This was not published for the plebs, but for their own consumption. They’ve been intoxicating themselves for quite a while, but this is one of the most striking examples I’ve seen lately.
“No Means No!”
As opposed to “hesitancy”.



Here’s the study, my brief critical notes come after.

COVID-19 Vaccine Hesitancy in Canada: Content Analysis of Tweets Using the Theoretical Domains Framework

J Med Internet Res.  .Published online 2021 Apr 13. doi: 10.2196/26874

Monitoring Editor: Rita Kukafka and Corey Basch
Reviewed by Romaric Marcilly and Christina Cheng Janessa Griffith, BA, MSc,1,2,3 Husayn Marani, BHSc, MSc,4 and Helen Monkman, BSc, MA, PhD51

Abstract

Background

With the approval of two COVID-19 vaccines in Canada, many people feel a sense of relief, as hope is on the horizon. However, only about 75% of people in Canada plan to receive one of the vaccines.

Objective

The purpose of this study is to determine the reasons why people in Canada feel hesitant toward receiving a COVID-19 vaccine.

Methods

We screened 3915 tweets from public Twitter profiles in Canada by using the search words “vaccine” and “COVID.” The tweets that met the inclusion criteria (ie, those about COVID-19 vaccine hesitancy) were coded via content analysis. Codes were then organized into themes and interpreted by using the Theoretical Domains Framework.

Results

Overall, 605 tweets were identified as those about COVID-19 vaccine hesitancy. Vaccine hesitancy stemmed from the following themes: concerns over safety, suspicion about political or economic forces driving the COVID-19 pandemic or vaccine development, a lack of knowledge about the vaccine, antivaccine or confusing messages from authority figures, and a lack of legal liability from vaccine companies. This study also examined mistrust toward the medical industry not due to hesitancy, but due to the legacy of communities marginalized by health care institutions. These themes were categorized into the following five Theoretical Domains Framework constructs: knowledge, beliefs about consequences, environmental context and resources, social influence, and emotion.

Conclusions

With the World Health Organization stating that one of the worst threats to global health is vaccine hesitancy, it is important to have a comprehensive understanding of the reasons behind this reluctance. By using a behavioral science framework, this study adds to the emerging knowledge about vaccine hesitancy in relation to COVID-19 vaccines by analyzing public discourse in tweets in real time. Health care leaders and clinicians may use this knowledge to develop public health interventions that are responsive to the concerns of people who are hesitant to receive vaccines.

Introduction

The approval of the Pfizer-BioNTech and Moderna vaccines sent waves of excitement and relief across the world. However, some people remain hesitant about receiving a vaccine for COVID-19 [1,2]. The World Health Organization noted in 2019 that one of the greatest threats to global health was vaccine hesitancy [3]. Emerging international evidence on COVID-19 vaccine hesitancy suggests that there is a range of reasons for this reluctance, including doubts about the safety and efficacy of the vaccine, political or pharmaceutical mistrust, belief in natural immunity, and the belief that the virus is mild or not life-threatening [46].

For herd immunity to any communicable disease to be effective, a considerable portion of the population needs to be vaccinated or have antibodies present from being recently infected. Achieving herd immunity is difficult when a large portion of the public is not vaccinated. For herd immunity to be effective for measles and polio, 95% and 80% of the population need to be vaccinated, respectively [7]. The exact percentage required for herd immunity to COVID-19 is difficult to estimate [7].

A Statistics Canada survey conducted in September 2020 (before a vaccine was approved) indicated that 75% of Canadians were either likely or somewhat likely to receive a vaccination [8]. An Angus Reid Institute [4] study conducted between December 8 and 11, 2020 found that 48% of Canadians sampled wanted to be vaccinated immediately if a vaccine was available, and 31% wanted to be vaccinated but preferred to wait. Additionally, 7% of respondents indicated that they were unsure if they would receive a vaccination, and 14% indicated that they would not get vaccinated [4].

In the context of influenza vaccinations, there remains a broad, ethical imperative to respect others’ agency over personal health decisions (eg, choosing to not get vaccinated). However, from a public health ethics perspective, the decision to not be vaccinated creates a conflict between population safety and personal liberty [9]. As of yet, COVID-19 vaccination has not been deemed mandatory by any nation, but conversations about whether such a public mandate should exist are emerging [10]. Whether vaccines are mandated, it is worthwhile for public institutions to understand how to change behaviors concerning vaccine hesitancy to ensure that informed decision-making practices are being exercised.

Previous research has suggested that behavioral change interventions are more successful when they are grounded in theory [11]. Thus, we selected a behavioral change framework to guide this study. The Theoretical Domains Framework (TDF) was selected because of its ability to help identify the barriers and facilitators to behavior change while taking into account social and environmental factors [12]. Other public health interventions have used the TDF. For example, Garbutt et al [13] used this framework to improve human papillomavirus vaccine uptake in primary care settings. The use of such theories can facilitate the development of comprehensive health education programs [11], but this requires correctly identifying the attributes of individuals and their surroundings, which influence behavioral patterns [14]. As Bandura [15] and other behavioral theorists have posited, social norms, social relationships, and social networks have a substantial and persistent influence on behaviors [15]. It is worth understanding public discourse about vaccine hesitancy in order to develop interventions that are responsive to the needs of the population and effectively address their concerns.

In the past decade, there has been a particular interest in the utility of Twitter as a tool for monitoring and surveilling public health [16], detecting trends [17], conducting research, and disseminating information [18,19]. A systematic review of using Twitter data for health research found that most studies were in the overlapping fields of public health (23%) and infectious disease (20%) [18]. With 187 million active users worldwide as of January 2021 [20], Twitter has become a powerful social network for disseminating important public health information.

