

Niels Kaj Jerne has proposed the “immune network theory” of interactions among anti‐idiotypic antibodies, able to interfere with humoral responses to certain antigens. After the occurrence of the primary generation of antibodies, against an antigenic epitope, idiotypes of these antibodies induce anti‐idiotypic antibodies that modulate the intensity of the first response, and so on. Adverse effects following SARS‐COV‐2 COVID‐19 vaccines are occasionally similar to the symptoms of COVID‐19 infection. Rare events linked to SARS‐CoV‐2 vaccines also resemble some rarely (...) reported COVID‐19 complications. Safety data from product information by European Medicines Agency suggest that spectra do overlap for four main vaccines. The proposition is that vaccine events and COVID‐19 complications are related to anti‐idiotypic antibodies whose spatial shape can lead to interactions with ACE2 molecules, in individuals with a prolonged Spike protein synthesis. The vaccines target cells by their affinity to the vaccine vector, or to engulf lipid nanoparticles. Anti‐idiotypic antibodies shaped similarly to the Spike protein possibly interact with ACE2 molecules and cause diverse signs and symptoms. (shrink)

Churches have always been regarded as a safe haven during calamities. This changed during COVID-19 lockdown when churches were forced to shut down. The COVID-19 pandemic has posed a new normal to the world at large, calling for immediate action from authorities and introducing vaccination as an antidote. However, some religious practitioners as a vehicle of change through the institution of the church have been acting on the contrary because it discourages the uptake of vaccines, leading to vaccine hesitancy. (...) COVID-19 vaccine hesitancy has been observed in the Christian community because Christians use Bible verses as a scapegoat for not getting a jab. There is a chasm that exists between faith and science, and it perpetuates the discourse of vaccine hesitancy. Contributions: This article applies a qualitative descriptive phenomenological approach and seeks to address the conspiracy theories and the use of Bible verses as discourse on vaccine uptake. (shrink)

Churches have always been regarded as a safe haven during calamities. This changed during COVID-19 lockdown when churches were forced to shut down. The COVID-19 pandemic has posed a new normal to the world at large, calling for immediate action from authorities and introducing vaccination as an antidote. However, some religious practitioners as a vehicle of change through the institution of the church have been acting on the contrary because it discourages the uptake of vaccines, leading to vaccine hesitancy. (...) COVID-19 vaccine hesitancy has been observed in the Christian community because Christians use Bible verses as a scapegoat for not getting a jab. There is a chasm that exists between faith and science, and it perpetuates the discourse of vaccine hesitancy. CONTRIBUTIONS: This article applies a qualitative descriptive phenomenological approach and seeks to address the conspiracy theories and the use of Bible verses as discourse on vaccine uptake. (shrink)

The rise in vaccine hesitancy in high-income countries has led some to recommend that certain vaccinations be made compulsory in states where they are currently voluntary. In contrast, I contend that legal coercion is generally inappropriate to address the complex social and psychological phenomenon of vaccine anxieties.

When considering the persuasive characteristics and prospective influences of Darwin‐skeptic mass media, uncertainties remain about how to reciprocally promote evolutionary theory to skeptical audiences. This study aims to improve evolution advocacy by translating some of the most successful methods of science endorsement to Evolution Wars contexts. In particular, strategies used to address vaccine hesitancies and enhance immunization uptake policies are reinterpreted for those seeking to improve pro‐evolution communications to religious publics. What results are three recommendation categories described as General (...) Guiding Principles, Proximate Interventions, and Auxiliary Interventions. (shrink)

Vaccine apartheid is creating conditions that make for premature death, poverty, and disease in racialized ways. Invoking vaccine apartheid as opposed to euphemisms like vaccine nationalism, is necessary to highlight the racialized distributional consequences of vaccine inequities witnessed with COVID-19. This commentary clarifies the concept of vaccine apartheid against the historical and legal usage of apartheid. It reflects on the connections and important disjunctions between the two. It places the intellectual property regime under heightened scrutiny (...) for reform and transformation. This commentary finds that drawing on the intersections between a human rights and health justice approach can provide creative and novel approaches for anti-subordination. It concludes that acknowledging and naming the structural injustice of vaccine apartheid is only the first step towards providing redress. (shrink)

