Introduction : La variabilité du rythme cardiaque est étudiée à partir des variations de durée des cycles cardiaques (intervalle R-R de l’électrocardiogramme). Ces variations peuvent être analysées par des méthodes linéaires (temporelles et fréquentielles) et non linéaires (théorie de l’information ou des fractales) de quantifications mathématiques et statistiques qui donnent des informations innovantes sur les signaux analysés. L’application de ces méthodes d’étude en néonatologie a démontré un intérêt pour le diagnostique précoce de l’infection néonatale tardive du prématuré mais n’avait pas été étudié dans l’infection néonatale précoce du nouveau-né à terme, dans le contexte des évènements cardio-respiratoires suivant la primo-vaccination des prématurés ou pour évaluer un effet neurologique de l’hyperbilirubinémie dans l’ictère néonatal. Notre hypothèse dans ce travail était qu’il était possible de : (i) caractériser la variabilité du rythme cardiaque en cas d’infection materno fœtale ou de méningite néonatale, (ii) mettre en évidence des facteurs prédisposant à la survenue d’évènements cardio-respiratoires post-vaccinaux, (iii) Identifier un éventuel retentissement neurologique de l’ictère néonatal par étude de la variabilité du rythme cardiaque. / The heart rate variability measures permitted to evaluate equilibrium state and perturbation in the regulation of cardio-vascular system.  These tools, based on heart rate variability analysis, helped to recognize associated disease state as early onset neonatal sepsis and non-infectious inflammatory response induced to immunization. An increase in global variability (SD), long term variability (SD, LF) and low approximated entropy (ApEn) were observed in the proven-sepsis full term infants. Importance of decrease in ApEn was correlated to the severity of sepsis assessed by blood markers. These suggest an association of sepsis with uncoordinated sympatho-vagal coactivation together with loss of adaptability. In premature infants, the risk of increase in cardio-respiratory events after the first immunization was associated with a specific pre-immunization profile: sympathetic predominance in heart rate control (high LF/HF ratio), abnormal oversimplification of heart rate variability and persistence rhythm control immaturity. Increased ApEn after immunization reflects a marginal result from adaptability of the heart rate to environmental changes without possibility to reserve in case of severe infection.

Ma thèse a permis de développer une nouvelle approche pour étudier, par imagerie in vivo, le comportement des cellules présentatrices d’antigènes (CPA) de la peau suite à la vaccination par voie intradermique chez le primate non-humain. Le ciblage des CPA a été réalisé par injection in vivo d’un anticorps monoclonal anti-HLA-DR fluorescent. L’effet sur les CPA d’un adjuvant (R-848, ligand du TLR7/8) et l’immuno-ciblage des cellules de Langerhans par une protéine de fusion vaccinale anti-VIH (anti-langérine-VIHGag) ont ainsi été évalués par imagerie in vivo, vidéomicroscopie confocale ex vivo et cytométrie en flux. Ce travail a contribué à améliorer nos connaissances immunologiques sur les effets locaux et précoces des vaccins et /ou adjuvants. / My pHD project allowed the development of in vivo imaging approaches to study the skin antigen presenting cell (APC) behavior post-intradermal vaccination in non-human primates. APC targeting was performed by in vivo injection of fluorescent anti-HLA-DR monoclonal antibody. The effect of an adjuvant (R-848, ligand of TLR7/8) on skin APC and the immunotargeting of Langerhans cells by anti-HIV vaccinal fusion protein (anti-langerin-HIVGag) were assessed by in vivo fluorescent imaging, ex vivo confocal videomicroscopy and flow cytometry. This work contributed to improve immunological knowledge on local and early events post-vaccination with or without adjuvant.

