tag:theconversation.com,2011:/fr/topics/vaccine-confidence-106384/articlesVaccine confidence – The Conversation2021-12-20T20:48:42Ztag:theconversation.com,2011:article/1684792021-12-20T20:48:42Z2021-12-20T20:48:42ZThe nanoparticles in mRNA vaccines are nothing to fear: We interact with many useful, tiny particles every day<figure><img src="https://images.theconversation.com/files/437870/original/file-20211215-19-6a71aq.jpg?ixlib=rb-1.1.0&rect=14%2C0%2C3244%2C2428&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">We interact with nanoparticles in multiple ways every day. The nanoparticles in this illustration are delivering drugs to cells.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 175px; border: none; position: relative; z-index: 1;" allowtransparency="" src="https://narrations.ad-auris.com/widget/the-conversation-canada/the-nanoparticles-in-mrna-vaccines-are-nothing-to-fear--we-interact-with-many-useful--tiny-particles-every-day" width="100%" height="400"></iframe>
<p>Let’s be honest: there are many ways in which size matters, and for some purposes small is beautiful. However, sometimes very small things, like nanoparticles, are misunderstood.</p>
<p>In recent months, many people have had difficult conversations with friends and family members who were hesitant about taking the COVID-19 vaccine. In some cases, this hesitance arose because they have been led to believe that <a href="https://ca.style.yahoo.com/covid-19-vaccine-nanotechnology-microchip-theories-214017318.html">vaccines can’t be trusted because they contain nanoparticles</a>. It is lipid nanoparticles — called liposomes — that <a href="https://theconversation.com/what-happens-when-the-covid-19-vaccines-enter-the-body-a-road-map-for-kids-and-grown-ups-164624">carry the mRNA molecule</a> in the COVID-19 mRNA vaccines. </p>
<h2>The nanoparticles in mRNA vaccines</h2>
<p>Those <a href="https://www.ted.com/talks/kaitlyn_sadtler_and_elizabeth_wayne_how_the_covid_19_vaccines_were_created_so_quickly">liposomes act as vehicles delivering the viral protein template</a> to where it can interact with the immune system and trigger the production of antibodies. Their small size allows them to do that job faster and more effectively. </p>
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<span class="attribution"><a class="source" href="https://theconversation.com/ca/topics/vaccine-confidence-in-canada-107061">Click here for more articles in our series about vaccine confidence.</a></span>
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<p>Liposomes are minuscule droplets of fat that mimic the membranes of our cells. This allows the particles to not only travel to their destination in the body without triggering an immune reaction, but also to fuse with our cells that can then uptake the mRNA molecule and synthesize the protein for which it codes. Once delivery is complete, these lipid nanoparticles are degraded by our body just like any other lipid. </p>
<p>This technology has been made possible through years of concerted efforts by the scientific community. These types of nanoparticles are a potentially useful vehicle for all sorts of other medicines. These include <a href="https://theconversation.com/3-mrna-vaccines-researchers-are-working-on-that-arent-covid-157858">other vaccines</a>, and also <a href="https://doi.org/10.1124/pr.115.012070">promising cancer treatments</a>.</p>
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Read more:
<a href="https://theconversation.com/covid-19-vaccines-how-pfizers-and-modernas-95-effective-mrna-shots-work-149957">COVID-19 vaccines: How Pfizer's and Moderna's 95% effective mRNA shots work</a>
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<p>As scientists who <em>make</em> nanoparticles, we had hoped that at least our loved ones would be less fearful of our work. Thankfully, they are all now fully vaccinated, but vaccine hesitancy stemming from the novelty of the terms nanoparticles and nanotechnology leaves us concerned. </p>
<p>With the rise of COVID cases due to the Omicron variant, efforts to address vaccine hesitancy across the globe need to be ramped up, including information about nanoparticles. The terms nanoparticles and nanotechnology may be uncommon to a lot of people, but humans have been interacting with nanoparticles for millennia, and each one of us comes into contact with nanotechnology-based products every single day. </p>
<h2>Nanoparticles</h2>
<p>One of the authors — Keroles Riad — mass-produces nanoparticles by literally <a href="https://www.concordia.ca/cunews/offices/vprgs/sgs/public-scholars-20/2021/03/16/i-set-things-on-fire-intentionally.html">setting chemicals on fire</a> (very satisfying). This process — called flame spray pyrolysis — can produce special nanoparticles called <a href="https://pubs.acs.org/doi/abs/10.1021/acsomega.0c06227">quantum dots</a>, which are used in lithium batteries and gas-sensing devices. But nanotechnology has uses in every aspect of our lives, affecting things like our wine, our guts and our climate.</p>
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<p>The nanoparticles in mRNA vaccines are not the first nanoparticles used for health applications. For instance, co-author Sylvie Ouellette is currently synthesizing lipid nanodiscs <a href="https://www.youtube.com/watch?v=YYBmI_cfRQQ">in her lab</a>. This consists of breaking down the lipid layer of <em>E. coli</em> bacteria into small pieces, to study the proteins it contains as if they were still in their natural environment. Since these proteins are involved in antibiotic resistance, lipid nanodiscs are an important tool in the fight against infection. </p>
<p>Sylvie has also studied <a href="https://doi.org/10.1038/s41598-017-10872-3">gold nanoparticles</a> to assess their usefulness in diagnosing and treating cancer and other health conditions.</p>
<p>Nanoparticles have been used for centuries. In fourth century China, <a href="https://doi.org/10.1016/j.culher.2012.02.001">nanoparticles were made via flame and used as inks</a>. </p>
<p>Gold nanoparticles have been at the core of <a href="https://doi.org/10.1166/jbn.2011.1205">Ayurveda, a traditional Indian healing practice</a>, for thousands of years. Although the jury is still out as to whether these gold nanoparticles in and of themselves confer healing properties, the method by which they are synthesized has paved the way for their use in modern medicine. They are now studied as a vehicle <a href="https://doi.org/10.1021/acs.molpharmaceut.8b00810">to target medically active compounds to tissue or cells involved in various diseases such as cancer</a>.</p>
<h2>How small is a nanometer?</h2>
<p>“Nano” comes from a <a href="https://nanoscience.ch/en/about-us/nanosciences/what-does-nano-mean/">Greek word meaning “dwarf</a>.” In essence, it means “very small.” A nanometer is 70,000 times smaller than the thickness of a human hair. A nanoparticle is anything that is so small that its size ranges from one to a few hundred nanometers. If you cut a block of wood to pieces that are about 0.0000001 centimetres (one nanometer), you will have made nanoparticles. </p>
<p>Nanoparticles can be made out of almost anything, from metals to fat. They can form naturally or inadvertently, and can also be synthesized in research or industrial laboratories. </p>
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<span class="caption">Different coloured copper oxide quantum dots from Keroles’s lab.</span>
<span class="attribution"><span class="source">(Andrew Kingsley Jeyaraj)</span>, <span class="license">Author provided</span></span>
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<p>Perhaps one of the most common nanoparticles today is <a href="https://www.mdpi.com/2073-4360/13/4/538/htm">carbon black</a>, which is used to reinforce our car tires and improve their wear resistance, <a href="https://www.alliedmarketresearch.com/carbon-black-market">constituting a US$17.5 billion dollar industry in 2018</a>. We <a href="https://coatings.specialchem.com/selection-guide/complete-guide-on-titanium-dioxide">paint the walls in our homes</a> with titanium white nanoparticles. The pills we swallow to treat our headaches or serious illnesses are usually <a href="https://tdma.info/the-crucial-role-of-titanium-dioxide-in-modern-pharmaceuticals/">coated</a> with silica or titanium nanoparticles. </p>
<p>More recently, several brands of anti-aging creams have boasted higher efficacy thanks to their <a href="https://www.taylorfrancis.com/chapters/edit/10.1201/9780429291470-7/liposomes-cosmetics-guy-vanlerberghe">active compounds being contained in liposomes</a> — the same type of nano-sized fat particles that are at the core of the mRNA COVID vaccines. </p>
<p>Given the broad incidence and wide variety of nanoparticles, there are also some that are not beneficial. For example, the <a href="https://dx.doi.org/10.7554%2FeLife.09623">nano-sized soot particles from cigarettes</a> that smokers inhale are very harmful to the lungs. </p>
<p>Other types of soot nanoparticles enter the atmosphere when planes and cargo ships burn fuel, where they are the third major contributor to the climate crisis. However, unlike other greenhouse gases, <a href="https://carleton.ca/eptl/research/">soot’s stay in the atmosphere is only a few weeks long</a> (compared to a hundred years in the case of carbon dioxide). That means that if we were to stop emitting soot today, the benefits would be immediate. </p>
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Read more:
<a href="https://theconversation.com/the-9-psychological-barriers-that-lead-to-covid-19-vaccine-hesitancy-and-refusal-168643">The 9 psychological barriers that lead to COVID-19 vaccine hesitancy and refusal</a>
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<p>Small is good when used beneficially, but nanoparticles can sometimes trigger fear or mistrust. Just like the conversations we’ve had with our own families, helping people understand how nanoparticles are part of our everyday lives may help dissolve some of those fears.</p>
