Mobile Phone Survey Research Articles

The Impact of the COVID-19 Pandemic on Mobility Trends and the Associated Rise in Population-Level Physical Inactivity: Insights From International Mobile Phone and National Survey Data.

IntroductionThe COVID-19 pandemic has reduced physical activity (PA) levels. This is important as physical inactivity is linked to poor COVID-19 outcomes. This study aimed to assess the impact of COVID-19 pandemic restrictions on greenspace and residence mobility, walking levels and in turn how these translated to trends in (UK) PA levels.MethodsGoogle Mobility Reports, the Oxford COVID-19 Government Response Tracker and Apple Mobility geospatial datasets were interrogated for international data. Residence mobility represents home mobility, greenspace mobility includes parks, walking direction requests is proportion of walking directions; stringency index measures lockdown intensity. The Sports England Active Lives Survey dataset was assessed for complementary changes in English PA levels.ResultsUsing mobility data of 10 countries we observed that during lockdown there were reductions in greenspace mobility and walking directions alongside increased residence mobility; more pronounced changes were seen in countries with higher stringency indices. From a UK perspective, complementary English PA survey data demonstrated the impact of these mobility changes on the proportion and demographic characteristics of PA levels. The most vulnerable in society, the elderly (ages 75+) and Black and Asian minority ethnicity (BAME) individuals were more likely to become physically inactive.ConclusionsThe COVID-19 pandemic reduced greenspace mobility and walking direction requests globally. Complementary assessment of English PA levels demonstrated a greater proportion of the population became inactive. Demographics (75+ and BAME) prone to worse COVID-19 outcomes became disproportionately inactive. UK Urban planning should prioritize greenspace development. This could improve city walkability and PA levels.

Using real-time mobile phone data to characterize the relationships between small-scale farmers’ planting dates and socio-environmental factors

Accurate and operational indicators of the start of growing season (SOS) are critical for crop modeling, famine early warning, and agricultural management in the developing world. Erroneous SOS estimates–late, or early, relative to actual planting dates–can lead to inaccurate crop production and food-availability forecasts. Adapting rainfed agriculture to climate change requires improved harmonization of planting with the onset of rains, and the rising ubiquity of mobile phones in east Africa enables real-time monitoring of this important agricultural decision. We investigate whether antecedent agro-meteorological variables and household-level attributes can be used to predict planting dates of small-scale maize producers in central Kenya. Using random forest models, we compare remote estimates of SOS with field-level survey data of actual planting dates. We compare three years of planting dates (2016–2018) for two rainy seasons (the October-to-December short rains, and the March-to-May long rains) gathered from weekly Short Message Service (SMS) mobile phone surveys. In situ data are compared to SOS from the Water Requirement Satisfaction Index (SOSWRSI) and other agro-meteorological variables from Earth observation (EO) datasets (rainfall, NDVI, and evaporative demand). The majority of farmers planted within 20 days of the SOSWRSI from 2016 to 2018. In the 2016 long rains season, many farmers reported planting late, which corresponds to drought conditions. We find that models relying solely on EO variables perform as well as models using both socio-economic and EO variables. The predictive accuracy of EO variables appears to be insensitive to differences in reference periods that were tested for deriving EO anomalies (1, 3, 5, or 10 years). As such, it would appear that farmers are either responding to short-term weather conditions (e.g., intra-seasonal variability), or longer trends than were included in this study (e.g., 25–30 years), when planting. The methodologies used in this study, weekly SMS surveys, provide an operational means for estimating farmer behaviors–information which is traditionally difficult and costly to collect.

Pseudo-Pflow: Development of Nationwide Synthetic Open Dataset for People Movement Based on Limited Travel Survey and Open Statistical Data

People flow data are utilized in diverse fields such as urban and commercial planning and disaster management. However, people flow data collected from mobile phones, such as using global positioning system and call detail records data, are difficult to obtain because of privacy issues. Even if the data were obtained, they would be difficult to handle. This study developed pseudo-people-flow data covering all of Japan by combining public statistical and travel survey data from limited urban areas. This dataset is not a representation of actual travel movements but of typical weekday movements of people. Therefore it is expected to be useful for various purposes. Additionally, the dataset represents the seamless movement of people throughout Japan, with no restrictions on coverage, unlike the travel surveys. In this paper, we propose a method for generating pseudo-people-flow and describe the development of a "Pseudo-PFLOW" dataset covering the entire population of approximately 130 million people. We then evaluated the accuracy of the dataset using mobile phone and trip survey data from multiple metropolitan areas. The results showed that a coefficient of determination of more than 0.5 was confirmed for comparisons regarding population distribution and trip volume.

