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Johansen I, Selim M, J Hoffman S, Dawson-Hahn E, Yu K. Pivoting From Influenza to COVID-19 Vaccinations: How a Minnesota Vaccination Program Reduced Barriers for Refugee, Immigrant, and Migrant Communities Accessing Vaccines During the COVID-19 Pandemic. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:701-709. [PMID: 39041765 DOI: 10.1097/phh.0000000000001931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
The Minnesota Immunization Networking Initiative (MINI) led by Fairview Health Services has addressed barriers to accessing immunizations through partnerships with community organizations to provide free influenza vaccinations to historically underserved communities, especially refugee, immigrant, and migrant communities. Once the COVID-19 vaccine was available, MINI quickly pivoted operations to distribute the vaccine and provide technical assistance to community partners amidst rapidly evolving guidance. With infrastructure and a vaccination team in place, MINI responded to new and emerging needs, eg, implementing a more accessible and low-tech scheduling system, increasing staffing to meet growing needs, and expanding partnerships with community organizations and leaders. From February 2021 to September 2023, MINI organized 1120 community-based vaccine clinics and administered 43,123 COVID-19 vaccinations. Of those vaccine recipients, 88% identified as Black, Indigenous, and other people of color, and for preferred language, over half stated that they preferred a language other than English. These demographics are similar to those of the earlier influenza clinics, even as average annual clinics have tripled and average total vaccinations have quadrupled since the pivot to COVID-19 vaccination clinics. Some keys to success were: (1) consistent, bidirectional communication and shared decision-making with community partners; (2) prioritizing sustainable staffing models with the support of administrative leadership and resources; and (3) having a community-informed approach supported by the practice of hiring staff from communities served. Because of the effectiveness of this model, MINI is primed to respond to planned and unplanned emergent public health crises.
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Affiliation(s)
- Ingrid Johansen
- Community Clinical Care (Ms Johansen and Mr Selim), Fairview Health Services, Minneapolis, Minnesota; Population Health and Systems,University of Minnesota School of Nursing (Dr Hoffman); Division of General Pediatrics, University of Washington (Dr Dawson-Hahn), Seattle, Washington; and Center for Global Health and Social Responsibility Project, National Resource Center for Refugee, Immigrants, and Migrants (Ms Yu), University of Minnesota, Minneapolis, Minnesota
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Mercado M, Lopez G, Ignacio M, Ayers S, Carver A, Hamm K, Wolfersteig W, Oesterle S. Hesitant or Confident: A Qualitative Study Examining Latinos' Perceptions of COVID-19 Vaccines in Arizona. HEALTH EDUCATION & BEHAVIOR 2024; 51:512-520. [PMID: 38804533 DOI: 10.1177/10901981241255619] [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] [Indexed: 05/29/2024]
Abstract
This study aimed to understand vaccine hesitancy and confidence toward the COVID-19 vaccines among Latino adults in Arizona. Latinos (n = 71) aged 18 years or older who resided in Arizona participated in 14 focus groups between February and June 2021. Theoretical thematic analysis was used to examine drivers of these two behaviors, namely, vaccine hesitancy and confidence toward the COVID-19 vaccines, using the COM-B model, comprising capability, opportunity, and motivation factors that generate a behavior. Vaccine hesitancy stemmed from the need for vaccine information (capability factor) and fear of the vaccines, religious beliefs, and perceived barriers stemming from government mistrust (motivation factors). Vaccine confidence arose from trust in science and doctors (capability factor), and a fear of getting sick, protection against COVID-19, getting vaccinated as a civic duty, and a desire to return to normal life (motivation factors). The influence of opportunity factors, such as having access to vaccinations, were not discussed as contributing to vaccine confidence or hesitancy. As predicted by the COM-B model, factors reflecting capabilities and motivations contributed to vaccine hesitancy and confidence, all of which need to be considered in public health messaging. These factors can be targeted to facilitate efforts to promote vaccine uptake and reduce the spread of COVID-19.
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Affiliation(s)
- Micaela Mercado
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Gilberto Lopez
- School of Transboarder Studies, Arizona State University, Phoenix, AZ, USA
| | - Matt Ignacio
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Stephanie Ayers
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Ann Carver
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Kathryn Hamm
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Wendy Wolfersteig
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ, USA
| | - Sabrina Oesterle
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University, Phoenix, AZ, USA
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Cénat JM, Dromer E, Farahi SMMM, Ndamage CM, Yun A, Zuta H, Mkhatri J, Samson E, Barara R, Labelle PR, Xu Y. Venous thromboembolism in Black COVID-19 patients in a minority context compared to White, Asian and other racialized patients: A systematic review and meta-analysis. Thromb Res 2024; 238:197-205. [PMID: 38733691 DOI: 10.1016/j.thromres.2024.05.007] [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: 03/21/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
IMPORTANCE COVID-19 has disproportionately affected racialized populations, with particular impact among individuals of Black individuals. However, it is unclear whether disparities in venous thromboembolic (VTE) complications exist between Black individuals and those belonging to other racial groups with confirmed SARS-CoV2 infections. OBJECTIVE To summarize the prevalence and moderators associated with VTE among Black COVID-19 patients in minoritized settings, and to compare this to White and Asian COVID-19 patients according to sex, age, and comorbid health conditions (heart failure, cancer, obesity, hypertension). DESIGN SETTING, AND PARTICIPANTS A systematic search of MEDLINE, Embase, CINAHL and CENTRAL for articles or reports published from inception to February 15, 2023. STUDY SELECTION Reports on VTE among Black individuals infected with SARS-CoV2, in countries where Black people are considered a minority population group. DATA EXTRACTION AND SYNTHESIS Study characteristics and results of eligible studies were independently extracted by 2 pairs of reviewers. VTE prevalence was extracted, and risk of bias was assessed. Prevalence estimates of VTE prevalence among Black individuals with COVID19 in each study were pooled. Where studies provided race-stratified VTE prevalence among COVID19 patients, odds ratios were generated using a random-effects model. MAIN OUTCOMES AND MEASURES Prevalence of VTE, comprising of deep vein thrombosis and pulmonary embolism. RESULTS Ten studies with 66,185 Black individuals reporting the prevalence of COVID-19 associated VTE were included. Weighted median age of included studies was 47.60. Pooled prevalence of COVID-19 associated VTE was 7.2 % (95 % CI, 3.8 % - 11.5 %) among Black individuals. Among individuals with SARS-CoV2 infections, Black population had higher risks of VTE compared to their White (OR = 1.79, [95 % CI 1.28-2.53], p < .001) or Asian (OR = 2.01, [95 % CI, 1.14-3.60], p = .017) counterparts, or patients with other racial identities (OR = 2.01, [95 % CI, 1.39, 2.92]; p < .001). CONCLUSIONS AND RELEVANCE Black individuals with COVID-19 had substantially higher risk of VTE compared to White or Asian individuals. Given racial disparities in thrombotic disease burden related to COVID-19, medical education, research, and health policy interventions are direly needed to ensure adequate disease awareness among Black individuals, to facilitate appropriate diagnosis and treatment among Black patients with suspected and confirmed VTE, and to advocate for culturally safe VTE prevention strategies, including pre-existing inequalities to the COVID-19 pandemic that persist after the crisis.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | - Elisabeth Dromer
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Aiden Yun
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Hannah Zuta
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jihane Mkhatri
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Eden Samson
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Raina Barara
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Yan Xu
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada
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Price O, Swanton R, Grebely J, Hajarizadeh B, Webb P, Peacock A, Dore GJ, Cowie BC, Vickerman P, Degenhardt L. Vaccination coverage among people who inject drugs: A systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 127:104382. [PMID: 38503233 DOI: 10.1016/j.drugpo.2024.104382] [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: 11/27/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND People who inject drugs may be at excess risk of acquiring vaccine-preventable diseases and negative associated health outcomes, but experience barriers to vaccination. We aimed to determine vaccination coverage among people who inject drugs globally. METHODOLOGY We conducted systematic searches of the peer-reviewed and grey literature, date limited from January 2008 to August 2023, focusing on diseases for which people who inject drugs are at elevated risk for and for which an adult vaccination dose is recommended (COVID-19, hepatitis A, hepatitis B, human papillomavirus, influenza, pneumococcal disease, tetanus). To summarise available data, we conducted a narrative synthesis. RESULTS We included 78 studies/reports comprising 117 estimates of vaccination coverage across 36 countries. Most estimates were obtained from high income countries (80%, n=94). We located estimates for hepatitis B vaccination in 33 countries, which included 18 countries with data on serological evidence of vaccine-derived hepatitis B immunity (range: 6-53%) and 22 countries with self-report data for vaccine uptake (<1-96%). Data for other vaccines were scarcer: reported hepatitis A vaccination coverage ranged 3-89% (five countries), COVID-19 ranged 4-84% (five countries), while we located estimates from fewer than five countries for influenza, tetanus, pneumococcal disease, and human papillomavirus. CONCLUSION Estimates were sparse but where available indicative of suboptimal vaccination coverage among people who inject drugs. Improving the consistency, timeliness, and geographic coverage of vaccine uptake data among this population is essential to inform efforts to increase uptake.
