%PDF-1.3 1 0 obj << /Type /Catalog /Outlines 2 0 R /Pages 3 0 R >> endobj 2 0 obj << /Type /Outlines /Count 0 >> endobj 3 0 obj << /Type /Pages /Kids [6 0 R 136 0 R 450 0 R 506 0 R 654 0 R 722 0 R 724 0 R ] /Count 7 /Resources << /ProcSet 4 0 R /Font << /F1 8 0 R /F2 9 0 R /F3 10 0 R /F4 11 0 R /F5 12 0 R /F6 13 0 R >> /XObject << /I1 14 0 R /I2 15 0 R /I3 554 0 R /I4 555 0 R /I5 602 0 R /I6 603 0 R /I7 650 0 R /I8 651 0 R /I9 652 0 R /I10 653 0 R >> >> /MediaBox [0.000 0.000 612.000 792.000] >> endobj 4 0 obj [/PDF /Text /ImageC ] endobj 5 0 obj << /Creator (DOMPDF) /CreationDate (D:20180721151845+00'00') /ModDate (D:20180721151845+00'00') /Title (Vaccine Hesitancy: Clarifying a Theoretical Framework for an Ambiguous Notion PLOS Currents Outbreaks) >> endobj 6 0 obj << /Type /Page /Parent 3 0 R /Annots [ 16 0 R 18 0 R 20 0 R 22 0 R 24 0 R 26 0 R 28 0 R 30 0 R 32 0 R 34 0 R 36 0 R 38 0 R 40 0 R 42 0 R 44 0 R 46 0 R 48 0 R 50 0 R 52 0 R 54 0 R 56 0 R 58 0 R 60 0 R 62 0 R 64 0 R 66 0 R 68 0 R 70 0 R 72 0 R 74 0 R 76 0 R 78 0 R 80 0 R 82 0 R 84 0 R 86 0 R 88 0 R 90 0 R 92 0 R 94 0 R 96 0 R 98 0 R 100 0 R 102 0 R 104 0 R 106 0 R 108 0 R 110 0 R 112 0 R 114 0 R 116 0 R 118 0 R 120 0 R 122 0 R 124 0 R 126 0 R 128 0 R 130 0 R 132 0 R 134 0 R ] /Contents 7 0 R >> endobj 7 0 obj << /Length 26627 >> stream q 375.000 0 0 39.000 222.000 738.000 cm /I2 Do 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 Hesitancy: Clarifying a Theoretical Framework for an )] TJ ET BT 15.000 693.094 Td /F2 21.0 Tf [(Ambiguous Notion)] 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 [(Patrick Peretti-Watel)] TJ ET 0.271 0.267 0.267 rg BT 115.102 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 120.523 663.247 Td /F1 9.8 Tf [(Heidi J Larson)] TJ ET 0.271 0.267 0.267 rg BT 182.835 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 188.256 663.247 Td /F1 9.8 Tf [(Jeremy K. Ward)] TJ ET 0.271 0.267 0.267 rg BT 258.144 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 263.565 663.247 Td /F1 9.8 Tf [(William S Schulz)] TJ ET 0.271 0.267 0.267 rg BT 336.154 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 341.575 663.247 Td /F1 9.8 Tf [(Pierre Verger)] TJ ET 0.271 0.267 0.267 rg BT 26.250 651.342 Td /F1 9.8 Tf [(Peretti-Watel P, Larson HJ, Ward JK, Schulz WS, Verger P. Vaccine Hesitancy: Clarifying a Theoretical Framework for an )] TJ ET BT 26.250 639.438 Td /F1 9.8 Tf [(Ambiguous Notion. PLOS Currents Outbreaks. 2015 Feb 25 . Edition 1. doi: )] TJ ET BT 26.250 627.533 Td /F1 9.8 Tf [(10.1371/currents.outbreaks.6844c80ff9f5b273f34c91f71b7fc289.)] TJ ET q 15.000 46.187 577.500 578.965 re W n 0.271 0.267 0.267 rg BT 26.250 598.430 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 578.476 Td /F1 9.8 Tf [(Today, according to many public health experts, public confidence in vaccines is waning. The term vaccine hesitancy \(VH\) is )] TJ ET BT 26.250 566.571 Td /F1 9.8 Tf [(increasingly used to describe the spread of such vaccine reluctance. But VH is an ambiguous notion and its theoretical )] TJ ET BT 26.250 554.667 Td /F1 9.8 Tf [(background appears uncertain. To clarify this concept, we first review the current definitions of VH in the public health literature )] TJ ET BT 26.250 542.762 Td /F1 9.8 Tf [(and examine its most prominent characteristics. VH has been defined as a set of beliefs, attitudes, or behaviours, or some )] TJ ET BT 26.250 530.857 Td /F1 9.8 Tf [(combination of them, shared by a large and heterogeneous portion of the population and including people who exhibit reluctant )] TJ ET BT 26.250 518.952 Td /F1 9.8 Tf [(conformism \(they may either decline a vaccine, delay it or accept it despite their doubts\) and vaccine-specific behaviours. )] TJ ET BT 26.250 507.048 Td /F1 9.8 Tf [(Secondly, we underline some of the ambiguities of this notion and argue that it is more a catchall category than a real concept. )] TJ ET BT 26.250 495.143 Td /F1 9.8 Tf [(We also call into question the usefulness of understanding VH as an intermediate position along a continuum ranging from anti-)] TJ ET BT 26.250 483.238 Td /F1 9.8 Tf [(vaccine to pro-vaccine attitudes, and we discuss its qualification as a belief, attitude or behaviour. Thirdly, we propose a )] TJ ET BT 26.250 471.333 Td /F1 9.8 Tf [(theoretical framework, based on previous literature and taking into account some major structural features of contemporary )] TJ ET BT 26.250 459.429 Td /F1 9.8 Tf [(societies, that considers VH as a kind of decision-making process that depends on peoples level of commitment to )] TJ ET BT 26.250 447.524 Td /F1 9.8 Tf [(healthism/risk culture and on their level of confidence in the health authorities and mainstream medicine.)] TJ ET BT 26.250 410.921 Td /F4 12.0 Tf [(Funding Statement)] TJ ET BT 26.250 390.967 Td /F1 9.8 Tf [(Funding: Agence Nationale de Scurit du Mdicament et des Produits de Sant \(ANSM\) in the frame of the call for research )] TJ ET BT 26.250 379.062 Td /F1 9.8 Tf [(projects in 2013 \(grant 2013S064\).)] TJ ET BT 26.250 349.960 Td /F4 12.0 Tf [(Related Articles)] TJ ET BT 26.250 330.006 Td /F1 9.8 Tf [(The article is part of the )] TJ ET BT 130.838 330.006 Td /F5 9.8 Tf [(PLOS Currents Outbreaks )] TJ ET BT 247.341 330.006 Td /F1 9.8 Tf [()] TJ ET 0.267 0.267 0.267 rg BT 250.588 330.006 Td /F1 9.8 Tf [(Vaccine Hesitancy Collection)] TJ ET 0.271 0.267 0.267 rg BT 376.294 330.006 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 293.403 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 273.449 Td /F1 9.8 Tf [(Today, according to many public health experts, public confidence in vaccines is waning)] TJ ET 0.267 0.267 0.267 rg BT 405.584 274.956 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 410.402 277.337 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 412.812 274.956 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 417.630 277.337 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 420.040 274.956 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 424.858 273.449 Td /F1 9.8 Tf [(. Researchers investigating this )] TJ ET BT 26.250 261.544 Td /F1 9.8 Tf [(phenomenon are now abandoning expressions such as vaccine resistance or vaccine opposition, increasingly replacing )] TJ ET BT 26.250 249.639 Td /F1 9.8 Tf [(them by the new term vaccine hesitancy \(VH\) to describe the spread of vaccine reluctance. According to the Working Group )] TJ ET BT 26.250 237.735 Td /F1 9.8 Tf [(on Vaccine Hesitancy appointed by the World Health Organisations Strategic Advisory Group of Experts \(SAGE\) on )] TJ ET BT 26.250 225.830 Td /F1 9.8 Tf [(Immunisation, VH refers to delay in acceptance or refusal of vaccines despite availability of vaccination services, and this )] TJ ET BT 26.250 213.925 Td /F1 9.8 Tf [(phenomenon is complex and context specific varying across time, place and vaccines )] TJ ET 0.267 0.267 0.267 rg BT 404.482 215.432 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 409.300 213.925 Td /F1 9.8 Tf [(. Several literature reviews have )] TJ ET BT 26.250 202.020 Td /F1 9.8 Tf [(already been devoted to this issue )] TJ ET 0.267 0.267 0.267 rg BT 176.917 203.528 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 181.735 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 184.145 203.528 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 188.963 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 191.373 203.528 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 196.191 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 198.601 203.528 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 203.419 202.020 Td /F1 9.8 Tf [(. Articles using the VH terminology have mainly been published in journals specialised )] TJ ET BT 26.250 190.116 Td /F1 9.8 Tf [(in vaccination or paediatric issues, but also in more generalist journals \(Lancet, )] TJ ET BT 369.265 190.116 Td /F5 9.8 Tf [(British Medical Journal,)] TJ ET BT 470.041 190.116 Td /F5 9.8 Tf [(Science\).)] TJ ET 0.267 0.267 0.267 rg BT 510.679 191.623 Td /F6 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 515.497 194.004 Td /F5 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 517.907 191.623 Td /F6 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 522.725 194.004 Td /F5 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 525.135 191.623 Td /F6 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 26.250 170.711 Td /F1 9.8 Tf [(Despite or perhaps because of this success, VH is an ambiguous notion and its theoretical background appears uncertain. )] TJ ET BT 26.250 158.806 Td /F1 9.8 Tf [(It may have originated as a catchy expression coined by experts to capture policy-makers attention, as current vaccine )] TJ ET BT 26.250 146.901 Td /F1 9.8 Tf [(coverage rates do not yet reflect the growing reluctance toward vaccination witnessed by empirical researchers. But hasty use )] TJ ET BT 26.250 134.997 Td /F1 9.8 Tf [(of this notion may lead to misunderstandings and ineffective policies if, for example, one considers hesitancy as a necessarily )] TJ ET BT 26.250 123.092 Td /F1 9.8 Tf [(transient state between full support and strong opposition.)] TJ ET BT 26.250 103.687 Td /F1 9.8 Tf [(In this paper, we first review the current definitions of VH in the public health literature and examine its most prominent )] TJ ET BT 26.250 91.782 Td /F1 9.8 Tf [(characteristics; we also underline some of its ambiguities. We then call into question the usefulness of the common )] TJ ET BT 26.250 79.878 Td /F1 9.8 Tf [(understanding of VH as an intermediate position along a continuum ranging from anti-vaccine to pro-vaccine attitudes, and we )] TJ ET BT 26.250 67.973 Td /F1 9.8 Tf [(discuss its qualification as a belief, attitude, or behaviour. Finally, we propose a theoretical framework related to two different )] TJ ET BT 26.250 56.068 Td /F1 9.8 Tf [(concepts: healthism/risk culture and \(dis\)trust toward health authorities and mainstream medicine.)] 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 Hesitancy: Clarifying a Theoretical Framework for an )] TJ ET BT 15.000 693.094 Td /F2 21.0 Tf [(Ambiguous Notion)] 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 [(Patrick Peretti-Watel)] TJ ET 0.271 0.267 0.267 rg BT 115.102 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 120.523 663.247 Td /F1 9.8 Tf [(Heidi J Larson)] TJ ET 0.271 0.267 0.267 rg BT 182.835 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 188.256 663.247 Td /F1 9.8 Tf [(Jeremy K. Ward)] TJ ET 0.271 0.267 0.267 rg BT 258.144 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 263.565 663.247 Td /F1 9.8 Tf [(William S Schulz)] TJ ET 0.271 0.267 0.267 rg BT 336.154 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 341.575 663.247 Td /F1 9.8 Tf [(Pierre Verger)] TJ ET 0.271 0.267 0.267 rg BT 26.250 651.342 Td /F1 9.8 Tf [(Peretti-Watel P, Larson HJ, Ward JK, Schulz WS, Verger P. Vaccine Hesitancy: Clarifying a Theoretical Framework for an )] TJ ET BT 26.250 639.438 Td /F1 9.8 Tf [(Ambiguous Notion. PLOS Currents Outbreaks. 2015 Feb 25 . Edition 1. doi: )] TJ ET BT 26.250 627.533 Td /F1 9.8 Tf [(10.1371/currents.outbreaks.6844c80ff9f5b273f34c91f71b7fc289.)] TJ ET q 15.000 46.187 577.500 578.965 re W n 0.271 0.267 0.267 rg BT 26.250 598.430 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 578.476 Td /F1 9.8 Tf [(Today, according to many public health experts, public confidence in vaccines is waning. The term vaccine hesitancy \(VH\) is )] TJ ET BT 26.250 566.571 Td /F1 9.8 Tf [(increasingly used to describe the spread of such vaccine reluctance. But VH is an ambiguous notion and its theoretical )] TJ ET BT 26.250 554.667 Td /F1 9.8 Tf [(background appears uncertain. To clarify this concept, we first review the current definitions of VH in the public health literature )] TJ ET BT 26.250 542.762 Td /F1 9.8 Tf [(and examine its most prominent characteristics. VH has been defined as a set of beliefs, attitudes, or behaviours, or some )] TJ ET BT 26.250 530.857 Td /F1 9.8 Tf [(combination of them, shared by a large and heterogeneous portion of the population and including people who exhibit reluctant )] TJ ET BT 26.250 518.952 Td /F1 9.8 Tf [(conformism \(they may either decline a vaccine, delay it or accept it despite their doubts\) and vaccine-specific behaviours. )] TJ ET BT 26.250 507.048 Td /F1 9.8 Tf [(Secondly, we underline some of the ambiguities of this notion and argue that it is more a catchall category than a real concept. )] TJ ET BT 26.250 495.143 Td /F1 9.8 Tf [(We also call into question the usefulness of understanding VH as an intermediate position along a continuum ranging from anti-)] TJ ET BT 26.250 483.238 Td /F1 9.8 Tf [(vaccine to pro-vaccine attitudes, and we discuss its qualification as a belief, attitude or behaviour. Thirdly, we propose a )] TJ ET BT 26.250 471.333 Td /F1 9.8 Tf [(theoretical framework, based on previous literature and taking into account some major structural features of contemporary )] TJ ET BT 26.250 459.429 Td /F1 9.8 Tf [(societies, that considers VH as a kind of decision-making process that depends on peoples level of commitment to )] TJ ET BT 26.250 447.524 Td /F1 9.8 Tf [(healthism/risk culture and on their level of confidence in the health authorities and mainstream medicine.)] TJ ET BT 26.250 410.921 Td /F4 12.0 Tf [(Funding Statement)] TJ ET BT 26.250 390.967 Td /F1 9.8 Tf [(Funding: Agence Nationale de Scurit du Mdicament et des Produits de Sant \(ANSM\) in the frame of the call for research )] TJ ET BT 26.250 379.062 Td /F1 9.8 Tf [(projects in 2013 \(grant 2013S064\).)] TJ ET BT 26.250 349.960 Td /F4 12.0 Tf [(Related Articles)] TJ ET BT 26.250 330.006 Td /F1 9.8 Tf [(The article is part of the )] TJ ET BT 130.838 330.006 Td /F5 9.8 Tf [(PLOS Currents Outbreaks )] TJ ET BT 247.341 330.006 Td /F1 9.8 Tf [()] TJ ET 0.267 0.267 0.267 rg BT 250.588 330.006 Td /F1 9.8 Tf [(Vaccine Hesitancy Collection)] TJ ET 0.271 0.267 0.267 rg BT 376.294 330.006 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 293.403 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 273.449 Td /F1 9.8 Tf [(Today, according to many public health experts, public confidence in vaccines is waning)] TJ ET 0.267 0.267 0.267 rg BT 405.584 274.956 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 410.402 277.337 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 412.812 274.956 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 417.630 277.337 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 420.040 274.956 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 424.858 273.449 Td /F1 9.8 Tf [(. Researchers investigating this )] TJ ET BT 26.250 261.544 Td /F1 9.8 Tf [(phenomenon are now abandoning expressions such as vaccine resistance or vaccine opposition, increasingly replacing )] TJ ET BT 26.250 249.639 Td /F1 9.8 Tf [(them by the new term vaccine hesitancy \(VH\) to describe the spread of vaccine reluctance. According to the Working Group )] TJ ET BT 26.250 237.735 Td /F1 9.8 Tf [(on Vaccine Hesitancy appointed by the World Health Organisations Strategic Advisory Group of Experts \(SAGE\) on )] TJ ET BT 26.250 225.830 Td /F1 9.8 Tf [(Immunisation, VH refers to delay in acceptance or refusal of vaccines despite availability of vaccination services, and this )] TJ ET BT 26.250 213.925 Td /F1 9.8 Tf [(phenomenon is complex and context specific varying across time, place and vaccines )] TJ ET 0.267 0.267 0.267 rg BT 404.482 215.432 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 409.300 213.925 Td /F1 9.8 Tf [(. Several literature reviews have )] TJ ET BT 26.250 202.020 Td /F1 9.8 Tf [(already been devoted to this issue )] TJ ET 0.267 0.267 0.267 rg BT 176.917 203.528 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 181.735 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 184.145 203.528 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 188.963 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 191.373 203.528 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 196.191 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 198.601 203.528 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 203.419 202.020 Td /F1 9.8 Tf [(. Articles using the VH terminology have mainly been published in journals specialised )] TJ ET BT 26.250 190.116 Td /F1 9.8 Tf [(in vaccination or paediatric issues, but also in more generalist journals \(Lancet, )] TJ ET BT 369.265 190.116 Td /F5 9.8 Tf [(British Medical Journal,)] TJ ET BT 470.041 190.116 Td /F5 9.8 Tf [(Science\).)] TJ ET 0.267 0.267 0.267 rg BT 510.679 191.623 Td /F6 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 515.497 194.004 Td /F5 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 517.907 191.623 Td /F6 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 522.725 194.004 Td /F5 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 525.135 191.623 Td /F6 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 26.250 170.711 Td /F1 9.8 Tf [(Despite or perhaps because of this success, VH is an ambiguous notion and its theoretical background appears uncertain. )] TJ ET BT 26.250 158.806 Td /F1 9.8 Tf [(It may have originated as a catchy expression coined by experts to capture policy-makers attention, as current vaccine )] TJ ET BT 26.250 146.901 Td /F1 9.8 Tf [(coverage rates do not yet reflect the growing reluctance toward vaccination witnessed by empirical researchers. But hasty use )] TJ ET BT 26.250 134.997 Td /F1 9.8 Tf [(of this notion may lead to misunderstandings and ineffective policies if, for example, one considers hesitancy as a necessarily )] TJ ET BT 26.250 123.092 Td /F1 9.8 Tf [(transient state between full support and strong opposition.)] TJ ET BT 26.250 103.687 Td /F1 9.8 Tf [(In this paper, we first review the current definitions of VH in the public health literature and examine its most prominent )] TJ ET BT 26.250 91.782 Td /F1 9.8 Tf [(characteristics; we also underline some of its ambiguities. We then call into question the usefulness of the common )] TJ ET BT 26.250 79.878 Td /F1 9.8 Tf [(understanding of VH as an intermediate position along a continuum ranging from anti-vaccine to pro-vaccine attitudes, and we )] TJ ET BT 26.250 67.973 Td /F1 9.8 Tf [(discuss its qualification as a belief, attitude, or behaviour. Finally, we propose a theoretical framework related to two different )] TJ ET BT 26.250 56.068 Td /F1 9.8 Tf [(concepts: healthism/risk culture and \(dis\)trust toward health authorities and mainstream medicine.)] 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 Hesitancy: Clarifying a Theoretical Framework for an )] TJ ET BT 15.000 693.094 Td /F2 21.0 Tf [(Ambiguous Notion)] 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 [(Patrick Peretti-Watel)] TJ ET 0.271 0.267 0.267 rg BT 115.102 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 120.523 663.247 Td /F1 9.8 Tf [(Heidi J Larson)] TJ ET 0.271 0.267 0.267 rg BT 182.835 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 188.256 663.247 Td /F1 9.8 Tf [(Jeremy K. Ward)] TJ ET 0.271 0.267 0.267 rg BT 258.144 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 263.565 663.247 Td /F1 9.8 Tf [(William S Schulz)] TJ ET 0.271 0.267 0.267 rg BT 336.154 663.247 Td /F1 9.8 Tf [(, )] TJ ET 0.267 0.267 0.267 rg BT 341.575 663.247 Td /F1 9.8 Tf [(Pierre Verger)] TJ ET 0.271 0.267 0.267 rg BT 26.250 651.342 Td /F1 9.8 Tf [(Peretti-Watel P, Larson HJ, Ward JK, Schulz WS, Verger P. Vaccine Hesitancy: Clarifying a Theoretical Framework for an )] TJ ET BT 26.250 639.438 Td /F1 9.8 Tf [(Ambiguous Notion. PLOS Currents Outbreaks. 2015 Feb 25 . Edition 1. doi: )] TJ ET BT 26.250 627.533 Td /F1 9.8 Tf [(10.1371/currents.outbreaks.6844c80ff9f5b273f34c91f71b7fc289.)] TJ ET q 15.000 46.187 577.500 578.965 re W n 0.271 0.267 0.267 rg BT 26.250 598.430 Td /F4 12.0 Tf [(Abstract)] TJ ET BT 26.250 578.476 Td /F1 9.8 Tf [(Today, according to many public health experts, public confidence in vaccines is waning. The term vaccine hesitancy \(VH\) is )] TJ ET BT 26.250 566.571 Td /F1 9.8 Tf [(increasingly used to describe the spread of such vaccine reluctance. But VH is an ambiguous notion and its theoretical )] TJ ET BT 26.250 554.667 Td /F1 9.8 Tf [(background appears uncertain. To clarify this concept, we first review the current definitions of VH in the public health literature )] TJ ET BT 26.250 542.762 Td /F1 9.8 Tf [(and examine its most prominent characteristics. VH has been defined as a set of beliefs, attitudes, or behaviours, or some )] TJ ET BT 26.250 530.857 Td /F1 9.8 Tf [(combination of them, shared by a large and heterogeneous portion of the population and including people who exhibit reluctant )] TJ ET BT 26.250 518.952 Td /F1 9.8 Tf [(conformism \(they may either decline a vaccine, delay it or accept it despite their doubts\) and vaccine-specific behaviours. )] TJ ET BT 26.250 507.048 Td /F1 9.8 Tf [(Secondly, we underline some of the ambiguities of this notion and argue that it is more a catchall category than a real concept. )] TJ ET BT 26.250 495.143 Td /F1 9.8 Tf [(We also call into question the usefulness of understanding VH as an intermediate position along a continuum ranging from anti-)] TJ ET BT 26.250 483.238 Td /F1 9.8 Tf [(vaccine to pro-vaccine attitudes, and we discuss its qualification as a belief, attitude or behaviour. Thirdly, we propose a )] TJ ET BT 26.250 471.333 Td /F1 9.8 Tf [(theoretical framework, based on previous literature and taking into account some major structural features of contemporary )] TJ ET BT 26.250 459.429 Td /F1 9.8 Tf [(societies, that considers VH as a kind of decision-making process that depends on peoples level of commitment to )] TJ ET BT 26.250 447.524 Td /F1 9.8 Tf [(healthism/risk culture and on their level of confidence in the health authorities and mainstream medicine.)] TJ ET BT 26.250 410.921 Td /F4 12.0 Tf [(Funding Statement)] TJ ET BT 26.250 390.967 Td /F1 9.8 Tf [(Funding: Agence Nationale de Scurit du Mdicament et des Produits de Sant \(ANSM\) in the frame of the call for research )] TJ ET BT 26.250 379.062 Td /F1 9.8 Tf [(projects in 2013 \(grant 2013S064\).)] TJ ET BT 26.250 349.960 Td /F4 12.0 Tf [(Related Articles)] TJ ET BT 26.250 330.006 Td /F1 9.8 Tf [(The article is part of the )] TJ ET BT 130.838 330.006 Td /F5 9.8 Tf [(PLOS Currents Outbreaks )] TJ ET BT 247.341 330.006 Td /F1 9.8 Tf [()] TJ ET 0.267 0.267 0.267 rg BT 250.588 330.006 Td /F1 9.8 Tf [(Vaccine Hesitancy Collection)] TJ ET 0.271 0.267 0.267 rg BT 376.294 330.006 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 293.403 Td /F4 12.0 Tf [(Introduction)] TJ ET BT 26.250 273.449 Td /F1 9.8 Tf [(Today, according to many public health experts, public confidence in vaccines is waning)] TJ ET 0.267 0.267 0.267 rg BT 405.584 274.956 Td /F4 8.7 Tf [(1)] TJ ET 0.271 0.267 0.267 rg BT 410.402 277.337 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 412.812 274.956 Td /F4 8.7 Tf [(2)] TJ ET 0.271 0.267 0.267 rg BT 417.630 277.337 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 420.040 274.956 Td /F4 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 424.858 273.449 Td /F1 9.8 Tf [(. Researchers investigating this )] TJ ET BT 26.250 261.544 Td /F1 9.8 Tf [(phenomenon are now abandoning expressions such as vaccine resistance or vaccine opposition, increasingly replacing )] TJ ET BT 26.250 249.639 Td /F1 9.8 Tf [(them by the new term vaccine hesitancy \(VH\) to describe the spread of vaccine reluctance. According to the Working Group )] TJ ET BT 26.250 237.735 Td /F1 9.8 Tf [(on Vaccine Hesitancy appointed by the World Health Organisations Strategic Advisory Group of Experts \(SAGE\) on )] TJ ET BT 26.250 225.830 Td /F1 9.8 Tf [(Immunisation, VH refers to delay in acceptance or refusal of vaccines despite availability of vaccination services, and this )] TJ ET BT 26.250 213.925 Td /F1 9.8 Tf [(phenomenon is complex and context specific varying across time, place and vaccines )] TJ ET 0.267 0.267 0.267 rg BT 404.482 215.432 Td /F4 8.7 Tf [(4)] TJ ET 0.271 0.267 0.267 rg BT 409.300 213.925 Td /F1 9.8 Tf [(. Several literature reviews have )] TJ ET BT 26.250 202.020 Td /F1 9.8 Tf [(already been devoted to this issue )] TJ ET 0.267 0.267 0.267 rg BT 176.917 203.528 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 181.735 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 184.145 203.528 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 188.963 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 191.373 203.528 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 196.191 205.909 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 198.601 203.528 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 203.419 202.020 Td /F1 9.8 Tf [(. Articles using the VH terminology have mainly been published in journals specialised )] TJ ET BT 26.250 190.116 Td /F1 9.8 Tf [(in vaccination or paediatric issues, but also in more generalist journals \(Lancet, )] TJ ET BT 369.265 190.116 Td /F5 9.8 Tf [(British Medical Journal,)] TJ ET BT 470.041 190.116 Td /F5 9.8 Tf [(Science\).)] TJ ET 0.267 0.267 0.267 rg BT 510.679 191.623 Td /F6 8.7 Tf [(3)] TJ ET 0.271 0.267 0.267 rg BT 515.497 194.004 Td /F5 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 517.907 191.623 Td /F6 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 522.725 194.004 Td /F5 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 525.135 191.623 Td /F6 8.7 Tf [(10)] TJ ET 0.271 0.267 0.267 rg BT 26.250 170.711 Td /F1 9.8 Tf [(Despite or perhaps because of this success, VH is an ambiguous notion and its theoretical background appears uncertain. )] TJ ET BT 26.250 158.806 Td /F1 9.8 Tf [(It may have originated as a catchy expression coined by experts to capture policy-makers attention, as current vaccine )] TJ ET BT 26.250 146.901 Td /F1 9.8 Tf [(coverage rates do not yet reflect the growing reluctance toward vaccination witnessed by empirical researchers. But hasty use )] TJ ET BT 26.250 134.997 Td /F1 9.8 Tf [(of this notion may lead to misunderstandings and ineffective policies if, for example, one considers hesitancy as a necessarily )] TJ ET BT 26.250 123.092 Td /F1 9.8 Tf [(transient state between full support and strong opposition.)] TJ ET BT 26.250 103.687 Td /F1 9.8 Tf [(In this paper, we first review the current definitions of VH in the public health literature and examine its most prominent )] TJ ET BT 26.250 91.782 Td /F1 9.8 Tf [(characteristics; we also underline some of its ambiguities. We then call into question the usefulness of the common )] TJ ET BT 26.250 79.878 Td /F1 9.8 Tf [(understanding of VH as an intermediate position along a continuum ranging from anti-vaccine to pro-vaccine attitudes, and we )] TJ ET BT 26.250 67.973 Td /F1 9.8 Tf [(discuss its qualification as a belief, attitude, or behaviour. Finally, we propose a theoretical framework related to two different )] TJ ET BT 26.250 56.068 Td /F1 9.8 Tf [(concepts: healthism/risk culture and \(dis\)trust toward health authorities and mainstream medicine.)] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(1)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Outbreaks)] TJ ET Q endstream endobj 8 0 obj << /Type /Font /Subtype /Type1 /Name /F1 /BaseFont /Helvetica /Encoding /WinAnsiEncoding >> endobj 9 0 obj << /Type /Font /Subtype /Type1 /Name /F2 /BaseFont /Times-Bold /Encoding /WinAnsiEncoding >> endobj 10 0 obj << /Type /Font /Subtype /Type1 /Name /F3 /BaseFont /Times-Italic /Encoding /WinAnsiEncoding >> endobj 11 0 obj << /Type /Font /Subtype /Type1 /Name /F4 /BaseFont /Helvetica-Bold /Encoding /WinAnsiEncoding >> endobj 12 0 obj << /Type /Font /Subtype /Type1 /Name /F5 /BaseFont /Helvetica-Oblique /Encoding /WinAnsiEncoding >> endobj 13 0 obj << /Type /Font /Subtype /Type1 /Name /F6 /BaseFont /Helvetica-BoldOblique /Encoding /WinAnsiEncoding >> endobj 14 0 obj << /Type /XObject /Subtype /Image /Width 500 /Height 52 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 1 /Columns 500 /BitsPerComponent 8>> /ColorSpace /DeviceGray /BitsPerComponent 8 /Length 144>> stream x1 0 'ݲ؎"e{dzAdzAdzAdzAdzAdzAdzAdzAdzAdzAdzAdzAtlM0\ endstream endobj 15 0 obj << /Type /XObject /Subtype /Image /Width 500 /Height 52 /SMask 14 0 R /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 500 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 9410>> stream xy\SGFIʎ ^dZq(Z}֥Z *EZwQA@A,!}oB S{1s,wb̜9sF" xʝP r' !;W$O83OOYfjSR$ÆL&t[[[MtRss7_IQQQuuw7D#˖-C%ׯ_YX "''[=|nnnw+,sߙ r\@,bS 4NBݭ @ť{ԨQG <666b2l```cccbbbnnnllagQM(ʪn!H:::l6a2 Jbnnnff5 Ac```dddnnf/E&陘 yx-˕JT*t\.\.wpp2d訪bX4 >Ѐn/-͛7d2b߅}*RiaaaccAPKK srr WϞ=d..."B)  eI$v2lhhhooOWl0LLL>EswDD:wx\.H$ݻweeej S{Vh/_ĉ'Oj#JҥKZ6cW^PZUU̙3YNXX˗%涽Swvv._, lddf333\gϞ ݽ lٲBz/^pqq hԨQAAA&&&ȷ~ ]vW^eXzzzN¾͆aΝ;ɾUxxxpp0xw^bbbLbdd`0pS -V(ϟ?2e ^r+]vxvv6X2֭[сk goQˬYX,։'|GXvٵ /TKղ**xr?x Je0+VyϞ=|P( Ο?)Ǐ))))d2966.X &#Fdgg#"~Wkkkݻd6liӐ?veyz^^A`&p8 ݻT*Dk׮ h.hh" W^! @6wy=~`ȑT*U"WWW?~|@rʔ)/_>u,6om4>p8*Rk3g 2 0 k9Ztww/^ĉjD"oy<^JJ Br}nݺe92^x1j(mmm/^diiicc%K @]]]`:thtt:::ЧJ!P(]]]B4j BGGG ,]d~gmh4JB&xPgݻ2$ Js\CCC͛7rHj[[ۃ$%%_obbbVVqjjjrr#Gvcʕ(IOOGSF BDGGz@!Huuu:::w hرL>B充eee,AÇ/a AdɒǏ{zz2 l( .,,,߾ɓ'GEEM0/56ħOZYY}7oLLL @D"X,A LMMdC+""aXGGJjgplO?z>LMM4P(b=U6n8m4Y`oozO2l6F6 UMMM ,ƍ50 d2MMM=/-++=z4At:t={z{{̆ pG1L/_...UUU8 }}}ׯ hʕ)((@M{܁<~>**d999Ν(X'? *IMMuwwǥy?r<--mȍ7H7n̛7/((h̙Ǐrׯ!ILLtuu^pϒ%K꼽gϞ:(JBI$Һu~zAA@ (,,lܸqBpݨV*ܼyw֭h rxF[[L;;;^j7TϜ9sD777WWZ:͟=%%˗VBrAA QQQ[P(ZZZ F|~49Iwwwii)HJdj>xJ=:;;W~4442dL&wM6q[ 6y?dXUA߿ӧk֬qppPksεkv5 аf???//'ܺu g}JHH$''۷xGFF駾'OtO```||qWq-X7888!!gq3foPPoDDDuu5-z{{.] NW~:L.sN].?~|cǎ>}[# 0x9o???R?p__i˗;;;9ΪU꫱cN0!//ʕ+4 y X䳳]]]5nnnᩩj___rrD3JRpr B:ׯqBBN@ w@ڮB__߼;v,_`aH$MIiCCiӦİlR9siӦq͘1qآ^~mbb*°|D" 9s̙3cccq F>}o,^' wMJJNOO'Hk֬y/+ahvsڵ^ZtZϟBdhh ֭[~3IsGfX1WFյ?F[zJOOڛ^ZZI$^Y_hh;]!p-?q℮#GДOۃ=(˖-ùXbҤIΜ9YYYao@#55A^{{{l䉝;wzyyjQ*T*֭[G}ׯ]]]ЧdΜ9^^^P(ohh.w}}}]]]lْkPs*T*{{{E"Q{{{eeeIIɃ8Ξ={bcc!ߠ ssw6*]?p  0 o bܹ, }JJj]u߾}= yϙ3租~•w~昐PYYaÆ nK :Rd2N.`yC%$$x;v ӧO322lv~~>ֻD"Y[[߸qŋ#Gdj|Wt:gp>}ZZZ*HΝ+ˁH$244trrXhvd2J;;;ϛ7oMTB.WVVj(d2W^Jm۶ݺu+..HTO:UTTZEЏGٸq#A׮]/ǏoooAP(TОٳg/#G>uuuRT__?>>{nkk >ɓl6{߾}oߎ1b>366uww}ݻw---[ yfNNJMNN#H8D"yyyڵ-99~PǏh4kkkRԤ ΝYZRRr1iaaaaa!C***T hzPSv(RYYR ##`XXXy]H˗/[[[wX ɽUUU, (lᩩ߲e D" Lxb/knnm۶M67nKF6p[&A.\1117opAÇ!B&/?Iqq1 b8<<ԩSQ;\./5ס.<<`0ݗ-[_yzzbZN83F"x& Qc O&LښMLL>qܹ_~Y͛WYY3w\ܜ:wܚE^ۿpp ߺu+ֈzI30 :LLLFyvէT*NR8+J5aɓ'gddtuua0 :i$ EH?GGGD E L޸q9s޽+ݷ=zs<<>>z*==Hnڴ  ḙ; B4{CC֦%III-A56L:i~wzac!r]]]˗/GSZZZlmmߏ+Sxˠk׮7o~ƭvݟ-V3$$$** M9zǏ[[[Ç v}i{{{tt4344T[Vwܹl B4r@L&GEEsϐ6hҤI87vX T5?z[BWWWFFf{O>ĉ]]]jSYYtRmN.\PuxPEΝ3118qΝ; Ξ=pBJ"lݺUGGg͚57o<{]II 333׮]{񴴴aÆy{{cO@ÇS_}gSSӴcǎedd9se<}4>QΜ9cddСCCGEDD 6Ν;`ydnnnTTɪUٷSҽ{S!++.j:N%5ѡ:CBBԆ-//?rȔ)SpGQQQǎC/۷o^Zhbbbb58}c2OnG>r䈪k˖-666&MUOoܸaiiioolggK@hh(.\*&$$DFFΞ=k``8bGGGwww4o\\\RR.7ou>?}t0*ʲH333 qр ` x<^ss3koow)XZZh@XrU]C.ÇP|{0 [YYi<)okk#CBmhhhiib&9tPKKK+++wJvttԈb*jbbҟ eeed2 KKKX,^AH$#DǍ_p8htvv֢-H$'''_]] %˛( p fff/kkkmmѣ݂檪*Baeeh ^cvyќ9sRI+A} W ^B$''g~~~P(S(Grjd2hvP2d2 Ǔ'O@wPh``a" vO0 N: -V/^O+V(]oD># ̀5AaeAd,aFmyر۶mcXfff֭CCLP(J" xW~? ; >@N@@@'ZG endstream endobj 16 0 obj << /Type /Annot /Subtype /Link /A 17 0 R /Border [0 0 0] /H /I /Rect [ 15.0000 716.1516 584.2470 736.9416 ] >> endobj 17 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article/vaccine-hesitancy-clarifying-a-theoretical-framework-for-an-ambiguous-notion/) >> endobj 18 0 obj << /Type /Annot /Subtype /Link /A 19 0 R /Border [0 0 0] /H /I /Rect [ 15.0000 691.2036 183.6090 711.9936 ] >> endobj 19 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article/vaccine-hesitancy-clarifying-a-theoretical-framework-for-an-ambiguous-notion/) >> endobj 20 0 obj << /Type /Annot /Subtype /Link /A 21 0 R /Border [0 0 0] /H /I /Rect [ 98.1382 674.2101 140.9310 683.8626 ] >> endobj 21 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article_category/discussion/) >> endobj 22 0 obj << /Type /Annot /Subtype /Link /A 23 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 662.3453 115.1017 672.2659 ] >> endobj 23 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/patrick-peretti-watelinserm-fr/) >> endobj 24 0 obj << /Type /Annot /Subtype /Link /A 25 0 R /Border [0 0 0] /H /I /Rect [ 120.5228 662.3453 182.8350 672.2659 ] >> endobj 25 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/heidi-larsonlshtm-ac-uk/) >> endobj 26 0 obj << /Type /Annot /Subtype /Link /A 27 0 R /Border [0 0 0] /H /I /Rect [ 188.2560 662.3453 258.1440 672.2659 ] >> endobj 27 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/jeremykward/) >> endobj 28 0 obj << /Type /Annot /Subtype /Link /A 29 0 R /Border [0 0 0] /H /I /Rect [ 263.5650 662.3453 336.1538 672.2659 ] >> endobj 29 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/wm-s-schulzgmail-com/) >> endobj 30 0 obj << /Type /Annot /Subtype /Link /A 31 0 R /Border [0 0 0] /H /I /Rect [ 341.5747 662.3453 399.5482 672.2659 ] >> endobj 31 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/pierre-vergerinserm-fr/) >> endobj 32 0 obj << /Type /Annot /Subtype /Link /A 33 0 R /Border [0 0 0] /H /I /Rect [ 250.5877 329.1038 376.2945 339.0245 ] >> endobj 33 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/perspectives-on-vaccine-hesitancy-and-vaccination-coverage/) >> endobj 34 0 obj << /Type /Annot /Subtype /Link /A 35 0 R /Border [0 0 0] /H /I /Rect [ 405.5835 274.1544 410.4022 282.9728 ] >> endobj 35 0 obj << /Type /Action >> endobj 36 0 obj << /Type /Annot /Subtype /Link /A 37 0 R /Border [0 0 0] /H /I /Rect [ 412.8115 274.1544 417.6302 282.9728 ] >> endobj 37 0 obj << /Type /Action >> endobj 38 0 obj << /Type /Annot /Subtype /Link /A 39 0 R /Border [0 0 0] /H /I /Rect [ 420.0395 274.1544 424.8582 282.9728 ] >> endobj 39 0 obj << /Type /Action >> endobj 40 0 obj << /Type /Annot /Subtype /Link /A 41 0 R /Border [0 0 0] /H /I /Rect [ 404.4817 214.6307 409.3004 223.4490 ] >> endobj 41 0 obj << /Type /Action >> endobj 42 0 obj << /Type /Annot /Subtype /Link /A 43 0 R /Border [0 0 0] /H /I /Rect [ 176.9168 202.7259 181.7354 211.5443 ] >> endobj 43 0 obj << /Type /Action >> endobj 44 0 obj << /Type /Annot /Subtype /Link /A 45 0 R /Border [0 0 0] /H /I /Rect [ 184.1448 202.7259 188.9634 211.5443 ] >> endobj 45 0 obj << /Type /Action >> endobj 46 0 obj << /Type /Annot /Subtype /Link /A 47 0 R /Border [0 0 0] /H /I /Rect [ 191.3728 202.7259 196.1914 211.5443 ] >> endobj 47 0 obj << /Type /Action >> endobj 48 0 obj << /Type /Annot /Subtype /Link /A 49 0 R /Border [0 0 0] /H /I /Rect [ 198.6008 202.7259 203.4194 211.5443 ] >> endobj 49 0 obj << /Type /Action >> endobj 50 0 obj << /Type /Annot /Subtype /Link /A 51 0 R /Border [0 0 0] /H /I /Rect [ 510.6787 190.8212 515.4974 199.6395 ] >> endobj 51 0 obj << /Type /Action >> endobj 52 0 obj << /Type /Annot /Subtype /Link /A 53 0 R /Border [0 0 0] /H /I /Rect [ 517.9067 190.8212 522.7254 199.6395 ] >> endobj 53 0 obj << /Type /Action >> endobj 54 0 obj << /Type /Annot /Subtype /Link /A 55 0 R /Border [0 0 0] /H /I /Rect [ 525.1347 190.8212 534.7721 199.6395 ] >> endobj 55 0 obj << /Type /Action >> endobj 56 0 obj << /Type /Annot /Subtype /Link /A 57 0 R /Border [0 0 0] /H /I /Rect [ 15.0000 716.1516 584.2470 736.9416 ] >> endobj 57 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article/vaccine-hesitancy-clarifying-a-theoretical-framework-for-an-ambiguous-notion/) >> endobj 58 0 obj << /Type /Annot /Subtype /Link /A 59 0 R /Border [0 0 0] /H /I /Rect [ 15.0000 691.2036 183.6090 711.9936 ] >> endobj 59 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article/vaccine-hesitancy-clarifying-a-theoretical-framework-for-an-ambiguous-notion/) >> endobj 60 0 obj << /Type /Annot /Subtype /Link /A 61 0 R /Border [0 0 0] /H /I /Rect [ 98.1382 674.2101 140.9310 683.8626 ] >> endobj 61 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article_category/discussion/) >> endobj 62 0 obj << /Type /Annot /Subtype /Link /A 63 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 662.3453 115.1017 672.2659 ] >> endobj 63 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/patrick-peretti-watelinserm-fr/) >> endobj 64 0 obj << /Type /Annot /Subtype /Link /A 65 0 R /Border [0 0 0] /H /I /Rect [ 120.5228 662.3453 182.8350 672.2659 ] >> endobj 65 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/heidi-larsonlshtm-ac-uk/) >> endobj 66 0 obj << /Type /Annot /Subtype /Link /A 67 0 R /Border [0 0 0] /H /I /Rect [ 188.2560 662.3453 258.1440 672.2659 ] >> endobj 67 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/jeremykward/) >> endobj 68 0 obj << /Type /Annot /Subtype /Link /A 69 0 R /Border [0 0 0] /H /I /Rect [ 263.5650 662.3453 336.1538 672.2659 ] >> endobj 69 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/wm-s-schulzgmail-com/) >> endobj 70 0 obj << /Type /Annot /Subtype /Link /A 71 0 R /Border [0 0 0] /H /I /Rect [ 341.5747 662.3453 399.5482 672.2659 ] >> endobj 71 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/pierre-vergerinserm-fr/) >> endobj 72 0 obj << /Type /Annot /Subtype /Link /A 73 0 R /Border [0 0 0] /H /I /Rect [ 250.5877 329.1038 376.2945 339.0245 ] >> endobj 73 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/perspectives-on-vaccine-hesitancy-and-vaccination-coverage/) >> endobj 74 0 obj << /Type /Annot /Subtype /Link /A 75 0 R /Border [0 0 0] /H /I /Rect [ 405.5835 274.1544 410.4022 282.9728 ] >> endobj 75 0 obj << /Type /Action >> endobj 76 0 obj << /Type /Annot /Subtype /Link /A 77 0 R /Border [0 0 0] /H /I /Rect [ 412.8115 274.1544 417.6302 282.9728 ] >> endobj 77 0 obj << /Type /Action >> endobj 78 0 obj << /Type /Annot /Subtype /Link /A 79 0 R /Border [0 0 0] /H /I /Rect [ 420.0395 274.1544 424.8582 282.9728 ] >> endobj 79 0 obj << /Type /Action >> endobj 80 0 obj << /Type /Annot /Subtype /Link /A 81 0 R /Border [0 0 0] /H /I /Rect [ 404.4817 214.6307 409.3004 223.4490 ] >> endobj 81 0 obj << /Type /Action >> endobj 82 0 obj << /Type /Annot /Subtype /Link /A 83 0 R /Border [0 0 0] /H /I /Rect [ 176.9168 202.7259 181.7354 211.5443 ] >> endobj 83 0 obj << /Type /Action >> endobj 84 0 obj << /Type /Annot /Subtype /Link /A 85 0 R /Border [0 0 0] /H /I /Rect [ 184.1448 202.7259 188.9634 211.5443 ] >> endobj 85 0 obj << /Type /Action >> endobj 86 0 obj << /Type /Annot /Subtype /Link /A 87 0 R /Border [0 0 0] /H /I /Rect [ 191.3728 202.7259 196.1914 211.5443 ] >> endobj 87 0 obj << /Type /Action >> endobj 88 0 obj << /Type /Annot /Subtype /Link /A 89 0 R /Border [0 0 0] /H /I /Rect [ 198.6008 202.7259 203.4194 211.5443 ] >> endobj 89 0 obj << /Type /Action >> endobj 90 0 obj << /Type /Annot /Subtype /Link /A 91 0 R /Border [0 0 0] /H /I /Rect [ 510.6787 190.8212 515.4974 199.6395 ] >> endobj 91 0 obj << /Type /Action >> endobj 92 0 obj << /Type /Annot /Subtype /Link /A 93 0 R /Border [0 0 0] /H /I /Rect [ 517.9067 190.8212 522.7254 199.6395 ] >> endobj 93 0 obj << /Type /Action >> endobj 94 0 obj << /Type /Annot /Subtype /Link /A 95 0 R /Border [0 0 0] /H /I /Rect [ 525.1347 190.8212 534.7721 199.6395 ] >> endobj 95 0 obj << /Type /Action >> endobj 96 0 obj << /Type /Annot /Subtype /Link /A 97 0 R /Border [0 0 0] /H /I /Rect [ 15.0000 716.1516 584.2470 736.9416 ] >> endobj 97 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article/vaccine-hesitancy-clarifying-a-theoretical-framework-for-an-ambiguous-notion/) >> endobj 98 0 obj << /Type /Annot /Subtype /Link /A 99 0 R /Border [0 0 0] /H /I /Rect [ 15.0000 691.2036 183.6090 711.9936 ] >> endobj 99 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article/vaccine-hesitancy-clarifying-a-theoretical-framework-for-an-ambiguous-notion/) >> endobj 100 0 obj << /Type /Annot /Subtype /Link /A 101 0 R /Border [0 0 0] /H /I /Rect [ 98.1382 674.2101 140.9310 683.8626 ] >> endobj 101 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/article_category/discussion/) >> endobj 102 0 obj << /Type /Annot /Subtype /Link /A 103 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 662.3453 115.1017 672.2659 ] >> endobj 103 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/patrick-peretti-watelinserm-fr/) >> endobj 104 0 obj << /Type /Annot /Subtype /Link /A 105 0 R /Border [0 0 0] /H /I /Rect [ 120.5228 662.3453 182.8350 672.2659 ] >> endobj 105 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/heidi-larsonlshtm-ac-uk/) >> endobj 106 0 obj << /Type /Annot /Subtype /Link /A 107 0 R /Border [0 0 0] /H /I /Rect [ 188.2560 662.3453 258.1440 672.2659 ] >> endobj 107 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/jeremykward/) >> endobj 108 0 obj << /Type /Annot /Subtype /Link /A 109 0 R /Border [0 0 0] /H /I /Rect [ 263.5650 662.3453 336.1538 672.2659 ] >> endobj 109 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/wm-s-schulzgmail-com/) >> endobj 110 0 obj << /Type /Annot /Subtype /Link /A 111 0 R /Border [0 0 0] /H /I /Rect [ 341.5747 662.3453 399.5482 672.2659 ] >> endobj 111 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/author/pierre-vergerinserm-fr/) >> endobj 112 0 obj << /Type /Annot /Subtype /Link /A 113 0 R /Border [0 0 0] /H /I /Rect [ 250.5877 329.1038 376.2945 339.0245 ] >> endobj 113 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/perspectives-on-vaccine-hesitancy-and-vaccination-coverage/) >> endobj 114 0 obj << /Type /Annot /Subtype /Link /A 115 0 R /Border [0 0 0] /H /I /Rect [ 405.5835 274.1544 410.4022 282.9728 ] >> endobj 115 0 obj << /Type /Action >> endobj 116 0 obj << /Type /Annot /Subtype /Link /A 117 0 R /Border [0 0 0] /H /I /Rect [ 412.8115 274.1544 417.6302 282.9728 ] >> endobj 117 0 obj << /Type /Action >> endobj 118 0 obj << /Type /Annot /Subtype /Link /A 119 0 R /Border [0 0 0] /H /I /Rect [ 420.0395 274.1544 424.8582 282.9728 ] >> endobj 119 0 obj << /Type /Action >> endobj 120 0 obj << /Type /Annot /Subtype /Link /A 121 0 R /Border [0 0 0] /H /I /Rect [ 404.4817 214.6307 409.3004 223.4490 ] >> endobj 121 0 obj << /Type /Action >> endobj 122 0 obj << /Type /Annot /Subtype /Link /A 123 0 R /Border [0 0 0] /H /I /Rect [ 176.9168 202.7259 181.7354 211.5443 ] >> endobj 123 0 obj << /Type /Action >> endobj 124 0 obj << /Type /Annot /Subtype /Link /A 125 0 R /Border [0 0 0] /H /I /Rect [ 184.1448 202.7259 188.9634 211.5443 ] >> endobj 125 0 obj << /Type /Action >> endobj 126 0 obj << /Type /Annot /Subtype /Link /A 127 0 R /Border [0 0 0] /H /I /Rect [ 191.3728 202.7259 196.1914 211.5443 ] >> endobj 127 0 obj << /Type /Action >> endobj 128 0 obj << /Type /Annot /Subtype /Link /A 129 0 R /Border [0 0 0] /H /I /Rect [ 198.6008 202.7259 203.4194 211.5443 ] >> endobj 129 0 obj << /Type /Action >> endobj 130 0 obj << /Type /Annot /Subtype /Link /A 131 0 R /Border [0 0 0] /H /I /Rect [ 510.6787 190.8212 515.4974 199.6395 ] >> endobj 131 0 obj << /Type /Action >> endobj 132 0 obj << /Type /Annot /Subtype /Link /A 133 0 R /Border [0 0 0] /H /I /Rect [ 517.9067 190.8212 522.7254 199.6395 ] >> endobj 133 0 obj << /Type /Action >> endobj 134 0 obj << /Type /Annot /Subtype /Link /A 135 0 R /Border [0 0 0] /H /I /Rect [ 525.1347 190.8212 534.7721 199.6395 ] >> endobj 135 0 obj << /Type /Action >> endobj 136 0 obj << /Type /Page /Parent 3 0 R /Annots [ 138 0 R 140 0 R 142 0 R 144 0 R 146 0 R 148 0 R 150 0 R 152 0 R 154 0 R 156 0 R 158 0 R 160 0 R 162 0 R 164 0 R 166 0 R 168 0 R 170 0 R 172 0 R 174 0 R 176 0 R 178 0 R 180 0 R 182 0 R 184 0 R 186 0 R 188 0 R 190 0 R 192 0 R 194 0 R 196 0 R 198 0 R 200 0 R 202 0 R 204 0 R 206 0 R 208 0 R 210 0 R 212 0 R 214 0 R 216 0 R 218 0 R 220 0 R 222 0 R 224 0 R 226 0 R 228 0 R 230 0 R 232 0 R 234 0 R 236 0 R 238 0 R 240 0 R 242 0 R 244 0 R 246 0 R 248 0 R 250 0 R 252 0 R 254 0 R 256 0 R 258 0 R 260 0 R 262 0 R 264 0 R 266 0 R 268 0 R 270 0 R 272 0 R 274 0 R 276 0 R 278 0 R 280 0 R 282 0 R 284 0 R 286 0 R 288 0 R 290 0 R 292 0 R 294 0 R 296 0 R 298 0 R 300 0 R 302 0 R 304 0 R 306 0 R 308 0 R 310 0 R 312 0 R 314 0 R 316 0 R 318 0 R 320 0 R 322 0 R 324 0 R 326 0 R 328 0 R 330 0 R 332 0 R 334 0 R 336 0 R 338 0 R 340 0 R 342 0 R 344 0 R 346 0 R 348 0 R 350 0 R 352 0 R 354 0 R 356 0 R 358 0 R 360 0 R 362 0 R 364 0 R 366 0 R 368 0 R 370 0 R 372 0 R 374 0 R 376 0 R 378 0 R 380 0 R 382 0 R 384 0 R 386 0 R 388 0 R 390 0 R 392 0 R 394 0 R 396 0 R 398 0 R 400 0 R 402 0 R 404 0 R 406 0 R 