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/Title (Vaccine Narratives and Public Health: Investigating Criticisms of H1N1 Pandemic Vaccination � PLOS Currents Outbreaks)
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BT 15.000 718.042 Td /F2 21.0 Tf  [(Vaccine Narratives and Public Health: Investigating Criticisms )] TJ ET
BT 15.000 693.094 Td /F2 21.0 Tf  [(of H1N1 Pandemic Vaccination)] TJ ET
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BT 15.000 675.088 Td /F3 9.8 Tf  [(February 25, 2015)] TJ ET
BT 93.263 675.088 Td /F3 9.8 Tf  [(�)] TJ ET
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BT 98.138 675.088 Td /F3 9.8 Tf  [(Discussion)] TJ ET
BT 26.250 663.247 Td /F1 9.8 Tf  [(Sudeepa Abeysinghe)] TJ ET
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BT 31.254 652.075 Td /F1 9.0 Tf  [( University of Edinburgh)] TJ ET
BT 26.250 640.353 Td /F1 9.8 Tf  [(Abeysinghe S. Vaccine Narratives and Public Health: Investigating Criticisms of H1N1 Pandemic Vaccination. PLOS Currents )] TJ ET
BT 26.250 628.449 Td /F1 9.8 Tf  [(Outbreaks. 2015 Feb 25 . Edition 1. doi: 10.1371/currents.outbreaks.17b6007099e92486483872ff39ede178.)] TJ ET
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BT 26.250 599.346 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 579.392 Td /F1 9.8 Tf  [(Vaccine hesitancy is often understood and explored on the level of individual decision-making. However, questions surrounding )] TJ ET
BT 26.250 567.487 Td /F1 9.8 Tf  [(the risk and efficacy of vaccination are evident in wider public discourse; social narratives of vaccination inform and impact on )] TJ ET
BT 26.250 555.582 Td /F1 9.8 Tf  [(the individual level. This paper takes a narrative analysis approach from the sociology of health to examine data drawn from a )] TJ ET
BT 26.250 543.678 Td /F1 9.8 Tf  [(wider study on global public health responses to the H1N1 pandemic. The paper concentrates upon criticisms to mass )] TJ ET
BT 26.250 531.773 Td /F1 9.8 Tf  [(vaccination as recounted within the Council of Europe�s debate of the handling of H1N1. It shows that three narratives were )] TJ ET
BT 26.250 519.868 Td /F1 9.8 Tf  [(particularly dominant: problematizing the use of vaccination as a public health response; criticising the efficacy of the vaccines; )] TJ ET
BT 26.250 507.963 Td /F1 9.8 Tf  [(and, questioning the safety of the strategy. This debate presents an important case study in understanding the way in which )] TJ ET
BT 26.250 496.059 Td /F1 9.8 Tf  [(vaccines are problematized within the public discourse.)] TJ ET
BT 26.250 459.456 Td /F4 12.0 Tf  [(Funding Statement)] TJ ET
BT 26.250 439.502 Td /F1 9.8 Tf  [(The research was supported by an Australian Postgraduate Award. The funders had no role in study design, data collection )] TJ ET
BT 560.599 439.502 Td /F1 9.8 Tf  [(and )] TJ ET
BT 26.250 427.597 Td /F1 9.8 Tf  [(analysis, decision to publish, or preparation of the manuscript)] TJ ET
BT 26.250 398.495 Td /F4 12.0 Tf  [(Related Articles)] TJ ET
BT 26.250 378.540 Td /F1 9.8 Tf  [(The article is part of the )] TJ ET
BT 130.838 378.540 Td /F5 9.8 Tf  [(PLOS Currents Outbreaks )] TJ ET
BT 247.341 378.540 Td /F1 9.8 Tf  [(�)] TJ ET
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BT 250.588 378.540 Td /F1 9.8 Tf  [(Vaccine Hesitancy Collection)] TJ ET
0.271 0.267 0.267 rg
BT 376.294 378.540 Td /F1 9.8 Tf  [(�.)] TJ ET
BT 26.250 341.938 Td /F4 12.0 Tf  [(Introduction)] TJ ET
BT 26.250 321.984 Td /F1 9.8 Tf  [(Mass vaccination has been widely recognised as a key public health achievement. However, vaccine hesitancy � bound up in )] TJ ET
BT 26.250 310.079 Td /F1 9.8 Tf  [(uncertainty or lack of confidence in the safety and effectiveness of vaccination � may serve to undermine comprehensive )] TJ ET
BT 26.250 298.174 Td /F1 9.8 Tf  [(coverage. Vaccine hesitancy is often examined on the scale of individual decision-making, or through referring to questions of )] TJ ET
BT 26.250 286.269 Td /F1 9.8 Tf  [(ethics and freedom of choice. However, when considering the problem of vaccine hesitancy, social scientists of medicine would )] TJ ET
BT 26.250 274.365 Td /F1 9.8 Tf  [(note that the public discourse surrounding vaccines � the way in which vaccines are represented and publicly understood � )] TJ ET
BT 26.250 262.460 Td /F1 9.8 Tf  [(forms another important piece of the puzzle. It is not just individuals, but rather wider social representations of vaccination, )] TJ ET
BT 26.250 250.555 Td /F1 9.8 Tf  [(which underpin vaccine hesitancy. Individual �choices� are produced in the context of narratives and public conversations about )] TJ ET
BT 26.250 238.650 Td /F1 9.8 Tf  [(the efficacy and safety of vaccine use. The ways in which vaccines are described and discussed in the public domain impacts )] TJ ET
BT 26.250 226.746 Td /F1 9.8 Tf  [(upon private decision-making. Understanding these narratives is therefore pivotal to the wider understanding of the problem of )] TJ ET
BT 26.250 214.841 Td /F1 9.8 Tf  [(vaccine hesitancy.)] TJ ET
BT 26.250 195.436 Td /F1 9.8 Tf  [(This paper examines the case study of the Council of Europe�s public criticism of mass vaccination during the H1N1 Influenza )] TJ ET
BT 26.250 183.531 Td /F1 9.8 Tf  [(Pandemic. In December 2009, Council of Europe parliamentarian and epidemiologist Wolfgang Wodarg presented a )] TJ ET
BT 26.250 171.627 Td /F1 9.8 Tf  [(recommendation to the Council of Europe entitled �Faked Pandemics: A Threat to Public Health�.)] TJ ET
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BT 441.892 173.134 Td /F4 8.7 Tf  [(1)] TJ ET
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BT 446.711 171.627 Td /F1 9.8 Tf  [( Following subsequent months )] TJ ET
BT 26.250 159.722 Td /F1 9.8 Tf  [(of debate, the Council of Europe passed a motion decrying the WHO�s public health reaction to H1N1. Criticism of the H1N1 )] TJ ET
BT 26.250 147.817 Td /F1 9.8 Tf  [(vaccine was central to these findings. Such contestations can have an important effect on the public discourse, for example )] TJ ET
BT 26.250 135.912 Td /F1 9.8 Tf  [(through media attention and public discussion of vaccination. The Council of Europe�s criticisms were a source of extended )] TJ ET
BT 26.250 124.008 Td /F1 9.8 Tf  [(media commentary, and public scrutiny over the use of vaccines during the H1N1 pandemic continues. This paper draws upon )] TJ ET
BT 26.250 112.103 Td /F1 9.8 Tf  [(social scientific analyses of vaccine narratives and illustrates the ways in which the Council of Europe�s account of H1N1 )] TJ ET
BT 26.250 100.198 Td /F1 9.8 Tf  [(vaccines both reflected and influenced the wider societal discourses on vaccine uptake.)] TJ ET
BT 26.250 80.793 Td /F1 9.8 Tf  [(This paper utilises narrative analysis from the sociology of health to draw out the way in which vaccines were discussed and )] TJ ET
BT 26.250 68.889 Td /F1 9.8 Tf  [(criticised. Narrative analysis allows for the identification of ideological and discursive constructions,)] TJ ET
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BT 451.603 70.396 Td /F4 8.7 Tf  [(2)] TJ ET
0.271 0.267 0.267 rg
BT 456.422 68.889 Td /F1 9.8 Tf  [( including constructions )] TJ ET
BT 26.250 56.984 Td /F1 9.8 Tf  [(surrounding the social �reality� underpinning vaccine use. Narrative texts, as linguistic and discursive processes, are of )] TJ ET
BT 26.250 45.079 Td /F1 9.8 Tf  [(fundamental importance in forming subjectivities and making the social world intelligible to those who live in it.)] TJ ET
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BT 498.764 46.586 Td /F4 8.7 Tf  [(2)] TJ ET
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BT 503.583 45.079 Td /F1 9.8 Tf  [( The analysis of )] TJ ET
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BT 15.000 718.042 Td /F2 21.0 Tf  [(Vaccine Narratives and Public Health: Investigating Criticisms )] TJ ET
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BT 15.000 675.088 Td /F3 9.8 Tf  [(February 25, 2015)] TJ ET
BT 93.263 675.088 Td /F3 9.8 Tf  [(�)] TJ ET
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BT 98.138 675.088 Td /F3 9.8 Tf  [(Discussion)] TJ ET
BT 26.250 663.247 Td /F1 9.8 Tf  [(Sudeepa Abeysinghe)] TJ ET
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BT 118.933 667.135 Td /F1 8.7 Tf  [(1)] TJ ET
BT 26.250 652.075 Td /F4 9.0 Tf  [(1)] TJ ET
BT 31.254 652.075 Td /F1 9.0 Tf  [( University of Edinburgh)] TJ ET
BT 26.250 640.353 Td /F1 9.8 Tf  [(Abeysinghe S. Vaccine Narratives and Public Health: Investigating Criticisms of H1N1 Pandemic Vaccination. PLOS Currents )] TJ ET
BT 26.250 628.449 Td /F1 9.8 Tf  [(Outbreaks. 2015 Feb 25 . Edition 1. doi: 10.1371/currents.outbreaks.17b6007099e92486483872ff39ede178.)] TJ ET
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BT 26.250 599.346 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 579.392 Td /F1 9.8 Tf  [(Vaccine hesitancy is often understood and explored on the level of individual decision-making. However, questions surrounding )] TJ ET
BT 26.250 567.487 Td /F1 9.8 Tf  [(the risk and efficacy of vaccination are evident in wider public discourse; social narratives of vaccination inform and impact on )] TJ ET
BT 26.250 555.582 Td /F1 9.8 Tf  [(the individual level. This paper takes a narrative analysis approach from the sociology of health to examine data drawn from a )] TJ ET
BT 26.250 543.678 Td /F1 9.8 Tf  [(wider study on global public health responses to the H1N1 pandemic. The paper concentrates upon criticisms to mass )] TJ ET
BT 26.250 531.773 Td /F1 9.8 Tf  [(vaccination as recounted within the Council of Europe�s debate of the handling of H1N1. It shows that three narratives were )] TJ ET