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Affiliation(s)
- Olivia Price
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia.
| | - Rosie Swanton
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | | | | | - Paige Webb
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | | | - Benjamin C Cowie
- Department of Infectious Diseases, University of Melbourne, Melbourne, Australia; WHO Collaborating Centre for Viral Hepatitis, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, Melbourne, Australia; Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia
| | - Peter Vickerman
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
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Marcelin JR, Hicks LA, Evans CD, Wiley Z, Kalu IC, Abdul-Mutakabbir JC. Advancing health equity through action in antimicrobial stewardship and healthcare epidemiology. Infect Control Hosp Epidemiol 2024; 45:412-419. [PMID: 38351853 DOI: 10.1017/ice.2024.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Jasmine R Marcelin
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Lauri A Hicks
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher D Evans
- Healthcare-Associated Infections and Antimicrobial Resistance Program, Tennessee Department of Health, Nashville, Tennessee
| | - Zanthia Wiley
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Ibukunoluwa C Kalu
- Division of Pediatric Infectious Disease, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Jacinda C Abdul-Mutakabbir
- Division of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, California
- Division of the Black Diaspora and African American Studies, University of California San Diego, La Jolla, California
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O'Leary ST, Opel DJ, Cataldi JR, Hackell JM. Strategies for Improving Vaccine Communication and Uptake. Pediatrics 2024; 153:e2023065483. [PMID: 38404211 DOI: 10.1542/peds.2023-065483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/27/2024] Open
Abstract
Vaccines have led to a significant decrease in rates of vaccine-preventable diseases and have made a significant impact on the health of children. However, some parents express concerns about vaccine safety and the necessity of vaccines. The concerns of parents range from hesitancy about some immunizations to refusal of all vaccines. This clinical report provides information about the scope and impact of the problem, the facts surrounding common vaccination concerns, and the latest evidence regarding effective communication techniques for the vaccine conversation. After reading this clinical report, readers can expect to: Understand concepts and underlying determinants of vaccine uptake and vaccine hesitancy.Understand the relationship between vaccine hesitancy and costs of preventable medical care.Recognize and address specific concerns (eg, vaccine safety) with caregivers when hesitancy is present.
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Affiliation(s)
- Sean T O'Leary
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado
| | - Douglas J Opel
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Jessica R Cataldi
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, Colorado
| | - Jesse M Hackell
- Department of Pediatrics, New York Medical College, Valhalla, New York
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Cénat JM, Moshirian Farahi SMM, Broussard C, Dalexis RD. The state of COVID-19 vaccine confidence and need in Black individuals in Canada: Understanding the role of sociodemographic factors, health literacy, conspiracy theories, traumatic stressors and racial discrimination. Vaccine 2024; 42:960-968. [PMID: 37891050 DOI: 10.1016/j.vaccine.2023.10.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Black communities in Canada have been among the most affected by the COVID-19 pandemic, in terms of number of infections and deaths. They are also among those most hesitant about vaccination against COVID-19. However, while a few studies have documented the factors associated with COVID-19 vaccine hesitancy, those related to vaccine confidence remain unknown. To respond to this gap, this study aims to investigate factors associated to vaccine confidence in Black individuals in Canada. METHODS A total of 2002 participants (1034 women) aged 14 to 89 years old (Mean age = 29.34, SD = 10.13) completed questionnaires assessing sociodemographic information, COVID-19 vaccine confidence and need, health literacy, conspiracy beliefs, major racial discrimination, and traumatic stressors related to COVID-19. RESULTS Results showed an average score of COVID-19 vaccine confidence and need of 33.27 (SD = 7.24), with no significant difference between men (33.48; SD = 7.24) and women (33.08; SD = 7.91), t (1999) = 1.19, p = 0.234. However, there were significant differences according to employment status, migration status, age, inhabited province, spoken language, education, marital status, religion, and income. The linear regression model explained 25.8 % of the variance and showed that health literacy (B = 0.12, p < 0.001) and traumatic stressors related to COVID-19 (B = 0.21, p < .001) predicted COVID-19 vaccine confidence and need positively, while conspiracy beliefs (B = -1.14, p < 0.001) and major racial discrimination (B = -0.20, p = 0.044) predicted it negatively. CONCLUSIONS This study showed that building the confidence of Black communities in vaccines requires health education, elimination of racial discrimination in the Canadian society and a focus on certain groups (e.g., young people, those living in Quebec and Ontario). The results also argue in favor of involving community leaders and organizations in the development and implementation of vaccination-related tools, strategies and programs by city, provincial and federal public health agencies.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | | | - Cathy Broussard
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Rose Darly Dalexis
- Interdisciplinary School of Population Health, University of Ottawa, Ottawa, Ontario, Canada
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Assoumou SA, Bonilla HV, Vautour L, White C, Read Newcomb A, Kibbe D, Goldie J, Merrill A, Monahan M, Linas BP, Drainoni ML, Pierre CM, Graham R. A Communications Campaign to Build Confidence in Covid-19 Vaccines: The Boston Medical Center Experience. NEJM CATALYST INNOVATIONS IN CARE DELIVERY 2024; 5. [PMID: 38813133 PMCID: PMC11132119 DOI: 10.1056/cat.23.0322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Health systems could play an important role in efforts to build vaccine confidence in communities that have been hardest hit by Covid-19. Boston Medical Center (BMC) health system, New England's largest safety-net hospital, along with its community partners, implemented a Covid Response Program aimed at building vaccine confidence. The program was supported by a multifaceted and multilingual communications campaign including: 1) traditional and social media channels with trusted messengers, 2) consistent and accessible core messaging, 3) transparent dialogue, and 4) partnership with state and local health government officials. Between December 2020 and June 2022, BMC disseminated 650 social media posts leading to 12 million impressions and more than 1.8 million post engagements. The campaign included a TikTok video later featured during the presidential inauguration, resulting in more than 3.7 million views. BMC's HealthCity digital publication released 20 articles gaining more than 73,000 views while the FAQ/vaccine scheduling site, translated into seven languages, reached 844,000 page visits. At six months into the vaccination program, 70% of BMC primary care patients 18 years or older had received at least one shot and 60% were fully vaccinated, having received either two mRNA doses or one adenovirus vaccine. The proportions rose to 82% with one dose and 75% fully vaccinated at 12 months. By 24 months into the program, 83% of BMC primary care patients had received at least one shot and 77% were fully vaccinated; however, notable differences existed by race/ethnicity. Seventy six percent of Black patients and 75% of Latino patients were fully vaccinated, compared with 85% of Asian and 81% White patients. Key lessons learned include the importance of a multilingual, multimedia campaign and the need for bidirectional communication that could quickly shift to address evolving issues.
