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National Survey: “Trust” at the Heart of Low U.S. Vaccination Rates

Why aren’t more people getting vaccinated? The answer comes down to a lack of trust, according to the COVID States Project, the largest ongoing national survey tracking people’s opinions and behaviors during the pandemic.

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National Survey: “Trust” at the Heart of Low U.S. Vaccination Rates

Unvaccinated individuals are 10 times more likely to contract COVID-19 than vaccinated individuals, according to the Centers for Disease Control and Prevention, yet only 54.8% of the total U.S. population is fully vaccinated against COVID-19 and 74.8% of eligible individuals have had at least one dose. The current rise in COVID-19 cases is, therefore, truly a pandemic of the unvaccinated.

The big question for public health officials is “why?” The effectiveness and safety of COVID-19 vaccines have been proven, with more than 386 million doses administered during the past nearly 11 months. (Remember, the two leading vaccines require two doses.) So, why aren’t more people getting vaccinated?

The answer comes down to a lack of trust, according to the COVID States Project, the largest ongoing national survey tracking people’s opinions and behaviors during the pandemic. It is a joint project of Northeastern University, Harvard University, Rutgers University and Northwestern University.

The survey of 20,699 Americans from all 50 states and the District of Columbia, conducted during June and July, found that the unvaccinated – 35% of respondents – didn’t trust that the vaccines were safe or effective. Specific concerns included the risk of side effects – notably, blood clots or heart inflammation, and allergic reactions to prior vaccines. The risk of side-effects was listed by 90% of unvaccinated individuals as the top reason they were not vaccinated. Approximately one-third said they were afraid of catching COVID from the vaccine itself.

Another frequent concern was that the vaccine had been developed too quickly. As one individual said, responding to an open-ended question, “In 10 years, lawyers are going to be saying, ‘if you had the COVID vaccine, call lawyers at 1-800…. (You) can’t cure the common cold but you can come up with a vaccine in months.” Another said, “I don’t think it’s been tested long enough to determine the long-term safety of it.” Some cited the Johnson & Johnson vaccine as an example. It was approved and then halted while the company investigated serious adverse events.

Whom to trust is an issue. When it came to pharmaceutical companies, 31% trusted them “a lot,” while 20% trusted them “not too much (15%) or not at all (5%).” Even vaccinated individuals were skeptical, as the survey reported that only 14% trusted pharma companies a lot “to do the right thing” to handle the COVID-19 pandemic, while 48% were wary. The White House, however, was trusted even less, if only by a few percentage points.

The most trusted sources regarding COVID-19 were hospitals and physicians, cited by 92% of respondents. Some 86% trusted scientists and researchers, but far fewer trusted the leading COVID-19 communicators. For example, only 66% trusted Anthony Fauci (director of the National Institute of Allergy and Infectious Diseases), 63% trusted the White House, 45% trusted the news media and 33% trusted social media. Each of those categories declined slightly from a previous survey conducted in April.

As one respondent pointed out, “there have been so many times we all heard the CDC, WHO, (and) Fauci say, ‘we were wrong,’ and have adjusted…the guidelines. No one mentions that we were told an N95 mask is the only protection, and now everyone is wearing masks that are completely useless in halting the spread.”

Exacerbating that fear is an underlying distrust of the institutions vouching for the safety and efficacy of the vaccines – the U.S. Food and Drug Administration, the CDC and the state and federal government. Pointedly, one said, “I won’t do something that the government is pushing so hard, in ridiculous ways (using celebrities, financial incentives). I won’t do something that involves threats by the government if I don’t comply (vaccine ‘passports’).”

Another alluded to a history of abuse in the healthcare system. “I do not trust the government as a Black woman. They are pushing a little too hard for people to take this when other diseases are treated as cash cows. This is highly suspicious to me.” Others alluded to the government advocating for a vaccine that at the time of the survey had not yet been FDA-approved.

According to the study’s lead author, Katherine Ognyanova, associate professor of communication at Rutgers’ School of Communication and Information, “lack of trust is a more important challenge at this point than the remaining logistic problems that people experience.”

Uncertainty and distrust were intertwined themes throughout the survey. In closed questions of the 1,205 survey participants who had not yet been vaccinated, 35% perceived the risk from COVID-19 to be overstated and equated it to the seasonal flu. Additionally, 24% were concerned about the risks associated with the vaccine itself and 15% said they didn’t trust the institutions associated with the vaccine. Another 12% saw little benefit to being vaccinated.