BT 26.250 519.868 Td /F1 9.8 Tf  [(particularly dominant: problematizing the use of vaccination as a public health response; criticising the efficacy of the vaccines; )] TJ ET
BT 26.250 507.963 Td /F1 9.8 Tf  [(and, questioning the safety of the strategy. This debate presents an important case study in understanding the way in which )] TJ ET
BT 26.250 496.059 Td /F1 9.8 Tf  [(vaccines are problematized within the public discourse.)] TJ ET
BT 26.250 459.456 Td /F4 12.0 Tf  [(Funding Statement)] TJ ET
BT 26.250 439.502 Td /F1 9.8 Tf  [(The research was supported by an Australian Postgraduate Award. The funders had no role in study design, data collection )] TJ ET
BT 560.599 439.502 Td /F1 9.8 Tf  [(and )] TJ ET
BT 26.250 427.597 Td /F1 9.8 Tf  [(analysis, decision to publish, or preparation of the manuscript)] TJ ET
BT 26.250 398.495 Td /F4 12.0 Tf  [(Related Articles)] TJ ET
BT 26.250 378.540 Td /F1 9.8 Tf  [(The article is part of the )] TJ ET
BT 130.838 378.540 Td /F5 9.8 Tf  [(PLOS Currents Outbreaks )] TJ ET
BT 247.341 378.540 Td /F1 9.8 Tf  [(�)] TJ ET
0.267 0.267 0.267 rg
BT 250.588 378.540 Td /F1 9.8 Tf  [(Vaccine Hesitancy Collection)] TJ ET
0.271 0.267 0.267 rg
BT 376.294 378.540 Td /F1 9.8 Tf  [(�.)] TJ ET
BT 26.250 341.938 Td /F4 12.0 Tf  [(Introduction)] TJ ET
BT 26.250 321.984 Td /F1 9.8 Tf  [(Mass vaccination has been widely recognised as a key public health achievement. However, vaccine hesitancy � bound up in )] TJ ET
BT 26.250 310.079 Td /F1 9.8 Tf  [(uncertainty or lack of confidence in the safety and effectiveness of vaccination � may serve to undermine comprehensive )] TJ ET
BT 26.250 298.174 Td /F1 9.8 Tf  [(coverage. Vaccine hesitancy is often examined on the scale of individual decision-making, or through referring to questions of )] TJ ET
BT 26.250 286.269 Td /F1 9.8 Tf  [(ethics and freedom of choice. However, when considering the problem of vaccine hesitancy, social scientists of medicine would )] TJ ET
BT 26.250 274.365 Td /F1 9.8 Tf  [(note that the public discourse surrounding vaccines � the way in which vaccines are represented and publicly understood � )] TJ ET
BT 26.250 262.460 Td /F1 9.8 Tf  [(forms another important piece of the puzzle. It is not just individuals, but rather wider social representations of vaccination, )] TJ ET
BT 26.250 250.555 Td /F1 9.8 Tf  [(which underpin vaccine hesitancy. Individual �choices� are produced in the context of narratives and public conversations about )] TJ ET
BT 26.250 238.650 Td /F1 9.8 Tf  [(the efficacy and safety of vaccine use. The ways in which vaccines are described and discussed in the public domain impacts )] TJ ET
BT 26.250 226.746 Td /F1 9.8 Tf  [(upon private decision-making. Understanding these narratives is therefore pivotal to the wider understanding of the problem of )] TJ ET
BT 26.250 214.841 Td /F1 9.8 Tf  [(vaccine hesitancy.)] TJ ET
BT 26.250 195.436 Td /F1 9.8 Tf  [(This paper examines the case study of the Council of Europe�s public criticism of mass vaccination during the H1N1 Influenza )] TJ ET
BT 26.250 183.531 Td /F1 9.8 Tf  [(Pandemic. In December 2009, Council of Europe parliamentarian and epidemiologist Wolfgang Wodarg presented a )] TJ ET
BT 26.250 171.627 Td /F1 9.8 Tf  [(recommendation to the Council of Europe entitled �Faked Pandemics: A Threat to Public Health�.)] TJ ET
0.267 0.267 0.267 rg
BT 441.892 173.134 Td /F4 8.7 Tf  [(1)] TJ ET
0.271 0.267 0.267 rg
BT 446.711 171.627 Td /F1 9.8 Tf  [( Following subsequent months )] TJ ET
BT 26.250 159.722 Td /F1 9.8 Tf  [(of debate, the Council of Europe passed a motion decrying the WHO�s public health reaction to H1N1. Criticism of the H1N1 )] TJ ET
BT 26.250 147.817 Td /F1 9.8 Tf  [(vaccine was central to these findings. Such contestations can have an important effect on the public discourse, for example )] TJ ET
BT 26.250 135.912 Td /F1 9.8 Tf  [(through media attention and public discussion of vaccination. The Council of Europe�s criticisms were a source of extended )] TJ ET
BT 26.250 124.008 Td /F1 9.8 Tf  [(media commentary, and public scrutiny over the use of vaccines during the H1N1 pandemic continues. This paper draws upon )] TJ ET
BT 26.250 112.103 Td /F1 9.8 Tf  [(social scientific analyses of vaccine narratives and illustrates the ways in which the Council of Europe�s account of H1N1 )] TJ ET
BT 26.250 100.198 Td /F1 9.8 Tf  [(vaccines both reflected and influenced the wider societal discourses on vaccine uptake.)] TJ ET
BT 26.250 80.793 Td /F1 9.8 Tf  [(This paper utilises narrative analysis from the sociology of health to draw out the way in which vaccines were discussed and )] TJ ET
BT 26.250 68.889 Td /F1 9.8 Tf  [(criticised. Narrative analysis allows for the identification of ideological and discursive constructions,)] TJ ET
0.267 0.267 0.267 rg
BT 451.603 70.396 Td /F4 8.7 Tf  [(2)] TJ ET
0.271 0.267 0.267 rg
BT 456.422 68.889 Td /F1 9.8 Tf  [( including constructions )] TJ ET
BT 26.250 56.984 Td /F1 9.8 Tf  [(surrounding the social �reality� underpinning vaccine use. Narrative texts, as linguistic and discursive processes, are of )] TJ ET
BT 26.250 45.079 Td /F1 9.8 Tf  [(fundamental importance in forming subjectivities and making the social world intelligible to those who live in it.)] TJ ET
0.267 0.267 0.267 rg
BT 498.764 46.586 Td /F4 8.7 Tf  [(2)] TJ ET
0.271 0.267 0.267 rg
BT 503.583 45.079 Td /F1 9.8 Tf  [( The analysis of )] TJ ET
Q
q
15.000 684.354 577.500 53.646 re W n
0.267 0.267 0.267 rg
BT 15.000 718.042 Td /F2 21.0 Tf  [(Vaccine Narratives and Public Health: Investigating Criticisms )] TJ ET
BT 15.000 693.094 Td /F2 21.0 Tf  [(of H1N1 Pandemic Vaccination)] TJ ET
Q
0.271 0.267 0.267 rg
BT 15.000 675.088 Td /F3 9.8 Tf  [(February 25, 2015)] TJ ET
BT 93.263 675.088 Td /F3 9.8 Tf  [(�)] TJ ET
0.267 0.267 0.267 rg
BT 98.138 675.088 Td /F3 9.8 Tf  [(Discussion)] TJ ET
BT 26.250 663.247 Td /F1 9.8 Tf  [(Sudeepa Abeysinghe)] TJ ET
0.271 0.267 0.267 rg
BT 118.933 667.135 Td /F1 8.7 Tf  [(1)] TJ ET
BT 26.250 652.075 Td /F4 9.0 Tf  [(1)] TJ ET
BT 31.254 652.075 Td /F1 9.0 Tf  [( University of Edinburgh)] TJ ET
BT 26.250 640.353 Td /F1 9.8 Tf  [(Abeysinghe S. Vaccine Narratives and Public Health: Investigating Criticisms of H1N1 Pandemic Vaccination. PLOS Currents )] TJ ET
BT 26.250 628.449 Td /F1 9.8 Tf  [(Outbreaks. 2015 Feb 25 . Edition 1. doi: 10.1371/currents.outbreaks.17b6007099e92486483872ff39ede178.)] TJ ET
q
15.000 30.793 577.500 595.274 re W n
0.271 0.267 0.267 rg
BT 26.250 599.346 Td /F4 12.0 Tf  [(Abstract)] TJ ET
BT 26.250 579.392 Td /F1 9.8 Tf  [(Vaccine hesitancy is often understood and explored on the level of individual decision-making. However, questions surrounding )] TJ ET
BT 26.250 567.487 Td /F1 9.8 Tf  [(the risk and efficacy of vaccination are evident in wider public discourse; social narratives of vaccination inform and impact on )] TJ ET
BT 26.250 555.582 Td /F1 9.8 Tf  [(the individual level. This paper takes a narrative analysis approach from the sociology of health to examine data drawn from a )] TJ ET
BT 26.250 543.678 Td /F1 9.8 Tf  [(wider study on global public health responses to the H1N1 pandemic. The paper concentrates upon criticisms to mass )] TJ ET
BT 26.250 531.773 Td /F1 9.8 Tf  [(vaccination as recounted within the Council of Europe�s debate of the handling of H1N1. It shows that three narratives were )] TJ ET
BT 26.250 519.868 Td /F1 9.8 Tf  [(particularly dominant: problematizing the use of vaccination as a public health response; criticising the efficacy of the vaccines; )] TJ ET
BT 26.250 507.963 Td /F1 9.8 Tf  [(and, questioning the safety of the strategy. This debate presents an important case study in understanding the way in which )] TJ ET
BT 26.250 496.059 Td /F1 9.8 Tf  [(vaccines are problematized within the public discourse.)] TJ ET
BT 26.250 459.456 Td /F4 12.0 Tf  [(Funding Statement)] TJ ET
BT 26.250 439.502 Td /F1 9.8 Tf  [(The research was supported by an Australian Postgraduate Award. The funders had no role in study design, data collection )] TJ ET
BT 560.599 439.502 Td /F1 9.8 Tf  [(and )] TJ ET
BT 26.250 427.597 Td /F1 9.8 Tf  [(analysis, decision to publish, or preparation of the manuscript)] TJ ET
BT 26.250 398.495 Td /F4 12.0 Tf  [(Related Articles)] TJ ET
BT 26.250 378.540 Td /F1 9.8 Tf  [(The article is part of the )] TJ ET
BT 130.838 378.540 Td /F5 9.8 Tf  [(PLOS Currents Outbreaks )] TJ ET
BT 247.341 378.540 Td /F1 9.8 Tf  [(�)] TJ ET
0.267 0.267 0.267 rg
BT 250.588 378.540 Td /F1 9.8 Tf  [(Vaccine Hesitancy Collection)] TJ ET
0.271 0.267 0.267 rg
BT 376.294 378.540 Td /F1 9.8 Tf  [(�.)] TJ ET
BT 26.250 341.938 Td /F4 12.0 Tf  [(Introduction)] TJ ET
BT 26.250 321.984 Td /F1 9.8 Tf  [(Mass vaccination has been widely recognised as a key public health achievement. However, vaccine hesitancy � bound up in )] TJ ET
BT 26.250 310.079 Td /F1 9.8 Tf  [(uncertainty or lack of confidence in the safety and effectiveness of vaccination � may serve to undermine comprehensive )] TJ ET
BT 26.250 298.174 Td /F1 9.8 Tf  [(coverage. Vaccine hesitancy is often examined on the scale of individual decision-making, or through referring to questions of )] TJ ET
BT 26.250 286.269 Td /F1 9.8 Tf  [(ethics and freedom of choice. However, when considering the problem of vaccine hesitancy, social scientists of medicine would )] TJ ET
BT 26.250 274.365 Td /F1 9.8 Tf  [(note that the public discourse surrounding vaccines � the way in which vaccines are represented and publicly understood � )] TJ ET
BT 26.250 262.460 Td /F1 9.8 Tf  [(forms another important piece of the puzzle. It is not just individuals, but rather wider social representations of vaccination, )] TJ ET