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Affiliation(s)
- Sabrina A Assoumou
- Associate Professor, Department of Medicine, Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston
| | - Haley V Bonilla
- Research Data Associate, Section of Infectious Diseases, Boston Medical Center, Boston
| | - Lillian Vautour
- Senior Director, Marketing, Boston Medical Center Health System, Boston
| | - Caitlin White
- Senior Content Manager, Boston Medical Center Health System, Boston
| | - Amanda Read Newcomb
- Manager, Digital Marketing Analytics, Marketing and Communications, Boston Medical Center, Boston
| | - David Kibbe
- Senior Director, External Communications, Boston Medical Center, Boston
| | - John Goldie
- Vice President, Systems Analytics, Boston Medical Center, Boston
| | - Alison Merrill
- Senior Director, Internal Communications, Marketing and Communications, Boston Medical Center Health System, Boston
| | - Melissa Monahan
- Chief of Staff, President and CEO's Office, Boston Medical Center Health System, Boston
| | - Benjamin P Linas
- Professor of Medicine, Boston University School of Medicine, Professor of Epidemiology, Boston University School of Public Health, Boston
| | - Mari-Lynn Drainoni
- Research Professor, Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston
- Research Professor, Department of Health Law Policy & Management, Boston University School of Public Health, Boston
- Co-Director, Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston
| | - Cassandra M Pierre
- Assistant Professor of Medicine, Associate Hospital Epidemiologist, Medical Director, Public Health Programs, Boston Medical Center, Boston
| | - Robert Graham
- Vice President, Marketing and Communication, Boston Medical Center Health System, Boston
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Purvis RS, Moore R, Rojo MO, Riklon S, Alik E, Alik D, Maddison BK, McElfish PA. COVID-19 vaccine hesitancy among Marshallese in Northwest Arkansas (USA). J Public Health Res 2024; 13:22799036241231549. [PMID: 38440055 PMCID: PMC10910884 DOI: 10.1177/22799036241231549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/23/2024] [Indexed: 03/06/2024] Open
Abstract
Background COVID-19 has disproportionately affected Pacific Islander communities, with disparities in the prevalence of infection, serious illness, and death compared to non-Hispanic whites in the US. Marshallese Pacific Islanders face significant COVID-19 disparities. Design and methods This exploratory study aimed to understand Marshallese community attitudes about the COVID-19 vaccine to identify and implement culturally relevant strategies to encourage vaccine uptake. Data were collected from 17 participants in three focus groups. Results Using content analysis, researchers identified two global themes: (1) barriers to vaccination and (2) facilitators of COVID-19 vaccine uptake. Within these themes, participants described fear, lack of knowledge about vaccines, negative perceptions of the COVID-19 vaccine, health concerns, and transportation as barriers to vaccination. Participants described several factors influencing vaccine behavior, including location of and personnel at vaccine clinics, vaccine experiences, the need for trusted information, positive perceptions, cultural leaders, and mandates. Conclusions The qualitative study makes a significant contribution as the first to report community perceptions and experiences related to the COVID-19 vaccine in Marshallese participants' own words. Findings show that cultural influencers and brokers are crucial bridges for public health messaging related to COVID-19 vaccination targeted to this vulnerable and underserved population. Culturally appropriate and effective public health messaging can help achieve vaccine equity and improve COVID-19-related health disparities in the Marshallese community.
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Affiliation(s)
- Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Martha O Rojo
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR, USA
| | - Eldon Alik
- Republic of the Marshall Islands Consulate, Springdale, AR, USA
| | - Derek Alik
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | | | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
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Mark-Carew M, van Zyl A, Tatti KM, Chong M, Rose C, Sifre K, Jarris D, Still W, Aynalem G, Welton M, Thomas ES, Hall L, Samson ME. Understanding COVID-19 Vaccine Hesitancy Among K-12 Staff, Parents, and Students: District of Columbia, February to April, 2022. THE JOURNAL OF SCHOOL HEALTH 2023; 93:1079-1090. [PMID: 37602945 PMCID: PMC10833106 DOI: 10.1111/josh.13382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE Despite widespread availability of COVID-19 vaccines, millions of Americans have not received the recommended vaccine doses. In the District of Columbia (DC), COVID-19 vaccination rates are lowest among residents who are Non-Hispanic (NH) Black and among school-aged children. We assessed COVID-19 vaccine hesitancy among staff and parents of students in DC K-12 public and public charter schools. METHODS We conducted a telephone-based survey from February 6 to April 16, 2022 to staff, students, and parents of students who participated in school-based COVID-19 screening testing. COVID-19-related survey items included: vaccination status, reasons for not getting vaccinated, perceived vaccine access, and trusted COVID-19 information sources. Utilizing time-to-event analyses, we evaluated differences across demographic groups. RESULTS The interview response rate was 25.8% (308/1193). Most unvaccinated participants were NH Black and ages 5 to 11 years. Median time from vaccine eligibility to uptake was 236 days for NH Black participants vs. 10 days for NH White participants. Vaccine safety was the top concern among unvaccinated participants. Government and healthcare providers were the most trusted COVID-19 information sources. CONCLUSIONS Differences in timing of vaccine uptake among respondents and greater vaccine hesitancy among NH Black participants compared to other racial/ethnic groups highlight a need for continued tailored outreach and communication using trusted sources to convey the importance, benefits, and safety of COVID-19 vaccination.
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Affiliation(s)
- Miguella Mark-Carew
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - André van Zyl
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Kathleen M. Tatti
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Muhling Chong
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Charles Rose
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Katlynn Sifre
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Daniel Jarris
- District of Columbia Department of Health, Washington, District of Columbia, USA
| | - Will Still
- District of Columbia Department of Health, Washington, District of Columbia, USA
| | - Getahun Aynalem
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Michael Welton
- Global Government Solutions (G2S) Corporation, 12500 San Pedro Ave, Suite 403 San Antonio, TX 78216
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Ebony S. Thomas
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - LaShonda Hall
- US Centers for Disease Control and Prevention COVID-19 Emergency Response Team, 1600 Clifton Road, Atlanta, GA 30329
| | - Marsha E. Samson
- District of Columbia Department of Health, Washington, District of Columbia, USA
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Swartz TH, Aberg JA. Preserving the Future of Infectious Diseases: Why We Must Address the Decline in Compensation for Clinicians and Researchers. Clin Infect Dis 2023; 77:1387-1394. [PMID: 37436703 DOI: 10.1093/cid/ciad416] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/01/2023] [Accepted: 07/10/2023] [Indexed: 07/13/2023] Open
Abstract
Infectious diseases (ID) physicians play a pivotal role in patient care and public health, yet concerns are mounting about their under-compensation compared with other medical specialties. This trend sees ID physicians, including new graduates, receiving lower remuneration than their general and hospital medicine peers, despite their significant contributions. The persistent disparity in compensation has been identified as a key factor behind the declining interest in the ID specialty among medical students and residents, potentially threatening patient care quality, research advancement, and diversity within the ID workforce. This viewpoint underscores the urgent need for the ID community to rally behind the Infectious Diseases Society of America in advocating for fair compensation for ID physicians and researchers. While focusing on wellness and work-life balance is vital, it is critical to address compensation, a significant source of distress for physicians. Failure to confront the issue of under-compensation promptly may jeopardize the future growth and sustainability of the ID specialty.
