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  1. Jul 2021
    1. The Russian marketing agency Fazze made a splash with attempts to pay off European influencers to spread fake dirt about Western vaccines in an apparent bid to make Moscow’s COVID-19 jab seem more appealing
    2. The multi-type branching process model lends itself to a method of simulating cascades which is more computationally efficient than network-based methods with no finite-size effects. There is very strong agreement in the cascade size distribution for both methods. (5/6)
    3. Using this model we get some nice analytical results about the criticality of the system, we can identify parameter regions where we expect subcritical (and supercritical) diffusion. We compare this for networks with different clustering levels. (3/6)
    4. We describe a model using multi-type branching processes (more commonly used to model populations in ecology) to track the propagation of clique motifs in a network under complex contagion dynamics. The motifs are characterised by the infection state of the nodes. (2/6)
    5. This work with @DavidJPOS and @gleesonj is now on arXiv (http://arxiv.org/abs/2107.10134): "A multi-type branching process method for modelling complex contagion on clustered networks" Here is a quick overview of our paper: (1/6)
    1. Today I issued a Surgeon General’s Advisory to call our country’s attention to health misinformation – an urgent threat to our health that requires an all-of-society response. http://surgeongeneral.gov/healthmisinformation
    1. The AstraZeneca Africa Director, Barbara Nel, has disclosed that a total of 1.6 billion fully funded COVID-19 vaccines would be made available for COVAX dependent countries later this year through to 2022. | Watch the full interview with @benkoku here: https://bit.ly/3yVOg6u
    1. One reason the right-wing outrage machine is focused on attacking Biden’s plan for door-to door outreach isn’t because they actually fear confiscation of guns or Bibles. It’s because they don’t want poor people to have access to life-saving vaccinations
    2. I continue to see a lot of judgment from folks who identify as liberal/progressive/leftist but who lack any awareness of what it is like to live as a poor person in the US. Stop judging people whose everyday lives require more fortitude and problem-solving than you can imagine.
    3. The policy corollary is to make accessing critical services like vaccines as easy as possible for low income communities—to bring the service into the present moment and make vaccinations the answer to the “what is needed NOW” question. And make sure everyone knows they’re free.
    4. When you’re poor, time is foreshortened. You take care of one emergency (“Okay, I got food and toilet paper…”) only to face another one just as pressing (“How am I going to pay this overdue utility bill?”). Out of necessity, you live in the present moment: what is needed NOW?
    5. When you’re poor, simply keeping yourself and loved ones fed and sheltered involves constant high stakes juggling that can be hard to understand if you haven’t experienced it. Medical care often stays on the list of important things you mean to get to soon—and then months pass.
    1. We’ve built and open-sourced BlenderBot 2.0, the first #chatbot that can store and access long-term memory, search the internet for timely information, and converse intelligently on nearly any topic. It’s a significant advancement in conversational AI.
    1. Finally: we looked at rates of vaccination among depressed/non-depressed people. 13-point gap, but not because of resistance. Underappreciated opportunity to reach people who need more help accessing vaccines? @celinegounder @CDCDirector @ASlavitt @MDaware
    2. April-May 50-state survey data from http://covidstates.org (n~21,733): rates of depression remain elevated, especially among 18-34, increasing among Asian Americans, 10 point gap between parents/non-parents, and more including vaccines... quick recap: https://osf.io/cgfzt/
    1. Vaccines work or they don’t…. If they do…. Opening up… let them do there job… If they don’t…. You have to return to normality at some stage… Otherwise then what… restrictions on who you see, what you do and where you go until when…. Forever.. It’s one or the other…
    1. Legal questions remain over whether campuses can require inoculations of vaccines under emergency use authorization and some students have filed lawsuits over it, including three at Cal State Chico. An @ACEducation memo says courts would probably uphold campus mandates.
    1. Doing this for last few months was a privilege. Working in TL--a neighborhood w challenges, but pulsing w life, amazing ppl and joy. Working w @codetenderloin @GLIDEsf @SFCHC415 @UCSFHospitals & @SF_DPH & 100s of volunteers was The work continues...
