"Misinformation can decrease public confidence in vaccines, and reduce vaccination intent and uptake. One strategy for countering these negative impacts comes from inoculation theory. Similar to biological vaccination, inoculation theory posits that exposure to a weakened form of misinformation can
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develop cognitive immunity, reducing the likelihood of being misled. Online games offer an interactive, technologydriven, and scalable solution using an active form of inoculation that engages and incentivizes players to build resilience against misinformation. We document the development of the critical thinking game Cranky Uncle Vaccine. The game applies research findings from inoculation theory, critical thinking, humor in science communication, and serious games. The game content was iterated through a series of co-design workshops in Kampala (Uganda), Kitale (Kenya), and Kigali (Rwanda). Workshop participants offered feedback on cartoon character design, gameplay experience, and the game’s content, helping to make the game more culturally relevant and avoid unintended consequences in East African countries. Our co-design methodology offers an approach for further adaptation of the Cranky Uncle Vaccine game to other regions, as well as a template for developing locally relevant interventions to counter future infodemics." (Abstract)
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This book illuminates the complex relationship between social media, identity, and youth in the Global South. By examining the profound impact on the psychosocial well-being and economic prospects of young people across diverse regions, the collection present empirical evidence from scholars spannin
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g Asia, Africa, North America, Central, and South America. Contributors show how young people experience adverse side-effects online, such as social withdrawal, or animosity to others, and how good social health and social media use can help young people develop economic resources, become independent, and socially responsible. Additionally, the book explores the role of social media channels, such as Facebook and Instagram, in the rise of cyberbullying, sexting, and online radicalization; how these platforms re-negotiate identity in developing countries and compromise productivity; and how the behaviour of celebrities on said platforms influence youth behaviour. Structured into five thematic sections, this book presents a nuanced understanding of the well-being implications arising from social media use among young people hailing from diverse socio-cultural and economic backgrounds and political exigencies.
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"Internews designed “The Power of Trust” to strengthen intercultural health networks and provide information to build trust around COVID-19 vaccines. Over 11 months, Internews and local partners continuously listened to the information needs of the communities. In response, we developed forums i
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n conjunction with knowledgeable health professionals and promoted media coverage of topics based on feedback in partner meetings and reports. Partners maintained ongoing relationships with Indigenous, Afro-descendant, rural, last-mile, and marginalized communities with insufficient health care, building capacities of local media sources and communicators to increase access to COVID-19 information. Internews collaborated with local partners, community communicators and media sources to adapt project activities to priority community needs. As a result, co-created sessions actively centered participants, were in local languages, used cultural codes specific to each community, and focused on context-specific concerns. In addition, Internews helped facilitate discussion spaces for community members to build dialogue with health experts to bridge gaps across Western and traditional medicine in addressing COVID-19 and other health issues. As the pandemic evolved, Internews also identified changing health priorities among focus communities and adapted trainings to mitigate the perceived changes, allowing project participants within these communities to more effectively reduce the spread of rumors related to COVID, vaccines, and other emerging health crises. Weekly radio programs on platforms like local Indigenous radio Radio Waira in Putumayo, Colombia incorporated intercultural approaches to discussing health topics to build trust." (Executive summary)
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"African countries experience high rates of infectious diseases that are mostly preventable by vaccination. Despite the risks of infections and other adverse outcomes, vaccination coverage in the African region remains significantly low. Poor vaccination knowledge is a contributory factor, and effec
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tive communication is crucial to bridging the vaccination uptake gap. This review summarises vaccination communication strategies adopted across African countries and associated changes in vaccine uptake. Methods: A systematic search was conducted in five bibliographic databases between 2000 and 2023 and supplemented with an additional Google Scholar search. Studies with data on vaccination communication and uptake in the English language were considered. A narrative synthesis was performed, and findings were presented in text and tables. Findings: Forty-one studies from fourteen African countries met the inclusion criteria. Several communication strategies were implemented for 13 different vaccines, mainly childhood vaccines. Mass campaigns and capacity building were the most common strategies for the public and health