408 0 R 410 0 R 412 0 R 414 0 R 416 0 R 418 0 R 420 0 R 422 0 R 424 0 R 426 0 R 428 0 R 430 0 R 432 0 R 434 0 R 436 0 R 438 0 R 440 0 R 442 0 R 444 0 R 446 0 R 448 0 R ] /Contents 137 0 R >> endobj 137 0 obj << /Length 43468 >> stream 0.271 0.267 0.267 rg q 15.000 24.958 577.500 752.042 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(The ambiguities of current definitions of VH.)] TJ ET BT 26.250 730.324 Td /F4 9.8 Tf [(VH definitions in the public health literature.)] TJ ET BT 26.250 710.919 Td /F1 9.8 Tf [(VH has been defined as a set of beliefs )] TJ ET 0.267 0.267 0.267 rg BT 198.601 712.427 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 208.238 710.919 Td /F1 9.8 Tf [(, attitudes )] TJ ET 0.267 0.267 0.267 rg BT 253.225 712.427 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 258.043 714.808 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 260.453 712.427 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 270.090 710.919 Td /F1 9.8 Tf [(, behaviours )] TJ ET 0.267 0.267 0.267 rg BT 325.909 712.427 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 335.546 710.919 Td /F1 9.8 Tf [(, or some combination of them )] TJ ET 0.267 0.267 0.267 rg BT 469.394 712.427 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 479.031 714.808 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 481.441 712.427 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 491.078 710.919 Td /F1 9.8 Tf [(, exhibited by lay )] TJ ET BT 26.250 699.015 Td /F1 9.8 Tf [(people in regard to their own or their childrens immunisations, but also sometimes by healthcare professionals. VH is an )] TJ ET BT 26.250 687.110 Td /F1 9.8 Tf [(attribute ascribed to a large and heterogeneous category )] TJ ET 0.267 0.267 0.267 rg BT 273.929 688.617 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 278.748 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 281.157 688.617 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 285.976 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 288.385 688.617 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 293.204 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 295.613 688.617 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 305.251 687.110 Td /F1 9.8 Tf [( that regroups people who share varying degrees and motives )] TJ ET BT 26.250 675.205 Td /F1 9.8 Tf [(of indecision and who hold an intermediate position along a continuum ranging from full support for vaccination to strong )] TJ ET BT 26.250 663.300 Td /F1 9.8 Tf [(opposition to any vaccine )] TJ ET 0.267 0.267 0.267 rg BT 138.433 664.808 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 143.252 667.189 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 145.662 664.808 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 150.480 667.189 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 152.890 664.808 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 162.527 663.300 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 643.896 Td /F1 9.8 Tf [(These people are characterised by what we may call reluctant conformism and vaccine-specific behaviours )] TJ ET 0.267 0.267 0.267 rg BT 490.087 645.403 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 494.905 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 497.315 645.403 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 502.133 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 504.543 645.403 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 509.361 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 511.771 645.403 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 521.408 643.896 Td /F1 9.8 Tf [(. They may )] TJ ET BT 26.250 631.991 Td /F1 9.8 Tf [(decline a vaccine, but they may also delay it or even accept it in due time despite their doubts/reluctance. In other words, they )] TJ ET BT 26.250 620.086 Td /F1 9.8 Tf [(may endorse a wide range of non-specific behaviours, all of which can result from something else than VH. This behavioural )] TJ ET BT 26.250 608.181 Td /F1 9.8 Tf [(outcome can vary from one vaccine to another: they may accept one vaccine, but decline/delay another, as they base their )] TJ ET BT 26.250 596.277 Td /F1 9.8 Tf [(decision on vaccine-specific features.)] TJ ET BT 26.250 576.872 Td /F4 9.8 Tf [(A catchall category, not a concept.)] TJ ET BT 26.250 557.467 Td /F1 9.8 Tf [(Definitions that try to describe VH as it is used by researchers tend to be very broad and to embrace heterogeneous )] TJ ET BT 26.250 545.562 Td /F1 9.8 Tf [(people/situations and many different explanatory factors \(including historic, political and socio-cultural contexts, as well as )] TJ ET BT 26.250 533.658 Td /F1 9.8 Tf [(individual/social group influences )] TJ ET 0.267 0.267 0.267 rg BT 171.476 535.165 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 176.295 537.546 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 178.704 535.165 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 183.523 537.546 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 185.932 535.165 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 190.751 533.658 Td /F1 9.8 Tf [(\). Moreover, some previous empirical studies have found quite contrasting profiles of )] TJ ET BT 26.250 521.753 Td /F1 9.8 Tf [(attitudes among those who could be categorised as vaccine-hesitant )] TJ ET 0.267 0.267 0.267 rg BT 324.317 523.260 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 333.955 525.641 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 336.364 523.260 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 346.001 521.753 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 502.348 Td /F1 9.8 Tf [(Previous studies also show several contradictions in their use of VH. First, some authors argue that it is something new, distinct )] TJ ET BT 26.250 490.443 Td /F1 9.8 Tf [(from old-fashioned anti-vaccination )] TJ ET 0.267 0.267 0.267 rg BT 180.144 491.951 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 189.781 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 192.191 491.951 Td /F4 8.7 Tf [(15)] TJ ET 0.271 0.267 0.267 rg BT 201.828 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 204.237 491.951 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 213.875 490.443 Td /F1 9.8 Tf [(, while others state that it is as old as vaccination itself )] TJ ET 0.267 0.267 0.267 rg BT 450.146 491.951 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 454.965 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 457.374 491.951 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 467.012 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 469.421 491.951 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 479.058 490.443 Td /F1 9.8 Tf [(. Second, some )] TJ ET BT 26.250 478.539 Td /F1 9.8 Tf [(authors consider that VH corresponds to an intermediate position, in the middle of the continuum between the pro-vaccination )] TJ ET BT 26.250 466.634 Td /F1 9.8 Tf [(and anti-vaccination positions \(that is, on what we shall refer to as the pro/anti continuum )] TJ ET 0.267 0.267 0.267 rg BT 415.343 468.141 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 420.162 470.522 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 422.571 468.141 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 427.390 470.522 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 429.799 468.141 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 439.437 466.634 Td /F1 9.8 Tf [( , while others consider that VH )] TJ ET BT 26.250 454.729 Td /F1 9.8 Tf [(includes strong opposition to vaccination )] TJ ET 0.267 0.267 0.267 rg BT 204.002 456.236 Td /F4 8.7 Tf [(18)] TJ ET 0.271 0.267 0.267 rg BT 213.640 458.617 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 216.049 456.236 Td /F4 8.7 Tf [(19)] TJ ET 0.271 0.267 0.267 rg BT 225.686 454.729 Td /F1 9.8 Tf [(. Third, authors argue that VH is due to ignorance, misperceptions or )] TJ ET BT 26.250 442.824 Td /F1 9.8 Tf [(disinformation )] TJ ET 0.267 0.267 0.267 rg BT 89.644 444.332 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 99.282 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 101.691 444.332 Td /F4 8.7 Tf [(21)] TJ ET 0.271 0.267 0.267 rg BT 111.329 442.824 Td /F1 9.8 Tf [(, and others that it may result from too much information )] TJ ET 0.267 0.267 0.267 rg BT 355.722 444.332 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 365.359 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 367.769 444.332 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 377.406 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 379.815 444.332 Td /F4 8.7 Tf [(22)] TJ ET 0.271 0.267 0.267 rg BT 389.453 442.824 Td /F1 9.8 Tf [(. One author even states that VH is driven )] TJ ET BT 26.250 430.920 Td /F1 9.8 Tf [(basically by emotions and irrationality and vaccine refusers should be liable for the harm they cause to others )] TJ ET 0.267 0.267 0.267 rg BT 499.330 432.427 Td /F4 8.7 Tf [(23)] TJ ET 0.271 0.267 0.267 rg BT 508.967 430.920 Td /F1 9.8 Tf [(. Fourth, VH is )] TJ ET BT 26.250 419.015 Td /F1 9.8 Tf [(sometimes described with a neutral tone, or even praised )] TJ ET 0.267 0.267 0.267 rg BT 276.065 420.522 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 280.883 422.903 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 283.293 420.522 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 292.930 422.903 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 295.339 420.522 Td /F4 8.7 Tf [(24)] TJ ET 0.271 0.267 0.267 rg BT 304.977 419.015 Td /F1 9.8 Tf [(, but it has also been described \(metaphorically?\) as a )] TJ ET BT 26.250 407.110 Td /F1 9.8 Tf [(condition more or less severe that should be diagnosed among people at risk )] TJ ET 0.267 0.267 0.267 rg BT 380.643 408.617 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 385.462 410.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 387.871 408.617 Td /F4 8.7 Tf [(25)] TJ ET 0.271 0.267 0.267 rg BT 397.508 410.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 399.918 408.617 Td /F4 8.7 Tf [(26)] TJ ET 0.271 0.267 0.267 rg BT 409.555 407.110 Td /F1 9.8 Tf [( and as a weed deeply rooted in the )] TJ ET BT 26.250 395.205 Td /F1 9.8 Tf [(defects of human nature )] TJ ET 0.267 0.267 0.267 rg BT 134.105 396.713 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 143.742 395.205 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 375.801 Td /F1 9.8 Tf [(Finally, while some empirical studies report that VH is more frequent among people with a high socioeconomic status \(SES\), )] TJ ET BT 26.250 363.896 Td /F1 9.8 Tf [(others report the opposite or observe no relation, especially regarding educational level )] TJ ET 0.267 0.267 0.267 rg BT 404.511 365.403 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 409.330 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 411.739 365.403 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 416.558 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 418.967 365.403 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 423.786 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 426.195 365.403 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 435.832 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 438.242 365.403 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 447.879 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 450.288 365.403 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 459.926 363.896 Td /F1 9.8 Tf [(. Such inconsistent results )] TJ ET BT 26.250 351.991 Td /F1 9.8 Tf [(are disturbing for social scientists, as SES is supposed to strongly shape our beliefs, attitudes and behaviours, in meaningful )] TJ ET BT 26.250 340.086 Td /F1 9.8 Tf [(ways.)] TJ ET BT 26.250 320.682 Td /F1 9.8 Tf [(These different attitudes tend to assort into specific profiles; for example, those who consider VH an old phenomenon that )] TJ ET BT 26.250 308.777 Td /F1 9.8 Tf [(encompasses anti-vaccination attitudes often attribute it to ignorance, misinformation or irrationality, while those who describe it )] TJ ET BT 26.250 296.872 Td /F1 9.8 Tf [(as a new attitude, distinct from strong opposition to vaccination, also argue that it is positively correlated with vaccine-related )] TJ ET BT 26.250 284.967 Td /F1 9.8 Tf [(knowledge.)] TJ ET BT 26.250 265.563 Td /F1 9.8 Tf [(More generally, VH is not really an empirical concept, as the term concept traditionally refers to a general mental )] TJ ET BT 26.250 253.658 Td /F1 9.8 Tf [(representation derived from the variety of perceived objects and defines what is common to them the features necessary and )] TJ ET BT 26.250 241.753 Td /F1 9.8 Tf [(sufficient for membership in the class/concept through comparison, reflection and abstraction. The current definitions of VH, )] TJ ET BT 26.250 229.848 Td /F1 9.8 Tf [(rather than delineating a set of core elements, cover a wide range of heterogeneous, and even sometimes contradictory, )] TJ ET BT 26.250 217.944 Td /F1 9.8 Tf [(elements.)] TJ ET BT 26.250 181.341 Td /F4 12.0 Tf [(Two issues raised by the VH definitions: what is VH, and where to position it?)] TJ ET BT 26.250 161.387 Td /F4 9.8 Tf [(A belief/attitude, a behaviour, or a decision-making process?)] TJ ET BT 26.250 141.982 Td /F1 9.8 Tf [(It is not fully satisfactory to define VH as a behaviour, as it is associated in the literature with various and non-specific )] TJ ET BT 26.250 130.077 Td /F1 9.8 Tf [(behaviours and outcomes \(due to reluctant conformism and vaccine-specific behaviours\). Moreover, VH is not the only possible )] TJ ET BT 26.250 118.173 Td /F1 9.8 Tf [(explanation for each of these different outcomes: acceptance might also be due to strong support, refusal to strong opposition, )] TJ ET BT 26.250 106.268 Td /F1 9.8 Tf [(and delay to procrastination, oversight, or ignorance. Nevertheless, VH may be associated with other kinds of behaviours, such )] TJ ET BT 26.250 94.363 Td /F1 9.8 Tf [(as information seeking, and the notion of attitude can be defined in many different ways \(including a positive or negative )] TJ ET BT 26.250 82.458 Td /F1 9.8 Tf [(evaluation, or a disposition to act\). This ambiguity regarding the nature of VH may create problems in dealing with it: when )] TJ ET BT 26.250 70.554 Td /F1 9.8 Tf [(researchers design an intervention aimed at promoting vaccination or a specific vaccine, for example, should they target an )] TJ ET BT 26.250 58.649 Td /F1 9.8 Tf [(attitudinal or a behavioural outcome?)] TJ ET BT 26.250 39.244 Td /F1 9.8 Tf [(Nevertheless, beyond this ambiguity, it would be probably more useful to consider VH as a decision-making process \(how/why )] TJ ET Q q 15.000 24.958 577.500 752.042 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(The ambiguities of current definitions of VH.)] TJ ET BT 26.250 730.324 Td /F4 9.8 Tf [(VH definitions in the public health literature.)] TJ ET BT 26.250 710.919 Td /F1 9.8 Tf [(VH has been defined as a set of beliefs )] TJ ET 0.267 0.267 0.267 rg BT 198.601 712.427 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 208.238 710.919 Td /F1 9.8 Tf [(, attitudes )] TJ ET 0.267 0.267 0.267 rg BT 253.225 712.427 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 258.043 714.808 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 260.453 712.427 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 270.090 710.919 Td /F1 9.8 Tf [(, behaviours )] TJ ET 0.267 0.267 0.267 rg BT 325.909 712.427 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 335.546 710.919 Td /F1 9.8 Tf [(, or some combination of them )] TJ ET 0.267 0.267 0.267 rg BT 469.394 712.427 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 479.031 714.808 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 481.441 712.427 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 491.078 710.919 Td /F1 9.8 Tf [(, exhibited by lay )] TJ ET BT 26.250 699.015 Td /F1 9.8 Tf [(people in regard to their own or their childrens immunisations, but also sometimes by healthcare professionals. VH is an )] TJ ET BT 26.250 687.110 Td /F1 9.8 Tf [(attribute ascribed to a large and heterogeneous category )] TJ ET 0.267 0.267 0.267 rg BT 273.929 688.617 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 278.748 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 281.157 688.617 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 285.976 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 288.385 688.617 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 293.204 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 295.613 688.617 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 305.251 687.110 Td /F1 9.8 Tf [( that regroups people who share varying degrees and motives )] TJ ET BT 26.250 675.205 Td /F1 9.8 Tf [(of indecision and who hold an intermediate position along a continuum ranging from full support for vaccination to strong )] TJ ET BT 26.250 663.300 Td /F1 9.8 Tf [(opposition to any vaccine )] TJ ET 0.267 0.267 0.267 rg BT 138.433 664.808 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 143.252 667.189 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 145.662 664.808 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 150.480 667.189 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 152.890 664.808 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 162.527 663.300 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 643.896 Td /F1 9.8 Tf [(These people are characterised by what we may call reluctant conformism and vaccine-specific behaviours )] TJ ET 0.267 0.267 0.267 rg BT 490.087 645.403 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 494.905 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 497.315 645.403 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 502.133 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 504.543 645.403 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 509.361 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 511.771 645.403 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 521.408 643.896 Td /F1 9.8 Tf [(. They may )] TJ ET BT 26.250 631.991 Td /F1 9.8 Tf [(decline a vaccine, but they may also delay it or even accept it in due time despite their doubts/reluctance. In other words, they )] TJ ET BT 26.250 620.086 Td /F1 9.8 Tf [(may endorse a wide range of non-specific behaviours, all of which can result from something else than VH. This behavioural )] TJ ET BT 26.250 608.181 Td /F1 9.8 Tf [(outcome can vary from one vaccine to another: they may accept one vaccine, but decline/delay another, as they base their )] TJ ET BT 26.250 596.277 Td /F1 9.8 Tf [(decision on vaccine-specific features.)] TJ ET BT 26.250 576.872 Td /F4 9.8 Tf [(A catchall category, not a concept.)] TJ ET BT 26.250 557.467 Td /F1 9.8 Tf [(Definitions that try to describe VH as it is used by researchers tend to be very broad and to embrace heterogeneous )] TJ ET BT 26.250 545.562 Td /F1 9.8 Tf [(people/situations and many different explanatory factors \(including historic, political and socio-cultural contexts, as well as )] TJ ET BT 26.250 533.658 Td /F1 9.8 Tf [(individual/social group influences )] TJ ET 0.267 0.267 0.267 rg BT 171.476 535.165 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 176.295 537.546 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 178.704 535.165 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 183.523 537.546 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 185.932 535.165 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 190.751 533.658 Td /F1 9.8 Tf [(\). Moreover, some previous empirical studies have found quite contrasting profiles of )] TJ ET BT 26.250 521.753 Td /F1 9.8 Tf [(attitudes among those who could be categorised as vaccine-hesitant )] TJ ET 0.267 0.267 0.267 rg BT 324.317 523.260 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 333.955 525.641 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 336.364 523.260 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 346.001 521.753 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 502.348 Td /F1 9.8 Tf [(Previous studies also show several contradictions in their use of VH. First, some authors argue that it is something new, distinct )] TJ ET BT 26.250 490.443 Td /F1 9.8 Tf [(from old-fashioned anti-vaccination )] TJ ET 0.267 0.267 0.267 rg BT 180.144 491.951 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 189.781 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 192.191 491.951 Td /F4 8.7 Tf [(15)] TJ ET 0.271 0.267 0.267 rg BT 201.828 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 204.237 491.951 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 213.875 490.443 Td /F1 9.8 Tf [(, while others state that it is as old as vaccination itself )] TJ ET 0.267 0.267 0.267 rg BT 450.146 491.951 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 454.965 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 457.374 491.951 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 467.012 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 469.421 491.951 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 479.058 490.443 Td /F1 9.8 Tf [(. Second, some )] TJ ET BT 26.250 478.539 Td /F1 9.8 Tf [(authors consider that VH corresponds to an intermediate position, in the middle of the continuum between the pro-vaccination )] TJ ET BT 26.250 466.634 Td /F1 9.8 Tf [(and anti-vaccination positions \(that is, on what we shall refer to as the pro/anti continuum )] TJ ET 0.267 0.267 0.267 rg BT 415.343 468.141 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 420.162 470.522 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 422.571 468.141 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 427.390 470.522 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 429.799 468.141 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 439.437 466.634 Td /F1 9.8 Tf [( , while others consider that VH )] TJ ET BT 26.250 454.729 Td /F1 9.8 Tf [(includes strong opposition to vaccination )] TJ ET 0.267 0.267 0.267 rg BT 204.002 456.236 Td /F4 8.7 Tf [(18)] TJ ET 0.271 0.267 0.267 rg BT 213.640 458.617 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 216.049 456.236 Td /F4 8.7 Tf [(19)] TJ ET 0.271 0.267 0.267 rg BT 225.686 454.729 Td /F1 9.8 Tf [(. Third, authors argue that VH is due to ignorance, misperceptions or )] TJ ET BT 26.250 442.824 Td /F1 9.8 Tf [(disinformation )] TJ ET 0.267 0.267 0.267 rg BT 89.644 444.332 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 99.282 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 101.691 444.332 Td /F4 8.7 Tf [(21)] TJ ET 0.271 0.267 0.267 rg BT 111.329 442.824 Td /F1 9.8 Tf [(, and others that it may result from too much information )] TJ ET 0.267 0.267 0.267 rg BT 355.722 444.332 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 365.359 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 367.769 444.332 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 377.406 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 379.815 444.332 Td /F4 8.7 Tf [(22)] TJ ET 0.271 0.267 0.267 rg BT 389.453 442.824 Td /F1 9.8 Tf [(. One author even states that VH is driven )] TJ ET BT 26.250 430.920 Td /F1 9.8 Tf [(basically by emotions and irrationality and vaccine refusers should be liable for the harm they cause to others )] TJ ET 0.267 0.267 0.267 rg BT 499.330 432.427 Td /F4 8.7 Tf [(23)] TJ ET 0.271 0.267 0.267 rg BT 508.967 430.920 Td /F1 9.8 Tf [(. Fourth, VH is )] TJ ET BT 26.250 419.015 Td /F1 9.8 Tf [(sometimes described with a neutral tone, or even praised )] TJ ET 0.267 0.267 0.267 rg BT 276.065 420.522 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 280.883 422.903 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 283.293 420.522 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 292.930 422.903 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 295.339 420.522 Td /F4 8.7 Tf [(24)] TJ ET 0.271 0.267 0.267 rg BT 304.977 419.015 Td /F1 9.8 Tf [(, but it has also been described \(metaphorically?\) as a )] TJ ET BT 26.250 407.110 Td /F1 9.8 Tf [(condition more or less severe that should be diagnosed among people at risk )] TJ ET 0.267 0.267 0.267 rg BT 380.643 408.617 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 385.462 410.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 387.871 408.617 Td /F4 8.7 Tf [(25)] TJ ET 0.271 0.267 0.267 rg BT 397.508 410.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 399.918 408.617 Td /F4 8.7 Tf [(26)] TJ ET 0.271 0.267 0.267 rg BT 409.555 407.110 Td /F1 9.8 Tf [( and as a weed deeply rooted in the )] TJ ET BT 26.250 395.205 Td /F1 9.8 Tf [(defects of human nature )] TJ ET 0.267 0.267 0.267 rg BT 134.105 396.713 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 143.742 395.205 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 375.801 Td /F1 9.8 Tf [(Finally, while some empirical studies report that VH is more frequent among people with a high socioeconomic status \(SES\), )] TJ ET BT 26.250 363.896 Td /F1 9.8 Tf [(others report the opposite or observe no relation, especially regarding educational level )] TJ ET 0.267 0.267 0.267 rg BT 404.511 365.403 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 409.330 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 411.739 365.403 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 416.558 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 418.967 365.403 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 423.786 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 426.195 365.403 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 435.832 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 438.242 365.403 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 447.879 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 450.288 365.403 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 459.926 363.896 Td /F1 9.8 Tf [(. Such inconsistent results )] TJ ET BT 26.250 351.991 Td /F1 9.8 Tf [(are disturbing for social scientists, as SES is supposed to strongly shape our beliefs, attitudes and behaviours, in meaningful )] TJ ET BT 26.250 340.086 Td /F1 9.8 Tf [(ways.)] TJ ET BT 26.250 320.682 Td /F1 9.8 Tf [(These different attitudes tend to assort into specific profiles; for example, those who consider VH an old phenomenon that )] TJ ET BT 26.250 308.777 Td /F1 9.8 Tf [(encompasses anti-vaccination attitudes often attribute it to ignorance, misinformation or irrationality, while those who describe it )] TJ ET BT 26.250 296.872 Td /F1 9.8 Tf [(as a new attitude, distinct from strong opposition to vaccination, also argue that it is positively correlated with vaccine-related )] TJ ET BT 26.250 284.967 Td /F1 9.8 Tf [(knowledge.)] TJ ET BT 26.250 265.563 Td /F1 9.8 Tf [(More generally, VH is not really an empirical concept, as the term concept traditionally refers to a general mental )] TJ ET BT 26.250 253.658 Td /F1 9.8 Tf [(representation derived from the variety of perceived objects and defines what is common to them the features necessary and )] TJ ET BT 26.250 241.753 Td /F1 9.8 Tf [(sufficient for membership in the class/concept through comparison, reflection and abstraction. The current definitions of VH, )] TJ ET BT 26.250 229.848 Td /F1 9.8 Tf [(rather than delineating a set of core elements, cover a wide range of heterogeneous, and even sometimes contradictory, )] TJ ET BT 26.250 217.944 Td /F1 9.8 Tf [(elements.)] TJ ET BT 26.250 181.341 Td /F4 12.0 Tf [(Two issues raised by the VH definitions: what is VH, and where to position it?)] TJ ET BT 26.250 161.387 Td /F4 9.8 Tf [(A belief/attitude, a behaviour, or a decision-making process?)] TJ ET BT 26.250 141.982 Td /F1 9.8 Tf [(It is not fully satisfactory to define VH as a behaviour, as it is associated in the literature with various and non-specific )] TJ ET BT 26.250 130.077 Td /F1 9.8 Tf [(behaviours and outcomes \(due to reluctant conformism and vaccine-specific behaviours\). Moreover, VH is not the only possible )] TJ ET BT 26.250 118.173 Td /F1 9.8 Tf [(explanation for each of these different outcomes: acceptance might also be due to strong support, refusal to strong opposition, )] TJ ET BT 26.250 106.268 Td /F1 9.8 Tf [(and delay to procrastination, oversight, or ignorance. Nevertheless, VH may be associated with other kinds of behaviours, such )] TJ ET BT 26.250 94.363 Td /F1 9.8 Tf [(as information seeking, and the notion of attitude can be defined in many different ways \(including a positive or negative )] TJ ET BT 26.250 82.458 Td /F1 9.8 Tf [(evaluation, or a disposition to act\). This ambiguity regarding the nature of VH may create problems in dealing with it: when )] TJ ET BT 26.250 70.554 Td /F1 9.8 Tf [(researchers design an intervention aimed at promoting vaccination or a specific vaccine, for example, should they target an )] TJ ET BT 26.250 58.649 Td /F1 9.8 Tf [(attitudinal or a behavioural outcome?)] TJ ET BT 26.250 39.244 Td /F1 9.8 Tf [(Nevertheless, beyond this ambiguity, it would be probably more useful to consider VH as a decision-making process \(how/why )] TJ ET Q q 15.000 24.958 577.500 752.042 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(The ambiguities of current definitions of VH.)] TJ ET BT 26.250 730.324 Td /F4 9.8 Tf [(VH definitions in the public health literature.)] TJ ET BT 26.250 710.919 Td /F1 9.8 Tf [(VH has been defined as a set of beliefs )] TJ ET 0.267 0.267 0.267 rg BT 198.601 712.427 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 208.238 710.919 Td /F1 9.8 Tf [(, attitudes )] TJ ET 0.267 0.267 0.267 rg BT 253.225 712.427 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 258.043 714.808 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 260.453 712.427 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 270.090 710.919 Td /F1 9.8 Tf [(, behaviours )] TJ ET 0.267 0.267 0.267 rg BT 325.909 712.427 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 335.546 710.919 Td /F1 9.8 Tf [(, or some combination of them )] TJ ET 0.267 0.267 0.267 rg BT 469.394 712.427 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 479.031 714.808 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 481.441 712.427 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 491.078 710.919 Td /F1 9.8 Tf [(, exhibited by lay )] TJ ET BT 26.250 699.015 Td /F1 9.8 Tf [(people in regard to their own or their childrens immunisations, but also sometimes by healthcare professionals. VH is an )] TJ ET BT 26.250 687.110 Td /F1 9.8 Tf [(attribute ascribed to a large and heterogeneous category )] TJ ET 0.267 0.267 0.267 rg BT 273.929 688.617 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 278.748 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 281.157 688.617 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 285.976 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 288.385 688.617 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 293.204 690.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 295.613 688.617 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 305.251 687.110 Td /F1 9.8 Tf [( that regroups people who share varying degrees and motives )] TJ ET BT 26.250 675.205 Td /F1 9.8 Tf [(of indecision and who hold an intermediate position along a continuum ranging from full support for vaccination to strong )] TJ ET BT 26.250 663.300 Td /F1 9.8 Tf [(opposition to any vaccine )] TJ ET 0.267 0.267 0.267 rg BT 138.433 664.808 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 143.252 667.189 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 145.662 664.808 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 150.480 667.189 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 152.890 664.808 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 162.527 663.300 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 643.896 Td /F1 9.8 Tf [(These people are characterised by what we may call reluctant conformism and vaccine-specific behaviours )] TJ ET 0.267 0.267 0.267 rg BT 490.087 645.403 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 494.905 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 497.315 645.403 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 502.133 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 504.543 645.403 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 509.361 647.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 511.771 645.403 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 521.408 643.896 Td /F1 9.8 Tf [(. They may )] TJ ET BT 26.250 631.991 Td /F1 9.8 Tf [(decline a vaccine, but they may also delay it or even accept it in due time despite their doubts/reluctance. In other words, they )] TJ ET BT 26.250 620.086 Td /F1 9.8 Tf [(may endorse a wide range of non-specific behaviours, all of which can result from something else than VH. This behavioural )] TJ ET BT 26.250 608.181 Td /F1 9.8 Tf [(outcome can vary from one vaccine to another: they may accept one vaccine, but decline/delay another, as they base their )] TJ ET BT 26.250 596.277 Td /F1 9.8 Tf [(decision on vaccine-specific features.)] TJ ET BT 26.250 576.872 Td /F4 9.8 Tf [(A catchall category, not a concept.)] TJ ET BT 26.250 557.467 Td /F1 9.8 Tf [(Definitions that try to describe VH as it is used by researchers tend to be very broad and to embrace heterogeneous )] TJ ET BT 26.250 545.562 Td /F1 9.8 Tf [(people/situations and many different explanatory factors \(including historic, political and socio-cultural contexts, as well as )] TJ ET BT 26.250 533.658 Td /F1 9.8 Tf [(individual/social group influences )] TJ ET 0.267 0.267 0.267 rg BT 171.476 535.165 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 176.295 537.546 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 178.704 535.165 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 183.523 537.546 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 185.932 535.165 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 190.751 533.658 Td /F1 9.8 Tf [(\). Moreover, some previous empirical studies have found quite contrasting profiles of )] TJ ET BT 26.250 521.753 Td /F1 9.8 Tf [(attitudes among those who could be categorised as vaccine-hesitant )] TJ ET 0.267 0.267 0.267 rg BT 324.317 523.260 Td /F4 8.7 Tf [(13)] TJ ET 0.271 0.267 0.267 rg BT 333.955 525.641 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 336.364 523.260 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 346.001 521.753 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 502.348 Td /F1 9.8 Tf [(Previous studies also show several contradictions in their use of VH. First, some authors argue that it is something new, distinct )] TJ ET BT 26.250 490.443 Td /F1 9.8 Tf [(from old-fashioned anti-vaccination )] TJ ET 0.267 0.267 0.267 rg BT 180.144 491.951 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 189.781 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 192.191 491.951 Td /F4 8.7 Tf [(15)] TJ ET 0.271 0.267 0.267 rg BT 201.828 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 204.237 491.951 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 213.875 490.443 Td /F1 9.8 Tf [(, while others state that it is as old as vaccination itself )] TJ ET 0.267 0.267 0.267 rg BT 450.146 491.951 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 454.965 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 457.374 491.951 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 467.012 494.332 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 469.421 491.951 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 479.058 490.443 Td /F1 9.8 Tf [(. Second, some )] TJ ET BT 26.250 478.539 Td /F1 9.8 Tf [(authors consider that VH corresponds to an intermediate position, in the middle of the continuum between the pro-vaccination )] TJ ET BT 26.250 466.634 Td /F1 9.8 Tf [(and anti-vaccination positions \(that is, on what we shall refer to as the pro/anti continuum )] TJ ET 0.267 0.267 0.267 rg BT 415.343 468.141 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 420.162 470.522 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 422.571 468.141 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 427.390 470.522 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 429.799 468.141 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 439.437 466.634 Td /F1 9.8 Tf [( , while others consider that VH )] TJ ET BT 26.250 454.729 Td /F1 9.8 Tf [(includes strong opposition to vaccination )] TJ ET 0.267 0.267 0.267 rg BT 204.002 456.236 Td /F4 8.7 Tf [(18)] TJ ET 0.271 0.267 0.267 rg BT 213.640 458.617 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 216.049 456.236 Td /F4 8.7 Tf [(19)] TJ ET 0.271 0.267 0.267 rg BT 225.686 454.729 Td /F1 9.8 Tf [(. Third, authors argue that VH is due to ignorance, misperceptions or )] TJ ET BT 26.250 442.824 Td /F1 9.8 Tf [(disinformation )] TJ ET 0.267 0.267 0.267 rg BT 89.644 444.332 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 99.282 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 101.691 444.332 Td /F4 8.7 Tf [(21)] TJ ET 0.271 0.267 0.267 rg BT 111.329 442.824 Td /F1 9.8 Tf [(, and others that it may result from too much information )] TJ ET 0.267 0.267 0.267 rg BT 355.722 444.332 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 365.359 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 367.769 444.332 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 377.406 446.713 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 379.815 444.332 Td /F4 8.7 Tf [(22)] TJ ET 0.271 0.267 0.267 rg BT 389.453 442.824 Td /F1 9.8 Tf [(. One author even states that VH is driven )] TJ ET BT 26.250 430.920 Td /F1 9.8 Tf [(basically by emotions and irrationality and vaccine refusers should be liable for the harm they cause to others )] TJ ET 0.267 0.267 0.267 rg BT 499.330 432.427 Td /F4 8.7 Tf [(23)] TJ ET 0.271 0.267 0.267 rg BT 508.967 430.920 Td /F1 9.8 Tf [(. Fourth, VH is )] TJ ET BT 26.250 419.015 Td /F1 9.8 Tf [(sometimes described with a neutral tone, or even praised )] TJ ET 0.267 0.267 0.267 rg BT 276.065 420.522 Td /F4 8.7 Tf [(9)] TJ ET 0.271 0.267 0.267 rg BT 280.883 422.903 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 283.293 420.522 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 292.930 422.903 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 295.339 420.522 Td /F4 8.7 Tf [(24)] TJ ET 0.271 0.267 0.267 rg BT 304.977 419.015 Td /F1 9.8 Tf [(, but it has also been described \(metaphorically?\) as a )] TJ ET BT 26.250 407.110 Td /F1 9.8 Tf [(condition more or less severe that should be diagnosed among people at risk )] TJ ET 0.267 0.267 0.267 rg BT 380.643 408.617 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 385.462 410.