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<p><em>Do you have a question about COVID-19 vaccines? Email us at <a href="mailto:ca-vaccination@theconversation.com">ca-vaccination@theconversation.com</a> and vaccine experts will answer questions in upcoming articles.</em></p><img src="https://counter.theconversation.com/content/168479/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Some vaccine hesitancy is based on a fear of the nanoparticles used in mRNA vaccines. But humans have been interacting with nanoparticles for millennia, and we use nanotechnology-based devices every day.Keroles Riad, Postdoctoral fellow, Chemical and Materials Engineering, Concordia UniversitySylvie Ouellette, PhD Candidate, Chemistry/Biochemistry, Concordia UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1740322021-12-19T11:14:36Z2021-12-19T11:14:36ZAnswers from COVID experts: How do you talk to family members who aren’t vaccinated? How can the vaccines be safe if they were developed so quickly? Is natural immunity better than being vaccinated?<figure><img src="https://images.theconversation.com/files/438294/original/file-20211218-23072-19asa4x.JPG?ixlib=rb-1.1.0&rect=4%2C4%2C2991%2C1962&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">With the holiday season approaching, people wait to receive a COVID-19 vaccination in Montréal as the pandemic continues in Canada and around the world. </span> <span class="attribution"><span class="source">THE CANADIAN PRESS/Graham Hughes </span></span></figcaption></figure><p><em>The Conversation Canada and McMaster University recently co-hosted a live event on vaccine hesitancy. Editor-in-Chief Scott White spoke with four researchers from McMaster: Medical doctor, educator and researcher Zain Chagla; immunologist Dawn Bowdish; Manali Mukherjee, an assistant professor in the division of respirology at McMaster’s department of medicine; political scientist Clifton van der Linden, who has been conducting ongoing public opinion surveys on COVID-19. Viewers submitted questions to the panel. This is an edited excerpt from the discussion, but you can watch the entire event in the video below.</em></p>
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<p><strong>Scott White</strong>: How many of you have a vaccine hesitant person in your inner circle? What have you tried to say to them to persuade them that vaccines are safe?</p>
<p><strong>Dawn Bowdish</strong>: All the good practices that I use with strangers, I have a hard time implementing with my own family. I think one of the important parts about vaccine hesitancy is it’s not my facts versus your facts and I have all the right facts and you have all the wrong facts, because people who are vaccine hesitant have lots of information, and there’s no metric to say that makes them feel that my information is better than theirs. So I feel like listening to people’s concerns and being really specific and not making judgment calls about what their concerns might be. Because to be honest, the vaccine hesitancy spectrum is huge. So where I have gone wrong with my own family is doing all the things that you shouldn’t do. I talked more than I listened. I threw scientific facts as opposed to listening to people’s stories and concerns. And I appealed to the authority. “I’ve got a PhD. I’ve been working on this for 20 plus years,” and that was a mistake. And so those are the things I would caution people against when you have your own conversations with your vaccine hesitant family members or friends.</p>
<p><strong>Zain Chagla</strong>: We know from things like smoking cessation where the more times that conversation happens in a nonjudgmental and non-confrontational matter, it often ends up with the right outcome at the end of the day. So again, it’s not a conversation to win to the other side and get someone to the pharmacy that afternoon. It’s a conversation to start another conversation and start another conversation and keep going along those lines.</p>
<p><strong>Scott White</strong>: Cliff, you’ve done a lot of work on taking the public pulse on this. What have you learned on trying to convince someone?</p>
<p><strong>Clifton van der Linden</strong>: Certainly, no matter how we model the public opinion data coming in on attitudes towards COVID-19, when it comes to vaccine hesitancy, trust is really the major factor. I think we are in an era where there’s a real sense of anti-intellectualism that’s being cultivated in certain corners of the internet. I think the social media discourse has a huge role to play in the way that trust has eroded as a society. But there are factors in the way that government has conducted itself. There are factors in the bad faith in which certain public actors have conducted themselves. And so there are lots of reasons for mistrust at an institutional level. So I do think that trying to ground conversations with people we love in that framework of trust, knowing that we are concerned about them, that we’re approaching them not because we want to be right but because the consequences of them being wrong are so dire for themselves and for our families and loved ones.</p>
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<span class="attribution"><a class="source" href="https://theconversation.com/ca/topics/vaccine-confidence-in-canada-107061">Click here for more articles in our series about vaccine confidence.</a></span>
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<h2>Why are there such strong reactions against vaccines?</h2>
<p><strong>Scott White</strong>: One thing that’s always puzzled me is that there seems to be this really rabid reaction against vaccines, but not other medical procedures like surgery, which is far more invasive, or taking medicine. What is it about vaccines that really seems to cause this hesitancy or resistance?</p>
<p><strong>Dawn Bowdish</strong>: My belief is that it’s partly because it’s a needle and partly because there’s this big mystery about how the immune system works and how it (the vaccine) could be so powerful. The active ingredients in our current vaccines is like 10 micrograms. If you look in your medicine cabinet at your Tylenol, your Advil or whatever, you’ll see that we work in milligrams. But 10 micrograms, a thousand times less, has this incredible powerful effect to be able to create a whole immune response. The amount of stuff that’s in the vaccine is negligible. It’s nothing. But this incredibly powerful immune event, I think is a little bit humbling in some ways.</p>
<p><strong>Clifton van der Linden</strong>: I think that especially in the last five or six years, we have been flooded with discussions of fake news, misinformation, disinformation. I mean, we are told not to trust what we hear from government, depending on who’s running government. The idea that you can trust one day and then not trust the next when there’s a change of party, it leaves people in the state of constant cynicism about the good faith I think particularly of elected officials, but also of government institutions in general. I think there’s a difference in Canada compared to countries like the U.S., where in Canada we do see that the public tends not to trust elected officials, but we still do have a lot of trust in our public health institutions in Canada.</p>
<h2>The safety of vaccines that were developed so quickly</h2>
<p><strong>Scott White</strong>: At <em>The Conversation</em>, we’ve been running <a href="https://theconversation.com/ca/topics/vaccine-confidence-in-canada-107061">a series of articles about vaccine confidence and vaccine hesitancy</a> and have been inviting questions from the public. And sort of one of the recurring questions that we get is that people seem to have trouble wrapping their head around the fact that the COVID vaccines have been developed so quickly and that scientists don’t know the long-term effects.</p>
<p><strong>Dawn Bowdish</strong>: The apparent speed was based on decades of fundamental research. I love this as a story because often times as a university academic, the general public thinks we waste time working on things that are fundamentally unimportant. In fact, we did have mRNA based vaccines in the pipeline for many different infections. One of the beauties of the mRNA technology is that it’s fairly easy to alter. Many of the features of vaccination – the dosing intervals, the amount of doses, how we de develop things for kids and for adults and older people – are all based on decades and decades of experience.</p>
<h2>Pregnancy and vaccines</h2>
<p><strong>Scott White</strong>: We get a lot of questions about the potential impact of vaccines on fertility. Zain, from a medical perspective, what are the dangers of not being vaccinated if you are pregnant?</p>
<p><strong>Zain Chagla</strong>: Look, no one is going to deny that most people do get through their infections and don’t die. I think we know this very well, but it doesn’t say that everyone is safe. We do know that elderly people are much more at risk of complications. We know what people with comorbidities are in much more risk of complications. And we have seen young people, who despite looking great on paper, are sitting in our ICUs ventilated, because again, once this virus gets out of control, once the immune system gets super jacked up, it really can cause chaos. And we sometimes don’t know who is that person that it’s going to be chaotic in and not. Pregnant women, I think we’re recognizing much more are in that risk group now. And then we have seen some fairly sick pregnant women. They’re physiologically unwell. They’re obviously carrying a baby. The concerns of having severe COVID not only in the mother, but in the baby, are also a major issue. Unfortunately, we’ve had to deliver babies prematurely for the fact that it would spare the mother their lives more and then make their mother’s oxygenation better.</p>
<p><strong>Dawn Bowdish</strong>: We don’t have a single example of a vaccine leading to long term fertility issues or leading to, I don’t even know what people are envisioning with the context of fertility, but the immune system attacking your ovaries or whatever. And in fact, all those mythologies I think were incredibly clever by the anti-vax group. Because if you’re a parent, what more do you want than grandchildren? And so what is going to trigger your emotional response and your desire to wait and to see more than that threat?</p>
<h2>What is long COVID?</h2>
<p><strong>Scott White</strong>: Manali, you’ve not only researched long COVID, but you’re dealing with it personally. I’m not sure that people fully understand the term and the impact that it can have on your life. So can you tell us about that? And then also speak about the best way to avoid it.</p>
<p><strong>Manali Mukherjee</strong>: A considerable proportion of people who have been infected with COVID-19, irrespective of how severe they were, whether they were in the hospital or whether they recover at home, they continue to have symptoms or actually develop new symptoms long after they have so-called recovered. So the public health gives you that call and tells you, “You know, you have recovered. If you’re feeling fine, go back to work.” But there are a number of people who still feel sick, who have lingering symptoms. These symptoms can range anywhere from chronic fatigue, sense of smell not being there, completely being distorted, having diffused pain, and of course all these can lead to anxiety, palpitations and cognitive impairment. So it’s a constellation of symptoms that’s kind of lingering. And none of these symptoms can be attributed to a clinical diagnosis that they either had before getting COVID. We are trying to look at what might be the reason behind it. I have reasons to believe that it’s deep seated within the immune system. I think that after having COVID, the immune system is still so hyper and it still thinks that the virus is possibly hiding somewhere or there is something still going on and the symptoms are a clinical manifestation of that misunderstanding that the immune system has. So that’s what we are trying to right now unravel and understand and makes sense.</p>
