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            Free, publicly-accessible full text available May 11, 2026
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            Achieving sufficient COVID-19 vaccination coverage has been hindered in many areas by vaccine hesitancy. Many studies based on large survey samples have characterized vaccine refusal, but there are fewer in-depth qualitative studies that explore hesitant adoption: the middle-ground between vaccine acceptance and refusal, and how individuals may move across this continuum depending on their lived experience. For this paper, we use the narratives of 25 adults living in off-road, predominately Alaska Native communities to describe the complex decision-making processes undertaken by ‘hesitant adopters’, defined in our study as those who completed their initial COVID-19 series despite reporting hesitancy. Interviewees' stories help illustrate how hesitant adopters' decision-making processes involved making sense of information through interactions with trusted individuals, lived experiences, observations, emotions, and personal motivations. For the majority of these hesitant adopters' (n = 20, 80%) interpersonal interactions were key in helping to make the decision to get vaccinated. Over half of the interviewees (n = 14, 56%) described how conversations with individuals they trusted, including healthcare providers, family, friends, and interactions through their professional network made them feel safe. One third of the hesitant adopters (n = 7, 28%) attributed their decision to get vaccinated based on the influence of Alaska Native Elders including their knowledge, personal experiences, as well as being motivated by the desire to protect them. Independent research was also important to about a quarter of hesitant adopters (n = 6, 24%), and for these interviewees it was the process of gathering information on their own and learning from others, especially healthcare providers who could answer their questions and alleviate their concerns. This paper illustrates the temporality of vaccine decision-making: vaccine acceptance for those who are hesitant may be an ongoing process that is influenced by personal experience, relationships, and context.more » « less
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            null (Ed.)The late-season extreme fire activity in Southcentral Alaska during 2019 was highly unusual and consequential. Firefighting operations had to be extended by a month in 2019 due to the extreme conditions of hot summer temperature and prolonged drought. The ongoing fires created poor air quality in the region containing most of Alaska’s population, leading to substantial impacts to public health. Suppression costs totaled over $70 million for Southcentral Alaska. This study’s main goals are to place the 2019 season into historical context, provide an attribution analysis, and assess future changes in wildfire risk in the region. The primary tools are meteorological observations and climate model simulations from the NCAR CESM Large Ensemble (LENS). The 2019 fire season in Southcentral Alaska included the hottest and driest June–August season over the 1979–2019 period. The LENS simulation analysis suggests that the anthropogenic signal of increased fire risk had not yet emerged in 2019 because of the CESM’s internal variability, but that the anthropogenic signal will emerge by the 2040–2080 period. The effect of warming temperatures dominates the effect of enhanced precipitation in the trend towards increased fire risk.more » « less
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