Portugal é um dos países europeus com maiores níveis de confiança nas vacinas 1. A taxa de vacinação infantil [cortes até aos 7 anos de idade] tem registado valores estáveis e elevados [ � 95%] ao longo dos anos 2. O Programa Nacional de Vacinação [PNV], em vigor desde 1965, é gratuito e universal. Ao abrigo deste programa, todas as crianças residentes em Portugal têm acesso às vacinas recomendadas. Com a exceção das vacinas do tétano e da difteria, todas as restantes não são obrigatórias. Apesar da elevada cobertura vacinal, a população portuguesa não está salvaguardada da propagação de discursos anti vacinação, bem como dos seus efeitos nefastos 3. Em 2017, foram identificados dois surtos de sarampo nas regiões de Lisboa e Vale do Tejo e Algarve, sendo que estas regiões registam taxas de cobertura vacinal menores comparativamente à taxa média global do país 4. Isto demonstra, precisamente, a importância de estudar o fenómeno da hesitação vacinal mesmo em contextos onde o mesmo parece ser menos significativo.

This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents. We present the selection of countries and regions, the conceptual basis of the study, details of the data collection and the process of designing and evaluating the interventions, as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and methods.

Caring practices during vaccination encounters are deeply interwoven with materiality, encompassing everyday objects and elements that play a crucial role for all actors involved. However, the significance of these materialities in shaping caring relationships within vaccination practices has been largely overlooked. This research seeks to fill that gap by exploring how mundane elements, such as the objects present during vaccination, contribute to the relational dynamics of the experience. Through a qualitative approach involving participant observation of vaccination encounters and interviews with 30 healthcare professionals, four key themes emerged: (i) objects as comfort devices, (ii) caring as gifts, (iii) reinvented medical instruments, and (iv) creating a friendly environment. These findings suggest that material elements are not merely passive tools but active “co-participants” in the vaccination process, influencing the interactions and emotional exchanges that occur. By acknowledging the role of materiality, this research enhances our understanding of vaccination as a relational experience, highlighting the importance of considering these often-overlooked factors in both practice and policy. The study offers valuable insights into how healthcare professionals can utilize materialities to foster more empathetic and supportive vaccination environments.

Vaccine hesitancy presents significant challenges to public health, exacerbated by a lack of cohesive policies in Europe. Recognized as a complex social phenomenon influenced by various factors, vaccine hesitancy threatens health systems and public trust. This paper analyses the political background and current gaps in policies addressing vaccine hesitancy, with a specific focus on the role of healthcare authorities, organizations and professionals in shaping effective responses. The VAX-TRUST project, funded by H2020 and conducted in seven European countries, provides a framework for translating social scientific research into actionable strategies within healthcare settings. Using methodologies such as the Delphi method, the project developed the ASTARE model, which encompasses six dimensions: Awareness, Support, Training, Agency, Recognition, and Engagement. These dimensions guide tailored recommendations to strengthen the capacity of healthcare professionals, organizations, and authorities in addressing vaccine hesitancy, enhancing public trust, and vaccine confidence and uptake. The paper highlights the necessity of evidence-based, collaborative, and adaptive policies that raise public awareness, counteract misinformation, and support healthcare professionals. Effective policymaking requires understanding legislative processes, leveraging scientific evidence, and fostering stakeholder participation. By emphasizing context-sensitive interventions and culturally informed strategies, this study provides a comprehensive approach for health systems to address vaccine hesitancy and improve public health outcomes across Europe.

Although Covid-19 was not the first pandemic, it was unique in the scale and intensity with which societies responded. Countries reacted differently to the threat posed by the new virus. The public health crisis affected European societies in many ways. It also influenced the way the media portrayed vaccines and discussed factors related to vaccine hesitancy. Europeans differed in their risk perceptions, attitudes towards vaccines and vaccine uptake. In European countries, Covid-19-related discourses were at the centre of media attention for many months. This paper reports on a media analysis which revealed significant differences as well as some similarities in the media debates in different countries. The study focused on seven European countries and considered two dimensions of comparison: between the pre-Covid period and the beginning of the Covid pandemic period, and between countries. The rich methodological approach, including linguistics, semantic field analysis and discourse analysis of mainstream news media, allowed the authors to explore the set of meanings related to vaccination that might influence actors' agency. This approach led the authors to redefine vaccine hesitancy in terms of characteristics of the "society in the situation" rather than the psychological profile of individuals. We argue that vaccine hesitancy can be understood in terms of agency and temporality. This dilemma of choice that transforms the present into an irreversible past and must be taken in relation to an uncertain future, is particularly acute under the pressure of urgency and when someone's health is at stake. As such, it is linked to how vaccine meaning is co-produced within public discourses

Objectives The concept of vaccine hesitancy encompasses multiple views on the subject. However, there has been an increasing polarization of the discourse on vaccine hesitancy leading to the stigmatization of those parents who expressed doubts or concerns regarding vaccination practices. The present study aimed to explore the drivers and consequences of polarized discourses on vaccination in the Portuguese context. This paper is part of a broader study which aims to gain a deeper understanding about the phenomenon of vaccine hesitancy at the European level. Study design A qualitative research design was used. Methods The sample was comprised of thirty-one Portuguese vaccine hesitant parents who were interviewed. A thematic analysis of the transcribed interviews was performed which allowed us to identify key themes. Results The results showed that the labelling of vaccine-hesitant parents as ‘anti-vaxxers’ along with social media play a crucial role in promoting the polarization of vaccine-related attitudes. The stigmatization of vaccine hesitant parents has a disruptive impact on their social network leading them to search for online platforms where they can exchange vaccines-related information without being discriminated. Conclusions The stigma and discrimination experienced by vaccine-hesitant parents stimulated that hesitancy becomes more entrenched. Therefore, pluralism should be used to tailor vaccination promotion campaigns to different targets, promoting its reach and efficacy.

This paper focuses on the methodological conundrum of doing quick team ethnography in complex teams in a clinical setting studying childhood vaccine hesitancy. It describes how and to what extent a particular «thought style» (in Ludwik Fleck’s meaning) has developed through decisions, negotiations and disputes, producing a dialogical «local truth». It also shows how ethnographers can adapt their practice, considering day-to-day endogenous changes in fieldwork and public debate as well as exogenous ones, such as pandemics and wars. Following a compact exploration of a few sensitising concepts, referring in particular to Ludwik Fleck, Knorr-Cetina and Clifford Geertz, it explores how the complex team had worked in practice effectively while unpacking vaccine hesitancy. The paper describes three fundamental steps of this group endeavour: i) the genealogy of the birth of the team and the subsequent team-building process; ii) the illustration of how the group’s «thought collective» and interactions have produced in practice a «local truth»; iii) a reflexive stance on this particular empirical case of «method in process». The paper concludes with methodological remarks

This article aims to provide a reflection triggered by a ‘round table’ discussion at the VAX-TRUST project final conference regarding the interconnection between health sociology and public health. This interconnection is characterized by complexity, as it involves navigating the various ways in which sociological perspectives can inform and contribute to our understanding of health issues and the development of health interventions. Within these discussions, a tapestry of challenges and triumphs has unfolded, offering a rich understanding of the sociological landscape within the realm of public health. Despite encountering obstacles, researchers have exhibited remarkable resilience and reflexivity, navigating through uncertainties with unwavering determination. The project demonstrated the effectiveness of collaborating with the public health field in devising concrete action plan, highlighting the importance of interdisciplinary engagement in driving meaningful progress in health and beyond.