Representativeness of individual-level data in COVID-19 phone surveys: Findings from Sub-Saharan Africa.

The COVID-19 pandemic has created urgent demand for timely data, leading to a surge in mobile phone surveys for tracking the impacts of and responses to the pandemic. Using data from national phone surveys implemented in Ethiopia, Malawi, Nigeria and Uganda during the pandemic and the pre-COVID-19 national face-to-face surveys that served as the sampling frames for the phone surveys, this paper documents selection the biases in individual-level analyses based on phone survey data. In most cases, individual-level data are available only for phone survey respondents, who we find are more likely to be household heads or their spouses and non-farm enterprise owners, and on average, are older and better educated vis-a-vis the general adult population. These differences are the result of uneven access to mobile phones in the population and the way that phone survey respondents are selected. To improve the representativeness of individual-level analysis using phone survey data, we recalibrate the phone survey sampling weights based on propensity score adjustments that are derived from a model of an individual's likelihood of being interviewed as a function of individual- and household-level attributes. We find that reweighting improves the representativeness of the estimates for phone survey respondents, moving them closer to those of the general adult population. This holds for both women and men and for a range of demographic, education, and labor market outcomes. However, reweighting increases the variance of the estimates and, in most cases, fails to overcome selection biases. This indicates limitations to deriving representative individual-level estimates from phone survey data. Obtaining reliable data on men and women through future phone surveys will require random selection of adult interviewees within sampled households.

Population Health Surveillance Using Mobile Phone Surveys in Low- and Middle-Income Countries: Methodology and Sample Representativeness of a Cross-sectional Survey of Live Poultry Exposure in Bangladesh.

BackgroundPopulation-based health surveys are typically conducted using face-to-face household interviews in low- and middle-income countries (LMICs). However, telephone-based surveys are cheaper, faster, and can provide greater access to hard-to-reach or remote populations. The rapid growth in mobile phone ownership in LMICs provides a unique opportunity to implement novel data collection methods for population health surveys.ObjectiveThis study aims to describe the development and population representativeness of a mobile phone survey measuring live poultry exposure in urban Bangladesh.MethodsA population-based, cross-sectional, mobile phone survey was conducted between September and November 2019 in North and South Dhaka City Corporations (DCC), Bangladesh, to measure live poultry exposure using a stratified probability sampling design. Data were collected using a computer-assisted telephone interview platform. The call operational data were summarized, and the participant data were weighted by age, sex, and education to the 2011 census. The demographic distribution of the weighted sample was compared with external sources to assess population representativeness.ResultsA total of 5486 unique mobile phone numbers were dialed, with 1047 respondents completing the survey. The survey had an overall response rate of 52.2% (1047/2006) and a co-operation rate of 89.0% (1047/1176). Initial results comparing the sociodemographic profile of the survey sample to the census population showed that mobile phone sampling slightly underrepresented older individuals and overrepresented those with higher secondary education. After weighting, the demographic profile of the sample population matched well with the latest DCC census population profile.ConclusionsProbability-based mobile phone survey sampling and data collection methods produced a population-representative sample with minimal adjustment in DCC, Bangladesh. Mobile phone–based surveys can offer an efficient, economic, and robust way to conduct surveillance for population health outcomes, which has important implications for improving population health surveillance in LMICs.

Effects of Coronavirus Pandemic on Young Adults’ Ability to Access Health Services and Practice Recommended Preventive Measures