BT 26.250 250.555 Td /F1 9.8 Tf  [(which underpin vaccine hesitancy. Individual �choices� are produced in the context of narratives and public conversations about )] TJ ET
BT 26.250 238.650 Td /F1 9.8 Tf  [(the efficacy and safety of vaccine use. The ways in which vaccines are described and discussed in the public domain impacts )] TJ ET
BT 26.250 226.746 Td /F1 9.8 Tf  [(upon private decision-making. Understanding these narratives is therefore pivotal to the wider understanding of the problem of )] TJ ET
BT 26.250 214.841 Td /F1 9.8 Tf  [(vaccine hesitancy.)] TJ ET
BT 26.250 195.436 Td /F1 9.8 Tf  [(This paper examines the case study of the Council of Europe�s public criticism of mass vaccination during the H1N1 Influenza )] TJ ET
BT 26.250 183.531 Td /F1 9.8 Tf  [(Pandemic. In December 2009, Council of Europe parliamentarian and epidemiologist Wolfgang Wodarg presented a )] TJ ET
BT 26.250 171.627 Td /F1 9.8 Tf  [(recommendation to the Council of Europe entitled �Faked Pandemics: A Threat to Public Health�.)] TJ ET
0.267 0.267 0.267 rg
BT 441.892 173.134 Td /F4 8.7 Tf  [(1)] TJ ET
0.271 0.267 0.267 rg
BT 446.711 171.627 Td /F1 9.8 Tf  [( Following subsequent months )] TJ ET
BT 26.250 159.722 Td /F1 9.8 Tf  [(of debate, the Council of Europe passed a motion decrying the WHO�s public health reaction to H1N1. Criticism of the H1N1 )] TJ ET
BT 26.250 147.817 Td /F1 9.8 Tf  [(vaccine was central to these findings. Such contestations can have an important effect on the public discourse, for example )] TJ ET
BT 26.250 135.912 Td /F1 9.8 Tf  [(through media attention and public discussion of vaccination. The Council of Europe�s criticisms were a source of extended )] TJ ET
BT 26.250 124.008 Td /F1 9.8 Tf  [(media commentary, and public scrutiny over the use of vaccines during the H1N1 pandemic continues. This paper draws upon )] TJ ET
BT 26.250 112.103 Td /F1 9.8 Tf  [(social scientific analyses of vaccine narratives and illustrates the ways in which the Council of Europe�s account of H1N1 )] TJ ET
BT 26.250 100.198 Td /F1 9.8 Tf  [(vaccines both reflected and influenced the wider societal discourses on vaccine uptake.)] TJ ET
BT 26.250 80.793 Td /F1 9.8 Tf  [(This paper utilises narrative analysis from the sociology of health to draw out the way in which vaccines were discussed and )] TJ ET
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BT 26.250 398.301 Td /F1 9.8 Tf  [(Scepticism or concern about vaccination is bound in problems of trust and mistrust. At the individual level, as Dew)] TJ ET
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BT 521.474 398.301 Td /F1 9.8 Tf  [( notes, this )] TJ ET
BT 26.250 386.396 Td /F1 9.8 Tf  [(involves a particular patient�s trust in their medical practitioner, or in �medicine� as a broader institution. The question of trust was )] TJ ET
BT 26.250 374.491 Td /F1 9.8 Tf  [(also central to the Council of Europe�s contestation of H1N1 vaccination. In the case of the H1N1 pandemic, the Council of )] TJ ET
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BT 26.250 338.777 Td /F1 9.8 Tf  [(structures and the World Health Organization.)] TJ ET
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BT 26.250 295.563 Td /F1 9.8 Tf  [(General Keiji Fukuda stated: �vaccines are really one of the prevention methods against infectious diseases which is best in )] TJ ET
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BT 179.015 287.546 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 181.424 285.165 Td /F4 8.7 Tf  [(7)] TJ ET
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BT 186.243 283.658 Td /F1 9.8 Tf  [( Given concerns that, as one member of the press put it to Marie-Paul Keiny, WHO )] TJ ET
BT 26.250 271.753 Td /F1 9.8 Tf  [(Director of the Initiative for Vaccine Research, �the [H1N1] vaccination campaign could actually create problems for the )] TJ ET
BT 26.250 259.848 Td /F1 9.8 Tf  [(reputation of vaccines�)] TJ ET
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BT 123.253 261.356 Td /F4 8.7 Tf  [(9)] TJ ET
0.271 0.267 0.267 rg
BT 128.071 259.848 Td /F1 9.8 Tf  [( the WHO strove to emphasise the safety and efficacy of H1N1 vaccines. The WHO upheld the )] TJ ET
BT 26.250 247.944 Td /F1 9.8 Tf  [(dominant public health discourse surrounding the efficacy of vaccination.)] TJ ET
BT 26.250 228.539 Td /F1 9.8 Tf  [(The criticisms of the Council of Europe actors highlighted the problem of trusting the WHO. It was suggested by Paul Flynn )] TJ ET
BT 26.250 216.634 Td /F1 9.8 Tf  [(\(Council of Europe Rapporteur on the matter of the handling of H1N1\), Hancock \(representative for the UK\), and Wodarg, that )] TJ ET
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BT 303.686 206.237 Td /F4 8.7 Tf  [(10)] TJ ET
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BT 313.324 208.618 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 315.733 206.237 Td /F4 8.7 Tf  [(11)] TJ ET
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BT 325.370 208.618 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 327.780 206.237 Td /F4 8.7 Tf  [(12)] TJ ET
0.271 0.267 0.267 rg
BT 337.417 204.729 Td /F1 9.8 Tf  [( over H1N1, and the �credibility� and �accountability� of )] TJ ET
BT 26.250 192.825 Td /F1 9.8 Tf  [(the WHO had been undermined by the affair)] TJ ET
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BT 217.555 194.332 Td /F4 8.7 Tf  [(1)] TJ ET
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BT 222.373 196.713 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 224.783 194.332 Td /F4 8.7 Tf  [(16)] TJ ET
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BT 531.263 192.825 Td /F1 9.8 Tf  [( These )] TJ ET
BT 26.250 180.920 Td /F1 9.8 Tf  [(narratives were underpinned by the major political concern that the Council of Europe�s criticisms were addressing � that the )] TJ ET
BT 26.250 169.015 Td /F1 9.8 Tf  [(mass vaccination campaign had been costly, since as Frahm \(representative for Denmark\) put it, the WHO�s recommendation )] TJ ET
BT 26.250 157.110 Td /F1 9.8 Tf  [(had �forced countries to spend billions on unnecessary supplies�)] TJ ET
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BT 301.541 158.618 Td /F4 8.7 Tf  [(10)] TJ ET
0.271 0.267 0.267 rg
BT 311.179 157.110 Td /F1 9.8 Tf  [( of antivirals and vaccines.)] TJ ET
BT 26.250 137.706 Td /F1 9.8 Tf  [(For the Council of Europe, the WHO�s decisions \(and lack of credibility\) had been a direct result of influence by pharmaceutical )] TJ ET
BT 26.250 125.801 Td /F1 9.8 Tf  [(manufacturers. It was argued that the costly vaccination campaign had merely served to profit vaccine makers and that industry )] TJ ET
BT 26.250 113.896 Td /F1 9.8 Tf  [(was able to �directly influence� public health decisions surrounding H1N1.)] TJ ET
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BT 350.179 113.896 Td /F1 9.8 Tf  [( It was argued that there was �great commercial )] TJ ET
BT 26.250 101.991 Td /F1 9.8 Tf  [(pressure� to manage the H1N1 through the use of vaccines and other pharmaceuticals,)] TJ ET
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BT 26.250 70.682 Td /F1 9.8 Tf  [(Scepticism over the motives of key actors � the WHO and the producers of vaccines � was a key narrative. Action surrounding )] TJ ET
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BT 26.250 767.476 Td /F1 9.8 Tf  [(texts is important in understanding representations of disease, as narrative texts both present and constitute cultural )] TJ ET
BT 26.250 755.571 Td /F1 9.8 Tf  [(interpretations of reality,)] TJ ET
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BT 135.111 755.571 Td /F1 9.8 Tf  [( providing insight into the social discourse underpinning this phenomena. The narratives and quotes )] TJ ET
BT 26.250 743.667 Td /F1 9.8 Tf  [(discussed here are drawn out of a wider project which examined the global health management of the 2009-2010 H1N1 )] TJ ET
BT 26.250 731.762 Td /F1 9.8 Tf  [(Pandemic. As part of this, a comprehensive analysis was made of all publicly available documents produced and published )] TJ ET
BT 26.250 719.857 Td /F1 9.8 Tf  [(through the course of the Council of Europe�s discussions surrounding the WHO�s management of H1N1. This paper particularly )] TJ ET
BT 26.250 707.952 Td /F1 9.8 Tf  [(utilises data gleaned from the textual analysis of expert testimony, parliamentary debates, parliamentary reports, and )] TJ ET
BT 26.250 696.048 Td /F1 9.8 Tf  [(documents produced by the Council of Europe during their examination of the World Health Organization�s management of the )] TJ ET
BT 26.250 684.143 Td /F1 9.8 Tf  [(H1N1 Pandemic, focussing on statements concerning the use or misuse of vaccines in combating H1N1.)] TJ ET
BT 26.250 664.738 Td /F1 9.8 Tf  [(Sociological analyses of vaccine resistance and hesitancy can be dated from Stern�s)] TJ ET
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BT 390.413 666.245 Td /F4 8.7 Tf  [(4)] TJ ET
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BT 395.231 664.738 Td /F1 9.8 Tf  [( key early work in the sociology of vaccine )] TJ ET
BT 26.250 652.833 Td /F1 9.8 Tf  [(uptake, which articulates the irrational motives, beliefs, and the vested interests of those who resist the use of vaccines. Critical )] TJ ET
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BT 216.463 642.436 Td /F4 8.7 Tf  [(5)] TJ ET
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BT 221.281 640.929 Td /F1 9.8 Tf  [( rightly notes, vaccine resistance is a communal activity. Although vaccine )] TJ ET