The word individuals used most often to explain why they were unvaccinated was “trust” – as in lack thereof. The second-most used term was “side effect,” showing real concern about the efficacy and safety of the vaccine. For respondents who were vaccinated, the most-used word was “protect.” For that group, the word “trust” barely appeared. The second most-used word for the vaccinated individuals was “family.” The researchers considered the differences in the word cloud striking.

Source: BioSpace

Economic and logistic factors played more modest roles among the unvaccinated. Of those who were not yet vaccinated but were willing, 17% were concerned about being able to take time off work if there were side effects. The same percentage was concerned about out-of-pocket costs. Logistical hurdles – difficulty traveling to a vaccination site and the inability to take time off from work – concerned 11% and 9% respectively.

Understanding the reasons behind vaccine hesitancy is the first step in addressing them. Only then can Americans be persuaded to vaccinate themselves against this viral disease the country can begin to approach herd immunity.

 

BioSpace source:

https://www.biospace.com/article/national-survey-trust-at-the-heart-of-low-u-s-vaccination-rates-

 

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The next pandemic? It’s already here for Earth’s wildlife

Bird flu is decimating species already threatened by climate change and habitat loss.

I am a conservation biologist who studies emerging infectious diseases. When people ask me what I think the next pandemic will be I often say that we are in the midst of one – it’s just afflicting a great many species more than ours.

I am referring to the highly pathogenic strain of avian influenza H5N1 (HPAI H5N1), otherwise known as bird flu, which has killed millions of birds and unknown numbers of mammals, particularly during the past three years.

This is the strain that emerged in domestic geese in China in 1997 and quickly jumped to humans in south-east Asia with a mortality rate of around 40-50%. My research group encountered the virus when it killed a mammal, an endangered Owston’s palm civet, in a captive breeding programme in Cuc Phuong National Park Vietnam in 2005.

How these animals caught bird flu was never confirmed. Their diet is mainly earthworms, so they had not been infected by eating diseased poultry like many captive tigers in the region.

This discovery prompted us to collate all confirmed reports of fatal infection with bird flu to assess just how broad a threat to wildlife this virus might pose.

This is how a newly discovered virus in Chinese poultry came to threaten so much of the world’s biodiversity.

H5N1 originated on a Chinese poultry farm in 1997. ChameleonsEye/Shutterstock

The first signs

Until December 2005, most confirmed infections had been found in a few zoos and rescue centres in Thailand and Cambodia. Our analysis in 2006 showed that nearly half (48%) of all the different groups of birds (known to taxonomists as “orders”) contained a species in which a fatal infection of bird flu had been reported. These 13 orders comprised 84% of all bird species.

We reasoned 20 years ago that the strains of H5N1 circulating were probably highly pathogenic to all bird orders. We also showed that the list of confirmed infected species included those that were globally threatened and that important habitats, such as Vietnam’s Mekong delta, lay close to reported poultry outbreaks.

Mammals known to be susceptible to bird flu during the early 2000s included primates, rodents, pigs and rabbits. Large carnivores such as Bengal tigers and clouded leopards were reported to have been killed, as well as domestic cats.

Our 2006 paper showed the ease with which this virus crossed species barriers and suggested it might one day produce a pandemic-scale threat to global biodiversity.

Unfortunately, our warnings were correct.

A roving sickness

Two decades on, bird flu is killing species from the high Arctic to mainland Antarctica.

In the past couple of years, bird flu has spread rapidly across Europe and infiltrated North and South America, killing millions of poultry and a variety of bird and mammal species. A recent paper found that 26 countries have reported at least 48 mammal species that have died from the virus since 2020, when the latest increase in reported infections started.

Not even the ocean is safe. Since 2020, 13 species of aquatic mammal have succumbed, including American sea lions, porpoises and dolphins, often dying in their thousands in South America. A wide range of scavenging and predatory mammals that live on land are now also confirmed to be susceptible, including mountain lions, lynx, brown, black and polar bears.

The UK alone has lost over 75% of its great skuas and seen a 25% decline in northern gannets. Recent declines in sandwich terns (35%) and common terns (42%) were also largely driven by the virus.

Scientists haven’t managed to completely sequence the virus in all affected species. Research and continuous surveillance could tell us how adaptable it ultimately becomes, and whether it can jump to even more species. We know it can already infect humans – one or more genetic mutations may make it more infectious.