Given the limited attention to young adults as key contributors to the spread of COVID-19 in Uganda, this study examines the effects of the outbreak on the ability of young adults aged 18-29 to access health services and practice preventive measures. A national population-based mobile phone survey was conducted in December 2020. Multivariable regression analyses were used to explore the effect of the COVID-19 pandemic on access to health care services. Control variables included region, education level, parity, and source of health information. The majority (98%) perceived COVID-19 as a serious threat to Ugandans. Although the majority reported handwashing (97%) and masking (92%), fewer respondents avoided shaking hands (39%), ensured physical distancing (57%), avoided groups of more than four people (43%), stayed home most days (30%), avoided touching eyes, nose, and mouth (14%), and practiced sneezing/coughing into their elbow (7%). Participants noted that the COVID-19 pandemic affected their ability to access family planning (40%), HIV (49%), maternal health (55%), child health (56%), and malaria (63%) services. The perceived effect of the COVID-19 pandemic on services was higher for those in the Northern region (OR= 2.00, 95% CI 1.00-4.02), those with higher education OR= 2.26, 95% CI 1.28-3.99), those with five plus children (OR= 2.05, 95% CI 0.92-4.56), and those who trust radio for COVID-19 information (OR= 1.65, 95% CI 1.01-2.67). The findings show the pragmatic importance of understanding the dynamic characteristics and behavioral patterns of young adults in the context of COVID-19 to inform targeted programming.

Patchy signals: capturing women’s voices in mobile phone surveys of rural India

Phone surveys are a rapid and cost-effective way to collect primary data for research, monitoring and evaluation purposes. But for these data to be precise, reliable and unbiased, women’s perspectives...

Antibiotics Use and Its Knowledge in the Community: A Mobile Phone Survey during the COVID-19 Pandemic in Bangladesh.

The general population has been excessively using antibiotics during the COVID-19 pandemic. Therefore, the use of antibiotics for any reported illnesses in the preceding four weeks and knowledge of antibiotics among the general population in the community were assessed for possible interventions. A mobile phone survey among a general population across eight administrative divisions of Bangladesh was conducted during January–March 2021. Reported illness episodes irrespective of COVID-19 in the preceding four weeks of the interview, use of antibiotics for the illnesses, and knowledge on antibiotics among the general population were recorded. Descriptive analyses were performed. We randomly interviewed 1854 participants, with a mean age of 28.5 years (range: 18–75 years); 60.6% were male. Among all participants, 86.3% (95% CI: 84.7–87.8) heard names of antibiotics, but only 12.1% reported unspecified harmful effects, and 3.5% reported antimicrobial resistance when antibiotics were taken without a physician’s prescription. Among 257 (13.9%) participants, who consumed medicines for their recent illness episode, 32.7% (95% CI: 27.2–38.6) reported using antibiotics. Of those who could recall the names of antibiotics prescribed (n = 36), the most frequently used was azithromycin (22.2%) followed by cefixime (11.1%) and ciprofloxacin (5.6%). Our findings show an increased antibiotic use for illnesses reported in the preceding four weeks and an elevated knowledge at the community level during the COVID-19 pandemic compared with the pre-pandemic period.

Who do phone surveys miss, and how to reduce exclusion: recommendations from phone surveys in nine Indian states

Computer-assisted telephone interviews (CATI) through mobile phones are a low-cost, rapid and safe way to collect data. However, decisions for how such mobile phone surveys are designed and implemented, and...

COVID-19 vaccine access and attitudes among people experiencing homelessness from pilot mobile phone survey in Los Angeles, CA.

People experiencing homelessness (PEH) are at high risk for COVID-19 complications and fatality, and have been prioritized for vaccination in many areas. Yet little is known about vaccine acceptance in this population. The objective of this study was to determine the level of vaccine hesitancy among PEH in Los Angeles, CA and to understand the covariates of hesitancy in relation to COVID-19 risk, threat perception, self-protection and information sources. A novel mobile survey platform was deployed to recruit PEH from a federally qualified health center (FQHC) in Los Angeles to participate in a monthly rapid response study of COVID-19 attitudes, behaviors, and risks. Of 90 PEH surveyed, 43 (48%) expressed some level of vaccine hesitancy based either on actual vaccine offers (17/90 = 19%) or a hypothetical offer (73/90 = 81%). In bivariate analysis, those with high COVID-19 threat perception were less likely to be vaccine hesitant (OR = 0.34, P = 0.03), while those who frequently practiced COVID-19 protective behaviors were more likely to be vaccine hesitant (OR = 2.21, P = 0.08). In a multivariate model, those with high threat perception (AOR = 0.25, P = 0.02) were less likely to be hesitant, while those engaging in COVID-19 protective behaviors were more hesitant (AOR = 3.63, P = 0.02). Those who trusted official sources were less hesitant (AOR = 0.37, P = 0.08) while those who trusted friends and family for COVID-19 information (AOR = 2.70, P = 0.07) were more likely to be hesitant. Findings suggest that targeted educational and social influence interventions are needed to address high levels of vaccine hesitancy among PEH.