<p><strong>Scott White</strong>: Who’s more susceptible to long COVID? Is it younger people? Older people? Do we know?</p>
<p><strong>Manali Mukherjee</strong>: In my study, I’m seeing people from all age groups, all ethnicities coming in. Even asymptomatic people, people who have the infection, PCR positive test was in asymptomatic. Now they’re having symptoms. So really, we don’t know who’s going to get affected, why they’ll be affected. And worse, we just don’t know when this will stop or whether it will. What worries me right now is we don’t know much right now about the long COVID cases that we have from the original virus, the Wuhan virus to the alpha, beta, delta strains, how long COVID symptoms vary. And now the omicron has come in where we don’t know how it’s really going to be affecting our immune system given that it seems to have a higher transmissibility. And having been said, despite having a milder load, we don’t know how it’s going to really affect those with a longer COVID kind of situation. Will it affect more people with lingering, longer persisting symptoms than actually having a more severe acute infection phase? We don’t know. If you are vaccinated, there is data out there that it kind of reduces your long COVID symptoms. So if you are vaccinated and then still you get omicron, the logic tells me that your immune system might be a better streamlined, the way Dawn said, to handle that infection in a better mode as to not confuse it and make it more rowdier and lead to those lingering long COVID symptoms. So that is again another thing that tells me that vaccination and taking the boosters might actually be in our benefit as a society and community going towards natural immunity or herd immunity.</p>
<h2>Natural immunity vs. vaccine immunity</h2>
<p><strong>Scott White</strong>: There’s been a lot of discussion about herd immunity and on social media, instant experts say natural immunity is better than being vaccinated. Dawn, tell us about herd immunity and natural immunity versus vaccinated – especially as we’re now dealing with the omicron variant.</p>
<p><strong>Dawn Bowdish</strong>: Well, I mean, Manali just gave you an example of natural immunity, right? Long COVID is a natural immune response in some people. I don’t think there’s anything unnatural about a vaccine response. It’s giving your immune system the opportunity to work without distraction, right? So when you get infected with a virus, the virus doesn’t just say, “Oh, whoa. It was me. The immune system’s coming to get me.” It’s destroying tissues. The immune system in many cases is misdirecting and attacking those tissues. So some of the tissue damage we see is mediated by natural immunity, because it gets confused where there’s tissue damage in the context of infections. So natural immunity works sometimes, but vaccine immunity is natural immunity. It’s immunity working without distraction, letting the immune system do its thing without having this virus that’s fighting back and trying to thwart it. The thing about herd immunity is, let’s go back to a time before we had vaccines, antibiotics and doctors. One in three to one in five children died. There were more miscarriages, spontaneous abortions and babies born with severe complications because having an infection during pregnancy is problematic. Sure, if you were one of the lucky ones to survived your first birthday, you might have some level of protection until you got older or until you’ve had some immune compromising event or other illness. So a herd immune system gives a small percentage of the population a little bit of time to be protected from that. But as soon as a new baby’s born, a new pregnancy started, that susceptibility happens all over again. So the idea that we would just let a new virus run rampant in a population and take those risks to the young, the old, the random healthy adults is just cruel from my perspective. Really cruel. The best way for us to reach herd immunity is to get us all vaccinated.</p>
<p><strong>Zain Chagla</strong>: Right now our health-care system is burned to a crisp. We can’t deal with our current caseloads because we have complex patients coming in every day. We have ICU beds that are still allotted for COVID patients and we have health-care workers that are burnt out and have left the profession and are not coming back. So there is a lot of worry in the coming weeks and months as this circulates, that we’re going to see health systems overload. We’re going to see a lot of people test positive regardless of the vaccine status. And we’re going to see a lot of isolation and complications from that. The good news out of all of this though, is boosters do seem to really change the dynamic of vaccines and offer higher level of protection. We’re getting better data by the day that really is suggesting this. And so, I think there is work being done right now across the country, in particular Ontario, to make sure people do have access to a booster shot when their time comes.</p>
<h2>A lack of trust in expertise</h2>
<p><strong>Scott White</strong>: Some people don’t trust government. They don’t trust pharmaceutical companies. And although they may trust their personal doctor, they don’t trust intellectuals and they don’t trust people at universities. Why is that Cliff?</p>
<p><strong>Clifton van der Linden</strong>: We’ve seen a rise in populism throughout western democracies. And along with that rising populism, we’ve seen an unprecedented strain of anti-intellectualism, rejection of science in ways that we have not seen in the post-war era. So I think this is tied up in ideological convictions of partisanship, but really also in polarization. It’s no longer acceptable to have reasonable disagreements. I do think that the structure of public discourse on social media has conditioned us in such a way as to stick to our guns no matter what, to really not be permitted to make mistakes or reverse our judgment even if that means rejecting the decades of scientific research that have been undertaken. And then also looking for signals that substantiate that existing bias that one has.</p>
<h2>Isolation is not a protection strategy</h2>
<p><strong>Scott White</strong>: We had a question sent in to us about someone who’s homeschooled their kids and therefore they believe that that minimizes exposure to others. Again, you hear this from some people. “I don’t get out much” or “I don’t work in an office” or “I work outside, so therefore I don’t really need to be vaccinated.” How would you respond to someone who said something like that?</p>
<p><strong>Zain Chagla</strong>: I have seen people who have tried their best to isolate people that were homebound, but are reliant on certain people to be in their environment for their care that have gotten COVID. So number one, reducing your contacts and staying at home will reduce your risk, but it’s fallible. There are ways that people can get through it. People have to still go to the grocery store, people eventually have to see family, people have to get in public transit, and other ways that people came at exposed. Number two, there is this overlying belief that COVID-19 is somehow going to disappear from the face of this earth. And it’s not, right? This is going to be one of our endemic viruses. It’s not there yet. We’re still seeing epidemic spread, but this is going to be there today, it’s going to be there tomorrow, it’s going to be there the next day. And so, unless you plan on you and your family living a lifestyle where you’re going to be homeschooled and staying at home for the foreseeable decade or two, you’re going to encounter COVID at some point or another. And again, the best thing you can do for your body is have immunity to the virus and have a head start so that when you are encountering this virus, you can deal with it.</p>
<h2>Can minds be changed at this stage?</h2>
<p><strong>Scott White</strong>: Cliff, as someone who’s taking the pulse of the public all the time, do you think that at this stage, almost a year to when the vaccines have been available, is there anything that can be done to convince those who haven’t been vaccinated to actually make that decision now?</p>
<p><strong>Clifton van der Linden</strong>: I think there are some difficult decisions that policy makers have to engage with around this. We’ve seen the efficacy of mandatory vaccinations in certain sectors that has led to people who don’t want to be vaccinated, but nevertheless have made the decision to be vaccinated based on the policies that were put in place. That’s not something that should be done lightly. I think there are reasonable concerns about the government imposing mandatory measures, but there are choices to be made about the collective health of the population. And I will say that what we see in the data of public opinion is that the people who are reluctant to get vaccinated are not a homogenous group. There are different clusters within that group who have different motivations, ideas. They’re basing their decisions on different information and intuition and feelings. And they have different interactions with the public health-care system. But in terms of what we can do, I think it goes back to almost the beginning of the conversation and the really insightful things that my colleagues on this panel have spoken about, which is certainly any frame or any conversation that seeks to patronize or belittle the reasons that people have for not getting vaccinated is probably not going to end up being a successful path to convincing them otherwise. And these are not by and large people who haven’t read anything or who haven’t looked up information in the vaccine or who haven’t taken this very seriously. They do take it seriously. They read a lot about it. But there have been decades of concerted efforts to undermine science when it conflicts with certain interests. Look at the science on climate change for example. This is not something that’s new that has eroded confidence in science in general. We have also consistently underfunded STEM in our public education systems. And that lack of funding has led to an inability to discern authentic information from disinformation and misinformation in the broader public. So it’s almost a perfect storm of institutional and political failings that has led us at this point. I don’t fault individuals by and large. I think we have to think about the system that has led us to the place in which we are now.</p><img src="https://counter.theconversation.com/content/174032/count.gif" alt="The Conversation" width="1" height="1" />