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 387.871 408.617 Td /F4 8.7 Tf [(25)] TJ ET 0.271 0.267 0.267 rg BT 397.508 410.998 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 399.918 408.617 Td /F4 8.7 Tf [(26)] TJ ET 0.271 0.267 0.267 rg BT 409.555 407.110 Td /F1 9.8 Tf [( and as a weed deeply rooted in the )] TJ ET BT 26.250 395.205 Td /F1 9.8 Tf [(defects of human nature )] TJ ET 0.267 0.267 0.267 rg BT 134.105 396.713 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 143.742 395.205 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 375.801 Td /F1 9.8 Tf [(Finally, while some empirical studies report that VH is more frequent among people with a high socioeconomic status \(SES\), )] TJ ET BT 26.250 363.896 Td /F1 9.8 Tf [(others report the opposite or observe no relation, especially regarding educational level )] TJ ET 0.267 0.267 0.267 rg BT 404.511 365.403 Td /F4 8.7 Tf [(6)] TJ ET 0.271 0.267 0.267 rg BT 409.330 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 411.739 365.403 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 416.558 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 418.967 365.403 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 423.786 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 426.195 365.403 Td /F4 8.7 Tf [(12)] TJ ET 0.271 0.267 0.267 rg BT 435.832 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 438.242 365.403 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 447.879 367.784 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 450.288 365.403 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 459.926 363.896 Td /F1 9.8 Tf [(. Such inconsistent results )] TJ ET BT 26.250 351.991 Td /F1 9.8 Tf [(are disturbing for social scientists, as SES is supposed to strongly shape our beliefs, attitudes and behaviours, in meaningful )] TJ ET BT 26.250 340.086 Td /F1 9.8 Tf [(ways.)] TJ ET BT 26.250 320.682 Td /F1 9.8 Tf [(These different attitudes tend to assort into specific profiles; for example, those who consider VH an old phenomenon that )] TJ ET BT 26.250 308.777 Td /F1 9.8 Tf [(encompasses anti-vaccination attitudes often attribute it to ignorance, misinformation or irrationality, while those who describe it )] TJ ET BT 26.250 296.872 Td /F1 9.8 Tf [(as a new attitude, distinct from strong opposition to vaccination, also argue that it is positively correlated with vaccine-related )] TJ ET BT 26.250 284.967 Td /F1 9.8 Tf [(knowledge.)] TJ ET BT 26.250 265.563 Td /F1 9.8 Tf [(More generally, VH is not really an empirical concept, as the term concept traditionally refers to a general mental )] TJ ET BT 26.250 253.658 Td /F1 9.8 Tf [(representation derived from the variety of perceived objects and defines what is common to them the features necessary and )] TJ ET BT 26.250 241.753 Td /F1 9.8 Tf [(sufficient for membership in the class/concept through comparison, reflection and abstraction. The current definitions of VH, )] TJ ET BT 26.250 229.848 Td /F1 9.8 Tf [(rather than delineating a set of core elements, cover a wide range of heterogeneous, and even sometimes contradictory, )] TJ ET BT 26.250 217.944 Td /F1 9.8 Tf [(elements.)] TJ ET BT 26.250 181.341 Td /F4 12.0 Tf [(Two issues raised by the VH definitions: what is VH, and where to position it?)] TJ ET BT 26.250 161.387 Td /F4 9.8 Tf [(A belief/attitude, a behaviour, or a decision-making process?)] TJ ET BT 26.250 141.982 Td /F1 9.8 Tf [(It is not fully satisfactory to define VH as a behaviour, as it is associated in the literature with various and non-specific )] TJ ET BT 26.250 130.077 Td /F1 9.8 Tf [(behaviours and outcomes \(due to reluctant conformism and vaccine-specific behaviours\). Moreover, VH is not the only possible )] TJ ET BT 26.250 118.173 Td /F1 9.8 Tf [(explanation for each of these different outcomes: acceptance might also be due to strong support, refusal to strong opposition, )] TJ ET BT 26.250 106.268 Td /F1 9.8 Tf [(and delay to procrastination, oversight, or ignorance. Nevertheless, VH may be associated with other kinds of behaviours, such )] TJ ET BT 26.250 94.363 Td /F1 9.8 Tf [(as information seeking, and the notion of attitude can be defined in many different ways \(including a positive or negative )] TJ ET BT 26.250 82.458 Td /F1 9.8 Tf [(evaluation, or a disposition to act\). This ambiguity regarding the nature of VH may create problems in dealing with it: when )] TJ ET BT 26.250 70.554 Td /F1 9.8 Tf [(researchers design an intervention aimed at promoting vaccination or a specific vaccine, for example, should they target an )] TJ ET BT 26.250 58.649 Td /F1 9.8 Tf [(attitudinal or a behavioural outcome?)] TJ ET BT 26.250 39.244 Td /F1 9.8 Tf [(Nevertheless, beyond this ambiguity, it would be probably more useful to consider VH as a decision-making process \(how/why )] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(2)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Outbreaks)] TJ ET Q endstream endobj 138 0 obj << /Type /Annot /Subtype /Link /A 139 0 R /Border [0 0 0] /H /I /Rect [ 198.6008 711.6249 208.2381 720.4433 ] >> endobj 139 0 obj << /Type /Action >> endobj 140 0 obj << /Type /Annot /Subtype /Link /A 141 0 R /Border [0 0 0] /H /I /Rect [ 253.2246 711.6249 258.0433 720.4433 ] >> endobj 141 0 obj << /Type /Action >> endobj 142 0 obj << /Type /Annot /Subtype /Link /A 143 0 R /Border [0 0 0] /H /I /Rect [ 260.4526 711.6249 270.0899 720.4433 ] >> endobj 143 0 obj << /Type /Action >> endobj 144 0 obj << /Type /Annot /Subtype /Link /A 145 0 R /Border [0 0 0] /H /I /Rect [ 325.9087 711.6249 335.5460 720.4433 ] >> endobj 145 0 obj << /Type /Action >> endobj 146 0 obj << /Type /Annot /Subtype /Link /A 147 0 R /Border [0 0 0] /H /I /Rect [ 469.3940 711.6249 479.0313 720.4433 ] >> endobj 147 0 obj << /Type /Action >> endobj 148 0 obj << /Type /Annot /Subtype /Link /A 149 0 R /Border [0 0 0] /H /I /Rect [ 481.4407 711.6249 491.0780 720.4433 ] >> endobj 149 0 obj << /Type /Action >> endobj 150 0 obj << /Type /Annot /Subtype /Link /A 151 0 R /Border [0 0 0] /H /I /Rect [ 273.9293 687.8154 278.7479 696.6337 ] >> endobj 151 0 obj << /Type /Action >> endobj 152 0 obj << /Type /Annot /Subtype /Link /A 153 0 R /Border [0 0 0] /H /I /Rect [ 281.1572 687.8154 285.9759 696.6337 ] >> endobj 153 0 obj << /Type /Action >> endobj 154 0 obj << /Type /Annot /Subtype /Link /A 155 0 R /Border [0 0 0] /H /I /Rect [ 288.3853 687.8154 293.2039 696.6337 ] >> endobj 155 0 obj << /Type /Action >> endobj 156 0 obj << /Type /Annot /Subtype /Link /A 157 0 R /Border [0 0 0] /H /I /Rect [ 295.6133 687.8154 305.2506 696.6337 ] >> endobj 157 0 obj << /Type /Action >> endobj 158 0 obj << /Type /Annot /Subtype /Link /A 159 0 R /Border [0 0 0] /H /I /Rect [ 138.4335 664.0059 143.2522 672.8243 ] >> endobj 159 0 obj << /Type /Action >> endobj 160 0 obj << /Type /Annot /Subtype /Link /A 161 0 R /Border [0 0 0] /H /I /Rect [ 145.6615 664.0059 150.4802 672.8243 ] >> endobj 161 0 obj << /Type /Action >> endobj 162 0 obj << /Type /Annot /Subtype /Link /A 163 0 R /Border [0 0 0] /H /I /Rect [ 152.8895 664.0059 162.5268 672.8243 ] >> endobj 163 0 obj << /Type /Action >> endobj 164 0 obj << /Type /Annot /Subtype /Link /A 165 0 R /Border [0 0 0] /H /I /Rect [ 490.0867 644.6012 494.9054 653.4195 ] >> endobj 165 0 obj << /Type /Action >> endobj 166 0 obj << /Type /Annot /Subtype /Link /A 167 0 R /Border [0 0 0] /H /I /Rect [ 497.3148 644.6012 502.1334 653.4195 ] >> endobj 167 0 obj << /Type /Action >> endobj 168 0 obj << /Type /Annot /Subtype /Link /A 169 0 R /Border [0 0 0] /H /I /Rect [ 504.5428 644.6012 509.3614 653.4195 ] >> endobj 169 0 obj << /Type /Action >> endobj 170 0 obj << /Type /Annot /Subtype /Link /A 171 0 R /Border [0 0 0] /H /I /Rect [ 511.7708 644.6012 521.4081 653.4195 ] >> endobj 171 0 obj << /Type /Action >> endobj 172 0 obj << /Type /Annot /Subtype /Link /A 173 0 R /Border [0 0 0] /H /I /Rect [ 171.4762 534.3632 176.2949 543.1815 ] >> endobj 173 0 obj << /Type /Action >> endobj 174 0 obj << /Type /Annot /Subtype /Link /A 175 0 R /Border [0 0 0] /H /I /Rect [ 178.7043 534.3632 183.5229 543.1815 ] >> endobj 175 0 obj << /Type /Action >> endobj 176 0 obj << /Type /Annot /Subtype /Link /A 177 0 R /Border [0 0 0] /H /I /Rect [ 185.9323 534.3632 190.7509 543.1815 ] >> endobj 177 0 obj << /Type /Action >> endobj 178 0 obj << /Type /Annot /Subtype /Link /A 179 0 R /Border [0 0 0] /H /I /Rect [ 324.3173 522.4584 333.9546 531.2767 ] >> endobj 179 0 obj << /Type /Action >> endobj 180 0 obj << /Type /Annot /Subtype /Link /A 181 0 R /Border [0 0 0] /H /I /Rect [ 336.3639 522.4584 346.0013 531.2767 ] >> endobj 181 0 obj << /Type /Action >> endobj 182 0 obj << /Type /Annot /Subtype /Link /A 183 0 R /Border [0 0 0] /H /I /Rect [ 180.1440 491.1489 189.7813 499.9672 ] >> endobj 183 0 obj << /Type /Action >> endobj 184 0 obj << /Type /Annot /Subtype /Link /A 185 0 R /Border [0 0 0] /H /I /Rect [ 192.1907 491.1489 201.8280 499.9672 ] >> endobj 185 0 obj << /Type /Action >> endobj 186 0 obj << /Type /Annot /Subtype /Link /A 187 0 R /Border [0 0 0] /H /I /Rect [ 204.2373 491.1489 213.8747 499.9672 ] >> endobj 187 0 obj << /Type /Action >> endobj 188 0 obj << /Type /Annot /Subtype /Link /A 189 0 R /Border [0 0 0] /H /I /Rect [ 450.1464 491.1489 454.9651 499.9672 ] >> endobj 189 0 obj << /Type /Action >> endobj 190 0 obj << /Type /Annot /Subtype /Link /A 191 0 R /Border [0 0 0] /H /I /Rect [ 457.3744 491.1489 467.0118 499.9672 ] >> endobj 191 0 obj << /Type /Action >> endobj 192 0 obj << /Type /Annot /Subtype /Link /A 193 0 R /Border [0 0 0] /H /I /Rect [ 469.4211 491.1489 479.0584 499.9672 ] >> endobj 193 0 obj << /Type /Action >> endobj 194 0 obj << /Type /Annot /Subtype /Link /A 195 0 R /Border [0 0 0] /H /I /Rect [ 415.3433 467.3394 420.1619 476.1578 ] >> endobj 195 0 obj << /Type /Action >> endobj 196 0 obj << /Type /Annot /Subtype /Link /A 197 0 R /Border [0 0 0] /H /I /Rect [ 422.5713 467.3394 427.3899 476.1578 ] >> endobj 197 0 obj << /Type /Action >> endobj 198 0 obj << /Type /Annot /Subtype /Link /A 199 0 R /Border [0 0 0] /H /I /Rect [ 429.7993 467.3394 439.4366 476.1578 ] >> endobj 199 0 obj << /Type /Action >> endobj 200 0 obj << /Type /Annot /Subtype /Link /A 201 0 R /Border [0 0 0] /H /I /Rect [ 204.0023 455.4347 213.6396 464.2530 ] >> endobj 201 0 obj << /Type /Action >> endobj 202 0 obj << /Type /Annot /Subtype /Link /A 203 0 R /Border [0 0 0] /H /I /Rect [ 216.0489 455.4347 225.6863 464.2530 ] >> endobj 203 0 obj << /Type /Action >> endobj 204 0 obj << /Type /Annot /Subtype /Link /A 205 0 R /Border [0 0 0] /H /I /Rect [ 89.6445 443.5299 99.2818 452.3483 ] >> endobj 205 0 obj << /Type /Action >> endobj 206 0 obj << /Type /Annot /Subtype /Link /A 207 0 R /Border [0 0 0] /H /I /Rect [ 101.6912 443.5299 111.3285 452.3483 ] >> endobj 207 0 obj << /Type /Action >> endobj 208 0 obj << /Type /Annot /Subtype /Link /A 209 0 R /Border [0 0 0] /H /I /Rect [ 355.7220 443.5299 365.3593 452.3483 ] >> endobj 209 0 obj << /Type /Action >> endobj 210 0 obj << /Type /Annot /Subtype /Link /A 211 0 R /Border [0 0 0] /H /I /Rect [ 367.7687 443.5299 377.4060 452.3483 ] >> endobj 211 0 obj << /Type /Action >> endobj 212 0 obj << /Type /Annot /Subtype /Link /A 213 0 R /Border [0 0 0] /H /I /Rect [ 379.8153 443.5299 389.4527 452.3483 ] >> endobj 213 0 obj << /Type /Action >> endobj 214 0 obj << /Type /Annot /Subtype /Link /A 215 0 R /Border [0 0 0] /H /I /Rect [ 499.3297 431.6252 508.9671 440.4435 ] >> endobj 215 0 obj << /Type /Action >> endobj 216 0 obj << /Type /Annot /Subtype /Link /A 217 0 R /Border [0 0 0] /H /I /Rect [ 276.0645 419.7204 280.8832 428.5388 ] >> endobj 217 0 obj << /Type /Action >> endobj 218 0 obj << /Type /Annot /Subtype /Link /A 219 0 R /Border [0 0 0] /H /I /Rect [ 283.2925 419.7204 292.9298 428.5388 ] >> endobj 219 0 obj << /Type /Action >> endobj 220 0 obj << /Type /Annot /Subtype /Link /A 221 0 R /Border [0 0 0] /H /I /Rect [ 295.3392 419.7204 304.9765 428.5388 ] >> endobj 221 0 obj << /Type /Action >> endobj 222 0 obj << /Type /Annot /Subtype /Link /A 223 0 R /Border [0 0 0] /H /I /Rect [ 380.6430 407.8157 385.4617 416.6340 ] >> endobj 223 0 obj << /Type /Action >> endobj 224 0 obj << /Type /Annot /Subtype /Link /A 225 0 R /Border [0 0 0] /H /I /Rect [ 387.8710 407.8157 397.5083 416.6340 ] >> endobj 225 0 obj << /Type /Action >> endobj 226 0 obj << /Type /Annot /Subtype /Link /A 227 0 R /Border [0 0 0] /H /I /Rect [ 399.9177 407.8157 409.5550 416.6340 ] >> endobj 227 0 obj << /Type /Action >> endobj 228 0 obj << /Type /Annot /Subtype /Link /A 229 0 R /Border [0 0 0] /H /I /Rect [ 134.1045 395.9109 143.7418 404.7293 ] >> endobj 229 0 obj << /Type /Action >> endobj 230 0 obj << /Type /Annot /Subtype /Link /A 231 0 R /Border [0 0 0] /H /I /Rect [ 404.5110 364.6014 409.3297 373.4198 ] >> endobj 231 0 obj << /Type /Action >> endobj 232 0 obj << /Type /Annot /Subtype /Link /A 233 0 R /Border [0 0 0] /H /I /Rect [ 411.7390 364.6014 416.5577 373.4198 ] >> endobj 233 0 obj << /Type /Action >> endobj 234 0 obj << /Type /Annot /Subtype /Link /A 235 0 R /Border [0 0 0] /H /I /Rect [ 418.9670 364.6014 423.7857 373.4198 ] >> endobj 235 0 obj << /Type /Action >> endobj 236 0 obj << /Type /Annot /Subtype /Link /A 237 0 R /Border [0 0 0] /H /I /Rect [ 426.1950 364.6014 435.8323 373.4198 ] >> endobj 237 0 obj << /Type /Action >> endobj 238 0 obj << /Type /Annot /Subtype /Link /A 239 0 R /Border [0 0 0] /H /I /Rect [ 438.2417 364.6014 447.8790 373.4198 ] >> endobj 239 0 obj << /Type /Action >> endobj 240 0 obj << /Type /Annot /Subtype /Link /A 241 0 R /Border [0 0 0] /H /I /Rect [ 450.2883 364.6014 459.9257 373.4198 ] >> endobj 241 0 obj << /Type /Action >> endobj 242 0 obj << /Type /Annot /Subtype /Link /A 243 0 R /Border [0 0 0] /H /I /Rect [ 198.6008 711.6249 208.2381 720.4433 ] >> endobj 243 0 obj << /Type /Action >> endobj 244 0 obj << /Type /Annot /Subtype /Link /A 245 0 R /Border [0 0 0] /H /I /Rect [ 253.2246 711.6249 258.0433 720.4433 ] >> endobj 245 0 obj << /Type /Action >> endobj 246 0 obj << /Type /Annot /Subtype /Link /A 247 0 R /Border [0 0 0] /H /I /Rect [ 260.4526 711.6249 270.0899 720.4433 ] >> endobj 247 0 obj << /Type /Action >> endobj 248 0 obj << /Type /Annot /Subtype /Link /A 249 0 R /Border [0 0 0] /H /I /Rect [ 325.9087 711.6249 335.5460 720.4433 ] >> endobj 249 0 obj << /Type /Action >> endobj 250 0 obj << /Type /Annot /Subtype /Link /A 251 0 R /Border [0 0 0] /H /I /Rect [ 469.3940 711.6249 479.0313 720.4433 ] >> endobj 251 0 obj << /Type /Action >> endobj 252 0 obj << /Type /Annot /Subtype /Link /A 253 0 R /Border [0 0 0] /H /I /Rect [ 481.4407 711.6249 491.0780 720.4433 ] >> endobj 253 0 obj << /Type /Action >> endobj 254 0 obj << /Type /Annot /Subtype /Link /A 255 0 R /Border [0 0 0] /H /I /Rect [ 273.9293 687.8154 278.7479 696.6337 ] >> endobj 255 0 obj << /Type /Action >> endobj 256 0 obj << /Type /Annot /Subtype /Link /A 257 0 R /Border [0 0 0] /H /I /Rect [ 281.1572 687.8154 285.9759 696.6337 ] >> endobj 257 0 obj << /Type /Action >> endobj 258 0 obj << /Type /Annot /Subtype /Link /A 259 0 R /Border [0 0 0] /H /I /Rect [ 288.3853 687.8154 293.2039 696.6337 ] >> endobj 259 0 obj << /Type /Action >> endobj 260 0 obj << /Type /Annot /Subtype /Link /A 261 0 R /Border [0 0 0] /H /I /Rect [ 295.6133 687.8154 305.2506 696.6337 ] >> endobj 261 0 obj << /Type /Action >> endobj 262 0 obj << /Type /Annot /Subtype /Link /A 263 0 R /Border [0 0 0] /H /I /Rect [ 138.4335 664.0059 143.2522 672.8243 ] >> endobj 263 0 obj << /Type /Action >> endobj 264 0 obj << /Type /Annot /Subtype /Link /A 265 0 R /Border [0 0 0] /H /I /Rect [ 145.6615 664.0059 150.4802 672.8243 ] >> endobj 265 0 obj << /Type /Action >> endobj 266 0 obj << /Type /Annot /Subtype /Link /A 267 0 R /Border [0 0 0] /H /I /Rect [ 152.8895 664.0059 162.5268 672.8243 ] >> endobj 267 0 obj << /Type /Action >> endobj 268 0 obj << /Type /Annot /Subtype /Link /A 269 0 R /Border [0 0 0] /H /I /Rect [ 490.0867 644.6012 494.9054 653.4195 ] >> endobj 269 0 obj << /Type /Action >> endobj 270 0 obj << /Type /Annot /Subtype /Link /A 271 0 R /Border [0 0 0] /H /I /Rect [ 497.3148 644.6012 502.1334 653.4195 ] >> endobj 271 0 obj << /Type /Action >> endobj 272 0 obj << /Type /Annot /Subtype /Link /A 273 0 R /Border [0 0 0] /H /I /Rect [ 504.5428 644.6012 509.3614 653.4195 ] >> endobj 273 0 obj << /Type /Action >> endobj 274 0 obj << /Type /Annot /Subtype /Link /A 275 0 R /Border [0 0 0] /H /I /Rect [ 511.7708 644.6012 521.4081 653.4195 ] >> endobj 275 0 obj << /Type /Action >> endobj 276 0 obj << /Type /Annot /Subtype /Link /A 277 0 R /Border [0 0 0] /H /I /Rect [ 171.4762 534.3632 176.2949 543.1815 ] >> endobj 277 0 obj << /Type /Action >> endobj 278 0 obj << /Type /Annot /Subtype /Link /A 279 0 R /Border [0 0 0] /H /I /Rect [ 178.7043 534.3632 183.5229 543.1815 ] >> endobj 279 0 obj << /Type /Action >> endobj 280 0 obj << /Type /Annot /Subtype /Link /A 281 0 R /Border [0 0 0] /H /I /Rect [ 185.9323 534.3632 190.7509 543.1815 ] >> endobj 281 0 obj << /Type /Action >> endobj 282 0 obj << /Type /Annot /Subtype /Link /A 283 0 R /Border [0 0 0] /H /I /Rect [ 324.3173 522.4584 333.9546 531.2767 ] >> endobj 283 0 obj << /Type /Action >> endobj 284 0 obj << /Type /Annot /Subtype /Link /A 285 0 R /Border [0 0 0] /H /I /Rect [ 336.3639 522.4584 346.0013 531.2767 ] >> endobj 285 0 obj << /Type /Action >> endobj 286 0 obj << /Type /Annot /Subtype /Link /A 287 0 R /Border [0 0 0] /H /I /Rect [ 180.1440 491.1489 189.7813 499.9672 ] >> endobj 287 0 obj << /Type /Action >> endobj 288 0 obj << /Type /Annot /Subtype /Link /A 289 0 R /Border [0 0 0] /H /I /Rect [ 192.1907 491.1489 201.8280 499.9672 ] >> endobj 289 0 obj << /Type /Action >> endobj 290 0 obj << /Type /Annot /Subtype /Link /A 291 0 R /Border [0 0 0] /H /I /Rect [ 204.2373 491.1489 213.8747 499.9672 ] >> endobj 291 0 obj << /Type /Action >> endobj 292 0 obj << /Type /Annot /Subtype /Link /A 293 0 R /Border [0 0 0] /H /I /Rect [ 450.1464 491.1489 454.9651 499.9672 ] >> endobj 293 0 obj << /Type /Action >> endobj 294 0 obj << /Type /Annot /Subtype /Link /A 295 0 R /Border [0 0 0] /H /I /Rect [ 457.3744 491.1489 467.0118 499.9672 ] >> endobj 295 0 obj << /Type /Action >> endobj 296 0 obj << /Type /Annot /Subtype /Link /A 297 0 R /Border [0 0 0] /H /I /Rect [ 469.4211 491.1489 479.0584 499.9672 ] >> endobj 297 0 obj << /Type /Action >> endobj 298 0 obj << /Type /Annot /Subtype /Link /A 299 0 R /Border [0 0 0] /H /I /Rect [ 415.3433 467.3394 420.1619 476.1578 ] >> endobj 299 0 obj << /Type /Action >> endobj 300 0 obj << /Type /Annot /Subtype /Link /A 301 0 R /Border [0 0 0] /H /I /Rect [ 422.5713 467.3394 427.3899 476.1578 ] >> endobj 301 0 obj << /Type /Action >> endobj 302 0 obj << /Type /Annot /Subtype /Link /A 303 0 R /Border [0 0 0] /H /I /Rect [ 429.7993 467.3394 439.4366 476.1578 ] >> endobj 303 0 obj << /Type /Action >> endobj 304 0 obj << /Type /Annot /Subtype /Link /A 305 0 R /Border [0 0 0] /H /I /Rect [ 204.0023 455.4347 213.6396 464.2530 ] >> endobj 305 0 obj << /Type /Action >> endobj 306 0 obj << /Type /Annot /Subtype /Link /A 307 0 R /Border [0 0 0] /H /I /Rect [ 216.0489 455.4347 225.6863 464.2530 ] >> endobj 307 0 obj << /Type /Action >> endobj 308 0 obj << /Type /Annot /Subtype /Link /A 309 0 R /Border [0 0 0] /H /I /Rect [ 89.6445 443.5299 99.2818 452.3483 ] >> endobj 309 0 obj << /Type /Action >> endobj 310 0 obj << /Type /Annot /Subtype /Link /A 311 0 R /Border [0 0 0] /H /I /Rect [ 101.6912 443.5299 111.3285 452.3483 ] >> endobj 311 0 obj << /Type /Action >> endobj 312 0 obj << /Type /Annot /Subtype /Link /A 313 0 R /Border [0 0 0] /H /I /Rect [ 355.7220 443.5299 365.3593 452.3483 ] >> endobj 313 0 obj << /Type /Action >> endobj 314 0 obj << /Type /Annot /Subtype /Link /A 315 0 R /Border [0 0 0] /H /I /Rect [ 367.7687 443.5299 377.4060 452.3483 ] >> endobj 315 0 obj << /Type /Action >> endobj 316 0 obj << /Type /Annot /Subtype /Link /A 317 0 R /Border [0 0 0] /H /I /Rect [ 379.8153 443.5299 389.4527 452.3483 ] >> endobj 317 0 obj << /Type /Action >> endobj 318 0 obj << /Type /Annot /Subtype /Link /A 319 0 R /Border [0 0 0] /H /I /Rect [ 499.3297 431.6252 508.9671 440.4435 ] >> endobj 319 0 obj << /Type /Action >> endobj 320 0 obj << /Type /Annot /Subtype /Link /A 321 0 R /Border [0 0 0] /H /I /Rect [ 276.0645 419.7204 280.8832 428.5388 ] >> endobj 321 0 obj << /Type /Action >> endobj 322 0 obj << /Type /Annot /Subtype /Link /A 323 0 R /Border [0 0 0] /H /I /Rect [ 283.2925 419.7204 292.9298 428.5388 ] >> endobj 323 0 obj << /Type /Action >> endobj 324 0 obj << /Type /Annot /Subtype /Link /A 325 0 R /Border [0 0 0] /H /I /Rect [ 295.3392 419.7204 304.9765 428.5388 ] >> endobj 325 0 obj << /Type /Action >> endobj 326 0 obj << /Type /Annot /Subtype /Link /A 327 0 R /Border [0 0 0] /H /I /Rect [ 380.6430 407.8157 385.4617 416.6340 ] >> endobj 327 0 obj << /Type /Action >> endobj 328 0 obj << /Type /Annot /Subtype /Link /A 329 0 R /Border [0 0 0] /H /I /Rect [ 387.8710 407.8157 397.5083 416.6340 ] >> endobj 329 0 obj << /Type /Action >> endobj 330 0 obj << /Type /Annot /Subtype /Link /A 331 0 R /Border [0 0 0] /H /I /Rect [ 399.9177 407.8157 409.5550 416.6340 ] >> endobj 331 0 obj << /Type /Action >> endobj 332 0 obj << /Type /Annot /Subtype /Link /A 333 0 R /Border [0 0 0] /H /I /Rect [ 134.1045 395.9109 143.7418 404.7293 ] >> endobj 333 0 obj << /Type /Action >> endobj 334 0 obj << /Type /Annot /Subtype /Link /A 335 0 R /Border [0 0 0] /H /I /Rect [ 404.5110 364.6014 409.3297 373.4198 ] >> endobj 335 0 obj << /Type /Action >> endobj 336 0 obj << /Type /Annot /Subtype /Link /A 337 0 R /Border [0 0 0] /H /I /Rect [ 411.7390 364.6014 416.5577 373.4198 ] >> endobj 337 0 obj << /Type /Action >> endobj 338 0 obj << /Type /Annot /Subtype /Link /A 339 0 R /Border [0 0 0] /H /I /Rect [ 418.9670 364.6014 423.7857 373.4198 ] >> endobj 339 0 obj << /Type /Action >> endobj 340 0 obj << /Type /Annot /Subtype /Link /A 341 0 R /Border [0 0 0] /H /I /Rect [ 426.1950 364.6014 435.8323 373.4198 ] >> endobj 341 0 obj << /Type /Action >> endobj 342 0 obj << /Type /Annot /Subtype /Link /A 343 0 R /Border [0 0 0] /H /I /Rect [ 438.2417 364.6014 447.8790 373.4198 ] >> endobj 343 0 obj << /Type /Action >> endobj 344 0 obj << /Type /Annot /Subtype /Link /A 345 0 R /Border [0 0 0] /H /I /Rect [ 450.2883 364.6014 459.9257 373.4198 ] >> endobj 345 0 obj << /Type /Action >> endobj 346 0 obj << /Type /Annot /Subtype /Link /A 347 0 R /Border [0 0 0] /H /I /Rect [ 198.6008 711.6249 208.2381 720.4433 ] >> endobj 347 0 obj << /Type /Action >> endobj 348 0 obj << /Type /Annot /Subtype /Link /A 349 0 R /Border [0 0 0] /H /I /Rect [ 253.2246 711.6249 258.0433 720.4433 ] >> endobj 349 0 obj << /Type /Action >> endobj 350 0 obj << /Type /Annot /Subtype /Link /A 351 0 R /Border [0 0 0] /H /I /Rect [ 260.4526 711.6249 270.0899 720.4433 ] >> endobj 351 0 obj << /Type /Action >> endobj 352 0 obj << /Type /Annot /Subtype /Link /A 353 0 R /Border [0 0 0] /H /I /Rect [ 325.9087 711.6249 335.5460 720.4433 ] >> endobj 353 0 obj << /Type /Action >> endobj 354 0 obj << /Type /Annot /Subtype /Link /A 355 0 R /Border [0 0 0] /H /I /Rect [ 469.3940 711.6249 479.0313 720.4433 ] >> endobj 355 0 obj << /Type /Action >> endobj 356 0 obj << /Type /Annot /Subtype /Link /A 357 0 R /Border [0 0 0] /H /I /Rect [ 481.4407 711.6249 491.0780 720.4433 ] >> endobj 357 0 obj << /Type /Action >> endobj 358 0 obj << /Type /Annot /Subtype /Link /A 359 0 R /Border [0 0 0] /H /I /Rect [ 273.9293 687.8154 278.7479 696.6337 ] >> endobj 359 0 obj << /Type /Action >> endobj 360 0 obj << /Type /Annot /Subtype /Link /A 361 0 R /Border [0 0 0] /H /I /Rect [ 281.1572 687.8154 285.9759 696.6337 ] >> endobj 361 0 obj << /Type /Action >> endobj 362 0 obj << /Type /Annot /Subtype /Link /A 363 0 R /Border [0 0 0] /H /I /Rect [ 288.3853 687.8154 293.2039 696.6337 ] >> endobj 363 0 obj << /Type /Action >> endobj 364 0 obj << /Type /Annot /Subtype /Link /A 365 0 R /Border [0 0 0] /H /I /Rect [ 295.6133 687.8154 305.2506 696.6337 ] >> endobj 365 0 obj << /Type /Action >> endobj 366 0 obj << /Type /Annot /Subtype /Link /A 367 0 R /Border [0 0 0] /H /I /Rect [ 138.4335 664.0059 143.2522 672.8243 ] >> endobj 367 0 obj << /Type /Action >> endobj 368 0 obj << /Type /Annot /Subtype /Link /A 369 0 R /Border [0 0 0] /H /I /Rect [ 145.6615 664.0059 150.4802 672.8243 ] >> endobj 369 0 obj << /Type /Action >> endobj 370 0 obj << /Type /Annot /Subtype /Link /A 371 0 R /Border [0 0 0] /H /I /Rect [ 152.8895 664.0059 162.5268 672.8243 ] >> endobj 371 0 obj << /Type /Action >> endobj 372 0 obj << /Type /Annot /Subtype /Link /A 373 0 R /Border [0 0 0] /H /I /Rect [ 490.0867 644.6012 494.9054 653.4195 ] >> endobj 373 0 obj << /Type /Action >> endobj 374 0 obj << /Type /Annot /Subtype /Link /A 375 0 R /Border [0 0 0] /H /I /Rect [ 497.3148 644.6012 502.1334 653.4195 ] >> endobj 375 0 obj << /Type /Action >> endobj 376 0 obj << /Type /Annot /Subtype /Link /A 377 0 R /Border [0 0 0] /H /I /Rect [ 504.5428 644.6012 509.3614 653.4195 ] >> endobj 377 0 obj << /Type /Action >> endobj 378 0 obj << /Type /Annot /Subtype /Link /A 379 0 R /Border [0 0 0] /H /I /Rect [ 511.7708 644.6012 521.4081 653.4195 ] >> endobj 379 0 obj << /Type /Action >> endobj 380 0 obj << /Type /Annot /Subtype /Link /A 381 0 R /Border [0 0 0] /H /I /Rect [ 171.4762 534.3632 176.2949 543.1815 ] >> endobj 381 0 obj << /Type /Action >> endobj 382 0 obj << /Type /Annot /Subtype /Link /A 383 0 R /Border [0 0 0] /H /I /Rect [ 178.7043 534.3632 183.5229 543.1815 ] >> endobj 383 0 obj << /Type /Action >> endobj 384 0 obj << /Type /Annot /Subtype /Link /A 385 0 R /Border [0 0 0] /H /I /Rect [ 185.9323 534.3632 190.7509 543.1815 ] >> endobj 385 0 obj << /Type /Action >> endobj 386 0 obj << /Type /Annot /Subtype /Link /A 387 0 R /Border [0 0 0] /H /I /Rect [ 324.3173 522.4584 333.9546 531.2767 ] >> endobj 387 0 obj << /Type /Action >> endobj 388 0 obj << /Type /Annot /Subtype /Link /A 389 0 R /Border [0 0 0] /H /I /Rect [ 336.3639 522.4584 346.0013 531.2767 ] >> endobj 389 0 obj << /Type /Action >> endobj 390 0 obj << /Type /Annot /Subtype /Link /A 391 0 R /Border [0 0 0] /H /I /Rect [ 180.1440 491.1489 189.7813 499.9672 ] >> endobj 391 0 obj << /Type /Action >> endobj 392 0 obj << /Type /Annot /Subtype /Link /A 393 0 R /Border [0 0 0] /H /I /Rect [ 192.1907 491.1489 201.8280 499.9672 ] >> endobj 393 0 obj << /Type /Action >> endobj 394 0 obj << /Type /Annot /Subtype /Link /A 395 0 R /Border [0 0 0] /H /I /Rect [ 204.2373 491.1489 213.8747 499.9672 ] >> endobj 395 0 obj << /Type /Action >> endobj 396 0 obj << /Type /Annot /Subtype /Link /A 397 0 R /Border [0 0 0] /H /I /Rect [ 450.1464 491.1489 454.9651 499.9672 ] >> endobj 397 0 obj << /Type /Action >> endobj 398 0 obj << /Type /Annot /Subtype /Link /A 399 0 R /Border [0 0 0] /H /I /Rect [ 457.3744 491.1489 467.0118 499.9672 ] >> endobj 399 0 obj << /Type /Action >> endobj 400 0 obj << /Type /Annot /Subtype /Link /A 401 0 R /Border [0 0 0] /H /I /Rect [ 469.4211 491.1489 479.0584 499.9672 ] >> endobj 401 0 obj << /Type /Action >> endobj 402 0 obj << /Type /Annot /Subtype /Link /A 403 0 R /Border [0 0 0] /H /I /Rect [ 415.3433 467.3394 420.1619 476.1578 ] >> endobj 403 0 obj << /Type /Action >> endobj 404 0 obj << /Type /Annot /Subtype /Link /A 405 0 R /Border [0 0 0] /H /I /Rect [ 422.5713 467.3394 427.3899 476.1578 ] >> endobj 405 0 obj << /Type /Action >> endobj 406 0 obj << /Type /Annot /Subtype /Link /A 407 0 R /Border [0 0 0] /H /I /Rect [ 429.7993 467.3394 439.4366 476.1578 ] >> endobj 407 0 obj << /Type /Action >> endobj 408 0 obj << /Type /Annot /Subtype /Link /A 409 0 R /Border [0 0 0] /H /I /Rect [ 204.0023 455.4347 213.6396 464.2530 ] >> endobj 409 0 obj << /Type /Action >> endobj 410 0 obj << /Type /Annot /Subtype /Link /A 411 0 R /Border [0 0 0] /H /I /Rect [ 216.0489 455.4347 225.6863 464.2530 ] >> endobj 411 0 obj << /Type /Action >> endobj 412 0 obj << /Type /Annot /Subtype /Link /A 413 0 R /Border [0 0 0] /H /I /Rect [ 89.6445 443.5299 99.2818 452.3483 ] >> endobj 413 0 obj << /Type /Action >> endobj 414 0 obj << /Type /Annot /Subtype /Link /A 415 0 R /Border [0 0 0] /H /I /Rect [ 101.6912 443.5299 111.3285 452.3483 ] >> endobj 415 0 obj << /Type /Action >> endobj 416 0 obj << /Type /Annot /Subtype /Link /A 417 0 R /Border [0 0 0] /H /I /Rect [ 355.7220 443.5299 365.3593 452.3483 ] >> endobj 417 0 obj << /Type /Action >> endobj 418 0 obj << /Type /Annot /Subtype /Link /A 419 0 R /Border [0 0 0] /H /I /Rect [ 367.7687 443.5299 377.4060 452.3483 ] >> endobj 419 0 obj << /Type /Action >> endobj 420 0 obj << /Type /Annot /Subtype /Link /A 421 0 R /Border [0 0 0] /H /I /Rect [ 379.8153 443.5299 389.4527 452.3483 ] >> endobj 421 0 obj << /Type /Action >> endobj 422 0 obj << /Type /Annot /Subtype /Link /A 423 0 R /Border [0 0 0] /H /I /Rect [ 499.3297 431.6252 508.9671 440.4435 ] >> endobj 423 0 obj << /Type /Action >> endobj 424 0 obj << /Type /Annot /Subtype /Link /A 425 0 R /Border [0 0 0] /H /I /Rect [ 276.0645 419.7204 280.8832 428.5388 ] >> endobj 425 0 obj << /Type /Action >> endobj 426 0 obj << /Type /Annot /Subtype /Link /A 427 0 R /Border [0 0 0] /H /I /Rect [ 283.2925 419.7204 292.9298 428.5388 ] >> endobj 427 0 obj << /Type /Action >> endobj 428 0 obj << /Type /Annot /Subtype /Link /A 429 0 R /Border [0 0 0] /H /I /Rect [ 295.3392 419.7204 304.9765 428.5388 ] >> endobj 429 0 obj << /Type /Action >> endobj 430 0 obj << /Type /Annot /Subtype /Link /A 431 0 R /Border [0 0 0] /H /I /Rect [ 380.6430 407.8157 385.4617 416.6340 ] >> endobj 431 0 obj << /Type /Action >> endobj 432 0 obj << /Type /Annot /Subtype /Link /A 433 0 R /Border [0 0 0] /H /I /Rect [ 387.8710 407.8157 397.5083 416.6340 ] >> endobj 433 0 obj << /Type /Action >> endobj 434 0 obj << /Type /Annot /Subtype /Link /A 435 0 R /Border [0 0 0] /H /I /Rect [ 399.9177 407.8157 409.5550 416.6340 ] >> endobj 435 0 obj << /Type /Action >> endobj 436 0 obj << /Type /Annot /Subtype /Link /A 437 0 R /Border [0 0 0] /H /I /Rect [ 134.1045 395.9109 143.7418 404.7293 ] >> endobj 437 0 obj << /Type /Action >> endobj 438 0 obj << /Type /Annot /Subtype /Link /A 439 0 R /Border [0 0 0] /H /I /Rect [ 404.5110 364.6014 409.3297 373.4198 ] >> endobj 439 0 obj << /Type /Action >> endobj 440 0 obj << /Type /Annot /Subtype /Link /A 441 0 R /Border [0 0 0] /H /I /Rect [ 411.7390 364.6014 416.5577 373.4198 ] >> endobj 441 0 obj << /Type /Action >> endobj 442 0 obj << /Type /Annot /Subtype /Link /A 443 0 R /Border [0 0 0] /H /I /Rect [ 418.9670 364.6014 423.7857 373.4198 ] >> endobj 443 0 obj << /Type /Action >> endobj 444 0 obj << /Type /Annot /Subtype /Link /A 445 0 R /Border [0 0 0] /H /I /Rect [ 426.1950 364.6014 435.8323 373.4198 ] >> endobj 445 0 obj << /Type /Action >> endobj 446 0 obj << /Type /Annot /Subtype /Link /A 447 0 R /Border [0 0 0] /H /I /Rect [ 438.2417 364.6014 447.8790 373.4198 ] >> endobj 447 0 obj << /Type /Action >> endobj 448 0 obj << /Type /Annot /Subtype /Link /A 449 0 R /Border [0 0 0] /H /I /Rect [ 450.2883 364.6014 459.9257 373.4198 ] >> endobj 449 0 obj << /Type /Action >> endobj 450 0 obj << /Type /Page /Parent 3 0 R /Annots [ 452 0 R 454 0 R 456 0 R 458 0 R 460 0 R 462 0 R 464 0 R 466 0 R 468 0 R 470 0 R 472 0 R 474 0 R 476 0 R 478 0 R 480 0 R 482 0 R 484 0 R 486 0 R 488 0 R 490 0 R 492 0 R 494 0 R 496 0 R 498 0 R 500 0 R 502 0 R 504 0 R ] /Contents 451 0 R >> endobj 451 0 obj << /Length 28957 >> stream 0.271 0.267 0.267 rg q 15.000 21.991 577.500 755.009 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(do people come to accept/refuse/delay vaccination\) which is influenced by various contextual factors \(including local )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(vaccination cultures )] TJ ET 0.267 0.267 0.267 rg BT 117.822 757.079 Td /F4 8.7 Tf [(28)] TJ ET 0.271 0.267 0.267 rg BT 127.459 759.460 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 129.869 757.079 Td /F4 8.7 Tf [(29)] TJ ET 0.271 0.267 0.267 rg BT 139.506 755.571 Td /F1 9.8 Tf [(\) and leads to a variety of behavioural outcomes. From a public health perspective, behavioural )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(outcomes are important targets in terms of prevention. But it is worth studying VH even among people who have not yet refused )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(or delayed any vaccines, because they are more likely to do so in the future, and public health experts would like to prevent that )] TJ ET 0.267 0.267 0.267 rg BT 26.250 721.364 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 31.069 719.857 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(The decision-making process we are referring to may be easy or simple \(without hesitancy\) or practically automatic amongst )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(both pro-vaccine and anti-vaccine people because they have strong convictions about vaccines in general. On the contrary, this )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(process may be difficult, more uncertain and more worthy of interest among people who have doubts that is, who are )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(genuinely hesitant. Thus, although VH can be considered to be an intermediate position between the pro- and anti-vaccine )] TJ ET BT 26.250 652.833 Td /F1 9.8 Tf [(positions in terms of vaccine assessment \(positive/negative\), it is not in terms of the decision-making process. Moreover, a still )] TJ ET BT 26.250 640.929 Td /F1 9.8 Tf [(different group, those with no definite opinion, little knowledge and little interest about vaccination issues and who randomly )] TJ ET BT 26.250 629.024 Td /F1 9.8 Tf [(forget or delay some vaccines, share the same intermediate position on the anti/pro continuum, but they show the same )] TJ ET BT 26.250 617.119 Td /F1 9.8 Tf [(behavioural pattern as people who are uncertain but very interested and committed in vaccination issues, prone to information )] TJ ET BT 26.250 605.214 Td /F1 9.8 Tf [(seeking and long and balanced decision-making.)] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(In other words, the behavioural outcomes generally associated with VH may reflect the genuine inconsistency of uncommitted )] TJ ET BT 26.250 573.905 Td /F1 9.8 Tf [(people, as described above, but may also reflect a decision-making process that is not guided by a general attitude toward )] TJ ET BT 26.250 562.000 Td /F1 9.8 Tf [(vaccination, but that instead takes the specificities of each vaccine/context into account, among people strongly committed to )] TJ ET BT 26.250 550.095 Td /F1 9.8 Tf [(vaccination issues.)] TJ ET BT 26.250 530.691 Td /F4 9.8 Tf [(VH and the anti/pro continuum.)] TJ ET BT 26.250 511.286 Td /F1 9.8 Tf [(To a certain extent, keeping VH on the anti/pro continuum is convenient, as VH can be conceived as a temporary attitude of )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(individuals who have not yet chosen between the anti- and pro- attitudes and who can more easily be convinced to endorse the )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(latter than strong opponents )] TJ ET 0.267 0.267 0.267 rg BT 150.368 488.984 Td /F4 8.7 Tf [(30)] TJ ET 0.271 0.267 0.267 rg BT 160.005 487.476 Td /F1 9.8 Tf [(. One might then hope to help people to move along this continuum through interventions )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(designed to bring them what they lack: self-efficacy, knowledge or trust of the authorities.)] TJ ET BT 26.250 456.167 Td /F1 9.8 Tf [(Nevertheless, using this continuum to describe VH is not self-evident. First, from a statistical point of view, it is quite odd to )] TJ ET BT 26.250 444.262 Td /F1 9.8 Tf [(choose to describe a population by representing it on an axis where most individuals are supposed to be clumped in an )] TJ ET BT 26.250 432.357 Td /F1 9.8 Tf [(intermediate position. It is usually more informative to use axes that contrast individual positions.)] TJ ET BT 26.250 412.953 Td /F1 9.8 Tf [(Moreover, that vaccine-hesitant people are neither pro- nor anti-vaccination does not necessary imply that they endorse )] TJ ET BT 26.250 401.048 Td /F1 9.8 Tf [(intermediate attitudes regarding vaccination in general. We can use an analogy with politics to illustrate this point. One may )] TJ ET BT 26.250 389.143 Td /F1 9.8 Tf [(claim that there are hesitant voters: instead of being either leftists or rightists and always voting according to their orientation, )] TJ ET BT 26.250 377.238 Td /F1 9.8 Tf [(they may make an informed choice for each election, depending on the candidates, their election platforms, and the context and )] TJ ET BT 26.250 365.334 Td /F1 9.8 Tf [(territory level: they may choose to vote for a leftist candidate for the municipal election and a rightist candidate for the )] TJ ET BT 26.250 353.429 Td /F1 9.8 Tf [(presidential election, and to stay home from the elections for European Parliament members. Such hesitant voters are neither )] TJ ET BT 26.250 341.524 Td /F1 9.8 Tf [(leftists nor rightists, but claiming they are centrists would be highly arguable. The standard left-right clivage appears irrelevant to )] TJ ET BT 26.250 329.619 Td /F1 9.8 Tf [(describing their behaviour. Similarly, the anti/pro continuum about vaccination may not be relevant for describing VH.)] TJ ET BT 26.250 310.215 Td /F1 9.8 Tf [(Finally, these peoples attitudes are claimed to be strongly vaccine-dependent, for they may accept one vaccine, be suspicious )] TJ ET BT 26.250 298.310 Td /F1 9.8 Tf [(of another and strongly reject a third. Positioning them along a continuum corresponding to attitudes toward vaccination in )] TJ ET BT 26.250 286.405 Td /F1 9.8 Tf [(general thus appears quite inappropriate.)] TJ ET BT 26.250 249.803 Td /F4 12.0 Tf [(A theoretical model for VH)] TJ ET BT 26.250 229.848 Td /F4 9.8 Tf [(The indifference/commitment axis.)] TJ ET BT 26.250 210.444 Td /F1 9.8 Tf [(As specified above, considering VH a decision-making process helps to distinguish two very different kinds of VH: first, that of )] TJ ET BT 26.250 198.539 Td /F1 9.8 Tf [(people with poor knowledge of and indifference to vaccination issues, and erratic vaccination behaviours, and, second hand, )] TJ ET BT 26.250 186.634 Td /F1 9.8 Tf [(that of people who are very interested and committed to vaccination issues, prone to information seeking and long and balanced )] TJ ET BT 26.250 174.729 Td /F1 9.8 Tf [(decision-making. From a psychological point of view, this axis echoes the notion of locus of control: some people believe that )] TJ ET BT 26.250 162.825 Td /F1 9.8 Tf [(they can control events related to their life \(internal locus of control\), while others endorse a more fatalistic attitude, tending to )] TJ ET BT 26.250 150.920 Td /F1 9.8 Tf [(believe that their life is driven by forces outside themselves \(others, fate or luck: external locus of control\) )] TJ ET 0.267 0.267 0.267 rg BT 480.892 152.427 Td /F4 8.7 Tf [(31)] TJ ET 0.271 0.267 0.267 rg BT 490.530 150.920 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 131.515 Td /F1 9.8 Tf [(From a sociological point of view, this axis echoes two cultural features of contemporary societies, concepts known as risk )] TJ ET BT 26.250 119.610 Td /F1 9.8 Tf [(culture and healthism. Risk culture is a concept coined by the British sociologist Anthony Giddens )] TJ ET 0.267 0.267 0.267 rg BT 458.672 121.118 Td /F4 8.7 Tf [(32)] TJ ET 0.271 0.267 0.267 rg BT 468.310 119.610 Td /F1 9.8 Tf [(. According to him, )] TJ ET BT 26.250 107.706 Td /F1 9.8 Tf [(people in contemporary societies are encouraged to exert autonomy over their own lives, to use available expert knowledge to )] TJ ET BT 26.250 95.801 Td /F1 9.8 Tf [(stay continuously aware of risks and opportunities in their daily life, to assess risks and benefits in order to make their future )] TJ ET BT 26.250 83.896 Td /F1 9.8 Tf [(secure. Authorities promote risk culture, as it is easier to govern rational and autonomous individuals, whose rationality makes )] TJ ET BT 26.250 71.991 Td /F1 9.8 Tf [(them more predictable )] TJ ET 0.267 0.267 0.267 rg BT 125.954 73.499 Td /F4 8.7 Tf [(33)] TJ ET 0.271 0.267 0.267 rg BT 135.591 71.991 Td /F1 9.8 Tf [(. This is especially true concerning health, which has become a super value: the rhetoric of self-)] TJ ET BT 26.250 60.087 Td /F1 9.8 Tf [(empowerment conveyed by health promotion praises enterprising and entrepreneurial individuals who exercise control over )] TJ ET BT 26.250 48.182 Td /F1 9.8 Tf [(their own behaviours and use information spread by health authorities to maximise their life expectancy. This specific cultural )] TJ ET BT 26.250 36.277 Td /F1 9.8 Tf [(feature is described as healthism )] TJ ET 0.267 0.267 0.267 rg BT 171.476 37.784 Td /F4 8.7 Tf [(34)] TJ ET 0.271 0.267 0.267 rg BT 181.114 40.165 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 183.523 37.784 Td /F4 8.7 Tf [(35)] TJ ET 0.271 0.267 0.267 rg BT 193.160 36.277 Td /F1 9.8 Tf [(. Thus the indifference/commitment axis can also be viewed as measuring the extent to )] TJ ET Q q 15.000 21.991 577.500 755.009 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(do people come to accept/refuse/delay vaccination\) which is influenced by various contextual factors \(including local )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(vaccination cultures )] TJ ET 0.267 0.267 0.267 rg BT 117.822 757.079 Td /F4 8.7 Tf [(28)] TJ ET 0.271 0.267 0.267 rg BT 127.459 759.460 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 129.869 757.079 Td /F4 8.7 Tf [(29)] TJ ET 0.271 0.267 0.267 rg BT 139.506 755.571 Td /F1 9.8 Tf [(\) and leads to a variety of behavioural outcomes. From a public health perspective, behavioural )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(outcomes are important targets in terms of prevention. But it is worth studying VH even among people who have not yet refused )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(or delayed any vaccines, because they are more likely to do so in the future, and public health experts would like to prevent that )] TJ ET 0.267 0.267 0.267 rg BT 26.250 721.364 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 31.069 719.857 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(The decision-making process we are referring to may be easy or simple \(without hesitancy\) or practically automatic amongst )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(both pro-vaccine and anti-vaccine people because they have strong convictions about vaccines in general. On the contrary, this )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(process may be difficult, more uncertain and more worthy of interest among people who have doubts that is, who are )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(genuinely hesitant. Thus, although VH can be considered to be an intermediate position between the pro- and anti-vaccine )] TJ ET BT 26.250 652.833 Td /F1 9.8 Tf [(positions in terms of vaccine assessment \(positive/negative\), it is not in terms of the decision-making process. Moreover, a still )] TJ ET BT 26.250 640.929 Td /F1 9.8 Tf [(different group, those with no definite opinion, little knowledge and little interest about vaccination issues and who randomly )] TJ ET BT 26.250 629.024 Td /F1 9.8 Tf [(forget or delay some vaccines, share the same intermediate position on the anti/pro continuum, but they show the same )] TJ ET BT 26.250 617.119 Td /F1 9.8 Tf [(behavioural pattern as people who are uncertain but very interested and committed in vaccination issues, prone to information )] TJ ET BT 26.250 605.214 Td /F1 9.8 Tf [(seeking and long and balanced decision-making.)] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(In other words, the behavioural outcomes generally associated with VH may reflect the genuine inconsistency of uncommitted )] TJ ET BT 26.250 573.905 Td /F1 9.8 Tf [(people, as described above, but may also reflect a decision-making process that is not guided by a general attitude toward )] TJ ET BT 26.250 562.000 Td /F1 9.8 Tf [(vaccination, but that instead takes the specificities of each vaccine/context into account, among people strongly committed to )] TJ ET BT 26.250 550.095 Td /F1 9.8 Tf [(vaccination issues.)] TJ ET BT 26.250 530.691 Td /F4 9.8 Tf [(VH and the anti/pro continuum.)] TJ ET BT 26.250 511.286 Td /F1 9.8 Tf [(To a certain extent, keeping VH on the anti/pro continuum is convenient, as VH can be conceived as a temporary attitude of )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(individuals who have not yet chosen between the anti- and pro- attitudes and who can more easily be convinced to endorse the )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(latter than strong opponents )] TJ ET 0.267 0.267 0.267 rg BT 150.368 488.984 Td /F4 8.7 Tf [(30)] TJ ET 0.271 0.267 0.267 rg BT 160.005 487.476 Td /F1 9.8 Tf [(. One might then hope to help people to move along this continuum through interventions )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(designed to bring them what they lack: self-efficacy, knowledge or trust of the authorities.)] TJ ET BT 26.250 456.167 Td /F1 9.8 Tf [(Nevertheless, using this continuum to describe VH is not self-evident. First, from a statistical point of view, it is quite odd to )] TJ ET BT 26.250 444.262 Td /F1 9.8 Tf [(choose to describe a population by representing it on an axis where most individuals are supposed to be clumped in an )] TJ ET BT 26.250 432.357 Td /F1 9.8 Tf [(intermediate position. It is usually more informative to use axes that contrast individual positions.)] TJ ET BT 26.250 412.953 Td /F1 9.8 Tf [(Moreover, that vaccine-hesitant people are neither pro- nor anti-vaccination does not necessary imply that they endorse )] TJ ET BT 26.250 401.048 Td /F1 9.8 Tf [(intermediate attitudes regarding vaccination in general. We can use an analogy with politics to illustrate this point. One may )] TJ ET BT 26.250 389.143 Td /F1 9.8 Tf [(claim that there are hesitant voters: instead of being either leftists or rightists and always voting according to their orientation, )] TJ ET BT 26.250 377.238 Td /F1 9.8 Tf [(they may make an informed choice for each election, depending on the candidates, their election platforms, and the context and )] TJ ET BT 26.250 365.334 Td /F1 9.8 Tf [(territory level: they may choose to vote for a leftist candidate for the municipal election and a rightist candidate for the )] TJ ET BT 26.250 353.429 Td /F1 9.8 Tf [(presidential election, and to stay home from the elections for European Parliament members. Such hesitant voters are neither )] TJ ET BT 26.250 341.524 Td /F1 9.8 Tf [(leftists nor rightists, but claiming they are centrists would be highly arguable. The standard left-right clivage appears irrelevant to )] TJ ET BT 26.250 329.619 Td /F1 9.8 Tf [(describing their behaviour. Similarly, the anti/pro continuum about vaccination may not be relevant for describing VH.)] TJ ET BT 26.250 310.215 Td /F1 9.8 Tf [(Finally, these peoples attitudes are claimed to be strongly vaccine-dependent, for they may accept one vaccine, be suspicious )] TJ ET BT 26.250 298.310 Td /F1 9.8 Tf [(of another and strongly reject a third. Positioning them along a continuum corresponding to attitudes toward vaccination in )] TJ ET BT 26.250 286.405 Td /F1 9.8 Tf [(general thus appears quite inappropriate.)] TJ ET BT 26.250 249.803 Td /F4 12.0 Tf [(A theoretical model for VH)] TJ ET BT 26.250 229.848 Td /F4 9.8 Tf [(The indifference/commitment axis.)] TJ ET BT 26.250 210.444 Td /F1 9.8 Tf [(As specified above, considering VH a decision-making process helps to distinguish two very different kinds of VH: first, that of )] TJ ET BT 26.250 198.539 Td /F1 9.8 Tf [(people with poor knowledge of and indifference to vaccination issues, and erratic vaccination behaviours, and, second hand, )] TJ ET BT 26.250 186.634 Td /F1 9.8 Tf [(that of people who are very interested and committed to vaccination issues, prone to information seeking and long and balanced )] TJ ET BT 26.250 174.729 Td /F1 9.8 Tf [(decision-making. From a psychological point of view, this axis echoes the notion of locus of control: some people believe that )] TJ ET BT 26.250 162.825 Td /F1 9.8 Tf [(they can control events related to their life \(internal locus of control\), while others endorse a more fatalistic attitude, tending to )] TJ ET BT 26.250 150.920 Td /F1 9.8 Tf [(believe that their life is driven by forces outside themselves \(others, fate or luck: external locus of control\) )] TJ ET 0.267 0.267 0.267 rg BT 480.892 152.427 Td /F4 8.7 Tf [(31)] TJ ET 0.271 0.267 0.267 rg BT 490.530 150.920 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 131.515 Td /F1 9.8 Tf [(From a sociological point of view, this axis echoes two cultural features of contemporary societies, concepts known as risk )] TJ ET BT 26.250 119.610 Td /F1 9.8 Tf [(culture and healthism. Risk culture is a concept coined by the British sociologist Anthony Giddens )] TJ ET 0.267 0.267 0.267 rg BT 458.672 121.118 Td /F4 8.7 Tf [(32)] TJ ET 0.271 0.267 0.267 rg BT 468.310 119.610 Td /F1 9.8 Tf [(. According to him, )] TJ ET BT 26.250 107.706 Td /F1 9.8 Tf [(people in contemporary societies are encouraged to exert autonomy over their own lives, to use available expert knowledge to )] TJ ET BT 26.250 95.801 Td /F1 9.8 Tf [(stay continuously aware of risks and opportunities in their daily life, to assess risks and benefits in order to make their future )] TJ ET BT 26.250 83.896 Td /F1 9.8 Tf [(secure. Authorities promote risk culture, as it is easier to govern rational and autonomous individuals, whose rationality makes )] TJ ET BT 26.250 71.991 Td /F1 9.8 Tf [(them more predictable )] TJ ET 0.267 0.267 0.267 rg BT 125.954 73.499 Td /F4 8.7 Tf [(33)] TJ ET 0.271 0.267 0.267 rg BT 135.591 71.991 Td /F1 9.8 Tf [(. This is especially true concerning health, which has become a super value: the rhetoric of self-)] TJ ET BT 26.250 60.087 Td /F1 9.8 Tf [(empowerment conveyed by health promotion praises enterprising and entrepreneurial individuals who exercise control over )] TJ ET BT 26.250 48.182 Td /F1 9.8 Tf [(their own behaviours and use information spread by health authorities to maximise their life expectancy. This specific cultural )] TJ ET BT 26.250 36.277 Td /F1 9.8 Tf [(feature is described as healthism )] TJ ET 0.267 0.267 0.267 rg BT 171.476 37.784 Td /F4 8.7 Tf [(34)] TJ ET 0.271 0.267 0.267 rg BT 181.114 40.165 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 183.523 37.784 Td /F4 8.7 Tf [(35)] TJ ET 0.271 0.267 0.267 rg BT 193.160 36.277 Td /F1 9.8 Tf [(. Thus the indifference/commitment axis can also be viewed as measuring the extent to )] TJ ET Q q 15.000 21.991 577.500 755.009 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(do people come to accept/refuse/delay vaccination\) which is influenced by various contextual factors \(including local )] TJ ET BT 26.250 755.571 Td /F1 9.8 Tf [(vaccination cultures )] TJ ET 0.267 0.267 0.267 rg BT 117.822 757.079 Td /F4 8.7 Tf [(28)] TJ ET 0.271 0.267 0.267 rg BT 127.459 759.460 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 129.869 757.079 Td /F4 8.7 Tf [(29)] TJ ET 0.271 0.267 0.267 rg BT 139.506 755.571 Td /F1 9.8 Tf [(\) and leads to a variety of behavioural outcomes. From a public health perspective, behavioural )] TJ ET BT 26.250 743.667 Td /F1 9.8 Tf [(outcomes are important targets in terms of prevention. But it is worth studying VH even among people who have not yet refused )] TJ ET BT 26.250 731.762 Td /F1 9.8 Tf [(or delayed any vaccines, because they are more likely to do so in the future, and public health experts would like to prevent that )] TJ ET 0.267 0.267 0.267 rg BT 26.250 721.364 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 31.069 719.857 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(The decision-making process we are referring to may be easy or simple \(without hesitancy\) or practically automatic amongst )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(both pro-vaccine and anti-vaccine people because they have strong convictions about vaccines in general. On the contrary, this )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(process may be difficult, more uncertain and more worthy of interest among people who have doubts that is, who are )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(genuinely hesitant. Thus, although VH can be considered to be an intermediate position between the pro- and anti-vaccine )] TJ ET BT 26.250 652.833 Td /F1 9.8 Tf [(positions in terms of vaccine assessment \(positive/negative\), it is not in terms of the decision-making process. Moreover, a still )] TJ ET BT 26.250 640.929 Td /F1 9.8 Tf [(different group, those with no definite opinion, little knowledge and little interest about vaccination issues and who randomly )] TJ ET BT 26.250 629.024 Td /F1 9.8 Tf [(forget or delay some vaccines, share the same intermediate position on the anti/pro continuum, but they show the same )] TJ ET BT 26.250 617.119 Td /F1 9.8 Tf [(behavioural pattern as people who are uncertain but very interested and committed in vaccination issues, prone to information )] TJ ET BT 26.250 605.214 Td /F1 9.8 Tf [(seeking and long and balanced decision-making.)] TJ ET BT 26.250 585.810 Td /F1 9.8 Tf [(In other words, the behavioural outcomes generally associated with VH may reflect the genuine inconsistency of uncommitted )] TJ ET BT 26.250 573.905 Td /F1 9.8 Tf [(people, as described above, but may also reflect a decision-making process that is not guided by a general attitude toward )] TJ ET BT 26.250 562.000 Td /F1 9.8 Tf [(vaccination, but that instead takes the specificities of each vaccine/context into account, among people strongly committed to )] TJ ET BT 26.250 550.095 Td /F1 9.8 Tf [(vaccination issues.)] TJ ET BT 26.250 530.691 Td /F4 9.8 Tf [(VH and the anti/pro continuum.)] TJ ET BT 26.250 511.286 Td /F1 9.8 Tf [(To a certain extent, keeping VH on the anti/pro continuum is convenient, as VH can be conceived as a temporary attitude of )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(individuals who have not yet chosen between the anti- and pro- attitudes and who can more easily be convinced to endorse the )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(latter than strong opponents )] TJ ET 0.267 0.267 0.267 rg BT 150.368 488.984 Td /F4 8.7 Tf [(30)] TJ ET 0.271 0.267 0.267 rg BT 160.005 487.476 Td /F1 9.8 Tf [(. One might then hope to help people to move along this continuum through interventions )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(designed to bring them what they lack: self-efficacy, knowledge or trust of the authorities.)] TJ ET BT 26.250 456.167 Td /F1 9.8 Tf [(Nevertheless, using this continuum to describe VH is not self-evident. First, from a statistical point of view, it is quite odd to )] TJ ET BT 26.250 444.262 Td /F1 9.8 Tf [(choose to describe a population by representing it on an axis where most individuals are supposed to be clumped in an )] TJ ET BT 26.250 432.357 Td /F1 9.8 Tf [(intermediate position. It is usually more informative to use axes that contrast individual positions.)] TJ ET BT 26.250 412.953 Td /F1 9.8 Tf [(Moreover, that vaccine-hesitant people are neither pro- nor anti-vaccination does not necessary imply that they endorse )] TJ ET BT 26.250 401.048 Td /F1 9.8 Tf [(intermediate attitudes regarding vaccination in general. We can use an analogy with politics to illustrate this point. One may )] TJ ET BT 26.250 389.143 Td /F1 9.8 Tf [(claim that there are hesitant voters: instead of being either leftists or rightists and always voting according to their orientation, )] TJ ET BT 26.250 377.238 Td /F1 9.8 Tf [(they may make an informed choice for each election, depending on the candidates, their election platforms, and the context and )] TJ ET BT 26.250 365.334 Td /F1 9.8 Tf [(territory level: they may choose to vote for a leftist candidate for the municipal election and a rightist candidate for the )] TJ ET BT 26.250 353.429 Td /F1 9.8 Tf [(presidential election, and to stay home from the elections for European Parliament members. Such hesitant voters are neither )] TJ ET BT 26.250 341.524 Td /F1 9.8 Tf [(leftists nor rightists, but claiming they are centrists would be highly arguable. The standard left-right clivage appears irrelevant to )] TJ ET BT 26.250 329.619 Td /F1 9.8 Tf [(describing their behaviour. Similarly, the anti/pro continuum about vaccination may not be relevant for describing VH.)] TJ ET BT 26.250 310.215 Td /F1 9.8 Tf [(Finally, these peoples attitudes are claimed to be strongly vaccine-dependent, for they may accept one vaccine, be suspicious )] TJ ET BT 26.250 298.310 Td /F1 9.8 Tf [(of another and strongly reject a third. Positioning them along a continuum corresponding to attitudes toward vaccination in )] TJ ET BT 26.250 286.405 Td /F1 9.8 Tf [(general thus appears quite inappropriate.)] TJ ET BT 26.250 249.803 Td /F4 12.0 Tf [(A theoretical model for VH)] TJ ET BT 26.250 229.848 Td /F4 9.8 Tf [(The indifference/commitment axis.)] TJ ET BT 26.250 210.444 Td /F1 9.8 Tf [(As specified above, considering VH a decision-making process helps to distinguish two very different kinds of VH: first, that of )] TJ ET BT 26.250 198.539 Td /F1 9.8 Tf [(people with poor knowledge of and indifference to vaccination issues, and erratic vaccination behaviours, and, second hand, )] TJ ET BT 26.250 186.634 Td /F1 9.8 Tf [(that of people who are very interested and committed to vaccination issues, prone to information seeking and long and balanced )] TJ ET BT 26.250 174.729 Td /F1 9.8 Tf [(decision-making. From a psychological point of view, this axis echoes the notion of locus of control: some people believe that )] TJ ET BT 26.250 162.825 Td /F1 9.8 Tf [(they can control events related to their life \(internal locus of control\), while others endorse a more fatalistic attitude, tending to )] TJ ET BT 26.250 150.920 Td /F1 9.8 Tf [(believe that their life is driven by forces outside themselves \(others, fate or luck: external locus of control\) )] TJ ET 0.267 0.267 0.267 rg BT 480.892 152.427 Td /F4 8.7 Tf [(31)] TJ ET 0.271 0.267 0.267 rg BT 490.530 150.920 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 131.515 Td /F1 9.8 Tf [(From a sociological point of view, this axis echoes two cultural features of contemporary societies, concepts known as risk )] TJ ET BT 26.250 119.610 Td /F1 9.8 Tf [(culture and healthism. Risk culture is a concept coined by the British sociologist Anthony Giddens )] TJ ET 0.267 0.267 0.267 rg BT 458.672 121.118 Td /F4 8.7 Tf [(32)] TJ ET 0.271 0.267 0.267 rg BT 468.310 119.610 Td /F1 9.8 Tf [(. According to him, )] TJ ET BT 26.250 107.706 Td /F1 9.8 Tf [(people in contemporary societies are encouraged to exert autonomy over their own lives, to use available expert knowledge to )] TJ ET BT 26.250 95.801 Td /F1 9.8 Tf [(stay continuously aware of risks and opportunities in their daily life, to assess risks and benefits in order to make their future )] TJ ET BT 26.250 83.896 Td /F1 9.8 Tf [(secure. Authorities promote risk culture, as it is easier to govern rational and autonomous individuals, whose rationality makes )] TJ ET BT 26.250 71.991 Td /F1 9.8 Tf [(them more predictable )] TJ ET 0.267 0.267 0.267 rg BT 125.954 73.499 Td /F4 8.7 Tf [(33)] TJ ET 0.271 0.267 0.267 rg BT 135.591 71.991 Td /F1 9.8 Tf [(. This is especially true concerning health, which has become a super value: the rhetoric of self-)] TJ ET BT 26.250 60.087 Td /F1 9.8 Tf [(empowerment conveyed by health promotion praises enterprising and entrepreneurial individuals who exercise control over )] TJ ET BT 26.250 48.182 Td /F1 9.8 Tf [(their own behaviours and use information spread by health authorities to maximise their life expectancy. This specific cultural )] TJ ET BT 26.250 36.277 Td /F1 9.8 Tf [(feature is described as healthism )] TJ ET 0.267 0.267 0.267 rg BT 171.476 37.784 Td /F4 8.7 Tf [(34)] TJ ET 0.271 0.267 0.267 rg BT 181.114 40.165 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 183.523 37.784 Td /F4 8.7 Tf [(35)] TJ ET 0.271 0.267 0.267 rg BT 193.160 36.277 Td /F1 9.8 Tf [(. Thus the indifference/commitment axis can also be viewed as measuring the extent to )] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(3)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Outbreaks)] TJ ET Q endstream endobj 452 0 obj << /Type /Annot /Subtype /Link /A 453 0 R /Border [0 0 0] /H /I /Rect [ 117.8220 756.2769 127.4593 765.0952 ] >> endobj 453 0 obj << /Type /Action >> endobj 454 0 obj << /Type /Annot /Subtype /Link /A 455 0 R /Border [0 0 0] /H /I /Rect [ 129.8687 756.2769 139.5060 765.0952 ] >> endobj 455 0 obj << /Type /Action >> endobj 456 0 obj << /Type /Annot /Subtype /Link /A 457 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 720.5627 31.0687 729.3810 ] >> endobj 457 0 obj << /Type /Action >> endobj 458 0 obj << /Type /Annot /Subtype /Link /A 459 0 R /Border [0 0 0] /H /I /Rect [ 150.3675 488.1819 160.0048 497.0002 ] >> endobj 459 0 obj << /Type /Action >> endobj 460 0 obj << /Type /Annot /Subtype /Link /A 461 0 R /Border [0 0 0] /H /I /Rect [ 480.8925 151.6254 490.5298 160.4437 ] >> endobj 461 0 obj << /Type /Action >> endobj 462 0 obj << /Type /Annot /Subtype /Link /A 463 0 R /Border [0 0 0] /H /I /Rect [ 458.6723 120.3159 468.3096 129.1342 ] >> endobj 463 0 obj << /Type /Action >> endobj 464 0 obj << /Type /Annot /Subtype /Link /A 465 0 R /Border [0 0 0] /H /I /Rect [ 125.9535 72.6969 135.5908 81.5152 ] >> endobj 465 0 obj << /Type /Action >> endobj 466 0 obj << /Type /Annot /Subtype /Link /A 467 0 R /Border [0 0 0] /H /I /Rect [ 171.4762 36.9827 181.1136 45.8010 ] >> endobj 467 0 obj << /Type /Action >> endobj 468 0 obj << /Type /Annot /Subtype /Link /A 469 0 R /Border [0 0 0] /H /I /Rect [ 183.5229 36.9827 193.1603 45.8010 ] >> endobj 469 0 obj << /Type /Action >> endobj 470 0 obj << /Type /Annot /Subtype /Link /A 471 0 R /Border [0 0 0] /H /I /Rect [ 117.8220 756.2769 127.4593 765.0952 ] >> endobj 471 0 obj << /Type /Action >> endobj 472 0 obj << /Type /Annot /Subtype /Link /A 473 0 R /Border [0 0 0] /H /I /Rect [ 129.8687 756.2769 139.5060 765.0952 ] >> endobj 473 0 obj << /Type /Action >> endobj 474 0 obj << /Type /Annot /Subtype /Link /A 475 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 720.5627 31.0687 729.3810 ] >> endobj 475 0 obj << /Type /Action >> endobj 476 0 obj << /Type /Annot /Subtype /Link /A 477 0 R /Border [0 0 0] /H /I /Rect [ 150.3675 488.1819 160.0048 497.0002 ] >> endobj 477 0 obj << /Type /Action >> endobj 478 0 obj << /Type /Annot /Subtype /Link /A 479 0 R /Border [0 0 0] /H /I /Rect [ 480.8925 151.6254 490.5298 160.4437 ] >> endobj 479 0 obj << /Type /Action >> endobj 480 0 obj << /Type /Annot /Subtype /Link /A 481 0 R /Border [0 0 0] /H /I /Rect [ 458.6723 120.3159 468.3096 129.1342 ] >> endobj 481 0 obj << /Type /Action >> endobj 482 0 obj << /Type /Annot /Subtype /Link /A 483 0 R /Border [0 0 0] /H /I /Rect [ 125.9535 72.6969 135.5908 81.5152 ] >> endobj 483 0 obj << /Type /Action >> endobj 484 0 obj << /Type /Annot /Subtype /Link /A 485 0 R /Border [0 0 0] /H /I /Rect [ 171.4762 36.9827 181.1136 45.8010 ] >> endobj 485 0 obj << /Type /Action >> endobj 486 0 obj << /Type /Annot /Subtype /Link /A 487 0 R /Border [0 0 0] /H /I /Rect [ 183.5229 36.9827 193.1603 45.8010 ] >> endobj 487 0 obj << /Type /Action >> endobj 488 0 obj << /Type /Annot /Subtype /Link /A 489 0 R /Border [0 0 0] /H /I /Rect [ 117.8220 756.2769 127.4593 765.0952 ] >> endobj 489 0 obj << /Type /Action >> endobj 490 0 obj << /Type /Annot /Subtype /Link /A 491 0 R /Border [0 0 0] /H /I /Rect [ 129.8687 756.2769 139.5060 765.0952 ] >> endobj 491 0 obj << /Type /Action >> endobj 492 0 obj << /Type /Annot /Subtype /Link /A 493 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 720.5627 31.0687 729.3810 ] >> endobj 493 0 obj << /Type /Action >> endobj 494 0 obj << /Type /Annot /Subtype /Link /A 495 0 R /Border [0 0 0] /H /I /Rect [ 150.3675 488.1819 160.0048 497.0002 ] >> endobj 495 0 obj << /Type /Action >> endobj 496 0 obj << /Type /Annot /Subtype /Link /A 497 0 R /Border [0 0 0] /H /I /Rect [ 480.8925 151.6254 490.5298 160.4437 ] >> endobj 497 0 obj << /Type /Action >> endobj 498 0 obj << /Type /Annot /Subtype /Link /A 499 0 R /Border [0 0 0] /H /I /Rect [ 458.6723 120.3159 468.3096 129.1342 ] >> endobj 499 0 obj << /Type /Action >> endobj 500 0 obj << /Type /Annot /Subtype /Link /A 501 0 R /Border [0 0 0] /H /I /Rect [ 125.9535 72.6969 135.5908 81.5152 ] >> endobj 501 0 obj << /Type /Action >> endobj 502 0 obj << /Type /Annot /Subtype /Link /A 503 0 R /Border [0 0 0] /H /I /Rect [ 171.4762 36.9827 181.1136 45.8010 ] >> endobj 503 0 obj << /Type /Action >> endobj 504 0 obj << /Type /Annot /Subtype /Link /A 505 0 R /Border [0 0 0] /H /I /Rect [ 183.5229 36.9827 193.1603 45.8010 ] >> endobj 505 0 obj << /Type /Action >> endobj 506 0 obj << /Type /Page /Parent 3 0 R /Annots [ 508 0 R 510 0 R 512 0 R 514 0 R 516 0 R 518 0 R 520 0 R 522 0 R 524 0 R 526 0 R 528 0 R 530 0 R 532 0 R 534 0 R 536 0 R 538 0 R 540 0 R 542 0 R 544 0 R 546 0 R 548 0 R 550 0 R 552 0 R 556 0 R 558 0 R 560 0 R 562 0 R 564 0 R 566 0 R 568 0 R 570 0 R 572 0 R 574 0 R 576 0 R 578 0 R 580 0 R 582 0 R 584 0 R 586 0 R 588 0 R 590 0 R 592 0 R 594 0 R 596 0 R 598 0 R 600 0 R 604 0 R 606 0 R 608 0 R 610 0 R 612 0 R 614 0 R 616 0 R 618 0 R 620 0 R 622 0 R 624 0 R 626 0 R 628 0 R 630 0 R 632 0 R 634 0 R 636 0 R 638 0 R 640 0 R 642 0 R 644 0 R 646 0 R 648 0 R ] /Contents 507 0 R >> endobj 507 0 obj << /Length 33292 >> stream 0.271 0.267 0.267 rg q 15.000 -145.735 577.500 922.735 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(which individuals are committed or indifferent to contemporary healthism.)] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(The link between healthism and VH is quite obvious in several studies. Gilkey et al. )] TJ ET 0.267 0.267 0.267 rg BT 386.610 749.579 Td /F4 8.7 Tf [(26)] TJ ET 0.271 0.267 0.267 rg BT 396.247 748.071 Td /F1 9.8 Tf [( observed that forgoing vaccines was )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(more common among parents more attentive to their childrens health and nutrition, and others underline the weight of rational )] TJ ET BT 26.250 724.262 Td /F1 9.8 Tf [(assessment and the importance of perceived control among people who were reluctant to be vaccinated against the H1N1 )] TJ ET BT 26.250 712.357 Td /F1 9.8 Tf [(influenza )] TJ ET 0.267 0.267 0.267 rg BT 67.980 713.864 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 77.617 716.245 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 80.027 713.864 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 89.664 712.357 Td /F1 9.8 Tf [(. Moreover, when Opel et al. )] TJ ET 0.267 0.267 0.267 rg BT 214.844 713.864 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 224.482 712.357 Td /F1 9.8 Tf [( built a questionnaire designed to identify VH, they not only used existing items )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(but also conducted focus groups to create new items. Because parents frequently claimed that they prefer to rely on their own )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(research on vaccines to come to an informed decision, rather than deferring to their childs doctor, the authors added the )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(following item: It is my role as a parent to question shots. We believe this item captures an aspect of commitment to risk )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(culture. Conversely, and rather remarkably, parents reluctance to get their child immunised has been used as a typical example )] TJ ET BT 26.250 652.833 Td /F1 9.8 Tf [(to illustrate contemporary healthism )] TJ ET 0.267 0.267 0.267 rg BT 182.845 654.341 Td /F4 8.7 Tf [(36)] TJ ET 0.271 0.267 0.267 rg BT 192.482 652.833 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 633.429 Td /F4 9.8 Tf [(The trust issue.)] TJ ET BT 26.250 614.024 Td /F1 9.8 Tf [(According to Giddens, contemporary individuals are exhorted to become the entrepreneur of their own life, but they must do so )] TJ ET BT 26.250 602.119 Td /F1 9.8 Tf [(in a context characterised by trust issues, as many if not all aspects of our daily lives depend on machines or systems that )] TJ ET BT 26.250 590.214 Td /F1 9.8 Tf [(are distant from us and beyond our understanding. Giddenss analysis is based on a concept of trust borrowed from the )] TJ ET BT 26.250 578.310 Td /F1 9.8 Tf [(psychologist Erik Erikson: depending on people/things that are not under our direct scrutiny or not fully understandable to us )] TJ ET BT 26.250 566.405 Td /F1 9.8 Tf [(induces anxiety, and we must trust them, trust a whole expert system, through a leap of faith. As our societies are characterised )] TJ ET BT 26.250 554.500 Td /F1 9.8 Tf [(by overspecialisation and the disembedding of social relationships, trust issues become essential )] TJ ET 0.267 0.267 0.267 rg BT 447.304 556.007 Td /F4 8.7 Tf [(32)] TJ ET 0.271 0.267 0.267 rg BT 456.941 554.500 Td /F1 9.8 Tf [(. Moreover, in Giddenss )] TJ ET BT 26.250 542.595 Td /F1 9.8 Tf [(perspective, the contemporary controversies regarding vaccination or other health-related issues are not the causes of distrust, )] TJ ET BT 26.250 530.691 Td /F1 9.8 Tf [(but only consequences of a wider structural phenomenon.)] TJ ET BT 26.250 511.286 Td /F1 9.8 Tf [(Trust issues are also crucial in Becks analyses of contemporary risk societies, especially regarding science and knowledge. )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(According to him, our societies are characterised by reflexive scientisation: scientific scepticism has been extended to science )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(itself and fuelled the disenchantment of science. As a result, there is a process of demonopolisation/feudalisation of scientific )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(knowledge, with conflictual equalisation tendencies in the gradient of rationality between experts and lay people. Sciences, )] TJ ET BT 26.250 463.667 Td /F1 9.8 Tf [(quasi-sciences and pseudo-sciences are competing sources that produce a flood of overspecialised, hyper-complex and )] TJ ET BT 26.250 451.762 Td /F1 9.8 Tf [(contradictory findings. Consequently, distrust toward science is no longer a sign of ignorance or even obscurantism, but is )] TJ ET BT 26.250 439.857 Td /F1 9.8 Tf [(endorsed by highly educated individuals )] TJ ET 0.267 0.267 0.267 rg BT 201.838 441.365 Td /F4 8.7 Tf [(37)] TJ ET 0.271 0.267 0.267 rg BT 211.475 439.857 Td /F1 9.8 Tf [(. Beck also pointed out the increasingly important issue of conflicts of interest, i.e., )] TJ ET BT 26.250 427.953 Td /F1 9.8 Tf [(situations in which scientists or experts are perceived as untrustworthy because of their financial links to industries. In this )] TJ ET BT 26.250 416.048 Td /F1 9.8 Tf [(context, people who endorse risk culture and decide to take their health in hand are confronted with discordant sources of )] TJ ET BT 26.250 404.143 Td /F1 9.8 Tf [(knowledge: they may distrust official sciences and experts, and put their faith in alternative sources of information or medical )] TJ ET BT 26.250 392.238 Td /F1 9.8 Tf [(practice \(such as homeopathy or acupuncture\).)] TJ ET BT 26.250 372.834 Td /F1 9.8 Tf [(Vaccination-related issues have not escaped from these structural features of contemporary societies, especially the crisis of )] TJ ET BT 26.250 360.929 Td /F1 9.8 Tf [(legitimacy faced by science, expertise and medical authorities. Vaccination may involve trust as a leap of faith, experienced )] TJ ET BT 26.250 349.024 Td /F1 9.8 Tf [(through relationality and familiarity with a physician [5,38]. An annual survey conducted by the IRSN \(Institute of Radiation )] TJ ET BT 26.250 337.119 Td /F1 9.8 Tf [(Protection and Nuclear Safety\) illustrates this crisis of legitimacy; it found that, generally speaking, the French people do not )] TJ ET BT 26.250 325.215 Td /F1 9.8 Tf [(trust the way authorities manage various kinds of risks, nor do they trust the information given to them. For example, only 38% )] TJ ET BT 26.250 313.310 Td /F1 9.8 Tf [(of the French had confidence that what authorities did about the H1N1 episode in 2009 was for their safety, and only 34% )] TJ ET BT 26.250 301.405 Td /F1 9.8 Tf [(believed that the information released was true. )] TJ ET 0.267 0.267 0.267 rg BT 233.808 302.912 Td /F4 8.7 Tf [(39)] TJ ET 0.271 0.267 0.267 rg BT 26.250 282.000 Td /F1 9.8 Tf [(Trust is generally considered as a crucial component of peoples attitudes toward vaccination, including VH )] TJ ET 0.267 0.267 0.267 rg BT 489.570 283.508 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 494.389 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 496.798 283.508 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 501.617 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 504.026 283.508 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 508.845 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 511.254 283.508 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 520.891 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 523.301 283.508 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 532.938 282.000 Td /F1 9.8 Tf [(. For )] TJ ET BT 26.250 270.096 Td /F1 9.8 Tf [(example, trust is a key dimension in the questionnaire developed by Opel et al to assess VH )] TJ ET 0.267 0.267 0.267 rg BT 426.185 271.603 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 435.823 270.096 Td /F1 9.8 Tf [(. More precisely, lay people may )] TJ ET BT 26.250 258.191 Td /F1 9.8 Tf [(not distrust vaccines per se, but rather distrust the health authorities who are believed to be strongly influenced by vaccines )] TJ ET BT 26.250 246.286 Td /F1 9.8 Tf [(producers )] TJ ET 0.267 0.267 0.267 rg BT 72.309 247.793 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 77.128 250.174 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 79.537 247.793 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 89.174 246.286 Td /F1 9.8 Tf [(. This feature of contemporary societies is closely related to healthism, and some authors have even combined )] TJ ET BT 26.250 234.381 Td /F1 9.8 Tf [(these concepts: in such cases, healthism refers to individuals who seek to control their \(childrens\) health, who want to become )] TJ ET BT 26.250 222.477 Td /F1 9.8 Tf [(its informed and rational entrepreneur, but who also express strong doubts about medical authorities and mainstream medicine )] TJ ET BT 26.250 210.572 Td /F1 9.8 Tf [(and are more prone to turn to alternative experts, including on vaccination issues )] TJ ET 0.267 0.267 0.267 rg BT 377.416 212.079 Td /F4 8.7 Tf [(36)] TJ ET 0.271 0.267 0.267 rg BT 387.053 210.572 Td /F1 9.8 Tf [(. This relation between empowerment and )] TJ ET BT 26.250 198.667 Td /F1 9.8 Tf [(distrust is also explicitly promoted by some groups critical of vaccines, which claim that trusting blindly can be the biggest risk )] TJ ET BT 26.250 186.762 Td /F1 9.8 Tf [(of all )] TJ ET 0.267 0.267 0.267 rg BT 52.799 188.270 Td /F4 8.7 Tf [(41)] TJ ET 0.271 0.267 0.267 rg BT 62.437 186.762 Td /F1 9.8 Tf [(. Moreover, several previous studies have already found a positive correlation between VH and use of alternative )] TJ ET BT 26.250 174.858 Td /F1 9.8 Tf [(medicines \(such as acupuncture, homeopathy or naturopathy )] TJ ET 0.267 0.267 0.267 rg BT 293.420 176.365 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 303.057 178.746 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 305.466 176.365 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 315.104 178.746 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 317.513 176.365 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 327.150 174.858 Td /F1 9.8 Tf [( \) , as well as distrust of colon cancer screening )] TJ ET 0.267 0.267 0.267 rg BT 534.689 176.365 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 544.326 174.858 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 138.255 Td /F4 12.0 Tf [(VH in a two-dimension map.)] TJ ET BT 26.250 118.301 Td /F1 9.8 Tf [(Thus we propose to add to the risk culture/healthism axis a second axis, assessing lay peoples attitudes toward health )] TJ ET BT 26.250 106.396 Td /F1 9.8 Tf [(authorities and mainstream medicine \(see Figure 1\).)] TJ ET 0.965 0.965 0.965 rg 26.250 -145.735 555.000 242.250 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 96.515 m 581.250 96.515 l 581.250 95.765 l 26.250 95.765 l f q 450.000 0 0 226.500 35.250 -139.735 cm /I4 Do Q q 35.250 -145.735 537.000 0.000 re W n Q Q q 15.000 -145.735 577.500 922.735 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(which individuals are committed or indifferent to contemporary healthism.)] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(The link between healthism and VH is quite obvious in several studies. Gilkey et al. )] TJ ET 0.267 0.267 0.267 rg BT 386.610 749.579 Td /F4 8.7 Tf [(26)] TJ ET 0.271 0.267 0.267 rg BT 396.247 748.071 Td /F1 9.8 Tf [( observed that forgoing vaccines was )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(more common among parents more attentive to their childrens health and nutrition, and others underline the weight of rational )] TJ ET BT 26.250 724.262 Td /F1 9.8 Tf [(assessment and the importance of perceived control among people who were reluctant to be vaccinated against the H1N1 )] TJ ET BT 26.250 712.357 Td /F1 9.8 Tf [(influenza )] TJ ET 0.267 0.267 0.267 rg BT 67.980 713.864 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 77.617 716.245 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 80.027 713.864 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 89.664 712.357 Td /F1 9.8 Tf [(. Moreover, when Opel et al. )] TJ ET 0.267 0.267 0.267 rg BT 214.844 713.864 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 224.482 712.357 Td /F1 9.8 Tf [( built a questionnaire designed to identify VH, they not only used existing items )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(but also conducted focus groups to create new items. Because parents frequently claimed that they prefer to rely on their own )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(research on vaccines to come to an informed decision, rather than deferring to their childs doctor, the authors added the )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(following item: It is my role as a parent to question shots. We believe this item captures an aspect of commitment to risk )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(culture. Conversely, and rather remarkably, parents reluctance to get their child immunised has been used as a typical example )] TJ ET BT 26.250 652.833 Td /F1 9.8 Tf [(to illustrate contemporary healthism )] TJ ET 0.267 0.267 0.267 rg BT 182.845 654.341 Td /F4 8.7 Tf [(36)] TJ ET 0.271 0.267 0.267 rg BT 192.482 652.833 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 633.429 Td /F4 9.8 Tf [(The trust issue.)] TJ ET BT 26.250 614.024 Td /F1 9.8 Tf [(According to Giddens, contemporary individuals are exhorted to become the entrepreneur of their own life, but they must do so )] TJ ET BT 26.250 602.119 Td /F1 9.8 Tf [(in a context characterised by trust issues, as many if not all aspects of our daily lives depend on machines or systems that )] TJ ET BT 26.250 590.214 Td /F1 9.8 Tf [(are distant from us and beyond our understanding. Giddenss analysis is based on a concept of trust borrowed from the )] TJ ET BT 26.250 578.310 Td /F1 9.8 Tf [(psychologist Erik Erikson: depending on people/things that are not under our direct scrutiny or not fully understandable to us )] TJ ET BT 26.250 566.405 Td /F1 9.8 Tf [(induces anxiety, and we must trust them, trust a whole expert system, through a leap of faith. As our societies are characterised )] TJ ET BT 26.250 554.500 Td /F1 9.8 Tf [(by overspecialisation and the disembedding of social relationships, trust issues become essential )] TJ ET 0.267 0.267 0.267 rg BT 447.304 556.007 Td /F4 8.7 Tf [(32)] TJ ET 0.271 0.267 0.267 rg BT 456.941 554.500 Td /F1 9.8 Tf [(. Moreover, in Giddenss )] TJ ET BT 26.250 542.595 Td /F1 9.8 Tf [(perspective, the contemporary controversies regarding vaccination or other health-related issues are not the causes of distrust, )] TJ ET BT 26.250 530.691 Td /F1 9.8 Tf [(but only consequences of a wider structural phenomenon.)] TJ ET BT 26.250 511.286 Td /F1 9.8 Tf [(Trust issues are also crucial in Becks analyses of contemporary risk societies, especially regarding science and knowledge. )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(According to him, our societies are characterised by reflexive scientisation: scientific scepticism has been extended to science )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(itself and fuelled the disenchantment of science. As a result, there is a process of demonopolisation/feudalisation of scientific )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(knowledge, with conflictual equalisation tendencies in the gradient of rationality between experts and lay people. Sciences, )] TJ ET BT 26.250 463.667 Td /F1 9.8 Tf [(quasi-sciences and pseudo-sciences are competing sources that produce a flood of overspecialised, hyper-complex and )] TJ ET BT 26.250 451.762 Td /F1 9.8 Tf [(contradictory findings. Consequently, distrust toward science is no longer a sign of ignorance or even obscurantism, but is )] TJ ET BT 26.250 439.857 Td /F1 9.8 Tf [(endorsed by highly educated individuals )] TJ ET 0.267 0.267 0.267 rg BT 201.838 441.365 Td /F4 8.7 Tf [(37)] TJ ET 0.271 0.267 0.267 rg BT 211.475 439.857 Td /F1 9.8 Tf [(. Beck also pointed out the increasingly important issue of conflicts of interest, i.e., )] TJ ET BT 26.250 427.953 Td /F1 9.8 Tf [(situations in which scientists or experts are perceived as untrustworthy because of their financial links to industries. In this )] TJ ET BT 26.250 416.048 Td /F1 9.8 Tf [(context, people who endorse risk culture and decide to take their health in hand are confronted with discordant sources of )] TJ ET BT 26.250 404.143 Td /F1 9.8 Tf [(knowledge: they may distrust official sciences and experts, and put their faith in alternative sources of information or medical )] TJ ET BT 26.250 392.238 Td /F1 9.8 Tf [(practice \(such as homeopathy or acupuncture\).)] TJ ET BT 26.250 372.834 Td /F1 9.8 Tf [(Vaccination-related issues have not escaped from these structural features of contemporary societies, especially the crisis of )] TJ ET BT 26.250 360.929 Td /F1 9.8 Tf [(legitimacy faced by science, expertise and medical authorities. Vaccination may involve trust as a leap of faith, experienced )] TJ ET BT 26.250 349.024 Td /F1 9.8 Tf [(through relationality and familiarity with a physician [5,38]. An annual survey conducted by the IRSN \(Institute of Radiation )] TJ ET BT 26.250 337.119 Td /F1 9.8 Tf [(Protection and Nuclear Safety\) illustrates this crisis of legitimacy; it found that, generally speaking, the French people do not )] TJ ET BT 26.250 325.215 Td /F1 9.8 Tf [(trust the way authorities manage various kinds of risks, nor do they trust the information given to them. For example, only 38% )] TJ ET BT 26.250 313.310 Td /F1 9.8 Tf [(of the French had confidence that what authorities did about the H1N1 episode in 2009 was for their safety, and only 34% )] TJ ET BT 26.250 301.405 Td /F1 9.8 Tf [(believed that the information released was true. )] TJ ET 0.267 0.267 0.267 rg BT 233.808 302.912 Td /F4 8.7 Tf [(39)] TJ ET 0.271 0.267 0.267 rg BT 26.250 282.000 Td /F1 9.8 Tf [(Trust is generally considered as a crucial component of peoples attitudes toward vaccination, including VH )] TJ ET 0.267 0.267 0.267 rg BT 489.570 283.508 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 494.389 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 496.798 283.508 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 501.617 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 504.026 283.508 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 508.845 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 511.254 283.508 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 520.891 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 523.301 283.508 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 532.938 282.000 Td /F1 9.8 Tf [(. For )] TJ ET BT 26.250 270.096 Td /F1 9.8 Tf [(example, trust is a key dimension in the questionnaire developed by Opel et al to assess VH )] TJ ET 0.267 0.267 0.267 rg BT 426.185 271.603 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 435.823 270.096 Td /F1 9.8 Tf [(. More precisely, lay people may )] TJ ET BT 26.250 258.191 Td /F1 9.8 Tf [(not distrust vaccines per se, but rather distrust the health authorities who are believed to be strongly influenced by vaccines )] TJ ET BT 26.250 246.286 Td /F1 9.8 Tf [(producers )] TJ ET 0.267 0.267 0.267 rg BT 72.309 247.793 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 77.128 250.174 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 79.537 247.793 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 89.174 246.286 Td /F1 9.8 Tf [(. This feature of contemporary societies is closely related to healthism, and some authors have even combined )] TJ ET BT 26.250 234.381 Td /F1 9.8 Tf [(these concepts: in such cases, healthism refers to individuals who seek to control their \(childrens\) health, who want to become )] TJ ET BT 26.250 222.477 Td /F1 9.8 Tf [(its informed and rational entrepreneur, but who also express strong doubts about medical authorities and mainstream medicine )] TJ ET BT 26.250 210.572 Td /F1 9.8 Tf [(and are more prone to turn to alternative experts, including on vaccination issues )] TJ ET 0.267 0.267 0.267 rg BT 377.416 212.079 Td /F4 8.7 Tf [(36)] TJ ET 0.271 0.267 0.267 rg BT 387.053 210.572 Td /F1 9.8 Tf [(. This relation between empowerment and )] TJ ET BT 26.250 198.667 Td /F1 9.8 Tf [(distrust is also explicitly promoted by some groups critical of vaccines, which claim that trusting blindly can be the biggest risk )] TJ ET BT 26.250 186.762 Td /F1 9.8 Tf [(of all )] TJ ET 0.267 0.267 0.267 rg BT 52.799 188.270 Td /F4 8.7 Tf [(41)] TJ ET 0.271 0.267 0.267 rg BT 62.437 186.762 Td /F1 9.8 Tf [(. Moreover, several previous studies have already found a positive correlation between VH and use of alternative )] TJ ET BT 26.250 174.858 Td /F1 9.8 Tf [(medicines \(such as acupuncture, homeopathy or naturopathy )] TJ ET 0.267 0.267 0.267 rg BT 293.420 176.365 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 303.057 178.746 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 305.466 176.365 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 315.104 178.746 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 317.513 176.365 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 327.150 174.858 Td /F1 9.8 Tf [( \) , as well as distrust of colon cancer screening )] TJ ET 0.267 0.267 0.267 rg BT 534.689 176.365 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 544.326 174.858 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 138.255 Td /F4 12.0 Tf [(VH in a two-dimension map.)] TJ ET BT 26.250 118.301 Td /F1 9.8 Tf [(Thus we propose to add to the risk culture/healthism axis a second axis, assessing lay peoples attitudes toward health )] TJ ET BT 26.250 106.396 Td /F1 9.8 Tf [(authorities and mainstream medicine \(see Figure 1\).)] TJ ET 0.965 0.965 0.965 rg 26.250 -145.735 555.000 242.250 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 96.515 m 581.250 96.515 l 581.250 95.765 l 26.250 95.765 l f q 450.000 0 0 226.500 35.250 -139.735 cm /I6 Do Q q 35.250 -145.735 537.000 0.000 re W n Q Q q 15.000 -145.735 577.500 922.735 re W n 0.271 0.267 0.267 rg BT 26.250 767.476 Td /F1 9.8 Tf [(which individuals are committed or indifferent to contemporary healthism.)] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(The link between healthism and VH is quite obvious in several studies. Gilkey et al. )] TJ ET 0.267 0.267 0.267 rg BT 386.610 749.579 Td /F4 8.7 Tf [(26)] TJ ET 0.271 0.267 0.267 rg BT 396.247 748.071 Td /F1 9.8 Tf [( observed that forgoing vaccines was )] TJ ET BT 26.250 736.167 Td /F1 9.8 Tf [(more common among parents more attentive to their childrens health and nutrition, and others underline the weight of rational )] TJ ET BT 26.250 724.262 Td /F1 9.8 Tf [(assessment and the importance of perceived control among people who were reluctant to be vaccinated against the H1N1 )] TJ ET BT 26.250 712.357 Td /F1 9.8 Tf [(influenza )] TJ ET 0.267 0.267 0.267 rg BT 67.980 713.864 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 77.617 716.245 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 80.027 713.864 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 89.664 712.357 Td /F1 9.8 Tf [(. Moreover, when Opel et al. )] TJ ET 0.267 0.267 0.267 rg BT 214.844 713.864 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 224.482 712.357 Td /F1 9.8 Tf [( built a questionnaire designed to identify VH, they not only used existing items )] TJ ET BT 26.250 700.452 Td /F1 9.8 Tf [(but also conducted focus groups to create new items. Because parents frequently claimed that they prefer to rely on their own )] TJ ET BT 26.250 688.548 Td /F1 9.8 Tf [(research on vaccines to come to an informed decision, rather than deferring to their childs doctor, the authors added the )] TJ ET BT 26.250 676.643 Td /F1 9.8 Tf [(following item: It is my role as a parent to question shots. We believe this item captures an aspect of commitment to risk )] TJ ET BT 26.250 664.738 Td /F1 9.8 Tf [(culture. Conversely, and rather remarkably, parents reluctance to get their child immunised has been used as a typical example )] TJ ET BT 26.250 652.833 Td /F1 9.8 Tf [(to illustrate contemporary healthism )] TJ ET 0.267 0.267 0.267 rg BT 182.845 654.341 Td /F4 8.7 Tf [(36)] TJ ET 0.271 0.267 0.267 rg BT 192.482 652.833 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 633.429 Td /F4 9.8 Tf [(The trust issue.)] TJ ET BT 26.250 614.024 Td /F1 9.8 Tf [(According to Giddens, contemporary individuals are exhorted to become the entrepreneur of their own life, but they must do so )] TJ ET BT 26.250 602.119 Td /F1 9.8 Tf [(in a context characterised by trust issues, as many if not all aspects of our daily lives depend on machines or systems that )] TJ ET BT 26.250 590.214 Td /F1 9.8 Tf [(are distant from us and beyond our understanding. Giddenss analysis is based on a concept of trust borrowed from the )] TJ ET BT 26.250 578.310 Td /F1 9.8 Tf [(psychologist Erik Erikson: depending on people/things that are not under our direct scrutiny or not fully understandable to us )] TJ ET BT 26.250 566.405 Td /F1 9.8 Tf [(induces anxiety, and we must trust them, trust a whole expert system, through a leap of faith. As our societies are characterised )] TJ ET BT 26.250 554.500 Td /F1 9.8 Tf [(by overspecialisation and the disembedding of social relationships, trust issues become essential )] TJ ET 0.267 0.267 0.267 rg BT 447.304 556.007 Td /F4 8.7 Tf [(32)] TJ ET 0.271 0.267 0.267 rg BT 456.941 554.500 Td /F1 9.8 Tf [(. Moreover, in Giddenss )] TJ ET BT 26.250 542.595 Td /F1 9.8 Tf [(perspective, the contemporary controversies regarding vaccination or other health-related issues are not the causes of distrust, )] TJ ET BT 26.250 530.691 Td /F1 9.8 Tf [(but only consequences of a wider structural phenomenon.)] TJ ET BT 26.250 511.286 Td /F1 9.8 Tf [(Trust issues are also crucial in Becks analyses of contemporary risk societies, especially regarding science and knowledge. )] TJ ET BT 26.250 499.381 Td /F1 9.8 Tf [(According to him, our societies are characterised by reflexive scientisation: scientific scepticism has been extended to science )] TJ ET BT 26.250 487.476 Td /F1 9.8 Tf [(itself and fuelled the disenchantment of science. As a result, there is a process of demonopolisation/feudalisation of scientific )] TJ ET BT 26.250 475.572 Td /F1 9.8 Tf [(knowledge, with conflictual equalisation tendencies in the gradient of rationality between experts and lay people. Sciences, )] TJ ET BT 26.250 463.667 Td /F1 9.8 Tf [(quasi-sciences and pseudo-sciences are competing sources that produce a flood of overspecialised, hyper-complex and )] TJ ET BT 26.250 451.762 Td /F1 9.8 Tf [(contradictory findings. Consequently, distrust toward science is no longer a sign of ignorance or even obscurantism, but is )] TJ ET BT 26.250 439.857 Td /F1 9.8 Tf [(endorsed by highly educated individuals )] TJ ET 0.267 0.267 0.267 rg BT 201.838 441.365 Td /F4 8.7 Tf [(37)] TJ ET 0.271 0.267 0.267 rg BT 211.475 439.857 Td /F1 9.8 Tf [(. Beck also pointed out the increasingly important issue of conflicts of interest, i.e., )] TJ ET BT 26.250 427.953 Td /F1 9.8 Tf [(situations in which scientists or experts are perceived as untrustworthy because of their financial links to industries. In this )] TJ ET BT 26.250 416.048 Td /F1 9.8 Tf [(context, people who endorse risk culture and decide to take their health in hand are confronted with discordant sources of )] TJ ET BT 26.250 404.143 Td /F1 9.8 Tf [(knowledge: they may distrust official sciences and experts, and put their faith in alternative sources of information or medical )] TJ ET BT 26.250 392.238 Td /F1 9.8 Tf [(practice \(such as homeopathy or acupuncture\).)] TJ ET BT 26.250 372.834 Td /F1 9.8 Tf [(Vaccination-related issues have not escaped from these structural features of contemporary societies, especially the crisis of )] TJ ET BT 26.250 360.929 Td /F1 9.8 Tf [(legitimacy faced by science, expertise and medical authorities. Vaccination may involve trust as a leap of faith, experienced )] TJ ET BT 26.250 349.024 Td /F1 9.8 Tf [(through relationality and familiarity with a physician [5,38]. An annual survey conducted by the IRSN \(Institute of Radiation )] TJ ET BT 26.250 337.119 Td /F1 9.8 Tf [(Protection and Nuclear Safety\) illustrates this crisis of legitimacy; it found that, generally speaking, the French people do not )] TJ ET BT 26.250 325.215 Td /F1 9.8 Tf [(trust the way authorities manage various kinds of risks, nor do they trust the information given to them. For example, only 38% )] TJ ET BT 26.250 313.310 Td /F1 9.8 Tf [(of the French had confidence that what authorities did about the H1N1 episode in 2009 was for their safety, and only 34% )] TJ ET BT 26.250 301.405 Td /F1 9.8 Tf [(believed that the information released was true. )] TJ ET 0.267 0.267 0.267 rg BT 233.808 302.912 Td /F4 8.7 Tf [(39)] TJ ET 0.271 0.267 0.267 rg BT 26.250 282.000 Td /F1 9.8 Tf [(Trust is generally considered as a crucial component of peoples attitudes toward vaccination, including VH )] TJ ET 0.267 0.267 0.267 rg BT 489.570 283.508 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 494.389 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 496.798 283.508 Td /F4 8.7 Tf [(7)] TJ ET 0.271 0.267 0.267 rg BT 501.617 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 504.026 283.508 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 508.845 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 511.254 283.508 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 520.891 285.889 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 523.301 283.508 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 532.938 282.000 Td /F1 9.8 Tf [(. For )] TJ ET BT 26.250 270.096 Td /F1 9.8 Tf [(example, trust is a key dimension in the questionnaire developed by Opel et al to assess VH )] TJ ET 0.267 0.267 0.267 rg BT 426.185 271.603 Td /F4 8.7 Tf [(11)] TJ ET 0.271 0.267 0.267 rg BT 435.823 270.096 Td /F1 9.8 Tf [(. More precisely, lay people may )] TJ ET BT 26.250 258.191 Td /F1 9.8 Tf [(not distrust vaccines per se, but rather distrust the health authorities who are believed to be strongly influenced by vaccines )] TJ ET BT 26.250 246.286 Td /F1 9.8 Tf [(producers )] TJ ET 0.267 0.267 0.267 rg BT 72.309 247.793 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 77.128 250.174 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 79.537 247.793 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 89.174 246.286 Td /F1 9.8 Tf [(. This feature of contemporary societies is closely related to healthism, and some authors have even combined )] TJ ET BT 26.250 234.381 Td /F1 9.8 Tf [(these concepts: in such cases, healthism refers to individuals who seek to control their \(childrens\) health, who want to become )] TJ ET BT 26.250 222.477 Td /F1 9.8 Tf [(its informed and rational entrepreneur, but who also express strong doubts about medical authorities and mainstream medicine )] TJ ET BT 26.250 210.572 Td /F1 9.8 Tf [(and are more prone to turn to alternative experts, including on vaccination issues )] TJ ET 0.267 0.267 0.267 rg BT 377.416 212.079 Td /F4 8.7 Tf [(36)] TJ ET 0.271 0.267 0.267 rg BT 387.053 210.572 Td /F1 9.8 Tf [(. This relation between empowerment and )] TJ ET BT 26.250 198.667 Td /F1 9.8 Tf [(distrust is also explicitly promoted by some groups critical of vaccines, which claim that trusting blindly can be the biggest risk )] TJ ET BT 26.250 186.762 Td /F1 9.8 Tf [(of all )] TJ ET 0.267 0.267 0.267 rg BT 52.799 188.270 Td /F4 8.7 Tf [(41)] TJ ET 0.271 0.267 0.267 rg BT 62.437 186.762 Td /F1 9.8 Tf [(. Moreover, several previous studies have already found a positive correlation between VH and use of alternative )] TJ ET BT 26.250 174.858 Td /F1 9.8 Tf [(medicines \(such as acupuncture, homeopathy or naturopathy )] TJ ET 0.267 0.267 0.267 rg BT 293.420 176.365 Td /F4 8.7 Tf [(16)] TJ ET 0.271 0.267 0.267 rg BT 303.057 178.746 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 305.466 176.365 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 315.104 178.746 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 317.513 176.365 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 327.150 174.858 Td /F1 9.8 Tf [( \) , as well as distrust of colon cancer screening )] TJ ET 0.267 0.267 0.267 rg BT 534.689 176.365 Td /F4 8.7 Tf [(14)] TJ ET 0.271 0.267 0.267 rg BT 544.326 174.858 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 138.255 Td /F4 12.0 Tf [(VH in a two-dimension map.)] TJ ET BT 26.250 118.301 Td /F1 9.8 Tf [(Thus we propose to add to the risk culture/healthism axis a second axis, assessing lay peoples attitudes toward health )] TJ ET BT 26.250 106.396 Td /F1 9.8 Tf [(authorities and mainstream medicine \(see Figure 1\).)] TJ ET 0.965 0.965 0.965 rg 26.250 -145.735 555.000 242.250 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 96.515 m 581.250 96.515 l 581.250 95.765 l 26.250 95.765 l f q 450.000 0 0 226.500 35.250 -139.735 cm /I8 Do Q q 35.250 -145.735 537.000 0.000 re W n Q Q q 450.000 0 0 226.500 35.250 -139.735 cm /I10 Do 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 Q endstream endobj 508 0 obj << /Type /Annot /Subtype /Link /A 509 0 R /Border [0 0 0] /H /I /Rect [ 386.6100 748.7769 396.2473 757.5952 ] >> endobj 509 0 obj << /Type /Action >> endobj 510 0 obj << /Type /Annot /Subtype /Link /A 511 0 R /Border [0 0 0] /H /I /Rect [ 67.9800 713.0627 77.6173 721.8810 ] >> endobj 511 0 obj << /Type /Action >> endobj 512 0 obj << /Type /Annot /Subtype /Link /A 513 0 R /Border [0 0 0] /H /I /Rect [ 80.0267 713.0627 89.6640 721.8810 ] >> endobj 513 0 obj << /Type /Action >> endobj 514 0 obj << /Type /Annot /Subtype /Link /A 515 0 R /Border [0 0 0] /H /I /Rect [ 214.8443 713.0627 224.4816 721.8810 ] >> endobj 515 0 obj << /Type /Action >> endobj 516 0 obj << /Type /Annot /Subtype /Link /A 517 0 R /Border [0 0 0] /H /I /Rect [ 182.8448 653.5389 192.4821 662.3573 ] >> endobj 517 0 obj << /Type /Action >> endobj 518 0 obj << /Type /Annot /Subtype /Link /A 519 0 R /Border [0 0 0] /H /I /Rect [ 447.3037 555.2057 456.9411 564.0240 ] >> endobj 519 0 obj << /Type /Action >> endobj 520 0 obj << /Type /Annot /Subtype /Link /A 521 0 R /Border [0 0 0] /H /I /Rect [ 201.8377 440.5629 211.4751 449.3813 ] >> endobj 521 0 obj << /Type /Action >> endobj 522 0 obj << /Type /Annot /Subtype /Link /A 523 0 R /Border [0 0 0] /H /I /Rect [ 233.8080 302.1107 243.4453 310.9290 ] >> endobj 523 0 obj << /Type /Action >> endobj 524 0 obj << /Type /Annot /Subtype /Link /A 525 0 R /Border [0 0 0] /H /I /Rect [ 489.5700 282.7059 494.3887 291.5243 ] >> endobj 525 0 obj << /Type /Action >> endobj 526 0 obj << /Type /Annot /Subtype /Link /A 527 0 R /Border [0 0 0] /H /I /Rect [ 496.7980 282.7059 501.6167 291.5243 ] >> endobj 527 0 obj << /Type /Action >> endobj 528 0 obj << /Type /Annot /Subtype /Link /A 529 0 R /Border [0 0 0] /H /I /Rect [ 504.0260 282.7059 508.8447 291.5243 ] >> endobj 529 0 obj << /Type /Action >> endobj 530 0 obj << /Type /Annot /Subtype /Link /A 531 0 R /Border [0 0 0] /H /I /Rect [ 511.2540 282.7059 520.8913 291.5243 ] >> endobj 531 0 obj << /Type /Action >> endobj 532 0 obj << /Type /Annot /Subtype /Link /A 533 0 R /Border [0 0 0] /H /I /Rect [ 523.3007 282.7059 532.9380 291.5243 ] >> endobj 533 0 obj << /Type /Action >> endobj 534 0 obj << /Type /Annot /Subtype /Link /A 535 0 R /Border [0 0 0] /H /I /Rect [ 426.1852 270.8012 435.8226 279.6195 ] >> endobj 535 0 obj << /Type /Action >> endobj 536 0 obj << /Type /Annot /Subtype /Link /A 537 0 R /Border [0 0 0] /H /I /Rect [ 72.3090 246.9917 77.1277 255.8100 ] >> endobj 537 0 obj << /Type /Action >> endobj 538 0 obj << /Type /Annot /Subtype /Link /A 539 0 R /Border [0 0 0] /H /I /Rect [ 79.5370 246.9917 89.1743 255.8100 ] >> endobj 539 0 obj << /Type /Action >> endobj 540 0 obj << /Type /Annot /Subtype /Link /A 541 0 R /Border [0 0 0] /H /I /Rect [ 377.4158 211.2774 387.0531 220.0958 ] >> endobj 541 0 obj << /Type /Action >> endobj 542 0 obj << /Type /Annot /Subtype /Link /A 543 0 R /Border [0 0 0] /H /I /Rect [ 52.7993 187.4679 62.4366 196.2863 ] >> endobj 543 0 obj << /Type /Action >> endobj 544 0 obj << /Type /Annot /Subtype /Link /A 545 0 R /Border [0 0 0] /H /I /Rect [ 293.4195 175.5632 303.0568 184.3815 ] >> endobj 545 0 obj << /Type /Action >> endobj 546 0 obj << /Type /Annot /Subtype /Link /A 547 0 R /Border [0 0 0] /H /I /Rect [ 305.4662 175.5632 315.1035 184.3815 ] >> endobj 547 0 obj << /Type /Action >> endobj 548 0 obj << /Type /Annot /Subtype /Link /A 549 0 R /Border [0 0 0] /H /I /Rect [ 317.5128 175.5632 327.1502 184.3815 ] >> endobj 549 0 obj << /Type /Action >> endobj 550 0 obj << /Type /Annot /Subtype /Link /A 551 0 R /Border [0 0 0] /H /I /Rect [ 534.6887 175.5632 544.3260 184.3815 ] >> endobj 551 0 obj << /Type /Action >> endobj 552 0 obj << /Type /Annot /Subtype /Link /A 553 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 -139.7347 485.2500 86.7653 ] >> endobj 553 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/files/2015/01/vaccine-hesitancy-e1424801031537.png) >> endobj 554 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 302 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 1 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceGray /BitsPerComponent 8 /Length 783>> stream xA 0 =" ʝ<2;EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$q endstream endobj 555 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 302 /SMask 554 0 R /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 64449>> stream xWw\G.礷HHx ADJJ*Sꚞ55O0gf֝{gMt[<=AO&Ho90rȓ P18;D$ QRU!I!D4 hMg},ehE] xN};_L{gcڪ!bN릠dk`Obl _%24?iNBt拹TE^csa^d2\Tabb@xuk== r򞡡LOax!Zx^BKt~л5sS^ŰWtפO 1Bތ7cFʷ[|LCC%TFuHBs4T3qӉkD?c%u+nF+/$p~G9 0y2?VdhbTL@ sdRP;k p y0:uYrz^B SWwOKZ)I BWI&\02AhyDSq?4x 6`hn? >)KRvϸx`bI3W0- lL1&$E&c*\"?%Npe,tҼ!݈O%xʸޫjÔ'WQ4V0$(oReӕ kdV<- <KO]ȃ> 4QZw!X!a_$tE:iL1l8 /oyEwa%+ktBc> {LW<|31 YS'2>3B.}"T$qzFOm >P`%kFc#Eӧ2wo üp;y1E'D!A(n\'O`-̂:D b#\dz aI^lBy3+A<`-5FV1ΌUPۭN6$XYaN#'슰0Z'4ӟvXpL08eڏI>z9-k%4B޶aLJh4s1))Y3ARL8v!K&wSVsc/ m-a'#f9Zv3!D-ْMUKJoDSUEUM&RKD2[&Bb>H5E!lK!$M2y8$"1[ X\q~$IҳA`<3;* x8Jf1TU1Jfe֣ P$.LLv8)ޞaI`z-XKQdyH 2w_U#R 6  *ZkKok4˥ţ54Hf ֦_{ٟ;_u3[_}ktcז_, }?|%皢ˬC!<,dWӲ[oqΉn?\K=vִm{^=Ѷ彛Jß"^'?są;c6oc1дWȵS'N ohWv)}}`.ekWa4B™CZ%`,e3%8WA0Y, &=z)g,TgZ9-,[2 a[(:  +ıHX@syWK- `4`reus؂jkZ:$Hq!/[ۺڛ]691qg9y8517?~C'犹S  >x&>v{*gʙSONɃx9HOӚբ`H?̺i̐y_e##35IDJ3cw'M?xo_kI?|x$k6hJzfft6#olg_YܽvʣDϖ/n[sšwA{ndth\"|Mmvyt,fjh_HZ6*ȞU V5}tbmln=z;L@$)pґ%j$i4A\hu+ 5Vgp)*S]>kt R4}cl4jb?W<=,6a !1 -I[y+Ma&v2͈IltYnSBR%GcfwSgd"Z)0?;*ɹ/>>x7`'S[὇B,>?=VKZ*-O0GǦB^RDd<6=Ό8qf`ZߴlpCG<9Y{u!#znpKZj g>K)`lB&IR&F/_| #f׭Y {3;,pt`d Hf N X3jG F|?[aZ*d3\IxVIR!ei_gΧMl2[MZ>6;'%B4Ǣ lfREgy>I+NMG%5zE@&3Cd6ft1Z!=Oӡm^EX;ӤL`o |\~ʿ84 l(l.l e6Y3"H:2B-{ i@ v)~ >2J=W 1m`#siZCU,x*\^YagM\, Np˗Lrк=C >. P< 6@dL BS<,JJDB=RÔq4Hq4f1k*,&2@SN6LL :˄! Aw0bu #ȸ [̋ \4iaoE1\E#7e$Hō#_ A"tA=jP%( 2z IЈg}a quޕV›V5ao\dy<-My]Pݚ6gPX+21 :% k|2*!| ~XJy)Jπ0g 2Y[Q:[TxJ $ Κ KU 5A׺L >w᥄KĪ+9'IX'\≏!C1mϿN޼ : P9) n{3s;Vg,|T2*Gg| &3d9A1Q'ga8p^!T/KWmGe5-fk @%'5 )>#6U˨VX'`mE,hڙeN|K>!.@4[f6-FoxFaKknixYh z\'hPf)cy B>7ݘ.@?[дVA_qpi Oz!P\?`U)FiCwÃc Z`!LLyr1AM$4h˞ X2 2,/A-'x2 &H0#.bm 0O &MO@/ʏ<4o](%'Wk୑V "q{}icmZʤɜz]v+-T"U^j~NeTV=^uF6t&3jankwS6KOkK^eD4Z3A ULخ S-#(vHN&(ړl[셀3OaD {9/ix-0w1AŚ 2ac @ )qR~lQ;~lE؈ $RFP-d;rt"sNKT MUUA픦iVN:{Te<X^%ZL>uF$Is)lB JX,**T,)4U)J"-f$Kp/_AWkg,u+ S"t[]I6 L@|K'SF(6!̄wDz7/l`fӫ bC iCXxhl<:n93+9,KD4d|.kb&529^]&l2g2 ќmsN[Vnm 2TXb":\NԊt<!d6˒%j5D+%l/>:?1䵔bm :ɘz.HP-dSssq},%Eb:̩obs{Gci޿h; 6"=M&Z&s7j13?7UL`e`5unrhj>ilomU%7>hhmm,dqz<6#M~Az,2 fX/C4hܥA.L+<04 n^:y .Zyrw L&e@ Te&/TӪoBGU=qҵcєڼ{ߞ} 6iWg^;s}.W(jˎ\hDZ 3w'_\kQ?~u}~!椉{'>.kv®-ާ0kgO3: 6^u3vl4g'^>[jܼ/t75kL dW_N]ɾ|Kegd7xoܾx\t~!Ҟ5nqK>͞`ƚ69>e 6zI~ Wnwyqj)5uɫwc/!p[ր^BfO'z'FGWt< ApHf3bq:AL/b̓c&D/3X9I13@K(QÐAM- H;D$/@i"e!|1(CS eT\ƽ&b܍Ǟ^uO\Iڂ>2pDZw~ߝ{mjo/<|ʽƭ? jM%&-paRtlltldXMW%W7$˚Ij11yD}ʏ]ӋҾu}[vCNwnLƦb3Ԋ|tl2ըݺy,jnnIUՈiD$NfKDQ5x!/ (n8AI:皠!_VU xy,`^_1Iqu x1Zr&x؍5Kͽ{GNtbf苏>2/O޽>_XH;qd+O_(|2q$9tQvwKkևӏg{~}S 759jD$Ilţ'߼:)biّd^zVLOOMHtvwu]O3W/Y_xu99gggN2ί?ە+^I5}o7}_M:\ H[kkhw9>x:?ӛsw~o}ṕX<67Nɿ[oebqX f.]0Q \oÓLUs^֚7~ɦ֖vUNxc4 tw&LM-zzrq$5/;֭_[ᬽw~ ٱ77z-|筽-~k jE6_bY77x7ymRb>ٰ%(gg'dzΦUo +s#E;{\.>{O\߹e3/RGNx;C3'1Kg/yc0Zɮ''7mZb}* "Kox[Df웠Nk.K+ZnN#h~4<Ы^g&,#>0-'x zv{S;gU$"&h<.%|5%,mw4C أG{{Uo[S5GgFc-Fshqg]&cIG`k͑KP[%5jǺ͑Pfb31~Y%'H$`r=-ע*O@_ܹ(E"aJLOZYS29տaբh Gi3%](ldaf^i^vU,5Nf;ZfY%31p9)貸y^3ѡge=L-/(}{yH7~F P 8C]]ju~;V^Zu|!zYfpx,1&˗ԬNP,DO .@#Vk`6'Vx%z-LCI<@06| e}Z ԰PgӚ&ݴ09=29#얩lFv6lž~p{nK\)b>H$&Ǯ|u3+s)ߚ6>=1MUIk)>35:;.)ʞM-OwT( |&LMMCw-D{ϗ¦L6~N_ӊ$JX*SӓV_OAVm!75Xg xqaҙE݉[nXұI䵩əD)Y$(dY`e&g;l.e7)b lă=p+[n&K>oݾwǖuVL$|nF(ٵkhnt`[ϖ]{hƏAUI9 WA3BOG{e8x7ˊZs0?,y*vt-؍wP^4HPZbGѨjq6m&yf.:ϸZ=/^=^('ҫ{Uݡ/~_3aiH"з+lܜJd:n5f:aKhFݦb|f2(5l׿Rhr"ݡO|ypk[G[N !}9n XYVo?Y`|n>^hli4Hznjl`45{"k:N^>鿦L{Cuh)ɾ&`3M'H%$n()m9r1KnLPڍ.>L3ݭv]$,;l_b6_uRl67lp{Ww}.ls7ڹk3ˆs)q2' F3D˟) ~Mo CG’-4*Y|3˱4G@6&>d (>Vۤ`nwV{GT\XH97oh sfݼ'Ll21?7?/V5n-H(շnæwm].e5eǖΐnJ|A|Vul߾g˥)յz=-6,$ۖM% {۶oݺ/M$4rXӉxRw7_3ɤкi󆎠$kt*]0w߶nUf'B>_ZWZKֻ~ۺUk!L4kP[WWKcffocQ[Ųjwv6+M;PkWW{0!$",_-tX̄TR8;:ANd3LőWF&㥳3ҍְZ5]JgƈT+l(BQ563z- .Q|&S$e!\&ʘ&Kj.L]*9vYee&ojn{lL"z͑j~/?K@"h Bߤoh mq3¯V0Gm+~1hd!O p}1Ϙ7?z!=e}4cX`{kk ּR B8cF#_\ ^-/ªu;.!(+`[aU⬸kҫ@tSԟu[aGg%BkKԿtxuK"҄i8O:LŃTh_45>1U:&uV!*҈*7W;xmAb$bj$ieVm:Q`U#(z6?e-?yֻ_ 1BN\yhN"5pP$1ք"&HVk,4ȴ&(@.[1GfF IA@iv $:A?m<Zyמ@ 0@\hTnr'm%4x2yLP7$nb#s;"v HH 'D5AEQbXOO\1,H^P An:ڊ|AE桭\ae Z jOz8z,iD=XU")#5xI _Py&qzGTKx ?a:y.3x][Ŕ|KRXĹ\dg+ggb9t 0dܴQPc^1Upcj#Aę-P陃y&CPC C*?R%gAPeT<yڀ\+[#ڊ \Nf >V "3Ș]]y@t< e~E4pgkA1;Ax%*HF.EWmtIԥ TyH7-PٙUgp.'8;4`1\AĥM0 @XUAAϓV*˃~ _Z+d0RؘH*`ŅπQmy[|6 LtHɓH&xw|b`iX}$ J?㤭`Ч=\WAHO=h@U v`Kh1z9p Э&ѡ] EB9o}5t/Q *VTL'yqK% 'Hc ZDë\Ie1H!5]7E8M+fwXpcX s5ց DoSZB*oF5< g- N8vx7ȠVՓH gTKgZaQ'q4M|--hzN (V" 3`#5㵴gxf56p2^aŇ}v\ %? jN .h(5i2:e'(3k7]x IK_>xw2}F'^5 %Ou%whA 1HIV<5`DϚqx$sFVbSA[5:A#e'($\ai4މ0{EI<*nd`T<'VlT0-<.2Idx*V\3e*uqWAP4:0x V#)@/ h^u+`ٿ>C(10+5$<1?bE\2t0AnD,,C9ӐT~#1/`Zc) N p4& 2u~ Z缌U[0NN9;6/HyՓW|hd3Rr( OyYWE5HǓK(OF3@mtV5_'F%>xaff: -c$;į18A@@1I?Fz[,t#g*ܹ+Wx#>kdDh 4љ ejcAPEwړA[T0mg)@X~+~+P0`<*nD3&!# 1e jba":yBgxqNb<\3ɬ Lu+_e$8.X |2e& $- L\/0h+§0Xm01!زu׎Hf.BbgOWݽ3~ ݛL3gCmA7Bl{lj;B^ ]yzRU #w.]1Դfﮍ.YL!l A~2$A#@pavKFMzÛvjv$/4o~?:o;|β"Q ×O|tyj;?{ejGb6W4YmVI&Sv]T4~G.~/ol4[i)3NNL+HW"@~EX$0y6Fs4M&nЙЗ&Oxf:?;=9+hsK$$Tl|lb>5#f*d#il6=MwKCv55;w.M'2Oa-''&f @m3?O i~=kZɡyդQ XQ55,2)l5%pkKaFn+طum5:e5?><4K%hp$ R)0/M~Y)KG A9Lp[esS/=-aŤғcikr|IUXlk"x8[Z|Ί1 M D STۺj&hDV & є^T9t"hZ!0=,IjXLD556| Vǧf拒n۝.IVJ?[KFW);{cݑWDzi}w0?3>>5=ͭpK"Z>ΗTMǣ)ni zeB$Bمim9-MMŦǧ%](X.HZhv"=I^}[Sm (mN|4A TW4 FXy.&CBlin޾um3lL9vh&_;Ks.<~ôfo]obM\=w EsK7~͖sE6}}||[|om@zKc޸7^0KH!j#W[ Y6RUR΅NMo/lP;vlV*ƆGԆ3wܸxpOKUݲW7f<{D* luSw-3cEWdAy|q7>boО|4lom ߻zӉkӫ^Xc IˌmM{voqׯ&/goEl&8|@D1 >$>ubHpe'w ![wl2e%6rб;Y{?>2VؾCSXɷiǶg`.>s̑勹ӇO]L.9G.&m];7Y?}/uO$?`x\q̲,Lff{۟|^,ܷgܛϥ&.~JYZޙsYqy@/|/aH.~?~ttM}`7R#wh o+VOf؈!kXFw,Н N;zé"gc_d_|<I$d6kO>zcp:>7vޟno^hj2YMÑ96ʱK>^oc)7~G ;[wO} L|'owњrOܙM$_>'J;7G?˱ss9gss9>542U$di 8ia}:sG@$0wiN~0zgX]XI;$(h2}p)d$k C>l:ltuK{n[J/ O-X2DXygk%XXqGgLm EN >|MWeΞ=7q붵^)z>ڵ* QB2+ۭ"=7ϝ9ί~n[nY[_oz_l XŎ-I^~em.ݙ1Hl0~]J^,^o~#Ieu}-ă^kOSBjEW_[m}Sxp?U͎P:kݰm|bwg8`,07ڱt 8V*`;{OƁ^{+/|u{<;nv6ڋy[wݟ*7Mo =q8.m˶oaWsx\Ŧ`1D>TM,&&=7#<ɊjD0լv4m~XB9꣤cI%Yrdkvem.6uŻ#t2vohZ-{9~?쮗_{m-O?N}卷dl%s[Ѵc SGG=W?0MFpk<+pjR>+%M#OW]Mk7nj7j{~ߙ#S{Ck6l{:"kw2luN-ycխIqڼ̗Df5w޾cMWmdYoMoSHvt֮km + P,4b2-&YS$_7^~p]~p-YSWGk{oھpss=u擙RI5|=mKRU&pՐ]+V* 1t %uH[lr[frْ>˲l5˲䰻l_3?/:B}}=I)omæPsyX]n4^sifvzlt|5׺_l+]OշG#P'[n;+K!3zh qW`M# ")R( e=ywfvf>G|gvg [lK(Q)1'AnM^*mHvݓ~9u;`XFҭϿ$ɆLʧ) #W>/tz|]-+F!r,;y׺Ö?}ogK>ɧMň=צj D;sCHꎴkZշzmc0׷N%ZWłd+_ӐYoo4` DZ!FY4f(ϯi@ ( cql Y *Z6:|R4UlEQuB T1@EQ0º`옶OqLKQ,|_Q ) @3t"8!NEmT,JejYDڶ7l! +0@ FCaduU7/;ikvw{lR9E ȱL2ǶqIַ޸}oM5h*#1B6*j$Uӿ-^]'hm䇎ئiٖBNXl`!vց،HD\K=`-K xxɭ0W+Bޥ.?Ydf09~!˲gv垒ũ;N3S4-̥ق_#_z&6 \}󳋗5a͢Qs}_կN&{vWHԥ@"ӿ.,-ջ@Klݱ_|洱֜ug.Ե/?txu-\=tl>lMB>o1ر-ӴƎcG747&]O65>5HojnNV/ֽIAi`0b`#4M Bm;[lZ?c_˗oln.ضB,Cc&p27I3 ݊ꍗJI=^DDo0D]k{K*(l,L a XicUt\9pyf约@CCKm*ξE~vlT0;Y,`G%ښwfPM]q&eb3_~׊R?X=P_BqޢrG%ej 8K6V9X^ )=\$G9Z8Ǒz9k7*iڻo>>a1wRO(ڵO2f2Ͻ_z/N·}uz(Ǒ@@8}`4~fyqxycl,M;}%%""x!6tBƓɠOWD ECd2 ZKG>xxh.ԻvuwCTc1#Z Kĭπ@,"R&R[AOQȣKCjH4ٗ*=!NjT}p2 jh< cD$Ȳjho`"Y tGcjmkqoF{k /^ol2ъڹeϳkx" FQn{~sfmҳp7jKbd4ÚHP6`VFb?#[H&9QU#Ȝ8S7{&BPU/Xm['F0R[_B$׮߼mKgS&Ʀfs{^yaLNMM_ܳ?u_5h,VYyמk]|L2’Lc[OWGX2lgOOKk?ϴLEablRWMwD~|]֬. Up:300绺cc P(!׶ZՐIlgwwK֧2ɘ0[:{b~4Yզ8rZ}mmKC0PT}p *!q*k (򅢥m#i*\(`(dY6@QJVt P !!}UtMSB>_0 r,޹B誻l]dKSzZZ\rE ۶  FP'!@GV]ES/?z-Kj#!NbӯZ"x ڶs͋.ٶ @V B!,-YE1P oqߴJ&N~ONoZՐe;%@1B*@XVTU5]ӰUX_("% }:@c(LA38/  D S(b~"˲K}>ߺu٬b%S] ,T2JmIaw&tqR'&P(4??mT!ĥݍȱPqRȱK?ޭi;0P4MV郒@jZtA. *}7clA(Š TTUg(*NJ82zd}CUS!w着 !rl99`8v7a*vJQTrj)u]4:S[uEm9jQb͋j?&rFFn:|P(~Bql`v*8VU B6fP*a :gB!T[KGgo sޥ͈** Ni*6 PQU"TK8¥լ*vwlǖ~-``8#Bh;/TE-5_Yl)'y5\l,2$e%D$"ڵt9N[F[ig,`=N'{ns@@r(*{ACKVqߟd ٬1f9.HW 42@UU~ ڶxiA`.͍޹3Z M5ɉ0.%/ c"IK6zK/#+A֓$asxS{py$bP~T%Og2=iZQwlq ?G x|^xp-׶Ltyz?BPnh%`t:JQ%UFnRIR 1Mv놮A>uޛ_w`,k DT:"5̫[x+ 2^c;Mj ^/kFc.R2`[aYp])^1gK5w+U]?-+c,:y'Q2)ۭ<+ܴ4%dŹ $3p+^C8eWcDX$ܴ -%nHxBp9uRˣWIrIPU+.2]vk{Prhcz*@vq&3uXZMurQBHP^$$|) *2!yoXRl Z"Tob\m$@Z⪕Xg%I{Qb(z' b,qNrhk&xH9`Q4'gxFAHQQ$Dq;dc,;yܐTȗA1^L R!lrP y򖨐sW M$˕ `ngvK Iur"7q{ąV4TXwIoEXfsܐȊrh08 6 6$7˳Q9DFtG. ?wH$*r+lD̩sݮ wKrBlSkR$zDX@ց 512MӲݔeVݨ(IzƑ/6dG IHGB!QwEE3K6.@'y +"2A!ubg^(~(TXE|@?P|2`ݐdMp=/wvpղ+ZUe|P4my!1o^9|gΎL/ K#U\Z\Lur3˞JD,O9) Kj,D/6{fdBPTBac *{M!ʐ$$ }I gEX f &+Hq-r$V\rD %ؼs'U_$ܱnX@e4vg~gn 2ٚgBX9=xӃі;7 e3ɸ{1X,(w P2pٟa"`YA ʼnaPYNyDDjP`jHa@tKbRU PE&VɃП@ WN|/޾<^&,`, ]XVe9<ܱiM}2t *KkNa~bpFMF$Y5]Q ( P,Yqż3{CicE*;zm Y)'Y7ΰ (bu{豱VއbWN+(-Ď=uՉau+?xiK3328<Vprىə"6ںt¯)ȱrKK6v!73=ckLCC"&GΟ0}jQ칩"cT}ƧB쥥8%cAqS\1a!ٓ#Sv$Yv |bKScӋZ(J.Wl*,,hT}&YwFF>{a5+ z pUr'BWYq^lk$ /'YN[IT98uG* `y@%㔓C "ey$D'H*yLZ'>=ry~JkS '?9SEGI4tnە/>U,LkN^18|kzxg44Yt`}7G?p|lk6-&n}k6mQ?yap*ּeMS^RšK:vc<ؽ淚٣]pkh g7l^t&Ν:scҾ#Rq{'N"hȫǣrP#Qg,a{[)Y,-WTqj'KT! H Il5-iT],@6,l#Y*[E,ß3@3??vDPS!PUa8q['՛6:p.^ɭ5>_;r|!/[d< ڱX,/~lۺ;y?lr{1ֶygp؁ͱXdžg76'~~\9jO|+;Jhч[vvG[Gƃ{_Y  Ϗ8~2R _w?u<ޯrQ;kSSD3)*%rk{8[BO1YdAvQʹ卭m丨BPTV8IQTNmhFd^%).h/RKV7AWWcISX\iL4R[V~ڙgn,WD.񙣗Fl2[]mgOp][ｔ܎?3m;?W}3.ZӖ-%Ұ+"p۰k__s%f_tC5u€5 ܘ\b1o9&XK5pؚ=Pu<ݭ8p7 V [~]Ԃ7@6_qId2;@+ PPRrm0W8ۛ8.Rw%H ;eIdHM$PpE9ڋK"+Sg BUT,&cl󃃷F SAD`kƎֶV\ZR4< ‰T*l8n)57<\_jn]em0߲}kK}*0tݟnZӹ5@vPUu c'Z߱gs[?oL+Z)ܺfMwGScGgk*/ZB@d$(AHhQ*@ W]>j#Y$4_Taf[]f /3-"qt+w{ޥVjYC wq/"rxzd`[u#ufFܜ+cDZm`DZ,aS0-(8ES1c(!Be[e6S4-1p`b*@E骪 @U @!n F@B0!6H~?Ïz# ƶ0 P!Fv@2lK->-+jOM\m Ss KQMRd|Ɋ{r\H$uu- 7/A-?6Q"^""L\ih-m/5J$ :ZjRš͢κBh;ٖi1@mYe9H- zG%GTԏ\/6*fLac ib1rbNe\~)WPZzY]__9ł8XB!_4;eّnY>,VˊbDU\8_"ݪn!ޓ%ep}#)P\l{*> e4GJ.XXI@v()U aKHao XN@Emw;_}Zaqw~[w{uz gF& {ܺ9Jįk@P@Q5_8OX/

Bx" (hF(HOSU IE44{VxfCO}M8 ԰PQh"5b +ԥYE4]B8975b  bA r0# R@)` (YrHт)qK3B1@ZD@ cB*,.,YX ǢACCq P A ĶZ_iiiUU78g/eɗܰP/FˊWrm}ܨ+t E/A6TU zQ3b){т})G-wLT)/ENR$sM1xu$w=@o` Kqlc TUSRQw?|BBa() @SilEU ) v_*B8waUUSrCESjo#q0*۶PTUQ r0*F۶ooll ]N 58%]>A^f}%Xk*l"H- <_ʺ2* R#;dcx+%ybMT%lٲennNU{n|@8+Rcӟ!@ -rjaAS&R\Nr+;r9U36$yުG ECl pRpא9u"VGԮ uM5Ie}g/]y{ h ޱPE%aRE:\I"shSPDH@LDqܻ,xZmOXhRJ6 sRJ_L^Sw=$])Iw"ou3{\"g=@VNJty;Gg(P\*SwYAjW>eJ.R*R"wI"b $)E0AYif \[uI-H|ew!r IA6["}4|ҢĢ[,XV8 eXv3䆃,BT`P*6.k.oxCCE"Aqr wMPzA9F9eE'/񖄼\=] {'O8#QR[U>J?Qր(}"&'ceX'ܗ$RЖ-r\X$qyuE='.[E,Gq.UQ"zj>d*ntlU,cP# U+uT%`cePTt">pEz ^xY}>m#*_ Y[X!iRJH=TU˞%-/w%/ԓ. dKnN-4R $`﮸()DlQ'{"O&s2? EP0q񖍏++dC-@=Yf+r}R$UX6TJ|:{`*Y!Fwo28]["dEa;ʢ{K>,gR%fNIfKtt/G[3: T܌DڭxO3g8I.&Ux>.Jjc'D ,0GܗԈdֹ:E+W/(%g>,N`7"7?)H2n"I863^A2群&GKO.@.JY,DJaRN|) nyyb\?D:5rKaT:$ȉ#v,..+T& $!6;㢩_z>=%B\\%j;_ȵ(' k&\EnWȜH-%.r [](fQkzB!٨e)D,sY%6VoqngIjHMS xjʤTif pH-Q;έm-!a= QZ/*TrA\!%KS^wz+P V` ūDTV?/o UJ[xOp+ Ai$z̹leD͂,/ dՃO5I]P؋ \)@NP)UV\&~=٩4y_tĻ_8/X"NK12  K  "%62,'g]R\C7"'nCB`El"?EѮ$zqO-1$Rjaʖ==3LC'@Ɩ1txRDq,$(pyb`grJBǎ@!Cz˽_+Z8:&ʤ(e=n' O1P/ "o+@]jHP[DK8ϕbV>}~}[ل뚧4ȢR"w`ypfQ#VZEa/ezB!RE$nƂ.t][i(r.e@"(hrͬB6W1|$TIJVvAfZ~uϏ@' 5Hma[@5L.f^R(* B J,-ww=?BB"dVHfHZR!eC:eH%,"&(,\ͬB81ֱurI6j%c兡,ғ /Qf-Q @Qe/D@[ RdTy]n*kd~P)*~rr+KS+Wܾ}G]aE۶WV UU @oۗIBq\. cQ)C|>UU ! Bt|oӕ,STVnOB!(E|T%M~8|a!4;;[(JZ ! y˲Bhv,koo羥%9J")~B|>_www}}=xPQR XCnE1~qTU]\\ܾ}{(*=,*=rt!fuadы:/v\k- ciZmmm:^!7_TGAm ζD"o۝*U鑒;oңQpﱲ,Nw 'Fap";PQeŝ|I=IF4&,N.]29C(w`!!g/"p&|8e!ʶO((PY+}ԋ䱏=)Q04#ǂ>MԒDbhP' @c7@m[[sD_V]é0S#{i)M㪶q+/7G餪 o\8}m)ug*9VP UI-8540Sӝ AP,FB>uT/@K:.ʪC* G #'O:@\W؃ e9`sa/~[owwfm/>#F^&cM];oȅyhKln_bnqzz&o! 8\\tDhˇ/M[:ӣ'&Kw&o7~_r??06_) @U,LA;}k7XXjb\zP}[cXl (B|a|n૯*Y |7pf`hv]2Ţ頻wbP4۹SG>=t~bޗ;R߾ޚc@wwbh:~ؖi1 szCUƉ?˷5b9 W/(FPS㠻jUr"@`d EBd1m˲K"9eЉ&|I :Vre͒\rMX$Dfnέ[sj-6&f@,GK ;㋁X]}"2}>p`&[kԤEkj~՚)T*ff {BJqj7utԧAO\?soUcsUdM5;3>>SƓOwМe[j> kn" eRA/ G5 }g9%ٔgM,_3lm"Vܵ;hmCs Lfa3X@؜-(2=:<2hmw6%_ѐ:nrG~֫B.WBU}JD챸 #@9Dg/ e>'c.4mXјpSO鯋с3g7DPB-xsdjWw4ԏLF _ *>b9[կz_2 ]?~r*ܵ;$">1Z8~;?1{ߞ/xBs?ؘ͍-u5a'񡫋_4f0]<ǃpծW﬷Ǝssjb_ED΍gkO^̂hwo)L|yWʦ* ](=yΝh *G>9P/ͫ;;8@P8ҴWMMO;}ħ}tl8v񱩩[>KG#ƅKɥ/޴uϾ6O@q~rtbgcG&ï?5o\(BݚsWuY;qZbc.N,ڂb#[^GHoTd\<}޷,8{Ｏ~מߺo?87?`)un_OF#sxm~۞}́A6)h~rjz%: ;wN1wv?݇5AվEdԯ6#/R2fܙ.P+N )hzWԦWAe:5uçR~Q1|sś+j,ݧC={_1~5XțJS7._/8ZsU{*pᱹ::!v쉛WO-LKGg{F#,jX6r,ϕ\ORp)zMl? XF,H;ZZ2rk\ c<3zgN}}sc߼qu76Ϝ8Օ3.ς_1{ggsgNūwW-Րx yAM Ȝ=46 zyuf0VC`3J4lOk2 cfn 8g熮;VWFvd g ߜ0[qC7'5uH#u{|gVEzarV\ڝTnOZܖysH׬sg/lۺ>pxÍokwP'ƯL_5걏773'OOFYzlJ[zk]o鬋FHk^4f[ nXZ&{~95?ܴ9xnR -)#w~r Ʋ L;_5:9kKÓKٴ&ۘ 0. _9w[oK mJ1/?tB}-۲5TمKKjI*"da6㓹XR*j,>5)WYZΰ)ܖfFnAy+' BEu骢(X3 a蚦H}k`0ҵg@Uu0tMUcp3Q9mPڭ=T+/.nkFx,Mt潎;0-i^2eUSqf,%0vr#Z&'Μ8ue,Ő]zt ShDgFǑ?iU0xl :]]u#9eGc].74iKб'Ff Jvݻgcx*UW?;9˾ZYLw߸7c +_>k2YʏS]lvC[M(jWMLz>Pag_޾6FYtc [g5>4':C028wjjLp$+m?[xl[kzaq66w 4>skt1ݘͤ57ug⋴"6ړ!4Pe;5=E47!cESM-f8R/ Uqn%j ]Ke9  HJ\9g.uR7A^pLǮWluW,G|/l>]==Whu`mGg jZLw տt8 <)7< U ݸ6X"Lڏ ~=̢V[G/ؒMGRn;Nן>?}yimDW!PUbN_pȱ4YXq)}(zYZ~}HFКT 7ϟ>y{{:Zh}95:̈́@\Z*XrӃg_ߨAPazxpd"߲=ky \F Bnqi)뾀y)uR1&䙁 ׇTׇF[ʼn[E%֘f3yЛX3o,kW%j[3UMOYzwCX 75uߚtshM_s]k>TTUSջө7dW9}:PL[O+8'`rųkQ*:Pc:E +gaE%Y|t+ŽKqºϧlc4jd҉xf2l6[L]]2 ™lS..JgP%˦m[yS˶vfkxMGGh[V:z2ĕ>8xcb1ھ홸zZ5ul^޸wF@}-=y7t3/v7wn_; CyPakǺrTD<|Skqя?nΦt_G> ;ll)ZZ3Aň4ݱy͟NxWhÞW_>R_-BBXBhz]=K|[mͺb$7?wL3[:o6@Sφ˛5ХӇjl0kX1/(Ǝ:0&W cwn$9 gMC%;іҐmsdP5Gs(hj:,M3PtCP5M~tjLfgwP~Ꙇ(QM%B]|) U!3,HLQ(@r|=I!#ضfK9% ;TMD'mԷ/~tĮ&Rт-ݫ[AC`4Y j:{Sab}~koܯxGwoGs]]m.SW4T!J44djP, D8N%Dwݻm xwu_Sm0d&4uvեxM};w̴̺jN Bh3L:#5ͫz;2ˇ}۷7t`՗jZU+(xKgoWs,Lgj!]?mH'D&K{?m[6uFLuvԇD2YJ:;k`4ٻ1)聆֞Umѐ/Zߟ ,/Zf{wm|̶wu5|Z}uߪL<'2W5tE˳kDKˡ:!W3)(]z#eU<R\#8@> O@Qd]%9 R$?`Ɂ?AEƦL"Tt_.ؐ dI#t:Kk-( A&{vwmڮ龜ٙ퇳;ٝiMI @h @$EAD! {F&C1{'< h C`A-YyBApò-3Q|Yńy̴,l6q#–Wp\fߨ L.zn.=;DBF񗅅l&[0p$ls&7纎gXVOق‘h2LeH6 &7y_EF!Me3ܭӽ ?O#i,@l(\qmqΙ\6< GerƘfr0/nsWpo܅psleH$d2񊏘x0My ôM. L:uc!kALp˶8c[p&>1*459#c#ȟ\.w}fuTUHk4y7 B_A,u-gx*|1Ҋ;c̽+݌lYevTlH1jeɀeH_5TUR4UaP8VkkkW E]׸FqSAUyFU(I 2M*@ Ht["j|r%L3YA> @% >lr3$MP4O5Vf4[Jx sURHCXJ\%A$wJb,ŀiCGUUdؚ $Z27Z9H49(WȆT A`$+9\ӲKu6`~|Je|Gojz֨S4FV$F=ROd"]SN\vq+rA}eQE (\J[N*["$ďR6nҠV.A@H˥ 4`"N_I<:=OOrA3# r ^(˞X)w؁!War/W]]!fbLJ1VhXdysN+U)OZO'ʶʺw2&OT4Le85y`v`}1U:El18A<^h qQLݨ"V>9AB*Aȸ R+0k<)@`T! f:Lkƫd IFf>vXvvR(J{'%dTl]8VBfD/48* xhIepUv58+U UJVACnѐ%b44m[?1 Q)LH$ACoe$k!GYr,$ NPAtb2eզ$U*sOА;'4dVrYiŗʒa"'@#!=0,>[o5)[p$yRcʴɘa(|x\e&H[5 0Y, bUzsP*ώ UF7PqɖH&~ϳ B" A )u \IU!  [_VE0A_I?p$iJc$ B?˦5 LQ(Bp4.s=Ưrs@Qu>dlsh3R^|I^LP @(\A9k` 컯ޖA*e>YA_6 V9_SAC0RyL3eI XX!iX5RVg5nW:D5`R?~wҢd%*ae ;NP틌YFв SyFKye`*f8O~| D`bR{'mIeT?U˱u IA}}y$cʡ cc~^4*/# b$$S3!#Z BPd!GKت*_IA֐ DQPRGU@ƟĶȵodz2ݒI+#n1 xAQ`pKJ@b O6%TT`r|LQ]kW^?yIJ$Ĥ2y ٥΄;tjw13Zg" iʷ1T,5-PPnI}LPH4nhꩪUt YĖ! ewEƌ}2r?9(UU2G%"i1rW6;rh<+}"@P**D嵸韂Pɪ2TUVꫀ;%([$+W(AKqC"&×V7% GUw/aZbh~1P@d<0 Lh|S\ɪ-o(ZJ L WAؖj1AUI]\x@&AMQ\-Ld Z6 [\m RlO! R#)Jwؑ5F*M UeK{c}{U~^ Let(\jZ H =rS%RBp5|?Uu 5iLQE3|VU p  `ŵ? TFh4YH},y9xJ!H渜doU5T?0AME҈z@ҹBܮ8XNɅ\j50*Z_%ҩ.lD_Hv y-^A/b A&9 0`Q.ebq_5`x$XVfizU* g"K蛟^WV*ϖ^s.:\6w\bsX/!sT"X4y|e纎1#d :]q=n ـ 757_h< E * TyUM$`4m؇c:`YHo\' .3H,D| T*P, 'HR/u)>? y.c/=~Sfwn뮍xNfzblPu7 }˜ǥb(rƄsN޸mH Sp"Z!וp]0_xsS߼p^37ރL1 LFLMP͆^vc/?ݿ\n&DCnvݻP-p3t冓HyֶD2^&=sݙ,oimH ٬cF1dSHfO$A6I ,K-\Z[dh<=KMO7ď֮[۾Sc;VCk{sCMӣ~oݭ5-/|=eԶT8\vfrqa'it&[ps3DcKKC"bqfSsOxMWwgU$xHɅ%ڷz=i<'pI/R\˥޹=vZZꣶ٬ SGKOOXF6=?919 Ƅ23woN;u-udB2sܞNU --;^χBGޜ'c!#=p鴗klm-3^~~|l±mɰ9n!=;5zAE&ՉX2[HͥNϭ`A_B~cM s!CT%h1)u85%tAP` 'Z7lq|z R邑|aw`Ν9_;oc>9~s:ص'/6N޺tKMJIcƗt"^{z'ܛNs;:~@K$hmlaxǼc{l^ɺ<\Žwlf=Q6ԗy^&q;uɛh4T/uvЩs|N/=;;9{+[df'Lλool?wF378ܚ}m;oiώ]5_}G_C Ax 4Q%U!H|j`]3?0ԟL z7,/޽Q~g熪9}i6;Fַ~I0,tMM\l}jʉ16ܲq'o?W׳kś^zmm#G^<Nzi l.q -L:  ٶerܿzpǧHuoʈ'{rͦM?ɞ̭W5b\D,8s^*V7ݳ{sShȇ}sm\Bd򓷷V|slOz_ɮ^:nڋu{{ѵ{^MH_aQ!*"5q ! ЩAX{EE2691%t&yx1oKpޑ-UVk_;)r?~tжkǶdm"p{O6ܳ>N!uS.ՙ驁Bo>?t/N\=Cmn}Fք 63oZjb]s=毞=/B/v~Ѿާ\I5kSM*1]gǾmmohjmjLm==]uIQͺVЦcugw.ݯ֏l߽u(;}O>H4۾:{BGU5 ̃py 5/8ZϰM8=Fc(M(,q"_'+ 3 2o8u<}:yVupӺqCesvU˦{YtmW7646x޶jāW_|p~Mֱs|Ǫj~֑臿2{z#胪[݂7PowsDh>t_{?>uҶ֚x~n#}tbז|q|٩_U>`Jl1! ˴Dv⩃Gڞ>ydʴ#ė>䳫]7oH>|^q̇۶JD!Cd;sƑmM >?;ٿ+Y?s|s|oO=Η_}}^Lrbo\kkp&q h*{-1do}{mlC̭/Of+L*6 dWjd;j#[UיXo??~ꝉY?b;?V{wG/^әp'ͧI?;E׭[[M\m KfP6~ <M+HCRP\YT!#9g3&ljv|l=ozmgSuڞu}QCཇ#ߢPUsT/p$gBPxZyW5lڸ9Ϟ~P(84sӳc_8y}l63>&s\s6P(LiCuoHئW84tC"桵 p&2)SH߻ɯe7f\1!aZD8^o33`٩ɩt6z̉:ۛcy#=4XD摡ћ[C!u]Yշ]n>2d>O/=5{3Z;6͛{Oox6-۶,[eYV(m3/t2+' n#c\xŒUw wfmsK}U({'e$۫#eMlq+.$G̲=ut@h?TVS-J[sH q"554OJ\湅\6{ Cm;B& Ƅ[;nh*\|06ya5إK7fur#<;moڥޝy믯v ecGS(Gxlqt:T׷V?p#_c]7Bo߿+6nl}$dMâ+rl3/o M_>t{W_KGG6KFx!+xGlώ^ܥق㺅\&cήVo򾏎~y'~q;7sL:ͻcs \s9yN>/xB0R7/]<o/|s},:yȚSWQٜ Ƅ2t[S~/O8vۻ#/!į~{аf@2;=%Ґ<x[¸53@5Lqt +J1`V$پv+gN|,"<ۻ7 }ݰD2)"_(JT%!Jvnضs?~{č|!֞G>gqkú5P$LlZ{z_~{{ v<o{mXc̰"D2jZ:_ޱ!ijNO{{wPOo>9оD/8+m PsUzH84x @42ðbD2&7,{`㦑s7GoL=Ã[9x-=WlH4uI{*JCٶ}˅>?>Ss;ڦq݊ƒxq#&p(KM_FÑDUҎ؆aɚ긗xoFgCf~I 9zpo;|:8km}u׿:l}0:64Òi۟CdUf__%& y_ʛ?d4^ѿv`omU,niYa[olmJZojL 04h{y|o`gSS[W_O+/ j^VWTmk_xvm޺D ˎ7w8^8cf8_nm{s}c{_OGŜEITl*k^{ϻ8\$jZ w5'ummuDu}K뺚j[uqǮWmIZa Z{zmˬnٸuۋTG-/b&'[ i5@ M2A8" Rȫ[xLۆc\nnnq c yh2< ';7v L0|f4Z\pΘ0=Oq2s)[h,[ oaW C+>.d9aZX"b1ͥ]n'B y3msfg̊)뺂c C0&<1n,;?uy4[16;z}w/ۇ[p,,K/UmN-D0Fe} Z`>߿Ի[[[  T*\͡crd{\*kcX2纮 /NHp;g̛zmp8H&Mħj< c0y=o-rVQfp/Y";8nSSe8+#-ebxy²Coz*neB (aZ!>v:lL8 ӲL:1nicE [N^j;7n|ͷ8 C2ʉ < 8O,,k*mU€|&m 52m'|.kYQc??[e10Ι%S$ (50e_őh8wj3x8fEײǾ:! NO,ڿg s &i>hñ%1>[ 0| PΩ3CD/.A<Fcш Â1V*)eL!%Ec> A(XŏC`RУ8|lNHh[J\_PZ)!DQy=vZ?K]Rd,:l+{ &x43 Aq0hj+I`c{ݒ"I7To0)8X,>U%`XLN#Ҝ&%@0+hP42`B-K70-Wp X,L& 5$uZ}UkS-ĆO+ 0^˫\BF X;H h2sT8>,&8xN8^k%Q|a3"]$ }":3jV#| +?9FQxA#ًY:Pfy 1}!R[W - :Y)8`fUn~g@ʳғ(=-XM5K0A )|K*2fCe+WA]#$5ۻȣaw"_F[pƀUX '_ub_AvI1L_6c{ j\(I9`ib3,ȊĊ CFՊ XSSo` <:./pŅIz8z;r_ $Uit]BT> YW1rE-frG+y\6*+ 8E  S2 `F^\xV$3W/E_H>4˨@ƒ֢* V#)W1A$l|YqGd &]"uU @,RBp4T x c S%tb?G>& '%y;6η!AbI`[U#0d!I?I.VBp4HQeY@җWp~?rk?;A+ ~ aer$ #+;b(g2p HJ (A*'1+є`8 *WF<9s0ѩe킴I`_p`V㼊&#W)"yF׎ʈ$)\"ZRDQO 7:`~-?A ˓LAj55DV|!d=Bp|(V'53jpqȫTz9,C%Ob[2/ +/r> +!΢AȱZ fbR,]Q]_L 6Fb2x0r=5$Hx hᴑ%jcd܃PcBj2\q]&k(o2ĮƢ*PʢҘ^,AVJ-HUmqpJ7]LN LU4RFKUMVI?-tAWUtJ9sdФ!k5y`Y OAʼjV=]B!^ 6Ku#7mt .zr,kF9Aqph5[:, ArsBGdҫ>j rR#CVFRwShe@IZ#,; pQKHxeygH=2fٱ0)0อ|d"edr  \ RN`RKUQVwEݪYet01i<2". G87@$$6^)/˓~Ȭ\|A@NԆR 5,xM#nlU4[ ͸3NBzɓ-ʚduM֯ߝ !MސjB6Q_?^嵫 ٌ9Lf%A:$V>O@U dwB =Ny#eȭ44Kz`/|6b J*㑣 G,@rx4= xUTE#@a2A[[ !!R!|4`(ˀO4HzF O#Uh t#5WdH=!A_H.L:k쐲{@ bBp9 t,H/AarZsdΒIW!:(k0y@UXi8&ꓜ,dzeu&q2ɶ@ךH$I HV(AUܒ3r& /MjGrhrBpu4Yrz&UNo<@)_lMj6Lc 1*xlj}%A\1F@.*Uh.j/aUO\BПYAΞdT)gUj+|Wr'u{Hba`Ko*n# ͞6O 41B|R+; a] %.Y!(IOBP5d}z ҙS!VA#paտaGuY4gU$7П}rO"@P <$/4ȑ'HF?:pـ*TUd6+cQSLAr `Y^!VAQ)$+M +f eS}P=%- F2%XR@w]괄q?k"AIҟYAliW8?Ukmi?C!"`Ҁ$&o*ު9PeWVrA}a(`U!%zDjS "V!|4*8 !>ek>T,*(*lv=.iN?_A pTb!G%cvl5EP>i ϵ|} doeŤBp541_3""R-  vJF]y v9ANP:A<AMWjiJ`VA<9M;S_NA=nѲQjl3[w1I$NR UcUj0֌P+@'i*@ɄһoD#hI8%RY B"WaC n *H~|B:VnMBi9A$ UQWY!V! @T^ȏ4s$qЬ⃱tMh Av}L\`kbB) 2; *p`wlAGWK6U@ŶD<2* 9(Bpu4 VBl$+u(9_-(ǽ x CHL}aFY@T9<'{?$Aյ ؈-A je&TC_7qAZ+W+Ag?d*2Ei/F:b$$$`%`c>_ deHj"H'5d 5ЃBb&i cT bBb3H VQ`lW+WAҐWO됀nM$2U#lbh6r2\ra0P&Ȭԡ &m1ɫoo/&[UѐM$T}:7huq1bZ,(N-`U~ %03KjqNHr$Mu्d9 BN> J| J!L 9 fK1/m6X9d#ΡՒT,0D j5U]S/d)XLHȌN&Bp55'  )OH .d5@!K.T/Q][&,2S< $ovI80`HlWV"3Qʪ п I&- Ѐ. F!Ǽ$76.{䭼G%נĦ堏|JZNԇţX@^"VP!2UJ! 0V4A5ͭCS9Y:5BpE5*@eyY*C@zd2a 9BC%q2teMubY 5VT,A>a\*8ltR vU @Óu HK S$, D(dXΉ~Դq^v}'`KC"r0q3*R$Aծ%I jY%;w96l bUF<™W2Jं4STP쨥jq\F 0uX *H^.|wB'AO-I  Gj)ֆO }$cM5ϑʖՉKj& sU=!AeWLe(T<$bBA,QEW  Pٖ< /$sBD;Q}E _H$SG`%Ad|̀j,\ed%!ԄHEhL{ 5cT-,[ׇMƉ&B6xUh^C$UU'G0Fn4Ȣm0 Liw$R DO@0}zzUB>%5kJUi.TCC"ݱ~*2&9W*_I> 2`TH@s-' KS zʚ}fF?4cτy〦 3O^R5I543|`px~5*WaFrUSXde)+ X.Yqf{acB 0Z@@?TЪ j ɤ ܲP(sNpi;`"\uCIRxOI 2zsA4Fd'Ux_@ j &cSY ʞ4<[US&y^?!¸p]Y[1ak֬ B> 06dJ_ B0˃%,O3eDĊ< FhBBpה7iQ-[|(YԆbA Io`sQ˲ $΀c=x+\*W42^4(NւT:dp%z/vQd/iX&Lя X+ 'Xl,D)BpH؞|B!GyL!']4V\,/`[ cWjZ)`!KU˱B3e+*%xL.-.#F*䌯 YBpiflNE0`q+sku7pe\˼ ̀蝹/z*AfTzT˪ bbiceEii,_B- K@=`Jfݯ Ea[`w4# /,΃v p3'lìoFNX,I*XdWU\Z@!8A@g-6S{0H>86(!T.HhU܃$F"u!XJ A L8?iM6y@[TL=hIP}G4En YdA)<#["k[6'hYr\nUh5KH1`.σ󑬡IYm]7Pq VORyٜ/ 2,cФ*"y> r) Is521`OUCnz&*VЌrx%VB6f͹dQT 8Y*Ac/*  RT4jF5Р!)`a`GϜ: endstream endobj 556 0 obj << /Type /Annot /Subtype /Link /A 557 0 R /Border [0 0 0] /H /I /Rect [ 386.6100 748.7769 396.2473 757.5952 ] >> endobj 557 0 obj << /Type /Action >> endobj 558 0 obj << /Type /Annot /Subtype /Link /A 559 0 R /Border [0 0 0] /H /I /Rect [ 67.9800 713.0627 77.6173 721.8810 ] >> endobj 559 0 obj << /Type /Action >> endobj 560 0 obj << /Type /Annot /Subtype /Link /A 561 0 R /Border [0 0 0] /H /I /Rect [ 80.0267 713.0627 89.6640 721.8810 ] >> endobj 561 0 obj << /Type /Action >> endobj 562 0 obj << /Type /Annot /Subtype /Link /A 563 0 R /Border [0 0 0] /H /I /Rect [ 214.8443 713.0627 224.4816 721.8810 ] >> endobj 563 0 obj << /Type /Action >> endobj 564 0 obj << /Type /Annot /Subtype /Link /A 565 0 R /Border [0 0 0] /H /I /Rect [ 182.8448 653.5389 192.4821 662.3573 ] >> endobj 565 0 obj << /Type /Action >> endobj 566 0 obj << /Type /Annot /Subtype /Link /A 567 0 R /Border [0 0 0] /H /I /Rect [ 447.3037 555.2057 456.9411 564.0240 ] >> endobj 567 0 obj << /Type /Action >> endobj 568 0 obj << /Type /Annot /Subtype /Link /A 569 0 R /Border [0 0 0] /H /I /Rect [ 201.8377 440.5629 211.4751 449.3813 ] >> endobj 569 0 obj << /Type /Action >> endobj 570 0 obj << /Type /Annot /Subtype /Link /A 571 0 R /Border [0 0 0] /H /I /Rect [ 233.8080 302.1107 243.4453 310.9290 ] >> endobj 571 0 obj << /Type /Action >> endobj 572 0 obj << /Type /Annot /Subtype /Link /A 573 0 R /Border [0 0 0] /H /I /Rect [ 489.5700 282.7059 494.3887 291.5243 ] >> endobj 573 0 obj << /Type /Action >> endobj 574 0 obj << /Type /Annot /Subtype /Link /A 575 0 R /Border [0 0 0] /H /I /Rect [ 496.7980 282.7059 501.6167 291.5243 ] >> endobj 575 0 obj << /Type /Action >> endobj 576 0 obj << /Type /Annot /Subtype /Link /A 577 0 R /Border [0 0 0] /H /I /Rect [ 504.0260 282.7059 508.8447 291.5243 ] >> endobj 577 0 obj << /Type /Action >> endobj 578 0 obj << /Type /Annot /Subtype /Link /A 579 0 R /Border [0 0 0] /H /I /Rect [ 511.2540 282.7059 520.8913 291.5243 ] >> endobj 579 0 obj << /Type /Action >> endobj 580 0 obj << /Type /Annot /Subtype /Link /A 581 0 R /Border [0 0 0] /H /I /Rect [ 523.3007 282.7059 532.9380 291.5243 ] >> endobj 581 0 obj << /Type /Action >> endobj 582 0 obj << /Type /Annot /Subtype /Link /A 583 0 R /Border [0 0 0] /H /I /Rect [ 426.1852 270.8012 435.8226 279.6195 ] >> endobj 583 0 obj << /Type /Action >> endobj 584 0 obj << /Type /Annot /Subtype /Link /A 585 0 R /Border [0 0 0] /H /I /Rect [ 72.3090 246.9917 77.1277 255.8100 ] >> endobj 585 0 obj << /Type /Action >> endobj 586 0 obj << /Type /Annot /Subtype /Link /A 587 0 R /Border [0 0 0] /H /I /Rect [ 79.5370 246.9917 89.1743 255.8100 ] >> endobj 587 0 obj << /Type /Action >> endobj 588 0 obj << /Type /Annot /Subtype /Link /A 589 0 R /Border [0 0 0] /H /I /Rect [ 377.4158 211.2774 387.0531 220.0958 ] >> endobj 589 0 obj << /Type /Action >> endobj 590 0 obj << /Type /Annot /Subtype /Link /A 591 0 R /Border [0 0 0] /H /I /Rect [ 52.7993 187.4679 62.4366 196.2863 ] >> endobj 591 0 obj << /Type /Action >> endobj 592 0 obj << /Type /Annot /Subtype /Link /A 593 0 R /Border [0 0 0] /H /I /Rect [ 293.4195 175.5632 303.0568 184.3815 ] >> endobj 593 0 obj << /Type /Action >> endobj 594 0 obj << /Type /Annot /Subtype /Link /A 595 0 R /Border [0 0 0] /H /I /Rect [ 305.4662 175.5632 315.1035 184.3815 ] >> endobj 595 0 obj << /Type /Action >> endobj 596 0 obj << /Type /Annot /Subtype /Link /A 597 0 R /Border [0 0 0] /H /I /Rect [ 317.5128 175.5632 327.1502 184.3815 ] >> endobj 597 0 obj << /Type /Action >> endobj 598 0 obj << /Type /Annot /Subtype /Link /A 599 0 R /Border [0 0 0] /H /I /Rect [ 534.6887 175.5632 544.3260 184.3815 ] >> endobj 599 0 obj << /Type /Action >> endobj 600 0 obj << /Type /Annot /Subtype /Link /A 601 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 -139.7347 485.2500 86.7653 ] >> endobj 601 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/files/2015/01/vaccine-hesitancy-e1424801031537.png) >> endobj 602 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 302 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 1 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceGray /BitsPerComponent 8 /Length 783>> stream xA 0 =" ʝ<2;EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$q endstream endobj 603 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 302 /SMask 602 0 R /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 64449>> stream xWw\G.礷HHx ADJJ*Sꚞ55O0gf֝{gMt[<=AO&Ho90rȓ P18;D$ QRU!I!D4 hMg},ehE] xN};_L{gcڪ!bN릠dk`Obl _%24?iNBt拹TE^csa^d2\Tabb@xuk== r򞡡LOax!Zx^BKt~л5sS^ŰWtפO 1Bތ7cFʷ[|LCC%TFuHBs4T3qӉkD?c%u+nF+/$p~G9 0y2?VdhbTL@ sdRP;k p y0:uYrz^B SWwOKZ)I BWI&\02AhyDSq?4x 6`hn? >)KRvϸx`bI3W0- lL1&$E&c*\"?%Npe,tҼ!݈O%xʸޫjÔ'WQ4V0$(oReӕ kdV<- <KO]ȃ> 4QZw!X!a_$tE:iL1l8 /oyEwa%+ktBc> {LW<|31 YS'2>3B.}"T$qzFOm >P`%kFc#Eӧ2wo üp;y1E'D!A(n\'O`-̂:D b#\dz aI^lBy3+A<`-5FV1ΌUPۭN6$XYaN#'슰0Z'4ӟvXpL08eڏI>z9-k%4B޶aLJh4s1))Y3ARL8v!K&wSVsc/ m-a'#f9Zv3!D-ْMUKJoDSUEUM&RKD2[&Bb>H5E!lK!$M2y8$"1[ X\q~$IҳA`<3;* x8Jf1TU1Jfe֣ P$.LLv8)ޞaI`z-XKQdyH 2w_U#R 6  *ZkKok4˥ţ54Hf ֦_{ٟ;_u3[_}ktcז_, }?|%皢ˬC!<,dWӲ[oqΉn?\K=vִm{^=Ѷ彛Jß"^'?są;c6oc1дWȵS'N ohWv)}}`.ekWa4B™CZ%`,e3%8WA0Y, &=z)g,TgZ9-,[2 a[(:  +ıHX@syWK- `4`reus؂jkZ:$Hq!/[ۺڛ]691qg9y8517?~C'犹S  >x&>v{*gʙSONɃx9HOӚբ`H?̺i̐y_e##35IDJ3cw'M?xo_kI?|x$k6hJzfft6#olg_YܽvʣDϖ/n[sšwA{ndth\"|Mmvyt,fjh_HZ6*ȞU V5}tbmln=z;L@$)pґ%j$i4A\hu+ 5Vgp)*S]>kt R4}cl4jb?W<=,6a !1 -I[y+Ma&v2͈IltYnSBR%GcfwSgd"Z)0?;*ɹ/>>x7`'S[὇B,>?=VKZ*-O0GǦB^RDd<6=Ό8qf`ZߴlpCG<9Y{u!#znpKZj g>K)`lB&IR&F/_| #f׭Y {3;,pt`d Hf N X3jG F|?[aZ*d3\IxVIR!ei_gΧMl2[MZ>6;'%B4Ǣ lfREgy>I+NMG%5zE@&3Cd6ft1Z!=Oӡm^EX;ӤL`o |\~ʿ84 l(l.l e6Y3"H:2B-{ i@ v)~ >2J=W 1m`#siZCU,x*\^YagM\, Np˗Lrк=C >. P< 6@dL BS<,JJDB=RÔq4Hq4f1k*,&2@SN6LL :˄! Aw0bu #ȸ [̋ \4iaoE1\E#7e$Hō#_ A"tA=jP%( 2z IЈg}a quޕV›V5ao\dy<-My]Pݚ6gPX+21 :% k|2*!| ~XJy)Jπ0g 2Y[Q:[TxJ $ Κ KU 5A׺L >w᥄KĪ+9'IX'\≏!C1mϿN޼ : P9) n{3s;Vg,|T2*Gg| &3d9A1Q'ga8p^!T/KWmGe5-fk @%'5 )>#6U˨VX'`mE,hڙeN|K>!.@4[f6-FoxFaKknixYh z\'hPf)cy B>7ݘ.@?[дVA_qpi Oz!P\?`U)FiCwÃc Z`!LLyr1AM$4h˞ X2 2,/A-'x2 &H0#.bm 0O &MO@/ʏ<4o](%'Wk୑V "q{}icmZʤɜz]v+-T"U^j~NeTV=^uF6t&3jankwS6KOkK^eD4Z3A ULخ S-#(vHN&(ړl[셀3OaD {9/ix-0w1AŚ 2ac @ )qR~lQ;~lE؈ $RFP-d;rt"sNKT MUUA픦iVN:{Te<X^%ZL>uF$Is)lB JX,**T,)4U)J"-f$Kp/_AWkg,u+ S"t[]I6 L@|K'SF(6!̄wDz7/l`fӫ bC iCXxhl<:n93+9,KD4d|.kb&529^]&l2g2 ќmsN[Vnm 2TXb":\NԊt<!d6˒%j5D+%l/>:?1䵔bm :ɘz.HP-dSssq},%Eb:̩obs{Gci޿h; 6"=M&Z&s7j13?7UL`e`5unrhj>ilomU%7>hhmm,dqz<6#M~Az,2 fX/C4hܥA.L+<04 n^:y .Zyrw L&e@ Te&/TӪoBGU=qҵcєڼ{ߞ} 6iWg^;s}.W(jˎ\hDZ 3w'_\kQ?~u}~!椉{'>.kv®-ާ0kgO3: 6^u3vl4g'^>[jܼ/t75kL dW_N]ɾ|Kegd7xoܾx\t~!Ҟ5nqK>͞`ƚ69>e 6zI~ Wnwyqj)5uɫwc/!p[ր^BfO'z'FGWt< ApHf3bq:AL/b̓c&D/3X9I13@K(QÐAM- H;D$/@i"e!|1(CS eT\ƽ&b܍Ǟ^uO\Iڂ>2pDZw~ߝ{mjo/<|ʽƭ? jM%&-paRtlltldXMW%W7$˚Ij11yD}ʏ]ӋҾu}[vCNwnLƦb3Ԋ|tl2ըݺy,jnnIUՈiD$NfKDQ5x!/ (n8AI:皠!_VU xy,`^_1Iqu x1Zr&x؍5Kͽ{GNtbf苏>2/O޽>_XH;qd+O_(|2q$9tQvwKkևӏg{~}S 759jD$Ilţ'߼:)biّd^zVLOOMHtvwu]O3W/Y_xu99gggN2ί?ە+^I5}o7}_M:\ H[kkhw9>x:?ӛsw~o}ṕX<67Nɿ[oebqX f.]0Q \oÓLUs^֚7~ɦ֖vUNxc4 tw&LM-zzrq$5/;֭_[ᬽw~ ٱ77z-|筽-~k jE6_bY77x7ymRb>ٰ%(gg'dzΦUo +s#E;{\.>{O\߹e3/RGNx;C3'1Kg/yc0Zɮ''7mZb}* "Kox[Df웠Nk.K+ZnN#h~4<Ы^g&,#>0-'x zv{S;gU$"&h<.%|5%,mw4C أG{{Uo[S5GgFc-Fshqg]&cIG`k͑KP[%5jǺ͑Pfb31~Y%'H$`r=-ע*O@_ܹ(E"aJLOZYS29տaբh Gi3%](ldaf^i^vU,5Nf;ZfY%31p9)貸y^3ѡge=L-/(}{yH7~F P 8C]]ju~;V^Zu|!zYfpx,1&˗ԬNP,DO .@#Vk`6'Vx%z-LCI<@06| e}Z ԰PgӚ&ݴ09=29#얩lFv6lž~p{nK\)b>H$&Ǯ|u3+s)ߚ6>=1MUIk)>35:;.)ʞM-OwT( |&LMMCw-D{ϗ¦L6~N_ӊ$JX*SӓV_OAVm!75Xg xqaҙE݉[nXұI䵩əD)Y$(dY`e&g;l.e7)b lă=p+[n&K>oݾwǖuVL$|nF(ٵkhnt`[ϖ]{hƏAUI9 WA3BOG{e8x7ˊZs0?,y*vt-؍wP^4HPZbGѨjq6m&yf.:ϸZ=/^=^('ҫ{Uݡ/~_3aiH"з+lܜJd:n5f:aKhFݦb|f2(5l׿Rhr"ݡO|ypk[G[N !}9n XYVo?Y`|n>^hli4Hznjl`45{"k:N^>鿦L{Cuh)ɾ&`3M'H%$n()m9r1KnLPڍ.>L3ݭv]$,;l_b6_uRl67lp{Ww}.ls7ڹk3ˆs)q2' F3D˟) ~Mo CG’-4*Y|3˱4G@6&>d (>Vۤ`nwV{GT\XH97oh sfݼ'Ll21?7?/V5n-H(շnæwm].e5eǖΐnJ|A|Vul߾g˥)յz=-6,$ۖM% {۶oݺ/M$4rXӉxRw7_3ɤкi󆎠$kt*]0w߶nUf'B>_ZWZKֻ~ۺUk!L4kP[WWKcffocQ[Ųjwv6+M;PkWW{0!$",_-tX̄TR8;:ANd3LőWF&㥳3ҍְZ5]JgƈT+l(BQ563z- .Q|&S$e!\&ʘ&Kj.L]*9vYee&ojn{lL"z͑j~/?K@"h Bߤoh mq3¯V0Gm+~1hd!O p}1Ϙ7?z!=e}4cX`{kk ּR B8cF#_\ ^-/ªu;.!(+`[aU⬸kҫ@tSԟu[aGg%BkKԿtxuK"҄i8O:LŃTh_45>1U:&uV!*҈*7W;xmAb$bj$ieVm:Q`U#(z6?e-?yֻ_ 1BN\yhN"5pP$1ք"&HVk,4ȴ&(@.[1GfF IA@iv $:A?m<Zyמ@ 0@\hTnr'm%4x2yLP7$nb#s;"v HH 'D5AEQbXOO\1,H^P An:ڊ|AE桭\ae Z jOz8z,iD=XU")#5xI _Py&qzGTKx ?a:y.3x][Ŕ|KRXĹ\dg+ggb9t 0dܴQPc^1Upcj#Aę-P陃y&CPC C*?R%gAPeT<yڀ\+[#ڊ \Nf >V "3Ș]]y@t< e~E4pgkA1;Ax%*HF.EWmtIԥ TyH7-PٙUgp.'8;4`1\AĥM0 @XUAAϓV*˃~ _Z+d0RؘH*`ŅπQmy[|6 LtHɓH&xw|b`iX}$ J?㤭`Ч=\WAHO=h@U v`Kh1z9p Э&ѡ] EB9o}5t/Q *VTL'yqK% 'Hc ZDë\Ie1H!5]7E8M+fwXpcX s5ց DoSZB*oF5< g- N8vx7ȠVՓH gTKgZaQ'q4M|--hzN (V" 3`#5㵴gxf56p2^aŇ}v\ %? jN .h(5i2:e'(3k7]x IK_>xw2}F'^5 %Ou%whA 1HIV<5`DϚqx$sFVbSA[5:A#e'($\ai4މ0{EI<*nd`T<'VlT0-<.2Idx*V\3e*uqWAP4:0x V#)@/ h^u+`ٿ>C(10+5$<1?bE\2t0AnD,,C9ӐT~#1/`Zc) N p4& 2u~ Z缌U[0NN9;6/HyՓW|hd3Rr( OyYWE5HǓK(OF3@mtV5_'F%>xaff: -c$;į18A@@1I?Fz[,t#g*ܹ+Wx#>kdDh 4љ ejcAPEwړA[T0mg)@X~+~+P0`<*nD3&!# 1e jba":yBgxqNb<\3ɬ Lu+_e$8.X |2e& $- L\/0h+§0Xm01!زu׎Hf.BbgOWݽ3~ ݛL3gCmA7Bl{lj;B^ ]yzRU #w.]1Դfﮍ.YL!l A~2$A#@pavKFMzÛvjv$/4o~?:o;|β"Q ×O|tyj;?{ejGb6W4YmVI&Sv]T4~G.~/ol4[i)3NNL+HW"@~EX$0y6Fs4M&nЙЗ&Oxf:?;=9+hsK$$Tl|lb>5#f*d#il6=MwKCv55;w.M'2Oa-''&f @m3?O i~=kZɡyդQ XQ55,2)l5%pkKaFn+طum5:e5?><4K%hp$ R)0/M~Y)KG A9Lp[esS/=-aŤғcikr|IUXlk"x8[Z|Ί1 M D STۺj&hDV & є^T9t"hZ!0=,IjXLD556| Vǧf拒n۝.IVJ?[KFW);{cݑWDzi}w0?3>>5=ͭpK"Z>ΗTMǣ)ni zeB$Bمim9-MMŦǧ%](X.HZhv"=I^}[Sm (mN|4A TW4 FXy.&CBlin޾um3lL9vh&_;Ks.<~ôfo]obM\=w EsK7~͖sE6}}||[|om@zKc޸7^0KH!j#W[ Y6RUR΅NMo/lP;vlV*ƆGԆ3wܸxpOKUݲW7f<{D* luSw-3cEWdAy|q7>boО|4lom ߻zӉkӫ^Xc IˌmM{voqׯ&/goEl&8|@D1 >$>ubHpe'w ![wl2e%6rб;Y{?>2VؾCSXɷiǶg`.>s̑勹ӇO]L.9G.&m];7Y?}/uO$?`x\q̲,Lff{۟|^,ܷgܛϥ&.~JYZޙsYqy@/|/aH.~?~ttM}`7R#wh o+VOf؈!kXFw,Н N;zé"gc_d_|<I$d6kO>zcp:>7vޟno^hj2YMÑ96ʱK>^oc)7~G ;[wO} L|'owњrOܙM$_>'J;7G?˱ss9gss9>542U$di 8ia}:sG@$0wiN~0zgX]XI;$(h2}p)d$k C>l:ltuK{n[J/ O-X2DXygk%XXqGgLm EN >|MWeΞ=7q붵^)z>ڵ* QB2+ۭ"=7ϝ9ί~n[nY[_oz_l XŎ-I^~em.ݙ1Hl0~]J^,^o~#Ieu}-ă^kOSBjEW_[m}Sxp?U͎P:kݰm|bwg8`,07ڱt 8V*`;{OƁ^{+/|u{<;nv6ڋy[wݟ*7Mo =q8.m˶oaWsx\Ŧ`1D>TM,&&=7#<ɊjD0լv4m~XB9꣤cI%Yrdkvem.6uŻ#t2vohZ-{9~?쮗_{m-O?N}卷dl%s[Ѵc SGG=W?0MFpk<+pjR>+%M#OW]Mk7nj7j{~ߙ#S{Ck6l{:"kw2luN-ycխIqڼ̗Df5w޾cMWmdYoMoSHvt֮km + P,4b2-&YS$_7^~p]~p-YSWGk{oھpss=u擙RI5|=mKRU&pՐ]+V* 1t %uH[lr[frْ>˲l5˲䰻l_3?/:B}}=I)omæPsyX]n4^sifvzlt|5׺_l+]OշG#P'[n;+K!3zh qW`M# ")R( e=ywfvf>G|gvg [lK(Q)1'AnM^*mHvݓ~9u;`XFҭϿ$ɆLʧ) #W>/tz|]-+F!r,;y׺Ö?}ogK>ɧMň=צj D;sCHꎴkZշzmc0׷N%ZWłd+_ӐYoo4` DZ!FY4f(ϯi@ ( cql Y *Z6:|R4UlEQuB T1@EQ0º`옶OqLKQ,|_Q ) @3t"8!NEmT,JejYDڶ7l! +0@ FCaduU7/;ikvw{lR9E ȱL2ǶqIַ޸}oM5h*#1B6*j$Uӿ-^]'hm䇎ئiٖBNXl`!vց،HD\K=`-K xxɭ0W+Bޥ.?Ydf09~!˲gv垒ũ;N3S4-̥ق_#_z&6 \}󳋗5a͢Qs}_կN&{vWHԥ@"ӿ.,-ջ@Klݱ_|洱֜ug.Ե/?txu-\=tl>lMB>o1ر-ӴƎcG747&]O65>5HojnNV/ֽIAi`0b`#4M Bm;[lZ?c_˗oln.ضB,Cc&p27I3 ݊ꍗJI=^DDo0D]k{K*(l,L a XicUt\9pyf约@CCKm*ξE~vlT0;Y,`G%ښwfPM]q&eb3_~׊R?X=P_BqޢrG%ej 8K6V9X^ )=\$G9Z8Ǒz9k7*iڻo>>a1wRO(ڵO2f2Ͻ_z/N·}uz(Ǒ@@8}`4~fyqxycl,M;}%%""x!6tBƓɠOWD ECd2 ZKG>xxh.ԻvuwCTc1#Z Kĭπ@,"R&R[AOQȣKCjH4ٗ*=!NjT}p2 jh< cD$Ȳjho`"Y tGcjmkqoF{k /^ol2ъڹeϳkx" FQn{~sfmҳp7jKbd4ÚHP6`VFb?#[H&9QU#Ȝ8S7{&BPU/Xm['F0R[_B$׮߼mKgS&Ʀfs{^yaLNMM_ܳ?u_5h,VYyמk]|L2’Lc[OWGX2lgOOKk?ϴLEablRWMwD~|]֬. Up:300绺cc P(!׶ZՐIlgwwK֧2ɘ0[:{b~4Yզ8rZ}mmKC0PT}p *!q*k (򅢥m#i*\(`(dY6@QJVt P !!}UtMSB>_0 r,޹B誻l]dKSzZZ\rE ۶  FP'!@GV]ES/?z-Kj#!NbӯZ"x ڶs͋.ٶ @V B!,-YE1P oqߴJ&N~ONoZՐe;%@1B*@XVTU5]ӰUX_("% }:@c(LA38/  D S(b~"˲K}>ߺu٬b%S] ,T2JmIaw&tqR'&P(4??mT!ĥݍȱPqRȱK?ޭi;0P4MV郒@jZtA. *}7clA(Š TTUg(*NJ82zd}CUS!w着 !rl99`8v7a*vJQTrj)u]4:S[uEm9jQb͋j?&rFFn:|P(~Bql`v*8VU B6fP*a :gB!T[KGgo sޥ͈** Ni*6 PQU"TK8¥լ*vwlǖ~-``8#Bh;/TE-5_Yl)'y5\l,2$e%D$"ڵt9N[F[ig,`=N'{ns@@r(*{ACKVqߟd ٬1f9.HW 42@UU~ ڶxiA`.͍޹3Z M5ɉ0.%/ c"IK6zK/#+A֓$asxS{py$bP~T%Og2=iZQwlq ?G x|^xp-׶Ltyz?BPnh%`t:JQ%UFnRIR 1Mv놮A>uޛ_w`,k DT:"5̫[x+ 2^c;Mj ^/kFc.R2`[aYp])^1gK5w+U]?-+c,:y'Q2)ۭ<+ܴ4%dŹ $3p+^C8eWcDX$ܴ -%nHxBp9uRˣWIrIPU+.2]vk{Prhcz*@vq&3uXZMurQBHP^$$|) *2!yoXRl Z"Tob\m$@Z⪕Xg%I{Qb(z' b,qNrhk&xH9`Q4'gxFAHQQ$Dq;dc,;yܐTȗA1^L R!lrP y򖨐sW M$˕ `ngvK Iur"7q{ąV4TXwIoEXfsܐȊrh08 6 6$7˳Q9DFtG. ?wH$*r+lD̩sݮ wKrBlSkR$zDX@ց 512MӲݔeVݨ(IzƑ/6dG IHGB!QwEE3K6.@'y +"2A!ubg^(~(TXE|@?P|2`ݐdMp=/wvpղ+ZUe|P4my!1o^9|gΎL/ K#U\Z\Lur3˞JD,O9) Kj,D/6{fdBPTBac *{M!ʐ$$ }I gEX f &+Hq-r$V\rD %ؼs'U_$ܱnX@e4vg~gn 2ٚgBX9=xӃі;7 e3ɸ{1X,(w P2pٟa"`YA ʼnaPYNyDDjP`jHa@tKbRU PE&VɃП@ WN|/޾<^&,`, ]XVe9<ܱiM}2t *KkNa~bpFMF$Y5]Q ( P,Yqż3{CicE*;zm Y)'Y7ΰ (bu{豱VއbWN+(-Ď=uՉau+?xiK3328<Vprىə"6ںt¯)ȱrKK6v!73=ckLCC"&GΟ0}jQ칩"cT}ƧB쥥8%cAqS\1a!ٓ#Sv$Yv |bKScӋZ(J.Wl*,,hT}&YwFF>{a5+ z pUr'BWYq^lk$ /'YN[IT98uG* `y@%㔓C "ey$D'H*yLZ'>=ry~JkS '?9SEGI4tnە/>U,LkN^18|kzxg44Yt`}7G?p|lk6-&n}k6mQ?yap*ּeMS^RšK:vc<ؽ淚٣]pkh g7l^t&Ν:scҾ#Rq{'N"hȫǣrP#Qg,a{[)Y,-WTqj'KT! H Il5-iT],@6,l#Y*[E,ß3@3??vDPS!PUa8q['՛6:p.^ɭ5>_;r|!/[d< ڱX,/~lۺ;y?lr{1ֶygp؁ͱXdžg76'~~\9jO|+;Jhч[vvG[Gƃ{_Y  Ϗ8~2R _w?u<ޯrQ;kSSD3)*%rk{8[BO1YdAvQʹ卭m丨BPTV8IQTNmhFd^%).h/RKV7AWWcISX\iL4R[V~ڙgn,WD.񙣗Fl2[]mgOp][ｔ܎?3m;?W}3.ZӖ-%Ұ+"p۰k__s%f_tC5u€5 ܘ\b1o9&XK5pؚ=Pu<ݭ8p7 V [~]Ԃ7@6_qId2;@+ PPRrm0W8ۛ8.Rw%H ;eIdHM$PpE9ڋK"+Sg BUT,&cl󃃷F SAD`kƎֶV\ZR4< ‰T*l8n)57<\_jn]em0߲}kK}*0tݟnZӹ5@vPUu c'Z߱gs[?oL+Z)ܺfMwGScGgk*/ZB@d$(AHhQ*@ W]>j#Y$4_Taf[]f /3-"qt+w{ޥVjYC wq/"rxzd`[u#ufFܜ+cDZm`DZ,aS0-(8ES1c(!Be[e6S4-1p`b*@E骪 @U @!n F@B0!6H~?Ïz# ƶ0 P!Fv@2lK->-+jOM\m Ss KQMRd|Ɋ{r\H$uu- 7/A-?6Q"^""L\ih-m/5J$ :ZjRš͢κBh;ٖi1@mYe9H- zG%GTԏ\/6*fLac ib1rbNe\~)WPZzY]__9ł8XB!_4;eّnY>,VˊbDU\8_"ݪn!ޓ%ep}#)P\l{*> e4GJ.XXI@v()U aKHao XN@Emw;_}Zaqw~[w{uz gF& {ܺ9Jįk@P@Q5_8OX/