A cost study for mobile phone health surveys using interactive voice response for assessing risk factors of noncommunicable diseases

BackgroundThis is the first study to examine the costs of conducting a mobile phone survey (MPS) through interactive voice response (IVR) to collect information on risk factors for noncommunicable diseases (NCD) in three low- and middle-income countries (LMIC); Bangladesh, Colombia, and Uganda.MethodsThis is a micro-costing study conducted from the perspective of the payer/funder with a 1-year horizon. The study evaluates the fixed costs and variable costs of implementing one nationally representative MPS for NCD risk factors of the adult population. In this costing study, we estimated the sample size of calls required to achieve a population-representative survey and associated incentives. Cost inputs were obtained from direct economic costs incurred by a central study team, from country-specific collaborators, and from platform developers who participated in the deployment of these MPS during 2017. Costs were reported in US dollars (USD). A sensitivity analysis was conducted assessing different scenarios of pricing and incentive strategies. Also, costs were calculated for a survey deployed targeting only adults younger than 45 years.ResultsWe estimated the fixed costs ranging between $47,000 USD and $74,000 USD. Variable costs were found to be between $32,000 USD and $129,000 USD per nationally representative survey. The main cost driver was the number of calls required to meet the sample size, and its variability largely depends on the extent of mobile phone coverage and access in the country. Therefore, a larger number of calls were estimated to survey specific harder-to-reach sub-populations.ConclusionMobile phone surveys have the potential to be a relatively less expensive and timely method of collecting survey information than face-to-face surveys, allowing decision-makers to deploy survey-based monitoring or evaluation programs more frequently than it would be possible having only face-to-face contact. The main driver of variable costs is survey time, and most of the variability across countries is attributable to the sampling differences associated to reaching out to population subgroups with low mobile phone ownership or access.

Validity of using mobile phone surveys to evaluate community health worker program in Mali

BackgroundThe monitoring and evaluation of public health programs based on traditional face-to-face interviews in hard-to-reach and unstable regions present many challenges. Mobile phone-based methods are considered to be an effective alternative, but the validity of mobile phone-based data for assessing implementation strength has not been sufficiently studied yet. Nested within an evaluation project for an integrated community case management (iCCM) and family planning program in Mali, this study aimed to assess the validity of a mobile phone-based health provider survey to measure the implementation strength of this program.MethodsFrom July to August 2018, a cross-sectional survey was conducted among the community health workers (ASCs) from six rural districts working with the iCCM and family planning program. ASCs were first reached to complete the mobile phone-based survey; within a week, ASCs were visited in their communities to complete the in-person survey. Both surveys used identical implementation strength tools to collect data on program activities related to iCCM and family planning. Sensitivity and specificity were calculated for each implementation strength indicator collected from the phone-based survey, with the in-person survey as the gold standard. A threshold of ≥ 80% for sensitivity and specificity was considered adequate for evaluation purposes.ResultsOf the 157 ASCs interviewed by mobile phone, 115 (73.2%) were reached in person. Most of the training (2/2 indicators), supervision (2/3), treatment/modern contraceptive supply (9/9), and reporting (3/3) indicators reached the 80% threshold for sensitivity, while only one supervision indicator and one supply indicator reached 80% for specificity. In contrast, most of the stock-out indicators (8/9) reached 80% for specificity, while only two indicators reached the threshold for sensitivity.ConclusionsThe validity of mobile phone-based data was adequate for general training, supervision, and supply indicators for iCCM and family planning. With sufficient mobile phone coverage and reliable mobile network connection, mobile phone-based surveys are useful as an alternative for data collection to assess the implementation strength of general activities in hard-to-reach areas.

Single-level approach to estimate origin-destination matrix: exploiting turning proportions and partial OD flows

ABSTRACT This research proposes a novel single-level approach to traffic counts-based OD estimation using observed turning proportions and partial OD flows. The key idea is to relax the need for explicit assignment-based bi-level models and exploit the observations from big traffic data. The observed turning proportions are used to estimate traffic counts; and the structural knowledge of partial OD flows is used to improve the quality of OD estimates. Numerical experiments considering different spatial coverage of partial OD from Bluetooth are conducted on two networks. The study findings indicated that the quality of estimates improve with higher percentage of partial OD information. The proposed approach is computationally faster and yielded slightly better results than the traditional bi-level. The methodology is not limited to data from Bluetooth but adaptive with other sources such as GPS, mobile phone, and travel surveys that can provide turning proportions and/or partial OD flows.