Streptococcus suis, l'une des principales bactéries pathogènes présentes chez les porcelets sevrés, est responsable d’importantes pertes économiques dans l'industrie porcine. Aujourd'hui, les vaccins autogènes composés de bactéries tuées (bactérines) sont principalement utilisés mais les études ayant mesuré leur effet chez les porcs sont rares et controversées. Cette étude a évalué la réponse immunitaire induite par ces vaccins sur le terrain en comparant la vaccination des truies (immunité passive transférée aux porcelets) et des porcelets (immunité active). L’étude utilisait une ferme ayant des problèmes récurrents à S. suis et était divisée en deux parties : I) Les porcelets de truies non vaccinées ont reçu 2 doses d'une bactérine autogène. II) Les truies ont reçu 2 doses du même vaccin durant la gestation. Les réponses en anticorps ont été analysées par ELISA et leur effet protecteur par un test d'opsonophagocytose (OPA). La vaccination des porcelets n'a pas induit de réponse immunitaire active même après deux doses. Dans la deuxième partie, des taux élevés d'anticorps (principalement d'origine maternelle) avec une importante activité OPA ont été observés chez les porcelets âgés d’environ 1 semaine, indépendamment de la vaccination des truies. Ils diminuaient à 3 semaines d’âge, période la plus à risque. Malgré une légère augmentation des anticorps chez les truies vaccinées, le transfert d'immunité maternelle aux porcelets restait identique. Globalement, un programme de vaccination actif ou passif de porcelet avec la bactérine autogène utilisée ici n'a pas induit de protection durable chez les porcelets post-sevrés. Une amélioration de la formulation du vaccin est requise. / Streptococcus suis, one of the most important bacterial pathogen in weaned piglets, is responsible for serious economic losses in the swine industry. Today, mostly autogenous vaccines composed of killed bacteria (bacterins) are used but studies that assessed their protective effect on pigs are missing and their ability to protect is controversial. This comparative field study evaluated the immunological response induced by these vaccines comparing vaccination of sows (passive immunity transferred to piglets) or piglets (active immunity). Using a sow herd with recurrent S. suis problems, the study was divided in two parts: I) Piglets from non-vaccinated sows received 2 doses of an autogenous bacterin. II) Sows received 2 doses of the same vaccine during gestation. Antibody responses were analyzed by ELISA and their protective effect was evaluated by an opsonophagocytosis assay (OPA). Piglet vaccination failed to induce an active immune response even after two vaccine doses. In the 2nd part of the study, high levels of antibodies (mainly maternal-derived) with marked OPA activity were observed in piglets at 1 week old approximately, independently of sow vaccination. These antibodies decreased at 3 weeks of age, in the post-weaning high-risk period. In spite of a slight increase of antibodies in vaccinated sows, maternal immunity transfer to piglets did not increase. Overall, an active or passive piglet vaccination program with the autogenous bacterin used herein failed to induce lasting protection in post-weaned piglets. An improvement of vaccine formulation may be required.

This thesis’s main purpose is to understand the recent debate in Sweden concerning the vaccine passport that was caused due to the recent spread of the corona virus. The focus is on what a variety of arguments and positions from different public political debaters have taken in a number of issues regarding vaccine passports. If they have been ideologically consistent regarding their previous ideologic positions in other debates in Sweden. First the thesis describes the three main ideologies used (liberalism, socialism and conservatism) and outlines their main positions. By doing so, the thesis can later compare what Swedish opinion leaders have argued in regards to the vaccine passport and therefore find out if they are relatable to their main ideology.  This has been made possible by the implementation of the design of an Ide whose purpose is to investigate and try to understand why different sides of this debate think about how they think about vaccine passports along with if it seems consistent.. The result points to that it can indeed be found ideological inconsistencies in some varieties. For example, if opinion leaders affiliated with the liberal ideology finding the vaccine passports useful might seem to clash with the main positions of the liberal ideology.