Soon after the coronavirus disease 2019 (COVID‐19) pandemic outbreak, it became clear that vaccination will be the most useful tool to combat the disease. Despite the apparent safety and efficacy of the developed anti‐COVID‐19 vaccines, relatively high percentages of the population worldwide refused to get vaccinated, including many health workers and health students. The present cross‐sectional study examined the motives, attitudes, and personal characteristics of those who did not get vaccinated against COVID‐19 or vaccinated without complete willingness among nursing (...) students and nursing faculty members in Israel (n = 472). Results show that the vast majority of the study participants (97%) received at least one dose of the anti‐COVID‐19 vaccine. Nearly 37% of the participants indicated that they received the vaccine without complete willingness. As compared to faculty members, nursing students reported lower trust in the efficacy of the vaccine, perceived the COVID‐19 pandemic as a health threat to a lesser extent, exhibited lower institutional and personal trust, and had higher levels of posttraumatic stress disorder symptoms. Non‐Jewish participants were at risk of vaccinating without complete willingness. These findings underscore the need for developing evidence‐based strategies to promote the safety and efficacy of the anti‐COVID‐19 vaccines in nursing schools. (shrink)

Health ethics can justify the use of vaccination mandates. However, policies that pressurize parents to vaccinate their children can undermine traditional clinical ethics standards (e.g. autonomy and informed consent). The aim of this paper is to argue that the ethical impact of vaccination mandates can only be determined in the context of the clinical encounter. Public debate on the topic tends to be general in nature and, as a result, issues that require clarification to help sustain the trust of service (...) users are underexamined. In addition, ethical debates are hampered by a toxic dichotomy in the public sphere between those (anti-vaccinators) who claim a move away from parental choice is necessarily a serious ethical violation; and others (often health scientists) who neglect serious consideration of ethical issues. This predicament permits flawed ethical claims to be made, and to remain unchallenged. Despite this, ethical concerns – including those relating to trust and individual freedom – are fundamental to sustaining confidence in vaccination. This has recently been highlighted by the Covid-19 pandemic which made accessing childhood vaccinations harder, leading to a further decline in uptake. The pandemic has also revealed the strength of public feeling towards infection control measures that restrict peoples’ freedoms. In this paper I argue that to minimize the ethical disruption associated with the use of vaccination mandates, it is essential to focus more attention on their impact in the clinic and to accurately identify the drivers of such tensions. (shrink)

The fact that Internet companies may record our personal data and track our online behavior for commercial or political purpose has emphasized aspects related to online privacy. This has also led to the development of search engines that promise no tracking and privacy. Search engines also have a major role in spreading low-quality health information such as that of anti-vaccine websites. This study investigates the relationship between search engines’ approach to privacy and the scientific quality of the information (...) they return. We analyzed the first 30 webpages returned searching “vaccines autism” in English, Spanish, Italian, and French. The results show that not only “alternative” search engines but also other commercial engines often return more anti-vaccine pages (10–53%) than Google (0%). Some localized versions of Google, however, returned more anti-vaccine webpages (up to 10%) than Google. Health information returned by search engines has an impact on public health and, specifically, in the acceptance of vaccines. The issue of information quality when seeking information for making health-related decisions also impact the ethical aspect represented by the right to an informed consent. Our study suggests that designing a search engine that is privacy savvy and avoids issues with filter bubbles that can result from user-tracking is necessary but insufficient; instead, mechanisms should be developed to test search engines from the perspective of information quality (particularly for health-related webpages) before they can be deemed trustworthy providers of public health information. (shrink)