BT 26.250 629.024 Td /F1 9.8 Tf  [(resistance and hesitancy is made up of individual acts of refusal or uncertainty, resistance itself is found in the �anti-vaccination )] TJ ET
BT 26.250 617.119 Td /F1 9.8 Tf  [(movements�, as structured social movements as well as contemporary social norms of �questioning� vaccines.)] TJ ET
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BT 26.250 593.310 Td /F1 9.8 Tf  [(harms of immunization. Dew)] TJ ET
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BT 154.055 593.310 Td /F1 9.8 Tf  [( suggests that narratives surrounding vaccines which run counter to the public health discourse )] TJ ET
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BT 26.250 545.691 Td /F1 9.8 Tf  [(elements of each of these common tropes. In particular, concerns over safety and side-effects formed substantial components )] TJ ET
BT 26.250 533.786 Td /F1 9.8 Tf  [(of the arguments developed by the Council of Europe critics. However, additional arguments � which may also be seen as )] TJ ET
BT 26.250 521.881 Td /F1 9.8 Tf  [(recurring themes within the counter-vaccine discourse � were also evident in this case.)] TJ ET
BT 26.250 502.476 Td /F1 9.8 Tf  [(The narratives that marked the case of the Council of Europe�s criticism of H1N1 vaccines were the following: 1.\) Arguments )] TJ ET
BT 26.250 490.572 Td /F1 9.8 Tf  [(surrounding trust and the decision to utilise mass vaccination as a public health tool in the case of H1N1; 2.\) Criticisms of the )] TJ ET
BT 26.250 478.667 Td /F1 9.8 Tf  [(efficacy of the vaccines themselves, including scepticism of the efficiency of vaccines in general, and the H1N1 vaccine in )] TJ ET
BT 26.250 466.762 Td /F1 9.8 Tf  [(particular; and 3.\) Questions surrounding the safety of these vaccines. Understanding these narratives can lead to a greater )] TJ ET
BT 26.250 454.857 Td /F1 9.8 Tf  [(appreciation of ways in which the public health community can address vaccine hesitancy.)] TJ ET
BT 26.250 418.255 Td /F4 12.0 Tf  [(Trust and Vaccination as an Effective Public Health Response)] TJ ET
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BT 521.474 398.301 Td /F1 9.8 Tf  [( notes, this )] TJ ET
BT 26.250 386.396 Td /F1 9.8 Tf  [(involves a particular patient�s trust in their medical practitioner, or in �medicine� as a broader institution. The question of trust was )] TJ ET
BT 26.250 374.491 Td /F1 9.8 Tf  [(also central to the Council of Europe�s contestation of H1N1 vaccination. In the case of the H1N1 pandemic, the Council of )] TJ ET
BT 26.250 362.586 Td /F1 9.8 Tf  [(Europe argued that the World Health Organization was responsible for proposing vaccines as a management strategy. Rather )] TJ ET
BT 26.250 350.682 Td /F1 9.8 Tf  [(than problematising trust in medicine or medical professionals, this case shows the problematisation of trust in public health )] TJ ET
BT 26.250 338.777 Td /F1 9.8 Tf  [(structures and the World Health Organization.)] TJ ET
BT 26.250 319.372 Td /F1 9.8 Tf  [(For the WHO, influenza vaccination was understood as a pivotal public health strategy. Early mistrust in the H1N1 vaccines )] TJ ET
BT 26.250 307.467 Td /F1 9.8 Tf  [(were regarded by the WHO as a problem given that, as the Special Advisor for Pandemic Influenza and Deputy Director-)] TJ ET
BT 26.250 295.563 Td /F1 9.8 Tf  [(General Keiji Fukuda stated: �vaccines are really one of the prevention methods against infectious diseases which is best in )] TJ ET
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BT 181.424 285.165 Td /F4 8.7 Tf  [(7)] TJ ET
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BT 186.243 283.658 Td /F1 9.8 Tf  [( Given concerns that, as one member of the press put it to Marie-Paul Keiny, WHO )] TJ ET
BT 26.250 271.753 Td /F1 9.8 Tf  [(Director of the Initiative for Vaccine Research, �the [H1N1] vaccination campaign could actually create problems for the )] TJ ET
BT 26.250 259.848 Td /F1 9.8 Tf  [(reputation of vaccines�)] TJ ET
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BT 123.253 261.356 Td /F4 8.7 Tf  [(9)] TJ ET
0.271 0.267 0.267 rg
BT 128.071 259.848 Td /F1 9.8 Tf  [( the WHO strove to emphasise the safety and efficacy of H1N1 vaccines. The WHO upheld the )] TJ ET
BT 26.250 247.944 Td /F1 9.8 Tf  [(dominant public health discourse surrounding the efficacy of vaccination.)] TJ ET
BT 26.250 228.539 Td /F1 9.8 Tf  [(The criticisms of the Council of Europe actors highlighted the problem of trusting the WHO. It was suggested by Paul Flynn )] TJ ET
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BT 315.733 206.237 Td /F4 8.7 Tf  [(11)] TJ ET
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BT 325.370 208.618 Td /F1 8.7 Tf  [(,)] TJ ET
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BT 327.780 206.237 Td /F4 8.7 Tf  [(12)] TJ ET
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BT 217.555 194.332 Td /F4 8.7 Tf  [(1)] TJ ET
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BT 26.250 85.554 Td /F1 9.8 Tf  [(account. It is also significant, because while \(for example\) allusions to the possible carcinogenic nature of the vaccines was not )] TJ ET
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BT 311.311 663.300 Td /F1 9.8 Tf  [( The notion of risk is particularly key to the issue of vaccine )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(hesitancy � here, a lack of vaccine uptake is a choice \(rather than a problem of lack of access\), and this choice is underpinned )] TJ ET
BT 26.250 639.491 Td /F1 9.8 Tf  [(by an understanding of the relative advantages and disadvantages of vaccine use. In assessing the benefits of vaccination, )] TJ ET
BT 26.250 627.586 Td /F1 9.8 Tf  [(questions of efficacy are central. One of the ways in which vaccines are problematized is through challenging notions of )] TJ ET
BT 26.250 615.681 Td /F1 9.8 Tf  [(efficacy, either at the general level or in regard to a particular type of vaccination. Such narratives of \(in\)efficacy were central to )] TJ ET
BT 26.250 603.777 Td /F1 9.8 Tf  [(the Council of Europe actors� representation of the H1N1 vaccination campaign.)] TJ ET
BT 26.250 584.372 Td /F1 9.8 Tf  [(The Council of Europe critics contested the need for administering vaccination against H1N1. The decision to undertake a mass )] TJ ET
BT 26.250 572.467 Td /F1 9.8 Tf  [(immunisation campaign against the pandemic strain was decried as �without sufficient justification� and unnecessary \(Circene, )] TJ ET
BT 26.250 560.562 Td /F1 9.8 Tf  [(representative for Latvia\).)] TJ ET
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BT 136.796 562.070 Td /F4 8.7 Tf  [(10)] TJ ET
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BT 146.433 560.562 Td /F1 9.8 Tf  [( This suggestion was reinforced � with the benefit of hindsight � by comparisons between countries )] TJ ET
BT 26.250 548.658 Td /F1 9.8 Tf  [(that undertook vaccination and those that did not. So for example, it was argued that �[t]he country that spent the least was )] TJ ET
BT 26.250 536.753 Td /F1 9.8 Tf  [(Poland, which rejected the idea that this disease was dangerous and which has suspicions about the safety of the vaccine�� )] TJ ET
BT 26.250 524.848 Td /F1 9.8 Tf  [(where, compared the Britain�s comparatively larger spending on pharmaceuticals ��the number of deaths per million from )] TJ ET
BT 26.250 512.943 Td /F1 9.8 Tf  [(swine flu in Britain was about twice the number in Poland� \(Flynn\).)] TJ ET
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BT 310.190 514.451 Td /F4 8.7 Tf  [(10)] TJ ET
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BT 319.827 512.943 Td /F1 9.8 Tf  [( It was suggested that vaccination was therefore not an )] TJ ET
BT 26.250 501.039 Td /F1 9.8 Tf  [(effective public health response to H1N1.)] TJ ET
BT 26.250 481.634 Td /F1 9.8 Tf  [(In addition to specific criticisms of the efficacy of the H1N1 vaccine, the critics also suggested that vaccination more generally )] TJ ET
BT 26.250 469.729 Td /F1 9.8 Tf  [(does not act as an efficient public health measure. For example, Tom Jefferson from the Cochrane Institute was called in to )] TJ ET
BT 26.250 457.824 Td /F1 9.8 Tf  [(provide expert testimony on the case. Dr Jefferson argued that �vaccines and antivirals have a weak or non-existent evidence )] TJ ET
BT 26.250 445.920 Td /F1 9.8 Tf  [(base against influenza�.)] TJ ET
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BT 128.137 447.427 Td /F4 8.7 Tf  [(14)] TJ ET
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BT 137.775 445.920 Td /F1 9.8 Tf  [( Such statements undermined the fundamental concept that influenza vaccination is an effective )] TJ ET
BT 26.250 434.015 Td /F1 9.8 Tf  [(global health action. Likewise, it was argued that �the performance of the [influenza] vaccines in healthy adults is nothing to get )] TJ ET
BT 26.250 422.110 Td /F1 9.8 Tf  [(excited about� given that �we need to vaccinate 100 healthy adults to prevent one set of symptoms�.)] TJ ET
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BT 453.310 423.617 Td /F4 8.7 Tf  [(14)] TJ ET
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BT 462.947 422.110 Td /F1 9.8 Tf  [( Other public health )] TJ ET
BT 26.250 410.205 Td /F1 9.8 Tf  [(measures were described as having �a much better evidence base than vaccines�.)] TJ ET
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BT 379.570 411.713 Td /F4 8.7 Tf  [(14)] TJ ET
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BT 26.250 390.801 Td /F1 9.8 Tf  [(The strategy of emphasising the lack of efficacy of vaccine use is a key narrative in problematizing vaccination. In the case of )] TJ ET
BT 26.250 378.896 Td /F1 9.8 Tf  [(H1N1, it was suggested that vaccines were a costly and ineffective strategy against the pandemic. This uptake of narratives )] TJ ET
