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All things no matter its material basis have ideas, practices and beliefs surrounding it, legitimized culturally and socially (Kleinman). These ideas, beliefs,and practices around something are influenced by the world we live in, and alsochanges as the world around us changes (Kleinman). This is the case with vaccines. No matter what a vaccine is materially; a weakened or killed form of a microbe intended to provide immunity, how it is understood is shaped largely by culture, which we use as a resource to understand the world around us (Wardlow). Thus,the social construction of reality around vaccines and how it is perceived by an individual, ultimately affects ones decision to vaccinate or not (if they havea choice). As follows, when trying to increase the amount of vaccination rates in an area, addressing the underlying determinants around vaccine refusals is ofparamount importance in global health interventions, just as much as supplying the actual vaccine.Ukraine, a country that was once a part of the former Soviet Union, has had thelowest vaccination rates in Europe for several years. In the BBC broadcast titled, Why does Ukraine have Europes lowest vaccination rate?, David Stern narrates that this is due to a myriad of reasons including; the death of a 16 year old boy after a measles injection, beliefs that the vaccine is of poor quality, several doctors encouraging not to vaccinate due to perceived risks, and a shortage of the vaccine itself. Stern reports that only 70-75% of the population is immunizedfrom Polio, whereas 80-85% coverage is needed to stop the spread of the disease;leaving the country vulnerable to an outbreak at any time. An update on the current situation is given in another article from Newsweek, titled Millions of Ukrainian Children at Risk from New Epidemics. In this report, Maxim Tucker writes th

at the aforementioned low vaccination coverage and risk to Polio-like outbreaks,is now further exacerbated by the ongoing war. This conflict in Ukraine; has resulted in poor living conditions, a collapsing health care system, restrictionof access to civilians in the midst of the conflict zone, and shortages of vaccines; leading to conditions for an imminent outbreak. As of present, efforts are being made to supply vaccines, to support the health care system, and to supply other medical equipment, yet there has been no mention of efforts being madeto address the misconceptions around vaccinating.BBC video attributes beliefs of certain doctors and the public to thinking vaccines are harmful and risky rather beneficial, due to ONE reason; the death of Anton who the media wrongly blamed vaccines as the cause of death. The media failsto mention the other myriad of reasons, and culture and health related behaviours are not caused by a single reason but many underlying determinants. Health off

icials say this is due to internet disinformation about risks and harms, and a doctor who is pro vaccination say vaccines are good quality, implying this is what Ukranians need to hear to improve vaccination rates. It is implied vaccinationrefusals can be solved by just communicating the risks and benefits more effectively rather than addressing underlying determinants like political economy, andgovernment corruption, which the video briefly hints to with the distribution system and shortages. To increase vaccination rates just communicating the risksand benefits will not change opinion, but need to address the underlying determinants people use to understand the world around them, reference Wardlow. Also reference Maria about underlying issues.In the BBC video about Ukraines low vaccination rates (have epidemiological number), it is observed that parents concerned about their childrens health, choose not to vaccinate because they believe the vaccinations available to them are of po

or quality, and can harm or kill her children (Stern, BBC).

is mentioned that even the pediatrician, also decided not to vaccinate her children, because she believes that the risk of the vaccine is far greater than the complications from the disease. Stern explains that this started after the deathof a 16 year old boy, after people wrongly accused vaccines as the cause of thedeath, and vaccination numbers plunged drastically. After this many doctors convinced patients not to vaccinate their children. Health officials say the fears are baseless driven partly by internet disinformation. Another doctor is shown sa

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ying that the vaccines in Ukraine is high quality. The video does mention that for people who want to vaccinate, vaccines are hard to come by, but the government does not have enough money to buy vaccines, and the distribution system is plagued with problems. Doritz says that Polio is the first disease that when it arrives parents will say What did I do? I thought the disease did not exist. Healthofficials say if immunization rates do not increase it is not a question of if but when.The BBC video attributes that the death of the 16 year old boy, and people wrongly blaming vaccines as the cause, is what caused vaccination rates to plunge. This is inaccurate for the video tpHealth-related behaviours are often influenced by a myriad of factors. In the BBC broadcast Stern narrates that Ukraine has the lowest immunization rates in Europe and the former Soviet Union, the problem started when people wrongly blameda measles injection for the death of a 16-year old boy. After this vaccination numbers dropped, to just half the child population, and many doctors advised parents to not vaccinate their children. The newscast only attributes one reason asto why vaccination rates are low, and does not explore the other lurking factorsas to why this occurs. Health related behaviours are often influenced by a myriad of factors and not just one D. The broadcast also failed to explore why parents would believe vaccines are harmful enough, to be considered the cause of death. Stern also narrates that parents believe that vaccines are poor quality and fails to explore why that is, and also says that doctors also believe that vaccines are risky and harmful, and encourage patients to not vaccinate their children. The video also fails to explore why doctors and parents believe vaccines are

poor quality, and fails to explore the reasons why. He also attributes the boy dyeing as the reason for why parents and doctors started to not vaccinate. When it is clear that these two populations are stratified by their jobs, and probablyhave different reasons as to why they believe so.