IntroductionTo successfully combat COVID-19 vaccine hesitancy and increase uptake, research has demonstrated that interventions are most effective when tailored to meet local needs through active engagement and co-development with communities. This mixed-methods project uses a human-centred design (HCD) approach to understand local perspectives of COVID-19 vaccine hesitancy and develop strategies to enhance vaccine confidence for children and adolescents.Methods and analysisProject ECHO (Étude Communautaire sur l’Hésitation vaccinale contre la COVID-19) combines population-based surveys of parents and adolescents with community-based participatory action research to design and pilot strategies to enhance COVID-19 vaccine confidence in two underserved and ethnoculturally diverse neighbourhoods of Montreal, Canada. Two surveys conducted 6 months apart through primary and secondary schools are used to monitor vaccine acceptance and its social determinants among children and youth. Analyses of survey data include descriptive and inferential statistical approaches. Community-led design teams of parents and youth from the two participating neighbourhoods, supported by academic researchers, design thinking experts and community partners, use an HCD approach to: (1) gather data to understand COVID-19 vaccine decision-making among parents and youth in their community and frame a design challenge (inspiration phase); (2) develop an intervention to address the design challenge (ideation phase) and (3) pilot the intervention (implementation phase). Strategies to evaluate the community-led interventions will be co-developed during the implementation phase.Ethics and disseminationThis study has been approved by the research ethics boards of the Sainte-Justine University Hospital Centre and the University of Montreal. Community design teams will be involved in the dissemination of findings and the design of knowledge translation initiatives that foster dialogue related to COVID-19 vaccination for children and adolescents among community, school and public health stakeholders. Findings will be disseminated through peer-reviewed publications, conference presentations, community forums, policy briefs, and social media content.

Background The global debate on the efficacy of hydroxychloroquine (HCQ) on COVID-19 has gone far beyond the scientific framework and has been highly politicized. These issues immediately invested the debate on HCQ and made it an object of particular crystallization. This study analyzes, through the Malian press, the echo of this debate in the national background. Methods Mixed methods design, based on a review of 452 articles about COVID-19 published by six major Malian newspapers, from January 1st to July 31st 2020. Results of a content analysis with WORDSTAT8 software were further explained by a thematic qualitative analysis using and deductive-indictive approach. Results The debate on HCQ has had very little echo in the Malian press despite some interest, because of a lack of anchoring and thus of a "response" at the national level. The national health authorities, who adopted the treatment as part of clinical trials, and the press, stayed away from both the medical and the "ideological" components of the debate, despite these a priori directly involved a country like Mali. Conclusions The paper sheds light on the issues at stake in the HCQ debate based on a case study of an atypical country in terms of impacts of Covid-19. The governance of COVID helped crystallize political opposition to the presidential regime leading to a coup in August.

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