BT 26.250 366.991 Td /F1 9.8 Tf  [(serves to minimise the �benefit� aspect of the risk-to-benefit estimate that is central to estimations of the utility of vaccination.)] TJ ET
BT 26.250 330.389 Td /F4 12.0 Tf  [(Vaccine Safety)] TJ ET
BT 26.250 310.434 Td /F1 9.8 Tf  [(Vaccine hesitancy at the individual level highlights the important role of the relative \(perceived\) weight of the risk of vaccination )] TJ ET
BT 26.250 298.530 Td /F1 9.8 Tf  [(to the benefits incurred. Perceptions of the severity of the disease being vaccination against are weighed up against perceptions )] TJ ET
BT 26.250 286.625 Td /F1 9.8 Tf  [(of adverse reactions to vaccination. Counter-vaccination movements are particularly prone to discourses of risk and uncertainty )] TJ ET
BT 26.250 274.720 Td /F1 9.8 Tf  [(� vaccines are characterised as unsafe due to the risks of severe or lasting medical consequences. Unlike the short term and )] TJ ET
BT 26.250 262.815 Td /F1 9.8 Tf  [(acute reactions acknowledged by the medical community, counter-vaccine narratives commonly emphasise long-term and )] TJ ET
BT 26.250 250.911 Td /F1 9.8 Tf  [(severe reactions to vaccination.)] TJ ET
BT 26.250 231.506 Td /F1 9.8 Tf  [(Narratives that problematized vaccine safety were therefore central to the Council of Europe critics� discussions. It was argued )] TJ ET
BT 26.250 219.601 Td /F1 9.8 Tf  [(that �several independent medical experts raised warnings regarding excessive vaccination�[where]�there was no clinical )] TJ ET
BT 26.250 207.696 Td /F1 9.8 Tf  [(scientific evidence to justify this�.)] TJ ET
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BT 166.591 209.204 Td /F4 8.7 Tf  [(11)] TJ ET
0.271 0.267 0.267 rg
BT 176.229 207.696 Td /F1 9.8 Tf  [( The safety of vaccination was questioned and problematized.)] TJ ET
BT 26.250 188.292 Td /F1 9.8 Tf  [(In the case of H1N1, an important point of contention revolved around the novel manufacturing method, which was used, it was )] TJ ET
BT 26.250 176.387 Td /F1 9.8 Tf  [(argued, due to the concern over quickening production and furthering profits. It was suggested that the vaccines �primarily )] TJ ET
BT 26.250 164.482 Td /F1 9.8 Tf  [(follow[ed] economic strategies and was not to optimise public health needs�.)] TJ ET
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BT 353.567 165.989 Td /F4 8.7 Tf  [(15)] TJ ET
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BT 363.205 164.482 Td /F1 9.8 Tf  [( This method, it was argued �involved higher risks )] TJ ET
BT 26.250 152.577 Td /F1 9.8 Tf  [(than usual vaccines�[since]�some adjuvants were added and injected of which we know, that they stimulate the immune )] TJ ET
BT 26.250 140.673 Td /F1 9.8 Tf  [(system manifold, which means that they could possibly lead to autoimmune diseases \(such as multiple sclerosis\) and )] TJ ET
BT 26.250 128.768 Td /F1 9.8 Tf  [(immunological complication�.)] TJ ET
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BT 26.250 109.363 Td /F1 9.8 Tf  [(Several other potential adverse effects were cited. For example the �fast growing cancer-like cells� were highlighted.)] TJ ET
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BT 533.332 109.363 Td /F1 9.8 Tf  [( While )] TJ ET
BT 26.250 97.458 Td /F1 9.8 Tf  [(such statement were allusions rather than definitive statements, the problematisation of vaccine safety was evident in this )] TJ ET
BT 26.250 85.554 Td /F1 9.8 Tf  [(account. It is also significant, because while \(for example\) allusions to the possible carcinogenic nature of the vaccines was not )] TJ ET
BT 26.250 73.649 Td /F1 9.8 Tf  [(greatly emphasised within the Council of Europe�s hearing on the pandemic, such statements had been mobilised by the media )] TJ ET
BT 26.250 61.744 Td /F1 9.8 Tf  [(and actors within the anti-vaccination movement,)] TJ ET
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BT 26.250 731.762 Td /F1 9.8 Tf  [(objectivity but in terms of wider institutional structures, is therefore fundamental to perceptions surrounding vaccination.)] TJ ET
BT 26.250 695.159 Td /F4 12.0 Tf  [(The Efficacy of Vaccination)] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(There is now a wide literature within the social sciences suggesting that the perception and management of risk is central to )] TJ ET
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BT 311.311 663.300 Td /F1 9.8 Tf  [( The notion of risk is particularly key to the issue of vaccine )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(hesitancy � here, a lack of vaccine uptake is a choice \(rather than a problem of lack of access\), and this choice is underpinned )] TJ ET
BT 26.250 639.491 Td /F1 9.8 Tf  [(by an understanding of the relative advantages and disadvantages of vaccine use. In assessing the benefits of vaccination, )] TJ ET
BT 26.250 627.586 Td /F1 9.8 Tf  [(questions of efficacy are central. One of the ways in which vaccines are problematized is through challenging notions of )] TJ ET
BT 26.250 615.681 Td /F1 9.8 Tf  [(efficacy, either at the general level or in regard to a particular type of vaccination. Such narratives of \(in\)efficacy were central to )] TJ ET
BT 26.250 603.777 Td /F1 9.8 Tf  [(the Council of Europe actors� representation of the H1N1 vaccination campaign.)] TJ ET
BT 26.250 584.372 Td /F1 9.8 Tf  [(The Council of Europe critics contested the need for administering vaccination against H1N1. The decision to undertake a mass )] TJ ET
BT 26.250 572.467 Td /F1 9.8 Tf  [(immunisation campaign against the pandemic strain was decried as �without sufficient justification� and unnecessary \(Circene, )] TJ ET
BT 26.250 560.562 Td /F1 9.8 Tf  [(representative for Latvia\).)] TJ ET
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0.271 0.267 0.267 rg
BT 146.433 560.562 Td /F1 9.8 Tf  [( This suggestion was reinforced � with the benefit of hindsight � by comparisons between countries )] TJ ET
BT 26.250 548.658 Td /F1 9.8 Tf  [(that undertook vaccination and those that did not. So for example, it was argued that �[t]he country that spent the least was )] TJ ET
BT 26.250 536.753 Td /F1 9.8 Tf  [(Poland, which rejected the idea that this disease was dangerous and which has suspicions about the safety of the vaccine�� )] TJ ET
BT 26.250 524.848 Td /F1 9.8 Tf  [(where, compared the Britain�s comparatively larger spending on pharmaceuticals ��the number of deaths per million from )] TJ ET
BT 26.250 512.943 Td /F1 9.8 Tf  [(swine flu in Britain was about twice the number in Poland� \(Flynn\).)] TJ ET
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BT 310.190 514.451 Td /F4 8.7 Tf  [(10)] TJ ET
0.271 0.267 0.267 rg
BT 319.827 512.943 Td /F1 9.8 Tf  [( It was suggested that vaccination was therefore not an )] TJ ET
BT 26.250 501.039 Td /F1 9.8 Tf  [(effective public health response to H1N1.)] TJ ET
BT 26.250 481.634 Td /F1 9.8 Tf  [(In addition to specific criticisms of the efficacy of the H1N1 vaccine, the critics also suggested that vaccination more generally )] TJ ET
BT 26.250 469.729 Td /F1 9.8 Tf  [(does not act as an efficient public health measure. For example, Tom Jefferson from the Cochrane Institute was called in to )] TJ ET
BT 26.250 457.824 Td /F1 9.8 Tf  [(provide expert testimony on the case. Dr Jefferson argued that �vaccines and antivirals have a weak or non-existent evidence )] TJ ET
BT 26.250 445.920 Td /F1 9.8 Tf  [(base against influenza�.)] TJ ET
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BT 128.137 447.427 Td /F4 8.7 Tf  [(14)] TJ ET
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BT 137.775 445.920 Td /F1 9.8 Tf  [( Such statements undermined the fundamental concept that influenza vaccination is an effective )] TJ ET
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BT 453.310 423.617 Td /F4 8.7 Tf  [(14)] TJ ET
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BT 462.947 422.110 Td /F1 9.8 Tf  [( Other public health )] TJ ET
BT 26.250 410.205 Td /F1 9.8 Tf  [(measures were described as having �a much better evidence base than vaccines�.)] TJ ET
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BT 379.570 411.713 Td /F4 8.7 Tf  [(14)] TJ ET
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BT 26.250 390.801 Td /F1 9.8 Tf  [(The strategy of emphasising the lack of efficacy of vaccine use is a key narrative in problematizing vaccination. In the case of )] TJ ET
BT 26.250 378.896 Td /F1 9.8 Tf  [(H1N1, it was suggested that vaccines were a costly and ineffective strategy against the pandemic. This uptake of narratives )] TJ ET
BT 26.250 366.991 Td /F1 9.8 Tf  [(serves to minimise the �benefit� aspect of the risk-to-benefit estimate that is central to estimations of the utility of vaccination.)] TJ ET
BT 26.250 330.389 Td /F4 12.0 Tf  [(Vaccine Safety)] TJ ET
BT 26.250 310.434 Td /F1 9.8 Tf  [(Vaccine hesitancy at the individual level highlights the important role of the relative \(perceived\) weight of the risk of vaccination )] TJ ET
BT 26.250 298.530 Td /F1 9.8 Tf  [(to the benefits incurred. Perceptions of the severity of the disease being vaccination against are weighed up against perceptions )] TJ ET
BT 26.250 286.625 Td /F1 9.8 Tf  [(of adverse reactions to vaccination. Counter-vaccination movements are particularly prone to discourses of risk and uncertainty )] TJ ET
BT 26.250 274.720 Td /F1 9.8 Tf  [(� vaccines are characterised as unsafe due to the risks of severe or lasting medical consequences. Unlike the short term and )] TJ ET
BT 26.250 262.815 Td /F1 9.8 Tf  [(acute reactions acknowledged by the medical community, counter-vaccine narratives commonly emphasise long-term and )] TJ ET
