Can online self-reports assist in real-time identification of influenza vaccination uptake? A cross-sectional study of influenza vaccine-related tweets in the USA, 2013-2017

The Centers for Disease Control and Prevention (CDC) spend significant time and resources to track influenza vaccination coverage each influenza season using national surveys. Emerging data from social media provide an alternative solution to surveillance at both national and local levels of influenza vaccination coverage in near real time. This study aimed to characterise and analyse the vaccinated population from temporal, demographical and geographical perspectives using automatic classification of vaccination-related Twitter data. In this cross-sectional study, we continuously collected tweets containing both influenza-related terms and vaccine-related terms covering four consecutive influenza seasons from 2013 to 2017. We created a machine learning classifier to identify relevant tweets, then evaluated the approach by comparing to data from the CDC's FluVaxView. We limited our analysis to tweets geolocated within the USA. We assessed 1 124 839 tweets. We found strong correlations of 0.799 between monthly Twitter estimates and CDC, with correlations as high as 0.950 in individual influenza seasons. We also found that our approach obtained geographical correlations of 0.387 at the US state level and 0.467 at the regional level. Finally, we found a higher level of influenza vaccine tweets among female users than male users, also consistent with the results of CDC surveys on vaccine uptake. Significant correlations between Twitter data and CDC data show the potential of using social media for vaccination surveillance. Temporal variability is captured better than geographical and demographical variability. We discuss potential paths forward for leveraging this approach.</p

Evaluation of online videos to engage viewers and support decision-making for COVID-19 vaccination: how narratives and race/ethnicity enhance viewer experiences

BackgroundVaccine hesitancy has hampered the control of COVID-19 and other vaccine-preventable diseases.MethodsWe conducted a national internet-based, quasi-experimental study to evaluate COVID-19 vaccine informational videos. Participants received an informational animated video paired with the randomized assignment of (1) a credible source (differing race/ethnicity) and (2) sequencing of a personal narrative before or after the video addressing their primary vaccine concern. We examined viewing time and asked video evaluation questions to those who viewed the full video.ResultsAmong 14,235 participants, 2,422 (17.0%) viewed the full video. Those who viewed a personal story first (concern video second) were 10 times more likely to view the full video (p &lt; 0.01). Respondent–provider race/ethnicity congruence was associated with increased odds of viewing the full video (aOR: 1.89, p &lt; 0.01). Most viewers rated the informational video(s) to be helpful, easy to understand, trustworthy, and likely to impact others' vaccine decisions, with differences by demographics and also vaccine intentions and concerns.ConclusionUsing peer-delivered, personal narrative, and/or racially congruent credible sources to introduce and deliver vaccine safety information may improve the openness of vaccine message recipients to messages and engagement

LetsTalkShots: personalized vaccine risk communication

IntroductionVaccine hesitancy is a global health threat undermining control of many vaccine-preventable diseases. Patient-level education has largely been ineffective in reducing vaccine concerns and increasing vaccine uptake. We built and evaluated a personalized vaccine risk communication website called LetsTalkShots in English, Spanish and French (Canadian) for vaccines across the lifespan. LetsTalkShots tailors lived experiences, credible sources and informational animations to disseminate the right message from the right messenger to the right person, applying a broad range of behavioral theories.MethodsWe used mixed-methods research to test our animation and some aspects of credible sources and personal narratives. We conducted 67 discussion groups (n = 325 persons), stratified by race/ethnicity (African American, Hispanic, and White people) and population (e.g., parents, pregnant women, adolescents, younger adults, and older adults). Using a large Ipsos survey among English-speaking respondents (n = 2,272), we tested animations aligned with vaccine concerns and specific to population (e.g., parents of children, parents of adolescents, younger adults, older adults).ResultsDiscussion groups provided robust feedback specific to each animation as well as areas for improvements across animations. Most respondents indicated that the information presented was interesting (85.5%), clear (96.0%), helpful (87.0%), and trustworthy (82.2%).DiscussionTailored vaccine risk communication can assist decision makers as they consider vaccination for themselves, their families, and their communities. LetsTalkShots presents a model for personalized communication in other areas of medicine and public health

Promoting Vaccination in India through Videos: The Role of Humor, Collectivistic Appeal and Gender