Since the start of the COVID-19 pandemic, social networking platforms like Facebook and YouTube have become stricter with their oversight of the spread of COVID-19 misinformation by deleting false information and providing hyperlinks to government websites containing credible and validated information on COVID-19. Twitter took a similar screening approach in May 2020 [21], yet the scale, spread, and speed of information sharing has made this process challenging. Further, at the start of the pandemic, Twitter introduced a system for verifying COVID-19 experts (indicated with a blue checkmark), including physicians, epidemiologists, scientists, and academics, to provide credible information concerning COVID-19 [22]. Yet, there continues to be influential individuals who have also been verified by Twitter and have enough public credibility to contradict expert opinions or present false information.

We can combat the spread of misinformation by creating targeted approaches to changing behaviors and promoting the understanding of vaccines. Thus, the purpose of this study was to identify the reasons behind vaccine hesitancy among people in Canada by conducting a content analysis of tweets through the lens of behavioral science. Our findings can be used to develop behavior change strategies and policies that are responsive to target populations.Go to:

Methods

Study Design

Twitter is a social media platform that allows users to microblog and socially network. Each user is allowed up to 280 characters in a post (called a tweet). Users can post text, pictures, videos, or links to websites. Users who have registered for an account can tweet, like, and comment on another user’s tweet and repost tweets (called a retweet). Registered users can also follow accounts and send private messages to each other. Unregistered users can read tweets, retweets, and comments but cannot engage in any interactions [23].

Twitter was selected because of its ability to capture real-time data [19]. Other studies have used Twitter to capture data on vaccine hesitancy. One study compared survey results about vaccine hesitancy in 2018 (before the COVID-19 pandemic) to data captured from Twitter and found that the data were similar to each other [24]. The study argued that Twitter could potentially be used instead of surveys in some contexts and similar results would be obtained [24]. Another study went as far as saying that Twitter is a “sentinel tool” for identifying public opinions on vaccinations [25]. Thus, Twitter was selected as the site of data collection because it offers a publicly available repository of discourse data (ie, tweets) that are captured in a specific point in time for a specific geographic area.

This study did not require research ethics approval, as it was based on data that were publicly available. Other Canadian-based studies [26] have forgone ethical review by using publicly available Twitter data, as some sources are anonymous or unidentifiable. Only the Twitter user’s username (ie, handle), city or town, and tweet content were extracted. This paper only presents aggregated data. Moreover, no interaction occurred between the authors of this study and any of the Twitter users.

Data Collection

After the researcher (JG) was approved for a developer account on Twitter, she received credentials for accessing Twitter’s application programming interface. By using a Jupyter environment, the researcher created a Python program to access Twitter’s application programming interface. Twitter allows access to tweets up to 1 week after they are posted. Thus, the researcher collected data from two time periods (December 18 and 23, 2020) to access 2 weeks’ worth of tweets. Tweets that contained the words “COVID” and “vaccine” were extracted. Similar to a library search, tweets were returned based on variations of these words, such as “COVID-19,” “COVID19,” “vaccination,” and “vaccinate.”

Data were extracted from tweets from December 10, 2020, to December 23, 2020. These dates were selected because they followed the Pfizer-BioNTech vaccine approval announcement in Canada (December 9, 2020) and included the dates for the first vaccine administration in Canada (December 14, 2020) and the approval of the Moderna vaccine in Canada (December 23, 2020). This date range also accounted for the time frame when the highest number of searches for terms that included both “COVID” and “vaccine” occurred on Google, which perhaps indicated a spike in interest [27]. Thus, our data reflects a time period when receiving a COVID-19 vaccine was close to becoming a reality. Figure 1 provides a graph that shows when data were extracted and when COVID-19–related events occurred in Canada. Figure 1 – see it in original

A graph depicting Google Trends data for the combined search terms “covid” and “vaccine” aligning with vaccine approval and administration dates in Canada. Tweets that were posted between December 10 and 23, 2020 were eligible for analysis. This date range aligned with the time when the highest peaks in related Google search activity occurred in Canada. This figure indicates that the number of searches on Google for the combined words “COVID” and “vaccine” was highest in December 9, 2020. All other searches were relative to this highest peak. For example, on December 14, 2020, roughly 70% of related searches occurred in December 9, 2020 [28]. It was not possible to obtain more detailed numbers.

To only include tweets from Canada, the researchers used five geographic radiuses that covered most of Canada. However, several small areas were unintentionally omitted (Figure 2). It was not possible to know how many tweets were missed. Figure 2 see it in original

A map of where Twitter users were located. Tweets from outside of Canada (ie, those from the United States) were excluded.

Demographic data beyond users’ locations (ie, city or town) were not collected. It was possible to obtain estimates for other demographic information, such as age and gender, from third-party companies. However, this study was operating within the confines of publicly available data so as to disseminate the findings sooner.

Data Analysis

The results were exported to a comma-separated values file and were analyzed in Microsoft Excel. Tweets were randomized (ie, reordered) in Excel so that tweets were not included based on date. As we expected, the number of tweets extracted was insurmountably high for manual analysis. Therefore, we randomly selected 20% of the tweets to be screened for eligibility. This exceeded the number of randomly selected tweets in other studies, which only included 10% of returned tweets for screening [28]. Double screening was performed for 10% of the tweets to ensure consistency. Manual analysis was selected because this study was exploratory in nature; it was unclear what themes might emerge a priori. As such, training an automated analysis program was unfeasible.

Eligible tweets included any tweets from a Canadian location that contained an expression of hesitancy toward COVID-19 vaccines. These included tweets that provided links to articles or other media that expressed hesitancy toward any COVID-19 vaccine. Eligible tweets also included those with graphics that expressed sentiments of COVID-19 vaccine hesitancy. Tweets that expressed positive or unclear sentiments toward COVID-19 vaccines were excluded. Tweets captured from the United States (given the country’s geographic proximity to Canada) were also excluded. As data were extracted on two dates, several duplicate tweets were present. These were identified and deleted in Excel.