BT 26.250 250.911 Td /F1 9.8 Tf  [(severe reactions to vaccination.)] TJ ET
BT 26.250 231.506 Td /F1 9.8 Tf  [(Narratives that problematized vaccine safety were therefore central to the Council of Europe critics� discussions. It was argued )] TJ ET
BT 26.250 219.601 Td /F1 9.8 Tf  [(that �several independent medical experts raised warnings regarding excessive vaccination�[where]�there was no clinical )] TJ ET
BT 26.250 207.696 Td /F1 9.8 Tf  [(scientific evidence to justify this�.)] TJ ET
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BT 166.591 209.204 Td /F4 8.7 Tf  [(11)] TJ ET
0.271 0.267 0.267 rg
BT 176.229 207.696 Td /F1 9.8 Tf  [( The safety of vaccination was questioned and problematized.)] TJ ET
BT 26.250 188.292 Td /F1 9.8 Tf  [(In the case of H1N1, an important point of contention revolved around the novel manufacturing method, which was used, it was )] TJ ET
BT 26.250 176.387 Td /F1 9.8 Tf  [(argued, due to the concern over quickening production and furthering profits. It was suggested that the vaccines �primarily )] TJ ET
BT 26.250 164.482 Td /F1 9.8 Tf  [(follow[ed] economic strategies and was not to optimise public health needs�.)] TJ ET
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BT 353.567 165.989 Td /F4 8.7 Tf  [(15)] TJ ET
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BT 363.205 164.482 Td /F1 9.8 Tf  [( This method, it was argued �involved higher risks )] TJ ET
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BT 26.250 140.673 Td /F1 9.8 Tf  [(system manifold, which means that they could possibly lead to autoimmune diseases \(such as multiple sclerosis\) and )] TJ ET
BT 26.250 128.768 Td /F1 9.8 Tf  [(immunological complication�.)] TJ ET
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BT 150.319 130.275 Td /F4 8.7 Tf  [(15)] TJ ET
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BT 26.250 109.363 Td /F1 9.8 Tf  [(Several other potential adverse effects were cited. For example the �fast growing cancer-like cells� were highlighted.)] TJ ET
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BT 523.695 110.870 Td /F4 8.7 Tf  [(15)] TJ ET
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BT 533.332 109.363 Td /F1 9.8 Tf  [( While )] TJ ET
BT 26.250 97.458 Td /F1 9.8 Tf  [(such statement were allusions rather than definitive statements, the problematisation of vaccine safety was evident in this )] TJ ET
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BT 26.250 750.278 Td /F4 12.0 Tf  [(Conclusions)] TJ ET
BT 26.250 730.324 Td /F1 9.8 Tf  [(In order to understand the ways in which individuals make decisions regarding vaccine use, it is important to access the public )] TJ ET
BT 26.250 718.419 Td /F1 9.8 Tf  [(discourse surrounding vaccination. Such narratives incorporate ideas about vaccinations which, while contrary to medical and )] TJ ET
BT 26.250 706.515 Td /F1 9.8 Tf  [(scientific viewpoints, underpins the public understanding of vaccines. As such, it is important to see vaccine hesitancy as much )] TJ ET
BT 26.250 694.610 Td /F1 9.8 Tf  [(a result of public discourse as it is a problem of individual decision-making.)] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(The Council of Europe�s criticisms of the use of vaccines during the H1N1 Pandemic reflect many dominant discourses � lay )] TJ ET
BT 26.250 663.300 Td /F1 9.8 Tf  [(understandings of vaccination and public representations of vaccination -that may inform vaccine hesitancy. Contestations such )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(as this one, and the ways in which such debates are subsequently picked up by the media, have the potential to significantly )] TJ ET
BT 26.250 639.491 Td /F1 9.8 Tf  [(shape the public discourse. Simultaneously, this debate mirrors and mobilises common sentiments surrounding vaccines.)] TJ ET
BT 26.250 620.086 Td /F1 9.8 Tf  [(Key to the Council of Europe�s account were three issues: the problem of trust in relation to the decision to use vaccines to )] TJ ET
BT 26.250 608.181 Td /F1 9.8 Tf  [(combat H1N1, the problem of efficacy in terms of vaccines generally and the H1N1 vaccine specifically, and the problem of the )] TJ ET
BT 26.250 596.277 Td /F1 9.8 Tf  [(risk posed by mass vaccination and the safety of the H1N1 vaccines. Examining the vaccine counter-narratives provides )] TJ ET
BT 26.250 584.372 Td /F1 9.8 Tf  [(information that may be considered in addressing vaccine hesitancy. Trust building will be central to the task of impacting upon )] TJ ET
BT 26.250 572.467 Td /F1 9.8 Tf  [(the public debate. Likewise, effective communication of issues of risk and trust � in ways that speak directly to the existing )] TJ ET
BT 26.250 560.562 Td /F1 9.8 Tf  [(public understanding of vaccines � is also vital. Consequently it is important to acknowledge vaccine hesitancy as a problem not )] TJ ET
BT 26.250 548.658 Td /F1 9.8 Tf  [(just of the individual level, but critically also of the social.)] TJ ET
BT 26.250 512.055 Td /F4 12.0 Tf  [(Competing Interests)] TJ ET
BT 26.250 492.101 Td /F1 9.8 Tf  [(The authors have declared that no competing interests exist.)] TJ ET
BT 26.250 455.498 Td /F4 12.0 Tf  [(References)] TJ ET
BT 26.250 428.044 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 428.044 Td /F1 9.8 Tf  [(Wodarg, W. \( 18/12/09\) Faked Pandemics � A threat to Health. Motion of a Recommendation by the Parliamentary Assembly )] TJ ET
BT 26.250 416.139 Td /F1 9.8 Tf  [(of the Council of Europe Doc. 122110. Strasbourg: Council of Europe)] TJ ET
BT 26.250 396.735 Td /F1 9.8 Tf  [(2.)] TJ ET
BT 38.132 396.735 Td /F1 9.8 Tf  [(Lupton, D. \(1994\), Moral Threats and Dangerous Desires: AIDS and the News Media, London, Taylor and Francis.)] TJ ET
BT 26.250 377.330 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 377.330 Td /F1 9.8 Tf  [(Franozi, R. \(1998\), 'Narrative Analysis - Or Why \(and How\) Sociologists Should be Interested in Narrative', Annual Review of )] TJ ET
BT 26.250 365.425 Td /F1 9.8 Tf  [(Sociology, 24, 517-54.)] TJ ET
BT 26.250 346.020 Td /F1 9.8 Tf  [(4.)] TJ ET
BT 38.132 346.020 Td /F1 9.8 Tf  [(Stern, B.J. \(1941\). Society and medical progress. Princeton, Princeton University Press.)] TJ ET
BT 26.250 326.616 Td /F1 9.8 Tf  [(5.)] TJ ET
BT 38.132 326.616 Td /F1 9.8 Tf  [(Hobson-West, P. \(2003\). �Understanding Vaccine Resistance: Moving Beyond Risk� Health, Risk & Society, 5\(3\):273-283)] TJ ET
BT 26.250 307.211 Td /F1 9.8 Tf  [(6.)] TJ ET
BT 38.132 307.211 Td /F1 9.8 Tf  [(Blume, S. \(2003\). �Anti-vaccination Movements and their Interpretations,� Social Science & Medicine, 62\(3\): 628-642)] TJ ET
BT 26.250 287.806 Td /F1 9.8 Tf  [(7.)] TJ ET
BT 38.132 287.806 Td /F1 9.8 Tf  [(Dew, K. \(1999\). �Epidemics, Pandemic and Power: Representations of Measles and Measles Vaccines� Health: An )] TJ ET
BT 26.250 275.901 Td /F1 9.8 Tf  [(Interdisciplinary Journal, 3\(4\): 379�398)] TJ ET
BT 26.250 256.497 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 256.497 Td /F1 9.8 Tf  [(Fukuda, K. \(06/12/09\) WHO Press Briefing 03/12/09, available at: )] TJ ET
BT 26.250 244.592 Td /F1 9.8 Tf  [(http://www.who.int/mediacentre/multimedia/swineflupressbriefings/en/index.html)] TJ ET
BT 26.250 225.187 Td /F1 9.8 Tf  [(9.)] TJ ET
BT 38.132 225.187 Td /F1 9.8 Tf  [(Kieny, M-P. \(06/08/09\) WHO Press Briefing 06/07/09, available at: )] TJ ET
BT 26.250 213.282 Td /F1 9.8 Tf  [(http://www.who.int/mediacentre/multimedia/swineflupressbriefings/en/index.html)] TJ ET
BT 26.250 193.878 Td /F1 9.8 Tf  [(10.)] TJ ET
BT 43.553 193.878 Td /F1 9.8 Tf  [(Council of Europe Parliamentary Assembly \(24/06/10\). Verbatim Report � Twenty-Sixth Sitting of the Parliamentary )] TJ ET
BT 26.250 181.973 Td /F1 9.8 Tf  [(Assembly of the Council of Europe. [online] available at: )] TJ ET
BT 26.250 170.068 Td /F1 9.8 Tf  [(http://assembly.coe.int/Main.asp?/Documents/Records/2010/E/10062441500.htm)] TJ ET
BT 26.250 150.663 Td /F1 9.8 Tf  [(11.)] TJ ET
BT 43.553 150.663 Td /F1 9.8 Tf  [(Flynn, P \(23/03/10\). Memorandum: The Handling of the H1N1 Pandemic: More Transparency Needed. [online] available at: )] TJ ET
BT 26.250 138.759 Td /F1 9.8 Tf  [(http://www.assembly.coe.int/CommitteeDocs/2010/20122329_MemorandumPandemic_E.htm)] TJ ET
BT 26.250 119.354 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 119.354 Td /F1 9.8 Tf  [(Flynn, P. \(29/03/10\) Speech � Paul Flynn, Rapporteur. [online] available at: mms://coenews.int.vod/100329_w01_w.wnv)] TJ ET
BT 26.250 99.949 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 99.949 Td /F1 9.8 Tf  [(Flynn, P. \(07/06/10\). The Handling of the H1N1 Pandemic: More Transparency Needed. [Doc no. 12283 � Passed by the )] TJ ET
BT 26.250 88.044 Td /F1 9.8 Tf  [(Council of Europe 24/06/10])] TJ ET
BT 26.250 68.640 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 68.640 Td /F1 9.8 Tf  [(Jefferson, T. \(29/03/10\). Speech � Dr. Tom Jefferson, The Cochrane Collaboration. [online] available at: )] TJ ET
BT 26.250 56.735 Td /F1 9.8 Tf  [(mms://coenews.int.vod/100329_w01_w.wnv)] TJ ET
Q
q
15.000 46.854 577.500 730.146 re W n
0.271 0.267 0.267 rg
BT 26.250 750.278 Td /F4 12.0 Tf  [(Conclusions)] TJ ET
BT 26.250 730.324 Td /F1 9.8 Tf  [(In order to understand the ways in which individuals make decisions regarding vaccine use, it is important to access the public )] TJ ET
BT 26.250 718.419 Td /F1 9.8 Tf  [(discourse surrounding vaccination. Such narratives incorporate ideas about vaccinations which, while contrary to medical and )] TJ ET
BT 26.250 706.515 Td /F1 9.8 Tf  [(scientific viewpoints, underpins the public understanding of vaccines. As such, it is important to see vaccine hesitancy as much )] TJ ET