A panel of experts answer questions about vaccines, omicron and other COVID-related issues in a discussion with The Conversation.Scott White, CEO | Editor-in-Chief, The Conversation CanadaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1686432021-09-29T16:01:58Z2021-09-29T16:01:58ZThe 9 psychological barriers that lead to COVID-19 vaccine hesitancy and refusal<figure><img src="https://images.theconversation.com/files/423409/original/file-20210927-21-1vzipkt.JPG?ixlib=rb-1.1.0&rect=49%2C67%2C4039%2C2649&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People wait in line at a mass vaccination and testing clinic in Moncton, N.B., in September 2021.</span> <span class="attribution"><span class="source">THE CANADIAN PRESS/Christopher Katsarov </span></span></figcaption></figure><p>The fourth wave of the COVID-19 pandemic is putting pressure on hospital networks, upsetting many and making vaccine refusals seem foolish. To better understand what leads someone refuse or delay vaccination, it is important to <a href="https://dx.doi.org/10.1073%2Fpnas.0403823101">identify the psychological barriers that underlie the decision</a>.</p>
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<img alt="" src="https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><a class="source" href="https://theconversation.com/ca/topics/vaccine-confidence-in-canada-107061">Click here for more articles in our series about vaccine confidence.</a></span>
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<p>As a clinical psychologist who works mainly with adults suffering from personality, anxiety and mood disorders, I have a front-row seat for observing the distress, frustration and unease of those at the heart of this pandemic. Behind the refusal to be vaccinated, <a href="https://doi.org/10.1016/j.socscimed.2014.04.018">there is a complex emotional spectrum that colours each person’s behaviour and choices</a>.</p>
<p>Apart from religious and cultural reasons or health conditions that justify not receiving the vaccine, the choice to refuse vaccination can be explained by a range of other factors. The following nine factors provide a good picture of the complexity of the situation.</p>
<h2>Misunderstanding and lack of information</h2>
<p>A first barrier is lack of understanding about the vaccine or misunderstanding the necessity of vaccination.</p>
<p>Faced with contradictory opinions and a lack of information, some people are perplexed: Why should you get vaccinated if you can still catch the virus and transmit it? Why vaccinate young people if they are less vulnerable to the virus? </p>
<p><a href="https://doi.org/10.1016/j.vaccine.2021.08.037">Not finding satisfactory answers to these questions can paralyze someone’s thinking and reduce their willingness to take action</a>.</p>
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À lire aussi :
<a href="https://theconversation.com/a-researchers-view-on-covid-19-vaccine-hesitancy-the-scientific-process-needs-to-be-better-explained-167681">A researcher's view on COVID-19 vaccine hesitancy: The scientific process needs to be better explained</a>
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<h2>Fear of needles … and vaccines</h2>
<p><a href="https://doi.org/10.1016/j.vaccine.2012.04.066">Some people have a strong fear of needles or the pain related to vaccination</a>. Although this fear may seem irrational to others, it is something the sufferer feels intensely.</p>
<p><a href="https://dx.doi.org/10.1017%2FS0033291721002609">Apprehension about needles or pain is sometimes so anxiety-producing</a> that it can lead a person to avoid any situation that involves vaccination. Sometimes just seeing images of vaccination can provoke anxiety.</p>
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À lire aussi :
<a href="https://theconversation.com/needle-fears-can-cause-covid-19-vaccine-hesitancy-but-these-strategies-can-manage-pain-and-fear-165009">Needle fears can cause COVID-19 vaccine hesitancy, but these strategies can manage pain and fear</a>
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<p>In other cases, the fear is related to the possible side effects of the vaccine. Some people may not refuse to be vaccinated, but will wait until more people have been vaccinated so they can see if there are any long-term side effects.</p>
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<img alt="A man in a mask holds a dog in front of a young woman, also wearing the mask" src="https://images.theconversation.com/files/421994/original/file-20210919-15-16szdl6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/421994/original/file-20210919-15-16szdl6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=447&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421994/original/file-20210919-15-16szdl6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=447&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421994/original/file-20210919-15-16szdl6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=447&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421994/original/file-20210919-15-16szdl6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=561&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421994/original/file-20210919-15-16szdl6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=561&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421994/original/file-20210919-15-16szdl6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=561&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Zootherapist Sylvain Gonthier and his dog Bidule comfort Divine Nsabimana as she waits for her dose of COVID-19 vaccine, in Montréal, on August 26, 2021.</span>
<span class="attribution"><span class="source">The Canadian Press/Graham Hughes</span></span>
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<h2>Feelings of helplessness</h2>
<p>A further psychological barrier comes from the feelings of helplessness and discouragement in response to the possibility that the pandemic will continue, despite vaccination efforts, especially given the detection of new variants.</p>
<p><a href="https://apps.who.int/iris/bitstream/handle/10665/335820/WHO-EURO-2020-1160-40906-55390-eng.pdf">The term “pandemic fatigue”</a> reflects the weary and demotivated feeling that arises during a time of crisis when events appear to repeat themselves. <a href="https://doi.org/10.3390/vaccines9080900">Resignation and loss of hope can lead to reduced motivation</a>, and an unwillingness to follow recommendations, including vaccination. </p>
<h2>Aware but not concerned</h2>
<p>Other people are aware of the impact of the pandemic, but do not feel personally concerned: “I’m healthy, so that protects me.” </p>
<p>These individuals often lack knowledge about the disease and vaccination, so <a href="https://doi.org/10.1016/j.vaccine.2009.09.099">they are not particularly concerned about the harmful effects of the virus on their health or the risks of transmission</a> to others. It’s worth noting that these people are not actually be opposed to the vaccine.</p>
<h2>Mistrust of ingredients</h2>
<p>Some people pay close attention to what goes into their bodies and may be concerned about the ingredients of the COVID-19 vaccine. They experience visceral discomfort at the idea getting a vaccination, and may perceive the COVID-19 vaccine as an intrusion, contamination or aggression. </p>
<p>Not knowing about the <a href="https://www.cbc.ca/news/canada/manitoba/covid-19-vaccine-myths-dispelled-1.6014067">ingredients of the vaccine</a>, they may be <a href="https://doi.org/10.1111/cts.13077">reluctant or even opposed to receiving it</a>.</p>
<h2>Anxiety and denial</h2>
<p>Everyone reacts differently to anxiety-provoking situations. Some will jump into action and look for solutions, others will confide in loved ones <a href="https://doi.org/10.7202/1040167ar">or feel emotionally overwhelmed</a>.</p>
<p>Still others will go <a href="https://doi.org/10.3390/vaccines9080822">into denial</a>. Denial is an automatic, unconscious reflex that works as a Band-Aid to control anxiety. In the pandemic context, this may be expressed as denial of the seriousness of the disease, denial of one’s own vulnerability to contracting the virus, or even denial of the existence of the virus itself.</p>
<h2>Sense of rejection and exclusion</h2>
<p>As social beings, we are extremely sensitive to rejection. Rejection may be more common and painful for some than for others. These people feel more excluded from society and do not recognize themselves in the official discourse or the norms being proposed in response to the pandemic.</p>
<p>When health measures are announced, these people may find them controlling. When one feels neither represented nor listened to by the authorities, or when one is parodied or criticized by other groups in society, <a href="https://doi.org/10.1007/s10902-021-00398-x">the wounds of a past marked by rejection are reactivated and replayed</a>.</p>
<p>These people will also feel <a href="https://doi.org/10.3389/fpsyg.2021.682931">excluded and less likely to follow recommendations</a>. They are also more likely to feel <a href="https://doi.org/10.1080/0960085X.2021.1895682">better understood by alternative and refractory voices that make them feel heard at last</a>.</p>
<h2>Dependency and conflict avoidance</h2>
<p>Some people are more dependent on the opinions of those closest to them. The dynamics of the relationship are such that the person doubts themselves, relies on the other person to make day-to-day decisions for them and idealizes the other person or seeks to minimize conflicts with them.</p>
<p>In these cases, the person’s position and choice will be influenced by the fact that their peer does not consider vaccination to be important.</p>
<h2>Crisis of confidence</h2>
<p>The previously mentioned factors, such as mistrust of what goes into the body, denial and rejection, may crystallize into a <a href="https://www.eurosurveillance.org/content/10.2807/ese.14.49.19437-en">greater distrust of government sources, health authorities and the pharmaceutical industry</a>. This can also turn into a <a href="https://doi.org/10.1016/j.socscimed.2014.04.018">crisis of confidence and distrust of public health recommendations</a>. </p>
<p>Belief in conspiracy theories and the rejection of authority can shape one’s thinking and identity. That in turn creates a danger of polarization.</p>