All tweets that were deemed eligible after screening were analyzed (ie, qualitatively coded) by 2 authors (JG and HMVM). These researchers had expertise in qualitative coding. Additionally, 10% of the eligible tweets were double-coded to ensure consistency.

In Excel, a content analysis was performed on all eligible tweets. The majority of health studies that use Twitter data (56%) have conducted content analyses [18]. Content analysis was performed as described by Sutton et al [28]; the content of each tweet was systematically reviewed by at least 1 researcher. The researcher(s) then coded the content of tweets according to their meaning. The resulting codes were then organized into thematic categories. Each eligible tweet could be coded into one or more themes.

Once themes emerged from the content analysis, they were mapped onto the TDF. The TDF was selected because it applies a theory-based approach to understanding behavior and has been used extensively in implementation science research. The TDF consists of the following 14 domains: knowledge; skills; social and professional roles and identities; beliefs about capabilities; optimism; beliefs about consequences; reinforcement; intentions; goals; memory, attention, and decision processes; environmental context and resources; social influences; emotion; and behavioral regulation. It has been used in other research pertaining to seasonal flu [29] and human papillomavirus vaccine hesitancy [13] to identify barriers to vaccine uptake and plan for implementation interventions.

To these Pharma-junkies, logic sounds like The Force to an Imperial Trooper, rather used to miss the target all the time, if you catch my reference

Results

Tweet Characteristics and Themes

In total, 18,132 tweets were returned as search results. Overall, 3915 tweets were screened for eligibility. These tweets represented 21.6% of the total number of tweets. It took approximately 1 hour to manually screen 100 tweets. The 10% (400/3915) of tweets that were double-screened resulted in a Cohen κ coefficient of 0.89, indicating an almost perfect agreement. After screening, 605 tweets met the inclusion criteria. This was represented in a modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram (Figure 3).Figure 3

Modified PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram of the data extraction process.

Through content analysis, the included tweets were grouped into the following major themes concerning vaccine hesitancy: safety, political skepticism, influence from authority figures, a lack of knowledge, and legal liability. The final theme included medical legacies. This theme was different from the other categories of vaccine hesitancy. The themes were not mutually exclusive. Examples of tweets were not provided with the presentation of the themes to preserve the anonymity of Twitter users. In the following subsections, each theme will be described.

Safety

Overall, 48.3% (292/605) of tweets were about safety. These were largely centered around the worry that the vaccine would cause more harm than good. These tweets also expressed concerns that the COVID-19 vaccine was developed more quickly than other vaccines and that the COVID-19 vaccine was not tested to the same rigorous extent as other vaccines. Apprehension over severe side effects was also noted from tweets, including those that reported on nurses fainting and vaccine trial participants experiencing Bell palsy.

Political Skepticism

Another major theme found in 32.4% (196/605) of tweets was skepticism toward the political motivations behind vaccine development. Several Twitter users presented conspiracy theories about the COVID-19 vaccine being a vehicle for exerting political control over citizens. Other participants felt that the vaccine was not tested enough due to political pressures to reopen the economy. Several Twitter users in Canada were also highly influenced by politics in the United States; they cited rumors about the White House threatening the leadership of the US Food and Drug Administration to rush vaccine approval or face forced resignation. Tweets also indicated concern over the influence of big, government-backed pharmaceutical companies (“Big Pharma”) that were motivated by profits instead of the desire to help people.

Deficits in Medical and Epidemiologic Literacy Concerning the Benefits of Vaccination

Many tweets (159/605, 26.3%) indicated a lack of knowledge about vaccines among Twitter users. For example, several users expressed the idea that if those who contracted COVID-19 had a ≥99% survival rate, then they should not have to receive a vaccine that is said to be 95% effective. Additionally, Twitter users questioned why anyone else should be concerned if they do not receive the vaccine, indicating a lack of understanding of herd immunity. Twitter users also reported concerns about how the vaccine would alter human DNA. Several Twitter users also felt that a lack of a vaccine for cancer, heart disease, and AIDS was proof that a new virus could not be cured. Additionally, Twitter users viewed COVID-19 as a mild disease; therefore, their interest in undergoing vaccination was low.

Authority Figures

Another theme we found was mistrust toward the COVID-19 vaccine resulting from Canadian and international authority figures not taking the vaccine (51/605, 8.4%). For example, several tweets highlighted users’ mistrust toward the CEO of Pfizer and political figureheads in Canadian politics like Doug Ford (the elected provincial leader of Ontario), as they were not taking the vaccine. However, later tweets criticized public figures such as Dr Bonnie Henry (the Provincial Health Officer of British Columbia) and Alexandra Ocasio-Cortez (a member of the US House of Representatives) for receiving the vaccine before frontline workers and older adults.

Legal Liability

To a smaller extent (19/605, 3.1%), Twitter users also expressed mistrust toward vaccines that was based on reports of not being able to take legal action against drug companies if a person experiences any side effects. Additionally, news of the Federal Vaccine Injury Compensation Program in Canada resulted in further skepticism toward vaccine safety.

Medical Legacies

The final theme was unlike all of the other themes of vaccine hesitancy in this paper—the legacy of harm caused by health care institutions that have traditionally targeted the Black, Indigenous, and people of color (BIPOC) community and the lesbian, gay, bisexual, transgender, queer+ (LGBTQ+) community. Tweets (24/605, 4%) in this theme highlighted the lack of trust toward the COVID-19 vaccine resulting from how marginalized groups, such as the BIPOC and LGBTQ+ communities, have been historically targeted by the medical community. For example, the Tuskegee syphilis experiments were referenced in several tweets. Moreover, the first people who were vaccinated in the United States were Black health care workers, and several Twitter users viewed this as forced participation in medical experiments. Additionally, a poster promoting COVID-19 vaccination was viewed as paralleling the stigmatization of people who take pre-exposure prophylaxis, a medication for people living with HIV.

