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Lederman Z, Corcos S. The duty of care and the right to be cared for: is there a duty to treat the unvaccinated? MEDICINE, HEALTH CARE, AND PHILOSOPHY 2024; 27:81-91. [PMID: 38180693 PMCID: PMC10904556 DOI: 10.1007/s11019-023-10186-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 01/06/2024]
Abstract
Vaccine hesitancy or refusal has been one of the major obstacles to herd immunity against Covid-19 in high-income countries and one of the causes for the emergence of variants. The refusal of people who are eligible for vaccination to receive vaccination creates an ethical dilemma between the duty of healthcare professionals (HCPs) to care for patients and their right to be taken care of. This paper argues for an extended social contract between patients and society wherein vaccination against Covid-19 is conceived as essential for the protection of the right of healthcare providers to be taken care of. Thus, a duty of care is only valid when those who can receive vaccination actually receive it. Whenever that is not the case, the continuing functioning of HCPs can only be perceived as supererogatory and not obligatory.
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Affiliation(s)
- Zohar Lederman
- Department of Emergency Medicine, LKS Medical Faculty, University of Hong Kong, Hong Kong, Hong Kong.
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Santos RS, Barreto MDS, Silva EED, da Silva BS, de Jesus PC, Silva DMRR, Moura PHM, de Souza JB, dos Santos LMM, Guimarães AG, Santana LADM, Borges LP. COVID-19 Crisis in Brazil: Post-Vaccination Seroprevalence and Infection in More and Less Vaccinated Municipalities in a Northeastern State. Life (Basel) 2024; 14:94. [PMID: 38255709 PMCID: PMC10817450 DOI: 10.3390/life14010094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/29/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Given the impact of the pandemic in Brazil, vaccination is essential to prevent illness and death. Thus, this study sought to compare, after vaccination, the circulation of SARS-CoV-2 and the response to vaccination in the least and most vaccinated municipalities of a Brazilian state during the height of the pandemic when the Omicron variant was dominant. METHODS We tested for the SARS-CoV-2 antigen and confirmed infection using an RT-qPCR and measured IgM and IgG antibodies in fully vaccinated participants from municipalities with higher and lower vaccination rates. RESULTS We showed that participants from the least vaccinated municipalities were more likely to have detectable IgM antibodies and a positive antigen/RT-qPCR result for SARS-CoV-2 than participants from the most vaccinated municipalities. There were no differences between the vaccines used (BNT162b2, Ad26.COV2.S, AZD1222, and CoronaVac) and antibody production. CONCLUSIONS Our study evaluated municipal vaccination coverage and its effects on mortality, infections, and anti-SARS-CoV-2 antibodies during a critical phase of the pandemic. The results suggest that higher vaccination coverage reduces acute cases and confers higher memory antibody levels against SARS-CoV-2. Even with a full vaccination schedule, individuals living in places with low vaccination rates are more susceptible to infection.
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Affiliation(s)
- Ronaldy Santana Santos
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Marina dos Santos Barreto
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Eloia Emanuelly Dias Silva
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Beatriz Soares da Silva
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Pamela Chaves de Jesus
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Deise Maria Rego Rodrigues Silva
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Pedro Henrique Macedo Moura
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Jessiane Bispo de Souza
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Leticia Milena Machado dos Santos
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | - Adriana Gibara Guimarães
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
| | | | - Lysandro Pinto Borges
- Department of Pharmacy, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil; (M.d.S.B.); (E.E.D.S.); (B.S.d.S.); (P.C.d.J.); (D.M.R.R.S.); (P.H.M.M.); (J.B.d.S.); (L.M.M.d.S.); (A.G.G.)