BT 26.250 694.610 Td /F1 9.8 Tf  [(a result of public discourse as it is a problem of individual decision-making.)] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(The Council of Europe�s criticisms of the use of vaccines during the H1N1 Pandemic reflect many dominant discourses � lay )] TJ ET
BT 26.250 663.300 Td /F1 9.8 Tf  [(understandings of vaccination and public representations of vaccination -that may inform vaccine hesitancy. Contestations such )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(as this one, and the ways in which such debates are subsequently picked up by the media, have the potential to significantly )] TJ ET
BT 26.250 639.491 Td /F1 9.8 Tf  [(shape the public discourse. Simultaneously, this debate mirrors and mobilises common sentiments surrounding vaccines.)] TJ ET
BT 26.250 620.086 Td /F1 9.8 Tf  [(Key to the Council of Europe�s account were three issues: the problem of trust in relation to the decision to use vaccines to )] TJ ET
BT 26.250 608.181 Td /F1 9.8 Tf  [(combat H1N1, the problem of efficacy in terms of vaccines generally and the H1N1 vaccine specifically, and the problem of the )] TJ ET
BT 26.250 596.277 Td /F1 9.8 Tf  [(risk posed by mass vaccination and the safety of the H1N1 vaccines. Examining the vaccine counter-narratives provides )] TJ ET
BT 26.250 584.372 Td /F1 9.8 Tf  [(information that may be considered in addressing vaccine hesitancy. Trust building will be central to the task of impacting upon )] TJ ET
BT 26.250 572.467 Td /F1 9.8 Tf  [(the public debate. Likewise, effective communication of issues of risk and trust � in ways that speak directly to the existing )] TJ ET
BT 26.250 560.562 Td /F1 9.8 Tf  [(public understanding of vaccines � is also vital. Consequently it is important to acknowledge vaccine hesitancy as a problem not )] TJ ET
BT 26.250 548.658 Td /F1 9.8 Tf  [(just of the individual level, but critically also of the social.)] TJ ET
BT 26.250 512.055 Td /F4 12.0 Tf  [(Competing Interests)] TJ ET
BT 26.250 492.101 Td /F1 9.8 Tf  [(The authors have declared that no competing interests exist.)] TJ ET
BT 26.250 455.498 Td /F4 12.0 Tf  [(References)] TJ ET
BT 26.250 428.044 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 428.044 Td /F1 9.8 Tf  [(Wodarg, W. \( 18/12/09\) Faked Pandemics � A threat to Health. Motion of a Recommendation by the Parliamentary Assembly )] TJ ET
BT 26.250 416.139 Td /F1 9.8 Tf  [(of the Council of Europe Doc. 122110. Strasbourg: Council of Europe)] TJ ET
BT 26.250 396.735 Td /F1 9.8 Tf  [(2.)] TJ ET
BT 38.132 396.735 Td /F1 9.8 Tf  [(Lupton, D. \(1994\), Moral Threats and Dangerous Desires: AIDS and the News Media, London, Taylor and Francis.)] TJ ET
BT 26.250 377.330 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 377.330 Td /F1 9.8 Tf  [(Franozi, R. \(1998\), 'Narrative Analysis - Or Why \(and How\) Sociologists Should be Interested in Narrative', Annual Review of )] TJ ET
BT 26.250 365.425 Td /F1 9.8 Tf  [(Sociology, 24, 517-54.)] TJ ET
BT 26.250 346.020 Td /F1 9.8 Tf  [(4.)] TJ ET
BT 38.132 346.020 Td /F1 9.8 Tf  [(Stern, B.J. \(1941\). Society and medical progress. Princeton, Princeton University Press.)] TJ ET
BT 26.250 326.616 Td /F1 9.8 Tf  [(5.)] TJ ET
BT 38.132 326.616 Td /F1 9.8 Tf  [(Hobson-West, P. \(2003\). �Understanding Vaccine Resistance: Moving Beyond Risk� Health, Risk & Society, 5\(3\):273-283)] TJ ET
BT 26.250 307.211 Td /F1 9.8 Tf  [(6.)] TJ ET
BT 38.132 307.211 Td /F1 9.8 Tf  [(Blume, S. \(2003\). �Anti-vaccination Movements and their Interpretations,� Social Science & Medicine, 62\(3\): 628-642)] TJ ET
BT 26.250 287.806 Td /F1 9.8 Tf  [(7.)] TJ ET
BT 38.132 287.806 Td /F1 9.8 Tf  [(Dew, K. \(1999\). �Epidemics, Pandemic and Power: Representations of Measles and Measles Vaccines� Health: An )] TJ ET
BT 26.250 275.901 Td /F1 9.8 Tf  [(Interdisciplinary Journal, 3\(4\): 379�398)] TJ ET
BT 26.250 256.497 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 256.497 Td /F1 9.8 Tf  [(Fukuda, K. \(06/12/09\) WHO Press Briefing 03/12/09, available at: )] TJ ET
BT 26.250 244.592 Td /F1 9.8 Tf  [(http://www.who.int/mediacentre/multimedia/swineflupressbriefings/en/index.html)] TJ ET
BT 26.250 225.187 Td /F1 9.8 Tf  [(9.)] TJ ET
BT 38.132 225.187 Td /F1 9.8 Tf  [(Kieny, M-P. \(06/08/09\) WHO Press Briefing 06/07/09, available at: )] TJ ET
BT 26.250 213.282 Td /F1 9.8 Tf  [(http://www.who.int/mediacentre/multimedia/swineflupressbriefings/en/index.html)] TJ ET
BT 26.250 193.878 Td /F1 9.8 Tf  [(10.)] TJ ET
BT 43.553 193.878 Td /F1 9.8 Tf  [(Council of Europe Parliamentary Assembly \(24/06/10\). Verbatim Report � Twenty-Sixth Sitting of the Parliamentary )] TJ ET
BT 26.250 181.973 Td /F1 9.8 Tf  [(Assembly of the Council of Europe. [online] available at: )] TJ ET
BT 26.250 170.068 Td /F1 9.8 Tf  [(http://assembly.coe.int/Main.asp?/Documents/Records/2010/E/10062441500.htm)] TJ ET
BT 26.250 150.663 Td /F1 9.8 Tf  [(11.)] TJ ET
BT 43.553 150.663 Td /F1 9.8 Tf  [(Flynn, P \(23/03/10\). Memorandum: The Handling of the H1N1 Pandemic: More Transparency Needed. [online] available at: )] TJ ET
BT 26.250 138.759 Td /F1 9.8 Tf  [(http://www.assembly.coe.int/CommitteeDocs/2010/20122329_MemorandumPandemic_E.htm)] TJ ET
BT 26.250 119.354 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 119.354 Td /F1 9.8 Tf  [(Flynn, P. \(29/03/10\) Speech � Paul Flynn, Rapporteur. [online] available at: mms://coenews.int.vod/100329_w01_w.wnv)] TJ ET
BT 26.250 99.949 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 99.949 Td /F1 9.8 Tf  [(Flynn, P. \(07/06/10\). The Handling of the H1N1 Pandemic: More Transparency Needed. [Doc no. 12283 � Passed by the )] TJ ET
BT 26.250 88.044 Td /F1 9.8 Tf  [(Council of Europe 24/06/10])] TJ ET
BT 26.250 68.640 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 68.640 Td /F1 9.8 Tf  [(Jefferson, T. \(29/03/10\). Speech � Dr. Tom Jefferson, The Cochrane Collaboration. [online] available at: )] TJ ET
BT 26.250 56.735 Td /F1 9.8 Tf  [(mms://coenews.int.vod/100329_w01_w.wnv)] TJ ET
Q
q
15.000 46.854 577.500 730.146 re W n
0.271 0.267 0.267 rg
BT 26.250 750.278 Td /F4 12.0 Tf  [(Conclusions)] TJ ET
BT 26.250 730.324 Td /F1 9.8 Tf  [(In order to understand the ways in which individuals make decisions regarding vaccine use, it is important to access the public )] TJ ET
BT 26.250 718.419 Td /F1 9.8 Tf  [(discourse surrounding vaccination. Such narratives incorporate ideas about vaccinations which, while contrary to medical and )] TJ ET
BT 26.250 706.515 Td /F1 9.8 Tf  [(scientific viewpoints, underpins the public understanding of vaccines. As such, it is important to see vaccine hesitancy as much )] TJ ET
BT 26.250 694.610 Td /F1 9.8 Tf  [(a result of public discourse as it is a problem of individual decision-making.)] TJ ET
BT 26.250 675.205 Td /F1 9.8 Tf  [(The Council of Europe�s criticisms of the use of vaccines during the H1N1 Pandemic reflect many dominant discourses � lay )] TJ ET
BT 26.250 663.300 Td /F1 9.8 Tf  [(understandings of vaccination and public representations of vaccination -that may inform vaccine hesitancy. Contestations such )] TJ ET
BT 26.250 651.396 Td /F1 9.8 Tf  [(as this one, and the ways in which such debates are subsequently picked up by the media, have the potential to significantly )] TJ ET
BT 26.250 639.491 Td /F1 9.8 Tf  [(shape the public discourse. Simultaneously, this debate mirrors and mobilises common sentiments surrounding vaccines.)] TJ ET
BT 26.250 620.086 Td /F1 9.8 Tf  [(Key to the Council of Europe�s account were three issues: the problem of trust in relation to the decision to use vaccines to )] TJ ET
BT 26.250 608.181 Td /F1 9.8 Tf  [(combat H1N1, the problem of efficacy in terms of vaccines generally and the H1N1 vaccine specifically, and the problem of the )] TJ ET
BT 26.250 596.277 Td /F1 9.8 Tf  [(risk posed by mass vaccination and the safety of the H1N1 vaccines. Examining the vaccine counter-narratives provides )] TJ ET
BT 26.250 584.372 Td /F1 9.8 Tf  [(information that may be considered in addressing vaccine hesitancy. Trust building will be central to the task of impacting upon )] TJ ET
BT 26.250 572.467 Td /F1 9.8 Tf  [(the public debate. Likewise, effective communication of issues of risk and trust � in ways that speak directly to the existing )] TJ ET
BT 26.250 560.562 Td /F1 9.8 Tf  [(public understanding of vaccines � is also vital. Consequently it is important to acknowledge vaccine hesitancy as a problem not )] TJ ET
BT 26.250 548.658 Td /F1 9.8 Tf  [(just of the individual level, but critically also of the social.)] TJ ET
BT 26.250 512.055 Td /F4 12.0 Tf  [(Competing Interests)] TJ ET
BT 26.250 492.101 Td /F1 9.8 Tf  [(The authors have declared that no competing interests exist.)] TJ ET
BT 26.250 455.498 Td /F4 12.0 Tf  [(References)] TJ ET
BT 26.250 428.044 Td /F1 9.8 Tf  [(1.)] TJ ET
BT 38.132 428.044 Td /F1 9.8 Tf  [(Wodarg, W. \( 18/12/09\) Faked Pandemics � A threat to Health. Motion of a Recommendation by the Parliamentary Assembly )] TJ ET
BT 26.250 416.139 Td /F1 9.8 Tf  [(of the Council of Europe Doc. 122110. Strasbourg: Council of Europe)] TJ ET
BT 26.250 396.735 Td /F1 9.8 Tf  [(2.)] TJ ET
BT 38.132 396.735 Td /F1 9.8 Tf  [(Lupton, D. \(1994\), Moral Threats and Dangerous Desires: AIDS and the News Media, London, Taylor and Francis.)] TJ ET
BT 26.250 377.330 Td /F1 9.8 Tf  [(3.)] TJ ET
BT 38.132 377.330 Td /F1 9.8 Tf  [(Franozi, R. \(1998\), 'Narrative Analysis - Or Why \(and How\) Sociologists Should be Interested in Narrative', Annual Review of )] TJ ET
BT 26.250 365.425 Td /F1 9.8 Tf  [(Sociology, 24, 517-54.)] TJ ET