Theoretical Domains Framework

Themes were mapped to the TDF and categorized into the following five domains: knowledge, beliefs about consequences, environmental context and resources, social influence, and emotion. The mapping of themes to TDF domains was an interpretive and consensus-driven exercise that was conducted by two study authors (JG and HM). Disagreement was reconciled by a third study author (HMVM). Figure 4 displays a representation of the themes that were mapped to the TDF. We provide insight into this framework in the Discussion section. Overall, themes were not mutually exclusive; themes were classified according to several TDF domains. Figure 4 see it in original

Themes were categorized based on the TDF. The TDF domains are represented by the dark-gray circles. The themes from the content analysis (smaller colored circles) were mapped to relevant TDF domains. TDF: Theoretical Domains Framework.

Discussion

Principal Results

Through content analysis and TDF application, this study identified the reasons behind vaccine hesitancy among Twitter users in Canada. The major themes that emerged included concerns over safety, suspicion about political or economic forces driving the COVID-19 pandemic or vaccine development, a lack of knowledge about the COVID-19 vaccine, messages from authority figures, and a lack of legal liability from vaccine companies. An additional theme regarding the historical impact of medical mistrust among marginalized communities was also presented. These themes were categorized into the following five TDF constructs: knowledge, beliefs about consequences, environmental context and resources, social influence, and emotion. Thus, efforts to overcome vaccine hesitancy should focus on targeting these constructs.

Although evidence concerning vaccine hesitancy toward the COVID-19 vaccine is still emerging, our findings are consistent with previous studies. A study from Israel found that COVID-19 vaccine hesitancy was related to concerns about safety and efficacy and the belief that the disease is mild [5]. This was similar to our study, wherein concerns about safety was the top reason for vaccine hesitancy. The efficacy of the vaccine and the belief that the virus is mild were grouped into the lack of knowledge theme, which was another top reason for vaccine hesitancy in our study. Another study surveyed individuals from Canada and the United States in May 2020 and reported that vaccine hesitancy correlated with a lack of trust about a vaccine’s benefit, concerns about safety (ie, unknown future health consequences), commercial profiteering, and a belief in natural immunity [6]. Of note, these respondents were more likely to receive a vaccine if there was evidence of rigorous testing and safety measures [6]. Both of these studies were conducted prior to the development and implementation of a COVID-19 vaccine. As such, their results were hypothetical.

This study identified the particular reasons why people in Canada may be hesitant to receive a vaccine, so that implementation scientists who are responsible for vaccine rollouts can become responsive to these concerns. Although the analyzed tweets were from Canada, we believe that the tweets’ themes may be generalizable to other contexts. To our knowledge, no other study has analyzed tweets to determine the reasons behind COVID-19 vaccine hesitancy. This study’s contribution is especially important because the timing of our study coincided with the approval of the first two vaccines (ie, the Pfizer-BioNTech and Moderna vaccines) and the first vaccine administration in Canada.

Our results relate to vaccine hesitancy in general (ie, past research on non–COVID-19 vaccines), as prior related research has provided similar findings. For example, the influence of the media and people’s knowledge about vaccines, past experiences, perceptions of risk, and trust have all been documented [30]. However, hesitancy toward the COVID-19 vaccines presents new, unprecedented challenges; namely, the global COVID-19 pandemic is unlike any pandemic that has been experienced in the past century, herd immunity depends on vaccine participation on a global scale, and new SARS-CoV-2 strains can emerge if the virus has opportunities (ie, time and vectors) to mutate. Additionally, the long-term health consequences of COVID-19 are unknown [31].

Our recommendation for the organizations responsible for implementing vaccination programs is to create behavioral interventions that are responsive to the concerns presented in this study. The mapping of these themes to the TDF provided us with preliminary insights into how to best target these behavioral interventions. For example, safety was a top concern that was found in the tweets, and we mapped safety to both knowledge and beliefs about consequences. Thus, targeting vaccine literacy may be beneficial, and this can be done by explaining how vaccines work, why they are safe, and how no steps were missed in the expedient process of COVID-19 vaccine development. However, trust in politicians and pharmaceutical companies is a vaccine hesitancy factor that is difficult to target because both groups are necessarily involved in vaccine rollouts. One approach to targeting this concern might be to have trusted physicians speak to their patients about why it is important to be immunized. This approach falls under the domain of emotion in the TDF.

Although providing details on interventions for responding to vaccine hesitancy was beyond the scope of this study, Table 1 provides example suggestions for interventions based on each TDF domain.

Table 1

Reasons for vaccine hesitation fell under several Theoretical Domains Framework (TDF) constructs (left column). The rightmost column provides examples of intervention suggestions for responding to vaccine hesitancy in relation to the TDF construct.

TDF constructsContent analysis themeExample suggestions
KnowledgeLack of knowledgeIntroduce campaigns that educate the public about using clear language in media that are commonly used to digest content (eg, social media).
Social influenceAuthorityHave nonpolitical, respected older adult Canadian celebrities take the vaccine as an example. Such celebrities could be retired athletes or musicians.
Environmental context and resourcesPolitical skepticismEmphasize that vaccines are rooted in science and not politics. This is a difficult quality to understand.In action, this could be done by having messages come from trusted physicians instead of politicians.
Emotion and beliefs about consequencesSafetyHighlight examples of instances when the vaccine has worked.Reiterate the safety of the vaccine.Reiterate the fact that the steps in the scientific development of the vaccine were not missed.

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More research is necessary to determine whether addressing these concerns is effective in overcoming vaccine hesitancy.

