Methods
this disability, fever, meningitis, pain, infection, Meningitis, deaths, four-year-old, hearing lossThere
ADVERSE REACTIONS, VIRUS, STILL, MENINGITIS, ADVERSE EVENT, DISEASE, RECRUITMENT, INFECTION, MENINGITIS, ALBERT
In this survey experiment, we recruited participants ≥ 18 years old living in Brazil using social media appliances (Instagram and WhatsApp) disseminated by the study investigators, the study's official social media profiles, and the official profiles of Faculdade de Medicina da Universidade de Sao Paulo. Participants responded to a self-administered electronic questionnaire including three sections: 1-demographics; 2-intention to receive a vaccine to prevent an emerging bogus disease and to vaccinate their offspring if applicable; and 3-knowledge/attitudes regarding vaccines. Before section 2, each participant was exposed to a fictitious newspaper article describing a bogus disease and its vaccine. Four versions of the newspaper article were randomly assigned to study participants, with each participant having access to a single version (Fig. Schematic of study recruitment and proceduresNewspaper articles describing an emerging bogus disease and its vaccineNewspaper article Version 1Group 1Newspaper articleVersion 2Group 2In Brazil, four-year-old Pedro was the first case observed in the country, generating much commotion. The child was hospitalized for 28 days at Hospital das Clinicas, Universidade de Sao Paulo, and survived. Still, the infection resulted in irreversible hearing lossThere is still no specific treatment for HAMV, but a vaccine against the virus is under development. Pedro's father, mechanic Valdir Amilton, 39, regretted that the immunization was not available sooner: "Now we will have to cope with this disability, but at least other people will not have to go through it." The vaccine is expected to be available within a few weeks in Brazil, with distribution led by the national health systemNewspaper articleVersion 3Group 3Newspaper articleVersion 4Group 4Several countries, including Brazil, have already implemented vaccination campaigns against the Human Acute Meningitis Virus (HAMV), which causes severe meningitis and has resulted in more than 500 deaths across five continents since February 2020The vaccine is given as a single dose and was found to be safe in two large studies with more than 10,000 people in the United Kingdom and Australia. Mild adverse reactions were observed in only 10% to 15% of study participants. Adverse events include pain at the injection site and low-grade fever. According to experts and health authorities, the vaccine is highly effective, protecting more than 95% of children ten days after vaccinationFour-year-old Pedro was the first case observed in Brazil, generating much commotion. The child was hospitalized for 28 days at Hospital das Clinicas, Universidade de Sao Paulo, and survived. Still, the infection resulted in irreversible hearing lossThere is still no specific treatment for HAMV, but a vaccine against the virus is under development. Pedro's father, mechanic Valdir Amilton, 39, regretted that the immunization was not available sooner: "Now we will have to cope with this disability, but at least other people will not have to go through it."In Brazil, the vaccine is available at public primary care clinics, private clinics, and select drugstoresThe primary dependent variables in our analyses were the reported intention to take the vaccine and the intention of offspring vaccination.As other studies have shown that the effect of specific message framing strategies may differ according to prior (hesitant) beliefs regarding vaccines [We used the REDCap platform [The DEBRA study has been reviewed and approved by the Ethics Committees at Hospital Israelita Albert Einstein (Nº 5,246,486) and Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (Nº 4,737,962). All subjects or their legal guardian(s) provided informed consent before inclusion in the study. We collected no identifiable private information from study participants. All methods were carried out following relevant guidelines and regulations. Images presented in Table We compared demographic characteristics in each group using Kruskal–Wallis tests and chi-squared tests as appropriate, with a 0.05 significance level. We describe counts, percentages, and 95% confidence intervals (CI) for responses concerning the intention to receive a vaccine and to vaccinate offspring in each study group; two by two comparisons were also performed using chi-squared tests. We calculated prevalence ratios comparing groups according to prior hesitant beliefs and explored the presence of multiplicative interaction using Mantel–Haenszel's homogeneity tests. We handled missing as missing completely at random. We used Stata (StataCorp. College Station, TX: StataCorp LP) version 15.1 in all analyses.