workers, respectively. Community-based strategies using social mobilisation effectively complemented other communication strategies. Overall, vaccination uptake increased in all countries following vaccination communication interventions. Barriers and facilitators to optimising vaccination communication at systemic and individual levels were also identified. Key barriers included lack of vaccine information, access issues, and high cost, while facilitators included improved vaccine education, reminders, trust-building initiatives, and community involvement. Conclusions: This review highlights effective vaccination communication strategies implemented across Africa as well as systemic and individual barriers and facilitators influencing vaccination uptake. The findings can inform strategies for vaccination communication and campaign planning to improve vaccination coverage in Africa." (Abstract)
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"The antivaccine hesitancy movement represents a challenge to public policy and platform regulations. During COVID-19, various Latin American antivaccine groups clashed with official sanitary initiatives. Despite many responses, little progress has been made in reaching these groups to transform the
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ir perceptions about the benefits of the COVID-19 vaccine. During the pandemic in Latin America, the antivaccine network Médicos por la Verdad (Doctors for the Truth) gained prominence in various countries. Finding itself limited by legal and technical restrictions, this network used alternative media such as Telegram to disseminate messages. This study argues that such groups may be considered an antivaccination culture that opposes government measures. This focus emphasizes narrative construction and allows us to understand the phenomenon from the collective meaning-making perspective. This study analyzed 232,638 Telegram messages from 14 public channels associated with the Médicos por la Verdad network. Our findings indicate that this antivaccine network builds an oppositional culture expressed and reinforced through multimodal, trans-media, fragmented narratives and suspends disbelief that constructs a world where the community enacts a truth pact. These narrative methods foster building a resilient network of oppositional cultures, decreasing the effectiveness of policies. We conclude that research beyond the framework of misinformation and the analysis of conventional platforms is needed to understand the antivaccine oppositional cultures." (Abstract)
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"A majority of communities in sub–Saharan Africa subscribe to religion which is part of the people’s way of life. At the center of religion are religious leaders whom communities trust and consult on various issues beyond faith and religion. By partnering with these revered figures and building
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their capacity to be champions for health we are able to impact the health of these communities in their day-to-day life."
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"Pro-Russian disinformation networks and American anti-science websites are pushing anti-vaccine content that is reaching large West African Facebook Pages and Groups. These networks are spreading social media posts and articles that contain misleading messages about Covid-19 vaccines. These message
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s are amplifying wider narratives that could erode trust inkey actors and institutions connected to vaccines. Networks of French disinformation websites are playing a crucial role in enabling this content to reach West African social media. These websites are artificially amplifying English-language articles by publishing translated versions. Each version features slight modifications to the title, imagery or source quoted. The resulting variety of articles increases the chance that these messages will reach diverse online communities. North American and European conspiracy theories are reaching both Anglophone and Francophone West Africa on social media and are a key feature of online vaccinemisinformation in the region. These include conspiracy theories about depopulation programs, a totalitarian, one-world government known as the New World Order, and even certain elements of QAnon, such as the idea that former US President Donald Trump was secretly fighting a corrupt political and financial establishment." (Ke findings)
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"We conducted a systematic review to identify and describe communications-based strategies used to prevent and ameliorate the effect of mis- and disinformation on people’s attitudes and behaviours surrounding vaccination (objective 1) and examined their effectiveness (objective 2) [...] Of 2000 id
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entified records, 34 eligible studies addressed objective 1, 29 of which also addressed objective 2 (25 RCTs and 4 before-and-after studies). Nine ‘intervention approaches’ were identified; most focused on content of the intervention or message (debunking/correctional, informational, use of disease images or other ‘scare tactics’, use of humour, message intensity, inclusion of misinformation warnings, and communicating weight of evidence), while two focused on delivery of the intervention or message (timing and source). Some strategies, such as scare tactics, appear to be ineffective and may increase misinformation endorsement. Communicating with certainty, rather than acknowledging uncertainty around vaccine efficacy or risks, was also found to backfire. Promising approaches include communicating the weight-of-evidence and scientific consensus around vaccines and related myths, using humour and incorporating warnings about encountering misinformation. Trying to debunk misinformation, informational approaches, and communicating uncertainty had mixed results." (Abstract)