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Affiliation(s)
- Talia H Swartz
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Judith A Aberg
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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12
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Mac-Seing M, Gidey M, Di Ruggiero E. COVID-19-related global health governance and population health priorities for health equity in G20 countries: a scoping review. Int J Equity Health 2023; 22:232. [PMID: 37924074 PMCID: PMC10625304 DOI: 10.1186/s12939-023-02045-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023] Open
Abstract
Since the declaration of the COVID-19 pandemic, the promotion of health equity including the health of various population sub-groups has been compromised, human rights jeopardised, and social inequities further exacerbated. Citizens worldwide, including in the Group of 20 (G20) countries, were affected by both global health governance (GHG) processes and decisions and public health measures taken by governments to respond to COVID-19. While it is critical to swiftly respond to COVID-19, little is known about how and to what extent the GHG is affecting population health priorities for health equity in global economies such as the G20 countries. This scoping review synthesised and identified knowledge gaps on how the COVID-19-related GHG is affecting population health priorities for policy, programme, and research in G20 countries. We followed the five-stage scoping review methodology promoted by Arksey and O'Malley and the PRISMA Extension for Scoping Reviews guidelines. We searched four bibliographic databases for references conducted in G20 countries and regions and published in English and French, between January 2020 and April 2023. Out of 4,625 references and after two phases of screening, 14 studies met the inclusion criteria. G20 countries included in the review were Australia, Brazil, Canada, China, France, India, Italy, Japan, Russia, South Africa, the United Kingdom, the United States of America, and the European Union. We found insufficient collaboration and coordination and misalignment among governance actors at multiple levels. In most cases, equity considerations were not prioritised while unequal consequences of COVID-19 public health measures on population groups were widely reported. COVID-19-related population health priorities mainly focused on upstream and midstream determinants of health. Our scoping review showed the stark inequities of COVID-19 public health outcomes, coupled with a prevalent lack of coherent collaboration and coordination among governance actors. Moreover, governance as an object of empirical study is still emerging when examining its intersection with global health and population health policy, programme, and research. An urgent shift is required to effectively act upon structural health determinants that include transformative and comprehensive policies for prevention, equity, resilience, and sustainable health.
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Affiliation(s)
- Muriel Mac-Seing
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Québec, Canada.
- Social and Behavioural Health Sciences Division & Centre for Global Health, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
- Centre de recherche en santé publique, Université de Montréal, Montréal, Canada.
| | - Meron Gidey
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Erica Di Ruggiero
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Social and Behavioural Health Sciences Division, Institute of Health Policy, Management and Evaluation & Centre for Global Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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13
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Wiley ZE, Weber DJ. Approaching coronavirus disease 2019 (COVID-19) vaccine hesitancy among healthcare personnel: The importance of cultural competency. Infect Control Hosp Epidemiol 2023; 44:1371-1372. [PMID: 37462096 DOI: 10.1017/ice.2022.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Affiliation(s)
- Zanthia E Wiley
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - David J Weber
- Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
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14
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Whang C, Lynch KA, Huang T, Tsui EK. Critical Dynamics in Black and Latino Parents' Perceptions of Childhood COVID-19 Vaccination: How the "Middle" Moves. JOURNAL OF HEALTH COMMUNICATION 2023; 28:86-96. [PMID: 37390020 DOI: 10.1080/10810730.2023.2211033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
National and state data show low adoption of childhood COVID-19 vaccinations, despite emergency use authorizations and availability. We conducted 24 in-depth, semi-structured interviews with Black and Latino parents in New York City (15 in English, 9 in Spanish), who were undecided or somewhat likely to vaccinate their 5 to 11-year-old children in early 2022. The interviews explored the evolution of parental perceptions on childhood COVID-19 vaccines, and were analyzed using a matrix-driven rapid approach to thematic analysis. We present our findings as themes oriented around trust at three levels of the social ecological model. In summary, we found that structural positionality and historical traumas of participants seeded mistrust in institutions and government. This led to parental reliance on personal observations, conversations, and norms within social groups for vaccine decision-making. Our findings also describe key features of trust-building, supportive conversations that shaped the thinking of undecided parents. This study demonstrates how relational trust becomes a key factor in parental vaccine decision-making, and suggests the potential power of community ambassador models of vaccination promotion for increasing success and rebuilding trust with members of the "movable middle."
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Affiliation(s)
- Christine Whang
- Department of Health Policy and Management, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
- Center for Systems and Community Design (CSCD), Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
- NYU-CUNY Prevention Research Center (PRC), New York University Langone - Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - Kathleen A Lynch
- NYU-CUNY Prevention Research Center (PRC), New York University Langone - Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA
| | - Terry Huang
- Department of Health Policy and Management, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
- Center for Systems and Community Design (CSCD), Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
- NYU-CUNY Prevention Research Center (PRC), New York University Langone - Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
| | - Emma K Tsui
- Center for Systems and Community Design (CSCD), Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
- NYU-CUNY Prevention Research Center (PRC), New York University Langone - Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA
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15
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Kandasamy S, Manoharan B, Khan Z, Stennett R, Desai D, Nocos R, Wahi G, Banner D, de Souza RJ, Lear SA, Anand SS. Perceptions of COVID-19 risk, vaccine access and confidence: a qualitative description of South Asians in Canada. BMJ Open 2023; 13:e070433. [PMID: 37015794 PMCID: PMC10083522 DOI: 10.1136/bmjopen-2022-070433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES In the first full year of the COVID-19 pandemic (2020), South Asians living in the Greater Toronto and Hamilton Area (GTHA) and Greater Vancouver area (GVA) experienced specific barriers to accessing SARS-CoV-2 testing and reliable health information. However, between June 2021 and February 2022, the proportion of people having received at least one COVID-19 vaccine dose was higher among this group (96%) than among individuals who were not visible minorities (93%). A better understanding of successful approaches and the challenges experienced by those who remain unvaccinated among this highly vaccinated group may improve public health outreach in subsequent waves of the current pandemic or for future pandemic planning. Using qualitative methods, we sought to explore the perceptions of COVID-19 risk, vaccine access, uptake and confidence among South Asians living in Canada. DESIGN Semistructured interviews conducted with 25 participants analysed using thematic analysis. Throughout this process, we held frequent discussions with members of the study's advisory group to guide data collection (community engagement, recruitment and data analysis). SETTING Communities of the GTHA and GVA with interviews conducted virtually over Zoom or telephone. PARTICIPANTS 25 participants (15 from Ontario and 10 from British Columbia) were interviewed between July 2021 and January 2022. 10 individuals were community members, 9 were advocacy group leaders and 6 were public health staff. RESULTS Access to and confidence in the COVID-19 vaccine was impacted by individual risk perceptions; sources of trusted information (ethnic and non-ethnic); impact of COVID-19 and the pandemic on individuals, families and society; and experiences with COVID-19 mandates and policies (including temporal and generational differences). Approaches that include community-level awareness and tailored outreach (language and cultural context) were considered successful. CONCLUSIONS Understanding factors and developing strategies that build vaccine confidence and improve access can guide approaches that increase vaccine acceptance in the current and future pandemics.Visual abstract can be found at https://drive.google.com/file/d/1iXdnJj9ssc3hXCllZxP0QA9DhHH-7uwB/view.
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Affiliation(s)
- Sujane Kandasamy
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Baanu Manoharan
- Master of Public Health (MPH) Program, McMaster University, Hamilton, Ontario, Canada
| | - Zainab Khan
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Rosain Stennett
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Dipika Desai
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Rochelle Nocos
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Gita Wahi
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Davina Banner
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Russell J de Souza
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Sonia S Anand
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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16
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Baeker Bispo JA, Douyon A, Ashad-Bishop K, Balise R, Kobetz EK. How Trust in Cancer Information Has Changed in the Era of COVID-19: Patterns by Race and Ethnicity. JOURNAL OF HEALTH COMMUNICATION 2023; 28:131-143. [PMID: 36927415 PMCID: PMC10132996 DOI: 10.1080/10810730.2022.2117439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
COVID-19 emerged during an era of heightened attention to systemic racism and the spread of misinformation. This context may have impacted public trust in health information about chronic diseases like cancer. Here, we examine data from the 2018 and 2020 Health Information National Trends Survey (N = 7,369) to describe how trust in cancer information from government health agencies, doctors, family and friends, charitable organizations, and religious organizations changed after COVID-19 became a pandemic, and whether that change varied by race/ethnicity. Statistical methods included chi-square tests and multiple logistic regression modeling. Overall, the proportion of respondents who reported a high degree of trust in cancer information from doctors increased (73.65% vs. 77.34%, p = .04). Trends for trust in information from government health agencies and family and friends varied significantly by race/ethnicity, with substantial declines observed among non-Hispanic Blacks (NHB) only. The odds of reporting a high degree of trust in cancer information from government health agencies and friends and family decreased by 53% (OR = 0.47, 95% CI = 0.24-0.93) and 73% (OR = 0.27, 95% CI = 0.09-0.82), respectively, among NHB, but were stable for other groups. Future studies should monitor whether recent declines in trust among NHB persist and unfavorably impact participation in preventive care.