At the crossroads

Between January 1 2003 and December 21 2023, 882 cases of human infection with the H5N1 virus were reported from 23 countries, of which 461 (52%) were fatal.

Of these fatal cases, more than half were in Vietnam, China, Cambodia and Laos. Poultry-to-human infections were first recorded in Cambodia in December 2003. Intermittent cases were reported until 2014, followed by a gap until 2023, yielding 41 deaths from 64 cases. The subtype of H5N1 virus responsible has been detected in poultry in Cambodia since 2014. In the early 2000s, the H5N1 virus circulating had a high human mortality rate, so it is worrying that we are now starting to see people dying after contact with poultry again.

It’s not just H5 subtypes of bird flu that concern humans. The H10N1 virus was originally isolated from wild birds in South Korea, but has also been reported in samples from China and Mongolia.

Recent research found that these particular virus subtypes may be able to jump to humans after they were found to be pathogenic in laboratory mice and ferrets. The first person who was confirmed to be infected with H10N5 died in China on January 27 2024, but this patient was also suffering from seasonal flu (H3N2). They had been exposed to live poultry which also tested positive for H10N5.

Species already threatened with extinction are among those which have died due to bird flu in the past three years. The first deaths from the virus in mainland Antarctica have just been confirmed in skuas, highlighting a looming threat to penguin colonies whose eggs and chicks skuas prey on. Humboldt penguins have already been killed by the virus in Chile.

A colony of king penguins.
Remote penguin colonies are already threatened by climate change. AndreAnita/Shutterstock

How can we stem this tsunami of H5N1 and other avian influenzas? Completely overhaul poultry production on a global scale. Make farms self-sufficient in rearing eggs and chicks instead of exporting them internationally. The trend towards megafarms containing over a million birds must be stopped in its tracks.

To prevent the worst outcomes for this virus, we must revisit its primary source: the incubator of intensive poultry farms.

Diana Bell does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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A major cruise line is testing a monthly subscription service

The Cruise Scarlet Summer Season Pass was designed with remote workers in mind.

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While going on a cruise once meant disconnecting from the world when between ports because any WiFi available aboard was glitchy and expensive, advances in technology over the last decade have enabled millions to not only stay in touch with home but even work remotely.

With such remote workers and digital nomads in mind, Virgin Voyages has designed a monthly pass that gives those who want to work from the seas a WFH setup on its Scarlet Lady ship — while the latter acronym usually means "work from home," the cruise line is advertising as "work from the helm.”

Related: Royal Caribbean shares a warning with passengers

"Inspired by Richard Branson's belief and track record that brilliant work is best paired with a hearty dose of fun, we're welcoming Sailors on board Scarlet Lady for a full month to help them achieve that perfect work-life balance," Virgin Voyages said in announcing its new promotion. "Take a vacation away from your monotonous work-from-home set up (sorry, but…not sorry) and start taking calls from your private balcony overlooking the Mediterranean sea."

A man looks through his phone while sitting in a hot tub on a cruise ship.

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This is how much it'll cost you to work from a cruise ship for a month

While the single most important feature for successful work at sea — WiFi — is already available for free on Virgin cruises, the new Scarlet Summer Season Pass includes a faster connection, a $10 daily coffee credit, access to a private rooftop, and other member-only areas as well as wash and fold laundry service that Virgin advertises as a perk that will allow one to concentrate on work

More Travel:

The pass starts at $9,990 for a two-guest cabin and is available for four monthlong cruises departing in June, July, August, and September — each departs from ports such as Barcelona, Marseille, and Palma de Mallorca and spends four weeks touring around the Mediterranean.

Longer cruises are becoming more common, here's why

The new pass is essentially a version of an upgraded cruise package with additional perks but is specifically tailored to those who plan on working from the ship as an opportunity to market to them.

"Stay connected to your work with the fastest at-sea internet in the biz when you want and log-off to let the exquisite landscape of the Mediterranean inspire you when you need," reads the promotional material for the pass.

Amid the rise of remote work post-pandemic, cruise lines have been seeing growing interest in longer journeys in which many of the passengers not just vacation in the traditional sense but work from a mobile office.