Bx" (hF(HOSU IE44{VxfCO}M8 ԰PQh"5b +ԥYE4]B8975b  bA r0# R@)` (YrHт)qK3B1@ZD@ cB*,.,YX ǢACCq P A ĶZ_iiiUU78g/eɗܰP/FˊWrm}ܨ+t E/A6TU zQ3b){т})G-wLT)/ENR$sM1xu$w=@o` Kqlc TUSRQw?|BBa() @SilEU ) v_*B8waUUSrCESjo#q0*۶PTUQ r0*F۶ooll ]N 58%]>A^f}%Xk*l"H- <_ʺ2* R#;dcx+%ybMT%lٲennNU{n|@8+Rcӟ!@ -rjaAS&R\Nr+;r9U36$yުG ECl pRpא9u"VGԮ uM5Ie}g/]y{ h ޱPE%aRE:\I"shSPDH@LDqܻ,xZmOXhRJ6 sRJ_L^Sw=$])Iw"ou3{\"g=@VNJty;Gg(P\*SwYAjW>eJ.R*R"wI"b $)E0AYif \[uI-H|ew!r IA6["}4|ҢĢ[,XV8 eXv3䆃,BT`P*6.k.oxCCE"Aqr wMPzA9F9eE'/񖄼\=] {'O8#QR[U>J?Qր(}"&'ceX'ܗ$RЖ-r\X$qyuE='.[E,Gq.UQ"zj>d*ntlU,cP# U+uT%`cePTt">pEz ^xY}>m#*_ Y[X!iRJH=TU˞%-/w%/ԓ. dKnN-4R $`﮸()DlQ'{"O&s2? EP0q񖍏++dC-@=Yf+r}R$UX6TJ|:{`*Y!Fwo28]["dEa;ʢ{K>,gR%fNIfKtt/G[3: T܌DڭxO3g8I.&Ux>.Jjc'D ,0GܗԈdֹ:E+W/(%g>,N`7"7?)H2n"I863^A2群&GKO.@.JY,DJaRN|) nyyb\?D:5rKaT:$ȉ#v,..+T& $!6;㢩_z>=%B\\%j;_ȵ(' k&\EnWȜH-%.r [](fQkzB!٨e)D,sY%6VoqngIjHMS xjʤTif pH-Q;έm-!a= QZ/*TrA\!%KS^wz+P V` ūDTV?/o UJ[xOp+ Ai$z̹leD͂,/ dՃO5I]P؋ \)@NP)UV\&~=٩4y_tĻ_8/X"NK12  K  "%62,'g]R\C7"'nCB`El"?EѮ$zqO-1$Rjaʖ==3LC'@Ɩ1txRDq,$(pyb`grJBǎ@!Cz˽_+Z8:&ʤ(e=n' O1P/ "o+@]jHP[DK8ϕbV>}~}[ل뚧4ȢR"w`ypfQ#VZEa/ezB!RE$nƂ.t][i(r.e@"(hrͬB6W1|$TIJVvAfZ~uϏ@' 5Hma[@5L.f^R(* B J,-ww=?BB"dVHfHZR!eC:eH%,"&(,\ͬB81ֱurI6j%c兡,ғ /Qf-Q @Qe/D@[ RdTy]n*kd~P)*~rr+KS+Wܾ}G]aE۶WV UU @oۗIBq\. cQ)C|>UU ! Bt|oӕ,STVnOB!(E|T%M~8|a!4;;[(JZ ! y˲Bhv,koo羥%9J")~B|>_www}}=xPQR XCnE1~qTU]\\ܾ}{(*=,*=rt!fuadы:/v\k- ciZmmm:^!7_TGAm ζD"o۝*U鑒;oңQpﱲ,Nw 'Fap";PQeŝ|I=IF4&,N.]29C(w`!!g/"p&|8e!ʶO((PY+}ԋ䱏=)Q04#ǂ>MԒDbhP' @c7@m[[sD_V]é0S#{i)M㪶q+/7G餪 o\8}m)ug*9VP UI-8540Sӝ AP,FB>uT/@K:.ʪC* G #'O:@\W؃ e9`sa/~[owwfm/>#F^&cM];oȅyhKln_bnqzz&o! 8\\tDhˇ/M[:ӣ'&Kw&o7~_r??06_) @U,LA;}k7XXjb\zP}[cXl (B|a|n૯*Y |7pf`hv]2Ţ頻wbP4۹SG>=t~bޗ;R߾ޚc@wwbh:~ؖi1 szCUƉ?˷5b9 W/(FPS㠻jUr"@`d EBd1m˲K"9eЉ&|I :Vre͒\rMX$Dfnέ[sj-6&f@,GK ;㋁X]}"2}>p`&[kԤEkj~՚)T*ff {BJqj7utԧAO\?soUcsUdM5;3>>SƓOwМe[j> kn" eRA/ G5 }g9%ٔgM,_3lm"Vܵ;hmCs Lfa3X@؜-(2=:<2hmw6%_ѐ:nrG~֫B.WBU}JD챸 #@9Dg/ e>'c.4mXјpSO鯋с3g7DPB-xsdjWw4ԏLF _ *>b9[կz_2 ]?~r*ܵ;$">1Z8~;?1{ߞ/xBs?ؘ͍-u5a'񡫋_4f0]<ǃpծW﬷Ǝssjb_ED΍gkO^̂hwo)L|yWʦ* ](=yΝh *G>9P/ͫ;;8@P8ҴWMMO;}ħ}tl8v񱩩[>KG#ƅKɥ/޴uϾ6O@q~rtbgcG&ï?5o\(BݚsWuY;qZbc.N,ڂb#[^GHoTd\<}޷,8{Ｏ~מߺo?87?`)un_OF#sxm~۞}́A6)h~rjz%: ;wN1wv?݇5AվEdԯ6#/R2fܙ.P+N )hzWԦWAe:5uçR~Q1|sś+j,ݧC={_1~5XțJS7._/8ZsU{*pᱹ::!v쉛WO-LKGg{F#,jX6r,ϕ\ORp)zMl? XF,H;ZZ2rk\ c<3zgN}}sc߼qu76Ϝ8Օ3.ς_1{ggsgNūwW-Րx yAM Ȝ=46 zyuf0VC`3J4lOk2 cfn 8g熮;VWFvd g ߜ0[qC7'5uH#u{|gVEzarV\ڝTnOZܖysH׬sg/lۺ>pxÍokwP'ƯL_5걏773'OOFYzlJ[zk]o鬋FHk^4f[ nXZ&{~95?ܴ9xnR -)#w~r Ʋ L;_5:9kKÓKٴ&ۘ 0. _9w[oK mJ1/?tB}-۲5TمKKjI*"da6㓹XR*j,>5)WYZΰ)ܖfFnAy+' BEu骢(X3 a蚦H}k`0ҵg@Uu0tMUcp3Q9mPڭ=T+/.nkFx,Mt潎;0-i^2eUSqf,%0vr#Z&'Μ8ue,Ő]zt ShDgFǑ?iU0xl :]]u#9eGc].74iKб'Ff Jvݻgcx*UW?;9˾ZYLw߸7c +_>k2YʏS]lvC[M(jWMLz>Pag_޾6FYtc [g5>4':C028wjjLp$+m?[xl[kzaq66w 4>skt1ݘͤ57ug⋴"6ړ!4Pe;5=E47!cESM-f8R/ Uqn%j ]Ke9  HJ\9g.uR7A^pLǮWluW,G|/l>]==Whu`mGg jZLw տt8 <)7< U ݸ6X"Lڏ ~=̢V[G/ؒMGRn;Nן>?}yimDW!PUbN_pȱ4YXq)}(zYZ~}HFКT 7ϟ>y{{:Zh}95:̈́@\Z*XrӃg_ߨAPazxpd"߲=ky \F Bnqi)뾀y)uR1&䙁 ׇTׇF[ʼn[E%֘f3yЛX3o,kW%j[3UMOYzwCX 75uߚtshM_s]k>TTUSջө7dW9}:PL[O+8'`rųkQ*:Pc:E +gaE%Y|t+ŽKqºϧlc4jd҉xf2l6[L]]2 ™lS..JgP%˦m[yS˶vfkxMGGh[V:z2ĕ>8xcb1ھ홸zZ5ul^޸wF@}-=y7t3/v7wn_; CyPakǺrTD<|Skqя?nΦt_G> ;ll)ZZ3Aň4ݱy͟NxWhÞW_>R_-BBXBhz]=K|[mͺb$7?wL3[:o6@Sφ˛5ХӇjl0kX1/(Ǝ:0&W cwn$9 gMC%;іҐmsdP5Gs(hj:,M3PtCP5M~tjLfgwP~Ꙇ(QM%B]|) U!3,HLQ(@r|=I!#ضfK9% ;TMD'mԷ/~tĮ&Rт-ݫ[AC`4Y j:{Sab}~koܯxGwoGs]]m.SW4T!J44djP, D8N%Dwݻm xwu_Sm0d&4uvեxM};w̴̺jN Bh3L:#5ͫz;2ˇ}۷7t`՗jZU+(xKgoWs,Lgj!]?mH'D&K{?m[6uFLuvԇD2YJ:;k`4ٻ1)聆֞Umѐ/Zߟ ,/Zf{wm|̶wu5|Z}uߪL<'2W5tE˳kDKˡ:!W3)(]z#eU<R\#8@> O@Qd]%9 R$?`Ɂ?AEƦL"Tt_.ؐ dI#t:Kk-( A&{vwmڮ龜ٙ퇳;ٝiMI @h @$EAD! {F&C1{'< h C`A-YyBApò-3Q|Yńy̴,l6q#–Wp\fߨ L.zn.=;DBF񗅅l&[0p$ls&7纎gXVOق‘h2LeH6 &7y_EF!Me3ܭӽ ?O#i,@l(\qmqΙ\6< GerƘfr0/nsWpo܅psleH$d2񊏘x0My ôM. L:uc!kALp˶8c[p&>1*459#c#ȟ\.w}fuTUHk4y7 B_A,u-gx*|1Ҋ;c̽+݌lYevTlH1jeɀeH_5TUR4UaP8VkkkW E]׸FqSAUyFU(I 2M*@ Ht["j|r%L3YA> @% >lr3$MP4O5Vf4[Jx sURHCXJ\%A$wJb,ŀiCGUUdؚ $Z27Z9H49(WȆT A`$+9\ӲKu6`~|Je|Gojz֨S4FV$F=ROd"]SN\vq+rA}eQE (\J[N*["$ďR6nҠV.A@H˥ 4`"N_I<:=OOrA3# r ^(˞X)w؁!War/W]]!fbLJ1VhXdysN+U)OZO'ʶʺw2&OT4Le85y`v`}1U:El18A<^h qQLݨ"V>9AB*Aȸ R+0k<)@`T! f:Lkƫd IFf>vXvvR(J{'%dTl]8VBfD/48* xhIepUv58+U UJVACnѐ%b44m[?1 Q)LH$ACoe$k!GYr,$ NPAtb2eզ$U*sOА;'4dVrYiŗʒa"'@#!=0,>[o5)[p$yRcʴɘa(|x\e&H[5 0Y, bUzsP*ώ UF7PqɖH&~ϳ B" A )u \IU!  [_VE0A_I?p$iJc$ B?˦5 LQ(Bp4.s=Ưrs@Qu>dlsh3R^|I^LP @(\A9k` 컯ޖA*e>YA_6 V9_SAC0RyL3eI XX!iX5RVg5nW:D5`R?~wҢd%*ae ;NP틌YFв SyFKye`*f8O~| D`bR{'mIeT?U˱u IA}}y$cʡ cc~^4*/# b$$S3!#Z BPd!GKت*_IA֐ DQPRGU@ƟĶȵodz2ݒI+#n1 xAQ`pKJ@b O6%TT`r|LQ]kW^?yIJ$Ĥ2y ٥΄;tjw13Zg" iʷ1T,5-PPnI}LPH4nhꩪUt YĖ! ewEƌ}2r?9(UU2G%"i1rW6;rh<+}"@P**D嵸韂Pɪ2TUVꫀ;%([$+W(AKqC"&×V7% GUw/aZbh~1P@d<0 Lh|S\ɪ-o(ZJ L WAؖj1AUI]\x@&AMQ\-Ld Z6 [\m RlO! R#)Jwؑ5F*M UeK{c}{U~^ Let(\jZ H =rS%RBp5|?Uu 5iLQE3|VU p  `ŵ? TFh4YH},y9xJ!H渜doU5T?0AME҈z@ҹBܮ8XNɅ\j50*Z_%ҩ.lD_Hv y-^A/b A&9 0`Q.ebq_5`x$XVfizU* g"K蛟^WV*ϖ^s.:\6w\bsX/!sT"X4y|e纎1#d :]q=n ـ 757_h< E * TyUM$`4m؇c:`YHo\' .3H,D| T*P, 'HR/u)>? y.c/=~Sfwn뮍xNfzblPu7 }˜ǥb(rƄsN޸mH Sp"Z!וp]0_xsS߼p^37ރL1 LFLMP͆^vc/?ݿ\n&DCnvݻP-p3t冓HyֶD2^&=sݙ,oimH ٬cF1dSHfO$A6I ,K-\Z[dh<=KMO7ď֮[۾Sc;VCk{sCMӣ~oݭ5-/|=eԶT8\vfrqa'it&[ps3DcKKC"bqfSsOxMWwgU$xHɅ%ڷz=i<'pI/R\˥޹=vZZꣶ٬ SGKOOXF6=?919 Ƅ23woN;u-udB2sܞNU --;^χBGޜ'c!#=p鴗klm-3^~~|l±mɰ9n!=;5zAE&ՉX2[HͥNϭ`A_B~cM s!CT%h1)u85%tAP` 'Z7lq|z R邑|aw`Ν9_;oc>9~s:ص'/6N޺tKMJIcƗt"^{z'ܛNs;:~@K$hmlaxǼc{l^ɺ<\Žwlf=Q6ԗy^&q;uɛh4T/uvЩs|N/=;;9{+[df'Lλool?wF378ܚ}m;oiώ]5_}G_C Ax 4Q%U!H|j`]3?0ԟL z7,/޽Q~g熪9}i6;Fַ~I0,tMM\l}jʉ16ܲq'o?W׳kś^zmm#G^<Nzi l.q -L:  ٶerܿzpǧHuoʈ'{rͦM?ɞ̭W5b\D,8s^*V7ݳ{sShȇ}sm\Bd򓷷V|slOz_ɮ^:nڋu{{ѵ{^MH_aQ!*"5q ! ЩAX{EE2691%t&yx1oKpޑ-UVk_;)r?~tжkǶdm"p{O6ܳ>N!uS.ՙ驁Bo>?t/N\=Cmn}Fք 63oZjb]s=毞=/B/v~Ѿާ\I5kSM*1]gǾmmohjmjLm==]uIQͺVЦcugw.ݯ֏l߽u(;}O>H4۾:{BGU5 ̃py 5/8ZϰM8=Fc(M(,q"_'+ 3 2o8u<}:yVupӺqCesvU˦{YtmW7646x޶jāW_|p~Mֱs|Ǫj~֑臿2{z#胪[݂7PowsDh>t_{?>uҶ֚x~n#}tbז|q|٩_U>`Jl1! ˴Dv⩃Gڞ>ydʴ#ė>䳫]7oH>|^q̇۶JD!Cd;sƑmM >?;ٿ+Y?s|s|oO=Η_}}^Lrbo\kkp&q h*{-1do}{mlC̭/Of+L*6 dWjd;j#[UיXo??~ꝉY?b;?V{wG/^әp'ͧI?;E׭[[M\m KfP6~ <M+HCRP\YT!#9g3&ljv|l=ozmgSuڞu}QCཇ#ߢPUsT/p$gBPxZyW5lڸ9Ϟ~P(84sӳc_8y}l63>&s\s6P(LiCuoHئW84tC"桵 p&2)SH߻ɯe7f\1!aZD8^o33`٩ɩt6z̉:ۛcy#=4XD摡ћ[C!u]Yշ]n>2d>O/=5{3Z;6͛{Oox6-۶,[eYV(m3/t2+' n#c\xŒUw wfmsK}U({'e$۫#eMlq+.$G̲=ut@h?TVS-J[sH q"554OJ\湅\6{ Cm;B& Ƅ[;nh*\|06ya5إK7fur#<;moڥޝy믯v ecGS(Gxlqt:T׷V?p#_c]7Bo߿+6nl}$dMâ+rl3/o M_>t{W_KGG6KFx!+xGlώ^ܥق㺅\&cήVo򾏎~y'~q;7sL:ͻcs \s9yN>/xB0R7/]<o/|s},:yȚSWQٜ Ƅ2t[S~/O8vۻ#/!į~{аf@2;=%Ґ<x[¸53@5Lqt +J1`V$پv+gN|,"<ۻ7 }ݰD2)"_(JT%!Jvnضs?~{č|!֞G>gqkú5P$LlZ{z_~{{ v<o{mXc̰"D2jZ:_ޱ!ijNO{{wPOo>9оD/8+m PsUzH84x @42ðbD2&7,{`㦑s7GoL=Ã[9x-=WlH4uI{*JCٶ}˅>?>Ss;ڦq݊ƒxq#&p(KM_FÑDUҎ؆aɚ긗xoFgCf~I 9zpo;|:8km}u׿:l}0:64Òi۟CdUf__%& y_ʛ?d4^ѿv`omU,niYa[olmJZojL 04h{y|o`gSS[W_O+/ j^VWTmk_xvm޺D ˎ7w8^8cf8_nm{s}c{_OGŜEITl*k^{ϻ8\$jZ w5'ummuDu}K뺚j[uqǮWmIZa Z{zmˬnٸuۋTG-/b&'[ i5@ M2A8" Rȫ[xLۆc\nnnq c yh2< ';7v L0|f4Z\pΘ0=Oq2s)[h,[ oaW C+>.d9aZX"b1ͥ]n'B y3msfg̊)뺂c C0&<1n,;?uy4[16;z}w/ۇ[p,,K/UmN-D0Fe} Z`>߿Ի[[[  T*\͡crd{\*kcX2纮 /NHp;g̛zmp8H&Mħj< c0y=o-rVQfp/Y";8nSSe8+#-ebxy²Coz*neB (aZ!>v:lL8 ӲL:1nicE [N^j;7n|ͷ8 C2ʉ < 8O,,k*mU€|&m 52m'|.kYQc??[e10Ι%S$ (50e_őh8wj3x8fEײǾ:! NO,ڿg s &i>hñ%1>[ 0| PΩ3CD/.A<Fcш Â1V*)eL!%Ec> A(XŏC`RУ8|lNHh[J\_PZ)!DQy=vZ?K]Rd,:l+{ &x43 Aq0hj+I`c{ݒ"I7To0)8X,>U%`XLN#Ҝ&%@0+hP42`B-K70-Wp X,L& 5$uZ}UkS-ĆO+ 0^˫\BF X;H h2sT8>,&8xN8^k%Q|a3"]$ }":3jV#| +?9FQxA#ًY:Pfy 1}!R[W - :Y)8`fUn~g@ʳғ(=-XM5K0A )|K*2fCe+WA]#$5ۻȣaw"_F[pƀUX '_ub_AvI1L_6c{ j\(I9`ib3,ȊĊ CFՊ XSSo` <:./pŅIz8z;r_ $Uit]BT> YW1rE-frG+y\6*+ 8E  S2 `F^\xV$3W/E_H>4˨@ƒ֢* V#)W1A$l|YqGd &]"uU @,RBp4T x c S%tb?G>& '%y;6η!AbI`[U#0d!I?I.VBp4HQeY@җWp~?rk?;A+ ~ aer$ #+;b(g2p HJ (A*'1+є`8 *WF<9s0ѩe킴I`_p`V㼊&#W)"yF׎ʈ$)\"ZRDQO 7:`~-?A ˓LAj55DV|!d=Bp|(V'53jpqȫTz9,C%Ob[2/ +/r> +!΢AȱZ fbR,]Q]_L 6Fb2x0r=5$Hx hᴑ%jcd܃PcBj2\q]&k(o2ĮƢ*PʢҘ^,AVJ-HUmqpJ7]LN LU4RFKUMVI?-tAWUtJ9sdФ!k5y`Y OAʼjV=]B!^ 6Ku#7mt .zr,kF9Aqph5[:, ArsBGdҫ>j rR#CVFRwShe@IZ#,; pQKHxeygH=2fٱ0)0อ|d"edr  \ RN`RKUQVwEݪYet01i<2". G87@$$6^)/˓~Ȭ\|A@NԆR 5,xM#nlU4[ ͸3NBzɓ-ʚduM֯ߝ !MސjB6Q_?^嵫 ٌ9Lf%A:$V>O@U dwB =Ny#eȭ44Kz`/|6b J*㑣 G,@rx4= xUTE#@a2A[[ !!R!|4`(ˀO4HzF O#Uh t#5WdH=!A_H.L:k쐲{@ bBp9 t,H/AarZsdΒIW!:(k0y@UXi8&ꓜ,dzeu&q2ɶ@ךH$I HV(AUܒ3r& /MjGrhrBpu4Yrz&UNo<@)_lMj6Lc 1*xlj}%A\1F@.*Uh.j/aUO\BПYAΞdT)gUj+|Wr'u{Hba`Ko*n# ͞6O 41B|R+; a] %.Y!(IOBP5d}z ҙS!VA#paտaGuY4gU$7П}rO"@P <$/4ȑ'HF?:pـ*TUd6+cQSLAr `Y^!VAQ)$+M +f eS}P=%- F2%XR@w]괄q?k"AIҟYAliW8?Ukmi?C!"`Ҁ$&o*ު9PeWVrA}a(`U!%zDjS "V!|4*8 !>ek>T,*(*lv=.iN?_A pTb!G%cvl5EP>i ϵ|} doeŤBp541_3""R-  vJF]y v9ANP:A<AMWjiJ`VA<9M;S_NA=nѲQjl3[w1I$NR UcUj0֌P+@'i*@ɄһoD#hI8%RY B"WaC n *H~|B:VnMBi9A$ UQWY!V! @T^ȏ4s$qЬ⃱tMh Av}L\`kbB) 2; *p`wlAGWK6U@ŶD<2* 9(Bpu4 VBl$+u(9_-(ǽ x CHL}aFY@T9<'{?$Aյ ؈-A je&TC_7qAZ+W+Ag?d*2Ei/F:b$$$`%`c>_ deHj"H'5d 5ЃBb&i cT bBb3H VQ`lW+WAҐWO됀nM$2U#lbh6r2\ra0P&Ȭԡ &m1ɫoo/&[UѐM$T}:7huq1bZ,(N-`U~ %03KjqNHr$Mu्d9 BN> J| J!L 9 fK1/m6X9d#ΡՒT,0D j5U]S/d)XLHȌN&Bp55'  )OH .d5@!K.T/Q][&,2S< $ovI80`HlWV"3Qʪ п I&- Ѐ. F!Ǽ$76.{䭼G%נĦ堏|JZNԇţX@^"VP!2UJ! 0V4A5ͭCS9Y:5BpE5*@eyY*C@zd2a 9BC%q2teMubY 5VT,A>a\*8ltR vU @Óu HK S$, D(dXΉ~Դq^v}'`KC"r0q3*R$Aծ%I jY%;w96l bUF<™W2Jं4STP쨥jq\F 0uX *H^.|wB'AO-I  Gj)ֆO }$cM5ϑʖՉKj& sU=!AeWLe(T<$bBA,QEW  Pٖ< /$sBD;Q}E _H$SG`%Ad|̀j,\ed%!ԄHEhL{ 5cT-,[ׇMƉ&B6xUh^C$UU'G0Fn4Ȣm0 Liw$R DO@0}zzUB>%5kJUi.TCC"ݱ~*2&9W*_I> 2`TH@s-' KS zʚ}fF?4cτy〦 3O^R5I543|`px~5*WaFrUSXde)+ X.Yqf{acB 0Z@@?TЪ j ɤ ܲP(sNpi;`"\uCIRxOI 2zsA4Fd'Ux_@ j &cSY ʞ4<[US&y^?!¸p]Y[1ak֬ B> 06dJ_ B0˃%,O3eDĊ< FhBBpה7iQ-[|(YԆbA Io`sQ˲ $΀c=x+\*W42^4(NւT:dp%z/vQd/iX&Lя X+ 'Xl,D)BpH؞|B!GyL!']4V\,/`[ cWjZ)`!KU˱B3e+*%xL.-.#F*䌯 YBpiflNE0`q+sku7pe\˼ ̀蝹/z*AfTzT˪ bbiceEii,_B- K@=`Jfݯ Ea[`w4# /,΃v p3'lìoFNX,I*XdWU\Z@!8A@g-6S{0H>86(!T.HhU܃$F"u!XJ A L8?iM6y@[TL=hIP}G4En YdA)<#["k[6'hYr\nUh5KH1`.σ󑬡IYm]7Pq VORyٜ/ 2,cФ*"y> r) Is521`OUCnz&*VЌrx%VB6f͹dQT 8Y*Ac/*  RT4jF5Р!)`a`GϜ: endstream endobj 604 0 obj << /Type /Annot /Subtype /Link /A 605 0 R /Border [0 0 0] /H /I /Rect [ 386.6100 748.7769 396.2473 757.5952 ] >> endobj 605 0 obj << /Type /Action >> endobj 606 0 obj << /Type /Annot /Subtype /Link /A 607 0 R /Border [0 0 0] /H /I /Rect [ 67.9800 713.0627 77.6173 721.8810 ] >> endobj 607 0 obj << /Type /Action >> endobj 608 0 obj << /Type /Annot /Subtype /Link /A 609 0 R /Border [0 0 0] /H /I /Rect [ 80.0267 713.0627 89.6640 721.8810 ] >> endobj 609 0 obj << /Type /Action >> endobj 610 0 obj << /Type /Annot /Subtype /Link /A 611 0 R /Border [0 0 0] /H /I /Rect [ 214.8443 713.0627 224.4816 721.8810 ] >> endobj 611 0 obj << /Type /Action >> endobj 612 0 obj << /Type /Annot /Subtype /Link /A 613 0 R /Border [0 0 0] /H /I /Rect [ 182.8448 653.5389 192.4821 662.3573 ] >> endobj 613 0 obj << /Type /Action >> endobj 614 0 obj << /Type /Annot /Subtype /Link /A 615 0 R /Border [0 0 0] /H /I /Rect [ 447.3037 555.2057 456.9411 564.0240 ] >> endobj 615 0 obj << /Type /Action >> endobj 616 0 obj << /Type /Annot /Subtype /Link /A 617 0 R /Border [0 0 0] /H /I /Rect [ 201.8377 440.5629 211.4751 449.3813 ] >> endobj 617 0 obj << /Type /Action >> endobj 618 0 obj << /Type /Annot /Subtype /Link /A 619 0 R /Border [0 0 0] /H /I /Rect [ 233.8080 302.1107 243.4453 310.9290 ] >> endobj 619 0 obj << /Type /Action >> endobj 620 0 obj << /Type /Annot /Subtype /Link /A 621 0 R /Border [0 0 0] /H /I /Rect [ 489.5700 282.7059 494.3887 291.5243 ] >> endobj 621 0 obj << /Type /Action >> endobj 622 0 obj << /Type /Annot /Subtype /Link /A 623 0 R /Border [0 0 0] /H /I /Rect [ 496.7980 282.7059 501.6167 291.5243 ] >> endobj 623 0 obj << /Type /Action >> endobj 624 0 obj << /Type /Annot /Subtype /Link /A 625 0 R /Border [0 0 0] /H /I /Rect [ 504.0260 282.7059 508.8447 291.5243 ] >> endobj 625 0 obj << /Type /Action >> endobj 626 0 obj << /Type /Annot /Subtype /Link /A 627 0 R /Border [0 0 0] /H /I /Rect [ 511.2540 282.7059 520.8913 291.5243 ] >> endobj 627 0 obj << /Type /Action >> endobj 628 0 obj << /Type /Annot /Subtype /Link /A 629 0 R /Border [0 0 0] /H /I /Rect [ 523.3007 282.7059 532.9380 291.5243 ] >> endobj 629 0 obj << /Type /Action >> endobj 630 0 obj << /Type /Annot /Subtype /Link /A 631 0 R /Border [0 0 0] /H /I /Rect [ 426.1852 270.8012 435.8226 279.6195 ] >> endobj 631 0 obj << /Type /Action >> endobj 632 0 obj << /Type /Annot /Subtype /Link /A 633 0 R /Border [0 0 0] /H /I /Rect [ 72.3090 246.9917 77.1277 255.8100 ] >> endobj 633 0 obj << /Type /Action >> endobj 634 0 obj << /Type /Annot /Subtype /Link /A 635 0 R /Border [0 0 0] /H /I /Rect [ 79.5370 246.9917 89.1743 255.8100 ] >> endobj 635 0 obj << /Type /Action >> endobj 636 0 obj << /Type /Annot /Subtype /Link /A 637 0 R /Border [0 0 0] /H /I /Rect [ 377.4158 211.2774 387.0531 220.0958 ] >> endobj 637 0 obj << /Type /Action >> endobj 638 0 obj << /Type /Annot /Subtype /Link /A 639 0 R /Border [0 0 0] /H /I /Rect [ 52.7993 187.4679 62.4366 196.2863 ] >> endobj 639 0 obj << /Type /Action >> endobj 640 0 obj << /Type /Annot /Subtype /Link /A 641 0 R /Border [0 0 0] /H /I /Rect [ 293.4195 175.5632 303.0568 184.3815 ] >> endobj 641 0 obj << /Type /Action >> endobj 642 0 obj << /Type /Annot /Subtype /Link /A 643 0 R /Border [0 0 0] /H /I /Rect [ 305.4662 175.5632 315.1035 184.3815 ] >> endobj 643 0 obj << /Type /Action >> endobj 644 0 obj << /Type /Annot /Subtype /Link /A 645 0 R /Border [0 0 0] /H /I /Rect [ 317.5128 175.5632 327.1502 184.3815 ] >> endobj 645 0 obj << /Type /Action >> endobj 646 0 obj << /Type /Annot /Subtype /Link /A 647 0 R /Border [0 0 0] /H /I /Rect [ 534.6887 175.5632 544.3260 184.3815 ] >> endobj 647 0 obj << /Type /Action >> endobj 648 0 obj << /Type /Annot /Subtype /Link /A 649 0 R /Border [0 0 0] /H /I /Rect [ 35.2500 -139.7347 485.2500 86.7653 ] >> endobj 649 0 obj << /Type /Action /S /URI /URI (http://currents.plos.org/outbreaks/files/2015/01/vaccine-hesitancy-e1424801031537.png) >> endobj 650 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 302 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 1 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceGray /BitsPerComponent 8 /Length 783>> stream xA 0 =" ʝ<2;EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$q endstream endobj 651 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 302 /SMask 650 0 R /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 64449>> stream xWw\G.礷HHx ADJJ*Sꚞ55O0gf֝{gMt[<=AO&Ho90rȓ P18;D$ QRU!I!D4 hMg},ehE] xN};_L{gcڪ!bN릠dk`Obl _%24?iNBt拹TE^csa^d2\Tabb@xuk== r򞡡LOax!Zx^BKt~л5sS^ŰWtפO 1Bތ7cFʷ[|LCC%TFuHBs4T3qӉkD?c%u+nF+/$p~G9 0y2?VdhbTL@ sdRP;k p y0:uYrz^B SWwOKZ)I BWI&\02AhyDSq?4x 6`hn? >)KRvϸx`bI3W0- lL1&$E&c*\"?%Npe,tҼ!݈O%xʸޫjÔ'WQ4V0$(oReӕ kdV<- <KO]ȃ> 4QZw!X!a_$tE:iL1l8 /oyEwa%+ktBc> {LW<|31 YS'2>3B.}"T$qzFOm >P`%kFc#Eӧ2wo üp;y1E'D!A(n\'O`-̂:D b#\dz aI^lBy3+A<`-5FV1ΌUPۭN6$XYaN#'슰0Z'4ӟvXpL08eڏI>z9-k%4B޶aLJh4s1))Y3ARL8v!K&wSVsc/ m-a'#f9Zv3!D-ْMUKJoDSUEUM&RKD2[&Bb>H5E!lK!$M2y8$"1[ X\q~$IҳA`<3;* x8Jf1TU1Jfe֣ P$.LLv8)ޞaI`z-XKQdyH 2w_U#R 6  *ZkKok4˥ţ54Hf ֦_{ٟ;_u3[_}ktcז_, }?|%皢ˬC!<,dWӲ[oqΉn?\K=vִm{^=Ѷ彛Jß"^'?są;c6oc1дWȵS'N ohWv)}}`.ekWa4B™CZ%`,e3%8WA0Y, &=z)g,TgZ9-,[2 a[(:  +ıHX@syWK- `4`reus؂jkZ:$Hq!/[ۺڛ]691qg9y8517?~C'犹S  >x&>v{*gʙSONɃx9HOӚբ`H?̺i̐y_e##35IDJ3cw'M?xo_kI?|x$k6hJzfft6#olg_YܽvʣDϖ/n[sšwA{ndth\"|Mmvyt,fjh_HZ6*ȞU V5}tbmln=z;L@$)pґ%j$i4A\hu+ 5Vgp)*S]>kt R4}cl4jb?W<=,6a !1 -I[y+Ma&v2͈IltYnSBR%GcfwSgd"Z)0?;*ɹ/>>x7`'S[὇B,>?=VKZ*-O0GǦB^RDd<6=Ό8qf`ZߴlpCG<9Y{u!#znpKZj g>K)`lB&IR&F/_| #f׭Y {3;,pt`d Hf N X3jG F|?[aZ*d3\IxVIR!ei_gΧMl2[MZ>6;'%B4Ǣ lfREgy>I+NMG%5zE@&3Cd6ft1Z!=Oӡm^EX;ӤL`o |\~ʿ84 l(l.l e6Y3"H:2B-{ i@ v)~ >2J=W 1m`#siZCU,x*\^YagM\, Np˗Lrк=C >. P< 6@dL BS<,JJDB=RÔq4Hq4f1k*,&2@SN6LL :˄! Aw0bu #ȸ [̋ \4iaoE1\E#7e$Hō#_ A"tA=jP%( 2z IЈg}a quޕV›V5ao\dy<-My]Pݚ6gPX+21 :% k|2*!| ~XJy)Jπ0g 2Y[Q:[TxJ $ Κ KU 5A׺L >w᥄KĪ+9'IX'\≏!C1mϿN޼ : P9) n{3s;Vg,|T2*Gg| &3d9A1Q'ga8p^!T/KWmGe5-fk @%'5 )>#6U˨VX'`mE,hڙeN|K>!.@4[f6-FoxFaKknixYh z\'hPf)cy B>7ݘ.@?[дVA_qpi Oz!P\?`U)FiCwÃc Z`!LLyr1AM$4h˞ X2 2,/A-'x2 &H0#.bm 0O &MO@/ʏ<4o](%'Wk୑V "q{}icmZʤɜz]v+-T"U^j~NeTV=^uF6t&3jankwS6KOkK^eD4Z3A ULخ S-#(vHN&(ړl[셀3OaD {9/ix-0w1AŚ 2ac @ )qR~lQ;~lE؈ $RFP-d;rt"sNKT MUUA픦iVN:{Te<X^%ZL>uF$Is)lB JX,**T,)4U)J"-f$Kp/_AWkg,u+ S"t[]I6 L@|K'SF(6!̄wDz7/l`fӫ bC iCXxhl<:n93+9,KD4d|.kb&529^]&l2g2 ќmsN[Vnm 2TXb":\NԊt<!d6˒%j5D+%l/>:?1䵔bm :ɘz.HP-dSssq},%Eb:̩obs{Gci޿h; 6"=M&Z&s7j13?7UL`e`5unrhj>ilomU%7>hhmm,dqz<6#M~Az,2 fX/C4hܥA.L+<04 n^:y .Zyrw L&e@ Te&/TӪoBGU=qҵcєڼ{ߞ} 6iWg^;s}.W(jˎ\hDZ 3w'_\kQ?~u}~!椉{'>.kv®-ާ0kgO3: 6^u3vl4g'^>[jܼ/t75kL dW_N]ɾ|Kegd7xoܾx\t~!Ҟ5nqK>͞`ƚ69>e 6zI~ Wnwyqj)5uɫwc/!p[ր^BfO'z'FGWt< ApHf3bq:AL/b̓c&D/3X9I13@K(QÐAM- H;D$/@i"e!|1(CS eT\ƽ&b܍Ǟ^uO\Iڂ>2pDZw~ߝ{mjo/<|ʽƭ? jM%&-paRtlltldXMW%W7$˚Ij11yD}ʏ]ӋҾu}[vCNwnLƦb3Ԋ|tl2ըݺy,jnnIUՈiD$NfKDQ5x!/ (n8AI:皠!_VU xy,`^_1Iqu x1Zr&x؍5Kͽ{GNtbf苏>2/O޽>_XH;qd+O_(|2q$9tQvwKkևӏg{~}S 759jD$Ilţ'߼:)biّd^zVLOOMHtvwu]O3W/Y_xu99gggN2ί?ە+^I5}o7}_M:\ H[kkhw9>x:?ӛsw~o}ṕX<67Nɿ[oebqX f.]0Q \oÓLUs^֚7~ɦ֖vUNxc4 tw&LM-zzrq$5/;֭_[ᬽw~ ٱ77z-|筽-~k jE6_bY77x7ymRb>ٰ%(gg'dzΦUo +s#E;{\.>{O\߹e3/RGNx;C3'1Kg/yc0Zɮ''7mZb}* "Kox[Df웠Nk.K+ZnN#h~4<Ы^g&,#>0-'x zv{S;gU$"&h<.%|5%,mw4C أG{{Uo[S5GgFc-Fshqg]&cIG`k͑KP[%5jǺ͑Pfb31~Y%'H$`r=-ע*O@_ܹ(E"aJLOZYS29տaբh Gi3%](ldaf^i^vU,5Nf;ZfY%31p9)貸y^3ѡge=L-/(}{yH7~F P 8C]]ju~;V^Zu|!zYfpx,1&˗ԬNP,DO .@#Vk`6'Vx%z-LCI<@06| e}Z ԰PgӚ&ݴ09=29#얩lFv6lž~p{nK\)b>H$&Ǯ|u3+s)ߚ6>=1MUIk)>35:;.)ʞM-OwT( |&LMMCw-D{ϗ¦L6~N_ӊ$JX*SӓV_OAVm!75Xg xqaҙE݉[nXұI䵩əD)Y$(dY`e&g;l.e7)b lă=p+[n&K>oݾwǖuVL$|nF(ٵkhnt`[ϖ]{hƏAUI9 WA3BOG{e8x7ˊZs0?,y*vt-؍wP^4HPZbGѨjq6m&yf.:ϸZ=/^=^('ҫ{Uݡ/~_3aiH"з+lܜJd:n5f:aKhFݦb|f2(5l׿Rhr"ݡO|ypk[G[N !}9n XYVo?Y`|n>^hli4Hznjl`45{"k:N^>鿦L{Cuh)ɾ&`3M'H%$n()m9r1KnLPڍ.>L3ݭv]$,;l_b6_uRl67lp{Ww}.ls7ڹk3ˆs)q2' F3D˟) ~Mo CG’-4*Y|3˱4G@6&>d (>Vۤ`nwV{GT\XH97oh sfݼ'Ll21?7?/V5n-H(շnæwm].e5eǖΐnJ|A|Vul߾g˥)յz=-6,$ۖM% {۶oݺ/M$4rXӉxRw7_3ɤкi󆎠$kt*]0w߶nUf'B>_ZWZKֻ~ۺUk!L4kP[WWKcffocQ[Ųjwv6+M;PkWW{0!$",_-tX̄TR8;:ANd3LőWF&㥳3ҍְZ5]JgƈT+l(BQ563z- .Q|&S$e!\&ʘ&Kj.L]*9vYee&ojn{lL"z͑j~/?K@"h Bߤoh mq3¯V0Gm+~1hd!O p}1Ϙ7?z!=e}4cX`{kk ּR B8cF#_\ ^-/ªu;.!(+`[aU⬸kҫ@tSԟu[aGg%BkKԿtxuK"҄i8O:LŃTh_45>1U:&uV!*҈*7W;xmAb$bj$ieVm:Q`U#(z6?e-?yֻ_ 1BN\yhN"5pP$1ք"&HVk,4ȴ&(@.[1GfF IA@iv $:A?m<Zyמ@ 0@\hTnr'm%4x2yLP7$nb#s;"v HH 'D5AEQbXOO\1,H^P An:ڊ|AE桭\ae Z jOz8z,iD=XU")#5xI _Py&qzGTKx ?a:y.3x][Ŕ|KRXĹ\dg+ggb9t 0dܴQPc^1Upcj#Aę-P陃y&CPC C*?R%gAPeT<yڀ\+[#ڊ \Nf >V "3Ș]]y@t< e~E4pgkA1;Ax%*HF.EWmtIԥ TyH7-PٙUgp.'8;4`1\AĥM0 @XUAAϓV*˃~ _Z+d0RؘH*`ŅπQmy[|6 LtHɓH&xw|b`iX}$ J?㤭`Ч=\WAHO=h@U v`Kh1z9p Э&ѡ] EB9o}5t/Q *VTL'yqK% 'Hc ZDë\Ie1H!5]7E8M+fwXpcX s5ց DoSZB*oF5< g- N8vx7ȠVՓH gTKgZaQ'q4M|--hzN (V" 3`#5㵴gxf56p2^aŇ}v\ %? jN .h(5i2:e'(3k7]x IK_>xw2}F'^5 %Ou%whA 1HIV<5`DϚqx$sFVbSA[5:A#e'($\ai4މ0{EI<*nd`T<'VlT0-<.2Idx*V\3e*uqWAP4:0x V#)@/ h^u+`ٿ>C(10+5$<1?bE\2t0AnD,,C9ӐT~#1/`Zc) N p4& 2u~ Z缌U[0NN9;6/HyՓW|hd3Rr( OyYWE5HǓK(OF3@mtV5_'F%>xaff: -c$;į18A@@1I?Fz[,t#g*ܹ+Wx#>kdDh 4љ ejcAPEwړA[T0mg)@X~+~+P0`<*nD3&!# 1e jba":yBgxqNb<\3ɬ Lu+_e$8.X |2e& $- L\/0h+§0Xm01!زu׎Hf.BbgOWݽ3~ ݛL3gCmA7Bl{lj;B^ ]yzRU #w.]1Դfﮍ.YL!l A~2$A#@pavKFMzÛvjv$/4o~?:o;|β"Q ×O|tyj;?{ejGb6W4YmVI&Sv]T4~G.~/ol4[i)3NNL+HW"@~EX$0y6Fs4M&nЙЗ&Oxf:?;=9+hsK$$Tl|lb>5#f*d#il6=MwKCv55;w.M'2Oa-''&f @m3?O i~=kZɡyդQ XQ55,2)l5%pkKaFn+طum5:e5?><4K%hp$ R)0/M~Y)KG A9Lp[esS/=-aŤғcikr|IUXlk"x8[Z|Ί1 M D STۺj&hDV & є^T9t"hZ!0=,IjXLD556| Vǧf拒n۝.IVJ?[KFW);{cݑWDzi}w0?3>>5=ͭpK"Z>ΗTMǣ)ni zeB$Bمim9-MMŦǧ%](X.HZhv"=I^}[Sm (mN|4A TW4 FXy.&CBlin޾um3lL9vh&_;Ks.<~ôfo]obM\=w EsK7~͖sE6}}||[|om@zKc޸7^0KH!j#W[ Y6RUR΅NMo/lP;vlV*ƆGԆ3wܸxpOKUݲW7f<{D* luSw-3cEWdAy|q7>boО|4lom ߻zӉkӫ^Xc IˌmM{voqׯ&/goEl&8|@D1 >$>ubHpe'w ![wl2e%6rб;Y{?>2VؾCSXɷiǶg`.>s̑勹ӇO]L.9G.&m];7Y?}/uO$?`x\q̲,Lff{۟|^,ܷgܛϥ&.~JYZޙsYqy@/|/aH.~?~ttM}`7R#wh o+VOf؈!kXFw,Н N;zé"gc_d_|<I$d6kO>zcp:>7vޟno^hj2YMÑ96ʱK>^oc)7~G ;[wO} L|'owњrOܙM$_>'J;7G?˱ss9gss9>542U$di 8ia}:sG@$0wiN~0zgX]XI;$(h2}p)d$k C>l:ltuK{n[J/ O-X2DXygk%XXqGgLm EN >|MWeΞ=7q붵^)z>ڵ* QB2+ۭ"=7ϝ9ί~n[nY[_oz_l XŎ-I^~em.ݙ1Hl0~]J^,^o~#Ieu}-ă^kOSBjEW_[m}Sxp?U͎P:kݰm|bwg8`,07ڱt 8V*`;{OƁ^{+/|u{<;nv6ڋy[wݟ*7Mo =q8.m˶oaWsx\Ŧ`1D>TM,&&=7#<ɊjD0լv4m~XB9꣤cI%Yrdkvem.6uŻ#t2vohZ-{9~?쮗_{m-O?N}卷dl%s[Ѵc SGG=W?0MFpk<+pjR>+%M#OW]Mk7nj7j{~ߙ#S{Ck6l{:"kw2luN-ycխIqڼ̗Df5w޾cMWmdYoMoSHvt֮km + P,4b2-&YS$_7^~p]~p-YSWGk{oھpss=u擙RI5|=mKRU&pՐ]+V* 1t %uH[lr[frْ>˲l5˲䰻l_3?/:B}}=I)omæPsyX]n4^sifvzlt|5׺_l+]OշG#P'[n;+K!3zh qW`M# ")R( e=ywfvf>G|gvg [lK(Q)1'AnM^*mHvݓ~9u;`XFҭϿ$ɆLʧ) #W>/tz|]-+F!r,;y׺Ö?}ogK>ɧMň=צj D;sCHꎴkZշzmc0׷N%ZWłd+_ӐYoo4` DZ!FY4f(ϯi@ ( cql Y *Z6:|R4UlEQuB T1@EQ0º`옶OqLKQ,|_Q ) @3t"8!NEmT,JejYDڶ7l! +0@ FCaduU7/;ikvw{lR9E ȱL2ǶqIַ޸}oM5h*#1B6*j$Uӿ-^]'hm䇎ئiٖBNXl`!vց،HD\K=`-K xxɭ0W+Bޥ.?Ydf09~!˲gv垒ũ;N3S4-̥ق_#_z&6 \}󳋗5a͢Qs}_կN&{vWHԥ@"ӿ.,-ջ@Klݱ_|洱֜ug.Ե/?txu-\=tl>lMB>o1ر-ӴƎcG747&]O65>5HojnNV/ֽIAi`0b`#4M Bm;[lZ?c_˗oln.ضB,Cc&p27I3 ݊ꍗJI=^DDo0D]k{K*(l,L a XicUt\9pyf约@CCKm*ξE~vlT0;Y,`G%ښwfPM]q&eb3_~׊R?X=P_BqޢrG%ej 8K6V9X^ )=\$G9Z8Ǒz9k7*iڻo>>a1wRO(ڵO2f2Ͻ_z/N·}uz(Ǒ@@8}`4~fyqxycl,M;}%%""x!6tBƓɠOWD ECd2 ZKG>xxh.ԻvuwCTc1#Z Kĭπ@,"R&R[AOQȣKCjH4ٗ*=!NjT}p2 jh< cD$Ȳjho`"Y tGcjmkqoF{k /^ol2ъڹeϳkx" FQn{~sfmҳp7jKbd4ÚHP6`VFb?#[H&9QU#Ȝ8S7{&BPU/Xm['F0R[_B$׮߼mKgS&Ʀfs{^yaLNMM_ܳ?u_5h,VYyמk]|L2’Lc[OWGX2lgOOKk?ϴLEablRWMwD~|]֬. Up:300绺cc P(!׶ZՐIlgwwK֧2ɘ0[:{b~4Yզ8rZ}mmKC0PT}p *!q*k (򅢥m#i*\(`(dY6@QJVt P !!}UtMSB>_0 r,޹B誻l]dKSzZZ\rE ۶  FP'!@GV]ES/?z-Kj#!NbӯZ"x ڶs͋.ٶ @V B!,-YE1P oqߴJ&N~ONoZՐe;%@1B*@XVTU5]ӰUX_("% }:@c(LA38/  D S(b~"˲K}>ߺu٬b%S] ,T2JmIaw&tqR'&P(4??mT!ĥݍȱPqRȱK?ޭi;0P4MV郒@jZtA. *}7clA(Š TTUg(*NJ82zd}CUS!w着 !rl99`8v7a*vJQTrj)u]4:S[uEm9jQb͋j?&rFFn:|P(~Bql`v*8VU B6fP*a :gB!T[KGgo sޥ͈** Ni*6 PQU"TK8¥լ*vwlǖ~-``8#Bh;/TE-5_Yl)'y5\l,2$e%D$"ڵt9N[F[ig,`=N'{ns@@r(*{ACKVqߟd ٬1f9.HW 42@UU~ ڶxiA`.͍޹3Z M5ɉ0.%/ c"IK6zK/#+A֓$asxS{py$bP~T%Og2=iZQwlq ?G x|^xp-׶Ltyz?BPnh%`t:JQ%UFnRIR 1Mv놮A>uޛ_w`,k DT:"5̫[x+ 2^c;Mj ^/kFc.R2`[aYp])^1gK5w+U]?-+c,:y'Q2)ۭ<+ܴ4%dŹ $3p+^C8eWcDX$ܴ -%nHxBp9uRˣWIrIPU+.2]vk{Prhcz*@vq&3uXZMurQBHP^$$|) *2!yoXRl Z"Tob\m$@Z⪕Xg%I{Qb(z' b,qNrhk&xH9`Q4'gxFAHQQ$Dq;dc,;yܐTȗA1^L R!lrP y򖨐sW M$˕ `ngvK Iur"7q{ąV4TXwIoEXfsܐȊrh08 6 6$7˳Q9DFtG. ?wH$*r+lD̩sݮ wKrBlSkR$zDX@ց 512MӲݔeVݨ(IzƑ/6dG IHGB!QwEE3K6.@'y +"2A!ubg^(~(TXE|@?P|2`ݐdMp=/wvpղ+ZUe|P4my!1o^9|gΎL/ K#U\Z\Lur3˞JD,O9) Kj,D/6{fdBPTBac *{M!ʐ$$ }I gEX f &+Hq-r$V\rD %ؼs'U_$ܱnX@e4vg~gn 2ٚgBX9=xӃі;7 e3ɸ{1X,(w P2pٟa"`YA ʼnaPYNyDDjP`jHa@tKbRU PE&VɃП@ WN|/޾<^&,`, ]XVe9<ܱiM}2t *KkNa~bpFMF$Y5]Q ( P,Yqż3{CicE*;zm Y)'Y7ΰ (bu{豱VއbWN+(-Ď=uՉau+?xiK3328<Vprىə"6ںt¯)ȱrKK6v!73=ckLCC"&GΟ0}jQ칩"cT}ƧB쥥8%cAqS\1a!ٓ#Sv$Yv |bKScӋZ(J.Wl*,,hT}&YwFF>{a5+ z pUr'BWYq^lk$ /'YN[IT98uG* `y@%㔓C "ey$D'H*yLZ'>=ry~JkS '?9SEGI4tnە/>U,LkN^18|kzxg44Yt`}7G?p|lk6-&n}k6mQ?yap*ּeMS^RšK:vc<ؽ淚٣]pkh g7l^t&Ν:scҾ#Rq{'N"hȫǣrP#Qg,a{[)Y,-WTqj'KT! H Il5-iT],@6,l#Y*[E,ß3@3??vDPS!PUa8q['՛6:p.^ɭ5>_;r|!/[d< ڱX,/~lۺ;y?lr{1ֶygp؁ͱXdžg76'~~\9jO|+;Jhч[vvG[Gƃ{_Y  Ϗ8~2R _w?u<ޯrQ;kSSD3)*%rk{8[BO1YdAvQʹ卭m丨BPTV8IQTNmhFd^%).h/RKV7AWWcISX\iL4R[V~ڙgn,WD.񙣗Fl2[]mgOp][ｔ܎?3m;?W}3.ZӖ-%Ұ+"p۰k__s%f_tC5u€5 ܘ\b1o9&XK5pؚ=Pu<ݭ8p7 V [~]Ԃ7@6_qId2;@+ PPRrm0W8ۛ8.Rw%H ;eIdHM$PpE9ڋK"+Sg BUT,&cl󃃷F SAD`kƎֶV\ZR4< ‰T*l8n)57<\_jn]em0߲}kK}*0tݟnZӹ5@vPUu c'Z߱gs[?oL+Z)ܺfMwGScGgk*/ZB@d$(AHhQ*@ W]>j#Y$4_Taf[]f /3-"qt+w{ޥVjYC wq/"rxzd`[u#ufFܜ+cDZm`DZ,aS0-(8ES1c(!Be[e6S4-1p`b*@E骪 @U @!n F@B0!6H~?Ïz# ƶ0 P!Fv@2lK->-+jOM\m Ss KQMRd|Ɋ{r\H$uu- 7/A-?6Q"^""L\ih-m/5J$ :ZjRš͢κBh;ٖi1@mYe9H- zG%GTԏ\/6*fLac ib1rbNe\~)WPZzY]__9ł8XB!_4;eّnY>,VˊbDU\8_"ݪn!ޓ%ep}#)P\l{*> e4GJ.XXI@v()U aKHao XN@Emw;_}Zaqw~[w{uz gF& {ܺ9Jįk@P@Q5_8OX/

Bx" (hF(HOSU IE44{VxfCO}M8 ԰PQh"5b +ԥYE4]B8975b  bA r0# R@)` (YrHт)qK3B1@ZD@ cB*,.,YX ǢACCq P A ĶZ_iiiUU78g/eɗܰP/FˊWrm}ܨ+t E/A6TU zQ3b){т})G-wLT)/ENR$sM1xu$w=@o` Kqlc TUSRQw?|BBa() @SilEU ) v_*B8waUUSrCESjo#q0*۶PTUQ r0*F۶ooll ]N 58%]>A^f}%Xk*l"H- <_ʺ2* R#;dcx+%ybMT%lٲennNU{n|@8+Rcӟ!@ -rjaAS&R\Nr+;r9U36$yުG ECl pRpא9u"VGԮ uM5Ie}g/]y{ h ޱPE%aRE:\I"shSPDH@LDqܻ,xZmOXhRJ6 sRJ_L^Sw=$])Iw"ou3{\"g=@VNJty;Gg(P\*SwYAjW>eJ.R*R"wI"b $)E0AYif \[uI-H|ew!r IA6["}4|ҢĢ[,XV8 eXv3䆃,BT`P*6.k.oxCCE"Aqr wMPzA9F9eE'/񖄼\=] {'O8#QR[U>J?Qր(}"&'ceX'ܗ$RЖ-r\X$qyuE='.[E,Gq.UQ"zj>d*ntlU,cP# U+uT%`cePTt">pEz ^xY}>m#*_ Y[X!iRJH=TU˞%-/w%/ԓ. dKnN-4R $`﮸()DlQ'{"O&s2? EP0q񖍏++dC-@=Yf+r}R$UX6TJ|:{`*Y!Fwo28]["dEa;ʢ{K>,gR%fNIfKtt/G[3: T܌DڭxO3g8I.&Ux>.Jjc'D ,0GܗԈdֹ:E+W/(%g>,N`7"7?)H2n"I863^A2群&GKO.@.JY,DJaRN|) nyyb\?D:5rKaT:$ȉ#v,..+T& $!6;㢩_z>=%B\\%j;_ȵ(' k&\EnWȜH-%.r [](fQkzB!٨e)D,sY%6VoqngIjHMS xjʤTif pH-Q;έm-!a= QZ/*TrA\!%KS^wz+P V` ūDTV?/o UJ[xOp+ Ai$z̹leD͂,/ dՃO5I]P؋ \)@NP)UV\&~=٩4y_tĻ_8/X"NK12  K  "%62,'g]R\C7"'nCB`El"?EѮ$zqO-1$Rjaʖ==3LC'@Ɩ1txRDq,$(pyb`grJBǎ@!Cz˽_+Z8:&ʤ(e=n' O1P/ "o+@]jHP[DK8ϕbV>}~}[ل뚧4ȢR"w`ypfQ#VZEa/ezB!RE$nƂ.t][i(r.e@"(hrͬB6W1|$TIJVvAfZ~uϏ@' 5Hma[@5L.f^R(* B J,-ww=?BB"dVHfHZR!eC:eH%,"&(,\ͬB81ֱurI6j%c兡,ғ /Qf-Q @Qe/D@[ RdTy]n*kd~P)*~rr+KS+Wܾ}G]aE۶WV UU @oۗIBq\. cQ)C|>UU ! Bt|oӕ,STVnOB!(E|T%M~8|a!4;;[(JZ ! y˲Bhv,koo羥%9J")~B|>_www}}=xPQR XCnE1~qTU]\\ܾ}{(*=,*=rt!fuadы:/v\k- ciZmmm:^!7_TGAm ζD"o۝*U鑒;oңQpﱲ,Nw 'Fap";PQeŝ|I=IF4&,N.]29C(w`!!g/"p&|8e!ʶO((PY+}ԋ䱏=)Q04#ǂ>MԒDbhP' @c7@m[[sD_V]é0S#{i)M㪶q+/7G餪 o\8}m)ug*9VP UI-8540Sӝ AP,FB>uT/@K:.ʪC* G #'O:@\W؃ e9`sa/~[owwfm/>#F^&cM];oȅyhKln_bnqzz&o! 8\\tDhˇ/M[:ӣ'&Kw&o7~_r??06_) @U,LA;}k7XXjb\zP}[cXl (B|a|n૯*Y |7pf`hv]2Ţ頻wbP4۹SG>=t~bޗ;R߾ޚc@wwbh:~ؖi1 szCUƉ?˷5b9 W/(FPS㠻jUr"@`d EBd1m˲K"9eЉ&|I :Vre͒\rMX$Dfnέ[sj-6&f@,GK ;㋁X]}"2}>p`&[kԤEkj~՚)T*ff {BJqj7utԧAO\?soUcsUdM5;3>>SƓOwМe[j> kn" eRA/ G5 }g9%ٔgM,_3lm"Vܵ;hmCs Lfa3X@؜-(2=:<2hmw6%_ѐ:nrG~֫B.WBU}JD챸 #@9Dg/ e>'c.4mXјpSO鯋с3g7DPB-xsdjWw4ԏLF _ *>b9[կz_2 ]?~r*ܵ;$">1Z8~;?1{ߞ/xBs?ؘ͍-u5a'񡫋_4f0]<ǃpծW﬷Ǝssjb_ED΍gkO^̂hwo)L|yWʦ* ](=yΝh *G>9P/ͫ;;8@P8ҴWMMO;}ħ}tl8v񱩩[>KG#ƅKɥ/޴uϾ6O@q~rtbgcG&ï?5o\(BݚsWuY;qZbc.N,ڂb#[^GHoTd\<}޷,8{Ｏ~מߺo?87?`)un_OF#sxm~۞}́A6)h~rjz%: ;wN1wv?݇5AվEdԯ6#/R2fܙ.P+N )hzWԦWAe:5uçR~Q1|sś+j,ݧC={_1~5XțJS7._/8ZsU{*pᱹ::!v쉛WO-LKGg{F#,jX6r,ϕ\ORp)zMl? XF,H;ZZ2rk\ c<3zgN}}sc߼qu76Ϝ8Օ3.ς_1{ggsgNūwW-Րx yAM Ȝ=46 zyuf0VC`3J4lOk2 cfn 8g熮;VWFvd g ߜ0[qC7'5uH#u{|gVEzarV\ڝTnOZܖysH׬sg/lۺ>pxÍokwP'ƯL_5걏773'OOFYzlJ[zk]o鬋FHk^4f[ nXZ&{~95?ܴ9xnR -)#w~r Ʋ L;_5:9kKÓKٴ&ۘ 0. _9w[oK mJ1/?tB}-۲5TمKKjI*"da6㓹XR*j,>5)WYZΰ)ܖfFnAy+' BEu骢(X3 a蚦H}k`0ҵg@Uu0tMUcp3Q9mPڭ=T+/.nkFx,Mt潎;0-i^2eUSqf,%0vr#Z&'Μ8ue,Ő]zt ShDgFǑ?iU0xl :]]u#9eGc].74iKб'Ff Jvݻgcx*UW?;9˾ZYLw߸7c +_>k2YʏS]lvC[M(jWMLz>Pag_޾6FYtc [g5>4':C028wjjLp$+m?[xl[kzaq66w 4>skt1ݘͤ57ug⋴"6ړ!4Pe;5=E47!cESM-f8R/ Uqn%j ]Ke9  HJ\9g.uR7A^pLǮWluW,G|/l>]==Whu`mGg jZLw տt8 <)7< U ݸ6X"Lڏ ~=̢V[G/ؒMGRn;Nן>?}yimDW!PUbN_pȱ4YXq)}(zYZ~}HFКT 7ϟ>y{{:Zh}95:̈́@\Z*XrӃg_ߨAPazxpd"߲=ky \F Bnqi)뾀y)uR1&䙁 ׇTׇF[ʼn[E%֘f3yЛX3o,kW%j[3UMOYzwCX 75uߚtshM_s]k>TTUSջө7dW9}:PL[O+8'`rųkQ*:Pc:E +gaE%Y|t+ŽKqºϧlc4jd҉xf2l6[L]]2 ™lS..JgP%˦m[yS˶vfkxMGGh[V:z2ĕ>8xcb1ھ홸zZ5ul^޸wF@}-=y7t3/v7wn_; CyPakǺrTD<|Skqя?nΦt_G> ;ll)ZZ3Aň4ݱy͟NxWhÞW_>R_-BBXBhz]=K|[mͺb$7?wL3[:o6@Sφ˛5ХӇjl0kX1/(Ǝ:0&W cwn$9 gMC%;іҐmsdP5Gs(hj:,M3PtCP5M~tjLfgwP~Ꙇ(QM%B]|) U!3,HLQ(@r|=I!#ضfK9% ;TMD'mԷ/~tĮ&Rт-ݫ[AC`4Y j:{Sab}~koܯxGwoGs]]m.SW4T!J44djP, D8N%Dwݻm xwu_Sm0d&4uvեxM};w̴̺jN Bh3L:#5ͫz;2ˇ}۷7t`՗jZU+(xKgoWs,Lgj!]?mH'D&K{?m[6uFLuvԇD2YJ:;k`4ٻ1)聆֞Umѐ/Zߟ ,/Zf{wm|̶wu5|Z}uߪL<'2W5tE˳kDKˡ:!W3)(]z#eU<R\#8@> O@Qd]%9 R$?`Ɂ?AEƦL"Tt_.ؐ dI#t:Kk-( A&{vwmڮ龜ٙ퇳;ٝiMI @h @$EAD! {F&C1{'< h C`A-YyBApò-3Q|Yńy̴,l6q#–Wp\fߨ L.zn.=;DBF񗅅l&[0p$ls&7纎gXVOق‘h2LeH6 &7y_EF!Me3ܭӽ ?O#i,@l(\qmqΙ\6< GerƘfr0/nsWpo܅psleH$d2񊏘x0My ôM. L:uc!kALp˶8c[p&>1*459#c#ȟ\.w}fuTUHk4y7 B_A,u-gx*|1Ҋ;c̽+݌lYevTlH1jeɀeH_5TUR4UaP8VkkkW E]׸FqSAUyFU(I 2M*@ Ht["j|r%L3YA> @% >lr3$MP4O5Vf4[Jx sURHCXJ\%A$wJb,ŀiCGUUdؚ $Z27Z9H49(WȆT A`$+9\ӲKu6`~|Je|Gojz֨S4FV$F=ROd"]SN\vq+rA}eQE (\J[N*["$ďR6nҠV.A@H˥ 4`"N_I<:=OOrA3# r ^(˞X)w؁!War/W]]!fbLJ1VhXdysN+U)OZO'ʶʺw2&OT4Le85y`v`}1U:El18A<^h qQLݨ"V>9AB*Aȸ R+0k<)@`T! f:Lkƫd IFf>vXvvR(J{'%dTl]8VBfD/48* xhIepUv58+U UJVACnѐ%b44m[?1 Q)LH$ACoe$k!GYr,$ NPAtb2eզ$U*sOА;'4dVrYiŗʒa"'@#!=0,>[o5)[p$yRcʴɘa(|x\e&H[5 0Y, bUzsP*ώ UF7PqɖH&~ϳ B" A )u \IU!  [_VE0A_I?p$iJc$ B?˦5 LQ(Bp4.s=Ưrs@Qu>dlsh3R^|I^LP @(\A9k` 컯ޖA*e>YA_6 V9_SAC0RyL3eI XX!iX5RVg5nW:D5`R?~wҢd%*ae ;NP틌YFв SyFKye`*f8O~| D`bR{'mIeT?U˱u IA}}y$cʡ cc~^4*/# b$$S3!#Z BPd!GKت*_IA֐ DQPRGU@ƟĶȵodz2ݒI+#n1 xAQ`pKJ@b O6%TT`r|LQ]kW^?yIJ$Ĥ2y ٥΄;tjw13Zg" iʷ1T,5-PPnI}LPH4nhꩪUt YĖ! ewEƌ}2r?9(UU2G%"i1rW6;rh<+}"@P**D嵸韂Pɪ2TUVꫀ;%([$+W(AKqC"&×V7% GUw/aZbh~1P@d<0 Lh|S\ɪ-o(ZJ L WAؖj1AUI]\x@&AMQ\-Ld Z6 [\m RlO! R#)Jwؑ5F*M UeK{c}{U~^ Let(\jZ H =rS%RBp5|?Uu 5iLQE3|VU p  `ŵ? TFh4YH},y9xJ!H渜doU5T?0AME҈z@ҹBܮ8XNɅ\j50*Z_%ҩ.lD_Hv y-^A/b A&9 0`Q.ebq_5`x$XVfizU* g"K蛟^WV*ϖ^s.:\6w\bsX/!sT"X4y|e纎1#d :]q=n ـ 757_h< E * TyUM$`4m؇c:`YHo\' .3H,D| T*P, 'HR/u)>? y.c/=~Sfwn뮍xNfzblPu7 }˜ǥb(rƄsN޸mH Sp"Z!וp]0_xsS߼p^37ރL1 LFLMP͆^vc/?ݿ\n&DCnvݻP-p3t冓HyֶD2^&=sݙ,oimH ٬cF1dSHfO$A6I ,K-\Z[dh<=KMO7ď֮[۾Sc;VCk{sCMӣ~oݭ5-/|=eԶT8\vfrqa'it&[ps3DcKKC"bqfSsOxMWwgU$xHɅ%ڷz=i<'pI/R\˥޹=vZZꣶ٬ SGKOOXF6=?919 Ƅ23woN;u-udB2sܞNU --;^χBGޜ'c!#=p鴗klm-3^~~|l±mɰ9n!=;5zAE&ՉX2[HͥNϭ`A_B~cM s!CT%h1)u85%tAP` 'Z7lq|z R邑|aw`Ν9_;oc>9~s:ص'/6N޺tKMJIcƗt"^{z'ܛNs;:~@K$hmlaxǼc{l^ɺ<\Žwlf=Q6ԗy^&q;uɛh4T/uvЩs|N/=;;9{+[df'Lλool?wF378ܚ}m;oiώ]5_}G_C Ax 4Q%U!H|j`]3?0ԟL z7,/޽Q~g熪9}i6;Fַ~I0,tMM\l}jʉ16ܲq'o?W׳kś^zmm#G^<Nzi l.q -L:  ٶerܿzpǧHuoʈ'{rͦM?ɞ̭W5b\D,8s^*V7ݳ{sShȇ}sm\Bd򓷷V|slOz_ɮ^:nڋu{{ѵ{^MH_aQ!*"5q ! ЩAX{EE2691%t&yx1oKpޑ-UVk_;)r?~tжkǶdm"p{O6ܳ>N!uS.ՙ驁Bo>?t/N\=Cmn}Fք 63oZjb]s=毞=/B/v~Ѿާ\I5kSM*1]gǾmmohjmjLm==]uIQͺVЦcugw.ݯ֏l߽u(;}O>H4۾:{BGU5 ̃py 5/8ZϰM8=Fc(M(,q"_'+ 3 2o8u<}:yVupӺqCesvU˦{YtmW7646x޶jāW_|p~Mֱs|Ǫj~֑臿2{z#胪[݂7PowsDh>t_{?>uҶ֚x~n#}tbז|q|٩_U>`Jl1! ˴Dv⩃Gڞ>ydʴ#ė>䳫]7oH>|^q̇۶JD!Cd;sƑmM >?;ٿ+Y?s|s|oO=Η_}}^Lrbo\kkp&q h*{-1do}{mlC̭/Of+L*6 dWjd;j#[UיXo??~ꝉY?b;?V{wG/^әp'ͧI?;E׭[[M\m KfP6~ <M+HCRP\YT!#9g3&ljv|l=ozmgSuڞu}QCཇ#ߢPUsT/p$gBPxZyW5lڸ9Ϟ~P(84sӳc_8y}l63>&s\s6P(LiCuoHئW84tC"桵 p&2)SH߻ɯe7f\1!aZD8^o33`٩ɩt6z̉:ۛcy#=4XD摡ћ[C!u]Yշ]n>2d>O/=5{3Z;6͛{Oox6-۶,[eYV(m3/t2+' n#c\xŒUw wfmsK}U({'e$۫#eMlq+.$G̲=ut@h?TVS-J[sH q"554OJ\湅\6{ Cm;B& Ƅ[;nh*\|06ya5إK7fur#<;moڥޝy믯v ecGS(Gxlqt:T׷V?p#_c]7Bo߿+6nl}$dMâ+rl3/o M_>t{W_KGG6KFx!+xGlώ^ܥق㺅\&cήVo򾏎~y'~q;7sL:ͻcs \s9yN>/xB0R7/]<o/|s},:yȚSWQٜ Ƅ2t[S~/O8vۻ#/!į~{аf@2;=%Ґ<x[¸53@5Lqt +J1`V$پv+gN|,"<ۻ7 }ݰD2)"_(JT%!Jvnضs?~{č|!֞G>gqkú5P$LlZ{z_~{{ v<o{mXc̰"D2jZ:_ޱ!ijNO{{wPOo>9оD/8+m PsUzH84x @42ðbD2&7,{`㦑s7GoL=Ã[9x-=WlH4uI{*JCٶ}˅>?>Ss;ڦq݊ƒxq#&p(KM_FÑDUҎ؆aɚ긗xoFgCf~I 9zpo;|:8km}u׿:l}0:64Òi۟CdUf__%& y_ʛ?d4^ѿv`omU,niYa[olmJZojL 04h{y|o`gSS[W_O+/ j^VWTmk_xvm޺D ˎ7w8^8cf8_nm{s}c{_OGŜEITl*k^{ϻ8\$jZ w5'ummuDu}K뺚j[uqǮWmIZa Z{zmˬnٸuۋTG-/b&'[ i5@ M2A8" Rȫ[xLۆc\nnnq c yh2< ';7v L0|f4Z\pΘ0=Oq2s)[h,[ oaW C+>.d9aZX"b1ͥ]n'B y3msfg̊)뺂c C0&<1n,;?uy4[16;z}w/ۇ[p,,K/UmN-D0Fe} Z`>߿Ի[[[  T*\͡crd{\*kcX2纮 /NHp;g̛zmp8H&Mħj< c0y=o-rVQfp/Y";8nSSe8+#-ebxy²Coz*neB (aZ!>v:lL8 ӲL:1nicE [N^j;7n|ͷ8 C2ʉ < 8O,,k*mU€|&m 52m'|.kYQc??[e10Ι%S$ (50e_őh8wj3x8fEײǾ:! NO,ڿg s &i>hñ%1>[ 0| PΩ3CD/.A<Fcш Â1V*)eL!%Ec> A(XŏC`RУ8|lNHh[J\_PZ)!DQy=vZ?K]Rd,:l+{ &x43 Aq0hj+I`c{ݒ"I7To0)8X,>U%`XLN#Ҝ&%@0+hP42`B-K70-Wp X,L& 5$uZ}UkS-ĆO+ 0^˫\BF X;H h2sT8>,&8xN8^k%Q|a3"]$ }":3jV#| +?9FQxA#ًY:Pfy 1}!R[W - :Y)8`fUn~g@ʳғ(=-XM5K0A )|K*2fCe+WA]#$5ۻȣaw"_F[pƀUX '_ub_AvI1L_6c{ j\(I9`ib3,ȊĊ CFՊ XSSo` <:./pŅIz8z;r_ $Uit]BT> YW1rE-frG+y\6*+ 8E  S2 `F^\xV$3W/E_H>4˨@ƒ֢* V#)W1A$l|YqGd &]"uU @,RBp4T x c S%tb?G>& '%y;6η!AbI`[U#0d!I?I.VBp4HQeY@җWp~?rk?;A+ ~ aer$ #+;b(g2p HJ (A*'1+є`8 *WF<9s0ѩe킴I`_p`V㼊&#W)"yF׎ʈ$)\"ZRDQO 7:`~-?A ˓LAj55DV|!d=Bp|(V'53jpqȫTz9,C%Ob[2/ +/r> +!΢AȱZ fbR,]Q]_L 6Fb2x0r=5$Hx hᴑ%jcd܃PcBj2\q]&k(o2ĮƢ*PʢҘ^,AVJ-HUmqpJ7]LN LU4RFKUMVI?-tAWUtJ9sdФ!k5y`Y OAʼjV=]B!^ 6Ku#7mt .zr,kF9Aqph5[:, ArsBGdҫ>j rR#CVFRwShe@IZ#,; pQKHxeygH=2fٱ0)0อ|d"edr  \ RN`RKUQVwEݪYet01i<2". G87@$$6^)/˓~Ȭ\|A@NԆR 5,xM#nlU4[ ͸3NBzɓ-ʚduM֯ߝ !MސjB6Q_?^嵫 ٌ9Lf%A:$V>O@U dwB =Ny#eȭ44Kz`/|6b J*㑣 G,@rx4= xUTE#@a2A[[ !!R!|4`(ˀO4HzF O#Uh t#5WdH=!A_H.L:k쐲{@ bBp9 t,H/AarZsdΒIW!:(k0y@UXi8&ꓜ,dzeu&q2ɶ@ךH$I HV(AUܒ3r& /MjGrhrBpu4Yrz&UNo<@)_lMj6Lc 1*xlj}%A\1F@.*Uh.j/aUO\BПYAΞdT)gUj+|Wr'u{Hba`Ko*n# ͞6O 41B|R+; a] %.Y!(IOBP5d}z ҙS!VA#paտaGuY4gU$7П}rO"@P <$/4ȑ'HF?:pـ*TUd6+cQSLAr `Y^!VAQ)$+M +f eS}P=%- F2%XR@w]괄q?k"AIҟYAliW8?Ukmi?C!"`Ҁ$&o*ު9PeWVrA}a(`U!%zDjS "V!|4*8 !>ek>T,*(*lv=.iN?_A pTb!G%cvl5EP>i ϵ|} doeŤBp541_3""R-  vJF]y v9ANP:A<AMWjiJ`VA<9M;S_NA=nѲQjl3[w1I$NR UcUj0֌P+@'i*@ɄһoD#hI8%RY B"WaC n *H~|B:VnMBi9A$ UQWY!V! @T^ȏ4s$qЬ⃱tMh Av}L\`kbB) 2; *p`wlAGWK6U@ŶD<2* 9(Bpu4 VBl$+u(9_-(ǽ x CHL}aFY@T9<'{?$Aյ ؈-A je&TC_7qAZ+W+Ag?d*2Ei/F:b$$$`%`c>_ deHj"H'5d 5ЃBb&i cT bBb3H VQ`lW+WAҐWO됀nM$2U#lbh6r2\ra0P&Ȭԡ &m1ɫoo/&[UѐM$T}:7huq1bZ,(N-`U~ %03KjqNHr$Mu्d9 BN> J| J!L 9 fK1/m6X9d#ΡՒT,0D j5U]S/d)XLHȌN&Bp55'  )OH .d5@!K.T/Q][&,2S< $ovI80`HlWV"3Qʪ п I&- Ѐ. F!Ǽ$76.{䭼G%נĦ堏|JZNԇţX@^"VP!2UJ! 0V4A5ͭCS9Y:5BpE5*@eyY*C@zd2a 9BC%q2teMubY 5VT,A>a\*8ltR vU @Óu HK S$, D(dXΉ~Դq^v}'`KC"r0q3*R$Aծ%I jY%;w96l bUF<™W2Jं4STP쨥jq\F 0uX *H^.|wB'AO-I  Gj)ֆO }$cM5ϑʖՉKj& sU=!AeWLe(T<$bBA,QEW  Pٖ< /$sBD;Q}E _H$SG`%Ad|̀j,\ed%!ԄHEhL{ 5cT-,[ׇMƉ&B6xUh^C$UU'G0Fn4Ȣm0 Liw$R DO@0}zzUB>%5kJUi.TCC"ݱ~*2&9W*_I> 2`TH@s-' KS zʚ}fF?4cτy〦 3O^R5I543|`px~5*WaFrUSXde)+ X.Yqf{acB 0Z@@?TЪ j ɤ ܲP(sNpi;`"\uCIRxOI 2zsA4Fd'Ux_@ j &cSY ʞ4<[US&y^?!¸p]Y[1ak֬ B> 06dJ_ B0˃%,O3eDĊ< FhBBpה7iQ-[|(YԆbA Io`sQ˲ $΀c=x+\*W42^4(NւT:dp%z/vQd/iX&Lя X+ 'Xl,D)BpH؞|B!GyL!']4V\,/`[ cWjZ)`!KU˱B3e+*%xL.-.#F*䌯 YBpiflNE0`q+sku7pe\˼ ̀蝹/z*AfTzT˪ bbiceEii,_B- K@=`Jfݯ Ea[`w4# /,΃v p3'lìoFNX,I*XdWU\Z@!8A@g-6S{0H>86(!T.HhU܃$F"u!XJ A L8?iM6y@[TL=hIP}G4En YdA)<#["k[6'hYr\nUh5KH1`.σ󑬡IYm]7Pq VORyٜ/ 2,cФ*"y> r) Is521`OUCnz&*VЌrx%VB6f͹dQT 8Y*Ac/*  RT4jF5Р!)`a`GϜ: endstream endobj 652 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 302 /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 1 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceGray /BitsPerComponent 8 /Length 783>> stream xA 0 =" ʝ<2;EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$EX$q endstream endobj 653 0 obj << /Type /XObject /Subtype /Image /Width 600 /Height 302 /SMask 652 0 R /Filter /FlateDecode /DecodeParms << /Predictor 15 /Colors 3 /Columns 600 /BitsPerComponent 8>> /ColorSpace /DeviceRGB /BitsPerComponent 8 /Length 64449>> stream xWw\G.礷HHx ADJJ*Sꚞ55O0gf֝{gMt[<=AO&Ho90rȓ P18;D$ QRU!I!D4 hMg},ehE] xN};_L{gcڪ!bN릠dk`Obl _%24?iNBt拹TE^csa^d2\Tabb@xuk== r򞡡LOax!Zx^BKt~л5sS^ŰWtפO 1Bތ7cFʷ[|LCC%TFuHBs4T3qӉkD?c%u+nF+/$p~G9 0y2?VdhbTL@ sdRP;k p y0:uYrz^B SWwOKZ)I BWI&\02AhyDSq?4x 6`hn? >)KRvϸx`bI3W0- lL1&$E&c*\"?%Npe,tҼ!݈O%xʸޫjÔ'WQ4V0$(oReӕ kdV<- <KO]ȃ> 4QZw!X!a_$tE:iL1l8 /oyEwa%+ktBc> {LW<|31 YS'2>3B.}"T$qzFOm >P`%kFc#Eӧ2wo üp;y1E'D!A(n\'O`-̂:D b#\dz aI^lBy3+A<`-5FV1ΌUPۭN6$XYaN#'슰0Z'4ӟvXpL08eڏI>z9-k%4B޶aLJh4s1))Y3ARL8v!K&wSVsc/ m-a'#f9Zv3!D-ْMUKJoDSUEUM&RKD2[&Bb>H5E!lK!$M2y8$"1[ X\q~$IҳA`<3;* x8Jf1TU1Jfe֣ P$.LLv8)ޞaI`z-XKQdyH 2w_U#R 6  *ZkKok4˥ţ54Hf ֦_{ٟ;_u3[_}ktcז_, }?|%皢ˬC!<,dWӲ[oqΉn?\K=vִm{^=Ѷ彛Jß"^'?są;c6oc1дWȵS'N ohWv)}}`.ekWa4B™CZ%`,e3%8WA0Y, &=z)g,TgZ9-,[2 a[(:  +ıHX@syWK- `4`reus؂jkZ:$Hq!/[ۺڛ]691qg9y8517?~C'犹S  >x&>v{*gʙSONɃx9HOӚբ`H?̺i̐y_e##35IDJ3cw'M?xo_kI?|x$k6hJzfft6#olg_YܽvʣDϖ/n[sšwA{ndth\"|Mmvyt,fjh_HZ6*ȞU V5}tbmln=z;L@$)pґ%j$i4A\hu+ 5Vgp)*S]>kt R4}cl4jb?W<=,6a !1 -I[y+Ma&v2͈IltYnSBR%GcfwSgd"Z)0?;*ɹ/>>x7`'S[὇B,>?=VKZ*-O0GǦB^RDd<6=Ό8qf`ZߴlpCG<9Y{u!#znpKZj g>K)`lB&IR&F/_| #f׭Y {3;,pt`d Hf N X3jG F|?[aZ*d3\IxVIR!ei_gΧMl2[MZ>6;'%B4Ǣ lfREgy>I+NMG%5zE@&3Cd6ft1Z!=Oӡm^EX;ӤL`o |\~ʿ84 l(l.l e6Y3"H:2B-{ i@ v)~ >2J=W 1m`#siZCU,x*\^YagM\, Np˗Lrк=C >. P< 6@dL BS<,JJDB=RÔq4Hq4f1k*,&2@SN6LL :˄! Aw0bu #ȸ [̋ \4iaoE1\E#7e$Hō#_ A"tA=jP%( 2z IЈg}a quޕV›V5ao\dy<-My]Pݚ6gPX+21 :% k|2*!| ~XJy)Jπ0g 2Y[Q:[TxJ $ Κ KU 5A׺L >w᥄KĪ+9'IX'\≏!C1mϿN޼ : P9) n{3s;Vg,|T2*Gg| &3d9A1Q'ga8p^!T/KWmGe5-fk @%'5 )>#6U˨VX'`mE,hڙeN|K>!.@4[f6-FoxFaKknixYh z\'hPf)cy B>7ݘ.@?[дVA_qpi Oz!P\?`U)FiCwÃc Z`!LLyr1AM$4h˞ X2 2,/A-'x2 &H0#.bm 0O &MO@/ʏ<4o](%'Wk୑V "q{}icmZʤɜz]v+-T"U^j~NeTV=^uF6t&3jankwS6KOkK^eD4Z3A ULخ S-#(vHN&(ړl[셀3OaD {9/ix-0w1AŚ 2ac @ )qR~lQ;~lE؈ $RFP-d;rt"sNKT MUUA픦iVN:{Te<X^%ZL>uF$Is)lB JX,**T,)4U)J"-f$Kp/_AWkg,u+ S"t[]I6 L@|K'SF(6!̄wDz7/l`fӫ bC iCXxhl<:n93+9,KD4d|.kb&529^]&l2g2 ќmsN[Vnm 2TXb":\NԊt<!d6˒%j5D+%l/>:?1䵔bm :ɘz.HP-dSssq},%Eb:̩obs{Gci޿h; 6"=M&Z&s7j13?7UL`e`5unrhj>ilomU%7>hhmm,dqz<6#M~Az,2 fX/C4hܥA.L+<04 n^:y .Zyrw L&e@ Te&/TӪoBGU=qҵcєڼ{ߞ} 6iWg^;s}.W(jˎ\hDZ 3w'_\kQ?~u}~!椉{'>.kv®-ާ0kgO3: 6^u3vl4g'^>[jܼ/t75kL dW_N]ɾ|Kegd7xoܾx\t~!Ҟ5nqK>͞`ƚ69>e 6zI~ Wnwyqj)5uɫwc/!p[ր^BfO'z'FGWt< ApHf3bq:AL/b̓c&D/3X9I13@K(QÐAM- H;D$/@i"e!|1(CS eT\ƽ&b܍Ǟ^uO\Iڂ>2pDZw~ߝ{mjo/<|ʽƭ? jM%&-paRtlltldXMW%W7$˚Ij11yD}ʏ]ӋҾu}[vCNwnLƦb3Ԋ|tl2ըݺy,jnnIUՈiD$NfKDQ5x!/ (n8AI:皠!_VU xy,`^_1Iqu x1Zr&x؍5Kͽ{GNtbf苏>2/O޽>_XH;qd+O_(|2q$9tQvwKkևӏg{~}S 759jD$Ilţ'߼:)biّd^zVLOOMHtvwu]O3W/Y_xu99gggN2ί?ە+^I5}o7}_M:\ H[kkhw9>x:?ӛsw~o}ṕX<67Nɿ[oebqX f.]0Q \oÓLUs^֚7~ɦ֖vUNxc4 tw&LM-zzrq$5/;֭_[ᬽw~ ٱ77z-|筽-~k jE6_bY77x7ymRb>ٰ%(gg'dzΦUo +s#E;{\.>{O\߹e3/RGNx;C3'1Kg/yc0Zɮ''7mZb}* "Kox[Df웠Nk.K+ZnN#h~4<Ы^g&,#>0-'x zv{S;gU$"&h<.%|5%,mw4C أG{{Uo[S5GgFc-Fshqg]&cIG`k͑KP[%5jǺ͑Pfb31~Y%'H$`r=-ע*O@_ܹ(E"aJLOZYS29տaբh Gi3%](ldaf^i^vU,5Nf;ZfY%31p9)貸y^3ѡge=L-/(}{yH7~F P 8C]]ju~;V^Zu|!zYfpx,1&˗ԬNP,DO .@#Vk`6'Vx%z-LCI<@06| e}Z ԰PgӚ&ݴ09=29#얩lFv6lž~p{nK\)b>H$&Ǯ|u3+s)ߚ6>=1MUIk)>35:;.)ʞM-OwT( |&LMMCw-D{ϗ¦L6~N_ӊ$JX*SӓV_OAVm!75Xg xqaҙE݉[nXұI䵩əD)Y$(dY`e&g;l.e7)b lă=p+[n&K>oݾwǖuVL$|nF(ٵkhnt`[ϖ]{hƏAUI9 WA3BOG{e8x7ˊZs0?,y*vt-؍wP^4HPZbGѨjq6m&yf.:ϸZ=/^=^('ҫ{Uݡ/~_3aiH"з+lܜJd:n5f:aKhFݦb|f2(5l׿Rhr"ݡO|ypk[G[N !}9n XYVo?Y`|n>^hli4Hznjl`45{"k:N^>鿦L{Cuh)ɾ&`3M'H%$n()m9r1KnLPڍ.>L3ݭv]$,;l_b6_uRl67lp{Ww}.ls7ڹk3ˆs)q2' F3D˟) ~Mo CG’-4*Y|3˱4G@6&>d (>Vۤ`nwV{GT\XH97oh sfݼ'Ll21?7?/V5n-H(շnæwm].e5eǖΐnJ|A|Vul߾g˥)յz=-6,$ۖM% {۶oݺ/M$4rXӉxRw7_3ɤкi󆎠$kt*]0w߶nUf'B>_ZWZKֻ~ۺUk!L4kP[WWKcffocQ[Ųjwv6+M;PkWW{0!$",_-tX̄TR8;:ANd3LőWF&㥳3ҍְZ5]JgƈT+l(BQ563z- .Q|&S$e!\&ʘ&Kj.L]*9vYee&ojn{lL"z͑j~/?K@"h Bߤoh mq3¯V0Gm+~1hd!O p}1Ϙ7?z!=e}4cX`{kk ּR B8cF#_\ ^-/ªu;.!(+`[aU⬸kҫ@tSԟu[aGg%BkKԿtxuK"҄i8O:LŃTh_45>1U:&uV!*҈*7W;xmAb$bj$ieVm:Q`U#(z6?e-?yֻ_ 1BN\yhN"5pP$1ք"&HVk,4ȴ&(@.[1GfF IA@iv $:A?m<Zyמ@ 0@\hTnr'm%4x2yLP7$nb#s;"v HH 'D5AEQbXOO\1,H^P An:ڊ|AE桭\ae Z jOz8z,iD=XU")#5xI _Py&qzGTKx ?a:y.3x][Ŕ|KRXĹ\dg+ggb9t 0dܴQPc^1Upcj#Aę-P陃y&CPC C*?R%gAPeT<yڀ\+[#ڊ \Nf >V "3Ș]]y@t< e~E4pgkA1;Ax%*HF.EWmtIԥ TyH7-PٙUgp.'8;4`1\AĥM0 @XUAAϓV*˃~ _Z+d0RؘH*`ŅπQmy[|6 LtHɓH&xw|b`iX}$ J?㤭`Ч=\WAHO=h@U v`Kh1z9p Э&ѡ] EB9o}5t/Q *VTL'yqK% 'Hc ZDë\Ie1H!5]7E8M+fwXpcX s5ց DoSZB*oF5< g- N8vx7ȠVՓH gTKgZaQ'q4M|--hzN (V" 3`#5㵴gxf56p2^aŇ}v\ %? jN .h(5i2:e'(3k7]x IK_>xw2}F'^5 %Ou%whA 1HIV<5`DϚqx$sFVbSA[5:A#e'($\ai4މ0{EI<*nd`T<'VlT0-<.2Idx*V\3e*uqWAP4:0x V#)@/ h^u+`ٿ>C(10+5$<1?bE\2t0AnD,,C9ӐT~#1/`Zc) N p4& 2u~ Z缌U[0NN9;6/HyՓW|hd3Rr( OyYWE5HǓK(OF3@mtV5_'F%>xaff: -c$;į18A@@1I?Fz[,t#g*ܹ+Wx#>kdDh 4љ ejcAPEwړA[T0mg)@X~+~+P0`<*nD3&!# 1e jba":yBgxqNb<\3ɬ Lu+_e$8.X |2e& $- L\/0h+§0Xm01!زu׎Hf.BbgOWݽ3~ ݛL3gCmA7Bl{lj;B^ ]yzRU #w.]1Դfﮍ.YL!l A~2$A#@pavKFMzÛvjv$/4o~?:o;|β"Q ×O|tyj;?{ejGb6W4YmVI&Sv]T4~G.~/ol4[i)3NNL+HW"@~EX$0y6Fs4M&nЙЗ&Oxf:?;=9+hsK$$Tl|lb>5#f*d#il6=MwKCv55;w.M'2Oa-''&f @m3?O i~=kZɡyդQ XQ55,2)l5%pkKaFn+طum5:e5?><4K%hp$ R)0/M~Y)KG A9Lp[esS/=-aŤғcikr|IUXlk"x8[Z|Ί1 M D STۺj&hDV & є^T9t"hZ!0=,IjXLD556| Vǧf拒n۝.IVJ?[KFW);{cݑWDzi}w0?3>>5=ͭpK"Z>ΗTMǣ)ni zeB$Bمim9-MMŦǧ%](X.HZhv"=I^}[Sm (mN|4A TW4 FXy.&CBlin޾um3lL9vh&_;Ks.<~ôfo]obM\=w EsK7~͖sE6}}||[|om@zKc޸7^0KH!j#W[ Y6RUR΅NMo/lP;vlV*ƆGԆ3wܸxpOKUݲW7f<{D* luSw-3cEWdAy|q7>boО|4lom ߻zӉkӫ^Xc IˌmM{voqׯ&/goEl&8|@D1 >$>ubHpe'w ![wl2e%6rб;Y{?>2VؾCSXɷiǶg`.>s̑勹ӇO]L.9G.&m];7Y?}/uO$?`x\q̲,Lff{۟|^,ܷgܛϥ&.~JYZޙsYqy@/|/aH.~?~ttM}`7R#wh o+VOf؈!kXFw,Н N;zé"gc_d_|<I$d6kO>zcp:>7vޟno^hj2YMÑ96ʱK>^oc)7~G ;[wO} L|'owњrOܙM$_>'J;7G?˱ss9gss9>542U$di 8ia}:sG@$0wiN~0zgX]XI;$(h2}p)d$k C>l:ltuK{n[J/ O-X2DXygk%XXqGgLm EN >|MWeΞ=7q붵^)z>ڵ* QB2+ۭ"=7ϝ9ί~n[nY[_oz_l XŎ-I^~em.ݙ1Hl0~]J^,^o~#Ieu}-ă^kOSBjEW_[m}Sxp?U͎P:kݰm|bwg8`,07ڱt 8V*`;{OƁ^{+/|u{<;nv6ڋy[wݟ*7Mo =q8.m˶oaWsx\Ŧ`1D>TM,&&=7#<ɊjD0լv4m~XB9꣤cI%Yrdkvem.6uŻ#t2vohZ-{9~?쮗_{m-O?N}卷dl%s[Ѵc SGG=W?0MFpk<+pjR>+%M#OW]Mk7nj7j{~ߙ#S{Ck6l{:"kw2luN-ycխIqڼ̗Df5w޾cMWmdYoMoSHvt֮km + P,4b2-&YS$_7^~p]~p-YSWGk{oھpss=u擙RI5|=mKRU&pՐ]+V* 1t %uH[lr[frْ>˲l5˲䰻l_3?/:B}}=I)omæPsyX]n4^sifvzlt|5׺_l+]OշG#P'[n;+K!3zh qW`M# ")R( e=ywfvf>G|gvg [lK(Q)1'AnM^*mHvݓ~9u;`XFҭϿ$ɆLʧ) #W>/tz|]-+F!r,;y׺Ö?}ogK>ɧMň=צj D;sCHꎴkZշzmc0׷N%ZWłd+_ӐYoo4` DZ!FY4f(ϯi@ ( cql Y *Z6:|R4UlEQuB T1@EQ0º`옶OqLKQ,|_Q ) @3t"8!NEmT,JejYDڶ7l! +0@ FCaduU7/;ikvw{lR9E ȱL2ǶqIַ޸}oM5h*#1B6*j$Uӿ-^]'hm䇎ئiٖBNXl`!vց،HD\K=`-K xxɭ0W+Bޥ.?Ydf09~!˲gv垒ũ;N3S4-̥ق_#_z&6 \}󳋗5a͢Qs}_կN&{vWHԥ@"ӿ.,-ջ@Klݱ_|洱֜ug.Ե/?txu-\=tl>lMB>o1ر-ӴƎcG747&]O65>5HojnNV/ֽIAi`0b`#4M Bm;[lZ?c_˗oln.ضB,Cc&p27I3 ݊ꍗJI=^DDo0D]k{K*(l,L a XicUt\9pyf约@CCKm*ξE~vlT0;Y,`G%ښwfPM]q&eb3_~׊R?X=P_BqޢrG%ej 8K6V9X^ )=\$G9Z8Ǒz9k7*iڻo>>a1wRO(ڵO2f2Ͻ_z/N·}uz(Ǒ@@8}`4~fyqxycl,M;}%%""x!6tBƓɠOWD ECd2 ZKG>xxh.ԻvuwCTc1#Z Kĭπ@,"R&R[AOQȣKCjH4ٗ*=!NjT}p2 jh< cD$Ȳjho`"Y tGcjmkqoF{k /^ol2ъڹeϳkx" FQn{~sfmҳp7jKbd4ÚHP6`VFb?#[H&9QU#Ȝ8S7{&BPU/Xm['F0R[_B$׮߼mKgS&Ʀfs{^yaLNMM_ܳ?u_5h,VYyמk]|L2’Lc[OWGX2lgOOKk?ϴLEablRWMwD~|]֬. Up:300绺cc P(!׶ZՐIlgwwK֧2ɘ0[:{b~4Yզ8rZ}mmKC0PT}p *!q*k (򅢥m#i*\(`(dY6@QJVt P !!}UtMSB>_0 r,޹B誻l]dKSzZZ\rE ۶  FP'!@GV]ES/?z-Kj#!NbӯZ"x ڶs͋.ٶ @V B!,-YE1P oqߴJ&N~ONoZՐe;%@1B*@XVTU5]ӰUX_("% }:@c(LA38/  D S(b~"˲K}>ߺu٬b%S] ,T2JmIaw&tqR'&P(4??mT!ĥݍȱPqRȱK?ޭi;0P4MV郒@jZtA. *}7clA(Š TTUg(*NJ82zd}CUS!w着 !rl99`8v7a*vJQTrj)u]4:S[uEm9jQb͋j?&rFFn:|P(~Bql`v*8VU B6fP*a :gB!T[KGgo sޥ͈** Ni*6 PQU"TK8¥լ*vwlǖ~-``8#Bh;/TE-5_Yl)'y5\l,2$e%D$"ڵt9N[F[ig,`=N'{ns@@r(*{ACKVqߟd ٬1f9.HW 42@UU~ ڶxiA`.͍޹3Z M5ɉ0.%/ c"IK6zK/#+A֓$asxS{py$bP~T%Og2=iZQwlq ?G x|^xp-׶Ltyz?BPnh%`t:JQ%UFnRIR 1Mv놮A>uޛ_w`,k DT:"5̫[x+ 2^c;Mj ^/kFc.R2`[aYp])^1gK5w+U]?-+c,:y'Q2)ۭ<+ܴ4%dŹ $3p+^C8eWcDX$ܴ -%nHxBp9uRˣWIrIPU+.2]vk{Prhcz*@vq&3uXZMurQBHP^$$|) *2!yoXRl Z"Tob\m$@Z⪕Xg%I{Qb(z' b,qNrhk&xH9`Q4'gxFAHQQ$Dq;dc,;yܐTȗA1^L R!lrP y򖨐sW M$˕ `ngvK Iur"7q{ąV4TXwIoEXfsܐȊrh08 6 6$7˳Q9DFtG. ?wH$*r+lD̩sݮ wKrBlSkR$zDX@ց 512MӲݔeVݨ(IzƑ/6dG IHGB!QwEE3K6.@'y +"2A!ubg^(~(TXE|@?P|2`ݐdMp=/wvpղ+ZUe|P4my!1o^9|gΎL/ K#U\Z\Lur3˞JD,O9) Kj,D/6{fdBPTBac *{M!ʐ$$ }I gEX f &+Hq-r$V\rD %ؼs'U_$ܱnX@e4vg~gn 2ٚgBX9=xӃі;7 e3ɸ{1X,(w P2pٟa"`YA ʼnaPYNyDDjP`jHa@tKbRU PE&VɃП@ WN|/޾<^&,`, ]XVe9<ܱiM}2t *KkNa~bpFMF$Y5]Q ( P,Yqż3{CicE*;zm Y)'Y7ΰ (bu{豱VއbWN+(-Ď=uՉau+?xiK3328<Vprىə"6ںt¯)ȱrKK6v!73=ckLCC"&GΟ0}jQ칩"cT}ƧB쥥8%cAqS\1a!ٓ#Sv$Yv |bKScӋZ(J.Wl*,,hT}&YwFF>{a5+ z pUr'BWYq^lk$ /'YN[IT98uG* `y@%㔓C "ey$D'H*yLZ'>=ry~JkS '?9SEGI4tnە/>U,LkN^18|kzxg44Yt`}7G?p|lk6-&n}k6mQ?yap*ּeMS^RšK:vc<ؽ淚٣]pkh g7l^t&Ν:scҾ#Rq{'N"hȫǣrP#Qg,a{[)Y,-WTqj'KT! H Il5-iT],@6,l#Y*[E,ß3@3??vDPS!PUa8q['՛6:p.^ɭ5>_;r|!/[d< ڱX,/~lۺ;y?lr{1ֶygp؁ͱXdžg76'~~\9jO|+;Jhч[vvG[Gƃ{_Y  Ϗ8~2R _w?u<ޯrQ;kSSD3)*%rk{8[BO1YdAvQʹ卭m丨BPTV8IQTNmhFd^%).h/RKV7AWWcISX\iL4R[V~ڙgn,WD.񙣗Fl2[]mgOp][ｔ܎?3m;?W}3.ZӖ-%Ұ+"p۰k__s%f_tC5u€5 ܘ\b1o9&XK5pؚ=Pu<ݭ8p7 V [~]Ԃ7@6_qId2;@+ PPRrm0W8ۛ8.Rw%H ;eIdHM$PpE9ڋK"+Sg BUT,&cl󃃷F SAD`kƎֶV\ZR4< ‰T*l8n)57<\_jn]em0߲}kK}*0tݟnZӹ5@vPUu c'Z߱gs[?oL+Z)ܺfMwGScGgk*/ZB@d$(AHhQ*@ W]>j#Y$4_Taf[]f /3-"qt+w{ޥVjYC wq/"rxzd`[u#ufFܜ+cDZm`DZ,aS0-(8ES1c(!Be[e6S4-1p`b*@E骪 @U @!n F@B0!6H~?Ïz# ƶ0 P!Fv@2lK->-+jOM\m Ss KQMRd|Ɋ{r\H$uu- 7/A-?6Q"^""L\ih-m/5J$ :ZjRš͢κBh;ٖi1@mYe9H- zG%GTԏ\/6*fLac ib1rbNe\~)WPZzY]__9ł8XB!_4;eّnY>,VˊbDU\8_"ݪn!ޓ%ep}#)P\l{*> e4GJ.XXI@v()U aKHao XN@Emw;_}Zaqw~[w{uz gF& {ܺ9Jįk@P@Q5_8OX/