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Affiliation(s)
- JA Baeker Bispo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A Douyon
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - K Ashad-Bishop
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - R Balise
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - EK Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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17
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Abdul-Mutakabbir JC, Tillman F, Marcelin JR, Saunders IM, Arya V. Slowed progression: The utility of Test to Treat initiatives in improving the neglected inequities of COVID-19 among racially/ethnically minoritized groups. J Am Pharm Assoc (2003) 2023; 63:424-429. [PMID: 36470731 PMCID: PMC9625842 DOI: 10.1016/j.japh.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/22/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022]
Abstract
In the United States, coronavirus disease 2019 (COVID-19) has resulted in more than 95 million infections and 1 million deaths (as of September 2022), with individuals of racially/ethnically minoritized groups being disproportionately represented among these numbers. Despite the apparent pandemic fatigue in many communities, systemic and structural racism continue to place racially/ethnically minoritized groups at a disadvantage for overcoming the virus, especially as it relates to receiving vaccinations and COVID-19 targeted therapeutics. Test to Treat programs have the potential to mitigate these disparities by rapidly identifying the presence of a COVID-19 infection and readily offering treatment options. Nonetheless, Test to Treat programs must be optimized to adequately address the limitations to care within racially/ethnically minoritized communities.
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Affiliation(s)
- Jacinda C. Abdul-Mutakabbir
- Correspondence: Jacinda C. Abdul-Mutakabbir, PharmD, MPH, Assistant Professor, Loma Linda University School of Pharmacy, 24745 Stewart St., Loma Linda, CA 92350
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18
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Fahim C, Cooper J, Theivendrampillai S, Pham B, Straus SE. Exploring Canadian perceptions and experiences of stigma during the COVID-19 pandemic. Front Public Health 2023; 11:1068268. [PMID: 36960376 PMCID: PMC10027913 DOI: 10.3389/fpubh.2023.1068268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/13/2023] [Indexed: 03/09/2023] Open
Abstract
Background The COVID-19 pandemic has led to stigmatization of individuals based on race/ethnicity, age, gender, and occupation, among other factors. We canvassed Canadian residents to explore perceptions of and experiences with stigma during the COVID-19 pandemic. Methods We conducted an online survey between June 10 and December 31 2020. The survey was rooted in the Health Stigma and Discrimination Framework and included multiple choice, Likert and open-ended questions related to perceived and experienced stigma. Residents of Ontario, Canada were eligible to participate and we aimed to recruit a sample that was diverse by race/ethnicity and age. Results A total of 1,823 individuals participated in the survey (54% women, 39% men; 54% 18-40 years old, 28% 41-60 years old, 12% 61+ years old; 33% White, 26% East/SouthEast Asian, 14% Black, 12% South Asian). Fifty-one percent of participants agreed/strongly agreed that racist views had increased toward certain racial/ethnic groups in Canada during the pandemic. Participants perceived that people in Canada were stigmatized during the pandemic because of race/ethnicity (37%), political beliefs (26%), older age (24%), being a healthcare worker (23%), younger age (22%), being an essential worker (21%), and gender (11%). Thirty-nine percent of respondents feared experiencing and 37% experienced stigmatization during the pandemic. Men, individuals aged 18-40, and racialized participants were more likely to fear or experience stigma. With respect to health behaviors, 74, 68, and 59% of respondents were comfortable masking in public, seeking medical care if they became ill, and getting tested for COVID-19, respectively. Men were less likely to indicate comfort with mask wearing or seeking medical care. Participants aged 18-40 and Black participants were less likely to indicate comfort with all three behaviors compared to those over age 41 and White participants, respectively. South Asian participants were less likely to be comfortable seeking medical care compared to White Participants. Discussion Participants feared or experienced stigmatization towards various demographic characteristics during the COVID-19 pandemic. It is critical that the factors driving stigma during health emergencies in Canada be better understood in order to develop effective public health messaging and interventions.
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19
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Frew PM, Schamel JT, Randall LA, King AR, Spaulding AC, Wu E, Holloway IW. Vaccine confidence among people who use drugs: A cross-sectional survey. Hum Vaccin Immunother 2022; 18:2123201. [PMID: 36170655 DOI: 10.1080/21645515.2022.2123201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Adult immunization coverage remains low in the US, particularly for people who use drugs (PWUD), a population that experiences a disproportionate burden of vaccine-preventable diseases. The extent of and characteristics associated with vaccine confidence (VC) held by PWUD is poorly understood. As VC strongly correlates with vaccine uptake, this cross-sectional study identifies mutable factors associated with VC and quantifies its relationship to immunization status within a highly vulnerable, underimmunized population of PWUD. Using a community-engaged research strategy with select partner organizations hosting syringe exchange programs in Atlanta, Los Angeles, and Las Vegas, USA, we surveyed participants ages 18-69 years served by these organizations from 2019 to 2020. Survey measures included sociodemographics, health behavior including immunization receipt, and vaccine confidence in adult vaccinations using a modified Emory Vaccine Confidence Index (EVCI). The findings reflect relatively low VC among the 1,127 recruited participants, with 56% expressing low VC (EVCI 0-12), 35% medium (EVCI 13-20) and 10% high (EVCI 21-24). EVCI varied by city, with lowest confidence in Atlanta and highest in Las Vegas. VC was associated with past receipt of specific vaccines, including hepatitis A, MMR, Tdap, and influenza. VC varied by specific sociodemographic correlates such as housing insecurity (reduced confidence) and receipt of public benefits or disability (increased confidence). This study identified correlates associated with VC based on site and sociodemographic characteristics for this priority population, highlighting the need for specific interventions to raise VC among PWUD, especially among those experiencing housing insecurity and without public benefits.
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Affiliation(s)
- Paula M Frew
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Jay T Schamel
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Laura A Randall
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Adrian R King
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Elizabeth Wu
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,Southern California HIV/AIDS Policy Research Center, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,UCLA Hub for Health Intervention, Policy, and Practice, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
| | - Ian W Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,Southern California HIV/AIDS Policy Research Center, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,UCLA Hub for Health Intervention, Policy, and Practice, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
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20
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Nickitas DM, Emmons KR, Ackerman-Barger K. A policy pathway: Nursing's role in advancing diversity and health equity. Nurs Outlook 2022; 70:S38-S47. [PMID: 36446539 DOI: 10.1016/j.outlook.2022.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/15/2022] [Accepted: 03/25/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this manuscript is to embolden nurses to engage in policy that promotes diversity, equity, inclusion, and belonging to advance health equity. BACKGROUND It uses the Future of Nursing Report 2020-2030 to acknowledge the impact of structural racism and the need for a more equitable, just, and fair society. DISCUSSION It also recognizes that nurses must harness their power and political will, to change and strengthen policies, so all nurses can practice to the full extent of their education and license. CONCLUSION A case study of the response to COVID-19 in one underserved community is included to illustrate policy in action.