    2. As Delta variant spreads--we shouldn't leave folks behind. SF is doing fantastically w vaccine--but those not vaxxed remain vulnerable--& many want vaccines, but have complicated lives. Mobile vaccines take alot of effort--but compared to preventing illness--it's worth it! 8/x
    3. We vaxxed on street corners, stores, treatment ctrs, SROs. We served old folks, teens, homeless, workers--lots of folks face barriers to vax. It is on us to get vaccines to them. We used our local sites as hubs to vax those who could drop in & to support mobile teams-- 7/x
    4. We didn't shame. We gave choices: J & J or mRNA & explained tradeoffs. Yes--we had some folx not want vax, but many changed minds when saw friends getting vax. Vax became a community event. The ppl we vaxxed became ambassadors/cheerleaders. Making vax visible helps! 6/x
    5. Our teams went out on Thurs from @GLIDEsf & 1/2 day Sat at park w @ucsfhealth 1 team could do 10-20 vax in 3 hrs. (most days, had 4 teams) @codetenderloin spent lots of prep time--walking neighborhood, answering ? about vax, COVID. We carried narcan, health info, gift bags 5/x
    6. We used basic principles: 1) ensure equitable access 2) tailored approach 3) commit to being trustworthy. We answered ? honestly. We anticipated sxs & explained that these were expected/safe; gave care packages (socks,ibuprofen, drinks) https://blogs.bmj.com/bmj/2021/03/22/bringing-covid-19-vaccines-to-high-risk-populations-like-those-who-are-homeless-requires-a-tailored-approach/… 4/xBringing covid-19 vaccines to high risk populations—like those who are homeless—requires a tailored...Prioritizing vaccines for people experiencing homelessness is vital to an equitable and effective public health response, write Margot Kushel, Barbara DiPietro, and Bobby Watts Ensuring effective...blogs.bmj.com
    7. Mobile teams! Teams, led by the incredible @codetenderloin --ppl w deep roots in community, lived expertise--w MD/NP or RN & "scribe." Teams walked around neighborhood and vaccinated folks wherever we found them. We answered ?s, supported ppls' choices--& when ready--vaxxed 3/X
    8. We talk alot about vax "hesitancy" but--we found, access>>>hesitancy. We had small, local sites (@GLIDEsf & Boeddeker Park)--with great outreach/ no appts needed. Helpful for those who couldn't get to mass vax sites. Reached 100s of folx, but not enough: So, what worked? 2/X
    9. Aabout #COVID vaccines. The @ucsfbhhi has spent last several mos working w great partners to provide vax to folks in the Tenderloin--including those who are homeless/formerly homeless. After providing 2500+vax to folks who face many barriers to vaccines--some thoughts: 1/x
    1. Exactly. It says it is unknown how large the fomites risk is. And seeing the huge number of cases, the absence of clear reports of f transmission is telling. Seems there’s no proper evidence that surface cleaning is relevant, and it is expensive.
    2. As COVID cases drop in the U.S. and vaccinations increase, many companies are bringing their employees back to office buildings. Here are ways to evaluate the safety of a shared work space.Is Your Office Safe from COVID? What to Know Now That Your Boss Wants You BackWorkers are anxious because the coronavirus is still infecting people. Here are ways to evaluate the safety of a shared work spacescientificamerican.com
    1. I think that attribution is hard to make. I have no doubt they're systematically promoted by bad faith actors, but I think it's much harder to feel confident about all those who repeat them. But the rather extensive public discussion of efficacy does make this case seem unlikely
    2. more argument fallacy in action- this time false bifurcation/false dilemma/false binary: a failure to appreciate that there are more than two alternatives (i.e. stopping infection and transmission to a degree) this fallacy is common, but is it plausibly a good faith error here?Quote TweetRobin Monotti@robinmonotti2 · 15hWhat part of "if it does not stop infection or transmission it's not a vaccine it's a toxin" do some people still not understand?
    1. When relaxing infection precautions, its expected that risk among vaccinated increases, as is happening in UK & Israel. But the solution isn’t 3rd doses for vaccinated, it’s 1st & 2nd doses for unvaccinated!! More vaccines to more countries & in more arms should be our goal!!
    1. An Estimated 279,000 Deaths & up to 1.25 Million Hospitalizations Averted by U.S. #COVID19 Vaccination Campaign (@commonwealthfnd analysis) Interpretation: #VaccinesWork Link: https://commonwealthfund.org/publications/issue-briefs/2021/jul/deaths-and-hospitalizations-averted-rapid-us-vaccination-rollout… @Alison_Galvani @EricSchneiderMD @Vaccinologist @V2019N #SARSCoV2
    1. Also note that I and hundreds of other scientists have provided legitimate scientific information day in and day out through the pandemic for $0, while Tenpenny earned more than I will in several years' time for a short course full of misinformation.