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<img alt="A man holds a sign" src="https://images.theconversation.com/files/421993/original/file-20210919-15-i3ickh.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/421993/original/file-20210919-15-i3ickh.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=425&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421993/original/file-20210919-15-i3ickh.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=425&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421993/original/file-20210919-15-i3ickh.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=425&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421993/original/file-20210919-15-i3ickh.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=535&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421993/original/file-20210919-15-i3ickh.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=535&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421993/original/file-20210919-15-i3ickh.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=535&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">An anti-vaccine protester in front of a Montréal hospital.</span>
<span class="attribution"><span class="source">The Canadian Press/Paul Chiasson</span></span>
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<p>Other factors could be added to this list of what contributes to vaccine hesitancy and refusal. As a psychologist, I consider it essential to understand why a person refuses to be vaccinated. The measures and solutions to encourage vaccination reach people in different ways, depending on how they process information in the first place. </p>
<p>Some people will need explanations, others will need to be accompanied when they get vaccinated, and still others will need to be in a space where they feel listened to and feel that their irritation is accepted. Finally, to avoid feeling “controlled” some people will prefer following alternative recommendations, such as getting regular screening tests.</p>
<p>In order to offer relevant solutions and move forward collectively in this pandemic crisis, we need to better understand each other’s reactions. I believe that this understanding will better guide authorities in communicating information and how to both decide on and present public health measures. For any measure to be respected, we must know the underlying reasons people reject it.</p>
<p><em>Do you have a question about COVID-19 vaccines? Email us at <a href="mailto:ca-vaccination@theconversation.com">ca-vaccination@theconversation.com</a> and vaccine experts will answer questions in upcoming articles.</em></p><img src="https://counter.theconversation.com/content/168643/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Geneviève Beaulieu-Pelletier received funding from SSHRC for her work on activism and radicalization.</span></em></p>The decision not to get the COVID-19 vaccine comes from a complex set of psychological factors.Geneviève Beaulieu-Pelletier, Psychologue, conférencière et professeure associée, Université du Québec à Montréal (UQAM)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1676812021-09-15T23:01:00Z2021-09-15T23:01:00ZA researcher’s view on COVID-19 vaccine hesitancy: The scientific process needs to be better explained<figure><img src="https://images.theconversation.com/files/420655/original/file-20210912-27-1x5nmgm.jpg?ixlib=rb-1.1.0&rect=0%2C45%2C3798%2C2644&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In the reluctance to vaccinate, there is a lack of trust and understanding of the scientific process. Better communication would help rebuild bridges. </span> <span class="attribution"><span class="source">The Canadian Press/Paul Chiasson</span></span></figcaption></figure><iframe style="width: 100%; height: 175px; border: none; position: relative; z-index: 1;" allowtransparency="" src="https://narrations.ad-auris.com/widget/the-conversation-canada/a-researcher’s-view-on-covid-19-vaccine-hesitancy--the-scientific-process-needs-to-be-better-explained" width="100%" height="400"></iframe>
<p><a href="https://theconversation.com/what-scientists-are-doing-to-develop-a-vaccine-for-the-new-coronavirus-131255">When I first wrote about the arrival of SARS-CoV-2</a> in early March 2020, the question was whether or not the new virus would become a pandemic. At the time, most experts believed that we had already reached the point of no return.</p>
<p>Today, 18 months later, the answer is clear. You don’t need to be a scientist to know it. This pandemic is the worst public health emergency of international concern that our modern society has faced. To date, <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019?adgroupsurvey=%7Badgroupsurvey%7D&gclid=EAIaIQobChMIyfmOzMHy8gIVkYjICh3I8wo5EAAYAiAAEgKQ3_D_BwE">more than 215 million cases have been confirmed and 4.5 million deaths have been reported globally</a>.</p>
<p>These are just the reported cases. In reality, the number of cases is higher, and for a variety of reasons: lack of diagnostic capacity, infection without symptoms, unwillingness or inability to be tested or to visit a health facility, etc. The number of deaths due to COVID-19 is probably underestimated, both <a href="https://www.cp24.com/mobile/news/death-certificates-don-t-accurately-reflect-the-toll-of-the-pandemic-experts-say-1.5326970?cache=/7.363087">in Canada</a> and <a href="https://www.who.int/data/stories/the-true-death-toll-of-covid-19-estimating-global-excess-mortality">worldwide</a>.</p>
<p>In addition to changing the way we live our daily lives, the pandemic has brought scientific processes to public attention. Researchers, used to working in the shadows, now had to provide solutions — and explanations — to a very real threat, and they have been doing this under the watchful eye of the public.</p>
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<span class="attribution"><a class="source" href="https://theconversation.com/ca/topics/vaccine-confidence-in-canada-107061">Click here for more articles in our series about vaccine confidence.</a></span>
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<p>One of these solutions, vaccination, is far from new. Yet no matter what the context, <a href="https://timesofsandiego.com/opinion/2021/09/08/anti-vax-movement-has-a-long-deadly-history-from-smallpox-to-covid/">it has always generated news</a>. So where are we now?</p>
<p>Still in our laboratories! I recently completed my PhD in microbiology-immunology at Laval University, research that I conducted under the supervision of <a href="https://ipolitics.ca/2020/09/21/leading-vaccine-developer-walks-out-on-federal-vaccine-task-force/">Professor Gary Kobigner</a>, who is known for co-developing an effective vaccine and treatment for Ebola. This fall, I will begin a postdoctoral fellowship at the Galveston National Laboratory in Texas, where I will continue my work on the transmission of, and vaccine development against, severe pathogens.</p>
<h2>Relevant questions</h2>
<p>The World Health Organization (WHO) currently lists <a href="https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19">13 available COVID-19 vaccines, based on four different platforms, including mRNA vaccines and viral vector vaccines</a>. Globally, more than five billion doses of vaccines have been administered. In Canada, five of these vaccines are currently approved for use: <a href="https://health-infobase.canada.ca/covid-19/vaccine-administration/">Pfizer-BioNTech, Moderna, AstraZeneca, COVISHIELD and Janssen</a>, with <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/covid-19-vaccine-treatment/vaccine-rollout.html#a4">Pfizer-BioNTech, Moderna and AstraZeneca</a> in wide distribution. Combined, these vaccines have been administered to approximately <a href="https://health-infobase.canada.ca/covid-19/vaccination-coverage/">70 per cent</a> of Canadians.</p>
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<img alt="A woman administers a vaccine to another woman, seated, from behind" src="https://images.theconversation.com/files/420137/original/file-20210909-23-1miromd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/420137/original/file-20210909-23-1miromd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=396&fit=crop&dpr=1 600w, https://images.theconversation.com/files/420137/original/file-20210909-23-1miromd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=396&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/420137/original/file-20210909-23-1miromd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=396&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/420137/original/file-20210909-23-1miromd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=497&fit=crop&dpr=1 754w, https://images.theconversation.com/files/420137/original/file-20210909-23-1miromd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=497&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/420137/original/file-20210909-23-1miromd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=497&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A woman receives her COVID-19 vaccine at Olympic Stadium in Montréal. Five vaccines have been approved in Canada and about 70 per cent of the population is doubly vaccinated.</span>
<span class="attribution"><span class="source">The Canadian Press/Paul Chiasson</span></span>
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<p>However, <a href="https://theconversation.com/i-work-at-a-covid-19-vaccine-clinic-heres-what-people-ask-me-when-theyre-getting-their-shot-and-what-i-tell-them-167046">many people have raised questions about these vaccines</a>. And it is fair to do so! The unknown has always been a source of anxiety for human beings, it is normal to <a href="https://theconversation.com/astrazeneca-covid-19-vaccine-faq-why-do-the-age-recommendations-keep-changing-does-it-cause-vipit-blood-clots-is-it-effective-against-variants-158302">ask questions</a>.</p>
<p>So, after working tirelessly to develop vaccines against COVID-19, what are scientists and doctors doing now?</p>
<p>They are doing what they have always done: Practising the best science they can within the limits of current knowledge. This scientific practice means continuing to evaluate the effectiveness of these vaccines <a href="https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/">against new variants</a> in labs, as the virus continues to mutate. </p>
<p>It means continuing to record who has experienced side-effects (serious or not) from vaccination and continuing to investigate the potential links between these side-effects and the vaccine. The science they are practising involves studying the virus day and night to understand how it makes people sick, how we can prevent infection and what our options are for getting rid of it as quickly as possible.</p>
<p>The term “current knowledge” is very important here. It is possible that more side-effects related to vaccination will be discovered much later. Here’s why.</p>
<h2>The scientific method</h2>