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21
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Adu PA, Iyaniwura SA, Mahmood B, Jeong D, Makuza JD, Cua G, Binka M, García HAV, Ringa N, Wong S, Yu A, Irvine MA, Otterstatter M, Janjua NZ. Association between close interpersonal contact and vaccine hesitancy: Findings from a population-based survey in Canada. Front Public Health 2022; 10:971333. [PMID: 36267997 PMCID: PMC9577316 DOI: 10.3389/fpubh.2022.971333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/26/2022] [Indexed: 01/25/2023] Open
Abstract
Background Vaccine hesitancy threatens efforts to bring the coronavirus disease 2019 (COVID-19) pandemic to an end. Given that social or interpersonal contact is an important driver for COVID-19 transmission, understanding the relationship between contact rates and vaccine hesitancy may help identify appropriate targets for strategic intervention. The purpose of this study was to assess the association between interpersonal contact and COVID-19 vaccine hesitancy among a sample of unvaccinated adults in the Canadian province of British Columbia (BC). Methods Unvaccinated individuals participating in the BC COVID-19 Population Mixing Patterns Survey (BC-Mix) were asked to indicate their level of agreement to the statement, "I plan to get the COVID-19 vaccine." Multivariable multinomial logistic regression was used to assess the association between self-reported interpersonal contact and vaccine hesitancy, adjusting for age, sex, ethnicity, educational attainment, occupation, household size and region of residence. All analyses incorporated survey sampling weights based on age, sex, geography, and ethnicity. Results Results were based on survey responses collected between March 8, 2021 and December 6, 2021, by a total of 4,515 adults aged 18 years and older. Overall, 56.7% of respondents reported that they were willing to get the COVID-19 vaccine, 27.0% were unwilling and 16.3% were undecided. We found a dose-response association between interpersonal contact and vaccine hesitancy. Compared to individuals in the lowest quartile (least contact), those in the fourth quartile (highest contact), third quartile and second quartile groups were more likely to be vaccine hesitant, with adjusted odd ratios (aORs) of 2.85 (95% CI: 2.02, 4.00), 1.91(95% CI: 1.38, 2.64), 1.78 (95% CI: 1.13, 2.82), respectively. Conclusion Study findings show that among unvaccinated people in BC, vaccine hesitancy is greater among those who have high contact rates, and hence potentially at higher risk of acquiring and transmitting infection. This may also impact future uptake of booster doses.
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Affiliation(s)
- Prince A. Adu
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Sarafa A. Iyaniwura
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,Department of Mathematics, University of British Columbia, Vancouver, BC, Canada
| | - Bushra Mahmood
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Dahn Jeong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jean Damascene Makuza
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Georgine Cua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mawuena Binka
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Héctor A. Velásquez García
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Notice Ringa
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Stanley Wong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Amanda Yu
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Mike A. Irvine
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Michael Otterstatter
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Naveed Z. Janjua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada,Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada,*Correspondence: Naveed Z. Janjua
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22
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Milien E, Enoma E, Pierre-Louis L, Jones M, King K, Extravour T, Nolen LT. We Got Us: A community-centered approach to increasing vaccine access for minoritized groups. J Hosp Med 2022; 17:765-768. [PMID: 36039960 DOI: 10.1002/jhm.12927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/26/2022] [Accepted: 06/08/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Eileen Milien
- We Got Us: A Community Empowerment Project, Boston, Massachusetts, USA
- Emmanuel College, Boston, Massachusetts, USA
| | - Efosa Enoma
- We Got Us: A Community Empowerment Project, Boston, Massachusetts, USA
- Northeastern University, Boston, Massachusetts, USA
| | - Laetitia Pierre-Louis
- We Got Us: A Community Empowerment Project, Boston, Massachusetts, USA
- Northeastern University, Boston, Massachusetts, USA
| | - Melissa Jones
- We Got Us: A Community Empowerment Project, Boston, Massachusetts, USA
- Harvard College, Harvard University, Cambridge, Massachusetts, USA
| | - Kareem King
- We Got Us: A Community Empowerment Project, Boston, Massachusetts, USA
- Harvard College, Harvard University, Cambridge, Massachusetts, USA
| | - Taylor Extravour
- We Got Us: A Community Empowerment Project, Boston, Massachusetts, USA
- Northeastern University, Boston, Massachusetts, USA
| | - LaShyra T Nolen
- We Got Us: A Community Empowerment Project, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Harvard Kennedy School of Government, Cambridge, Massachusetts, USA
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Rapid Implementation of a Community-Academic Partnership Model to Promote COVID-19 Vaccine Equity within Racially and Ethnically Minoritized Communities. Vaccines (Basel) 2022; 10:vaccines10081364. [PMID: 36016251 PMCID: PMC9415044 DOI: 10.3390/vaccines10081364] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has highlighted inequities in mortalities and associated illnesses among non-Hispanic Black and Hispanic/Latino individuals. Immunization against COVID-19 is critical to ending the pandemic, especially within racial and ethnically minoritized communities. However, vaccine hesitancy and institutional mistrust in these communities, resulting from decades of mistreatment, structural racism, and barriers to vaccination access, have translated into low vaccination uptake. Trustworthy relationships with healthcare professionals and partnerships with faith and community leaders are critical to increasing vaccination rates within these minoritized communities. Loma Linda University researchers collaborated with local faith and community organizations in San Bernardino County, CA, to rapidly implement a three-tiered approach to increase the vaccination rates within non-Hispanic Black and Hispanic/Latino communities. This community–academic partnership model provided over 1700 doses of the COVID-19 vaccine within these vaccine-hesitant, targeted minoritized communities. As over 100,000 individuals are diagnosed with COVID-19 daily and updated vaccines targeting variants of the Omicron strain are expected to rollout in the coming months, the development of sustainable programs aimed at increasing vaccine uptake within vulnerable communities are of the utmost importance.
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Dubov A, Distelberg BJ, Abdul-Mutakabbir JC, Peteet B, Roberts L, Montgomery SB, Rockwood N, Patel P, Shoptaw S, Chrissian AA. Racial/Ethnic Variances in COVID-19 Inoculation among Southern California Healthcare Workers. Vaccines (Basel) 2022; 10:1331. [PMID: 36016219 PMCID: PMC9414471 DOI: 10.3390/vaccines10081331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/13/2022] [Accepted: 08/15/2022] [Indexed: 01/25/2023] Open
Abstract
Healthcare workers (HCWs) from minoritized communities are a critical partner in moving vaccine-hesitant populations toward vaccination, yet a significant number of these HCWs are delaying or deciding against their own COVID-19 vaccinations. Our study aims to provide a more nuanced understanding of vaccine hesitancy among racially and ethnically minoritized HCWs and to describe factors associated with vaccine non-acceptance. Analysis of a sub-sample of racially and ethnically minoritized HCWs (N = 1131), who participated in a cross-sectional study at two large Southern California medical centers, was conducted. Participants completed an online survey consisting of demographics, work setting and clinical role, influenza vaccination history, COVID-19 knowledge, beliefs, personal COVID-19 exposure, diagnosis, and impact on those closest to them. While overall most HCWs were vaccinated (84%), 28% of Black, 19% of Hispanic, and 8% of Asian American HCWs were vaccine-hesitant. Age, education level, occupation, history of COVID-19, and COVID-19 related knowledge were predictive of vaccine hesitancy. We found significant variations in COVID-19 related knowledge and reasons for vaccine hesitancy among Black (governmental mistrust), Hispanic (preference for physiological immunity), and Asian-American HCWs (concern about side effects) who were vaccine-hesitant or not. Our findings highlight racial and ethnic differences in vaccine-hesitancy and barriers to vaccination among HCWs of color. This study indicates the necessity of targeted interventions to reduce vaccine hesitancy that are mindful of the disparities in knowledge and access and differences between and among racial and ethnic groups.
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Affiliation(s)
- Alex Dubov
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Brian J. Distelberg
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | | | - Bridgette Peteet
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Lisa Roberts
- School of Nursing, Loma Linda University, Loma Linda, CA 92350, USA
| | | | - Nicholas Rockwood
- School of Behavioral Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Pranjal Patel
- School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
| | - Steven Shoptaw
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90032, USA
| | - Ara A. Chrissian
- School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA
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25
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A Framework for Inspiring COVID-19 Vaccine Confidence in African American and Latino Communities. Vaccines (Basel) 2022; 10:vaccines10081319. [PMID: 36016207 PMCID: PMC9416715 DOI: 10.3390/vaccines10081319] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic has disproportionately impacted racial and ethnic minority communities, particularly African American and Latino communities. The impacts of social determinants of health, structural racism, misinformation, and mistrust have contributed to a decreased COVID-19 vaccine uptake. Effective methods of addressing and combatting these barriers are essential. Accurate and targeted messaging delivered by trusted voices from community-based organizations, government health systems and organizations, and healthcare and academic systems is imperative. Outreach and communication should be culturally sensitive, provided in the preferred language of the community, flexible, and tailored for in-person and virtual outlets. This communication must also increase trust, combat misinformation, and inspire COVID-19 vaccine confidence. In this manuscript, we outline a framework for inspiring COVID-19 vaccine confidence in African American and Latino communities. These methods of targeted outreach should be considered and implemented for urgent and nonurgent community public health efforts beyond the COVID-19 pandemic (e.g., monkeypox) and as a framework to inspire vaccine confidence in those living in racial and ethnic minority communities globally.