This article is about the ways in which representations of users’ bodies mediate in the designers’ configuration of anti-fertility vaccines and their future users. Anti-fertility vaccines are a novel and not yet available method to regulate fertility. The researchers involved claim that anti-fertility vaccines can be developed for both men and women. But in the material and political specificities of the research contexts, representations of male bodies as users have disappeared, and most research involves the development of (...) a method to be used by women. Anti-fertility vaccines therefore provide an opportunity to study when the sex of future users is deemed relevant by the researchers. This article explores how the fact that most anti-fertility vaccines are developed for female users can be explained without resorting to biological or cultural determinism. How much room for maneuver did the researchers have in defining the vaccines and their users? (shrink)

The paper argues that one of the reasons the suppression of scientific dissent during the Covid pandemic has been so severe was because the dominant scientific Covid narrative has been turned into a political myth, i.e. a narrative mobilizing groups in support of key moral values. Taking the example of Covid vaccination, I show the key values with which it became linked in Czechia. Questioning vaccination came to be seen as endangering these values, which made scientific dissent appear as particularly (...) dangerous. I further analyse how this schematic discourse dealt with “free-vax” scientists, who were not against Covid vaccination as such but only against its blanket application. I show that their discreditation was mainly carried out by various fact-checking NGOs or social media influencers, who attempted to delegitimize them not by scientific arguments but rather by associating them with more dubious groups of social actors, or labelling their views as “disinformation”. This discrediting strategy was largely successful, but it also had some undesirable social and political backfire effects, in that it pushed some of the free-vaxxers out of the liberal democratic mainstream and forced them to seek alliance with more anti-systemic segments of the population in attempts at political resistance. (shrink)

In the decade following hepatitis B vaccine’s 1981 approval, U.S. health officials issued evolving guidelines on who should receive the vaccine: first, gay men, injection drug users, and healthcare workers; later, hepatitis B-positive women’s children; and later still, all newborns. States laws that mandated the vaccine for all children were quietly accepted in the 1990s; in the 2000s, however, popular anti-vaccine sentiment targeted the shot as an emblem of immunization policy excesses. Shifting attitudes toward the (...) vaccine in this period were informed by hepatitis B’s changing popular image, legible in textual and visual representations of the infection from the 1980s through the 1990s. Notably, the outbreak of AIDS, the advent of genetically engineered pharmaceuticals, and a Democratic push for health reform shaped and reshaped hepatitis B’s public image. Hepatitis B thus became, in turn, an AIDS-like scourge; proof of a new era of pharmaceuticals; a threat from which all American children had a right to be protected; and a cancer-causing infection spread by teenage lifestyles. The metamorphosis of the infection’s image was reflected in evolving policy recommendations regarding who should receive the vaccine in the 1980s, and was key to securing broad uptake of the vaccine in the 1990s. (shrink)

This paper challenges historically preconceived notions surrounding a minor’s ability to make medical decisions, arguing that federal health law should be reformed to allow minors with capacity as young as age 12 to consent to their own Centers for Diseases Control and Prevention (CDC)-approved COVID-19 vaccinations. This proposal aligns with and expands upon current exceptions to limitations on adolescent decision-making. This analysis reviews the historic and current anti-vaccination sentiment, examines legal precedence and rationale, outlines supporting ethical arguments regarding adolescent (...) decision-making, and offers rebuttals to anticipated ethical counterarguments. (shrink)

The spread of vaccine misinformation may contribute to vaccine refusal/hesitancy and consequent harms. Nonetheless, censorship is often rejected on the grounds of free expression. This article examines John Stuart Mill’s influential defence of free expression but finds that his arguments for freedom apply only to normal, reasonably favourable circumstances. In other cases, it may be permissible to restrict freedom, including freedom of speech. Thus, while Mill would ordinarily defend the right to express false views, such as that vaccines (...) cause autism, he might have accepted restrictions on anti-vaccine misinformation during the present pandemic. This illustrates that even the staunchest defenders of free speech can permit temporary restrictions in exceptional circumstances. (shrink)