<p>When vaccines are initially developed in the laboratory and tested on animals, it is normal that <em>not</em> all side-effects are identified. A mouse is not a human, after all, and models cannot account for all the variables that can be found in a human. Humans live in a complex environment and society where individuals each have their own genetics, immunity and lifestyle (exercise, smoking, nutrition).</p>
<p>Furthermore, the more people are vaccinated, the greater the likelihood of detecting a serious side-effect. Clinical trials, where <a href="https://theconversation.com/explainer-how-clinical-trials-test-covid-19-vaccines-146061">drugs and vaccines are evaluated in a small group of individuals</a> before being made available to the general population, are designed to be safe. Volunteers are usually healthy adults, without serious <a href="https://www.inspq.qc.ca/en/publications/3082-impact-comorbidities-risk-death-covid19">pre-existing medical conditions</a>.</p>
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<p>
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<strong>
À lire aussi :
<a href="https://theconversation.com/explainer-how-clinical-trials-test-covid-19-vaccines-146061">Explainer: How clinical trials test COVID-19 vaccines</a>
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<p>Vaccination is now widespread in many countries. It is therefore statistically normal that rarer effects (for example, ones that one in a million people develop) are now being observed. These effects are too rare to have been detected in a clinical trial of 10,000 people. This is the case for rare side-effects such as <a href="https://www.forbes.com/sites/siladityaray/2021/09/09/european-medicines-agency-lists-nerve-disorder-as-very-rare-side-effect-of-astrazeneca-covid-19-vaccine/?sh=5fd603e61a7b">Guillain-Barré syndrome</a> and <a href="https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2021/76203a-eng.php">Bell’s palsy</a>.</p>
<p>The <a href="https://www.sciencebuddies.org/science-fair-projects/science-fair/steps-of-the-scientific-method">scientific method</a> requires that the following process is followed: Observe a problem, formulate a hypothesis about its possible causes, evaluate it experimentally by controlling the variables, interpret the results and draw a conclusion.</p>
<p>It can turn out that our initial hypothesis is wrong, and that is equally acceptable. This is how science was designed. I think that before the pandemic, people considered science infallible. Opening up research to the general public has greatly changed this perception, especially as science quickly became embroiled in politics, particularly over <a href="https://www.who.int/health-topics/coronavirus/origins-of-the-virus">the question of the origin of the pandemic</a>.</p>
<figure class="align-center ">
<img alt="Justin Trudeau is surrounded by scientists, in a lab" src="https://images.theconversation.com/files/420138/original/file-20210909-21-17ccvfk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/420138/original/file-20210909-21-17ccvfk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=436&fit=crop&dpr=1 600w, https://images.theconversation.com/files/420138/original/file-20210909-21-17ccvfk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=436&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/420138/original/file-20210909-21-17ccvfk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=436&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/420138/original/file-20210909-21-17ccvfk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=548&fit=crop&dpr=1 754w, https://images.theconversation.com/files/420138/original/file-20210909-21-17ccvfk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=548&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/420138/original/file-20210909-21-17ccvfk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=548&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Prime Minister Justin Trudeau with scientists during a visit to the National Research Council of Canada (NRC), in Montréal, August 2020. The scientific method makes it possible to observe a problem, formulate a hypothesis about its causes, evaluate it experimentally by controlling the variables, interpret the results and draw a conclusion.</span>
<span class="attribution"><span class="source">The Canadian Press/Graham Hughes</span></span>
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<h2>Knowing how to communicate</h2>
<p>And that’s where the problem comes from, among other things. <a href="https://doi.org/10.1038/d41586-020-00452-3">The key to effective scientific communication is not the science. It’s the communication</a>. The results of laboratory experiments and clinical trials are what they are. Either the vaccine or drug works to reduce mortality, or it doesn’t work, and we go back to the drawing board.</p>
<p>So where does the reluctance about vaccines come from? One of the main problems is not the lack of information about the safety of the vaccine. Almost everyone has access to this information on internet. The problem is the lack of trust in institutions, <a href="https://www.cairn-int.info/journal-revue-internationale-de-politique-comparee-2003-3-page-433.htm">which has been growing globally in recent years</a>.</p>
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<p>
<em>
<strong>
À lire aussi :
<a href="https://theconversation.com/how-better-conversations-can-help-reduce-vaccine-hesitancy-for-covid-19-and-other-shots-159321">How better conversations can help reduce vaccine hesitancy for COVID-19 and other shots</a>
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<p>But this trust can be earned — or regained. It just takes time, respect and empathy. A study by researchers at the <a href="https://doi.org/10.1080/21645515.2018.1549451">Centre Hospitalier Universitaire de Sherbrooke</a> shows that an educational session about immunization that used motivational interviewing techniques with parents of infants resulted in a nine per cent increase in immunization rates compared with families who did not receive the sessions.</p>
<h2>Finding the right answer to a question</h2>
<p>Ultimately, the goal of science is to find the right answer to a question.</p>
<p>Of course, human nature being what it is, we are not immune to conflicts of interest. We need to ensure transparency about things like funding and links between scientists and potential investors. This is especially important since we are all responsible for funding research, whether through federal subsidies, which are partly derived from taxes paid by citizens, or through the ordinary purchase of drugs in pharmacies.</p>
<p>Since this concerns everyone, it is high time that the public became more involved. After all, scientific discoveries and health measures are everybody’s business. For example, few citizens are familiar with “<a href="https://www.ncbi.nlm.nih.gov/books/NBK285579/">gain-of-function research</a>.” These studies can involve a level of risk ranging from very low to very high. For example, producing a drug from a bacterium carries little risk and much benefit. However, increasing the virulence or transmissibility of a virus such as Ebola or Influenza could carry a lot of risk if such research were carried out by individuals with bad intentions, or in poorly secured laboratories.</p>
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<p>
<em>
<strong>
À lire aussi :
<a href="https://theconversation.com/origins-of-sars-cov-2-why-the-lab-leak-idea-is-being-considered-again-161947">Origins of SARS-CoV-2: Why the lab-leak idea is being considered again</a>
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<p>As with any aspect of science, a risk-benefit analysis must be carried out. Note that in the vast majority of institutions where research is done, the committees assessing whether or not a study is worth doing are not only composed of scientists and students, but also members of the public.</p>
<p>Now each side just has to do its part. Scientists need to do a better job of communicating their results and the interpretation of them, as well as specifically answering questions of interest to the public and regaining their trust. They need to listen and stop hiding behind mountains of data, complicated words and scientific articles that are not easily accessible to the general public.</p>
<p>To those who are hesitant about vaccination, scientists should ask: “What data would make you change your mind?”, “Why do you think the current data are insufficient?”, “Why do you trust this individual, but not another or the institutions?” This is how constructive dialogue can be initiated and more in-depth reflection can begin.</p>
<p>For their part, citizens can adopt better practices when it comes to getting information and not only consider information that fits into their personal narrative. It is also important to avoid falling into a spiral of conspiracy theories and trust in false experts. It is important to not be afraid to doubt, to find other sources to confirm or refute what you have just read and to ask trusted experts around you what they think.</p>
<p><em>Do you have a question about COVID-19 vaccines? Email us at <a href="mailto:ca-vaccination@theconversation.com">ca‑vaccination@theconversation.com</a> and vaccine experts will answer questions in upcoming articles.</em></p><img src="https://counter.theconversation.com/content/167681/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Marc-Antoine De La Vega ne travaille pas, ne conseille pas, ne possède pas de parts, ne reçoit pas de fonds d'une organisation qui pourrait tirer profit de cet article, et n'a déclaré aucune autre affiliation que son organisme de recherche.</span></em></p>Before the pandemic, the public perceived science as infallible and inaccessible. But the opening up of research to the general public has changed that perception.Marc-Antoine De La Vega, PhD Student in Microbiology-Immunology, Université LavalLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1652292021-08-24T14:32:20Z2021-08-24T14:32:20ZIndigenous children’s book ‘Little Louis’ aims to curb COVID-19 vaccine hesitancy with a culturally relevant story<figure><img src="https://images.theconversation.com/files/417088/original/file-20210819-23-o3wag8.jpg?ixlib=rb-1.1.0&rect=6%2C0%2C802%2C1079&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The children's book, Little Louis, tells the story of a young boy preparing for his COVID-19 vaccination.</span> <span class="attribution"><span class="source">(Morning Star Lodge)</span>, <span class="license">Author provided</span></span></figcaption></figure><iframe style="width: 100%; height: 175px; border: none; position: relative; z-index: 1;" allowtransparency="" src="https://narrations.ad-auris.com/widget/the-conversation-canada/indigenous-children-s-book--little-louis--aims-to-curb-covid-19-vaccine-hesitancy-with-a-culturally-relevant-story" width="100%" height="400"></iframe>