Leveraging mobile phone surveys during the COVID-19 pandemic in Ecuador and Sri Lanka: Methods, timeline and findings.

Effective and rapid decision making during a pandemic requires data not only about infections, but also about human behavior. Mobile phone surveys (MPS) offer the opportunity to collect real-time data on behavior, exposure, knowledge, and perception, as well as care and treatment to inform decision making. The surveys aimed to collect coronavirus disease 2019 (COVID-19) related information in Ecuador and Sri Lanka using mobile phones. In Ecuador, a Knowledge, Attitudes and Practices (KAP) survey was conducted. In Sri Lanka, an evaluation of a novel medicine delivery system was conducted. Using the established mobile network operator channels and technical assistance provided through The Bloomberg Philanthropies Data for Health Initiative (D4H), Ministries of Health fielded a population-based COVID-19-specific MPS using Surveda, the open source data collection tool developed as part of the initiative. A total of 1,185 adults in Ecuador completed the MPS in 14 days. A total of 5,001 adults over the age of 35 in Sri Lanka completed the MPS in 44 days. Both samples were adjusted to the 2019 United Nations Population Estimates to produce population-based estimates by age and sex. The Ecuador COVID-19 MPS found that there was compliance with the mitigation strategies implemented in that country. Overall, 96.5% of Ecuadorians reported wearing a face mask or face covering when leaving home. Overall, 3.8% of Sri Lankans used the service to receive medicines from a government clinic. Among those who used the medicine delivery service in Sri Lanka, 95.8% of those who used a private pharmacy received their medications within one week, and 69.9% of those using a government clinic reported the same. These studies demonstrate that MPS can be conducted quickly and gather essential data. MPS can help monitor the impact of interventions and programs, and rapidly identify what works in mitigating the impact of COVID-19.

Measurement of population mental health: evidence from a mobile phone survey in India.

In high-income countries, population health surveys often measure mental health. This is less common in low- and middle-income countries (LMICs), including in India, where mental health is under-researched relative to its disease burden. The objective of this study is to assess the performance of two questionnaires for measuring population mental health in a mobile phone survey. We adapt the Kessler-6 screening questionnaire and the World Health Organization’s Self-Reporting Questionnaire (SRQ) for a mobile phone survey in the Indian states of Bihar, Jharkhand and Maharashtra. The questionnaires differ in the symptoms they measure and in the number of response options offered. Questionnaires are randomly assigned to respondents. We consider a questionnaire to perform well if it identifies geographic and demographic disparities in mental health that are consistent with the literature and does not suffer from selective non-response. Both questionnaires measured less mental distress in Maharashtra than in Bihar and Jharkhand, which is consistent with Maharashtra’s higher human development indicators. The adapted SRQ, but not the adapted Kessler-6, identified women as having worse mental health than men in all three states. Conclusions about population mental health based on the adapted Kessler-6 are likely to be influenced by low response rates (about 82% across the three samples). Respondents were different from non-respondents: non-respondents were less educated and more likely to be female. The SRQ’s higher response rate (about 94% across the three states) may reflect the fact that it was developed for use in LMICs and that it focuses on physical, rather than emotional, symptoms, which may be less stigmatized.

When women eat last: Discrimination at home and women's mental health.

The 2011 India Human Development Survey found that in about a quarter of Indian households, women are expected to have their meals after men have finished eating. This study investigates whether this form of gender discrimination is associated with worse mental health outcomes for women. Our primary data source is a new, state-representative mobile phone survey of women ages 18-65 in Bihar, Jharkhand, and Maharashtra in 2018. We measure mental health using questions from the World Health Organization's Self-Reporting Questionnaire. We find that, for women in these states, eating last is correlated with worse mental health, even after accounting for differences in socioeconomic status. We discuss two possible mechanisms for this relationship: eating last may be associated with worse mental health because it is associated with worse physical health, or eating last may be associated with poor mental health because it is associated with less autonomy, or both.