Limitations

As of January 2021, roughly 6.45 million (~17%) Canadians use Twitter [32]. Therefore, the perspectives on vaccine hesitancy presented in this paper are not wholly representative of the perspectives of all people in Canada. All users included in this study represent people in Canada with broadband internet access, which, as the COVID-19 pandemic has illustrated, is an important determinant of health [33]. As such, we likely missed the perspectives of those who face challenges when accessing the internet. It is also possible that nonhuman Twitter users (bots) were represented in our sample. Previous research has found that Twitter bots have manipulated public opinion and fueled cascades of negative emotions related to topics about COVID-19 [34]. Without any way to systematically identify and exclude these tweets, we suspect that several such tweets were included in our analysis. We also searched for English-only tweets due to limitations in language expertise among this study’s authors. A more comprehensive content analysis that is representative of all people in Canada should include tweets that are written in other languages. This limitation may have resulted in themes not being identified, including those related to culturally specific concerns.

It was not possible to collect demographic data such as age, gender, and ethnicity while also preserving users’ anonymity. Thus, we were unable to analyze the demographic characteristics of Twitter users who expressed vaccine hesitancy.

Although the search strategy could have been expanded to include many more terms related to vaccination (eg, “shot,” “jab,” “immunization,” etc), the search results would have been insurmountable for conducting our manual analysis process. Additionally, terms related to hoax beliefs were not included; the inclusion of such terms would have likely produced more results. Although saturation was achieved for our search, we may have missed themes that used alternative language to express vaccine hesitancy.

Of note, the examples of interventions presented in Table 1 are merely suggestions. A behavioral scientist may have more informed suggestions about how to combat vaccine hesitancy according to the TDF.

Finally, the tweets related to the medical legacies discussed in this paper should not be viewed as tweets about vaccine hesitancy or conflated with those under the categories of safety, a lack of knowledge, political skepticism, messages from authority figures, and legal liability. As Mosby and Sridrovich [35] have emphasized, health care providers need to understand the history of “racially segregated health care and medical experimentation.” Additionally, Boyd [36] stated that the “hyper-focus on hesitancy implicitly blames Black communities for their undervaccination, and it obscures opportunities to address the primary barrier to COVID-19 vaccination: access.” Building trust in the medical system goes far beyond the suggestions presented in this paper.

Conclusions

Overall, this study identified the reasons why people in Canada may feel hesitant toward receiving a COVID-19 vaccine. These reasons fell under the following themes: safety concerns, suspicions about political or economic forces, a lack of knowledge, messages from authority figures, and a lack of legal liability from vaccine companies. Additionally, other tweets revealed the historical impact of medical mistrust among marginalized communities, which should not be viewed as hesitancy or as the result of the reasons identified in this paper. Overall, behavioral, implementation, and public health scientists can use theory-based approaches like the TDF to design interventions that are tailored to address the concerns that people have and improve the uptake of the COVID-19 vaccine, thereby increasing the chances of achieving the threshold necessary for herd immunity.Go to:

Acknowledgments

JG conceived the study idea and was involved in all study activities, including study data extraction and analysis and manuscript preparation. HM supported the literature extraction and manuscript preparation. HMVM supported the coding of tweets and manuscript revision. This study was conducted without financial support.Go to:

Abbreviations

BIPOCBlack, Indigenous, and people of color
LGBTQ+lesbian, gay, bisexual, transgender, queer+
PRISMAPreferred Reporting Items for Systematic Reviews and Meta-Analyses
TDFTheoretical Domains Framework

Footnotes

Conflicts of Interest: None declared.

LIVE FROM THE TRENCHES, Here’s just a few of the many reasons this is trash and whoever takes it seriously is a self-deluded clown:

  1. There’s almost no hesitancy in 2021. Whoever was hesitant before, stopped being so in 2020. Same way many of us stopped hesitating on 9/11. If they are not favorable, most of the messages out there are anti-certainly-harmful-covid-injections. Most of us don’t even think of them as “vaccines”. By a large.
  2. As opposed to the people they studied, Pharmafia self-intoxicates itself lumping Covid injections with vaccines. But the two draw support from different crowds. Which leads to the next self-intoxication:
  3. There’s new categories that their radar doesn’t even have sensors for: general pro-vaxxers who are either hesitant or determined not to take covid injections, as they keep taking vaccines. And the hesitant fraction of the fraction is tiny.
  4. Twitter is filled with pharmabots who infiltrate anti-vaxx communities. Thus, Pharmafia did a Hunter Biden again, and fell asleep with a meth pipe still hot between the upper lips. That was for sale.
    Besides that, it’s been shown that Twitter is the least accurate reflection of the general population of all social media networks, so the flaw is embedded in the pool.
  5. “Many tweets (159/605, 26.3%) indicated a lack of knowledge about vaccines among Twitter users” – Where does “many” start, that’s actually only a quarter, very little compared to how they portrait anti-vaxxers as generally Neanderthals. Also very little compared to pro-vaxx scores, where medical illiteracy is predominant even when they’re ideologically aligned with Pharmafia.
    A minimal intellectual decency requires a bit of comparative study there on the literacy – vaccine-opposition correlation. Or causation.
    But their main problem here is that they lump together ignoramus and people unaligned with the official lies exactly because they are in the know. The two don’t respond the same to whatever you want to do to them. Pharmafia’s gonna have a bad time if it keeps swallowing its own baits, can’t wait for the next laugh from them.
    I mean how much BS can you pack in a single sentence in a self-served “scientific” work? How is this any healthier than meth?
  6. There’s a huge mindset difference between someone who understood the truth and stopped hesitating and someone who’s in the process and still hesitating. Much larger than the difference between “anti-certainly-harmful-covid-injections” and “vaccine-hesitant”. Respectively, once you know, you can’t unknow. Once you left the womb, you can’t go back to be fed through an umbilical cord.
    So they only have a chance at people who don’t know enough yet and they can only hope to prevent them from getting there.
    But Pharmafia is guaranteed to fail as it keeps consuming the propaganda stash it fabricated for sale.

I wrote this mainly so we can mock them again later and shout “Told you so, dum’asses!’

PS: Isn’t “The Journal of Internet Medical Research” doing exactly what anti-vaxxers were mocked for with those “Google diplomas” 0IQ jokes?