La vaccination est l'un des plus grands progrès réalisés en santé publique. Toutefois, malgré de nombreuses connaissances sur le système immunitaire, de nombreux pans d’ombre empêchent la conception de vaccins contre des pathogènes complexes. Pour pallier ce problème, une meilleure compréhension des modes d'action des vaccins est requise. En particulier, la plupart des vaccins nécessitent plusieurs immunisations pour induire une mémoire immunitaire adaptative au long terme, mais l'impact du délai entre primo-vaccination, induisant une mémoire primaire, et rappel(s) la restimulant pour générer une mémoire secondaire, est peu défini. De plus, la réponse immunitaire innée, induite à chaque immunisation et façonnant l'immunité adaptative, reste peu caractérisée dans ce contexte vaccinal. En vaccinant des macaques cynomolgus avec le virus de la vaccine modifiée Ankara, selon un schéma de primo-vaccination suivie d’un rappel homologue à deux mois, et en utilisant la cytométrie de masse couplée à des analyses bio-informatiques, nous avons caractérisé la réponse innée induite par chaque immunisation. Les réponses innées diffèrent entre primo-vaccination et rappel, avec induction par la primo-vaccination d’une modification phénotypique tardive des cellules innées, suggérant une meilleure capacité à répondre au rappel. De surcroît, la réduction à deux semaines du délai entre primo-vaccination et rappel abroge la mobilisation de ces cellules innées phénotypiquement modifiées et altère la qualité de la réponse humorale. En définitive, en plus de la réponse innée précoce, ce projet a mis en évidence l'induction par la primo-vaccination d'un vraisemblable entraînement inné tardif, un concept émergent traduisant la capacité de mémorisation des cellules innées via des modifications épigénétiques. Ce vraisemblable entraînement, non seulement des monocytes et cellules tueuses naturelles, mais aussi des cellules dendritiques et surprenamment des neutrophiles, est corrélé à la qualité de la mémoire immunitaire adaptative, de manière hautement dépendante du délai entre primo-vaccination et rappel. Ces résultats contribuent à ouvrir la voie vers l’optimisation rationnelle des futurs vaccins, via l'optimisation des calendriers vaccinaux et la valorisation de l'entraînement inné. / Vaccination is one of the best achievements made in public health. However, designing vaccines against complex pathogens is currently challenging. The immune system is indeed uncompletely characterized, despite large amount of accumulated knowledges. A better understanding of vaccine-induced immunity is then required to optimize vaccine design. In particular, while most vaccines require several immunizations to induce a long-lasting adaptive immune memory, little is known on the impact of the delay beween the prime inducing a primary memory and the boost restimulating it to induce a secondary memory. Also, the innate immunity induced by each immunization and shaping the adaptative immunity is poorly characterized in this vaccine context.We studied the innate immune responses in cynomolgus macaques immunized with the modified vaccinia virus Ankara, following an homologous prime-boost vaccination at two months apart. We applied mass cytometry and bioinformatic analyses to characterize the innate response induced by each immunization. We showed that prime and boost vaccination triggered distinct innate responses. Actually, prime induced late phenotypic modifications of innate cells. These phenotypic changes suggest a stronger ability to react to the boost. Moreover, reducing the delay between prime and boost to two weeks impeded the mobilization of these phenotypically modified innate cells, and qualitatively altered humoral response.In conclusion, beyond the early innate responses, these results highlight the late induction by the prime of "likely trained" innate cells. This emerging concept corresponds to the ability of innate cells to display memory features based on epigenetic modifications. This "likely training" occured not only on monocytes and NK cells, but also on dendritic cells and strikingly on neutrophils. It was deeply connected with adaptive immune memory establishment, in a prime-boost delay dependant fashion. These findings contribute to pave the way towards to the rationale design of future vaccines, via vaccine schedule optimization and harnessment of innate training.