Gendered economic, social and health effects of the COVID-19 pandemic and mitigation policies in Kenya: evidence from a prospective cohort survey in Nairobi informal settlements

ObjectivesCOVID-19 may spread rapidly in densely populated urban informal settlements. Kenya swiftly implemented mitigation policies; we assess the economic, social and health-related harm disproportionately impacting women.DesignA prospective longitudinal cohort study...

Using Mobile Phone Data Collection Tool, Surveda, for Noncommunicable Disease Surveillance in Five Low- and Middle-income Countries.

The Noncommunicable Disease (NCD) Mobile Phone Survey, a component of the Bloomberg Philanthropies Data for Health Initiative, determines the prevalence of NCDs and their associated risk factors and demonstrates the use of mobile phone administered surveys to supplement periodic national household surveys. The NCD Mobile Phone Survey uses Surveda to administer the survey; Surveda is an open-source, multi-modal software specifically developed for the project. The objective of the paper is to describe Surveda, review data collection methods used in participating countries and discuss how Surveda and similar approaches can improve public health surveillance. Surveda features full-service survey design and implementation through a web application and collects data via Short Messaging Service (SMS), Interactive Voice Response (IVR) and/or mobile web. Surveda's survey design process employs five steps: creating a project, creating questionnaires, designing and starting a survey, monitoring survey progress, and exporting survey results. The NCD Mobile Phone Survey has been successfully conducted in five countries, Zambia (2017), Philippines (2018), Morocco (2019), Malawi (2019), and Sri Lanka (2019), with a total of 23,682 interviews completed. This approach to data collection demonstrates that mobile phone surveys can supplement face-to-face data collection methods. Furthermore, Surveda offers major advantages including automated mode-switch, question randomization and comparison features. Accurate and timely survey data informs a country's abilities to make targeted policy decisions while prioritizing limited resources. The high acceptance of Surveda demonstrates that the use of mobile phones for surveillance can deliver accurate and timely data collection.

User Perceptions and Experiences of an Interactive Voice Response Mobile Phone Survey Pilot in Uganda: Qualitative Study

BackgroundWith the growing burden of noncommunicable diseases in low- and middle- income countries, the World Health Organization recommended a stepwise approach of surveillance for noncommunicable diseases. This is expensive to conduct on a frequent basis and using interactive voice response mobile phone surveys has been put forth as an alternative. However, there is limited evidence on how to design and deliver interactive voice response calls that are robust and acceptable to respondents.ObjectiveThis study aimed to explore user perceptions and experiences of receiving and responding to an interactive voice response call in Uganda in order to adapt and refine the instrument prior to national deployment.MethodsA qualitative study design was used and comprised a locally translated audiorecorded interactive voice response survey delivered in 4 languages to 59 purposively selected participants' mobile phones in 5 survey rounds guided by data saturation. The interactive voice response survey had modules on sociodemographic characteristics, physical activity, fruit and vegetable consumption, diabetes, and hypertension. After the interactive voice response survey, study staff called participants back and used a semistructured interview to collect information on the participant’s perceptions of interactive voice response call audibility, instruction clarity, interview pace, language courtesy and appropriateness, the validity of questions, and the lottery incentive. Descriptive statistics were used for the interactive voice response survey, while a framework analysis was used to analyze qualitative data.ResultsKey findings that favored interactive voice response survey participation or completion included preference for brief surveys of 10 minutes or shorter, preference for evening calls between 6 PM and 10 PM, preference for courteous language, and favorable perceptions of the lottery-type incentive. While key findings curtailing participation were suspicion about the caller’s identity, unclear voice, confusing skip patterns, difficulty with the phone interface such as for selecting inappropriate digits for both ordinary and smartphones, and poor network connectivity for remote and rural participants.ConclusionsInteractive voice response surveys should be as brief as possible and considerate of local preferences to increase completion rates. Caller credibility needs to be enhanced through either masking the caller or prior community mobilization. There is need to evaluate the preferred timing of interactive voice response calls, as the finding of evening call preference is inconclusive and might be contextual.

Web Exclusive. Annals On Call - A Primer on COVID-19 Vaccines.