Vaccination hesitancy is a barrier to India&rsquo;s efforts to control the COVID-19 pandemic. Considerable resources have been spent to promote COVID-19 vaccination, but evaluations of such efforts are sparse. Our objective was to determine how vaccine videos that manipulate message appeal (collectivistic versus individualistic), tone (humorous versus serious), and source (male versus female protagonist) toward vaccines and vaccination. We developed eight videos that manipulated the type of appeal (collectivistic or individualistic), tone of the message (humor or serious), and gender of the vaccine promoter (male or female) in a 2 &times; 2 &times; 2 between-subjects experiment. Participants (N = 2349) were randomly assigned to watch one of eight videos in an online experiment. Beliefs about vaccines and those about vaccination were obtained before and after viewing the video. Manipulation checks demonstrated that each of the three independent variables was manipulated successfully. After exposure to the video, beliefs about vaccines became more negative, while beliefs about vaccination became more positive. Humor reduced negative beliefs about vaccines. Collectivism and protagonist gender did not affect beliefs about vaccines or vaccination. Those able to remember the protagonist&rsquo;s gender (a measure of attention) were likely to develop favorable beliefs if they had also seen the humorous videos. These findings suggest that people distinguish beliefs about vaccines, which deteriorated after exposure to the videos, from beliefs about vaccination, which improved. We recommend using humor when appropriate and focusing on the outcomes of vaccination, rather than on the vaccines themselves

MYC Ran Up the Clock: The Complex Interplay between MYC and the Molecular Circadian Clock in Cancer

The MYC oncoprotein and its family members N-MYC and L-MYC are known to drive a wide variety of human cancers. Emerging evidence suggests that MYC has a bi-directional relationship with the molecular clock in cancer. The molecular clock is responsible for circadian (~24 h) rhythms in most eukaryotic cells and organisms, as a mechanism to adapt to light/dark cycles. Disruption of human circadian rhythms, such as through shift work, may serve as a risk factor for cancer, but connections with oncogenic drivers such as MYC were previously not well understood. In this review, we examine recent evidence that MYC in cancer cells can disrupt the molecular clock; and conversely, that molecular clock disruption in cancer can deregulate and elevate MYC. Since MYC and the molecular clock control many of the same processes, we then consider competition between MYC and the molecular clock in several select aspects of tumor biology, including chromatin state, global transcriptional profile, metabolic rewiring, and immune infiltrate in the tumor. Finally, we discuss how the molecular clock can be monitored or diagnosed in human tumors, and how MYC inhibition could potentially restore molecular clock function. Further study of the relationship between the molecular clock and MYC in cancer may reveal previously unsuspected vulnerabilities which could lead to new treatment strategies

The efficacy of Facebook\u27s vaccine misinformation policies and architecture during the COVID-19 pandemic

Online misinformation promotes distrust in science, undermines public health, and may drive civil unrest. During the coronavirus disease 2019 pandemic, Facebook-the world\u27s largest social media company-began to remove vaccine misinformation as a matter of policy. We evaluated the efficacy of these policies using a comparative interrupted time-series design. We found that Facebook removed some antivaccine content, but we did not observe decreases in overall engagement with antivaccine content. Provaccine content was also removed, and antivaccine content became more misinformative, more politically polarized, and more likely to be seen in users\u27 newsfeeds. We explain these findings as a consequence of Facebook\u27s system architecture, which provides substantial flexibility to motivated users who wish to disseminate misinformation through multiple channels. Facebook\u27s architecture may therefore afford antivaccine content producers several means to circumvent the intent of misinformation removal policies

Twitter and Facebook posts about COVID-19 are less likely to spread misinformation compared to other health topics

The COVID-19 pandemic brought widespread attention to an “infodemic” of potential health misinformation. This claim has not been assessed based on evidence. We evaluated if health misinformation became more common during the pandemic. We gathered about 325 million posts sharing URLs from Twitter and Facebook during the beginning of the pandemic (March 8-May 1, 2020) compared to the same period in 2019. We relied on source credibility as an accepted proxy for misinformation across this database. Human annotators also coded a subsample of 3000 posts with URLs for misinformation. Posts about COVID-19 were 0.37 times as likely to link to “not credible” sources and 1.13 times more likely to link to “more credible” sources than prior to the pandemic. Posts linking to “not credible” sources were 3.67 times more likely to include misinformation compared to posts from “more credible” sources. Thus, during the earliest stages of the pandemic, when claims of an infodemic emerged, social media contained proportionally less misinformation than expected based on the prior year. Our results suggest that widespread health misinformation is not unique to COVID-19. Rather, it is a systemic feature of online health communication that can adversely impact public health behaviors and must therefore be addressed