<p>The COVID-19 pandemic has been difficult for everyone. But communities are different, and so are <a href="http://dx.doi.org/10.1136/jech-2020-214401">their pandemic experiences</a>. After more than a year of uncertainty and frustration, <a href="https://www.sciencemag.org/news/2021/02/how-soon-will-covid-19-vaccines-return-life-normal">vaccines have brought many a sense that a return to normal</a> is on the horizon. However, health and research communities now face a new challenge: vaccine hesitancy. </p>
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<img alt="" src="https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/410911/original/file-20210712-19-geybnm.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><a class="source" href="https://theconversation.com/ca/topics/vaccine-confidence-in-canada-107061">Click here for more articles in our series about vaccine confidence.</a></span>
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<p>While there are countless reasons to be vaccine hesitant, we must acknowledge the numerous legitimate reasons for hesitancy. </p>
<p>For example, if a community has experienced an exhausting history of <a href="https://doi.org/10.1353/his.2013.0015">medical experimentation</a>, <a href="https://www.cbc.ca/radio/thecurrent/the-current-for-november-13-2018-1.4902679/indigenous-women-kept-from-seeing-their-newborn-babies-until-agreeing-to-sterilization-says-lawyer-1.4902693">forced or coerced sterilization</a> and breaches of trust by the very institutions presenting the vaccine, their hesitancy is based on <a href="https://doi.org/10.4161/hv.24657">cultural or historical factors</a> and entirely distinct from the <a href="https://theconversation.com/the-inherent-racism-of-anti-vaxx-movements-163456">“anti-vaxx” movement</a>. </p>
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Read more:
<a href="https://theconversation.com/nutrition-researchers-saw-malnourished-children-at-indian-residential-schools-as-perfect-test-subjects-162986">Nutrition researchers saw malnourished children at Indian Residential Schools as perfect test subjects</a>
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<p>This is the daunting reality for <a href="https://doi.org/10.1503/cmaj.210112">many Indigenous communities</a> across the country. As a result, there is an urgent need to repair trust and promote vaccine confidence through evidence-based knowledge.</p>
<p>At <a href="https://www.indigenoushealthlab.com/">Morning Star Lodge</a>, we are part of a partnership between the community research advisory committee at <a href="https://fhqtc.com/star-blanket/">Star Blanket Cree Nation</a> and <a href="https://kidsinpain.ca/">Solutions for Kids in Pain (SKIP)</a>. Together we have collaborated to promote vaccine confidence while demonstrating the importance of community-led research.</p>
<h2>Reflecting culture</h2>
<p>We entered into this partnership to promote vaccine uptake under the direction of Indigenous communities. Through our discussions, we came to solutions about ways we could promote COVID-19 vaccination information — like booklets <a href="https://tinyurl.com/AllAboutMeKids">for Indigenous children</a> <a href="https://tinyurl.com/AllAboutMeAdults">and adults</a>. After coming up with several solutions, Star Blanket Cree Nation’s research advisory committee members pointed towards an additional need: A children’s book, and in came <em>Little Louis</em>. </p>
<p>Many Indigenous Peoples grew up without medical information that respected or reflected their culture, the CRAC recognized the need to reverse this trend. A children’s book that reflects the identities of Indigenous children is important for making information accessible to all.</p>
<p>SKIP, Morning Star Lodge and Indigenous community members began to prepare a children’s book that is engaging, educational and relevant for Indigenous children experiencing needle fear or vaccine hesitancy — seeing their culture reflected in a children’s book can make all the difference when it comes to getting the jab. Needle fear or hesitation <a href="https://doi.org/10.1503/cmaj.150391">is a common feeling</a> and there is minimal children’s literature on the topic, especially literature that is culturally relevant. </p>
<p>The Star Blanket Cree Nation’s cultural, community and <a href="http://mediacentre.maramatanga.ac.nz/system/files/NPM%20Conference%20Proceedings%202012.pdf#page=32">storytelling</a> expertise far exceeds that of SKIP or Morning Star Lodge. The community research advisory committee members live in, and are from, the communities we serve, <a href="https://www.ictinc.ca/blog/what-does-indigenous-knowledge-mean">their Indigenous Knowledge adds depth and relevance to all of our projects</a>. Their guidance and leadership ensures that developments, like <em>Little Louis</em>, directly reflect community needs. </p>
<h2>Indigenous Peoples expertise, guidance and leadership</h2>
<p><em>Little Louis</em> talks about how to prepare for getting a vaccine, what vaccines feel like and what parents and children can do in order to be supported. The intention is that <em>Little Louis</em> will evolve into several different stories that will target different audiences and address different issues as time goes on and different issues arise. This sort of flexibility is a requisite to working with dynamic communities.</p>
<p>Inflexible research was and is often the norm. <a href="https://irb.cherokee.org/media/rkknqeww/helicopter-research.pdf">“Helicopter” research</a> (where researchers enter communities, collect data and leave, never to be heard from again) was and is still practised. This entirely one-sided interaction always benefits researchers but rarely, if ever, benefits communities. It frequently misrepresents realities for Indigenous communities and <a href="http://doi.org/10.3233/SJI-180478">actively creates negative stereotypes</a> that have been used to justify systemic racism. </p>
<p>Historically, research with Indigenous Peoples was not conducted “<a href="https://caan.ca/tools-and-resources/resource/doing-research-in-a-good-way">in a good way</a>.” Today, researchers can be guided to correct the errors of the past through principles like <a href="https://fnigc.ca/ocap-training/">OCAP (ownership, control, access and possession)</a> and the <a href="https://www.gida-global.org/care">CARE and FAIR principles for Indigenous data governance</a>. Further, researchers can learn about <a href="https://www.indigenoushealthlab.com/courses">ethical engagement and cultural safety</a> to ensure their research is truly ethical and upholds community perspectives.</p>
<p><a href="https://ethics.gc.ca/eng/tcps2-eptc2_2018_chapter9-chapitre9.html">In practice, this means Indigenous Peoples should be at the helm</a> of any research that may impact them or is about them. Doing so can prevent harmful misrepresentations, promote self-determination and contribute to solutions Indigenous communities actually need — like a children’s book that addresses vaccine hesitancy.</p>
<p><em>The following is a synopsis of “Little Louis.” Check the <a href="https://www.indigenoushealthlab.com/blog">Morning Star Lodge blog for updates on publication</a>.</em></p>
<h2>Meet <em>Little Louis</em></h2>
<p><em>Little Louis</em> tells the story of Louis, a young boy preparing for his COVID-19 vaccination. Louis starts by sharing his fears and frustrations with safety restrictions and the vaccine. His family listens and tells him how brave he is for making the decision to keep himself and the community safe. </p>
<p>Still nervous and hesitant about the vaccine, Louis’ family has an idea to create a “little” Louis, out of paper, which he can bring to the vaccination clinic during his appointment. Louis’ family also shares the story of a <a href="http://www.metismuseum.ca/media/db/06280">brave Métis leader named Gabriel Dumont</a> and his rifle, <em>le petit</em> (little one). </p>
<p>The night before the vaccination appointment, Louis dreams of going on a fishing adventure with Little Louis where they reel in what they think is a fish but it turns out to be a big needle! Louis and Little Louis both bravely face the needle, reeling it in until it turns into the big catch they hoped for. The next morning Louis shares his dream with his family. They tell him that he was brave for facing his fears. </p>
<p>Finally, Louis goes to his vaccine appointment with Little Louis by his side. The doctor asks to see Little Louis to give him the vaccine first. Observing that Little Louis was brave and didn’t get scared, Louis is ready and the doctor gives Louis his vaccine. Both Louis and Little Louis are now protected from COVID-19! </p>
<p><em>Do you have a question about COVID-19 vaccines? Email us at <a href="mailto:ca-vaccination@theconversation.com">ca-vaccination@theconversation.com</a> and vaccine experts will answer questions in upcoming articles.</em></p><img src="https://counter.theconversation.com/content/165229/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Patrick Sullivan is directly employed by Morning Star Lodge and, by extension, indirectly employed by the communities Morning Star Lodge serves. Therefore, Patrick has an interest in promoting the methodologies utilized by Morning Star Lodge and the priorities identified by community members. </span></em></p><p class="fine-print"><em><span>Heather O'Watch 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.</span></em></p>There is an urgent need to combat historically fuelled vaccine hesitancy within Indigenous communities. The best way to do this is through evidence-based knowledge and community-led work.Patrick Sullivan, Sr. Research Assistant, Morning Star Lodge, University of SaskatchewanHeather O'Watch, Research Assistant, Morning Star Lodge, University of SaskatchewanLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1627252021-06-21T18:03:06Z2021-06-21T18:03:06ZPrivate messages contribute to the spread of COVID-19 conspiracies<figure><img src="https://images.theconversation.com/files/407461/original/file-20210621-35190-1rltdtt.jpg?ixlib=rb-1.1.0&rect=0%2C13%2C4493%2C2775&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Private messaging apps allow information to spread in an unchecked manner.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>The COVID-19 global pandemic has been accompanied by misinformation about the virus, its origins and how it spreads. </p>
<p>One in seven Canadians <a href="https://www.cybersecurepolicy.ca/private-messages-public-harms">thinks there is some truth</a> to the claim that <a href="https://www.forbes.com/sites/brucelee/2020/04/19/bill-gates-is-now-a-target-of-covid-19-coronavirus-conspiracy-theories/">Bill Gates is using the coronavirus to push a vaccine with a microchip capable of tracking people</a>. Those who believe this and other COVID-19 conspiracy theories are <a href="https://policyoptions.irpp.org/fr/magazines/july-2020/who-believes-in-covid-19-conspiracies-and-why-it-matters/">much more likely to get their news</a> from social media platforms like Facebook or Twitter. </p>