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Monroy A, Cullen T. A Multiresource Event Model Developed to Increase Access to COVID-19 Vaccines in Pima County, Arizona, Summer 2021. Public Health Rep 2022; 137:1061-1065. [PMID: 35915992 PMCID: PMC9548496 DOI: 10.1177/00333549221114896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In summer 2021, the Pima County Health Department (PCHD) developed and implemented a multiresource event model for vaccine clinics to increase access to COVID-19 vaccines and other resources, such as food, rental assistance, and public health services, in Pima County, Arizona, communities. The PCHD aimed to improve vaccine access in areas with vaccination rates <40% by involving community partners to plan a multiresource event with resources (eg, food, connection to economic resources, information on childcare, and heat relief)and incentives specific to community needs that could drive attendance. Resources would be made available to community members regardless of whether they received a COVID-19 vaccine at the event. The PCHD selected census tract 41.15 as the pilot group to apply the multiresouce COVID-19 vaccine event model. Census tract 41.15 is a heat-stressed area of Pima County comprising mostly Latino people and people with lower incomes and is an area with low vaccination rates for COVID-19. The vaccination rate increased in census tract 41.15 by 12.8 percentage points (absolute increase), starting at 33.9% on June 1, 2021, and increasing to 46.7% as of September 1, 2021. In addition, attendance at the pilot event versus attendance at previous events that did not use this model increased by >100%. The multiresource COVID-19 vaccine event, when held within a hyperlocal area and when the needs of residents in the community are considered, can improve vaccine uptake. This model provides a roadmap for COVID-19 vaccine delivery in areas of low uptake.
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Mody A, Bradley C, Redkar S, Fox B, Eshun-Wilson I, Hlatshwayo MG, Trolard A, Tram KH, Filiatreau LM, Thomas F, Haslam M, Turabelidze G, Sanders-Thompson V, Powderly WG, Geng EH. Quantifying inequities in COVID-19 vaccine distribution over time by social vulnerability, race and ethnicity, and location: A population-level analysis in St. Louis and Kansas City, Missouri. PLoS Med 2022; 19:e1004048. [PMID: 36026527 PMCID: PMC9417193 DOI: 10.1371/journal.pmed.1004048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Equity in vaccination coverage is a cornerstone for a successful public health response to COVID-19. To deepen understanding of the extent to which vaccination coverage compares with initial strategies for equitable vaccination, we explore primary vaccine series and booster rollout over time and by race/ethnicity, social vulnerability, and geography. METHODS AND FINDINGS We analyzed data from the Missouri Department of Health and Senior Services on all COVID-19 vaccinations administered across 7 counties in the St. Louis region and 4 counties in the Kansas City region. We compared rates of receiving the primary COVID-19 vaccine series and boosters relative to time, race/ethnicity, zip-code-level Social Vulnerability Index (SVI), vaccine location type, and COVID-19 disease burden. We adapted a well-established tool for measuring inequity-the Lorenz curve-to quantify inequities in COVID-19 vaccination relative to these key metrics. Between 15 December 2020 and 15 February 2022, 1,763,036 individuals completed the primary series and 872,324 received a booster. During early phases of the primary series rollout, Black and Hispanic individuals from high SVI zip codes were vaccinated at less than half the rate of White individuals from low SVI zip codes, but rates increased over time until they were higher than rates in White individuals after June 2021; Asian individuals maintained high levels of vaccination throughout. Increasing vaccination rates in Black and Hispanic communities corresponded with periods when more vaccinations were offered at small community-based sites such as pharmacies rather than larger health systems and mass vaccination sites. Using Lorenz curves, zip codes in the quartile with the lowest rates of primary series completion accounted for 19.3%, 18.1%, 10.8%, and 8.8% of vaccinations while representing 25% of the total population, cases, deaths, or population-level SVI, respectively. When tracking Gini coefficients, these disparities were greatest earlier during rollout, but improvements were slow and modest and vaccine disparities remained across all metrics even after 1 year. Patterns of disparities for boosters were similar but often of much greater magnitude during rollout in fall 2021. Study limitations include inherent limitations in the vaccine registry dataset such as missing and misclassified race/ethnicity and zip code variables and potential changes in zip code population sizes since census enumeration. CONCLUSIONS Inequities in the initial COVID-19 vaccination and booster rollout in 2 large US metropolitan areas were apparent across racial/ethnic communities, across levels of social vulnerability, over time, and across types of vaccination administration sites. Disparities in receipt of the primary vaccine series attenuated over time during a period in which sites of vaccination administration diversified, but were recapitulated during booster rollout. These findings highlight how public health strategies from the outset must directly target these deeply embedded structural and systemic determinants of disparities and track equity metrics over time to avoid perpetuating inequities in healthcare access.
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Affiliation(s)
- Aaloke Mody
- Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Cory Bradley
- Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Salil Redkar
- Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Branson Fox
- Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Ingrid Eshun-Wilson
- Washington University School of Medicine, St. Louis, Missouri, United States of America
| | | | - Anne Trolard
- Washington University School of Medicine, St. Louis, Missouri, United States of America
- Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Khai Hoan Tram
- University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Lindsey M. Filiatreau
- Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Franda Thomas
- St. Louis City Department of Health, St. Louis, Missouri, United States of America
| | - Matt Haslam
- St. Louis City Department of Health, St. Louis, Missouri, United States of America
| | - George Turabelidze
- Missouri Department of Health and Senior Services, Jefferson City and St Louis, Missouri, United States of America
| | - Vetta Sanders-Thompson
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - William G. Powderly
- Washington University School of Medicine, St. Louis, Missouri, United States of America
- Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Elvin H. Geng
- Washington University School of Medicine, St. Louis, Missouri, United States of America
- Institute for Public Health, Washington University in St. Louis, St. Louis, Missouri, United States of America
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Abdul‐Mutakabbir JC, Simiyu B, Walker RE, Christian RL, Dayo Y, Maxam M. Leveraging Black pharmacists to promote equity in COVID‐19 vaccine uptake within Black communities: A framework for researchers and clinicians. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022; 5:887-893. [PMID: 35942357 PMCID: PMC9350100 DOI: 10.1002/jac5.1669] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 11/10/2022]
Abstract
Black Americans are disproportionately represented among coronavirus disease 2019 (COVID‐19)‐related morbidities and mortalities. While the COVID‐19 vaccines are positioned to change this disparity, vaccine hesitancy, attributed to decades of systemic racism and mistreatment by the United States health care system, heavily exists among this racially and ethnically minoritized group. In addition, social determinants of health within Black communities including the lack of health care access and inequitable COVID‐19 vaccine allocation, further impacts vaccine uptake. Black pharmacists have worked to address the pandemic's deleterious effects that have been recognized within Black communities, as they are intimately aware of the structural and systematic limitations that contribute to lower vaccination rates in comparison to other racial and ethnic groups. Black pharmacists have been integral to promoting equity in COVID‐19 uptake within Black communities by disseminating factual, trustworthy information in collaboration with community leaders, advocating for the equitable access to the immunizations into vulnerable areas, and creating, low‐barrier, options to distribute the vaccines. Herein, we thoroughly explain these points and offer a framework that describes the role of Black pharmacists in narrowing vaccine equity gaps.