To be continued?
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We hardly made it before, but this summer something’s going on, our audience stats show bizarre patterns, we’re severely under estimates and the last savings are gone. We’re not your responsibility, but if you find enough benefits in this work…
Help SILVIEW.media survive and grow, please donate here, anything helps. Thank you!

! Articles can always be subject of later editing as a way of perfecting them

ORDER

No, I’m not going tabloid, bare this knuckle-head with me for a minute!

I’m guilty of fermenting well-founded indignation against some celebritard and professional tough guy who last year was begging “the powers that be” (exact quote) to save his tough ass from the Macarenavirus by locking his people down and ruining their lives, with military intervention, if needed.
You may have heard of this clown that goes around unsupervised, yet heavily guarded, under the name of Conor McGregor. He beats people for money and he’s very good at it, apparently, and that’s the least annoying thing about him.
And thing is he has just addressed his stupidity, proving he has taken his vitamins and has grown half a testicle since.
So I have the professional obligation (no, I don’t, but it’s a good lesson) to reflect his latest brain-fart accurately.
Point being: if we don’t take our daily dose of intellectual vitamins, we end up like this nitwit. I sweat hard to make it easier, I provide, free of charge, donations welcome, and my monthly earnings from this probably can’t pay a ticked to this door-knob’s 5-minute performances. But l retain immensely more human dignity and tight sleep from my position. I wish you what you wish yourself after watching this:

No, dipshit, we weren’t all lied! As a matter of fact, many of us sounded the alarm long before you vomited that abomination, and you social parasites slandered us, some still do. You learned your lesson 20 years too late to be an useful member of your society. See about catching up before your tiny brain falls out through your big mouth!
There’s no scientific evidence for a novel coronavirus, it all points at your novel species of remote-controlled brainless NPCs being the cause for the current societal collapse.

To be continued?
Our work and existence, as media and people, is funded solely by our most generous readers and we want to keep this way.
We hardly made it before, but this summer something’s going on, our audience stats show bizarre patterns, we’re severely under estimates and the last savings are gone. We’re not your responsibility, but if you find enough benefits in this work…
Help SILVIEW.media survive and grow, please donate here, anything helps. Thank you!

! Articles can always be subject of later editing as a way of perfecting them

ORDER


They’ve pushed an old senile lady down the stairs. Literally.

The short course
The long course

UPDATE MAY 24M 2021

NYT HAS JUST CONFIRMED ANYTHING AND BEYOND

But I’m not going to post that, I’m linking you to something better:

The New York Times has published a lengthy article revealing how the world is undergoing a “paradigm shift” of rapidly declining fertility rates, but fails to mention the possibility that environmental pollutants such as plastic chemicals are playing any role in the decline.

by Summit News

In an article entitled ‘Long Slide Looms for World Population, With Sweeping Ramifications’, the NYT reveals how there is a global “fertility bust” which represents “a dizzying reversal unmatched in recorded history that will make first-birthday parties a rarer sight than funerals, and empty homes a common eyesore.”

The piece notes how a demographic time bomb has the potential to cause social and economic catastrophe, but celebrates the notion that it would be good for the environment.

“A planet with fewer people could ease pressure on resources, slow the destructive impact of climate change and reduce household burdens for women,” write the authors.

The authors highlight how virtually every area of the world except for Africa, where the population will continue to grow, will be hit by rapidly dropping fertility rates.

“Like an avalanche, the demographic forces — pushing toward more deaths than births — seem to be expanding and accelerating,” states the piece, adding, “Demographers now predict that by the latter half of the century or possibly earlier, the global population will enter a sustained decline for the first time.”

Nowhere in the lengthy article is it mentioned that there could be cultural or environmental factors causing the drop in birth rates or anything beyond prosaic economic factors.

As we previously highlighted, a top environmental scientist recently warned that plastic pollution is shrinking penises and making men infertile, meaning most of them won’t be able to produce sperm by 2045.

“Phathalates mimic the hormone oestrogen and thus disrupt the natural production of hormones in the human body, which researchers have linked to interference in sexual development in infants and behaviours in adults,” reported Sky News.

The chemical, which is used to make plastics more flexible, is being transmitted to humans via toys, food and other items.

Exposure to such chemicals has also worsened as a result of face masks becoming ubiquitous since the start of the COVID pandemic.

Last year, a CNN piece acknowledged that if sperm was an animal it might be “heading toward extinction in western nations” and that one of the potential causes of testosterone and sperm counts are plummeting across Europe and North America was “pollution and chemicals in our food, clothes and water.”

The establishment has also relentlessly promoted the ‘virtues’ of not having children to westerners for decades, one of the latest examples being a piece about “the benefits of being single” published by CNN on Valentine’s Day.

The NYT piece also completely fails to mention how many of the same people now pushing global warming alarmism also pushed the ‘population bomb’ myth for decades from the 1960’s onwards.

America’s fertility rate currently stands at 1.8 births per woman.

From 2007 to 2011 the fertility rate in the U.S. declined 9% in the space of just 4 years.

In 2016, the U.S. fertility rate fell to 59.8 births per 1,000 women, the lowest since records began.

Fertility rates for white women were down in every US state in 2017, while among black and Hispanic women, fertility rates were up in 12 and 29 states, respectively.

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I survived many tough times focusing on the humor in them. And I find this highly amusing. But even more disturbing, when I look around and I see most people don’t flinch hearing such a claim.

Source

As for insurances and vaccines, the topic of that Forbes article… oh boy, oh boy… Check this out! And then THIS!

Follow up:

To be continued?
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Sometimes my memes are 3D. And you can own them. Or send them to someone.
You can even eat some of them.
CLICK HERE

We can’t allow another book-burning

THE TIMES OF ISRAEL  > OPS & BLOGS  > Manny Friedman

Jews DO control the media

JULY 1, 2012, 11:05 AM

We Jews are a funny breed. We love to brag about every Jewish actor. Sometimes we even pretend an actor is Jewish just because we like him enough that we think he deserves to be on our team. We brag about Jewish authors, Jewish politicians, Jewish directors. Every time someone mentions any movie or book or piece of art, we inevitably say something like, “Did you know that he was Jewish?” That’s just how we roll.

