Table 3.

Themes, example topics, and example comments for the “How” domain (discourse and rhetoric in arguments against the COVID-19 vaccine for children) emerging from thematic and discursive analysis of public comments on the EUA of COVID-19 vaccines for pediatric use.

Theme (number of topics mapped to this theme)	Example topics mapped to theme	Example comments from mapped topics
Appeals to ethos (n = 13)	(T24) science, follow, look, support, real, political, sense, scientific, actual, back, politics, money, true, agenda, behind, fear, common, ignore, statistic, truly (T63) symptom, day, sick, mild, son, two, recover, cold, daughter, positive, last, husband, fever, fine, three, mother, antibody, week, grandchild, ill (T64) dr, doctor, scientist, expert, malone, listen, robert, read, article, peter, review, physician, mccullough, md, video, technology, document, fauci, paper, university	(T24) You need to follow the real science not the science the FDA, pharma, and fauci want us to follow it's all political (T63) All 4 of my children had Covid. Harmless. No symptoms and 2 with mild runny noses. I see no reason for a vaccination. I will not choose this for my children. There is no data. (T64) Geert Vanden Bossche Robert Malone Peter McCullough Ryan Cole Byram Bridle Roger Hodkinson Pierre Kory Thousands of medical pros around the world…enough said Wake up people, lend an ear to these people, and do your jobs!
Appeals to pathos (n = 12)	(T29) stop, madness, insanity, nonsense, end, poison, immediately, tyranny, abuse, hurt, insane, mandating, pure, absolute, forcing, experimenting, craziness, killing, vaccinating, playing (T46) god, may, evil, pray, soul, love, day, jesus, mercy, name, lord, bless, hand, truth, answer, earth, judge, man, shall, conscience (T77) absolutely, wrong, push, evil, criminal, beyond, morally, idea, abuse, completely, innocent, disgust, unethical, shame, nothing, ethically, pure, immoral, level, onto	(T29) Stop this heinous madness, STOP this maniacal Idiocy…STOP making making Covid 19 Vaccines mandatory for kids and for adults. No…Stop…Cease… (T46) Jesus Christ was VERY clear about millstones. Your final judgment will be with God. Trying to save as many souls as possible from eternal damnation. (T77) It is shameful and utterly unbelievable that our supposedly free government would stoop to the totalitarian suggestion of mandatory vacintion of children 5 to 11. My prayer is that you will not carry out such an evil plan!
Appeals to logos (n = 21)	(T6) risk, benefit, outweigh, far, potential, weigh, ratio, analysis, possible, reward, associate, cost, worth, minimal, greatly, vs, known, exceed, negligible, perceived (T42) death, report, vaers, adverse, event, injury, reaction, number, cdc, thousand, accord, reporting, database, website, pull, combine, market, halt, record, actual (T73) death, cdc, report, case, state, accord, per, number, million, hospitalization, among, condition, mortality, total, website, united, compare, occur, hospitalize, comorbidities	(T6) There is no need to vaccinat 5-11. Risk don't outweigh the benefits. The financial cost don't outweigh the benefits. What are the benefits? What are all the cost $$$? What are all the risk? (T42) I am against any child receiving any COVID vaccination at this time. As stated in the VAERS website as of October 152 021, there’re has been reported: A—83 412 hospitalizations; B—24 806 permanent disabilities; C—2631 miscarriages; D—17 128 deaths. These statistics do not even include the unreported cases. (T73) Do not mandate covid vaccination for anyone, especially not for children! According to a July 19, 2021 WSJ op-ed piece by Dr. Marty Makary (Professor at Johns Hopkins), “there have been only 335 people under 18 that have died from COVID, the age group which has a population of 73.1 million. That equates to 335/73.1M = 0.00046% chance or 1 death in 218 208 children (a child is nearly twice as likely to die from a lightning strike; 1 in 138 849). Statistically children under 18 are at zero risk of death from COVID.”
Templated language (n = 15)	(T2) approval, adverse, still, vulnerable, potentially, neurological, event, teen, development, available, extremely, base, acknowledge, occur, immunological, firmly, concerned, company, nih, impact (T19) low, approval, severe, extremely, base, outweigh, significant, available, teen, pose, unknown, much, include, firmly, number, addition, large, confirm, month, uk (T36) support, evidence, unknown, yet, believe, clearly, administer, rush, call, available, current, caution, virtually, unnecessary, versus, face, exercise, reject, fear, history	(T2) I am opposed to the approval of the COVID-19 vaccines for children. Their immunological and neurological systems are still in development, making them more vulnerable to adverse effects than adults. Especially, given the seriousness of the adverse events that have occurred in teens and not acknowledged by the CDC, FDA, NIH, and the vaccine manufacturing companies. (T19) I am firmly against the approval of the COVID-19 vaccines for children. Based on available data, including the UK study on kids & COVID, the benefits do not outweigh the risks. It has been confirmed that children are at extremely low risk of getting severe COVID or long COVID, or of dying from COVID. By contrast, the data is showing the COVID vaccines are posing a significant risk to teens and young adults. This is in addition to all the unknown risks, which will only be discovered over time. (T36) I call upon our government and the regulators not to repeat mistakes from history and to reject the calls to vaccinate children against COVID-19. Extreme caution has been exercised over many aspects of the pandemic, but surely now is the most important time to exercise true caution—we must not be the generation that, through unnecessary haste and fear, risks the health of children.

Source: Authors’ own analysis of 149 897 public comments submitted to Docket FDA-2021-N-1088 from October 13 to 25, 2021, and Docket FDA-2022-N-0082 from February 4 to 14, 2022. The dockets pertained to amendment of the EUA for the Pfizer-BioNTech COVID-19 mRNA vaccines for administration to children aged 5-11 years and 6 months to 4 years, respectively.

Notes: Example topics and comments are keyed to the full annotated 100-topic database posted on Open Science Framework (20). “T” designates the topic number.

EUA, emergency use authorization; FDA, Food and Drug Administration