    2. ""Rather than trying to convince [society] and bring them to your side, the best thing that we can do is plant the seed of doubt," said Sobolev." Literally the "doubt is their product" guide to getting people to doubt science, per the tobacco industry.
    3. "What motivation could anti-vaxxers possibly have to spread misinformation?" Story: "Organizers of the course attended by CBC journalists said that 400 people had signed up, which at $623 per student, adds up to almost $250,000 in course fees" + tests & supplements she plugged.
    1. Fascinating new preprint on delta vs older variants in well-investigated outbreaks in China. Viral load for delta is 3 log higher, and latent period is shorter too (estimate is 4 days vs 6 days). This may explain much higher R estimates which may be due to elevated viral load
    1. I figured it was best to make a comprehensive thread concerning the study out of The Lancet concerning variant B.1.617.2 (Delta) after mRNA vaccination to help clear up some confusion. Most aren’t breaking it down into layman’s terms, so allow me. Let’s discuss.
    1. A quick visual summary of data on this week's article by @anthonybmasters & @d_spiegel The outlook is uncertain, although we have survived a variant once already (B.1.1.7). The data on the effect of variants is analysed as fast as it (reliably) arrives. https://app.powerbi.com/view?r=eyJrIjoiMDc5YWYxMDQtZTk3Ny00OTkyLWI1MjYtOTA2ZTFmNmM4YWRjIiwidCI6IjljNTAxMmM5LWI2MTYtNDRjMi1hOTE3LTY2ODE0ZmJlM2U4NyIsImMiOjh9&pageName=ReportSectionc43494eb8eb26ada4078…
    2. In today's Weekly Stats Uncovered, @d_spiegel and I look at Public Health England technical briefings, the spread of B1.617.2, and secondary attack rates.Why is the new Covid variant spreading? | David Spiegelhalter and Anthony MastersThe virus is now in a race with the vaccines and the victor is increasingly uncertaintheguardian.com
    3. · 3 Mayinteresting article on the perspectives of young/healthy people who don't plan on getting vaccinated and some ideas on how to change that byb @DKThomp https://theatlantic.com/ideas/archive/2021/05/the-people-who-wont-get-the-vaccine/618765/
    1. Follmann and Fay look at a similar idea, focusing on the statistical details (https://medrxiv.org/content/10.1101/2021.02.04.21251133v1…) and we focus on the epidemiologic assumptions (some nice synchronicity at work!)Vaccine Efficacy at a Point in TimeVaccine trials are generally designed to assess efficacy on clinical disease. The vaccine effect on infection, while important both as a proxy for transmission and to describe a vaccine’s total...medrxiv.org
    2. .@rebeccajk13 and @mlipsitch showed how to use that to estimate efficacy against prevalent infection (https://medrxiv.org/content/10.1101/2021.02.25.21252415v1…).Interpreting vaccine efficacy trial results for infection and transmissionRandomized controlled trials (RCTs) have shown high efficacy of multiple vaccines against SARS-CoV-2 disease (COVID-19), but evidence remains scarce about vaccines’ efficacy against infection with,...medrxiv.org
    3. .@nataliexdean has explained these different measures in Duplos (https://twitter.com/nataliexdean/status/1360701856616493060…) and words (https://blogs.bmj.com/bmj/2021/03/05/understanding-the-spectrum-of-vaccine-efficacy-measures/…) building on @betzhallo's key work in the areaQuote TweetNatalie E. Dean, PhD@nataliexdean · 13 FebOkay Twitter, I think you will appreciate this. So @TheEconomist is not the only one who can make Version 2.0 of my vaccine sketches. Inspired by a tweet from @johnpmcdermott, I present vaccine efficacy with Duplos. (Original thread below for reference.) twitter.com/nataliexdean/s…
    4. New preprint up with @rebeccajk13 and @mlipsitch: https://medrxiv.org/content/10.1101/2021.05.03.21256556v1…. Note: not yet peer reviewed! Brief summary:Estimating vaccine efficacy against transmission via effect on viral loadDetermining policies to end the SARS-CoV-2 pandemic will require an understanding of the efficacy and effectiveness (hereafter, efficacy) of vaccines. Beyond the efficacy against severe disease and...medrxiv.org
    1. Vaccine uptake is rising for Republicans Independents. - 61% of Republicans say they have been or will get jabbed - 52% of Independents (and 87% of Democrats) say the same - Reluctance is at 26%, down by 11 points over the last month
    2. New weekly The Economist/YouGov national poll shows vaccine reluctance hitting another new low. - 69% of adults say they have been at least partially vaccinated, or plan to get vaccinated soon - 17% say they will not get vaccinated - 14% say they're unsure
    1. J&J’s vaccine vs placebo (normal saline). Again note the 20+% fatigue and headache in the placebo group. (The ...ugh 2020 effect) Chills were an unsolicited side effect (meaning they had to report it vs being prompted like in some other trials)
    2. Okay Twitter! Here is the new vaccine side effect chart (aka reactogenicity) for FDA submitted COVID19 vaccines vs Shingrix & Flu. J&J’s Ad26.COV2.S has the least side effect profile of the COVID vaccines so far.