We’re a driven group, and not just in regards to the art world. We have, for example, AIPAC, which  was essentially constructed just to drive agenda in Washington DC. And it succeeds admirably. And we brag about it. Again, it’s just what we do.

But the funny part is when any anti-Semite or anti-Israel person starts to spout stuff like, “The Jews control the media!” and “The Jews control Washington!”

Suddenly we’re up in arms. We create huge campaigns to take these people down. We do what we can to put them out of work. We publish articles. We’ve created entire organizations that exist just to tell everyone that the Jews don’t control nothin’. No, we don’t control the media, we don’t have any more sway in DC than anyone else. No, no, no, we swear: We’re just like everybody else!

Does anyone else (who’s not a bigot) see the irony of this?

Let’s be honest with ourselves, here, fellow Jews. We do control the media. We’ve got so many dudes up in the executive offices in all the big movie production companies it’s almost obscene. Just about every movie or TV show, whether it be “Tropic Thunder” or “Curb Your Enthusiasm,” is rife with actors, directors, and writers who are Jewish. Did you know that all eight major film studios are run by Jews?

In his spare time as Ghislaine’s father, Robert Maxwell was a media mogul and spy for Israel
Read more

But that’s not all. We also control the ads that go on those TV shows.

And let’s not forget AIPAC, every anti-Semite’s favorite punching bag. We’re talking an organization that’s practically the equivalent of the Elders of Zion. I’ll never forget when I was involved in Israeli advocacy in college and being at one of the many AIPAC conventions. A man literally stood in front of us and told us that their whole goal was to only work with top-50 school graduate students because they would eventually be the people making changes in the government. Here I am, an idealistic little kid that goes to a bottom 50 school (ASU) who wants to do some grassroots advocacy, and these guys are literally talking about infiltrating the government. Intense.

Now, I know what everyone will say. That everyone tries to lobby. Every minority group and every majority group. That every group has some successful actors and directors. But that’s a far call from saying that we run Hollywood and Madison Avenue. That the Mel Gibsons of the world are right in saying we’re deliberately using our power to take over the world. That we’ve got some crazy conspiracy going down.

Okay. Fine. So some of that is kooky talk.

But let’s look at it a bit deeper.

Maybe it’s true: everyone lobbies. Maybe it’s true there are actors of every ethnicity out there. But come on. We’re the ones who are bragging about this stuff all the time. Can’t we admit that we’re incredibly successful? Can’t we say it to the world?

I’ll give my theory for why Jews don’t want to talk about their control of the media.

First of all, as much as Jews like to admit that so many of them are successful, and that so many of them have accomplished so much, they hate to admit that it has to do with they’re being Jewish. Maybe they’ll admit that it has something to do with the Jewish experience. But how many Jews will admit that there is something inherently a part of every single one of them that helps them to accomplish amazing things?

The ADL chairman, Abe Foxman, was interviewed in a great article about the subject and he said that he “would prefer people say that many executives in the industry ‘happen to be Jewish.’” This just about sums up the party line.

The truth is, the anti-Semites got it right. We Jews have something planted in each one of us that makes us completely different from every group in the world. We’re talking about a group of people that just got put in death camps, endured pogroms, their whole families decimated. And then they came to America, the one place that ever really let them have as much power as they wanted, and suddenly they’re taking over. Please don’t tell me that any other group in the world has ever done that. Only the Jews. And we’ve done it before. That’s why the Jews were enslaved in Egypt. We were too successful. Go look at the Torah — it’s right there. And we did it in Germany too.

This ability to succeed, this inner drive, comes not from the years of education or any other sort of conditional factors, but because of the inner spark within each Jew.

Now, the reason groups like the ADL and AIPAC hate admitting this is because, first of all, they are secular organizations. Their whole agenda is to prove that every Jew is the same as every other person in the world. I cannot imagine a more outlandish agenda. No, we’re different. We’re special.

And clearly, that whole thing about big Jewish noses was totally blown out of proportion.

Of course, people hate when anyone says this. They assume that if you’re saying that Jews are special, it somehow implies that they’re better.

To be honest, I’m not really sure what the word “better” even means. What I do know is that being special simply means a person has a responsibility to do good.

I think that’s the real reason most Jews are so afraid to admit that there’s something inherently powerful and good about them. Not because they’re afraid of being special. But because they’re afraid of being responsible. It means that they’re suddenly culpable when they create dirty TV shows that sully the spiritual atmosphere of the world. It means that things can’t just be created for the sake of amusement or fun or even “art.”

Suddenly, we can’t screw up the world.

The interesting thing is that Jews have done so much for the world in so many other ways. They’ve moved forward civil rights; they’ve helped save lives in Darfur, Haiti and just about everywhere else.

But that’s not enough. Fixing the world physically is only half the battle.

Our larger battle, the harder battle, is elevating the world spiritually. And this is what the people that fight with every inch of their soul to prove that Jews are just the same as everyone else are afraid of. It means that we can no longer just “express ourselves.” We’ll have to start thinking about the things we create and the way we act. It means we’ll have to start working together. It means we’ll have to hold one other, and ourselves, to a higher standard.

The time has come, though. We no longer have to change our names. We no longer have to blend in like chameleons. We own a whole freaking country.

Instead, we can be proud of who we are, and simultaneously aware of our huge responsibility — and opportunity.
Times of Israel

I don’t think they’ll ever delete this one though

Also read: “AS A PROUD JEW, I WANT AMERICA TO KNOW ABOUT OUR ACCOMPLISHMENT. YES, WE CONTROL HOLLYWOOD”

To be continued?
Our work and existence, as media and people, is funded solely by our most generous readers and we want to keep this way.
We hardly made it before, but this summer something’s going on, our audience stats show bizarre patterns, we’re severely under estimates and the last savings are gone. We’re not your responsibility, but if you find enough benefits in this work…
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Imagine Jewish company Ben&Jerry went like: “People who don’t eat our ice-cream are anti-food and anti-semitic”. That’s exactly what Pharmafia does, amplified by their presstitutes and mass-mediots.
But facts don’t care about fake Semites impersonating a victim while caring out a worldwide genocide.