In 2023, Turkish cruise line operator Miray even started selling cabins on a three-year tour around the world but the endeavor hit the rocks after one of the engineers declared the MV Gemini ship the company planned to use for the journey "unseaworthy" and the cruise ship line dealt with a PR scandal that ultimately sank the project before it could take off.

While three years at sea would have set a record as the longest cruise journey on the market, companies such as Royal Caribbean  (RCL) (both with its namesake brand and its Celebrity Cruises line) have been offering increasingly long cruises that serve as many people’s temporary homes and cross through multiple continents.

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As the pandemic turns four, here’s what we need to do for a healthier future

On the fourth anniversary of the pandemic, a public health researcher offers four principles for a healthier future.

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John Gomez/Shutterstock

Anniversaries are usually festive occasions, marked by celebration and joy. But there’ll be no popping of corks for this one.

March 11 2024 marks four years since the World Health Organization (WHO) declared COVID-19 a pandemic.

Although no longer officially a public health emergency of international concern, the pandemic is still with us, and the virus is still causing serious harm.

Here are three priorities – three Cs – for a healthier future.

Clear guidance

Over the past four years, one of the biggest challenges people faced when trying to follow COVID rules was understanding them.

From a behavioural science perspective, one of the major themes of the last four years has been whether guidance was clear enough or whether people were receiving too many different and confusing messages – something colleagues and I called “alert fatigue”.

With colleagues, I conducted an evidence review of communication during COVID and found that the lack of clarity, as well as a lack of trust in those setting rules, were key barriers to adherence to measures like social distancing.

In future, whether it’s another COVID wave, or another virus or public health emergency, clear communication by trustworthy messengers is going to be key.

Combat complacency

As Maria van Kerkove, COVID technical lead for WHO, puts it there is no acceptable level of death from COVID. COVID complacency is setting in as we have moved out of the emergency phase of the pandemic. But is still much work to be done.

First, we still need to understand this virus better. Four years is not a long time to understand the longer-term effects of COVID. For example, evidence on how the virus affects the brain and cognitive functioning is in its infancy.

The extent, severity and possible treatment of long COVID is another priority that must not be forgotten – not least because it is still causing a lot of long-term sickness and absence.

Culture change

During the pandemic’s first few years, there was a question over how many of our new habits, from elbow bumping (remember that?) to remote working, were here to stay.

Turns out old habits die hard – and in most cases that’s not a bad thing – after all handshaking and hugging can be good for our health.

But there is some pandemic behaviour we could have kept, under certain conditions. I’m pretty sure most people don’t wear masks when they have respiratory symptoms, even though some health authorities, such as the NHS, recommend it.

Masks could still be thought of like umbrellas: we keep one handy for when we need it, for example, when visiting vulnerable people, especially during times when there’s a spike in COVID.

If masks hadn’t been so politicised as a symbol of conformity and oppression so early in the pandemic, then we might arguably have seen people in more countries adopting the behaviour in parts of east Asia, where people continue to wear masks or face coverings when they are sick to avoid spreading it to others.

Although the pandemic led to the growth of remote or hybrid working, presenteeism – going to work when sick – is still a major issue.

Encouraging parents to send children to school when they are unwell is unlikely to help public health, or attendance for that matter. For instance, although one child might recover quickly from a given virus, other children who might catch it from them might be ill for days.

Similarly, a culture of presenteeism that pressures workers to come in when ill is likely to backfire later on, helping infectious disease spread in workplaces.

At the most fundamental level, we need to do more to create a culture of equality. Some groups, especially the most economically deprived, fared much worse than others during the pandemic. Health inequalities have widened as a result. With ongoing pandemic impacts, for example, long COVID rates, also disproportionately affecting those from disadvantaged groups, health inequalities are likely to persist without significant action to address them.

Vaccine inequity is still a problem globally. At a national level, in some wealthier countries like the UK, those from more deprived backgrounds are going to be less able to afford private vaccines.

We may be out of the emergency phase of COVID, but the pandemic is not yet over. As we reflect on the past four years, working to provide clearer public health communication, avoiding COVID complacency and reducing health inequalities are all things that can help prepare for any future waves or, indeed, pandemics.

Simon Nicholas Williams has received funding from Senedd Cymru, Public Health Wales and the Wales Covid Evidence Centre for research on COVID-19, and has consulted for the World Health Organization. However, this article reflects the views of the author only, in his academic capacity at Swansea University, and no funding or organizational bodies were involved in the writing or content of this article.

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