Online vaccine-critical sentiments are often expressed in appealing personal narratives, whereas vaccine-supporting information is often presented in a non-narrative, expository mode describing scientific facts. In two experiments, we empirically test whether and how these different formats impact the way in which readers process and retrieve information about childhood vaccination, and how this may impact their perceptions regarding vaccination. We assess two psychological mechanisms that are hypothesized to underlie the persuasive nature of vaccination narratives: the availability heuristic and cognitive (...) resistance. The results of experiment 1 showed no empirical evidence for the availability heuristic, but exploratory analyses did indicate that an anti-vaccination narrative might reduce cognitive resistance, decrease vaccination attitudes and reduce attitude certainty in a generally pro-vaccination sample, especially for those who were more vaccine hesitant. Preregistered experiment 2 formally tested this and showed that not narrative format, but prior vaccine hesitancy predicts cognitive resistance and post-reading attitudes. Hesitant participants showed less resistance toward an anti-vaccine text than vaccine-supporting participants, as well as less positive post-reading attitudes and attitude certainty. These findings demonstrate belief consistency effects rather than narrative persuasion, which has implications for scientific research as well as public health policy. (shrink)

Discussions about the extended mind have ‘extended’ in various directions in the last decades. While applied to other aspects of human cognition and even consciousness, the extended-mind hypothesis has also been criticized, as it questions fundamental ideas such as the image of a dual world, divided between an external and an internal domain by the border of ‘skin and skull’, the idea of a localized and constant decision center, and the role of internal representations. We suggest that the main virtue (...) of the hypothesis is not as a theory per se, but as a vaccine against persistent metaphysical prejudices about the mind’s structure, functions and borders. Being an hypothesis about the most efficient ways to combine resources and problems, and not a theory about the mind’s a-priori constitution, the extended mind view moves the focus from ontology to pragmatics and helps purify philosophy of mind from metaphysical remainders. (shrink)

The rapid development of widely available and effective vaccines has been integral to the international response to the COVID-19 pandemic. However, a significant minority of those offered vaccination have refused, often due to their adherence to ‘anti-vax’ beliefs. These beliefs include that vaccines are dangerous, render the recipient magnetic or contain government microchips.During the pandemic, numerous calls were made for those voluntarily refusing vaccination to be deprioritised when allocating scarce healthcare resources. While these calls were rejected, the likelihood of (...) the same calls being made during future pandemics necessitates a thorough examination of the ethical implications entailed by such a policy.Here, I consider an intuitive argument for the use of vaccination status when allocating healthcare resources. This argument claims that, by avoiding vaccination, vaccine refusers are failing to fulfil a social obligation to protect those around them from harm by facilitating herd immunity. They are, therefore, less deserving of healthcare than their vaccinated peers.I explore three objections to this argument. While a first objection, asserting that no individual can be held responsible for a failure to develop herd immunity, fails, I find two further responses, respectively asserting the primacy of patient autonomy and highlighting the harms deprioritising vaccine refusers would cause to disadvantaged minorities, compelling. I, therefore, conclude that vaccination status should not be considered during healthcare resource allocation, as such discrimination would disproportionately harm marginalised communities. (shrink)

In order to fully understand the ethical, cultural, and political debate that moves around the papillomavirus vaccine, a bit of attention has to be paid to its history.In 2006 the first advertisements for Gardasil, the commercial name of the vaccine, started to appear in the United States. Merck pharmaceutical was the main dealer. Their “One Less” campaign was characterized by adolescent girls staring into the camera and saying, “I’m one less,” declaring their intention to be vaccinated against the (...) human papillomavirus, and to be one less victim of cervical cancer; all it would take was three injections over six months. A few months after the appearance of the advertisement, the HPV matter took another turn when Texas Governor Rick Perry decided to issue an executive order mandating vaccination of all sixth-grade girls in the state. Texas, a state with a conservative political culture and well-organized anti-vaccination movement, bypassed the legislature, overturned Perry’s order .. (shrink)