BT 26.250 346.020 Td /F1 9.8 Tf  [(4.)] TJ ET
BT 38.132 346.020 Td /F1 9.8 Tf  [(Stern, B.J. \(1941\). Society and medical progress. Princeton, Princeton University Press.)] TJ ET
BT 26.250 326.616 Td /F1 9.8 Tf  [(5.)] TJ ET
BT 38.132 326.616 Td /F1 9.8 Tf  [(Hobson-West, P. \(2003\). �Understanding Vaccine Resistance: Moving Beyond Risk� Health, Risk & Society, 5\(3\):273-283)] TJ ET
BT 26.250 307.211 Td /F1 9.8 Tf  [(6.)] TJ ET
BT 38.132 307.211 Td /F1 9.8 Tf  [(Blume, S. \(2003\). �Anti-vaccination Movements and their Interpretations,� Social Science & Medicine, 62\(3\): 628-642)] TJ ET
BT 26.250 287.806 Td /F1 9.8 Tf  [(7.)] TJ ET
BT 38.132 287.806 Td /F1 9.8 Tf  [(Dew, K. \(1999\). �Epidemics, Pandemic and Power: Representations of Measles and Measles Vaccines� Health: An )] TJ ET
BT 26.250 275.901 Td /F1 9.8 Tf  [(Interdisciplinary Journal, 3\(4\): 379�398)] TJ ET
BT 26.250 256.497 Td /F1 9.8 Tf  [(8.)] TJ ET
BT 38.132 256.497 Td /F1 9.8 Tf  [(Fukuda, K. \(06/12/09\) WHO Press Briefing 03/12/09, available at: )] TJ ET
BT 26.250 244.592 Td /F1 9.8 Tf  [(http://www.who.int/mediacentre/multimedia/swineflupressbriefings/en/index.html)] TJ ET
BT 26.250 225.187 Td /F1 9.8 Tf  [(9.)] TJ ET
BT 38.132 225.187 Td /F1 9.8 Tf  [(Kieny, M-P. \(06/08/09\) WHO Press Briefing 06/07/09, available at: )] TJ ET
BT 26.250 213.282 Td /F1 9.8 Tf  [(http://www.who.int/mediacentre/multimedia/swineflupressbriefings/en/index.html)] TJ ET
BT 26.250 193.878 Td /F1 9.8 Tf  [(10.)] TJ ET
BT 43.553 193.878 Td /F1 9.8 Tf  [(Council of Europe Parliamentary Assembly \(24/06/10\). Verbatim Report � Twenty-Sixth Sitting of the Parliamentary )] TJ ET
BT 26.250 181.973 Td /F1 9.8 Tf  [(Assembly of the Council of Europe. [online] available at: )] TJ ET
BT 26.250 170.068 Td /F1 9.8 Tf  [(http://assembly.coe.int/Main.asp?/Documents/Records/2010/E/10062441500.htm)] TJ ET
BT 26.250 150.663 Td /F1 9.8 Tf  [(11.)] TJ ET
BT 43.553 150.663 Td /F1 9.8 Tf  [(Flynn, P \(23/03/10\). Memorandum: The Handling of the H1N1 Pandemic: More Transparency Needed. [online] available at: )] TJ ET
BT 26.250 138.759 Td /F1 9.8 Tf  [(http://www.assembly.coe.int/CommitteeDocs/2010/20122329_MemorandumPandemic_E.htm)] TJ ET
BT 26.250 119.354 Td /F1 9.8 Tf  [(12.)] TJ ET
BT 43.553 119.354 Td /F1 9.8 Tf  [(Flynn, P. \(29/03/10\) Speech � Paul Flynn, Rapporteur. [online] available at: mms://coenews.int.vod/100329_w01_w.wnv)] TJ ET
BT 26.250 99.949 Td /F1 9.8 Tf  [(13.)] TJ ET
BT 43.553 99.949 Td /F1 9.8 Tf  [(Flynn, P. \(07/06/10\). The Handling of the H1N1 Pandemic: More Transparency Needed. [Doc no. 12283 � Passed by the )] TJ ET
BT 26.250 88.044 Td /F1 9.8 Tf  [(Council of Europe 24/06/10])] TJ ET
BT 26.250 68.640 Td /F1 9.8 Tf  [(14.)] TJ ET
BT 43.553 68.640 Td /F1 9.8 Tf  [(Jefferson, T. \(29/03/10\). Speech � Dr. Tom Jefferson, The Cochrane Collaboration. [online] available at: )] TJ ET
BT 26.250 56.735 Td /F1 9.8 Tf  [(mms://coenews.int.vod/100329_w01_w.wnv)] TJ ET
Q
q
0.000 0.000 0.000 rg
BT 291.710 19.825 Td /F1 11.0 Tf  [(4)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Outbreaks)] TJ ET

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q
15.000 547.238 577.500 229.762 re W n
0.271 0.267 0.267 rg
BT 26.250 759.976 Td /F1 9.8 Tf  [(15.)] TJ ET
BT 43.553 759.976 Td /F1 9.8 Tf  [(Wodarg, W \(26/01/10\) Hearing on �The Handling of the H1N1 Pandemic� More Transparency Needed?� [online] available )] TJ ET
BT 26.250 748.071 Td /F1 9.8 Tf  [(at: http://www.coe.int/t/DC/Files/PA_session/jan_2010)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(16.)] TJ ET
BT 43.553 728.667 Td /F1 9.8 Tf  [(Council of Europe PACE Meeting \(29/03/10\). Questions and Debate. [online] available at: )] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(http://www.assembly.coe.int/CommitteeDocs/2010/20122329)] TJ ET
BT 26.250 697.357 Td /F1 9.8 Tf  [(17.)] TJ ET
BT 43.553 697.357 Td /F1 9.8 Tf  [(Bean, S. J. \(2011\). �Emerging and Continuing Trends in Vaccine Opposition Website Content� Vaccine, 29\(10\):1874-1880)] TJ ET
BT 26.250 677.952 Td /F1 9.8 Tf  [(18.)] TJ ET
BT 43.553 677.952 Td /F1 9.8 Tf  [(Bauman, Z. \(1999\), Post-Modernity and its Discontents, Cambridge, Polity Press.)] TJ ET
BT 26.250 658.548 Td /F1 9.8 Tf  [(19.)] TJ ET
BT 43.553 658.548 Td /F1 9.8 Tf  [(Beck, U. \(1992\), Risk Society: Towards a New Modernity, London, Sage)] TJ ET
BT 26.250 639.143 Td /F1 9.8 Tf  [(20.)] TJ ET
BT 43.553 639.143 Td /F1 9.8 Tf  [(Ncayiyana, D.J. \(2010\), 'H1N1 Hype a Treasure Trove for Conspiracy Theorists', South African Medical Journal, 100:131-)] TJ ET
BT 26.250 627.238 Td /F1 9.8 Tf  [(131.)] TJ ET
BT 26.250 607.833 Td /F1 9.8 Tf  [(21.)] TJ ET
BT 43.553 607.833 Td /F1 9.8 Tf  [(Odent, B. \(2010\), 'Influenza A: "They Organized a Psychosis"', Humanit� \(English translation version\) [online], )] TJ ET
BT 26.250 595.929 Td /F1 9.8 Tf  [(http://www.humaniteinenglish.com/spip.php?article1427.)] TJ ET
BT 26.250 576.524 Td /F1 9.8 Tf  [(22.)] TJ ET
BT 43.553 576.524 Td /F1 9.8 Tf  [(Wodarg, W. and Villesen, K. \(2009\), 'Faked Pandemic', Information \(English translation\) [online], )] TJ ET
BT 26.250 564.619 Td /F1 9.8 Tf  [(http://www.wodarg.de/english/3013320.html [accessed July 2010].)] TJ ET
Q
q
15.000 547.238 577.500 229.762 re W n
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BT 26.250 759.976 Td /F1 9.8 Tf  [(15.)] TJ ET
BT 43.553 759.976 Td /F1 9.8 Tf  [(Wodarg, W \(26/01/10\) Hearing on �The Handling of the H1N1 Pandemic� More Transparency Needed?� [online] available )] TJ ET
BT 26.250 748.071 Td /F1 9.8 Tf  [(at: http://www.coe.int/t/DC/Files/PA_session/jan_2010)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(16.)] TJ ET
BT 43.553 728.667 Td /F1 9.8 Tf  [(Council of Europe PACE Meeting \(29/03/10\). Questions and Debate. [online] available at: )] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(http://www.assembly.coe.int/CommitteeDocs/2010/20122329)] TJ ET
BT 26.250 697.357 Td /F1 9.8 Tf  [(17.)] TJ ET
BT 43.553 697.357 Td /F1 9.8 Tf  [(Bean, S. J. \(2011\). �Emerging and Continuing Trends in Vaccine Opposition Website Content� Vaccine, 29\(10\):1874-1880)] TJ ET
BT 26.250 677.952 Td /F1 9.8 Tf  [(18.)] TJ ET
BT 43.553 677.952 Td /F1 9.8 Tf  [(Bauman, Z. \(1999\), Post-Modernity and its Discontents, Cambridge, Polity Press.)] TJ ET
BT 26.250 658.548 Td /F1 9.8 Tf  [(19.)] TJ ET
BT 43.553 658.548 Td /F1 9.8 Tf  [(Beck, U. \(1992\), Risk Society: Towards a New Modernity, London, Sage)] TJ ET
BT 26.250 639.143 Td /F1 9.8 Tf  [(20.)] TJ ET
BT 43.553 639.143 Td /F1 9.8 Tf  [(Ncayiyana, D.J. \(2010\), 'H1N1 Hype a Treasure Trove for Conspiracy Theorists', South African Medical Journal, 100:131-)] TJ ET
BT 26.250 627.238 Td /F1 9.8 Tf  [(131.)] TJ ET
BT 26.250 607.833 Td /F1 9.8 Tf  [(21.)] TJ ET
BT 43.553 607.833 Td /F1 9.8 Tf  [(Odent, B. \(2010\), 'Influenza A: "They Organized a Psychosis"', Humanit� \(English translation version\) [online], )] TJ ET
BT 26.250 595.929 Td /F1 9.8 Tf  [(http://www.humaniteinenglish.com/spip.php?article1427.)] TJ ET
BT 26.250 576.524 Td /F1 9.8 Tf  [(22.)] TJ ET
BT 43.553 576.524 Td /F1 9.8 Tf  [(Wodarg, W. and Villesen, K. \(2009\), 'Faked Pandemic', Information \(English translation\) [online], )] TJ ET
BT 26.250 564.619 Td /F1 9.8 Tf  [(http://www.wodarg.de/english/3013320.html [accessed July 2010].)] TJ ET
Q
q
15.000 547.238 577.500 229.762 re W n
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BT 26.250 759.976 Td /F1 9.8 Tf  [(15.)] TJ ET
BT 43.553 759.976 Td /F1 9.8 Tf  [(Wodarg, W \(26/01/10\) Hearing on �The Handling of the H1N1 Pandemic� More Transparency Needed?� [online] available )] TJ ET
BT 26.250 748.071 Td /F1 9.8 Tf  [(at: http://www.coe.int/t/DC/Files/PA_session/jan_2010)] TJ ET
BT 26.250 728.667 Td /F1 9.8 Tf  [(16.)] TJ ET
BT 43.553 728.667 Td /F1 9.8 Tf  [(Council of Europe PACE Meeting \(29/03/10\). Questions and Debate. [online] available at: )] TJ ET
BT 26.250 716.762 Td /F1 9.8 Tf  [(http://www.assembly.coe.int/CommitteeDocs/2010/20122329)] TJ ET
BT 26.250 697.357 Td /F1 9.8 Tf  [(17.)] TJ ET
BT 43.553 697.357 Td /F1 9.8 Tf  [(Bean, S. J. \(2011\). �Emerging and Continuing Trends in Vaccine Opposition Website Content� Vaccine, 29\(10\):1874-1880)] TJ ET
BT 26.250 677.952 Td /F1 9.8 Tf  [(18.)] TJ ET
BT 43.553 677.952 Td /F1 9.8 Tf  [(Bauman, Z. \(1999\), Post-Modernity and its Discontents, Cambridge, Polity Press.)] TJ ET
BT 26.250 658.548 Td /F1 9.8 Tf  [(19.)] TJ ET
BT 43.553 658.548 Td /F1 9.8 Tf  [(Beck, U. \(1992\), Risk Society: Towards a New Modernity, London, Sage)] TJ ET
BT 26.250 639.143 Td /F1 9.8 Tf  [(20.)] TJ ET
BT 43.553 639.143 Td /F1 9.8 Tf  [(Ncayiyana, D.J. \(2010\), 'H1N1 Hype a Treasure Trove for Conspiracy Theorists', South African Medical Journal, 100:131-)] TJ ET
BT 26.250 627.238 Td /F1 9.8 Tf  [(131.)] TJ ET
BT 26.250 607.833 Td /F1 9.8 Tf  [(21.)] TJ ET
BT 43.553 607.833 Td /F1 9.8 Tf  [(Odent, B. \(2010\), 'Influenza A: "They Organized a Psychosis"', Humanit� \(English translation version\) [online], )] TJ ET
BT 26.250 595.929 Td /F1 9.8 Tf  [(http://www.humaniteinenglish.com/spip.php?article1427.)] TJ ET
BT 26.250 576.524 Td /F1 9.8 Tf  [(22.)] TJ ET
BT 43.553 576.524 Td /F1 9.8 Tf  [(Wodarg, W. and Villesen, K. \(2009\), 'Faked Pandemic', Information \(English translation\) [online], )] TJ ET
BT 26.250 564.619 Td /F1 9.8 Tf  [(http://www.wodarg.de/english/3013320.html [accessed July 2010].)] TJ ET
Q
q
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BT 291.710 19.825 Td /F1 11.0 Tf  [(5)] TJ ET
BT 25.000 19.825 Td /F1 11.0 Tf  [(PLOS Currents Outbreaks)] TJ ET

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