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Ji J, Wang H, Wang L, Ramazi P, Kong JD, Watmough J. Climate-dependent effectiveness of nonpharmaceutical interventions on COVID-19 mitigation. Math Biosci 2023; 366:109087. [PMID: 37858753 DOI: 10.1016/j.mbs.2023.109087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023]
Abstract
Environmental factors have a significant impact on the transmission of infectious diseases. Existing results show that the novel coronavirus can persist outside the host. We propose a susceptible-exposed-presymptomatic-infectious-asymptomatic-recovered-susceptible (SEPIARS) model with a vaccination compartment and indirect incidence to explore the effect of environmental conditions, temperature and humidity, on the transmission of the SARS-CoV-2 virus. Using climate data and daily confirmed cases data in two Canadian cities with different atmospheric conditions, we evaluate the mortality rates of the SARS-CoV-2 virus and further estimate the transmission rates by the inverse method, respectively. The numerical results show that high temperature or humidity can be helpful in mitigating the spread of COVID-19 during the warm summer months. Our findings verify that nonpharmaceutical interventions are less effective if the virus can persist for a long time on surfaces. Based on climate data, we can forecast the transmission rate and the infection cases up to four weeks in the future by a generalized boosting machine learning model.
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Affiliation(s)
- Juping Ji
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB T6G 2R3, Canada; Interdisciplinary Lab for Mathematical Ecology and Epidemiology, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Hao Wang
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB T6G 2R3, Canada; Interdisciplinary Lab for Mathematical Ecology and Epidemiology, University of Alberta, Edmonton, AB T6G 2R3, Canada.
| | - Lin Wang
- Department of Mathematics and Statistics, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
| | - Pouria Ramazi
- Department of Mathematics and Statistics, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - Jude Dzevela Kong
- Department of Mathematics and Statistics, York University, Toronto, ON M3J 1P3, Canada
| | - James Watmough
- Department of Mathematics and Statistics, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
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Krishnamurthy P, Mulvey MS, Gowda K, Singh M, Venkatesan NK, Syam SB, Shah P, Kumar S, Chaudhuri A, Narayanan R, Perne AL, Pangaria A. Drivers of vaccine hesitancy among vulnerable populations in India: a cross-sectional multi-state study. Front Public Health 2023; 11:1177634. [PMID: 37900017 PMCID: PMC10600374 DOI: 10.3389/fpubh.2023.1177634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 08/28/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives India's Covid-19 vaccination campaign engaged frontline workers (FLWs) to encourage vaccination among vulnerable segments of society. The FLWs report encountering a variety of barriers to vaccination and are often unsuccessful despite multiple visits to the same person. This cross-sectional study aims to pinpoint which of these barriers drive vaccine hesitancy among these segments, to help streamline vaccine communication, including FLW training, to better safeguard the population. Methods Trained field enumerators contacted 893 individuals from five states across India and collected self-reported assessments of fifteen vaccination barriers (identified through discussions with FLWs), current vaccination status and future vaccination intentions, and covariates (demographics/comorbidities). Factor analysis of the fifteen barriers yielded two factors, one relating to fear of vaccine adverse effects and a second focused on peripheral concerns regarding the vaccine. The covariates significantly associated with current vaccination status were combined under a latent class regime to yield three cluster types (health access, financial strength, and demographics). The primary analysis examined the effect of the two barrier factors, the covariate clusters, and comorbidity, on current vaccination status and future vaccine intentions. Results Fear of vaccine adverse effects was the primary driver of vaccine hesitancy; peripheral concerns frequently mentioned by the FLWs had no impact. Although cluster membership and the presence of comorbidities predicted vaccine uptake, neither of them materially altered the effect of fear of vaccine adverse effects with the following exception: fear of adverse effects was not associated with vaccination status among young Muslim men. Conclusion Subject to limitations, these results indicate that interventions to decrease vaccine hesitancy should focus primarily on fear associated with vaccines rather than spend resources trying to address peripheral concerns.
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Affiliation(s)
- Parthasarathy Krishnamurthy
- Department of Marketing and Entrepreneurship, C. T. Bauer College of Business, University of Houston, Houston, TX, United States
| | - Michael S. Mulvey
- Telfer School of Management, LIFE Research Institute, University of Ottawa, Ottawa, ON, Canada
| | | | | | | | | | - Prerak Shah
- Catalyst Management Services, Bengaluru, India
| | - Shiv Kumar
- Catalyst Management Services, Bengaluru, India
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