The effectiveness of vaccination programmes depends on high levels of public trust in political, scientific and health-related institutions, but public trust in vaccines can waver. This article explores aspects of public trust and mistrust on a web media platform about the MMR (measles-mumps-rubella) vaccine through the statements of a doctor and an anonymised ‘anti-vaxxer’. Thematic analysis identifies commonalities and divergences in both perspectives. Both trust and mistrust of MMR vaccination are presented as moral, reasoned stances by their proponents; (...) they are connected to the individual’s experiences and situations, but are associated with very different trust attitudes to scientific and political institutions. Moreover, both the trustworthiness of the speakers themselves and the (un)trustworthiness of authorities are emphasised. Trust and mistrust are also thematised in relation to contextual matters such as the role of social media and the historical MMR controversy. Further research towards identifying common ground between trust positions is recommended. (shrink)

Preventive vaccination is one of the greatest successes of modern medicine. The SARS-CoV-2 epidemic, during which vaccination is the main method of prevention against death and severe disease, gave rise to a resurgence of anti-vaccine movements. The aim of this study was to analyse the attitudes of students towards vaccination and the COVID-19 pandemic. The statistical analysis was performed with the use of the following data-mining methods: correspondence analysis and basket analysis. The obtained results show that students of (...) medicine are characterized with the highest level of knowledge. Students of other medical faculties, on the other hand, have a significantly less uniform views, as do students of non-medical faculties. (shrink)

BackgroundAt the start of 2021, oncologists lacked the necessary scientific knowledge to adapt their clinical practices optimally when faced with cancer patients refusing or reluctant to be vaccinated against COVID-19, despite the marked vulnerability of these patients to severe, and even fatal forms of this new viral infectious disease. Oncologists at Foch Hospital were confronted with this phenomenon, which was observed worldwide, in both the general population and the population of cancer patients.MethodsBetween April and November 2021, the Ethics and Oncology (...) Departments of Foch Hospital decided to investigate this subject, through an empirical and interdisciplinary study in bioethics. Our scientific objective was to try to identify and resolve the principal bio-ethical issues, with a view to improving clinical practices in oncology during future major pandemics of this kind, from a highly specific bio-ethical standpoint. We used a mainly qualitative methodological approach based on questionnaires and interviews.ResultsIn April 2021, 29 cancer patients refused or were reluctant to be vaccinated. Seventeen of these patients said that making vaccination mandatory would have helped them to accept vaccination. In October 2021, only 10 cancer patients continued to maintain their refusal. One of the main reasons for the decrease in refusals was probably the introduction of the “pass sanitaire” in July 2021, which rendered vaccination indispensable for many activities. However, even this was not sufficient to convince these 10 cancer patients.ConclusionWe identified a key bio-ethical issue, which we then tried to resolve: vaccination policy. We characterized a major tension between “the recommendation of anti-COVID-19 vaccination” and “free will”, and the duty to “protect each other”. Mandatory vaccination, at least in France, could resolve this tension, with positive effects on quality of life, or survival, in cancer patients initially refusing or reluctant to be vaccinated, but only if collective and individual scales are clearly distinguished. (shrink)

It is well established that chronic infections can lead to cancer. Almost unknown is that, in contrast, acute brief viral and bacterial infections may have beneficial effects in cases of established neoplastic disease, while exposure to pathogenic products by infection, vaccination, and inhalation can cause prophylactic effects. In the following I will align evidence from case studies of spontaneous regression and from epidemiological studies with recent immunology to conclude that pathogenic substances belonging to the group of “pathogen‐associated molecular patterns” can (...) trigger the innate immune system to establish anti‐neoplastic immune responses. A better understanding of the protective role of the innate immune system might leverage considerable prophylactic potential. (shrink)