Bx" (hF(HOSU IE44{VxfCO}M8 ԰PQh"5b +ԥYE4]B8975b  bA r0# R@)` (YrHт)qK3B1@ZD@ cB*,.,YX ǢACCq P A ĶZ_iiiUU78g/eɗܰP/FˊWrm}ܨ+t E/A6TU zQ3b){т})G-wLT)/ENR$sM1xu$w=@o` Kqlc TUSRQw?|BBa() @SilEU ) v_*B8waUUSrCESjo#q0*۶PTUQ r0*F۶ooll ]N 58%]>A^f}%Xk*l"H- <_ʺ2* R#;dcx+%ybMT%lٲennNU{n|@8+Rcӟ!@ -rjaAS&R\Nr+;r9U36$yުG ECl pRpא9u"VGԮ uM5Ie}g/]y{ h ޱPE%aRE:\I"shSPDH@LDqܻ,xZmOXhRJ6 sRJ_L^Sw=$])Iw"ou3{\"g=@VNJty;Gg(P\*SwYAjW>eJ.R*R"wI"b $)E0AYif \[uI-H|ew!r IA6["}4|ҢĢ[,XV8 eXv3䆃,BT`P*6.k.oxCCE"Aqr wMPzA9F9eE'/񖄼\=] {'O8#QR[U>J?Qր(}"&'ceX'ܗ$RЖ-r\X$qyuE='.[E,Gq.UQ"zj>d*ntlU,cP# U+uT%`cePTt">pEz ^xY}>m#*_ Y[X!iRJH=TU˞%-/w%/ԓ. dKnN-4R $`﮸()DlQ'{"O&s2? EP0q񖍏++dC-@=Yf+r}R$UX6TJ|:{`*Y!Fwo28]["dEa;ʢ{K>,gR%fNIfKtt/G[3: T܌DڭxO3g8I.&Ux>.Jjc'D ,0GܗԈdֹ:E+W/(%g>,N`7"7?)H2n"I863^A2群&GKO.@.JY,DJaRN|) nyyb\?D:5rKaT:$ȉ#v,..+T& $!6;㢩_z>=%B\\%j;_ȵ(' k&\EnWȜH-%.r [](fQkzB!٨e)D,sY%6VoqngIjHMS xjʤTif pH-Q;έm-!a= QZ/*TrA\!%KS^wz+P V` ūDTV?/o UJ[xOp+ Ai$z̹leD͂,/ dՃO5I]P؋ \)@NP)UV\&~=٩4y_tĻ_8/X"NK12  K  "%62,'g]R\C7"'nCB`El"?EѮ$zqO-1$Rjaʖ==3LC'@Ɩ1txRDq,$(pyb`grJBǎ@!Cz˽_+Z8:&ʤ(e=n' O1P/ "o+@]jHP[DK8ϕbV>}~}[ل뚧4ȢR"w`ypfQ#VZEa/ezB!RE$nƂ.t][i(r.e@"(hrͬB6W1|$TIJVvAfZ~uϏ@' 5Hma[@5L.f^R(* B J,-ww=?BB"dVHfHZR!eC:eH%,"&(,\ͬB81ֱurI6j%c兡,ғ /Qf-Q @Qe/D@[ RdTy]n*kd~P)*~rr+KS+Wܾ}G]aE۶WV UU @oۗIBq\. cQ)C|>UU ! Bt|oӕ,STVnOB!(E|T%M~8|a!4;;[(JZ ! y˲Bhv,koo羥%9J")~B|>_www}}=xPQR XCnE1~qTU]\\ܾ}{(*=,*=rt!fuadы:/v\k- ciZmmm:^!7_TGAm ζD"o۝*U鑒;oңQpﱲ,Nw 'Fap";PQeŝ|I=IF4&,N.]29C(w`!!g/"p&|8e!ʶO((PY+}ԋ䱏=)Q04#ǂ>MԒDbhP' @c7@m[[sD_V]é0S#{i)M㪶q+/7G餪 o\8}m)ug*9VP UI-8540Sӝ AP,FB>uT/@K:.ʪC* G #'O:@\W؃ e9`sa/~[owwfm/>#F^&cM];oȅyhKln_bnqzz&o! 8\\tDhˇ/M[:ӣ'&Kw&o7~_r??06_) @U,LA;}k7XXjb\zP}[cXl (B|a|n૯*Y |7pf`hv]2Ţ頻wbP4۹SG>=t~bޗ;R߾ޚc@wwbh:~ؖi1 szCUƉ?˷5b9 W/(FPS㠻jUr"@`d EBd1m˲K"9eЉ&|I :Vre͒\rMX$Dfnέ[sj-6&f@,GK ;㋁X]}"2}>p`&[kԤEkj~՚)T*ff {BJqj7utԧAO\?soUcsUdM5;3>>SƓOwМe[j> kn" eRA/ G5 }g9%ٔgM,_3lm"Vܵ;hmCs Lfa3X@؜-(2=:<2hmw6%_ѐ:nrG~֫B.WBU}JD챸 #@9Dg/ e>'c.4mXјpSO鯋с3g7DPB-xsdjWw4ԏLF _ *>b9[կz_2 ]?~r*ܵ;$">1Z8~;?1{ߞ/xBs?ؘ͍-u5a'񡫋_4f0]<ǃpծW﬷Ǝssjb_ED΍gkO^̂hwo)L|yWʦ* ](=yΝh *G>9P/ͫ;;8@P8ҴWMMO;}ħ}tl8v񱩩[>KG#ƅKɥ/޴uϾ6O@q~rtbgcG&ï?5o\(BݚsWuY;qZbc.N,ڂb#[^GHoTd\<}޷,8{Ｏ~מߺo?87?`)un_OF#sxm~۞}́A6)h~rjz%: ;wN1wv?݇5AվEdԯ6#/R2fܙ.P+N )hzWԦWAe:5uçR~Q1|sś+j,ݧC={_1~5XțJS7._/8ZsU{*pᱹ::!v쉛WO-LKGg{F#,jX6r,ϕ\ORp)zMl? XF,H;ZZ2rk\ c<3zgN}}sc߼qu76Ϝ8Օ3.ς_1{ggsgNūwW-Րx yAM Ȝ=46 zyuf0VC`3J4lOk2 cfn 8g熮;VWFvd g ߜ0[qC7'5uH#u{|gVEzarV\ڝTnOZܖysH׬sg/lۺ>pxÍokwP'ƯL_5걏773'OOFYzlJ[zk]o鬋FHk^4f[ nXZ&{~95?ܴ9xnR -)#w~r Ʋ L;_5:9kKÓKٴ&ۘ 0. _9w[oK mJ1/?tB}-۲5TمKKjI*"da6㓹XR*j,>5)WYZΰ)ܖfFnAy+' BEu骢(X3 a蚦H}k`0ҵg@Uu0tMUcp3Q9mPڭ=T+/.nkFx,Mt潎;0-i^2eUSqf,%0vr#Z&'Μ8ue,Ő]zt ShDgFǑ?iU0xl :]]u#9eGc].74iKб'Ff Jvݻgcx*UW?;9˾ZYLw߸7c +_>k2YʏS]lvC[M(jWMLz>Pag_޾6FYtc [g5>4':C028wjjLp$+m?[xl[kzaq66w 4>skt1ݘͤ57ug⋴"6ړ!4Pe;5=E47!cESM-f8R/ Uqn%j ]Ke9  HJ\9g.uR7A^pLǮWluW,G|/l>]==Whu`mGg jZLw տt8 <)7< U ݸ6X"Lڏ ~=̢V[G/ؒMGRn;Nן>?}yimDW!PUbN_pȱ4YXq)}(zYZ~}HFКT 7ϟ>y{{:Zh}95:̈́@\Z*XrӃg_ߨAPazxpd"߲=ky \F Bnqi)뾀y)uR1&䙁 ׇTׇF[ʼn[E%֘f3yЛX3o,kW%j[3UMOYzwCX 75uߚtshM_s]k>TTUSջө7dW9}:PL[O+8'`rųkQ*:Pc:E +gaE%Y|t+ŽKqºϧlc4jd҉xf2l6[L]]2 ™lS..JgP%˦m[yS˶vfkxMGGh[V:z2ĕ>8xcb1ھ홸zZ5ul^޸wF@}-=y7t3/v7wn_; CyPakǺrTD<|Skqя?nΦt_G> ;ll)ZZ3Aň4ݱy͟NxWhÞW_>R_-BBXBhz]=K|[mͺb$7?wL3[:o6@Sφ˛5ХӇjl0kX1/(Ǝ:0&W cwn$9 gMC%;іҐmsdP5Gs(hj:,M3PtCP5M~tjLfgwP~Ꙇ(QM%B]|) U!3,HLQ(@r|=I!#ضfK9% ;TMD'mԷ/~tĮ&Rт-ݫ[AC`4Y j:{Sab}~koܯxGwoGs]]m.SW4T!J44djP, D8N%Dwݻm xwu_Sm0d&4uvեxM};w̴̺jN Bh3L:#5ͫz;2ˇ}۷7t`՗jZU+(xKgoWs,Lgj!]?mH'D&K{?m[6uFLuvԇD2YJ:;k`4ٻ1)聆֞Umѐ/Zߟ ,/Zf{wm|̶wu5|Z}uߪL<'2W5tE˳kDKˡ:!W3)(]z#eU<R\#8@> O@Qd]%9 R$?`Ɂ?AEƦL"Tt_.ؐ dI#t:Kk-( A&{vwmڮ龜ٙ퇳;ٝiMI @h @$EAD! {F&C1{'< h C`A-YyBApò-3Q|Yńy̴,l6q#–Wp\fߨ L.zn.=;DBF񗅅l&[0p$ls&7纎gXVOق‘h2LeH6 &7y_EF!Me3ܭӽ ?O#i,@l(\qmqΙ\6< GerƘfr0/nsWpo܅psleH$d2񊏘x0My ôM. L:uc!kALp˶8c[p&>1*459#c#ȟ\.w}fuTUHk4y7 B_A,u-gx*|1Ҋ;c̽+݌lYevTlH1jeɀeH_5TUR4UaP8VkkkW E]׸FqSAUyFU(I 2M*@ Ht["j|r%L3YA> @% >lr3$MP4O5Vf4[Jx sURHCXJ\%A$wJb,ŀiCGUUdؚ $Z27Z9H49(WȆT A`$+9\ӲKu6`~|Je|Gojz֨S4FV$F=ROd"]SN\vq+rA}eQE (\J[N*["$ďR6nҠV.A@H˥ 4`"N_I<:=OOrA3# r ^(˞X)w؁!War/W]]!fbLJ1VhXdysN+U)OZO'ʶʺw2&OT4Le85y`v`}1U:El18A<^h qQLݨ"V>9AB*Aȸ R+0k<)@`T! f:Lkƫd IFf>vXvvR(J{'%dTl]8VBfD/48* xhIepUv58+U UJVACnѐ%b44m[?1 Q)LH$ACoe$k!GYr,$ NPAtb2eզ$U*sOА;'4dVrYiŗʒa"'@#!=0,>[o5)[p$yRcʴɘa(|x\e&H[5 0Y, bUzsP*ώ UF7PqɖH&~ϳ B" A )u \IU!  [_VE0A_I?p$iJc$ B?˦5 LQ(Bp4.s=Ưrs@Qu>dlsh3R^|I^LP @(\A9k` 컯ޖA*e>YA_6 V9_SAC0RyL3eI XX!iX5RVg5nW:D5`R?~wҢd%*ae ;NP틌YFв SyFKye`*f8O~| D`bR{'mIeT?U˱u IA}}y$cʡ cc~^4*/# b$$S3!#Z BPd!GKت*_IA֐ DQPRGU@ƟĶȵodz2ݒI+#n1 xAQ`pKJ@b O6%TT`r|LQ]kW^?yIJ$Ĥ2y ٥΄;tjw13Zg" iʷ1T,5-PPnI}LPH4nhꩪUt YĖ! ewEƌ}2r?9(UU2G%"i1rW6;rh<+}"@P**D嵸韂Pɪ2TUVꫀ;%([$+W(AKqC"&×V7% GUw/aZbh~1P@d<0 Lh|S\ɪ-o(ZJ L WAؖj1AUI]\x@&AMQ\-Ld Z6 [\m RlO! R#)Jwؑ5F*M UeK{c}{U~^ Let(\jZ H =rS%RBp5|?Uu 5iLQE3|VU p  `ŵ? TFh4YH},y9xJ!H渜doU5T?0AME҈z@ҹBܮ8XNɅ\j50*Z_%ҩ.lD_Hv y-^A/b A&9 0`Q.ebq_5`x$XVfizU* g"K蛟^WV*ϖ^s.:\6w\bsX/!sT"X4y|e纎1#d :]q=n ـ 757_h< E * TyUM$`4m؇c:`YHo\' .3H,D| T*P, 'HR/u)>? y.c/=~Sfwn뮍xNfzblPu7 }˜ǥb(rƄsN޸mH Sp"Z!וp]0_xsS߼p^37ރL1 LFLMP͆^vc/?ݿ\n&DCnvݻP-p3t冓HyֶD2^&=sݙ,oimH ٬cF1dSHfO$A6I ,K-\Z[dh<=KMO7ď֮[۾Sc;VCk{sCMӣ~oݭ5-/|=eԶT8\vfrqa'it&[ps3DcKKC"bqfSsOxMWwgU$xHɅ%ڷz=i<'pI/R\˥޹=vZZꣶ٬ SGKOOXF6=?919 Ƅ23woN;u-udB2sܞNU --;^χBGޜ'c!#=p鴗klm-3^~~|l±mɰ9n!=;5zAE&ՉX2[HͥNϭ`A_B~cM s!CT%h1)u85%tAP` 'Z7lq|z R邑|aw`Ν9_;oc>9~s:ص'/6N޺tKMJIcƗt"^{z'ܛNs;:~@K$hmlaxǼc{l^ɺ<\Žwlf=Q6ԗy^&q;uɛh4T/uvЩs|N/=;;9{+[df'Lλool?wF378ܚ}m;oiώ]5_}G_C Ax 4Q%U!H|j`]3?0ԟL z7,/޽Q~g熪9}i6;Fַ~I0,tMM\l}jʉ16ܲq'o?W׳kś^zmm#G^<Nzi l.q -L:  ٶerܿzpǧHuoʈ'{rͦM?ɞ̭W5b\D,8s^*V7ݳ{sShȇ}sm\Bd򓷷V|slOz_ɮ^:nڋu{{ѵ{^MH_aQ!*"5q ! ЩAX{EE2691%t&yx1oKpޑ-UVk_;)r?~tжkǶdm"p{O6ܳ>N!uS.ՙ驁Bo>?t/N\=Cmn}Fք 63oZjb]s=毞=/B/v~Ѿާ\I5kSM*1]gǾmmohjmjLm==]uIQͺVЦcugw.ݯ֏l߽u(;}O>H4۾:{BGU5 ̃py 5/8ZϰM8=Fc(M(,q"_'+ 3 2o8u<}:yVupӺqCesvU˦{YtmW7646x޶jāW_|p~Mֱs|Ǫj~֑臿2{z#胪[݂7PowsDh>t_{?>uҶ֚x~n#}tbז|q|٩_U>`Jl1! ˴Dv⩃Gڞ>ydʴ#ė>䳫]7oH>|^q̇۶JD!Cd;sƑmM >?;ٿ+Y?s|s|oO=Η_}}^Lrbo\kkp&q h*{-1do}{mlC̭/Of+L*6 dWjd;j#[UיXo??~ꝉY?b;?V{wG/^әp'ͧI?;E׭[[M\m KfP6~ <M+HCRP\YT!#9g3&ljv|l=ozmgSuڞu}QCཇ#ߢPUsT/p$gBPxZyW5lڸ9Ϟ~P(84sӳc_8y}l63>&s\s6P(LiCuoHئW84tC"桵 p&2)SH߻ɯe7f\1!aZD8^o33`٩ɩt6z̉:ۛcy#=4XD摡ћ[C!u]Yշ]n>2d>O/=5{3Z;6͛{Oox6-۶,[eYV(m3/t2+' n#c\xŒUw wfmsK}U({'e$۫#eMlq+.$G̲=ut@h?TVS-J[sH q"554OJ\湅\6{ Cm;B& Ƅ[;nh*\|06ya5إK7fur#<;moڥޝy믯v ecGS(Gxlqt:T׷V?p#_c]7Bo߿+6nl}$dMâ+rl3/o M_>t{W_KGG6KFx!+xGlώ^ܥق㺅\&cήVo򾏎~y'~q;7sL:ͻcs \s9yN>/xB0R7/]<o/|s},:yȚSWQٜ Ƅ2t[S~/O8vۻ#/!į~{аf@2;=%Ґ<x[¸53@5Lqt +J1`V$پv+gN|,"<ۻ7 }ݰD2)"_(JT%!Jvnضs?~{č|!֞G>gqkú5P$LlZ{z_~{{ v<o{mXc̰"D2jZ:_ޱ!ijNO{{wPOo>9оD/8+m PsUzH84x @42ðbD2&7,{`㦑s7GoL=Ã[9x-=WlH4uI{*JCٶ}˅>?>Ss;ڦq݊ƒxq#&p(KM_FÑDUҎ؆aɚ긗xoFgCf~I 9zpo;|:8km}u׿:l}0:64Òi۟CdUf__%& y_ʛ?d4^ѿv`omU,niYa[olmJZojL 04h{y|o`gSS[W_O+/ j^VWTmk_xvm޺D ˎ7w8^8cf8_nm{s}c{_OGŜEITl*k^{ϻ8\$jZ w5'ummuDu}K뺚j[uqǮWmIZa Z{zmˬnٸuۋTG-/b&'[ i5@ M2A8" Rȫ[xLۆc\nnnq c yh2< ';7v L0|f4Z\pΘ0=Oq2s)[h,[ oaW C+>.d9aZX"b1ͥ]n'B y3msfg̊)뺂c C0&<1n,;?uy4[16;z}w/ۇ[p,,K/UmN-D0Fe} Z`>߿Ի[[[  T*\͡crd{\*kcX2纮 /NHp;g̛zmp8H&Mħj< c0y=o-rVQfp/Y";8nSSe8+#-ebxy²Coz*neB (aZ!>v:lL8 ӲL:1nicE [N^j;7n|ͷ8 C2ʉ < 8O,,k*mU€|&m 52m'|.kYQc??[e10Ι%S$ (50e_őh8wj3x8fEײǾ:! NO,ڿg s &i>hñ%1>[ 0| PΩ3CD/.A<Fcш Â1V*)eL!%Ec> A(XŏC`RУ8|lNHh[J\_PZ)!DQy=vZ?K]Rd,:l+{ &x43 Aq0hj+I`c{ݒ"I7To0)8X,>U%`XLN#Ҝ&%@0+hP42`B-K70-Wp X,L& 5$uZ}UkS-ĆO+ 0^˫\BF X;H h2sT8>,&8xN8^k%Q|a3"]$ }":3jV#| +?9FQxA#ًY:Pfy 1}!R[W - :Y)8`fUn~g@ʳғ(=-XM5K0A )|K*2fCe+WA]#$5ۻȣaw"_F[pƀUX '_ub_AvI1L_6c{ j\(I9`ib3,ȊĊ CFՊ XSSo` <:./pŅIz8z;r_ $Uit]BT> YW1rE-frG+y\6*+ 8E  S2 `F^\xV$3W/E_H>4˨@ƒ֢* V#)W1A$l|YqGd &]"uU @,RBp4T x c S%tb?G>& '%y;6η!AbI`[U#0d!I?I.VBp4HQeY@җWp~?rk?;A+ ~ aer$ #+;b(g2p HJ (A*'1+є`8 *WF<9s0ѩe킴I`_p`V㼊&#W)"yF׎ʈ$)\"ZRDQO 7:`~-?A ˓LAj55DV|!d=Bp|(V'53jpqȫTz9,C%Ob[2/ +/r> +!΢AȱZ fbR,]Q]_L 6Fb2x0r=5$Hx hᴑ%jcd܃PcBj2\q]&k(o2ĮƢ*PʢҘ^,AVJ-HUmqpJ7]LN LU4RFKUMVI?-tAWUtJ9sdФ!k5y`Y OAʼjV=]B!^ 6Ku#7mt .zr,kF9Aqph5[:, ArsBGdҫ>j rR#CVFRwShe@IZ#,; pQKHxeygH=2fٱ0)0อ|d"edr  \ RN`RKUQVwEݪYet01i<2". G87@$$6^)/˓~Ȭ\|A@NԆR 5,xM#nlU4[ ͸3NBzɓ-ʚduM֯ߝ !MސjB6Q_?^嵫 ٌ9Lf%A:$V>O@U dwB =Ny#eȭ44Kz`/|6b J*㑣 G,@rx4= xUTE#@a2A[[ !!R!|4`(ˀO4HzF O#Uh t#5WdH=!A_H.L:k쐲{@ bBp9 t,H/AarZsdΒIW!:(k0y@UXi8&ꓜ,dzeu&q2ɶ@ךH$I HV(AUܒ3r& /MjGrhrBpu4Yrz&UNo<@)_lMj6Lc 1*xlj}%A\1F@.*Uh.j/aUO\BПYAΞdT)gUj+|Wr'u{Hba`Ko*n# ͞6O 41B|R+; a] %.Y!(IOBP5d}z ҙS!VA#paտaGuY4gU$7П}rO"@P <$/4ȑ'HF?:pـ*TUd6+cQSLAr `Y^!VAQ)$+M +f eS}P=%- F2%XR@w]괄q?k"AIҟYAliW8?Ukmi?C!"`Ҁ$&o*ު9PeWVrA}a(`U!%zDjS "V!|4*8 !>ek>T,*(*lv=.iN?_A pTb!G%cvl5EP>i ϵ|} doeŤBp541_3""R-  vJF]y v9ANP:A<AMWjiJ`VA<9M;S_NA=nѲQjl3[w1I$NR UcUj0֌P+@'i*@ɄһoD#hI8%RY B"WaC n *H~|B:VnMBi9A$ UQWY!V! @T^ȏ4s$qЬ⃱tMh Av}L\`kbB) 2; *p`wlAGWK6U@ŶD<2* 9(Bpu4 VBl$+u(9_-(ǽ x CHL}aFY@T9<'{?$Aյ ؈-A je&TC_7qAZ+W+Ag?d*2Ei/F:b$$$`%`c>_ deHj"H'5d 5ЃBb&i cT bBb3H VQ`lW+WAҐWO됀nM$2U#lbh6r2\ra0P&Ȭԡ &m1ɫoo/&[UѐM$T}:7huq1bZ,(N-`U~ %03KjqNHr$Mu्d9 BN> J| J!L 9 fK1/m6X9d#ΡՒT,0D j5U]S/d)XLHȌN&Bp55'  )OH .d5@!K.T/Q][&,2S< $ovI80`HlWV"3Qʪ п I&- Ѐ. F!Ǽ$76.{䭼G%נĦ堏|JZNԇţX@^"VP!2UJ! 0V4A5ͭCS9Y:5BpE5*@eyY*C@zd2a 9BC%q2teMubY 5VT,A>a\*8ltR vU @Óu HK S$, D(dXΉ~Դq^v}'`KC"r0q3*R$Aծ%I jY%;w96l bUF<™W2Jं4STP쨥jq\F 0uX *H^.|wB'AO-I  Gj)ֆO }$cM5ϑʖՉKj& sU=!AeWLe(T<$bBA,QEW  Pٖ< /$sBD;Q}E _H$SG`%Ad|̀j,\ed%!ԄHEhL{ 5cT-,[ׇMƉ&B6xUh^C$UU'G0Fn4Ȣm0 Liw$R DO@0}zzUB>%5kJUi.TCC"ݱ~*2&9W*_I> 2`TH@s-' KS zʚ}fF?4cτy〦 3O^R5I543|`px~5*WaFrUSXde)+ X.Yqf{acB 0Z@@?TЪ j ɤ ܲP(sNpi;`"\uCIRxOI 2zsA4Fd'Ux_@ j &cSY ʞ4<[US&y^?!¸p]Y[1ak֬ B> 06dJ_ B0˃%,O3eDĊ< FhBBpה7iQ-[|(YԆbA Io`sQ˲ $΀c=x+\*W42^4(NւT:dp%z/vQd/iX&Lя X+ 'Xl,D)BpH؞|B!GyL!']4V\,/`[ cWjZ)`!KU˱B3e+*%xL.-.#F*䌯 YBpiflNE0`q+sku7pe\˼ ̀蝹/z*AfTzT˪ bbiceEii,_B- K@=`Jfݯ Ea[`w4# /,΃v p3'lìoFNX,I*XdWU\Z@!8A@g-6S{0H>86(!T.HhU܃$F"u!XJ A L8?iM6y@[TL=hIP}G4En YdA)<#["k[6'hYr\nUh5KH1`.σ󑬡IYm]7Pq VORyٜ/ 2,cФ*"y> r) Is521`OUCnz&*VЌrx%VB6f͹dQT 8Y*Ac/*  RT4jF5Р!)`a`GϜ: endstream endobj 654 0 obj << /Type /Page /Parent 3 0 R /Annots [ 656 0 R 658 0 R 660 0 R 662 0 R 664 0 R 666 0 R 668 0 R 670 0 R 672 0 R 674 0 R 676 0 R 678 0 R 680 0 R 682 0 R 684 0 R 686 0 R 688 0 R 690 0 R 692 0 R 694 0 R 696 0 R 698 0 R 700 0 R 702 0 R 704 0 R 706 0 R 708 0 R 710 0 R 712 0 R 714 0 R 716 0 R 718 0 R 720 0 R ] /Contents 655 0 R >> endobj 655 0 obj << /Length 28831 >> stream q 15.000 13.377 577.500 763.623 re W n 0.965 0.965 0.965 rg 26.250 726.609 555.000 50.391 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 726.609 m 581.250 726.609 l 581.250 727.359 l 26.250 727.359 l f q 35.250 737.859 537.000 39.141 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 1: VH along two axes)] TJ ET BT 35.250 748.106 Td /F1 9.8 Tf [(Commitment to risk culture / healthism \(horizontal axis\) and distrust/trust toward health authorities \(vertical axis\).)] TJ ET Q BT 26.250 709.585 Td /F1 9.8 Tf [(These two axes can be used to represent different types of VH. For example, in their study of major motives for non-acceptance )] TJ ET BT 26.250 697.680 Td /F1 9.8 Tf [(of the A/H1N1 flu vaccine, Velan et al. )] TJ ET 0.267 0.267 0.267 rg BT 193.170 699.188 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 202.807 697.680 Td /F1 9.8 Tf [( found several contrasting profiles, including people whose motives suggested )] TJ ET BT 26.250 685.776 Td /F1 9.8 Tf [(passiveness, inaction and dependence \(I did not think about it, I somehow did not manage to do it\), corresponding here to )] TJ ET BT 26.250 673.871 Td /F1 9.8 Tf [(the lower-left quadrant \(erratic VH\), and people who made their decision after a process of reflection \(after some deliberation I )] TJ ET BT 26.250 661.966 Td /F1 9.8 Tf [(have decided not to do it, I realised that the disease is not serious, that it is not spreading\), corresponding here to the lower-)] TJ ET BT 26.250 650.061 Td /F1 9.8 Tf [(right quadrant. Specific views regarding VH could also be positioned here: for example, in Marshalls view )] TJ ET 0.267 0.267 0.267 rg BT 483.593 651.569 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 493.231 650.061 Td /F1 9.8 Tf [(, VH is due to a )] TJ ET BT 26.250 638.157 Td /F1 9.8 Tf [(lack of faith in authorities, combined with misperceptions, emotion-driven reactions, and gullibility toward rumours spread by anti-)] TJ ET BT 26.250 626.252 Td /F1 9.8 Tf [(champions and celebrities, corresponding to the lower-left quadrant.)] TJ ET BT 26.250 606.847 Td /F1 9.8 Tf [(This map also underlines that although health promotion policies aiming at encouraging people to take their health in their own )] TJ ET BT 26.250 594.942 Td /F1 9.8 Tf [(hands may move people further along the horizontal axis, health promotion may nonetheless fuel VH, at least among some )] TJ ET BT 26.250 583.038 Td /F1 9.8 Tf [(populations, unless they are positioned high on the trust axis.)] TJ ET BT 26.250 563.633 Td /F1 9.8 Tf [(Nevertheless, talking about vaccine hesitant people may be a misuse of language, as VH also strongly depends on vaccine-)] TJ ET BT 26.250 551.728 Td /F1 9.8 Tf [(specific factors; thus specific vaccines, rather than individual profiles, could be also positioned along our two axes. In other )] TJ ET BT 26.250 539.823 Td /F1 9.8 Tf [(words, instead of considering whether or not people are vaccine-hesitant, we should consider whether a specific )] TJ ET BT 26.250 527.919 Td /F1 9.8 Tf [(context/vaccine fuels their propensity to VH. For example, people are probably more likely to endorse an active attitude, seeking )] TJ ET BT 26.250 516.014 Td /F1 9.8 Tf [(information and assessing risk and benefits, when they are confronted with new vaccine, such as the H1N1 or the HPV )] TJ ET BT 26.250 504.109 Td /F1 9.8 Tf [(vaccines, while they may be more prone to follow their physicians advice routinely and passively for some childhood vaccines )] TJ ET BT 26.250 492.204 Td /F1 9.8 Tf [(or that against seasonal influenza. Moreover, the level of confidence in health authorities about any specific vaccine obviously )] TJ ET BT 26.250 480.300 Td /F1 9.8 Tf [(depends on the extent of media coverage of existing controversies regarding its potential side effects. In the UK, for example, )] TJ ET BT 26.250 468.395 Td /F1 9.8 Tf [(the MMR vaccine would have been positioned in the upper-left quadrant before the MMR/autism controversy began, along with )] TJ ET BT 26.250 456.490 Td /F1 9.8 Tf [(the vaccine against seasonal flu. On the contrary, the HPV vaccine could be considered as relatively new and less controversial )] TJ ET BT 26.250 444.585 Td /F1 9.8 Tf [(\(upper-right quadrant\), while the H1N1 vaccine was both new and controversial \(lower-right quadrant\) )] TJ ET 0.267 0.267 0.267 rg BT 466.248 446.093 Td /F4 8.7 Tf [(15)] TJ ET 0.271 0.267 0.267 rg BT 475.885 444.585 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 407.983 Td /F4 12.0 Tf [(Conclusion)] TJ ET BT 26.250 388.029 Td /F1 9.8 Tf [(In this paper, we have discussed some of the ambiguities and contradictions of the notion of vaccine hesitancy. We have )] TJ ET BT 26.250 376.124 Td /F1 9.8 Tf [(argued that it is currently more a catchall category than a real concept. This lack of consistence is likely to hamper both )] TJ ET BT 26.250 364.219 Td /F1 9.8 Tf [(research and interventions. Therefore, as a supplement to the previous work carried out by the SAGE working group, we )] TJ ET BT 26.250 352.314 Td /F1 9.8 Tf [(propose grounding the notion of vaccine hesitancy in an explicit theoretical framework that takes some major structural features )] TJ ET BT 26.250 340.410 Td /F1 9.8 Tf [(of contemporary societies into account. We consider VH to be a kind of decision-making process that depends on peoples level )] TJ ET BT 26.250 328.505 Td /F1 9.8 Tf [(of commitment to healthism/risk culture and on their level of confidence toward health authorities and mainstream medicine.)] TJ ET BT 26.250 309.100 Td /F1 9.8 Tf [(This framework abandons the anti/pro vaccination continuum. We do not claim here that the vaccine-hesitant do not have )] TJ ET BT 26.250 297.195 Td /F1 9.8 Tf [(opinions about vaccination in general, nor that such opinions do not influence their behaviours toward a specific vaccine. )] TJ ET BT 26.250 285.291 Td /F1 9.8 Tf [(Nevertheless, we believe that these general opinions are not a key determinant of their vaccination behaviours, especially in )] TJ ET BT 26.250 273.386 Td /F1 9.8 Tf [(comparison with the two other dimensions discussed here.)] TJ ET BT 26.250 253.981 Td /F1 9.8 Tf [(We also believe our approach opens new avenues for research on VH. For example, it would be useful to consider various )] TJ ET BT 26.250 242.076 Td /F1 9.8 Tf [(kinds of VH that may be correlated to individuals socioeconomic status \(SES\), as the social differentiation of health behaviors )] TJ ET BT 26.250 230.172 Td /F1 9.8 Tf [(may reflect the social differentiation of health-related cognition, including knowledge, attitudes and beliefs )] TJ ET 0.267 0.267 0.267 rg BT 482.014 231.679 Td /F4 8.7 Tf [(42)] TJ ET 0.271 0.267 0.267 rg BT 491.651 230.172 Td /F1 9.8 Tf [(. Erratic VH is more )] TJ ET BT 26.250 218.267 Td /F1 9.8 Tf [(likely to be displayed by people with low SES, while rationalised VH may be more frequent among the educated middle classes )] TJ ET 0.267 0.267 0.267 rg BT 26.250 207.869 Td /F4 8.7 Tf [(43)] TJ ET 0.271 0.267 0.267 rg BT 35.887 206.362 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 186.957 Td /F1 9.8 Tf [(Finally, as even highly educated people may show VH, we should not focus only on lay people. We should also study )] TJ ET BT 26.250 175.053 Td /F1 9.8 Tf [(extensively VH among health professionals, and especially among general practitioners, who still play a key role in promoting )] TJ ET BT 26.250 163.148 Td /F1 9.8 Tf [(vaccination, and who also display some kinds of VH )] TJ ET 0.267 0.267 0.267 rg BT 252.762 164.655 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 257.581 167.036 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 259.990 164.655 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 264.809 167.036 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 267.218 164.655 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 276.855 163.148 Td /F1 9.8 Tf [(. We should also study their interactions with their patients. In some )] TJ ET BT 26.250 151.243 Td /F1 9.8 Tf [(cases, health professionals may fuel patients VH \(directly, when homeopaths and naturopaths express convincingly their doubt )] TJ ET BT 26.250 139.338 Td /F1 9.8 Tf [(regarding vaccination to their patients )] TJ ET 0.267 0.267 0.267 rg BT 190.996 140.846 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 200.633 139.338 Td /F1 9.8 Tf [(, or indirectly, when pro-vaccine physicians refuse to accept into their practices families )] TJ ET BT 26.250 127.434 Td /F1 9.8 Tf [(who are reluctant to vaccinate their children )] TJ ET 0.267 0.267 0.267 rg BT 216.999 128.941 Td /F4 8.7 Tf [(25)] TJ ET 0.271 0.267 0.267 rg BT 226.636 127.434 Td /F1 9.8 Tf [(\), but sometimes vaccine-hesitant patients may raise doubts in their physicians )] TJ ET BT 26.250 115.529 Td /F1 9.8 Tf [(mind )] TJ ET 0.267 0.267 0.267 rg BT 50.089 117.036 Td /F4 8.7 Tf [(38)] TJ ET 0.271 0.267 0.267 rg BT 59.726 115.529 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 96.124 Td /F1 9.8 Tf [(More generally, we should study the interactions between the various participants involved in immunisation policies, from public )] TJ ET BT 26.250 84.219 Td /F1 9.8 Tf [(health experts to lay people: is there a hesitancy cascade, with waves of influences from political hesitancy to provider )] TJ ET BT 26.250 72.315 Td /F1 9.8 Tf [(hesitancy to public hesitancy, and is there a feedback effect in some cases \(patients VH reinforcing physicians VH, which in )] TJ ET BT 26.250 60.410 Td /F1 9.8 Tf [(turn fuels VH among other patients\)?)] TJ ET Q q 15.000 13.377 577.500 763.623 re W n 0.965 0.965 0.965 rg 26.250 726.609 555.000 50.391 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 726.609 m 581.250 726.609 l 581.250 727.359 l 26.250 727.359 l f q 35.250 737.859 537.000 39.141 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 1: VH along two axes)] TJ ET BT 35.250 748.106 Td /F1 9.8 Tf [(Commitment to risk culture / healthism \(horizontal axis\) and distrust/trust toward health authorities \(vertical axis\).)] TJ ET Q BT 26.250 709.585 Td /F1 9.8 Tf [(These two axes can be used to represent different types of VH. For example, in their study of major motives for non-acceptance )] TJ ET BT 26.250 697.680 Td /F1 9.8 Tf [(of the A/H1N1 flu vaccine, Velan et al. )] TJ ET 0.267 0.267 0.267 rg BT 193.170 699.188 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 202.807 697.680 Td /F1 9.8 Tf [( found several contrasting profiles, including people whose motives suggested )] TJ ET BT 26.250 685.776 Td /F1 9.8 Tf [(passiveness, inaction and dependence \(I did not think about it, I somehow did not manage to do it\), corresponding here to )] TJ ET BT 26.250 673.871 Td /F1 9.8 Tf [(the lower-left quadrant \(erratic VH\), and people who made their decision after a process of reflection \(after some deliberation I )] TJ ET BT 26.250 661.966 Td /F1 9.8 Tf [(have decided not to do it, I realised that the disease is not serious, that it is not spreading\), corresponding here to the lower-)] TJ ET BT 26.250 650.061 Td /F1 9.8 Tf [(right quadrant. Specific views regarding VH could also be positioned here: for example, in Marshalls view )] TJ ET 0.267 0.267 0.267 rg BT 483.593 651.569 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 493.231 650.061 Td /F1 9.8 Tf [(, VH is due to a )] TJ ET BT 26.250 638.157 Td /F1 9.8 Tf [(lack of faith in authorities, combined with misperceptions, emotion-driven reactions, and gullibility toward rumours spread by anti-)] TJ ET BT 26.250 626.252 Td /F1 9.8 Tf [(champions and celebrities, corresponding to the lower-left quadrant.)] TJ ET BT 26.250 606.847 Td /F1 9.8 Tf [(This map also underlines that although health promotion policies aiming at encouraging people to take their health in their own )] TJ ET BT 26.250 594.942 Td /F1 9.8 Tf [(hands may move people further along the horizontal axis, health promotion may nonetheless fuel VH, at least among some )] TJ ET BT 26.250 583.038 Td /F1 9.8 Tf [(populations, unless they are positioned high on the trust axis.)] TJ ET BT 26.250 563.633 Td /F1 9.8 Tf [(Nevertheless, talking about vaccine hesitant people may be a misuse of language, as VH also strongly depends on vaccine-)] TJ ET BT 26.250 551.728 Td /F1 9.8 Tf [(specific factors; thus specific vaccines, rather than individual profiles, could be also positioned along our two axes. In other )] TJ ET BT 26.250 539.823 Td /F1 9.8 Tf [(words, instead of considering whether or not people are vaccine-hesitant, we should consider whether a specific )] TJ ET BT 26.250 527.919 Td /F1 9.8 Tf [(context/vaccine fuels their propensity to VH. For example, people are probably more likely to endorse an active attitude, seeking )] TJ ET BT 26.250 516.014 Td /F1 9.8 Tf [(information and assessing risk and benefits, when they are confronted with new vaccine, such as the H1N1 or the HPV )] TJ ET BT 26.250 504.109 Td /F1 9.8 Tf [(vaccines, while they may be more prone to follow their physicians advice routinely and passively for some childhood vaccines )] TJ ET BT 26.250 492.204 Td /F1 9.8 Tf [(or that against seasonal influenza. Moreover, the level of confidence in health authorities about any specific vaccine obviously )] TJ ET BT 26.250 480.300 Td /F1 9.8 Tf [(depends on the extent of media coverage of existing controversies regarding its potential side effects. In the UK, for example, )] TJ ET BT 26.250 468.395 Td /F1 9.8 Tf [(the MMR vaccine would have been positioned in the upper-left quadrant before the MMR/autism controversy began, along with )] TJ ET BT 26.250 456.490 Td /F1 9.8 Tf [(the vaccine against seasonal flu. On the contrary, the HPV vaccine could be considered as relatively new and less controversial )] TJ ET BT 26.250 444.585 Td /F1 9.8 Tf [(\(upper-right quadrant\), while the H1N1 vaccine was both new and controversial \(lower-right quadrant\) )] TJ ET 0.267 0.267 0.267 rg BT 466.248 446.093 Td /F4 8.7 Tf [(15)] TJ ET 0.271 0.267 0.267 rg BT 475.885 444.585 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 407.983 Td /F4 12.0 Tf [(Conclusion)] TJ ET BT 26.250 388.029 Td /F1 9.8 Tf [(In this paper, we have discussed some of the ambiguities and contradictions of the notion of vaccine hesitancy. We have )] TJ ET BT 26.250 376.124 Td /F1 9.8 Tf [(argued that it is currently more a catchall category than a real concept. This lack of consistence is likely to hamper both )] TJ ET BT 26.250 364.219 Td /F1 9.8 Tf [(research and interventions. Therefore, as a supplement to the previous work carried out by the SAGE working group, we )] TJ ET BT 26.250 352.314 Td /F1 9.8 Tf [(propose grounding the notion of vaccine hesitancy in an explicit theoretical framework that takes some major structural features )] TJ ET BT 26.250 340.410 Td /F1 9.8 Tf [(of contemporary societies into account. We consider VH to be a kind of decision-making process that depends on peoples level )] TJ ET BT 26.250 328.505 Td /F1 9.8 Tf [(of commitment to healthism/risk culture and on their level of confidence toward health authorities and mainstream medicine.)] TJ ET BT 26.250 309.100 Td /F1 9.8 Tf [(This framework abandons the anti/pro vaccination continuum. We do not claim here that the vaccine-hesitant do not have )] TJ ET BT 26.250 297.195 Td /F1 9.8 Tf [(opinions about vaccination in general, nor that such opinions do not influence their behaviours toward a specific vaccine. )] TJ ET BT 26.250 285.291 Td /F1 9.8 Tf [(Nevertheless, we believe that these general opinions are not a key determinant of their vaccination behaviours, especially in )] TJ ET BT 26.250 273.386 Td /F1 9.8 Tf [(comparison with the two other dimensions discussed here.)] TJ ET BT 26.250 253.981 Td /F1 9.8 Tf [(We also believe our approach opens new avenues for research on VH. For example, it would be useful to consider various )] TJ ET BT 26.250 242.076 Td /F1 9.8 Tf [(kinds of VH that may be correlated to individuals socioeconomic status \(SES\), as the social differentiation of health behaviors )] TJ ET BT 26.250 230.172 Td /F1 9.8 Tf [(may reflect the social differentiation of health-related cognition, including knowledge, attitudes and beliefs )] TJ ET 0.267 0.267 0.267 rg BT 482.014 231.679 Td /F4 8.7 Tf [(42)] TJ ET 0.271 0.267 0.267 rg BT 491.651 230.172 Td /F1 9.8 Tf [(. Erratic VH is more )] TJ ET BT 26.250 218.267 Td /F1 9.8 Tf [(likely to be displayed by people with low SES, while rationalised VH may be more frequent among the educated middle classes )] TJ ET 0.267 0.267 0.267 rg BT 26.250 207.869 Td /F4 8.7 Tf [(43)] TJ ET 0.271 0.267 0.267 rg BT 35.887 206.362 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 186.957 Td /F1 9.8 Tf [(Finally, as even highly educated people may show VH, we should not focus only on lay people. We should also study )] TJ ET BT 26.250 175.053 Td /F1 9.8 Tf [(extensively VH among health professionals, and especially among general practitioners, who still play a key role in promoting )] TJ ET BT 26.250 163.148 Td /F1 9.8 Tf [(vaccination, and who also display some kinds of VH )] TJ ET 0.267 0.267 0.267 rg BT 252.762 164.655 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 257.581 167.036 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 259.990 164.655 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 264.809 167.036 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 267.218 164.655 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 276.855 163.148 Td /F1 9.8 Tf [(. We should also study their interactions with their patients. In some )] TJ ET BT 26.250 151.243 Td /F1 9.8 Tf [(cases, health professionals may fuel patients VH \(directly, when homeopaths and naturopaths express convincingly their doubt )] TJ ET BT 26.250 139.338 Td /F1 9.8 Tf [(regarding vaccination to their patients )] TJ ET 0.267 0.267 0.267 rg BT 190.996 140.846 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 200.633 139.338 Td /F1 9.8 Tf [(, or indirectly, when pro-vaccine physicians refuse to accept into their practices families )] TJ ET BT 26.250 127.434 Td /F1 9.8 Tf [(who are reluctant to vaccinate their children )] TJ ET 0.267 0.267 0.267 rg BT 216.999 128.941 Td /F4 8.7 Tf [(25)] TJ ET 0.271 0.267 0.267 rg BT 226.636 127.434 Td /F1 9.8 Tf [(\), but sometimes vaccine-hesitant patients may raise doubts in their physicians )] TJ ET BT 26.250 115.529 Td /F1 9.8 Tf [(mind )] TJ ET 0.267 0.267 0.267 rg BT 50.089 117.036 Td /F4 8.7 Tf [(38)] TJ ET 0.271 0.267 0.267 rg BT 59.726 115.529 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 96.124 Td /F1 9.8 Tf [(More generally, we should study the interactions between the various participants involved in immunisation policies, from public )] TJ ET BT 26.250 84.219 Td /F1 9.8 Tf [(health experts to lay people: is there a hesitancy cascade, with waves of influences from political hesitancy to provider )] TJ ET BT 26.250 72.315 Td /F1 9.8 Tf [(hesitancy to public hesitancy, and is there a feedback effect in some cases \(patients VH reinforcing physicians VH, which in )] TJ ET BT 26.250 60.410 Td /F1 9.8 Tf [(turn fuels VH among other patients\)?)] TJ ET Q q 15.000 13.377 577.500 763.623 re W n 0.965 0.965 0.965 rg 26.250 726.609 555.000 50.391 re f 0.267 0.267 0.267 rg 0.267 0.267 0.267 RG 26.250 726.609 m 581.250 726.609 l 581.250 727.359 l 26.250 727.359 l f q 35.250 737.859 537.000 39.141 re W n 0.271 0.267 0.267 rg BT 35.250 767.476 Td /F4 9.8 Tf [(Fig. 1: VH along two axes)] TJ ET BT 35.250 748.106 Td /F1 9.8 Tf [(Commitment to risk culture / healthism \(horizontal axis\) and distrust/trust toward health authorities \(vertical axis\).)] TJ ET Q BT 26.250 709.585 Td /F1 9.8 Tf [(These two axes can be used to represent different types of VH. For example, in their study of major motives for non-acceptance )] TJ ET BT 26.250 697.680 Td /F1 9.8 Tf [(of the A/H1N1 flu vaccine, Velan et al. )] TJ ET 0.267 0.267 0.267 rg BT 193.170 699.188 Td /F4 8.7 Tf [(27)] TJ ET 0.271 0.267 0.267 rg BT 202.807 697.680 Td /F1 9.8 Tf [( found several contrasting profiles, including people whose motives suggested )] TJ ET BT 26.250 685.776 Td /F1 9.8 Tf [(passiveness, inaction and dependence \(I did not think about it, I somehow did not manage to do it\), corresponding here to )] TJ ET BT 26.250 673.871 Td /F1 9.8 Tf [(the lower-left quadrant \(erratic VH\), and people who made their decision after a process of reflection \(after some deliberation I )] TJ ET BT 26.250 661.966 Td /F1 9.8 Tf [(have decided not to do it, I realised that the disease is not serious, that it is not spreading\), corresponding here to the lower-)] TJ ET BT 26.250 650.061 Td /F1 9.8 Tf [(right quadrant. Specific views regarding VH could also be positioned here: for example, in Marshalls view )] TJ ET 0.267 0.267 0.267 rg BT 483.593 651.569 Td /F4 8.7 Tf [(20)] TJ ET 0.271 0.267 0.267 rg BT 493.231 650.061 Td /F1 9.8 Tf [(, VH is due to a )] TJ ET BT 26.250 638.157 Td /F1 9.8 Tf [(lack of faith in authorities, combined with misperceptions, emotion-driven reactions, and gullibility toward rumours spread by anti-)] TJ ET BT 26.250 626.252 Td /F1 9.8 Tf [(champions and celebrities, corresponding to the lower-left quadrant.)] TJ ET BT 26.250 606.847 Td /F1 9.8 Tf [(This map also underlines that although health promotion policies aiming at encouraging people to take their health in their own )] TJ ET BT 26.250 594.942 Td /F1 9.8 Tf [(hands may move people further along the horizontal axis, health promotion may nonetheless fuel VH, at least among some )] TJ ET BT 26.250 583.038 Td /F1 9.8 Tf [(populations, unless they are positioned high on the trust axis.)] TJ ET BT 26.250 563.633 Td /F1 9.8 Tf [(Nevertheless, talking about vaccine hesitant people may be a misuse of language, as VH also strongly depends on vaccine-)] TJ ET BT 26.250 551.728 Td /F1 9.8 Tf [(specific factors; thus specific vaccines, rather than individual profiles, could be also positioned along our two axes. In other )] TJ ET BT 26.250 539.823 Td /F1 9.8 Tf [(words, instead of considering whether or not people are vaccine-hesitant, we should consider whether a specific )] TJ ET BT 26.250 527.919 Td /F1 9.8 Tf [(context/vaccine fuels their propensity to VH. For example, people are probably more likely to endorse an active attitude, seeking )] TJ ET BT 26.250 516.014 Td /F1 9.8 Tf [(information and assessing risk and benefits, when they are confronted with new vaccine, such as the H1N1 or the HPV )] TJ ET BT 26.250 504.109 Td /F1 9.8 Tf [(vaccines, while they may be more prone to follow their physicians advice routinely and passively for some childhood vaccines )] TJ ET BT 26.250 492.204 Td /F1 9.8 Tf [(or that against seasonal influenza. Moreover, the level of confidence in health authorities about any specific vaccine obviously )] TJ ET BT 26.250 480.300 Td /F1 9.8 Tf [(depends on the extent of media coverage of existing controversies regarding its potential side effects. In the UK, for example, )] TJ ET BT 26.250 468.395 Td /F1 9.8 Tf [(the MMR vaccine would have been positioned in the upper-left quadrant before the MMR/autism controversy began, along with )] TJ ET BT 26.250 456.490 Td /F1 9.8 Tf [(the vaccine against seasonal flu. On the contrary, the HPV vaccine could be considered as relatively new and less controversial )] TJ ET BT 26.250 444.585 Td /F1 9.8 Tf [(\(upper-right quadrant\), while the H1N1 vaccine was both new and controversial \(lower-right quadrant\) )] TJ ET 0.267 0.267 0.267 rg BT 466.248 446.093 Td /F4 8.7 Tf [(15)] TJ ET 0.271 0.267 0.267 rg BT 475.885 444.585 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 407.983 Td /F4 12.0 Tf [(Conclusion)] TJ ET BT 26.250 388.029 Td /F1 9.8 Tf [(In this paper, we have discussed some of the ambiguities and contradictions of the notion of vaccine hesitancy. We have )] TJ ET BT 26.250 376.124 Td /F1 9.8 Tf [(argued that it is currently more a catchall category than a real concept. This lack of consistence is likely to hamper both )] TJ ET BT 26.250 364.219 Td /F1 9.8 Tf [(research and interventions. Therefore, as a supplement to the previous work carried out by the SAGE working group, we )] TJ ET BT 26.250 352.314 Td /F1 9.8 Tf [(propose grounding the notion of vaccine hesitancy in an explicit theoretical framework that takes some major structural features )] TJ ET BT 26.250 340.410 Td /F1 9.8 Tf [(of contemporary societies into account. We consider VH to be a kind of decision-making process that depends on peoples level )] TJ ET BT 26.250 328.505 Td /F1 9.8 Tf [(of commitment to healthism/risk culture and on their level of confidence toward health authorities and mainstream medicine.)] TJ ET BT 26.250 309.100 Td /F1 9.8 Tf [(This framework abandons the anti/pro vaccination continuum. We do not claim here that the vaccine-hesitant do not have )] TJ ET BT 26.250 297.195 Td /F1 9.8 Tf [(opinions about vaccination in general, nor that such opinions do not influence their behaviours toward a specific vaccine. )] TJ ET BT 26.250 285.291 Td /F1 9.8 Tf [(Nevertheless, we believe that these general opinions are not a key determinant of their vaccination behaviours, especially in )] TJ ET BT 26.250 273.386 Td /F1 9.8 Tf [(comparison with the two other dimensions discussed here.)] TJ ET BT 26.250 253.981 Td /F1 9.8 Tf [(We also believe our approach opens new avenues for research on VH. For example, it would be useful to consider various )] TJ ET BT 26.250 242.076 Td /F1 9.8 Tf [(kinds of VH that may be correlated to individuals socioeconomic status \(SES\), as the social differentiation of health behaviors )] TJ ET BT 26.250 230.172 Td /F1 9.8 Tf [(may reflect the social differentiation of health-related cognition, including knowledge, attitudes and beliefs )] TJ ET 0.267 0.267 0.267 rg BT 482.014 231.679 Td /F4 8.7 Tf [(42)] TJ ET 0.271 0.267 0.267 rg BT 491.651 230.172 Td /F1 9.8 Tf [(. Erratic VH is more )] TJ ET BT 26.250 218.267 Td /F1 9.8 Tf [(likely to be displayed by people with low SES, while rationalised VH may be more frequent among the educated middle classes )] TJ ET 0.267 0.267 0.267 rg BT 26.250 207.869 Td /F4 8.7 Tf [(43)] TJ ET 0.271 0.267 0.267 rg BT 35.887 206.362 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 186.957 Td /F1 9.8 Tf [(Finally, as even highly educated people may show VH, we should not focus only on lay people. We should also study )] TJ ET BT 26.250 175.053 Td /F1 9.8 Tf [(extensively VH among health professionals, and especially among general practitioners, who still play a key role in promoting )] TJ ET BT 26.250 163.148 Td /F1 9.8 Tf [(vaccination, and who also display some kinds of VH )] TJ ET 0.267 0.267 0.267 rg BT 252.762 164.655 Td /F4 8.7 Tf [(5)] TJ ET 0.271 0.267 0.267 rg BT 257.581 167.036 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 259.990 164.655 Td /F4 8.7 Tf [(8)] TJ ET 0.271 0.267 0.267 rg BT 264.809 167.036 Td /F1 8.7 Tf [(,)] TJ ET 0.267 0.267 0.267 rg BT 267.218 164.655 Td /F4 8.7 Tf [(17)] TJ ET 0.271 0.267 0.267 rg BT 276.855 163.148 Td /F1 9.8 Tf [(. We should also study their interactions with their patients. In some )] TJ ET BT 26.250 151.243 Td /F1 9.8 Tf [(cases, health professionals may fuel patients VH \(directly, when homeopaths and naturopaths express convincingly their doubt )] TJ ET BT 26.250 139.338 Td /F1 9.8 Tf [(regarding vaccination to their patients )] TJ ET 0.267 0.267 0.267 rg BT 190.996 140.846 Td /F4 8.7 Tf [(40)] TJ ET 0.271 0.267 0.267 rg BT 200.633 139.338 Td /F1 9.8 Tf [(, or indirectly, when pro-vaccine physicians refuse to accept into their practices families )] TJ ET BT 26.250 127.434 Td /F1 9.8 Tf [(who are reluctant to vaccinate their children )] TJ ET 0.267 0.267 0.267 rg BT 216.999 128.941 Td /F4 8.7 Tf [(25)] TJ ET 0.271 0.267 0.267 rg BT 226.636 127.434 Td /F1 9.8 Tf [(\), but sometimes vaccine-hesitant patients may raise doubts in their physicians )] TJ ET BT 26.250 115.529 Td /F1 9.8 Tf [(mind )] TJ ET 0.267 0.267 0.267 rg BT 50.089 117.036 Td /F4 8.7 Tf [(38)] TJ ET 0.271 0.267 0.267 rg BT 59.726 115.529 Td /F1 9.8 Tf [(.)] TJ ET BT 26.250 96.124 Td /F1 9.8 Tf [(More generally, we should study the interactions between the various participants involved in immunisation policies, from public )] TJ ET BT 26.250 84.219 Td /F1 9.8 Tf [(health experts to lay people: is there a hesitancy cascade, with waves of influences from political hesitancy to provider )] TJ ET BT 26.250 72.315 Td /F1 9.8 Tf [(hesitancy to public hesitancy, and is there a feedback effect in some cases \(patients VH reinforcing physicians VH, which in )] TJ ET BT 26.250 60.410 Td /F1 9.8 Tf [(turn fuels VH among other patients\)?)] TJ ET Q q 0.000 0.000 0.000 rg 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 Q endstream endobj 656 0 obj << /Type /Annot /Subtype /Link /A 657 0 R /Border [0 0 0] /H /I /Rect [ 193.1700 698.3859 202.8073 707.2042 ] >> endobj 657 0 obj << /Type /Action >> endobj 658 0 obj << /Type /Annot /Subtype /Link /A 659 0 R /Border [0 0 0] /H /I /Rect [ 483.5933 650.7669 493.2306 659.5852 ] >> endobj 659 0 obj << /Type /Action >> endobj 660 0 obj << /Type /Annot /Subtype /Link /A 661 0 R /Border [0 0 0] /H /I /Rect [ 466.2480 445.2909 475.8853 454.1092 ] >> endobj 661 0 obj << /Type /Action >> endobj 662 0 obj << /Type /Annot /Subtype /Link /A 663 0 R /Border [0 0 0] /H /I /Rect [ 482.0138 230.8772 491.6511 239.6955 ] >> endobj 663 0 obj << /Type /Action >> endobj 664 0 obj << /Type /Annot /Subtype /Link /A 665 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 207.0677 35.8873 215.8860 ] >> endobj 665 0 obj << /Type /Action >> endobj 666 0 obj << /Type /Annot /Subtype /Link /A 667 0 R /Border [0 0 0] /H /I /Rect [ 252.7620 163.8534 257.5807 172.6717 ] >> endobj 667 0 obj << /Type /Action >> endobj 668 0 obj << /Type /Annot /Subtype /Link /A 669 0 R /Border [0 0 0] /H /I /Rect [ 259.9900 163.8534 264.8087 172.6717 ] >> endobj 669 0 obj << /Type /Action >> endobj 670 0 obj << /Type /Annot /Subtype /Link /A 671 0 R /Border [0 0 0] /H /I /Rect [ 267.2180 163.8534 276.8553 172.6717 ] >> endobj 671 0 obj << /Type /Action >> endobj 672 0 obj << /Type /Annot /Subtype /Link /A 673 0 R /Border [0 0 0] /H /I /Rect [ 190.9957 140.0439 200.6331 148.8622 ] >> endobj 673 0 obj << /Type /Action >> endobj 674 0 obj << /Type /Annot /Subtype /Link /A 675 0 R /Border [0 0 0] /H /I /Rect [ 216.9990 128.1392 226.6363 136.9575 ] >> endobj 675 0 obj << /Type /Action >> endobj 676 0 obj << /Type /Annot /Subtype /Link /A 677 0 R /Border [0 0 0] /H /I /Rect [ 50.0888 116.2344 59.7261 125.0527 ] >> endobj 677 0 obj << /Type /Action >> endobj 678 0 obj << /Type /Annot /Subtype /Link /A 679 0 R /Border [0 0 0] /H /I /Rect [ 193.1700 698.3859 202.8073 707.2042 ] >> endobj 679 0 obj << /Type /Action >> endobj 680 0 obj << /Type /Annot /Subtype /Link /A 681 0 R /Border [0 0 0] /H /I /Rect [ 483.5933 650.7669 493.2306 659.5852 ] >> endobj 681 0 obj << /Type /Action >> endobj 682 0 obj << /Type /Annot /Subtype /Link /A 683 0 R /Border [0 0 0] /H /I /Rect [ 466.2480 445.2909 475.8853 454.1092 ] >> endobj 683 0 obj << /Type /Action >> endobj 684 0 obj << /Type /Annot /Subtype /Link /A 685 0 R /Border [0 0 0] /H /I /Rect [ 482.0138 230.8772 491.6511 239.6955 ] >> endobj 685 0 obj << /Type /Action >> endobj 686 0 obj << /Type /Annot /Subtype /Link /A 687 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 207.0677 35.8873 215.8860 ] >> endobj 687 0 obj << /Type /Action >> endobj 688 0 obj << /Type /Annot /Subtype /Link /A 689 0 R /Border [0 0 0] /H /I /Rect [ 252.7620 163.8534 257.5807 172.6717 ] >> endobj 689 0 obj << /Type /Action >> endobj 690 0 obj << /Type /Annot /Subtype /Link /A 691 0 R /Border [0 0 0] /H /I /Rect [ 259.9900 163.8534 264.8087 172.6717 ] >> endobj 691 0 obj << /Type /Action >> endobj 692 0 obj << /Type /Annot /Subtype /Link /A 693 0 R /Border [0 0 0] /H /I /Rect [ 267.2180 163.8534 276.8553 172.6717 ] >> endobj 693 0 obj << /Type /Action >> endobj 694 0 obj << /Type /Annot /Subtype /Link /A 695 0 R /Border [0 0 0] /H /I /Rect [ 190.9957 140.0439 200.6331 148.8622 ] >> endobj 695 0 obj << /Type /Action >> endobj 696 0 obj << /Type /Annot /Subtype /Link /A 697 0 R /Border [0 0 0] /H /I /Rect [ 216.9990 128.1392 226.6363 136.9575 ] >> endobj 697 0 obj << /Type /Action >> endobj 698 0 obj << /Type /Annot /Subtype /Link /A 699 0 R /Border [0 0 0] /H /I /Rect [ 50.0888 116.2344 59.7261 125.0527 ] >> endobj 699 0 obj << /Type /Action >> endobj 700 0 obj << /Type /Annot /Subtype /Link /A 701 0 R /Border [0 0 0] /H /I /Rect [ 193.1700 698.3859 202.8073 707.2042 ] >> endobj 701 0 obj << /Type /Action >> endobj 702 0 obj << /Type /Annot /Subtype /Link /A 703 0 R /Border [0 0 0] /H /I /Rect [ 483.5933 650.7669 493.2306 659.5852 ] >> endobj 703 0 obj << /Type /Action >> endobj 704 0 obj << /Type /Annot /Subtype /Link /A 705 0 R /Border [0 0 0] /H /I /Rect [ 466.2480 445.2909 475.8853 454.1092 ] >> endobj 705 0 obj << /Type /Action >> endobj 706 0 obj << /Type /Annot /Subtype /Link /A 707 0 R /Border [0 0 0] /H /I /Rect [ 482.0138 230.8772 491.6511 239.6955 ] >> endobj 707 0 obj << /Type /Action >> endobj 708 0 obj << /Type /Annot /Subtype /Link /A 709 0 R /Border [0 0 0] /H /I /Rect [ 26.2500 207.0677 35.8873 215.8860 ] >> endobj 709 0 obj << /Type /Action >> endobj 710 0 obj << /Type /Annot /Subtype /Link /A 711 0 R /Border [0 0 0] /H /I /Rect [ 252.7620 163.8534 257.5807 172.6717 ] >> endobj 711 0 obj << /Type /Action >> endobj 712 0 obj << /Type /Annot /Subtype /Link /A 713 0 R /Border [0 0 0] /H /I /Rect [ 259.9900 163.8534 264.8087 172.6717 ] >> endobj 713 0 obj << /Type /Action >> endobj 714 0 obj << /Type /Annot /Subtype /Link /A 715 0 R /Border [0 0 0] /H /I /Rect [ 267.2180 163.8534 276.8553 172.6717 ] >> endobj 715 0 obj << /Type /Action >> endobj 716 0 obj << /Type /Annot /Subtype /Link /A 717 0 R /Border [0 0 0] /H /I /Rect [ 190.9957 140.0439 200.6331 148.8622 ] >> endobj 717 0 obj << /Type /Action >> endobj 718 0 obj << /Type /Annot /Subtype /Link /A 719 0 R /Border [0 0 0] /H /I /Rect [ 216.9990 128.1392 226.6363 136.9575 ] >> endobj 719 0 obj << /Type /Action >> endobj 720 0 obj << /Type /Annot /Subtype /Link /A 721 0 R /Border [0 0 0] /H /I /Rect [ 50.0888 116.2344 59.7261 125.0527 ] >> endobj 721 0 obj << /Type /Action >> endobj 722 0 obj << /Type /Page /Parent 3 0 R /Contents 723 0 R >> endobj 723 0 obj << /Length 20338 >> stream 0.271 0.267 0.267 rg q 15.000 47.815 577.500 729.185 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(Competing Interests)] TJ ET BT 26.250 730.324 Td /F1 9.8 Tf [(The authors have declared that no competing interests exist.)] TJ ET BT 26.250 693.722 Td /F4 12.0 Tf [(References)] TJ ET BT 26.250 666.267 Td /F1 9.8 Tf [(1.)] TJ ET BT 38.132 666.267 Td /F1 9.8 Tf [(Black S, Rapuolin R. \(2010\) A crisis of public confidence in vaccines. Science 61: 61mr1.)] TJ ET BT 26.250 646.863 Td /F1 9.8 Tf [(2.)] TJ ET BT 38.132 646.863 Td /F1 9.8 Tf [(Shetty P. \(2010\) Experts concerned about vaccination backlash. Lancet 375: 970-971.)] TJ ET BT 26.250 627.458 Td /F1 9.8 Tf [(3.)] TJ ET BT 38.132 627.458 Td /F1 9.8 Tf [(Larson HJ, Cooper LZ, Eskolan J, Katz SL, Ratzan S. \(2011\) Addressing the vaccine confidence gap. Lancet 378: 526-535.)] TJ ET BT 26.250 608.053 Td /F1 9.8 Tf [(4.)] TJ ET BT 38.132 608.053 Td /F1 9.8 Tf [(http://www.who.int/immunization/sage/sage_wg_vaccine_hesitancy_apr12/en/)] TJ ET BT 26.250 588.648 Td /F1 9.8 Tf [(5.)] TJ ET BT 38.132 588.648 Td /F1 9.8 Tf [(Dub E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger J. \(2013\) Vaccine hesitancy: an overview. Hum Vaccin )] TJ ET BT 26.250 576.744 Td /F1 9.8 Tf [(Immunother 9\(8\): 1763?1773.)] TJ ET BT 26.250 557.339 Td /F1 9.8 Tf [(6.)] TJ ET BT 38.132 557.339 Td /F1 9.8 Tf [(Gowda C, Dempsey AF. \(2013\) The rise \(and fall?\) of parental vaccine hesitancy. Hum Vaccin Immunother 9\(8\): 1755-1762.)] TJ ET BT 26.250 537.934 Td /F1 9.8 Tf [(7.)] TJ ET BT 38.132 537.934 Td /F1 9.8 Tf [(Larson HJ, Jarrett C, Eckersberger E, Smith DMD, Paterson P. \(2014\) Understanding vaccine hesitancy around vaccines )] TJ ET BT 26.250 526.029 Td /F1 9.8 Tf [(and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine 32\(19\): 2150?2159.)] TJ ET BT 26.250 506.625 Td /F1 9.8 Tf [(8.)] TJ ET BT 38.132 506.625 Td /F1 9.8 Tf [(Yaqub O, Castle-Clarke S, Sevdalis N, Chataway J. \(2014\) Attitudes to vaccination: A critical review. Soc Sci Med 112: 1-11.)] TJ ET BT 26.250 487.220 Td /F1 9.8 Tf [(9.)] TJ ET BT 38.132 487.220 Td /F1 9.8 Tf [(Limb M. \(2011\) "Vaccine hesitancy" means scientists need to be more honest about risks. BMJ 15;342: d2479.)] TJ ET BT 26.250 467.815 Td /F1 9.8 Tf [(10.)] TJ ET BT 43.553 467.815 Td /F1 9.8 Tf [(Bloom BR, Marcuse E, Mnookin S. \(2014\) Addressing vaccine hesitancy. Science 344\(6182\): 339.)] TJ ET BT 26.250 448.410 Td /F1 9.8 Tf [(11.)] TJ ET BT 43.553 448.410 Td /F1 9.8 Tf [(Opel DJ, Mangione-Smith R, Taylor JA, Korfiatis C, Wiese C, Catz S, Martin DP. \(2011\) Development of a survey to identify )] TJ ET BT 26.250 436.506 Td /F1 9.8 Tf [(vaccine-hesitant parents. The Parent Attitudes about Childhood Vaccines survey. Hum Vaccin 7\(4\): 419-425.)] TJ ET BT 26.250 417.101 Td /F1 9.8 Tf [(12.)] TJ ET BT 43.553 417.101 Td /F1 9.8 Tf [(Patel PR, Berenson AB. \(2013\) Sources of HPV vaccine hesitancy in parents. Hum Vaccin Immunother 9\(12\): 2649-2653.)] TJ ET BT 26.250 397.696 Td /F1 9.8 Tf [(13.)] TJ ET BT 43.553 397.696 Td /F1 9.8 Tf [(Gust D, Brown C, Sheedy K, Hibbs B, Weaver D, Nowak G. \(2005\) Immunization attitudes and beliefs among parents: )] TJ ET BT 26.250 385.791 Td /F1 9.8 Tf [(beyond a dichotomous perspective. Am J Health Behav 29\(1\): 81-92.)] TJ ET BT 26.250 366.387 Td /F1 9.8 Tf [(14.)] TJ ET BT 43.553 366.387 Td /F1 9.8 Tf [(Velan B, Boyko V, Lerner-Geva L, Ziv A, Yagar Y, Kaplan G. \(2012\) Individualism, acceptance and differentiation as attitude )] TJ ET BT 26.250 354.482 Td /F1 9.8 Tf [(traits in the publics response to vaccination. Hum Vaccin Immunother 8\(9\): 1272-1282.)] TJ ET BT 26.250 335.077 Td /F1 9.8 Tf [(15.)] TJ ET BT 43.553 335.077 Td /F1 9.8 Tf [(Velan B \(2011\). Acceptance on the move: public reaction to shifting vaccination realities. Human Vaccin 7\(12\): 1261-1270.)] TJ ET BT 26.250 315.672 Td /F1 9.8 Tf [(16.)] TJ ET BT 43.553 315.672 Td /F1 9.8 Tf [(Henrich N, Holmes B. \(2009\) The publics acceptance of novel vaccines during a pandemic: a focus group study and its )] TJ ET BT 26.250 303.768 Td /F1 9.8 Tf [(application to influenza H1N1. Emerging Health Threats Journal 2:e8. doi: 10.3134/ehtj.09.008.)] TJ ET BT 26.250 284.363 Td /F1 9.8 Tf [(17.)] TJ ET BT 43.553 284.363 Td /F1 9.8 Tf [(Siddiqui M, Salmon DA, Omer SB. \(2013\) Epidemiology of vaccine hesitancy in the United States. Hum Vaccin Immunother )] TJ ET BT 26.250 272.458 Td /F1 9.8 Tf [(9\(12\): 2643-2648.)] TJ ET BT 26.250 253.053 Td /F1 9.8 Tf [(18.)] TJ ET BT 43.553 253.053 Td /F1 9.8 Tf [(Healy CM, Pickering LK. \(2011\) How to communicate with vaccine-hesitant parents. Pediatrics 127: S127.)] TJ ET BT 26.250 233.649 Td /F1 9.8 Tf [(19.)] TJ ET BT 43.553 233.649 Td /F1 9.8 Tf [(Gowda C, Schaffer SE, Kopec K, Markel A, Dempsey AF. \(2013\). Does the relative importance of MMR vaccine concerns )] TJ ET BT 26.250 221.744 Td /F1 9.8 Tf [(differ by degree of parental vaccine hesitancy? An exploratory study. Hum Vaccin Immunother 9\(2\): 430-436.)] TJ ET BT 26.250 202.339 Td /F1 9.8 Tf [(20.)] TJ ET BT 43.553 202.339 Td /F1 9.8 Tf [(Marshall GS. \(2013\) Roots of Vaccine Hesitancy. S D Med Spec no: 52-57.)] TJ ET BT 26.250 182.934 Td /F1 9.8 Tf [(21.)] TJ ET BT 43.553 182.934 Td /F1 9.8 Tf [(MacDonald NE, Smith J, Appleton M. \(2012\) Risk perception, risk management and safety management: What can )] TJ ET BT 26.250 171.030 Td /F1 9.8 Tf [(governments do to increase public confidence in their vaccine system? Biologicals 40: 384-388.)] TJ ET BT 26.250 151.625 Td /F1 9.8 Tf [(22.)] TJ ET BT 43.553 151.625 Td /F1 9.8 Tf [(Glanz JM, Wagner NM, Narwaney KJ, Shoup JA, McClure DL, McCormick EV et al. \(2013\) A mixed method study of )] TJ ET BT 26.250 139.720 Td /F1 9.8 Tf [(parental vaccine decision making and parent-provider trust. Acad Pediatr 13\(5\): 481-488.)] TJ ET BT 26.250 120.315 Td /F1 9.8 Tf [(23.)] TJ ET BT 43.553 120.315 Td /F1 9.8 Tf [(Caplan A \(2013\). Liberty has its responsabilities. Hum Vaccin Immunother 9\(12\): 2666-2667.)] TJ ET BT 26.250 100.911 Td /F1 9.8 Tf [(24.)] TJ ET BT 43.553 100.911 Td /F1 9.8 Tf [(Opel DJ, Marcuse EK. \(2013\). Rethinking vaccine policy making in an era of vaccine hesitancy: time to rebuild, not )] TJ ET BT 26.250 89.006 Td /F1 9.8 Tf [(remodel? Hum Vaccin Immunother 9\(12\): 2672-2673.)] TJ ET BT 26.250 69.601 Td /F1 9.8 Tf [(25.)] TJ ET BT 43.553 69.601 Td /F1 9.8 Tf [(Diekema DS. \(2013\) Provider dismissal of vaccine-hesitant families: misguided policy that fails to benefit children. Hum )] TJ ET BT 26.250 57.696 Td /F1 9.8 Tf [(Vaccin Immunother 9\(12\): 2661-2662.)] TJ ET Q q 15.000 47.815 577.500 729.185 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(Competing Interests)] TJ ET BT 26.250 730.324 Td /F1 9.8 Tf [(The authors have declared that no competing interests exist.)] TJ ET BT 26.250 693.722 Td /F4 12.0 Tf [(References)] TJ ET BT 26.250 666.267 Td /F1 9.8 Tf [(1.)] TJ ET BT 38.132 666.267 Td /F1 9.8 Tf [(Black S, Rapuolin R. \(2010\) A crisis of public confidence in vaccines. Science 61: 61mr1.)] TJ ET BT 26.250 646.863 Td /F1 9.8 Tf [(2.)] TJ ET BT 38.132 646.863 Td /F1 9.8 Tf [(Shetty P. \(2010\) Experts concerned about vaccination backlash. Lancet 375: 970-971.)] TJ ET BT 26.250 627.458 Td /F1 9.8 Tf [(3.)] TJ ET BT 38.132 627.458 Td /F1 9.8 Tf [(Larson HJ, Cooper LZ, Eskolan J, Katz SL, Ratzan S. \(2011\) Addressing the vaccine confidence gap. Lancet 378: 526-535.)] TJ ET BT 26.250 608.053 Td /F1 9.8 Tf [(4.)] TJ ET BT 38.132 608.053 Td /F1 9.8 Tf [(http://www.who.int/immunization/sage/sage_wg_vaccine_hesitancy_apr12/en/)] TJ ET BT 26.250 588.648 Td /F1 9.8 Tf [(5.)] TJ ET BT 38.132 588.648 Td /F1 9.8 Tf [(Dub E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger J. \(2013\) Vaccine hesitancy: an overview. Hum Vaccin )] TJ ET BT 26.250 576.744 Td /F1 9.8 Tf [(Immunother 9\(8\): 1763?1773.)] TJ ET BT 26.250 557.339 Td /F1 9.8 Tf [(6.)] TJ ET BT 38.132 557.339 Td /F1 9.8 Tf [(Gowda C, Dempsey AF. \(2013\) The rise \(and fall?