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"This review aims to synthesize the global evidence on misinformation related to COVID-19 vaccines, including its prevalence, features, influencing factors, impacts, and solutions for combating misinformation. We performed a systematic review by searching 5 peer-reviewed databases (PubMed, Embase, W
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eb of Science, Scopus, and EBSCO). We included original articles that investigated misinformation related to COVID-19 vaccines and were published in English from January 1, 2020, to August 18, 2022 [...] Of the 8864 studies identified, 91 observational studies and 11 interventional studies met the inclusion criteria. Misinformation around COVID-19 vaccines covered conspiracy, concerns on vaccine safety and efficacy, no need for vaccines, morality, liberty, and humor. Conspiracy and safety concerns were the most prevalent misinformation. There was a great variation in misinformation prevalence, noted among 2.5%-55.4% in the general population and 6.0%-96.7% in the antivaccine/vaccine hesitant groups from survey-based studies, and in 0.1%-41.3% on general online data and 0.5%-56% on antivaccine/vaccine hesitant data from internet-based studies. Younger age, lower education and economic status, right-wing and conservative ideology, and having psychological problems enhanced beliefs in misinformation. The content, format, and source of misinformation influenced its spread. A 5-step framework was proposed to address vaccine-related misinformation, including identifying misinformation, regulating producers and distributors, cutting production and distribution, supporting target audiences, and disseminating trustworthy information. The debunking messages/videos were found to be effective in several experimental studies." (Abstract)
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"The objective of this document is to help professional health communicators (PHCs) in the countries of the Region of the Americas improve their local and national communications on vaccine-related risks, to strengthen trust in immunization, and ultimately to increase uptake of new and routine vacci
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nes across the life course. It is meant for health communications professionals, especially those working in the ministries of health supporting the NIP." (Page viii)
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"Risk and crisis communication (RCC) is a complex constellation of multiple actors, platforms, and voices. It involves institutional actors but also laypeople. Participation by social media users can both facilitate and obstruct effective RCC. The present study draws on in-depth interviews with Swed
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ish Facebook users, and explores motivational factors for lay participation in RCC in the context of vaccination utilizing Peter Dahlgren’s (2011) model. The contributions of this study are threefold. First, it identifies three dominant clusters of participation motivations: personal interest, information brokerage, and persuasion. Second, the results show that Facebook sociality is characterized by asynchronous communication, loops, and widespread hostility. Third, degrees of content visibility set up “zones of peace” (backstage, safe communication spaces) and “zones of fight” (frontstage, open sub-arenas where various views on vaccination are debated). Moreover, the study finds that these forms of sociality and levels of visibility can both strengthen and undermine user motivations." (Abstract)
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"Social media platforms have a wide and influential reach, and as such provide anopportunity to increase vaccine uptake. To date, there is no large-scale, robust evidence on the offline effects of online messaging campaigns. We aimed to test whether pre-tested, persuasive messaging campaigns from UN
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ICEF, disseminated on Facebook, influenced COVID-19 vaccine uptake in Ukraine, India, and Pakistan. In Ukraine, we deployed a stepped-wedge randomized controlled trial (RCT). Half of the 24 oblasts (provinces) received five weeks of the intervention, the other half ten weeks of the intervention. In India, an RCT with an augmented synthetic control was conducted in five states (Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan), whereby 40 out of 174 districts were randomized to receive six weeks of intervention. In Pakistan we deployed a pre-post design, whereby 25 city districts received six weeks of the intervention. Weekly COVID-19 vaccination data was sourced through government databases. Using Poisson regression models, the association between the intervention and vaccine uptake was estimated. In Ukraine we conducted a survey among Facebook users at three time points during the RCT, to ascertain vaccination intentions and trust in vaccines. The campaigns reached more than 110 million Facebook users and garnered 2.9 million clicks. In Ukraine, we found that the intervention did not affect oblast-level vaccination coverage (Relative Risk (RR): 0.93, 95% Confidence Interval (CI) 0.86-1.01). Similarly, in India and Pakistan we found no effect of our intervention (India: RR 0.85, 95% CI 0.70-1.04; Pakistan: RR 0.64, 95% CI 0.01-29.9). The survey among Facebook users in Ukraine showed that trust in vaccines and information sources was an important predictor of vaccination status and intention to get vaccinated. Our campaigns on Facebook had a wide reach, which did not translate in shifting behaviours. Timing and external events may have limited the effectiveness of our interventions." (Abstract)