Transmis par les moustiques, le virus de la fièvre de la vallée du Rift (vFVR) est un virus zoonotique qui affecte principalement les ruminants en Afrique et conduit à des pertes économiques importantes. Il n’existe actuellement pas de traitements et les seuls vaccins disponibles sont à usage vétérinaire. Le développement de nouveaux vaccins plus sûrs contre le vFVR est une priorité de l’OMS en raison du risque d’émergence de cet arbovirus dans d’autres continents. Dans cette étude, nous avons développé une vaccination à ADN optimisée contre le vFVR qui consiste à administrer par voie cutanée un plasmide codant pour l’ectodomaine de la glycoprotéine de surface Gn du vFVR (eGn) en présence d’un plasmide adjuvant codant le GM-CSF et combinée avec une électroporation. De plus, nous avons également optimisé la vaccination à ADN en l’associant à la stratégie de ciblage des cellules dendritiques (DCs) via un plasmide qui code des fragments d’anticorps scFv fusionnés avec l’eGn dirigés contre les récepteurs DEC205 et CD11c exprimés à la surface des DCs. Les vaccins ont été testés chez le mouton, hôte naturel du virus et dans le modèle murin pour étudier les mécanismes de protection. Dans nos deux modèles d’études, l’immunisation par le plasmide codant l’eGn confère une meilleure protection après une épreuve virale ainsi qu’une forte production d’anticorps non neutralisants par rapport au ciblage des DCs. En revanche, le ciblage d’eGn vers des récepteurs de DCs protège partiellement contre une épreuve virale et induit une immunogénicité différente dans les deux espèces. Nous avons confirmé le rôle protecteur de ces anticorps anti-eGn par un transfert passif dans le modèle murin et le mécanisme d’action de ces anticorps protecteurs reste encore à être déterminé. Notre étude montre pour la première fois la protection par un vaccin à ADN contre le vFVR chez le mouton. / The Rift valley fever virus (RVFV) is a mosquito-borne virus that mainly affect ruminants in Africa, resulting in economic burden. There is currently no treatment and only vaccine for veterinary use against the RVFV are available. The development of new and safer vaccine is urgently needed due to the risk of introduction of this arbovirus to other continents. In the present work, we developed an optimized DNA vaccination against RVFV using a plasmid encoding the ectodomain of surface glycoprotein Gn (eGn) of RVFV into the skin with plasmid adjuvant encoding GM-CSF and electroporation in sheep. We further optimized the DNA vaccination using dendritic cell targeting strategy with a plasmid encoding a single chain fragment variable (scFv) fused with eGn directed to two DC receptors, DEC205 and CD11c. The efficacy of the vaccines were tested in the sheep, the natural host and in the mouse model to investigate the mechanism of protection. In both models non-targeted eGn vaccine confer a better clinical protection and higher non-neutralizing antibody production than DC-targeted vaccine. However, in both models eGn targeting to DEC205 differentially affected the immune response and induced a partial protection after a challenge. We further demonstrated that non-neutralizing antibodies induced by native eGn protect mice by passive transfer. The mechanism mediated by these antibodies remains to be investigated. Overall, this work indicates the proof of concept that DNA vaccine can confer protection against the RVFV in the sheep.

Introduktion: HPV är den vanligaste sexuellt överförbara infektionen i Sverige och orsakar årligen cirka 1100 fall av anal- och cervixcancer. Föräldrars kunskaper och inställningar till HPV och HPV-vaccin varierar, och påverkas bland annat av förälderns kunskapsnivå, utbildningsnivå, inkomst och socioekonomisk status. Health literacy handlar om individens sociala och kognitiva färdigheter och förmåga att tillgodogöra sig information för att kunna främja och upprätthålla god hälsa. Syfte: Syftet var att undersöka mödrars health literacy med avseende på HPV och HPVvaccination av sina barn i åldrarna 6-15 år. Metod: En kvalitativ innehållsanalys med induktiv ansats tillämpades. Åtta mödrar med barn i åldern 6-15 år i Sverige intervjuades genom semistrukturerade intervjuer. Health literacy tillämpades som teoretisk referensram. Resultat: Resultatet bestod av fyra kategorier och två subkategorier, och belyste mödrars kunskaper och attityder till HPV-vaccin utifrån deras health literacy. Kategorierna benämndes: Mödrars kunskaper om HPV och HPV-vaccin, Mödrars inställningar till HPV och HPV-vaccin, Viljan att göra barnen delaktiga, Skolans och föräldrars roll som förmedlare av hälsoinformation. Subkategorierna benämndes: Sprida hälsoinformation till föräldrar, Sprida hälsoinformation till barn. Slutsats: Hur föräldrar tillgodogör sig hälsoinformation om HPV-vaccin grundas i deras health literacy, och påverkas av bland annat hälsomedvetenhet, tilltro till myndigheter och relationen till skolsköterskan på barnets skola. Att barn inkluderas i vaccinationsbeslutet samtidigt som fler föräldrar delaktiggörs och blir språkrör för vaccinet, samt att informationen om HPV tillgängliggörs för så många som möjligt, är av stor betydelse för att HPV-vaccinet ska kunna uppnå samma höga vaccinationstäckning som de övriga vaccinerna i Barnvaccinationsprogrammet. / Introduction: HPV is the most common sexually transmitted infection in Sweden and causes approximately 1100 cases of anal and cervical cancer annually. Parents' knowledge and attitudes towards HPV and HPV vaccine vary, and is influenced by their level of knowledge, educational stage, income and socio-economic status. Health literacy include the individual’s social and cognitive skills and ability to assimilate health information in order to maintain and promote health. Aim: The aim was to investigate mothers' health literacy in regards to HPV and HPVvaccination