Web Exclusives15 December 2020Annals On Call - A Primer on COVID-19 VaccinesFREERobert M. Centor, MD and Paul Goepfert, MDRobert M. Centor, MDHuntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)Search for more papers by this author and Paul Goepfert, MDThe University of Alabama at Birmingham, Birmingham, Alabama (P.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/A19-0044 Eligible for CME Point-of-CareCME/MOC SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this episode of Annals On Call, Dr. Centor discusses the COVID-19 vaccines under development with Dr. Paul Goepfert.Annals articles discussed include...COVID-19 Vaccine: What Physicians Need to Know: https://www.acpjournals.org/doi/10.7326/M20-6841About Annals On CallAnnals On Call focuses on a clinically influential article published in Annals of Internal Medicine. Dr. Robert Centor shares his own perspective on the material and interviews topic area experts to discuss, debate, and share diverse insights about patient care and health care delivery.For more information on Annals On Call and for more episodes, visit go.annals.org/OnCall. Comments0 CommentsSign In to Submit A Comment Sergio StagnaroQuantum Biophysical Semeiotic Research Laboratory11 January 2021 All Coronavirus vaccines stimulate the evolution of Constitution-Dependent, Inherited Real Risks. The most dangerous, but unfortunately unknown side effect of covid-19 vaccines is the persistent microcirculatory activation in the limbic system, particularly in the hippocampus, which began immediately after the inoculation of coronavirus vaccine (Pfizer, Sputnic V, Moderna, Astra Zeneca, and ReiThera vaccines) (1), I observed in a lot of people, chosen at random by means of psychokinetic Diagnostics (2). If my data will be confirmed on very large scale by that of the Department of Images, then a thorough reflection will be necessary, since the hippocampus intervenes in senile dementia, in Alzheimer Disease, in the transformation of memory short to long term, and in neuronal plasticity and mood (1). Really, these vaccines promote the pathological evolution of Inherited Real Risks, so that in 2030 I predict a pandemic of CVD, T2DM, degenerative Brain Disorders, and Cancer. We can prevent this tragedy by subjecting individuals to be vaccinated to Reconstructing Mitochiondrial Quantum Therapy (3). The result of this enterprise will be the elimination of the predisposition to the most frequent and serious degenerative diseases. References 1) Sergio Stagnaro, Simone Caramel. Un vaccino covid-19 a mRNA attiva i Brain Sensors del Sistema Limbico. http://www.sisbq.org/uploads/5/6/8/7/5687930/pfizerhippocampus.pdf 2) Sergio Stagnaro. Psychokinetic Diagnostics, Quantum Biophysica Semeiotics Evolution. http://sciphu.com/. , 12 March 2010, http://sciphu.com/2010/03/psychokinetic-diagnostics-quantum.html and http://wwwshiphusemeioticscom-stagnaro.blogspot.com/2010/03/psychokinetic-diagnostics-quantum.html 3) Sergio Stagnaro (2021). Consigli utili per evitare i danni da Vaccino anti-covid-19. https://stagnaro.wordpress.com/2021/01/06/consigli-utili-per-evitare-i-danni-da-vaccino-anti-covid-19/ ; http://www.sisbq.org/uploads/5/6/8/7/5687930/vaccinotqmr.pdf ; https://dabpensiero.wordpress.com/2021/01/08/consigli-utili-per-evitare-i-danni-da-vaccino-anti-covid-19/ Disclosures: No conflict of interest declared Author, Article, and Disclosure InformationAffiliations: Huntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)The University of Alabama at Birmingham, Birmingham, Alabama (P.G.)Disclosures: Dr. Centor has disclosed the following: Consultancy: DynaMed, MDCalc, Medscape, National Kidney Foundation, The Curbsiders. Employment: U.S. Department of Veterans Affairs. Dr. Goepfert has disclosed no conflicts of interest.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Stephanie Chang, MD, MPH, Deputy Editor, reports employment with the Agency for Healthcare Research and Quality, travel compensation from the Guidelines International Network, and participation in the Patient-Centered Outcomes Research Institute methodology committee. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interests to disclose. Eliseo Guallar, MD, MPH, DrPH, Deputy Editor, Statistics, reports that he has no financial relationships or interests to disclose. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.This article was published at Annals.org on 24 November 2020. Previousarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCOVID-19 Vaccine: What Physicians Need to Know Christine Laine , Deborah Cotton , and Darilyn V. Moyer Metrics Cited byThe Impact of the COVID-19 Pandemic on Mobility Trends and the Associated Rise in Population-Level Physical Inactivity: Insights From International Mobile Phone and National Survey Data 15 December 2020Volume 173, Issue 12Page: OC1 ePublished: 24 November 2020 Issue Published: 15 December 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.Loading ...