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"Although vaccination is the only hope to fight against COVID-19, existing vaccine hesitancy is a thought-provoking phenomenon. Significantly, vaccine hesitancy is worsening the situation in Pakistan, leading to an increased number of COVID cases. In this context, this study aims to examine people
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s perceptions and attitudes towards vaccination. Here the focus was on determining the factors causing disease hesitancy among the masses. The researchers randomly selected a sample of n=17 individuals and gathered data by using telephone interviews and assessed data by using the Interpretive Phenomenological Analysis (IPA) approach. Results revealed that the increased vaccine hesitancy is due to misinformation, conspiracies, myths, and rumors about the side effects of the vaccination. It was also notable that the participants indicated digital media as the primary source of information, showing a potential relationship between social media and misinformation. Also, an intense uncertainty about the healthcare system in Pakistan is hindering the efforts to sustain herd immunity. Thus, due to several myths, rumors, and distrust of the healthcare system, vaccine hesitancy is halting the country’s ability to overcome the COVID-19 outbreak. Misinformation is vigorously circulating due to ease of access to different communication platforms, instilling fear of presumed side effects. Hence, the researchers suggest some practical considerations for the government, healthcare workers, and media platforms to counteract the misinformation and increase vaccine acceptance among the masses." (Abstract)
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"Internews in Zimbabwe collected 276 rumors on-line and 36 offline in the communities of Masvingo, Matabeleland South, Matabeleland North, Bulawayo, and Midlands. The most trending rumors include that COVID-19 vaccines are unsafe for children (35%), COVID-19 vaccines cause death (31%), COVID-19 vacc
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ines are experimental (19%), COVID-19 is endemic (8%), and that government is using COVID-19 for corruption (8%). 41% of collected rumors showed sentiment of confusion, 14% indicated anger or frustration, 14% showed fear, 10% were sad, 3% demonstrated excitement and 3% were shocked." (Rumor data overview, page 2)
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"The aim of this study was to understand the impact of counselling in countering fake news-related COVID-19 vaccine. We conducted two separate experiments. In the first experiment, we exposed the treatment group to fake news on COVID-19 vaccine through a WhatsApp group chat while the control group w
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as not. We then tested the effectiveness of such fake news on their perception. In our second experiment, we exposed the treatment group to a social media-based counselling intervention wherein we attempted to counter the earlier fake news on COVID-19 vaccine which they were exposed to. We found that respondents who were exposed to fake news reported greater negative perception about COVID-19 vaccine than their counterparts in the control group. We also we found that as a result of the counselling intervention, the respondents in the treatment group reported more positive perception regarding COVID-19 vaccine while their counterparts in the control group who were earlier exposed to fake news on COVID-19 did not significantly change their perception. This study has highlighted the importance of counselling in countering fake news within the context of health promotion. This approach is yet to receive significant attention in literature, especially from developing countries." (Summary)
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"To date, no study has evaluated the effect of a radio-only campaign on infant vaccination coverage, timeliness, and related morbidity in a low-income country. We implemented the "10+10+30" radio campaign involving broadcasting a weekly 10-minute radio drama series on vaccination, followed by a 10-m
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inute discussion by community health workers, and then a 30-minute listener phone-in segment in Jimma Zone, Ethiopia for three months. To assess the impact of 10+10+30, which was aired on a community radio station, we recruited mothers of infants up to 5 weeks old in intervention district clusters that were inside the radio station's reception range (n = 328 dyads) and control district clusters that were outside of the range (n = 332 dyads). Intention-to-treat and per-protocol analyses, adjusted for pre-intervention differences between the districts, were conducted to examine the co-primary outcome of Penta-3 vaccination coverage and timeliness as well as those of other vaccines and outcomes related to infant morbidity. Both intention-to-treat and per-protocol analyses revealed higher vaccine coverage and more timely vaccine administration in the intervention district relative to the control district, with infants in the intervention district being 39% more likely to receive a Penta 3 vaccination. In addition, adjusted regression analyses of maternal retrospective reports over a two-week period revealed 80% less infant diarrhoea, 40% less fever and 58% less cough in the intervention district relative to the control district. This study provides compelling initial evidence that a radio drama integrated with discussion and phone-in components may improve infant vaccination coverage and timeliness and may reduce infant morbidity." (Abstract)
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