\) of parental vaccine hesitancy. Hum Vaccin Immunother 9\(8\): 1755-1762.)] TJ ET BT 26.250 537.934 Td /F1 9.8 Tf [(7.)] TJ ET BT 38.132 537.934 Td /F1 9.8 Tf [(Larson HJ, Jarrett C, Eckersberger E, Smith DMD, Paterson P. \(2014\) Understanding vaccine hesitancy around vaccines )] TJ ET BT 26.250 526.029 Td /F1 9.8 Tf [(and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine 32\(19\): 2150?2159.)] TJ ET BT 26.250 506.625 Td /F1 9.8 Tf [(8.)] TJ ET BT 38.132 506.625 Td /F1 9.8 Tf [(Yaqub O, Castle-Clarke S, Sevdalis N, Chataway J. \(2014\) Attitudes to vaccination: A critical review. Soc Sci Med 112: 1-11.)] TJ ET BT 26.250 487.220 Td /F1 9.8 Tf [(9.)] TJ ET BT 38.132 487.220 Td /F1 9.8 Tf [(Limb M. \(2011\) "Vaccine hesitancy" means scientists need to be more honest about risks. BMJ 15;342: d2479.)] TJ ET BT 26.250 467.815 Td /F1 9.8 Tf [(10.)] TJ ET BT 43.553 467.815 Td /F1 9.8 Tf [(Bloom BR, Marcuse E, Mnookin S. \(2014\) Addressing vaccine hesitancy. Science 344\(6182\): 339.)] TJ ET BT 26.250 448.410 Td /F1 9.8 Tf [(11.)] TJ ET BT 43.553 448.410 Td /F1 9.8 Tf [(Opel DJ, Mangione-Smith R, Taylor JA, Korfiatis C, Wiese C, Catz S, Martin DP. \(2011\) Development of a survey to identify )] TJ ET BT 26.250 436.506 Td /F1 9.8 Tf [(vaccine-hesitant parents. The Parent Attitudes about Childhood Vaccines survey. Hum Vaccin 7\(4\): 419-425.)] TJ ET BT 26.250 417.101 Td /F1 9.8 Tf [(12.)] TJ ET BT 43.553 417.101 Td /F1 9.8 Tf [(Patel PR, Berenson AB. \(2013\) Sources of HPV vaccine hesitancy in parents. Hum Vaccin Immunother 9\(12\): 2649-2653.)] TJ ET BT 26.250 397.696 Td /F1 9.8 Tf [(13.)] TJ ET BT 43.553 397.696 Td /F1 9.8 Tf [(Gust D, Brown C, Sheedy K, Hibbs B, Weaver D, Nowak G. \(2005\) Immunization attitudes and beliefs among parents: )] TJ ET BT 26.250 385.791 Td /F1 9.8 Tf [(beyond a dichotomous perspective. Am J Health Behav 29\(1\): 81-92.)] TJ ET BT 26.250 366.387 Td /F1 9.8 Tf [(14.)] TJ ET BT 43.553 366.387 Td /F1 9.8 Tf [(Velan B, Boyko V, Lerner-Geva L, Ziv A, Yagar Y, Kaplan G. \(2012\) Individualism, acceptance and differentiation as attitude )] TJ ET BT 26.250 354.482 Td /F1 9.8 Tf [(traits in the publics response to vaccination. Hum Vaccin Immunother 8\(9\): 1272-1282.)] TJ ET BT 26.250 335.077 Td /F1 9.8 Tf [(15.)] TJ ET BT 43.553 335.077 Td /F1 9.8 Tf [(Velan B \(2011\). Acceptance on the move: public reaction to shifting vaccination realities. Human Vaccin 7\(12\): 1261-1270.)] TJ ET BT 26.250 315.672 Td /F1 9.8 Tf [(16.)] TJ ET BT 43.553 315.672 Td /F1 9.8 Tf [(Henrich N, Holmes B. \(2009\) The publics acceptance of novel vaccines during a pandemic: a focus group study and its )] TJ ET BT 26.250 303.768 Td /F1 9.8 Tf [(application to influenza H1N1. Emerging Health Threats Journal 2:e8. doi: 10.3134/ehtj.09.008.)] TJ ET BT 26.250 284.363 Td /F1 9.8 Tf [(17.)] TJ ET BT 43.553 284.363 Td /F1 9.8 Tf [(Siddiqui M, Salmon DA, Omer SB. \(2013\) Epidemiology of vaccine hesitancy in the United States. Hum Vaccin Immunother )] TJ ET BT 26.250 272.458 Td /F1 9.8 Tf [(9\(12\): 2643-2648.)] TJ ET BT 26.250 253.053 Td /F1 9.8 Tf [(18.)] TJ ET BT 43.553 253.053 Td /F1 9.8 Tf [(Healy CM, Pickering LK. \(2011\) How to communicate with vaccine-hesitant parents. Pediatrics 127: S127.)] TJ ET BT 26.250 233.649 Td /F1 9.8 Tf [(19.)] TJ ET BT 43.553 233.649 Td /F1 9.8 Tf [(Gowda C, Schaffer SE, Kopec K, Markel A, Dempsey AF. \(2013\). Does the relative importance of MMR vaccine concerns )] TJ ET BT 26.250 221.744 Td /F1 9.8 Tf [(differ by degree of parental vaccine hesitancy? An exploratory study. Hum Vaccin Immunother 9\(2\): 430-436.)] TJ ET BT 26.250 202.339 Td /F1 9.8 Tf [(20.)] TJ ET BT 43.553 202.339 Td /F1 9.8 Tf [(Marshall GS. \(2013\) Roots of Vaccine Hesitancy. S D Med Spec no: 52-57.)] TJ ET BT 26.250 182.934 Td /F1 9.8 Tf [(21.)] TJ ET BT 43.553 182.934 Td /F1 9.8 Tf [(MacDonald NE, Smith J, Appleton M. \(2012\) Risk perception, risk management and safety management: What can )] TJ ET BT 26.250 171.030 Td /F1 9.8 Tf [(governments do to increase public confidence in their vaccine system? Biologicals 40: 384-388.)] TJ ET BT 26.250 151.625 Td /F1 9.8 Tf [(22.)] TJ ET BT 43.553 151.625 Td /F1 9.8 Tf [(Glanz JM, Wagner NM, Narwaney KJ, Shoup JA, McClure DL, McCormick EV et al. \(2013\) A mixed method study of )] TJ ET BT 26.250 139.720 Td /F1 9.8 Tf [(parental vaccine decision making and parent-provider trust. Acad Pediatr 13\(5\): 481-488.)] TJ ET BT 26.250 120.315 Td /F1 9.8 Tf [(23.)] TJ ET BT 43.553 120.315 Td /F1 9.8 Tf [(Caplan A \(2013\). Liberty has its responsabilities. Hum Vaccin Immunother 9\(12\): 2666-2667.)] TJ ET BT 26.250 100.911 Td /F1 9.8 Tf [(24.)] TJ ET BT 43.553 100.911 Td /F1 9.8 Tf [(Opel DJ, Marcuse EK. \(2013\). Rethinking vaccine policy making in an era of vaccine hesitancy: time to rebuild, not )] TJ ET BT 26.250 89.006 Td /F1 9.8 Tf [(remodel? Hum Vaccin Immunother 9\(12\): 2672-2673.)] TJ ET BT 26.250 69.601 Td /F1 9.8 Tf [(25.)] TJ ET BT 43.553 69.601 Td /F1 9.8 Tf [(Diekema DS. \(2013\) Provider dismissal of vaccine-hesitant families: misguided policy that fails to benefit children. Hum )] TJ ET BT 26.250 57.696 Td /F1 9.8 Tf [(Vaccin Immunother 9\(12\): 2661-2662.)] TJ ET Q q 15.000 47.815 577.500 729.185 re W n 0.271 0.267 0.267 rg BT 26.250 750.278 Td /F4 12.0 Tf [(Competing Interests)] TJ ET BT 26.250 730.324 Td /F1 9.8 Tf [(The authors have declared that no competing interests exist.)] TJ ET BT 26.250 693.722 Td /F4 12.0 Tf [(References)] TJ ET BT 26.250 666.267 Td /F1 9.8 Tf [(1.)] TJ ET BT 38.132 666.267 Td /F1 9.8 Tf [(Black S, Rapuolin R. \(2010\) A crisis of public confidence in vaccines. Science 61: 61mr1.)] TJ ET BT 26.250 646.863 Td /F1 9.8 Tf [(2.)] TJ ET BT 38.132 646.863 Td /F1 9.8 Tf [(Shetty P. \(2010\) Experts concerned about vaccination backlash. Lancet 375: 970-971.)] TJ ET BT 26.250 627.458 Td /F1 9.8 Tf [(3.)] TJ ET BT 38.132 627.458 Td /F1 9.8 Tf [(Larson HJ, Cooper LZ, Eskolan J, Katz SL, Ratzan S. \(2011\) Addressing the vaccine confidence gap. Lancet 378: 526-535.)] TJ ET BT 26.250 608.053 Td /F1 9.8 Tf [(4.)] TJ ET BT 38.132 608.053 Td /F1 9.8 Tf [(http://www.who.int/immunization/sage/sage_wg_vaccine_hesitancy_apr12/en/)] TJ ET BT 26.250 588.648 Td /F1 9.8 Tf [(5.)] TJ ET BT 38.132 588.648 Td /F1 9.8 Tf [(Dub E, Laberge C, Guay M, Bramadat P, Roy R, Bettinger J. \(2013\) Vaccine hesitancy: an overview. Hum Vaccin )] TJ ET BT 26.250 576.744 Td /F1 9.8 Tf [(Immunother 9\(8\): 1763?1773.)] TJ ET BT 26.250 557.339 Td /F1 9.8 Tf [(6.)] TJ ET BT 38.132 557.339 Td /F1 9.8 Tf [(Gowda C, Dempsey AF. \(2013\) The rise \(and fall?\) of parental vaccine hesitancy. Hum Vaccin Immunother 9\(8\): 1755-1762.)] TJ ET BT 26.250 537.934 Td /F1 9.8 Tf [(7.)] TJ ET BT 38.132 537.934 Td /F1 9.8 Tf [(Larson HJ, Jarrett C, Eckersberger E, Smith DMD, Paterson P. \(2014\) Understanding vaccine hesitancy around vaccines )] TJ ET BT 26.250 526.029 Td /F1 9.8 Tf [(and vaccination from a global perspective: a systematic review of published literature, 2007-2012. Vaccine 32\(19\): 2150?2159.)] TJ ET BT 26.250 506.625 Td /F1 9.8 Tf [(8.)] TJ ET BT 38.132 506.625 Td /F1 9.8 Tf [(Yaqub O, Castle-Clarke S, Sevdalis N, Chataway J. \(2014\) Attitudes to vaccination: A critical review. Soc Sci Med 112: 1-11.)] TJ ET BT 26.250 487.220 Td /F1 9.8 Tf [(9.)] TJ ET BT 38.132 487.220 Td /F1 9.8 Tf [(Limb M. \(2011\) "Vaccine hesitancy" means scientists need to be more honest about risks. BMJ 15;342: d2479.)] TJ ET BT 26.250 467.815 Td /F1 9.8 Tf [(10.)] TJ ET BT 43.553 467.815 Td /F1 9.8 Tf [(Bloom BR, Marcuse E, Mnookin S. \(2014\) Addressing vaccine hesitancy. Science 344\(6182\): 339.)] TJ ET BT 26.250 448.410 Td /F1 9.8 Tf [(11.)] TJ ET BT 43.553 448.410 Td /F1 9.8 Tf [(Opel DJ, Mangione-Smith R, Taylor JA, Korfiatis C, Wiese C, Catz S, Martin DP. \(2011\) Development of a survey to identify )] TJ ET BT 26.250 436.506 Td /F1 9.8 Tf [(vaccine-hesitant parents. The Parent Attitudes about Childhood Vaccines survey. Hum Vaccin 7\(4\): 419-425.)] TJ ET BT 26.250 417.101 Td /F1 9.8 Tf [(12.)] TJ ET BT 43.553 417.101 Td /F1 9.8 Tf [(Patel PR, Berenson AB. \(2013\) Sources of HPV vaccine hesitancy in parents. Hum Vaccin Immunother 9\(12\): 2649-2653.)] TJ ET BT 26.250 397.696 Td /F1 9.8 Tf [(13.)] TJ ET BT 43.553 397.696 Td /F1 9.8 Tf [(Gust D, Brown C, Sheedy K, Hibbs B, Weaver D, Nowak G. \(2005\) Immunization attitudes and beliefs among parents: )] TJ ET BT 26.250 385.791 Td /F1 9.8 Tf [(beyond a dichotomous perspective. Am J Health Behav 29\(1\): 81-92.)] TJ ET BT 26.250 366.387 Td /F1 9.8 Tf [(14.)] TJ ET BT 43.553 366.387 Td /F1 9.8 Tf [(Velan B, Boyko V, Lerner-Geva L, Ziv A, Yagar Y, Kaplan G. \(2012\) Individualism, acceptance and differentiation as attitude )] TJ ET BT 26.250 354.482 Td /F1 9.8 Tf [(traits in the publics response to vaccination. Hum Vaccin Immunother 8\(9\): 1272-1282.)] TJ ET BT 26.250 335.077 Td /F1 9.8 Tf [(15.)] TJ ET BT 43.553 335.077 Td /F1 9.8 Tf [(Velan B \(2011\). Acceptance on the move: public reaction to shifting vaccination realities. Human Vaccin 7\(12\): 1261-1270.)] TJ ET BT 26.250 315.672 Td /F1 9.8 Tf [(16.)] TJ ET BT 43.553 315.672 Td /F1 9.8 Tf [(Henrich N, Holmes B. \(2009\) The publics acceptance of novel vaccines during a pandemic: a focus group study and its )] TJ ET BT 26.250 303.768 Td /F1 9.8 Tf [(application to influenza H1N1. Emerging Health Threats Journal 2:e8. doi: 10.3134/ehtj.09.008.)] TJ ET BT 26.250 284.363 Td /F1 9.8 Tf [(17.)] TJ ET BT 43.553 284.363 Td /F1 9.8 Tf [(Siddiqui M, Salmon DA, Omer SB. \(2013\) Epidemiology of vaccine hesitancy in the United States. Hum Vaccin Immunother )] TJ ET BT 26.250 272.458 Td /F1 9.8 Tf [(9\(12\): 2643-2648.)] TJ ET BT 26.250 253.053 Td /F1 9.8 Tf [(18.)] TJ ET BT 43.553 253.053 Td /F1 9.8 Tf [(Healy CM, Pickering LK. \(2011\) How to communicate with vaccine-hesitant parents. Pediatrics 127: S127.)] TJ ET BT 26.250 233.649 Td /F1 9.8 Tf [(19.)] TJ ET BT 43.553 233.649 Td /F1 9.8 Tf [(Gowda C, Schaffer SE, Kopec K, Markel A, Dempsey AF. \(2013\). Does the relative importance of MMR vaccine concerns )] TJ ET BT 26.250 221.744 Td /F1 9.8 Tf [(differ by degree of parental vaccine hesitancy? An exploratory study. Hum Vaccin Immunother 9\(2\): 430-436.)] TJ ET BT 26.250 202.339 Td /F1 9.8 Tf [(20.)] TJ ET BT 43.553 202.339 Td /F1 9.8 Tf [(Marshall GS. \(2013\) Roots of Vaccine Hesitancy. S D Med Spec no: 52-57.)] TJ ET BT 26.250 182.934 Td /F1 9.8 Tf [(21.)] TJ ET BT 43.553 182.934 Td /F1 9.8 Tf [(MacDonald NE, Smith J, Appleton M. \(2012\) Risk perception, risk management and safety management: What can )] TJ ET BT 26.250 171.030 Td /F1 9.8 Tf [(governments do to increase public confidence in their vaccine system? Biologicals 40: 384-388.)] TJ ET BT 26.250 151.625 Td /F1 9.8 Tf [(22.)] TJ ET BT 43.553 151.625 Td /F1 9.8 Tf [(Glanz JM, Wagner NM, Narwaney KJ, Shoup JA, McClure DL, McCormick EV et al. \(2013\) A mixed method study of )] TJ ET BT 26.250 139.720 Td /F1 9.8 Tf [(parental vaccine decision making and parent-provider trust. Acad Pediatr 13\(5\): 481-488.)] TJ ET BT 26.250 120.315 Td /F1 9.8 Tf [(23.)] TJ ET BT 43.553 120.315 Td /F1 9.8 Tf [(Caplan A \(2013\). Liberty has its responsabilities. Hum Vaccin Immunother 9\(12\): 2666-2667.)] TJ ET BT 26.250 100.911 Td /F1 9.8 Tf [(24.)] TJ ET BT 43.553 100.911 Td /F1 9.8 Tf [(Opel DJ, Marcuse EK. \(2013\). Rethinking vaccine policy making in an era of vaccine hesitancy: time to rebuild, not )] TJ ET BT 26.250 89.006 Td /F1 9.8 Tf [(remodel? Hum Vaccin Immunother 9\(12\): 2672-2673.)] TJ ET BT 26.250 69.601 Td /F1 9.8 Tf [(25.)] TJ ET BT 43.553 69.601 Td /F1 9.8 Tf [(Diekema DS. \(2013\) Provider dismissal of vaccine-hesitant families: misguided policy that fails to benefit children. Hum )] TJ ET BT 26.250 57.696 Td /F1 9.8 Tf [(Vaccin Immunother 9\(12\): 2661-2662.)] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(6)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Outbreaks)] TJ ET Q endstream endobj 724 0 obj << /Type /Page /Parent 3 0 R /Contents 725 0 R >> endobj 725 0 obj << /Length 15364 >> stream 0.271 0.267 0.267 rg q 15.000 257.953 577.500 519.047 re W n 0.271 0.267 0.267 rg BT 26.250 759.976 Td /F1 9.8 Tf [(26.)] TJ ET BT 43.553 759.976 Td /F1 9.8 Tf [(Gilkey MB, McRee AL, Brewer NT. \(2013\) Forgone vaccination during childhood and adolescence: Finding of a statewide )] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(survey of parents. Prev Med 56: 202-206.)] TJ ET BT 26.250 728.667 Td /F1 9.8 Tf [(27.)] TJ ET BT 43.553 728.667 Td /F1 9.8 Tf [(Velan B, Kaplan G, Ziv A, Boyko V, Lerner-Geva L. \(2011\). Major motives in non-acceptance of A/H1N1 flu vaccination: the )] TJ ET BT 26.250 716.762 Td /F1 9.8 Tf [(weight of rational assessment. Vaccine 29: 1173-1179.)] TJ ET BT 26.250 697.357 Td /F1 9.8 Tf [(28.)] TJ ET BT 43.553 697.357 Td /F1 9.8 Tf [(Streefland P, Chowdhury AM, Ramos-Jimenez P. \(1999\) Patterns of vaccination acceptance. Soc Sci Med 49: 1705-1716.)] TJ ET BT 26.250 677.952 Td /F1 9.8 Tf [(29.)] TJ ET BT 43.553 677.952 Td /F1 9.8 Tf [(Blume S. \(2006\) Anti-vaccination movements and their interpretations. Soc Sci Med 62: 628-642.)] TJ ET BT 26.250 658.548 Td /F1 9.8 Tf [(30.)] TJ ET BT 43.553 658.548 Td /F1 9.8 Tf [(Opel DJ, Taylor JA, Zhou C, Catz S, Myaing M, Mangione-Smith R. \(2013\) The Relationship Between Parent Attitudes )] TJ ET BT 26.250 646.643 Td /F1 9.8 Tf [(About Childhood Vaccines Survey Scores and Future Child Immunization Status A Validation Study. JAMA Pediatr 167\(11\) : )] TJ ET BT 26.250 634.738 Td /F1 9.8 Tf [(1065-1071.)] TJ ET BT 26.250 615.333 Td /F1 9.8 Tf [(31.)] TJ ET BT 43.553 615.333 Td /F1 9.8 Tf [(Wallston KA, Wallston BS \(1982\) Who is responsible for your health? The construct of health locus of control. In : Sanders )] TJ ET BT 26.250 603.429 Td /F1 9.8 Tf [(G, Suls J, editors. Social psychology of health and illness. Hillsdale: Erlbaum. pp. 65-95.)] TJ ET BT 26.250 584.024 Td /F1 9.8 Tf [(32.)] TJ ET BT 43.553 584.024 Td /F1 9.8 Tf [(Giddens A \(1991\) Modernity and self-identity. Stanford: Stanford University Press.)] TJ ET BT 26.250 564.619 Td /F1 9.8 Tf [(33.)] TJ ET BT 43.553 564.619 Td /F1 9.8 Tf [(Foucault M \(2004\). Naissance de la biopolitique, Cours au Collge de France, 1978-1979. Paris: Gallimard/Seuil.)] TJ ET BT 26.250 545.214 Td /F1 9.8 Tf [(34.)] TJ ET BT 43.553 545.214 Td /F1 9.8 Tf [(Crawford R. \(1994\) The boundaries of the self and the unhealthy other: Reflections on health, culture and Aids. Soc Sci )] TJ ET BT 26.250 533.310 Td /F1 9.8 Tf [(Med 38\(10\): 13471365.)] TJ ET BT 26.250 513.905 Td /F1 9.8 Tf [(35.)] TJ ET BT 43.553 513.905 Td /F1 9.8 Tf [(Lupton, D. \(1995\). The imperative of health: Public health and the regulated body. London: Sage.)] TJ ET BT 26.250 494.500 Td /F1 9.8 Tf [(36.)] TJ ET BT 43.553 494.500 Td /F1 9.8 Tf [(Greenhalgh T, Wessely S. \(2004\) Health for me: a sociocultural analysis of healthism in the middle classes. Br Med Bull )] TJ ET BT 26.250 482.595 Td /F1 9.8 Tf [(69\(1\): 197-213.)] TJ ET BT 26.250 463.191 Td /F1 9.8 Tf [(37.)] TJ ET BT 43.553 463.191 Td /F1 9.8 Tf [(Beck U \(1992\) Risk Society. Towards a new modernity. London: Sage Publications.)] TJ ET BT 26.250 443.786 Td /F1 9.8 Tf [(38.)] TJ ET BT 43.553 443.786 Td /F1 9.8 Tf [(Brownlie J, Howson A. \(2006\) 'Between the demands of truth and government': health practitioners, trust and immunisation )] TJ ET BT 26.250 431.881 Td /F1 9.8 Tf [(work. Soc Sci Med 62\(2\): 433-443.)] TJ ET BT 26.250 412.476 Td /F1 9.8 Tf [(39.)] TJ ET BT 43.553 412.476 Td /F1 9.8 Tf [(Baromtre IRSN 2010. Perception des risques et de la scurit. Available: )] TJ ET BT 26.250 400.572 Td /F1 9.8 Tf [(http://www.irsn.fr/FR/IRSN/Publications/barometre/Documents/IRSN_Barometre_2010.pdf. Accessed 19 October 2014.)] TJ ET BT 26.250 381.167 Td /F1 9.8 Tf [(40.)] TJ ET BT 43.553 381.167 Td /F1 9.8 Tf [(Benin AL, Wisler-Scher DJ, Colson E, Shapiro ED, Holmboe ES. \(2006\) Qualitative analysis of mothers' decision-making )] TJ ET BT 26.250 369.262 Td /F1 9.8 Tf [(about vaccines for infants: the importance of trust. Pediatrics 117\(5\): 1532-1541.)] TJ ET BT 26.250 349.857 Td /F1 9.8 Tf [(41.)] TJ ET BT 43.553 349.857 Td /F1 9.8 Tf [(Hobson-West P. \(2007\) Trusting blindly can be the biggest risk of all: organised resistance to childhood vaccination in the )] TJ ET BT 26.250 337.953 Td /F1 9.8 Tf [(UK. Sociol Health Illn 29\(2\): 198-215.)] TJ ET BT 26.250 318.548 Td /F1 9.8 Tf [(42.)] TJ ET BT 43.553 318.548 Td /F1 9.8 Tf [(Wardle J, McCaffery K, Nadel M, Atkin W. \(2004\) Socioeconomic differences in cancer screening participation: comparing )] TJ ET BT 26.250 306.643 Td /F1 9.8 Tf [(cognitive and psychosocial explanations. Soc Sci Med 59: 249-261.)] TJ ET BT 26.250 287.238 Td /F1 9.8 Tf [(43.)] TJ ET BT 43.553 287.238 Td /F1 9.8 Tf [(Peretti-Watel P, Raude J, Sagaon-Teyssier L, Constant A, Verger P, Beck F. \(2014\) Attitudes toward vaccination and the )] TJ ET BT 26.250 275.334 Td /F1 9.8 Tf [(H1N1 vaccine: poor peoples unfounded fears or legitimate concerns of the elite? Soc Sci Med 109: 10-18.)] TJ ET Q q 15.000 257.953 577.500 519.047 re W n 0.271 0.267 0.267 rg BT 26.250 759.976 Td /F1 9.8 Tf [(26.)] TJ ET BT 43.553 759.976 Td /F1 9.8 Tf [(Gilkey MB, McRee AL, Brewer NT. \(2013\) Forgone vaccination during childhood and adolescence: Finding of a statewide )] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(survey of parents. Prev Med 56: 202-206.)] TJ ET BT 26.250 728.667 Td /F1 9.8 Tf [(27.)] TJ ET BT 43.553 728.667 Td /F1 9.8 Tf [(Velan B, Kaplan G, Ziv A, Boyko V, Lerner-Geva L. \(2011\). Major motives in non-acceptance of A/H1N1 flu vaccination: the )] TJ ET BT 26.250 716.762 Td /F1 9.8 Tf [(weight of rational assessment. Vaccine 29: 1173-1179.)] TJ ET BT 26.250 697.357 Td /F1 9.8 Tf [(28.)] TJ ET BT 43.553 697.357 Td /F1 9.8 Tf [(Streefland P, Chowdhury AM, Ramos-Jimenez P. \(1999\) Patterns of vaccination acceptance. Soc Sci Med 49: 1705-1716.)] TJ ET BT 26.250 677.952 Td /F1 9.8 Tf [(29.)] TJ ET BT 43.553 677.952 Td /F1 9.8 Tf [(Blume S. \(2006\) Anti-vaccination movements and their interpretations. Soc Sci Med 62: 628-642.)] TJ ET BT 26.250 658.548 Td /F1 9.8 Tf [(30.)] TJ ET BT 43.553 658.548 Td /F1 9.8 Tf [(Opel DJ, Taylor JA, Zhou C, Catz S, Myaing M, Mangione-Smith R. \(2013\) The Relationship Between Parent Attitudes )] TJ ET BT 26.250 646.643 Td /F1 9.8 Tf [(About Childhood Vaccines Survey Scores and Future Child Immunization Status A Validation Study. JAMA Pediatr 167\(11\) : )] TJ ET BT 26.250 634.738 Td /F1 9.8 Tf [(1065-1071.)] TJ ET BT 26.250 615.333 Td /F1 9.8 Tf [(31.)] TJ ET BT 43.553 615.333 Td /F1 9.8 Tf [(Wallston KA, Wallston BS \(1982\) Who is responsible for your health? The construct of health locus of control. In : Sanders )] TJ ET BT 26.250 603.429 Td /F1 9.8 Tf [(G, Suls J, editors. Social psychology of health and illness. Hillsdale: Erlbaum. pp. 65-95.)] TJ ET BT 26.250 584.024 Td /F1 9.8 Tf [(32.)] TJ ET BT 43.553 584.024 Td /F1 9.8 Tf [(Giddens A \(1991\) Modernity and self-identity. Stanford: Stanford University Press.)] TJ ET BT 26.250 564.619 Td /F1 9.8 Tf [(33.)] TJ ET BT 43.553 564.619 Td /F1 9.8 Tf [(Foucault M \(2004\). Naissance de la biopolitique, Cours au Collge de France, 1978-1979. Paris: Gallimard/Seuil.)] TJ ET BT 26.250 545.214 Td /F1 9.8 Tf [(34.)] TJ ET BT 43.553 545.214 Td /F1 9.8 Tf [(Crawford R. \(1994\) The boundaries of the self and the unhealthy other: Reflections on health, culture and Aids. Soc Sci )] TJ ET BT 26.250 533.310 Td /F1 9.8 Tf [(Med 38\(10\): 13471365.)] TJ ET BT 26.250 513.905 Td /F1 9.8 Tf [(35.)] TJ ET BT 43.553 513.905 Td /F1 9.8 Tf [(Lupton, D. \(1995\). The imperative of health: Public health and the regulated body. London: Sage.)] TJ ET BT 26.250 494.500 Td /F1 9.8 Tf [(36.)] TJ ET BT 43.553 494.500 Td /F1 9.8 Tf [(Greenhalgh T, Wessely S. \(2004\) Health for me: a sociocultural analysis of healthism in the middle classes. Br Med Bull )] TJ ET BT 26.250 482.595 Td /F1 9.8 Tf [(69\(1\): 197-213.)] TJ ET BT 26.250 463.191 Td /F1 9.8 Tf [(37.)] TJ ET BT 43.553 463.191 Td /F1 9.8 Tf [(Beck U \(1992\) Risk Society. Towards a new modernity. London: Sage Publications.)] TJ ET BT 26.250 443.786 Td /F1 9.8 Tf [(38.)] TJ ET BT 43.553 443.786 Td /F1 9.8 Tf [(Brownlie J, Howson A. \(2006\) 'Between the demands of truth and government': health practitioners, trust and immunisation )] TJ ET BT 26.250 431.881 Td /F1 9.8 Tf [(work. Soc Sci Med 62\(2\): 433-443.)] TJ ET BT 26.250 412.476 Td /F1 9.8 Tf [(39.)] TJ ET BT 43.553 412.476 Td /F1 9.8 Tf [(Baromtre IRSN 2010. Perception des risques et de la scurit. Available: )] TJ ET BT 26.250 400.572 Td /F1 9.8 Tf [(http://www.irsn.fr/FR/IRSN/Publications/barometre/Documents/IRSN_Barometre_2010.pdf. Accessed 19 October 2014.)] TJ ET BT 26.250 381.167 Td /F1 9.8 Tf [(40.)] TJ ET BT 43.553 381.167 Td /F1 9.8 Tf [(Benin AL, Wisler-Scher DJ, Colson E, Shapiro ED, Holmboe ES. \(2006\) Qualitative analysis of mothers' decision-making )] TJ ET BT 26.250 369.262 Td /F1 9.8 Tf [(about vaccines for infants: the importance of trust. Pediatrics 117\(5\): 1532-1541.)] TJ ET BT 26.250 349.857 Td /F1 9.8 Tf [(41.)] TJ ET BT 43.553 349.857 Td /F1 9.8 Tf [(Hobson-West P. \(2007\) Trusting blindly can be the biggest risk of all: organised resistance to childhood vaccination in the )] TJ ET BT 26.250 337.953 Td /F1 9.8 Tf [(UK. Sociol Health Illn 29\(2\): 198-215.)] TJ ET BT 26.250 318.548 Td /F1 9.8 Tf [(42.)] TJ ET BT 43.553 318.548 Td /F1 9.8 Tf [(Wardle J, McCaffery K, Nadel M, Atkin W. \(2004\) Socioeconomic differences in cancer screening participation: comparing )] TJ ET BT 26.250 306.643 Td /F1 9.8 Tf [(cognitive and psychosocial explanations. Soc Sci Med 59: 249-261.)] TJ ET BT 26.250 287.238 Td /F1 9.8 Tf [(43.)] TJ ET BT 43.553 287.238 Td /F1 9.8 Tf [(Peretti-Watel P, Raude J, Sagaon-Teyssier L, Constant A, Verger P, Beck F. \(2014\) Attitudes toward vaccination and the )] TJ ET BT 26.250 275.334 Td /F1 9.8 Tf [(H1N1 vaccine: poor peoples unfounded fears or legitimate concerns of the elite? Soc Sci Med 109: 10-18.)] TJ ET Q q 15.000 257.953 577.500 519.047 re W n 0.271 0.267 0.267 rg BT 26.250 759.976 Td /F1 9.8 Tf [(26.)] TJ ET BT 43.553 759.976 Td /F1 9.8 Tf [(Gilkey MB, McRee AL, Brewer NT. \(2013\) Forgone vaccination during childhood and adolescence: Finding of a statewide )] TJ ET BT 26.250 748.071 Td /F1 9.8 Tf [(survey of parents. Prev Med 56: 202-206.)] TJ ET BT 26.250 728.667 Td /F1 9.8 Tf [(27.)] TJ ET BT 43.553 728.667 Td /F1 9.8 Tf [(Velan B, Kaplan G, Ziv A, Boyko V, Lerner-Geva L. \(2011\). Major motives in non-acceptance of A/H1N1 flu vaccination: the )] TJ ET BT 26.250 716.762 Td /F1 9.8 Tf [(weight of rational assessment. Vaccine 29: 1173-1179.)] TJ ET BT 26.250 697.357 Td /F1 9.8 Tf [(28.)] TJ ET BT 43.553 697.357 Td /F1 9.8 Tf [(Streefland P, Chowdhury AM, Ramos-Jimenez P. \(1999\) Patterns of vaccination acceptance. Soc Sci Med 49: 1705-1716.)] TJ ET BT 26.250 677.952 Td /F1 9.8 Tf [(29.)] TJ ET BT 43.553 677.952 Td /F1 9.8 Tf [(Blume S. \(2006\) Anti-vaccination movements and their interpretations. Soc Sci Med 62: 628-642.)] TJ ET BT 26.250 658.548 Td /F1 9.8 Tf [(30.)] TJ ET BT 43.553 658.548 Td /F1 9.8 Tf [(Opel DJ, Taylor JA, Zhou C, Catz S, Myaing M, Mangione-Smith R. \(2013\) The Relationship Between Parent Attitudes )] TJ ET BT 26.250 646.643 Td /F1 9.8 Tf [(About Childhood Vaccines Survey Scores and Future Child Immunization Status A Validation Study. JAMA Pediatr 167\(11\) : )] TJ ET BT 26.250 634.738 Td /F1 9.8 Tf [(1065-1071.)] TJ ET BT 26.250 615.333 Td /F1 9.8 Tf [(31.)] TJ ET BT 43.553 615.333 Td /F1 9.8 Tf [(Wallston KA, Wallston BS \(1982\) Who is responsible for your health? The construct of health locus of control. In : Sanders )] TJ ET BT 26.250 603.429 Td /F1 9.8 Tf [(G, Suls J, editors. Social psychology of health and illness. Hillsdale: Erlbaum. pp. 65-95.)] TJ ET BT 26.250 584.024 Td /F1 9.8 Tf [(32.)] TJ ET BT 43.553 584.024 Td /F1 9.8 Tf [(Giddens A \(1991\) Modernity and self-identity. Stanford: Stanford University Press.)] TJ ET BT 26.250 564.619 Td /F1 9.8 Tf [(33.)] TJ ET BT 43.553 564.619 Td /F1 9.8 Tf [(Foucault M \(2004\). Naissance de la biopolitique, Cours au Collge de France, 1978-1979. Paris: Gallimard/Seuil.)] TJ ET BT 26.250 545.214 Td /F1 9.8 Tf [(34.)] TJ ET BT 43.553 545.214 Td /F1 9.8 Tf [(Crawford R. \(1994\) The boundaries of the self and the unhealthy other: Reflections on health, culture and Aids. Soc Sci )] TJ ET BT 26.250 533.310 Td /F1 9.8 Tf [(Med 38\(10\): 13471365.)] TJ ET BT 26.250 513.905 Td /F1 9.8 Tf [(35.)] TJ ET BT 43.553 513.905 Td /F1 9.8 Tf [(Lupton, D. \(1995\). The imperative of health: Public health and the regulated body. London: Sage.)] TJ ET BT 26.250 494.500 Td /F1 9.8 Tf [(36.)] TJ ET BT 43.553 494.500 Td /F1 9.8 Tf [(Greenhalgh T, Wessely S. \(2004\) Health for me: a sociocultural analysis of healthism in the middle classes. Br Med Bull )] TJ ET BT 26.250 482.595 Td /F1 9.8 Tf [(69\(1\): 197-213.)] TJ ET BT 26.250 463.191 Td /F1 9.8 Tf [(37.)] TJ ET BT 43.553 463.191 Td /F1 9.8 Tf [(Beck U \(1992\) Risk Society. Towards a new modernity. London: Sage Publications.)] TJ ET BT 26.250 443.786 Td /F1 9.8 Tf [(38.)] TJ ET BT 43.553 443.786 Td /F1 9.8 Tf [(Brownlie J, Howson A. \(2006\) 'Between the demands of truth and government': health practitioners, trust and immunisation )] TJ ET BT 26.250 431.881 Td /F1 9.8 Tf [(work. Soc Sci Med 62\(2\): 433-443.)] TJ ET BT 26.250 412.476 Td /F1 9.8 Tf [(39.)] TJ ET BT 43.553 412.476 Td /F1 9.8 Tf [(Baromtre IRSN 2010. Perception des risques et de la scurit. Available: )] TJ ET BT 26.250 400.572 Td /F1 9.8 Tf [(http://www.irsn.fr/FR/IRSN/Publications/barometre/Documents/IRSN_Barometre_2010.pdf. Accessed 19 October 2014.)] TJ ET BT 26.250 381.167 Td /F1 9.8 Tf [(40.)] TJ ET BT 43.553 381.167 Td /F1 9.8 Tf [(Benin AL, Wisler-Scher DJ, Colson E, Shapiro ED, Holmboe ES. \(2006\) Qualitative analysis of mothers' decision-making )] TJ ET BT 26.250 369.262 Td /F1 9.8 Tf [(about vaccines for infants: the importance of trust. Pediatrics 117\(5\): 1532-1541.)] TJ ET BT 26.250 349.857 Td /F1 9.8 Tf [(41.)] TJ ET BT 43.553 349.857 Td /F1 9.8 Tf [(Hobson-West P. \(2007\) Trusting blindly can be the biggest risk of all: organised resistance to childhood vaccination in the )] TJ ET BT 26.250 337.953 Td /F1 9.8 Tf [(UK. Sociol Health Illn 29\(2\): 198-215.)] TJ ET BT 26.250 318.548 Td /F1 9.8 Tf [(42.)] TJ ET BT 43.553 318.548 Td /F1 9.8 Tf [(Wardle J, McCaffery K, Nadel M, Atkin W. \(2004\) Socioeconomic differences in cancer screening participation: comparing )] TJ ET BT 26.250 306.643 Td /F1 9.8 Tf [(cognitive and psychosocial explanations. Soc Sci Med 59: 249-261.)] TJ ET BT 26.250 287.238 Td /F1 9.8 Tf [(43.)] TJ ET BT 43.553 287.238 Td /F1 9.8 Tf [(Peretti-Watel P, Raude J, Sagaon-Teyssier L, Constant A, Verger P, Beck F. \(2014\) Attitudes toward vaccination and the )] TJ ET BT 26.250 275.334 Td /F1 9.8 Tf [(H1N1 vaccine: poor peoples unfounded fears or legitimate concerns of the elite? Soc Sci Med 109: 10-18.)] TJ ET Q q 0.000 0.000 0.000 rg BT 291.710 19.825 Td /F1 11.0 Tf [(7)] TJ ET BT 25.000 19.825 Td /F1 11.0 Tf [(PLOS Currents Outbreaks)] TJ ET Q endstream endobj xref 0 726 0000000000 65535 f 0000000008 00000 n 0000000073 00000 n 0000000119 00000 n 0000000510 00000 n 0000000547 00000 n 0000000774 00000 n 0000001287 00000 n 0000027967 00000 n 0000028074 00000 n 0000028182 00000 n 0000028293 00000 n 0000028406 00000 n 0000028522 00000 n 0000028642 00000 n 0000029030 00000 n 0000038698 00000 n 0000038825 00000 n 0000038997 00000 n 0000039124 00000 n 0000039296 00000 n 0000039423 00000 n 0000039538 00000 n 0000039665 00000 n 0000039790 00000 n 0000039918 00000 n 0000040036 00000 n 0000040164 00000 n 0000040270 00000 n 0000040398 00000 n 0000040513 00000 n 0000040641 00000 n 0000040758 00000 n 0000040886 00000 n 0000041032 00000 n 0000041160 00000 n 0000041196 00000 n 0000041324 00000 n 0000041360 00000 n 0000041488 00000 n 0000041524 00000 n 0000041652 00000 n 0000041688 00000 n 0000041816 00000 n 0000041852 00000 n 0000041980 00000 n 0000042016 00000 n 0000042144 00000 n 0000042180 00000 n 0000042308 00000 n 0000042344 00000 n 0000042472 00000 n 0000042508 00000 n 0000042636 00000 n 0000042672 00000 n 0000042800 00000 n 0000042836 00000 n 0000042963 00000 n 0000043135 00000 n 0000043262 00000 n 0000043434 00000 n 0000043561 00000 n 0000043676 00000 n 0000043803 00000 n 0000043928 00000 n 0000044056 00000 n 0000044174 00000 n 0000044302 00000 n 0000044408 00000 n 0000044536 00000 n 0000044651 00000 n 0000044779 00000 n 0000044896 00000 n 0000045024 00000 n 0000045170 00000 n 0000045298 00000 n 0000045334 00000 n 0000045462 00000 n 0000045498 00000 n 0000045626 00000 n 0000045662 00000 n 0000045790 00000 n 0000045826 00000 n 0000045954 00000 n 0000045990 00000 n 0000046118 00000 n 0000046154 00000 n 0000046282 00000 n 0000046318 00000 n 0000046446 00000 n 0000046482 00000 n 0000046610 00000 n 0000046646 00000 n 0000046774 00000 n 0000046810 00000 n 0000046938 00000 n 0000046974 00000 n 0000047101 00000 n 0000047273 00000 n 0000047400 00000 n 0000047572 00000 n 0000047701 00000 n 0000047817 00000 n 0000047946 00000 n 0000048072 00000 n 0000048202 00000 n 0000048321 00000 n 0000048451 00000 n 0000048558 00000 n 0000048688 00000 n 0000048804 00000 n 0000048934 00000 n 0000049052 00000 n 0000049182 00000 n 0000049329 00000 n 0000049459 00000 n 0000049496 00000 n 0000049626 00000 n 0000049663 00000 n 0000049793 00000 n 0000049830 00000 n 0000049960 00000 n 0000049997 00000 n 0000050127 00000 n 0000050164 00000 n 0000050294 00000 n 0000050331 00000 n 0000050461 00000 n 0000050498 00000 n 0000050628 00000 n 0000050665 00000 n 0000050795 00000 n 0000050832 00000 n 0000050962 00000 n 0000050999 00000 n 0000051129 00000 n 0000051166 00000 n 0000052493 00000 n 0000096016 00000 n 0000096146 00000 n 0000096183 00000 n 0000096313 00000 n 0000096350 00000 n 0000096480 00000 n 0000096517 00000 n 0000096647 00000 n 0000096684 00000 n 0000096814 00000 n 0000096851 00000 n 0000096981 00000 n 0000097018 00000 n 0000097148 00000 n 0000097185 00000 n 0000097315 00000 n 0000097352 00000 n 0000097482 00000 n 0000097519 00000 n 0000097649 00000 n 0000097686 00000 n 0000097816 00000 n 0000097853 00000 n 0000097983 00000 n 0000098020 00000 n 0000098150 00000 n 0000098187 00000 n 0000098317 00000 n 0000098354 00000 n 0000098484 00000 n 0000098521 00000 n 0000098651 00000 n 0000098688 00000 n 0000098818 00000 n 0000098855 00000 n 0000098985 00000 n 0000099022 00000 n 0000099152 00000 n 0000099189 00000 n 0000099319 00000 n 0000099356 00000 n 0000099486 00000 n 0000099523 00000 n 0000099653 00000 n 0000099690 00000 n 0000099820 00000 n 0000099857 00000 n 0000099987 00000 n 0000100024 00000 n 0000100154 00000 n 0000100191 00000 n 0000100321 00000 n 0000100358 00000 n 0000100488 00000 n 0000100525 00000 n 0000100655 00000 n 0000100692 00000 n 0000100822 00000 n 0000100859 00000 n 0000100989 00000 n 0000101026 00000 n 0000101156 00000 n 0000101193 00000 n 0000101323 00000 n 0000101360 00000 n 0000101490 00000 n 0000101527 00000 n 0000101655 00000 n 0000101692 00000 n 0000101822 00000 n 0000101859 00000 n 0000101989 00000 n 0000102026 00000 n 0000102156 00000 n 0000102193 00000 n 0000102323 00000 n 0000102360 00000 n 0000102490 00000 n 0000102527 00000 n 0000102657 00000 n 0000102694 00000 n 0000102824 00000 n 0000102861 00000 n 0000102991 00000 n 0000103028 00000 n 0000103158 00000 n 0000103195 00000 n 0000103325 00000 n 0000103362 00000 n 0000103492 00000 n 0000103529 00000 n 0000103659 00000 n 0000103696 00000 n 0000103826 00000 n 0000103863 00000 n 0000103993 00000 n 0000104030 00000 n 0000104160 00000 n 0000104197 00000 n 0000104327 00000 n 0000104364 00000 n 0000104494 00000 n 0000104531 00000 n 0000104661 00000 n 0000104698 00000 n 0000104828 00000 n 0000104865 00000 n 0000104995 00000 n 0000105032 00000 n 0000105162 00000 n 0000105199 00000 n 0000105329 00000 n 0000105366 00000 n 0000105496 00000 n 0000105533 00000 n 0000105663 00000 n 0000105700 00000 n 0000105830 00000 n 0000105867 00000 n 0000105997 00000 n 0000106034 00000 n 0000106164 00000 n 0000106201 00000 n 0000106331 00000 n 0000106368 00000 n 0000106498 00000 n 0000106535 00000 n 0000106665 00000 n 0000106702 00000 n 0000106832 00000 n 0000106869 00000 n 0000106999 00000 n 0000107036 00000 n 0000107166 00000 n 0000107203 00000 n 0000107333 00000 n 0000107370 00000 n 0000107500 00000 n 0000107537 00000 n 0000107667 00000 n 0000107704 00000 n 0000107834 00000 n 0000107871 00000 n 0000108001 00000 n 0000108038 00000 n 0000108168 00000 n 0000108205 00000 n 0000108335 00000 n 0000108372 00000 n 0000108502 00000 n 0000108539 00000 n 0000108669 00000 n 0000108706 00000 n 0000108836 00000 n 0000108873 00000 n 0000109003 00000 n 0000109040 00000 n 0000109170 00000 n 0000109207 00000 n 0000109337 00000 n 0000109374 00000 n 0000109504 00000 n 0000109541 00000 n 0000109671 00000 n 0000109708 00000 n 0000109838 00000 n 0000109875 00000 n 0000110005 00000 n 0000110042 00000 n 0000110172 00000 n 0000110209 00000 n 0000110337 00000 n 0000110374 00000 n 0000110504 00000 n 0000110541 00000 n 0000110671 00000 n 0000110708 00000 n 0000110838 00000 n 0000110875 00000 n 0000111005 00000 n 0000111042 00000 n 0000111172 00000 n 0000111209 00000 n 0000111339 00000 n 0000111376 00000 n 0000111506 00000 n 0000111543 00000 n 0000111673 00000 n 0000111710 00000 n 0000111840 00000 n 0000111877 00000 n 0000112007 00000 n 0000112044 00000 n 0000112174 00000 n 0000112211 00000 n 0000112341 00000 n 0000112378 00000 n 0000112508 00000 n 0000112545 00000 n 0000112675 00000 n 0000112712 00000 n 0000112842 00000 n 0000112879 00000 n 0000113009 00000 n 0000113046 00000 n 0000113176 00000 n 0000113213 00000 n 0000113343 00000 n 0000113380 00000 n 0000113510 00000 n 0000113547 00000 n 0000113677 00000 n 0000113714 00000 n 0000113844 00000 n 0000113881 00000 n 0000114011 00000 n 0000114048 00000 n 0000114178 00000 n 0000114215 00000 n 0000114345 00000 n 0000114382 00000 n 0000114512 00000 n 0000114549 00000 n 0000114679 00000 n 0000114716 00000 n 0000114846 00000 n 0000114883 00000 n 0000115013 00000 n 0000115050 00000 n 0000115180 00000 n 0000115217 00000 n 0000115347 00000 n 0000115384 00000 n 0000115514 00000 n 0000115551 00000 n 0000115681 00000 n 0000115718 00000 n 0000115848 00000 n 0000115885 00000 n 0000116015 00000 n 0000116052 00000 n 0000116182 00000 n 0000116219 00000 n 0000116349 00000 n 0000116386 00000 n 0000116516 00000 n 0000116553 00000 n 0000116683 00000 n 0000116720 00000 n 0000116850 00000 n 0000116887 00000 n 0000117017 00000 n 0000117054 00000 n 0000117184 00000 n 0000117221 00000 n 0000117351 00000 n 0000117388 00000 n 0000117518 00000 n 0000117555 00000 n 0000117685 00000 n 0000117722 00000 n 0000117852 00000 n 0000117889 00000 n 0000118019 00000 n 0000118056 00000 n 0000118186 00000 n 0000118223 00000 n 0000118353 00000 n 0000118390 00000 n 0000118520 00000 n 0000118557 00000 n 0000118687 00000 n 0000118724 00000 n 0000118854 00000 n 0000118891 00000 n 0000119019 00000 n 0000119056 00000 n 0000119186 00000 n 0000119223 00000 n 0000119353 00000 n 0000119390 00000 n 0000119520 00000 n 0000119557 00000 n 0000119687 00000 n 0000119724 00000 n 0000119854 00000 n 0000119891 00000 n 0000120021 00000 n 0000120058 00000 n 0000120188 00000 n 0000120225 00000 n 0000120355 00000 n 0000120392 00000 n 0000120522 00000 n 0000120559 00000 n 0000120689 00000 n 0000120726 00000 n 0000120856 00000 n 0000120893 00000 n 0000121023 00000 n 0000121060 00000 n 0000121190 00000 n 0000121227 00000 n 0000121357 00000 n 0000121394 00000 n 0000121524 00000 n 0000121561 00000 n 0000121691 00000 n 0000121728 00000 n 0000121858 00000 n 0000121895 00000 n 0000122025 00000 n 0000122062 00000 n 0000122357 00000 n 0000151369 00000 n 0000151499 00000 n 0000151536 00000 n 0000151666 00000 n 0000151703 00000 n 0000151831 00000 n 0000151868 00000 n 0000151998 00000 n 0000152035 00000 n 0000152165 00000 n 0000152202 00000 n 0000152332 00000 n 0000152369 00000 n 0000152497 00000 n 0000152534 00000 n 0000152662 00000 n 0000152699 00000 n 0000152827 00000 n 0000152864 00000 n 0000152994 00000 n 0000153031 00000 n 0000153161 00000 n 0000153198 00000 n 0000153326 00000 n 0000153363 00000 n 0000153493 00000 n 0000153530 00000 n 0000153660 00000 n 0000153697 00000 n 0000153827 00000 n 0000153864 00000 n 0000153992 00000 n 0000154029 00000 n 0000154157 00000 n 0000154194 00000 n 0000154322 00000 n 0000154359 00000 n 0000154489 00000 n 0000154526 00000 n 0000154656 00000 n 0000154693 00000 n 0000154821 00000 n 0000154858 00000 n 0000154988 00000 n 0000155025 00000 n 0000155155 00000 n 0000155192 00000 n 0000155322 00000 n 0000155359 00000 n 0000155487 00000 n 0000155524 00000 n 0000155652 00000 n 0000155689 00000 n 0000155817 00000 n 0000155854 00000 n 0000156485 00000 n 0000189832 00000 n 0000189962 00000 n 0000189999 00000 n 0000190127 00000 n 0000190164 00000 n 0000190292 00000 n 0000190329 00000 n 0000190459 00000 n 0000190496 00000 n 0000190626 00000 n 0000190663 00000 n 0000190793 00000 n 0000190830 00000 n 0000190960 00000 n 0000190997 00000 n 0000191127 00000 n 0000191164 00000 n 0000191294 00000 n 0000191331 00000 n 0000191461 00000 n 0000191498 00000 n 0000191628 00000 n 0000191665 00000 n 0000191795 00000 n 0000191832 00000 n 0000191962 00000 n 0000191999 00000 n 0000192129 00000 n 0000192166 00000 n 0000192294 00000 n 0000192331 00000 n 0000192459 00000 n 0000192496 00000 n 0000192626 00000 n 0000192663 00000 n 0000192791 00000 n 0000192828 00000 n 0000192958 00000 n 0000192995 00000 n 0000193125 00000 n 0000193162 00000 n 0000193292 00000 n 0000193329 00000 n 0000193459 00000 n 0000193496 00000 n 0000193625 00000 n 0000193763 00000 n 0000194792 00000 n 0000259503 00000 n 0000259633 00000 n 0000259670 00000 n 0000259798 00000 n 0000259835 00000 n 0000259963 00000 n 0000260000 00000 n 0000260130 00000 n 0000260167 00000 n 0000260297 00000 n 0000260334 00000 n 0000260464 00000 n 0000260501 00000 n 0000260631 00000 n 0000260668 00000 n 0000260798 00000 n 0000260835 00000 n 0000260965 00000 n 0000261002 00000 n 0000261132 00000 n 0000261169 00000 n 0000261299 00000 n 0000261336 00000 n 0000261466 00000 n 0000261503 00000 n 0000261633 00000 n 0000261670 00000 n 0000261800 00000 n 0000261837 00000 n 0000261965 00000 n 0000262002 00000 n 0000262130 00000 n 0000262167 00000 n 0000262297 00000 n 0000262334 00000 n 0000262462 00000 n 0000262499 00000 n 0000262629 00000 n 0000262666 00000 n 0000262796 00000 n 0000262833 00000 n 0000262963 00000 n 0000263000 00000 n 0000263130 00000 n 0000263167 00000 n 0000263296 00000 n 0000263434 00000 n 0000264463 00000 n 0000329174 00000 n 0000329304 00000 n 0000329341 00000 n 0000329469 00000 n 0000329506 00000 n 0000329634 00000 n 0000329671 00000 n 0000329801 00000 n 0000329838 00000 n 0000329968 00000 n 0000330005 00000 n 0000330135 00000 n 0000330172 00000 n 0000330302 00000 n 0000330339 00000 n 0000330469 00000 n 0000330506 00000 n 0000330636 00000 n 0000330673 00000 n 0000330803 00000 n 0000330840 00000 n 0000330970 00000 n 0000331007 00000 n 0000331137 00000 n 0000331174 00000 n 0000331304 00000 n 0000331341 00000 n 0000331471 00000 n 0000331508 00000 n 0000331636 00000 n 0000331673 00000 n 0000331801 00000 n 0000331838 00000 n 0000331968 00000 n 0000332005 00000 n 0000332133 00000 n 0000332170 00000 n 0000332300 00000 n 0000332337 00000 n 0000332467 00000 n 0000332504 00000 n 0000332634 00000 n 0000332671 00000 n 0000332801 00000 n 0000332838 00000 n 0000332967 00000 n 0000333105 00000 n 0000334134 00000 n 0000398845 00000 n 0000399874 00000 n 0000464585 00000 n 0000464928 00000 n 0000493814 00000 n 0000493944 00000 n 0000493981 00000 n 0000494111 00000 n 0000494148 00000 n 0000494278 00000 n 0000494315 00000 n 0000494445 00000 n 0000494482 00000 n 0000494610 00000 n 0000494647 00000 n 0000494777 00000 n 0000494814 00000 n 0000494944 00000 n 0000494981 00000 n 0000495111 00000 n 0000495148 00000 n 0000495278 00000 n 0000495315 00000 n 0000495445 00000 n 0000495482 00000 n 0000495610 00000 n 0000495647 00000 n 0000495777 00000 n 0000495814 00000 n 0000495944 00000 n 0000495981 00000 n 0000496111 00000 n 0000496148 00000 n 0000496278 00000 n 0000496315 00000 n 0000496443 00000 n 0000496480 00000 n 0000496610 00000 n 0000496647 00000 n 0000496777 00000 n 0000496814 00000 n 0000496944 00000 n 0000496981 00000 n 0000497111 00000 n 0000497148 00000 n 0000497278 00000 n 0000497315 00000 n 0000497443 00000 n 0000497480 00000 n 0000497610 00000 n 0000497647 00000 n 0000497777 00000 n 0000497814 00000 n 0000497944 00000 n 0000497981 00000 n 0000498111 00000 n 0000498148 00000 n 0000498276 00000 n 0000498313 00000 n 0000498443 00000 n 0000498480 00000 n 0000498610 00000 n 0000498647 00000 n 0000498777 00000 n 0000498814 00000 n 0000498944 00000 n 0000498981 00000 n 0000499111 00000 n 0000499148 00000 n 0000499276 00000 n 0000499313 00000 n 0000499380 00000 n 0000519773 00000 n 0000519840 00000 n trailer << /Size 726 /Root 1 0 R /Info 5 0 R >> startxref 535259 %%EOF