Btw. Times of Israel deleted its most popular post of 2012, last one in my collage, but not quite every trace of it.

Source

They replaced that truth with more truth, but we need all of it

Source

“AS A PROUD JEW, I WANT AMERICA TO KNOW ABOUT OUR ACCOMPLISHMENT. YES, WE CONTROL HOLLYWOOD”

Who are the Jews behind the coronavirus vaccines?

World’s 50 most influential Jews – The Jerusalem Post’s first annual list of those who are shaping the future.

Argentine TV host fired over ‘Jews control the media’ tweet

COVID-19 Vaccines Have Jewish Links

Microsoft and Google invest in medical research platform

PULITZER-WORTHY! KLAUS SCHWAB’S NAZI ROOTS FINALLY TRACED!

Want more? There’s tons out there.

SOURCE

BONUS: 2021: Companies who gassed Jews and those who jab them hold hands, throw money at BLM & Climate-19

To be continued?
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We hardly made it before, but this summer something’s going on, our audience stats show bizarre patterns, we’re severely under estimates and the last savings are gone. We’re not your responsibility, but if you find enough benefits in this work…
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The testimonies may be only implicit, but they can’t be any more solid and legit.

Let’s play in a paradigm where we and YTFT (YouTube, Facebook, Twitter) recognize same figures as authoritative.

What would happen if I made a video claiming no clear evidence of human-to-human transmission of the novel coronavirus, like this Twit above, which is still live on many platforms?
What if I’d be just genuinely naive (like they assume we all are) and I’d bump into this Twit without following up for updates and retractions? And then I’d spread that claim around?
I’d go straight to internet jail, maybe even offline jail. Unlike other people.

Don’t trust us, verify and consider the following facts:

  1. Each and every medical organization on the planet has retracted or adjusted medical information, since 2020 more than ever. Thus, they admitted the initial publications were actually wrong aka “misinformation”. It’s part and parcel of sciencing and that’s not the issue here, that’s the point: errors are scientist’s best teachers.
  2. YTFT has actively promoted this admitted misinformation, its terms and policies did nothing to stop it, proving they can’t arbiter jack shit.
  3. This misinformation has not been retracted from YouTube, persists there to this day. In fact, most of the science believed to be true today has been retracted
  4. Users who argued this misinformation have been deplatformed and their content has been erased, while the misinformation persists on all platforms.
  5. YTFT are not independent from, but massive investors in medical business.
  6. Appeal to authority is a logical fallacy that has been abhorred by most science icons ever and only denotes scientific illiteracy.

Therefore, YTFT’s claim that they are in position to arbiter what is medical information is not only a blatant con job and misinformation, as proven by everything they do, it’s utterly insane. Anyone supporting it is accomplice in all their crimes. They can’t do better than the authorities they subject to, which have admitted to failure.
Which makes YTFT a huge threat to the global public health and security, given their immense global reach.

What happened to HCQ supporters on YTFT?

Bonus: Where is risk, there has to be freedom of choice, where is risky speech there has to be freedom of choice for speech (free speech, in short).


And if you needed me to explain such super-basic logic, you’re not intellectually equipped for survival and most likely you don’t have anymore time to catch up because the mental lazies stole the horizon from everyone. You are the virus, in fact. We’re better off if you go get a vaccine!
If you did figure this out by yourself, in your own terms, we need you to put some daily effort into spreading the truth and making our objection more powerful, it’s the only antidote to lies. You know what you have to do, thank you!
Ah, and also this:

To be continued?
Our work and existence, as media and people, is funded solely by our most generous readers and we want to keep this way.
We hardly made it before, but this summer something’s going on, our audience stats show bizarre patterns, we’re severely under estimates and the last savings are gone. We’re not your responsibility, but if you find enough benefits in this work…
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! Articles can always be subject of later editing as a way of perfecting them

How do I know the public discourse on Covid-19 is fully controlled and dishonest?
Because no one important is discussing the most crucial question.

If we’re talking a “novel virus”, which is the first logical question to ask for a microbiology ignorant like pretty much all politicians, presstitutes and big-techoles? As much as for anyone who “cares”?

And here’s the answer for the f-ing lazy cnts

A more extensive video with more evidence finally available HERE
Soon on more free speech platforms. Unfortunately, we can only embed Youtube videos here.

To be continued?
Our work and existence, as media and people, is funded solely by our most generous readers and we want to keep this way.
We hardly made it before, but this summer something’s going on, our audience stats show bizarre patterns, we’re severely under estimates and the last savings are gone. We’re not your responsibility, but if you find enough benefits in this work…
Help SILVIEW.media survive and grow, please donate here, anything helps. Thank you!

! Articles can always be subject of later editing as a way of perfecting them

I keep telling covidiots their actions speak way louder than their propaganda, it’s still rocket science to them. Not many words to add from my side.

These silly dipshits think they can control me with fear. Fear of channel deletion lol. They’ve already deleted all the joy from my life, you don’t do that to people and then hope to scare them with Youtube deletion!
What if WE delete YOU(tube)?


To be continued?
Our work and existence, as media and people, is funded solely by our most generous readers and we want to keep this way.
We hardly made it before, but this summer something’s going on, our audience stats show bizarre patterns, we’re severely under estimates and the last savings are gone. We’re not your responsibility, but if you find enough benefits in this work…
Help SILVIEW.media survive and grow, please donate here, anything helps. Thank you!

! Articles can always be subject of later editing as a way of perfecting them