    1. Coronavirus vaccines are free — but 9 percent of Americans say they're not getting one because they are worried about cost. I see this a lot in my reporting: patients who don't seek care because they're become so accustomed to surprise bills that follow.
    1. "Even if a link between myocarditis and the vaccine holds up, the condition is usually mild, requiring treatment only with anti-inflammatory drugs, whereas COVID-19 infection can also cause serious disease and long-term side effects, even in young people."
    2. Meanwhile, the evidence that the mRNA vaccines cause myocarditis keeps piling up. Israel reported today that the risk is 1 in 3000 to 1 in 6000 for young men. By way of comparison, the death risk of #Covid for healthy people under 25 is essentially too low to measure accurately.
    1. Direction broadly consistent with PHE findings below (with caveat that above is very rough estimate, plus different vaccine types being used in India vs UK) – https://khub.net/documents/135939561/430986542/Effectiveness+of+COVID-19+vaccines+against+the+B.1.617.2+variant.pdf/204c11a4-e02e-11f2-db19-b3664107ac42
    2. Useful data – quick look suggests odds ratio for detection of B.1.617.2 relative to non-B.1.617.2 in vaccinated group compared to controls is 2.7 (95% CI: 0.7-10) after one dose and 1.2 (0.4-3.6) after two...
    1. South Dakota has a vaccination rate of 50% (1+ dose). Maine is at 66%. So is Maine better protected? Not quite. If you factor in immunity from natural infection, SD has a total population immunity of ~70%, while ME is at ~62%. I created a calculator:
  2. Jun 2021
    1. The good news: an astonishing 98.2% of over-60s in Scotland are now fully vaccinated. That's an amazing uptake. It doesn't mean they are 100% protected of course (and especially not when case rates are high) but their risk of hospitalisation/death is cut by over 90%
    1. Number of Covid cases among children in US: >4 million. Number of Covid deaths in US children: 300-400. Number of kids vaccinated: 7 million. Number of kids who died from vaccine-related myocarditis: zero. #vaccinate @bhrenton @RickABright @angie_rasmussen @celinegounder
    1. Reading Cummings accounts of early creation of Test & Trace, a question I have is when and how it was morphed from aiming to find ~30 contacts per index case, needed to contain spread, into a service that contacts 2-4 contacts per index case, mostly within household.
    1. Adding Zambia, where Delta has reached 77% prevalence for infections and Uganda is at 97% https://nytimes.com/live/2021/06/25/world/covid-vaccine-coronavirus-mask#across-africa-the-delta-variant-is-driving-a-third-wave-of-the-virus-experts-say
    2. As the Delta variant (B.1.617.2) becomes dominant throughout the world, there are 2 patterns emerging: —Countries w/ low vaccination rates are seeing both case and fatality rates increase —Countries w/ high vaccination rate: some case increase and minimal to no fatality increase
    1. The cumulative incidence of VITT after AZ first vaccination in the UK is continuing to increase with the latest data being 1 in 81,000. However this is rather misleading because VITT is age related with a higher incidence in the young.
    2. "I think the #EU needs to be on the right side of history.” @JNkengasong Head of @AfricaCDC welcomes news of $1.2 bn EU investment but says the continent can produce vaccines at scale IF #patents are waived. "The time is always right to do the right thing..." PART I
    1. Perhaps an under appreciated point with the B.1.617.2 variant is that regional PHE teams and local authorities across the country are putting in heroic amounts of effort to break chains of transmission. (1/2)
    1. Direct link: https://psyarxiv.com/snj2d Like what you read? You can use the plaudits on PsyArXiv to give us a before we submit it for publication. Publicly comment using @hypothes_is, drop me an email, tweet or DM us! All feedback welcome!Preregistration of Applied Research for Evidence-Based PracticeWithin the context of the current replication and credibility crisis, open science practices have been pivotal in facilitating greater transparency in research. However, practices like preregistrat...psyarxiv.com
    2. But what do you think? We’d really appreciate your feedback on our ideas and recommendations...Quote TweetPsyArXiv-bot@PsyArXivBot · 21 MayPreregistration of Applied Research for Evidence-Based Practice https://zpr.io/RDSDF
    1. The program may have some speculative "someone should do something" sessions, but more competitive proposals will be ones reporting on the something that someone is doing -- outcomes of research, description of an intervention or new practice, evaluation of what's working or not.