<p>In extreme cases, conspiracy thinking spurred by online disinformation can result in hate-fuelled violence, as we saw in <a href="https://www.nytimes.com/interactive/2021/01/12/us/capitol-mob-timeline.html">the insurrection at the U.S. Capitol</a>, <a href="https://www.thecanadianencyclopedia.ca/en/article/quebec-city-mosque-shooting">the Québec City mosque shooting</a>, <a href="https://www.cbc.ca/news/canada/toronto/what-is-an-incel-toronto-van-attack-explainer-alek-minassian-1.4633893">the Toronto van attack</a> and <a href="https://www.thestar.com/politics/federal/2020/07/11/accused-in-rideau-hall-gun-incident-has-long-history-of-being-drawn-to-conspiracy-websites.html">the incident in 2020 where an armed man crashed his truck through the gates of Rideau Hall</a>.</p>
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Read more:
<a href="https://theconversation.com/coronavirus-conspiracy-theories-are-dangerous-heres-how-to-stop-them-spreading-136564">Coronavirus conspiracy theories are dangerous – here's how to stop them spreading</a>
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<h2>Moderate content</h2>
<p>These and other events have <a href="https://doi.org/10.1038/d41586-020-01107-z">placed pressure on social media platforms to label, remove and slow the spread of harmful, publicly viewable content</a>. As a result of implemented responses to the spread of misinformation, Donald Trump was <a href="https://www.cigionline.org/articles/trump-deplatforming-distraction-0/">deplatformed during the final weeks of his presidency</a>. </p>
<p>These discussions on content moderation have mainly centred around platforms where content is generally open and accessible to view, comment on and share. But what’s happening in those online spaces that aren’t open for all to see? It’s much harder to say. And perhaps not surprisingly, conspiracy theories are spreading on private messaging apps, like WhatsApp, Telegram, Messenger and WeChat, to spread harm.</p>
<p>By leveraging large groups of users and long chains of forwarded messages, false information <a href="https://firstdraftnews.org/wp-content/uploads/2019/06/Comprova-Full-Report-Final.pdf?x79527">can still go viral</a> on private platforms. </p>
<p>White nationalists and other extremist groups are trying to <a href="https://slate.com/technology/2019/08/telegram-white-nationalists-el-paso-shooting-facebook.html">use messaging apps to organize</a>, and malicious hackers are using private messages <a href="https://www.zdnet.com/article/what-is-phishing-how-to-protect-yourself-from-scam-emails-and-more/">to conduct cybercrime</a>. False stories spreading on messaging apps have also led to real-world violence, as happened <a href="https://globalnews.ca/news/4333499/india-whatsapp-lynchings-child-kidnappers-fake-news/">in India</a> and <a href="https://www.nytimes.com/2020/04/10/technology/coronavirus-5g-uk.html">the United Kingdom</a>.</p>
<h2>Trust and private communication</h2>
<p>We conducted a <a href="https://www.cybersecurepolicy.ca/private-messages-public-harms">survey of 2,500 Canadian residents in March 2021</a> and found that they’re increasingly using private messaging platforms to get their news. </p>
<p>Overall, 21 per cent said that they rely on private messages for news — up from 11 per cent in 2019. We also found that people who regularly receive their news through messaging apps are more likely to believe COVID-19 conspiracy theories, including the false claim that vaccines include microchips.</p>
<p>There is a level of intimacy in private messaging apps that’s different from news viewed on social media feeds or other platforms, with content shared directly by people we often know and trust. A majority of Canadians reported that they had a similar level of trust in the news they receive on private messaging apps as they do in the news from TV or news websites.</p>
<p>Our research also uncovered a uniquely Canadian phenomenon. As a multicultural society with many newcomers, the Canadian private messaging landscape is remarkably diverse. For example, people who have arrived in Canada in the last 10 years were more than twice as likely to use WhatsApp. Similarly, newcomers from China were five times more likely to use WeChat. </p>
<p>We also found that half of Canadians receive messages that they suspect are false at least a few times per month, and that one in four receive messages with hate speech at least monthly. These rates were <a href="https://www.crrf-fcrr.ca/en/news-a-events/media-releases/item/27349-poll-demonstrates-support-for-strong-social-media-regulations-to-prevent-online-hate-and-racism">higher among people of colour</a>. Because different apps provide different ways of spreading and mitigating harmful content, each requires a tailored strategy. </p>
<figure class="align-center ">
<img alt="A graph showing the self-reported frequency of receiving harmful private messages" src="https://images.theconversation.com/files/406789/original/file-20210616-23-cpqmpe.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406789/original/file-20210616-23-cpqmpe.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=359&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406789/original/file-20210616-23-cpqmpe.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=359&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406789/original/file-20210616-23-cpqmpe.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=359&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406789/original/file-20210616-23-cpqmpe.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=451&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406789/original/file-20210616-23-cpqmpe.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=451&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406789/original/file-20210616-23-cpqmpe.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=451&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A graph showing the self-reported frequency of receiving harmful private messages in a representative survey of Canadian residents.</span>
<span class="attribution"><span class="source">(Cybersecure Policy Exchange, Ryerson University)</span></span>
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<h2>Mitigating harm</h2>
<p>Platforms and governments around the world are grappling with the tension between mitigating online harms and protecting the democratic values of free expression and privacy, particularly among more private modes of communication. This tension is only exacerbated by some platforms’ use of <a href="https://www.wired.com/story/whatsapp-india-traceability-encryption/">privacy-preserving end-to-end encryption that ensures only the sender and receiver can read the messages</a>.</p>
<p>Some messaging apps have been experimenting with how to reduce the spread of harmful materials, including the introduction of limits on group sizes and on the number of times a message can be forwarded. WhatsApp is now testing a feature that <a href="https://www.financialexpress.com/industry/technology/fake-news-new-feature-in-whatsapp-will-allow-google-search-check-authenticity-of-messages/1903625/">nudges users to verify the source of highly forwarded messages by linking to a Google search of the message content</a>. Some experts are also <a href="https://www.cjr.org/tow_center/whatsapp-doesnt-have-to-break-encryption-to-beat-fake-news.php">advancing the idea</a> of adding warning labels to false news shared in messages — a concept that a majority (54 per cent) of Canadians supported when we described the idea.</p>
<figure class="align-center ">
<img alt="Infographic showing WhatsApp, WeChat, Signal, Viber, Facebook Messenger and Telegram's use by Canadians" src="https://images.theconversation.com/files/406797/original/file-20210616-13-183hpkl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/406797/original/file-20210616-13-183hpkl.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=360&fit=crop&dpr=1 600w, https://images.theconversation.com/files/406797/original/file-20210616-13-183hpkl.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=360&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/406797/original/file-20210616-13-183hpkl.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=360&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/406797/original/file-20210616-13-183hpkl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=452&fit=crop&dpr=1 754w, https://images.theconversation.com/files/406797/original/file-20210616-13-183hpkl.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=452&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/406797/original/file-20210616-13-183hpkl.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=452&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Some examples of private messaging app features that could reduce harms, such as group size or message forwarding limits.</span>
<span class="attribution"><span class="source">(Cybersecure Policy Exchange, Ryerson University)</span></span>
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<p>However, there is certainly more that governments can do in this quickly moving area. More transparency is required from messaging platforms about how they’re responding to user reports of harmful material and what approaches they’re using to stall the spread of these messages. Governments can also support digital literacy efforts and invest in research about harms through private messaging in Canada.</p>
<p>As Canadians shift to more private modes of communication, policy needs to keep up to maintain a vibrant and cohesive democracy in Canada while protecting free expression and privacy.</p><img src="https://counter.theconversation.com/content/162725/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sam Andrey received funding from the Government of Canada through the Privy Council Office’s Democratic Institutions Secretariat and the Social Sciences and Humanities Research Council for this research.</span></em></p><p class="fine-print"><em><span>Alex Rand received funding from the Government of Canada through the Privy Council Office’s Democratic Institutions Secretariat and the Social Sciences and Humanities Research Council for this research.</span></em></p>Canadians are increasingly turning to private messaging apps where COVID-19 misinformation and conspiracy theories spread in an unregulated manner.Sam Andrey, Director of Policy & Research, Ryerson Leadership Lab, Toronto Metropolitan UniversityAlex Rand, Research Assistant on Technology, Cybersecurity & Democracy, Toronto Metropolitan UniversityLicensed as Creative Commons – attribution, no derivatives.