of their children aged 6-15 years. Methods: A qualitative content analysis with an inductive approach was applied. Eight semistructured interviews with mothers with children aged 6-15 in Sweden were conducted. Health literacy was applied as a theoretical frame of reference. Results: The results consisted of four categories and two subcategories, and highlighted mothers' knowledge and attitudes to HPV vaccine based on their health literacy. The categories were: Mothers' knowledge of HPV and HPV vaccine, Mothers' attitudes to HPV and HPV vaccine, Willingness to involve children, School and parents' role as mediators of health information. The subcategories were: Distribute health information to parents, Distribute health information to children. Conclusion: Parents’ access to information about HPV-vaccines is affected by their health literacy, and is influenced by health awareness, trust in authorities and the relationship with the nurse at the child's school. Including children in the vaccination decision, getting more parents involved in the vaccination, and information about HPV that is made available to everybody is of great importance to achieve the same high vaccination coverage as the other vaccines in the Swedish childhood immunization programme

Coronapandemin tog världen med storm och med den blev vaccination mot viruset ett faktum. I Göteborg påvisades skillnader i statistik på vilka som vaccinerade sig, där en utmärkande grupp som hade lägre vaccinationsgrad än övriga var boende i särskilt utsatta områden som präglas av en socioekonomisk utsatthet. Det är även konstaterat att socioekonomiskt utsatta grupper lider större risk att bli smittade och även dö av covid-19 än övriga samhällsgrupper. Därför gjordes denna kvalitativa studie med fokus på att se vad Västra Götalandsregionen tillsammans med Göteborgs stad har implementerat för åtgärder för att öka vaccineringsgraden i dessa områden. Syftet med denna kvalitativa studie blev därmed att identifiera vilka insatser som har gjorts, men även att ta reda på varför insatserna ansågs vara nödvändiga. Vidare är syftet även att ta reda på tjänstepersonernas reflektioner kring arbetet. Det teoretiska perspektivet har varit att se hur region och kommun har arbetat för att stärka tilliten utifrån teorin om socialt kapital och effektiva institutioner. För att ta reda på detta har fyra intervjuer skett med företrädare för regionen och kommunen för att få olika synfallsvinklar. Resultatet visade att insatser som införts för att öka vaccinationsgraden har varit med fokus på information och kommunikation med målgruppen där personer med kultur- och språkkompetenser har varit på plats i dessa områden för att informera och skapa tillit. Både region och kommun har skapat arbetsgrupper som arbetar med dessa frågor för att hjälpas åt i ett samverkansprojekt. Regionen anlitade även mobila vaccinatörer som skulle finnas på plats i dessa områden. Respondenternas reflektioner av arbetet var att de varit nöjda med sina insatser men de har även stött på vissa hinder som till exempel tidsbrist och att de mobila vaccinatörerna upphörde att vaccinera under en viss tid. / The corona pandemic took the world by storm and with it, vaccination against the virus became a fact. In Gothenburg, differences were shown in statistics on who was vaccinated, where a distinct group that had a lower vaccination rate than the others were living in particularly vulnerable areas that are characterized by a socio-economic vulnerability. It has also been established that socio-economically vulnerable groups suffer a greater risk of becoming infected and also dying from covid-19 than other social groups. Therefore, this qualitative study was done with a focus on seeing what the Västra Götaland region is together with the City of Gothenburg has implemented measures to increase the vaccination rate in these areas. The purpose of this qualitative study was thus to identify which efforts have been made, but also to find out why the efforts were considered necessary. Furthermore, the purpose is also to find out the employees' reflections on the work. The theoretical perspective has been to see how the region and municipality have worked to strengthen trust from outside the theory of social capital and effective institutions. To find out, four interviews were conducted with representatives of the region and the municipality to get different points of view. The results showed that efforts introduced to increase the vaccination rate have focused on information and communication with the target group, where people with cultural and language skills have been in place in these areas to inform and create trust. Both the region and the municipality have created working groups that work with these issues to help in a collaborative project. The region also hired mobile vaccinators who would be on site in these areas. The respondents' reflections on the work were that they were satisfied with their efforts, but they have also encountered certain obstacles such as lack of time and that the mobile vaccinators stopped vaccinating for a certain period of time.