    2. Attend to diversity in social identities, career stage, and inclusion of communities that are underrepresented in science generally and metascience work particularly. No one session can represent everyone, but reviewers will be attending to this for the program as a whole.
    3. Tips for proposing: For symposia and moderated discussions especially, avoid disciplinary silos for topics and proposed presenters. Select a meta-theme and recruit presenters investigating or conducting applied work on that theme from different disciplines or stakeholder groups
    4. The C-A-E sessions can highlight great successes or ideas that seemed sensible and were challenging to translate into practice, or had entirely unanticipated consequences. The key for these sessions is to get out of "in theory" and to report what is happening in practice.
    5. Events can be symposia, concept-action-evaluation sessions, moderated discussions, debates, or open Q&As. Concept-action-evaluations are "theory to action" sessions. Presenters will provide theoretical rationale for a reform, present an implementation and report outcome evidence
    1. Across whole of England, 76% [74-78%] of all newly diagnosed infections now B.1.617.2. We see familiar pattern of combination of declining B.1.1.7 epidemic with exponentially increase in B.1.617.2 infections. High vaccination coverage will hopefully help to prevent big hosp wave.
    1. Reported yesterday: 1 new local case, 0 new cases acquired overseas. Got symptoms? Get tested. - 19,533 vaccine doses administered - 28,485 test results received More later: https://dhhs.vic.gov.au/victorian-coronavirus-covid-19-data… #COVID19VicData #COVID19Vic
    1. thanks to the person who pointed me towards this report: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/988217/S1246_CO-CIN_Dynamic_Report_2nd_Wave.pdf… (you know who you are!) - lots of interesting data. In particular it does support the anecdotal evidence that average length of stay in hospital is shorter in recent admissions: see this chart 1/3
    1. Estimated growth rate advantage of B.1.617.2 vs B.1.1.7 is 8.3%/day [7.9-8.8%] 95% CLs and 4%/day [3-5%] for B.1.617.1 vs B.1.1.7 or 1%/day [0.8-01.3%] for P.1. vs B.1.1.7. That's based on a model nnet::multinom(LINEAGE ~ ns(DATE, df=2)+STATE). A bit lower than in UK but not much
    1. Compare relationship between R and proportion of sequences consistent with the B.1.1.7 variant in autumn 2020 (below left, from https://science.sciencemag.org/content/372/6538/eabg3055…) with R vs proportion of B.1.1.7 (and hence not Delta) in spring 2021 (below right, from https://gov.uk/government/publications/spi-m-o-consensus-statement-on-covid-19-9-june-2021…)
    1. Here’s Where That COVID-19 Vaccine Infertility Myth Came From—And Why It Is Not True https://henryford.com/blog/2021/04/fertility-rumor-covid-vaccine… The evidence firmly shows that the COVID-19 vaccines don't cause infertility.
    1. Despite increasing incentives, the US vaccination campaign is really struggling. Notably, the top 5 states are approaching 60% total population fully vaccinated which should provide strong protection vs the delta variant. A different story for the bottom 5 states @OurWorldInData
    1. 6/ Many young Americans want to "wait & see." But they also want to do what their friends are doing. If you're a teen or 20-something (or really anyone), be a role model! Take that selfie pic/video when you get vaccinated and post it online.
    2. 4/ Vaccine access remains a major issue for communities of color: - Will they have to miss work (& wages) due to side effects? - Will they have to pay out of pocket? *COVID VACCINES ARE FREE!* - Can they get vaccinated at a place they trust?
    3. 3/ Although conservatives, White Evangelicals, and rural Americans are less enthusiastic about getting vaccinated, they're coming around: https://justhumanproductions.org/podcasts/s1e70-country-in-roads-building-vaccine-confidence-in-rural-america-elizabeth-ellis-dana-friend-anna-loge-and-chris-martin… https://justhumanproductions.org/podcasts/s1e73-getting-on-the-right-side-of-conservatives-and-vaccines-gov-chris-christie-brian-castrucci…
    4. 2/ We've made progress with those who want to "wait & see" across multiple demographics including communities of color and conservatives, who were the least vaccine confident at the start. The % who definitely don't want to get vaccinated has remained stable since January.
