Uncoupling vaccination from politics: a call to action

Political polarisation in the USA is impeding vaccination of the population against SARS-CoV-2. Today, the lowest COVID-19 vaccination rates in the USA are overwhelmingly in Republican-leaning states and counties. At a time when the delta variant is spreading, these are also the areas experiencing surges in admissions to hospital and intensive care.1 If political divides on COVID-19 vaccination become ingrained, the consequences could include greater resistance to all vaccination and outbreaks of other vaccine-preventable diseases. Understanding and countering this trend are urgent public health priorities

Effectiveness of vaccination mandates in improving uptake of COVID-19 vaccines in the USA

Many high-income countries have rapidly pivoted from hard decisions about who may receive COVID-19 vaccines, due to shortages, to equally hard decisions about who must receive them. As lasting containment of COVID-19 remains elusive, many nations—from Costa Rica, to Austria, to Turkmenistan—are turning to vaccination mandates of various kinds. Mandates, however, are controversial in many countries. Austria’s proposed mandate for adults, for example, provoked mass protests. Some objectors argue mandates represent undue encroachment on individual liberty. Some other objectors maintain that mandates will not be an effective policy for COVID-19 because many individuals will seek to evade them, and mandates might erode support for other public health measures such as mask wearing

The legacy of the COVID-19 pandemic for childhood vaccination in the USA

Before the onset of the COVID-19 pandemic, achievements in childhood vaccine coverage in the USA and globally appeared imperiled. Misinformation about vaccines was pervasive. Vaccine hesitancy––a motivational state of being conflicted about, or opposed to, vaccination––was a top ten global health threat. And vaccine-preventable diseases, such as measles, re-emerged following decades of successful control. Since the arrival of COVID-19, disruptions to childhood vaccine delivery have further jeopardised childhood vaccination efforts

Confronting the evolution and expansion of anti-vaccine activism in the USA in the COVID-19 era

Over the past two decades, anti-vaccine activism in the USA has evolved from a fringe subculture into an increasingly well organised, networked movement with important repercussions for public health. The COVID-19 pandemic has exacerbated this evolution and magnified the reach of vaccine misinformation. Anti-vaccine activists, who for many years spoke primarily to niche communities hesitant about childhood vaccinations, have used traditional and social media to amplify vaccine-related mistruths about COVID-19 vaccines while also targeting historically marginalised racial and ethnic communities. These efforts contributed to COVID-19 vaccine hesitancy and expanded the movement, with early indications suggesting that this hesitancy could now also be increasing hesitancy that existed pre-pandemic towards other vaccines. It is important to understand the implications of this recent evolution of anti-vaccine activism on vaccination uptake and the promotion of sound public health strategies. In this Viewpoint, we summarise the latest developments in US-based anti-vaccine activism and propose strategies for confronting them

Promoting COVID-19 vaccine acceptance: recommendations from the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA

Since the first case of COVID-19 was identified in the USA in January, 2020, over 46 million people in the country have tested positive for SARS-CoV-2 infection. Several COVID-19 vaccines have received emergency use authorisations from the US Food and Drug Administration, with the Pfizer–BioNTech vaccine receiving full approval on Aug 23, 2021. When paired with masking, physical distancing, and ventilation, COVID-19 vaccines are the best intervention to sustainably control the pandemic. However, surveys have consistently found that a sizeable minority of US residents do not plan to get a COVID-19 vaccine. The most severe consequence of an inadequate uptake of COVID-19 vaccines has been sustained community transmission (including of the delta [B.1.617.2] variant, a surge of which began in July, 2021). Exacerbating the direct impact of the virus, a low uptake of COVID-19 vaccines will prolong the social and economic repercussions of the pandemic on families and communities, especially low-income and minority ethnic groups, into 2022, or even longer. The scale and challenges of the COVID-19 vaccination campaign are unprecedented. Therefore, through a series of recommendations, we present a coordinated, evidence-based education, communication, and behavioural intervention strategy that is likely to improve the success of COVID-19 vaccine programmes across the USA

Algorithms & code jmasm 32: Multiple imputation of missing multilevel, longitudinal data: A case when practical considerations trump best practices?

A pedagogical tool is presented for applied researchers dealing with incomplete multilevel, longitudinal data. It explains why such data pose special challenges regarding missingness. Syntax created to perform a multiply-imputed growth modeling procedure in Stata Version 11 (StataCorp, 2009) is also described. © 2013 JMASM, Inc