Bakgrund: Förberedandet av barn inför vaccinering innefattar aktivt förebyggande och lindrande av smärta då det ses som del i god omvårdnad. Det kan nås via flera olika smärtlindrande interventioner som är; fysiologiska, farmakologiska, psykologiska och/ eller injektionstekniska. Trots att intramuskulärt injicerat vaccin är den erkänt vanligaste källan till procedurrelaterad smärta hos friska barn visar internationella studier att smärtlindrande interventioner vid vaccination ej praktiseras rutinmässigt. Syfte: Studien syftar till att belysa barnhälsovårdssjuksköterskans erfarenheter av att förbereda spädbarn inför vaccinering. Metod: Data samlades in via semistrukturerade intervjuer (n=14) som analyserades enligt metoden för kvalitativ innehållsanalys.  Resultat: Analysen resulterade i identifiering av fyra kategorier som belyser barnhälsovårdssjuksköterskans erfarenheter av att förbereda spädbarn inför vaccinering: Att barnet blir tryggt, Att barnet handhas snabbt och effektivt, Att barnet smärtlindras och Att barnet byter fokus. Konklusion: Barnhälsovårdssjuksköterskor tillämpar en kombination av olika interventioner för att minska obehag hos spädbarnet i samband med vaccination. Trots det var det flera evidensbaserade interventioner som inte tillämpades i särskilt hög utsträckning. Vidare forskning behövs som studerar varför vissa verksamheter förbereder spädbarn inför vaccinering i enlighet med evidensbaserad kunskap och andra inte. Därtill behövs forskning för att identifiera lämpliga utbildningsinsatser så att förberedelsen av spädbarn inför vaccinering optimeras. / Background: The preparation of children for vaccination includes active prevention and alleviation of pain as it is seen as part of good nursing care. It can be accessed through several different pain-management interventions which are; physiological, pharmacological, psychological and/or injection techniques. Although intramuscularly injected vaccine is recognized as the most common source of procedure-related pain in healthy children, international studies show that pain-management interventions during vaccination are not routinely practiced. Purpose: The purpose of this study was to illuminate child health service-nurses experiences of preparing infants for vaccination  Method: Data were collected through semi-structured interviews (n=14) which were analyzed according to the method of qualitative content analysis. Results: The analysis resulted in the identification of four categories that highlight the child health service nurse's experiences of preparing infants for vaccination: That the child feels safe, That the child is handled quickly and efficiently, That the child is relieved of pain and That the child changes focus. Conclusion: Child health service-nurses apply a combination of different interventions to reduce discomfort in the infant during vaccination. Despite that there were several evidence-based interventions that were not applied to a very high extent. Further research is needed that studies why some child health service units prepare infants for vaccination in accordance with evidence-based knowledge and others do not. In addition, research is needed to identify suitable educational interventions so that the preparation of infants for vaccination is optimized.

Denna studie har undersökt om och hur den ökade uppmaningen till att vaccinera sig från den svenska regeringen påverkat det sociala livet, både i privatlivet och på arbetsplatsen. Studien har utgått från följande frågeställningar; Hur påverkar det ökade vaccinationskravet det sociala livet? Finns det någon skillnad på vaccinationskravets påverkan mellan det privata sociala livet och på arbetsplatsen?  Syftet är att lyfta upp kunskap kring ett ganska nytt fenomen, ett ämne som det inte finns någon tidigare forskning om, och belysa hur samhället påverkas av situationer vi tidigare inte befunnit oss i. Metoden som använts till studien är den kvalitativa med semistrukturerade intervjuer där åtta personer deltagit. En hermeneutisk ansats har även använts till den här studien. Studien har använt sig av tre begrepp som legat till grund av analysen; Ulrich Beck - risksamhället, George Hermed Mead - Jaget och den generaliserade andre och Erving Goffman - Stigma. Resultaten visade på en ökad stigmatisering kring de som inte tagit vaccinet och en känsla av en förminskad samhörighet hos dessa individer. Resultaten visar även skillnader i vaccinationskravets påverkan på det sociala livet, privat och på arbetsplatsen. / This study has examined whether and how the Swedish covid-19 vaccine requirement has affected social life both privately and in the workplace. The study was based on the following questions; How does the increased vaccine requirement affected social life? And is there any difference in the impact of the vaccine requirement on private social life and the workplace?  The purpose is to raise knowledge about a fairly new phenomenon and shed light on how society is affected by situations we have not been in before and area topic that has not previously been researched. The study used a hermeneutic approach and a qualitative method with semi-structured interviews in which 8 people participated. The study has used 3 concepts as basis for the analysis: Ulrich Beck - the risk society, George Hermed Mead - The self and the generalized other and Erving Goffman - Stigma. The results showed an increased stigma around those who did not take the vaccine and the feeling of diminished belonging in these persons. The results also show the difference between social life in the private and the workplace domains.