    1. NEW: a common response to reports of hospitals struggling this winter is "it’s no different to a bad flu season!" I’ve tracked down historical data on flu ICU admissions, including winter 2017-18, a record high. Here’s how England’s Covid winter compares to a bad flu season
    1. Air passengers in the U.S. yesterday were up 20% week-over-week, the biggest advance since February, and the highest total daily passengers—1.98m—since the pandemic started. I initially thought it was an error and held off posting it, but it's apparently correct.
    1. The variants of concern/interest fall into a spectrum of immune evasiveness, w/ B.1.351 being most; B.1.1.7, B.1.429 least. This property pertains to potential for reinfection & some reduction in vaccine efficacy My prelim estimates based on publications/preprints, subject to Δ
    1. Event: The CONQUEST study has collected data on the contacts, behaviour & symptoms of staff & students @BristolUni during #COVID19 to inform policy & math modelling. Join us for this webinar on 8 June for an update on the study, its impact & future plans. http://bit.ly/3oXk8UM
    1. Steady gains in high work-from-home (and better-paid) sectors, now just 1.6% below pre-pandemic employment. After initial slow rebound, now moving back to baseline. In low work-from-home sectors, jobs still way below pre-pandemic baseline.
    1. https://reuters.com/business/environment/medics-march-who-headquarters-climate-campaign-2021-05-29/… @richardhorton1 speaking to @DrTedros today on video link at #WHA74 about the similarities of #COVID19 and #climatecrisis and the cost of inaction. This before Tedros addressed Doctors + Nurses protesting at the WHO. #WHO #RedAlertWHO
  3. May 2021
    1. "Digital fireside chat" with @adamhfinn and @BristolUni ProVC Prof John Iredale about "Vaccines milestones and combating conspiracy theories" now available at: https://digitalfireside.blogs.bristol.ac.uk/2021/02/17/episode-13-vaccines-milestones-and-combating-conspiracy-theories/… The C19vax handbook makes an appearance https://sks.to/c19vax @SciBeh
    1. So Hancock confirms that B.1.617.2 ("India" variant) is now dominant in England. Harries says we must remain "vigilant". What does vigilant even mean? That we watch very carefully as a new, more dangerous, variant takes over cos it was so fun last time? Yeah, I'm pissed off
    1. Feel nauseous watching this testimony. It's what we all could piece together was happening in No.10 & in SAGE, but to hear it directly and to re-live those weeks is just astonishing. How many lives could have been saved? How much of the harsh domestic restrictions were avoidable?
    1. 8/ In conclusion, vaccines are the best method for controlling the global Covid-19 pandemic but will only only work if people are prepared to receive them. Addressing vaccine hesitancy requires both individual and population-based approaches.
    2. 7/ Health system interventions also essential: - Call-Recall Systems (computer, not paper-based) - Reminders. Text message, letter, email, telephone - Financial reimbursement and incentives for providers - Feedback of data on provider performance -Mass media campaigns
    3. 6/ Discussion and engagement with patients who are vaccine hesitant should be conducted in an open, honest, and non-judgmental manner. Health professionals are well placed to have these conversations given their expertise and status.
    4. 5/ Recognising barriers to uptake helps to inform appropriate interventions to address them. The key is to build confidence, particularly listening to people’s concerns, and respecting cultural and religious beliefs.
    5. 4/ Reasons for vaccine hesitancy include concerns about long term effects, as well as immediate side effects; and side effects to other routine vaccines. Concerns about the the speed of development of vaccines is another important factor.
    6. 3/ Some of the key messages for health professionals around vaccine hesitancy require addressing questions about the safety and efficacy of vaccines, building trust with patients and working with local communities.
    7. 2/ Vaccine hesitancy is defined by WHO as “a delay in acceptance or refusal of safe vaccines despite availability of vaccine services.” Vaccine hesitancy is a spectrum with some people accepting all vaccines and a small minority refusing all vaccines.
    8. 1/ Our new article in @bmj_latest discusses vaccine hesitancy and how health professionals can collaborate with patients to improve confidence in vaccines. WHO has identified vaccine hesitancy as one of the top threats to global health.
    1. 14. All in all, these are absolutely useless numbers, compiled in a transparently inappropriate fashion, and coupled with a message promoting fear around the leading vaccine candidates while making the manufacturer's own vaccine look good. It's awful propaganda from Sputnik.