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Affiliation(s)
- Jacinda C. Abdul‐Mutakabbir
- Department of Pharmacy Practice Loma Linda University School of Pharmacy Loma Linda California USA
- Department of Basic Sciences Loma Linda University School of Medicine Loma Linda California USA
| | - Brenda Simiyu
- Department of Pharmacy Services University Medical Center New Orleans Louisiana USA
| | - Ramara E. Walker
- Department of Pharmacy Services Cleveland Clinic Cleveland Ohio USA
| | - Robbie L. Christian
- Department of Pharmacy Services Baton Rouge General Baton Rouge Louisiana USA
| | - Yewande Dayo
- Ochsner Health Department of System Pharmacy Services New Orleans Louisiana USA
| | - Meshell Maxam
- Department of Pharmacy Kaiser Permanente‐Georgia Atlanta Georgia USA
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29
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Mahoney MV, Bhagat H, Christian R, del Rio C, Hohmeier KC, Klepser ME, Pogue JM. Pharmacists as important prescribers of coronavirus disease 2019 (COVID-19) antivirals. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e112. [PMID: 36483352 PMCID: PMC9726491 DOI: 10.1017/ash.2022.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 06/17/2023]
Abstract
Although pharmacists are key members of the healthcare team, they are currently ineligible to independently prescribe the oral coronavirus disease 2019 (COVID-19) antivirals. We report the roles pharmacists have undertaken during the COVID-19 pandemic and provide evidence for the support of independent oral COVID-19 antiviral prescribing.
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Affiliation(s)
- Monica V. Mahoney
- Department of Pharmacy, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Hita Bhagat
- Department of Pharmacy, Community Health Network, Indianapolis, Indiana
| | | | - Carlos del Rio
- Division of Infectious Diseases, Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Kenneth C. Hohmeier
- Department of Clinical Pharmacy & Translational Science, University of Tennessee Health Science Center, Nashville, Tennessee
| | | | - Jason M. Pogue
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan
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30
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Assoumou SA, Peterson A, Ginman E, James T, Pierre CM, Hamilton S, Chapman S, Goldie J, Koenig R, Mendez-Escobar E, Leaver H, Graham R, Crichlow R, Weaver T, Cotterell S, Valdez G, De Las Nueces D, Scott NA, Linas BP, Cherry PM. Addressing Inequities in SARS-CoV-2 Vaccine Uptake: The Boston Medical Center Health System Experience. Ann Intern Med 2022; 175:879-884. [PMID: 35576586 DOI: 10.7326/m22-0028] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Academic medical centers could play an important role in increasing access to and uptake of SARS-CoV-2 vaccines, especially in Black and Latino communities that have been disproportionately affected by the pandemic. This article describes the vaccination program developed by the Boston Medical Center (BMC) health system (New England's largest safety-net health system), its affiliated community health centers (CHCs), and community partners. The program was based on a conceptual framework for community interventions and aimed to increase equitable access to vaccination in the hardest-hit communities through community-based sites in churches and community centers, mobile vaccination events, and vaccination on the BMC campus. Key strategies included a communication campaign featuring trusted messengers, a focus on health equity, established partnerships with community leaders and CHCs, and strong collaboration with local health departments and the Commonwealth of Massachusetts to ensure equitable allocation of the vaccine supply. Process factors involved the use of robust analytics relying on the Centers for Disease Control and Prevention's Social Vulnerability Index (SVI). The vaccination program administered 109 938 first doses, with 94 703 (86%) given at community sites and 2466 (2%) given at mobile sites. Mobile vaccination events were key in reaching younger people living in locations with the highest SVIs. Challenges included the need for a robust operational infrastructure and mistrust of the health system given the long history of economic disinvestment in the surrounding community. The BMC model could serve as a blueprint for other medical centers interested in implementing programs aimed at increasing vaccine uptake during a pandemic and in developing an infrastructure to address other health-related disparities.
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Affiliation(s)
- Sabrina A Assoumou
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, and Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts (S.A.A., C.M.P.)
| | - Alicia Peterson
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Ellen Ginman
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Thea James
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Cassandra M Pierre
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, and Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts (S.A.A., C.M.P.)
| | - Sebastian Hamilton
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Sheila Chapman
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - John Goldie
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Robert Koenig
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Elena Mendez-Escobar
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Hannah Leaver
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Robert Graham
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
| | - Renee Crichlow
- Codman Square Health Center, Boston, Massachusetts (R.C., T.W., S.Cotterell)
| | - Tarsha Weaver
- Codman Square Health Center, Boston, Massachusetts (R.C., T.W., S.Cotterell)
| | - Sandra Cotterell
- Codman Square Health Center, Boston, Massachusetts (R.C., T.W., S.Cotterell)
| | - Guale Valdez
- Mattapan Community Health Center, Boston, Massachusetts (G.V.)
| | | | - Nancy A Scott
- Boston University School of Public Health, Boston, Massachusetts (N.A.S.)
| | - Benjamin P Linas
- Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, and Boston University School of Public Health, Boston, Massachusetts (B.P.L.)
| | - Petrina Martin Cherry
- Boston Medical Center, Boston, Massachusetts (A.P., E.G., T.J., S.H., S.Chapman, J.G., R.K., E.M., H.L., R.G., P.M.C.)
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Titanji BK, Abdul-Mutakabbir JC, Christophers B, Flores L, Marcelin JR, Swartz TH. Social Media: Flattening Hierarchies for Women and Black, Indigenous, People Of Color (BIPOC) to Enter the Room Where It Happens. Clin Infect Dis 2022; 74:S222-S228. [PMID: 35568478 PMCID: PMC9107375 DOI: 10.1093/cid/ciac047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Social media platforms are widely used to connect people across multiple settings, including country of origin, profession, race/ethnicity, sexual orientation, gender identity, seniority, and training. Groups that have been marginalized or historically excluded from decision-making encounters may lack formal mentors/sponsors because of a lack of representation of women and Black, Indigenous, People Of Color (BIPOC) in senior leadership positions. This can serve as a barrier to professional advancement at all stages of career development. Identifying and connecting with these potential mentors/sponsors outside of one's institutional space can be challenging. For this reason, leveraging social media to develop these professional relationships through flattened hierarchies can allow for professional networking beyond traditional mechanisms. Here we aim to describe how individuals can connect through social media to advance their careers and scientific and clinical expertise, advocate for communities, and provide high-quality communication to the public.
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Affiliation(s)
- Boghuma K Titanji
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jacinda C Abdul-Mutakabbir
- Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, California, USA
- Department of Basic Science, Loma Linda School of Medicine, Loma Linda, California, USA
| | - Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York, USA
| | - Laura Flores
- University of Nebraska Medical Center, College of Allied Health Professions, Omaha, Nebraska, USA
| | - Jasmine R Marcelin
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USAand
| | - Talia H Swartz
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Chan DK, Alegria BD, Chadaga SR, Goren LJ, Mikasa TJ, Pearson AM, Podolsky SR, Won RS, LeTourneau JL. Rapid Deployment of Multiple-Tactics to Address SARS-CoV-2 Vaccine Uptake in Healthcare Employees with a focus on Those Who Identify as Black, Indigenous, and People of Color (BIPOC). Open Forum Infect Dis 2022; 9:ofac012. [PMID: 35198643 PMCID: PMC8860151 DOI: 10.1093/ofid/ofac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/10/2022] [Indexed: 11/12/2022] Open
Abstract
Background In the third quarter of 2021, government entities enacted vaccine requirements across multiple employment sectors, including healthcare. Experience from previous vaccination campaigns within healthcare emphasize the need to translate community modalities of vaccine outreach and education that partner with Black communities, Indigenous communities, and communities of Color stakeholders to increase vaccine confidence broadly. Methods This was an observational feasibility study conducted from August through October 2021 that deployed and measured the effect of a multimodal approach to increasing vaccine uptake in healthcare employees. Vaccine data were acquired through the Center for Disease Control Immunization Information Systems across Oregon and Washington. Rates of complete vaccination before the intervention were compared with rates after as a measure of feasibility of this intervention. These data were subdivided by race/ethnicity, age, gender, and job class. Complete vaccination was defined as completion of a 2-dose mRNA SARS-CoV-2 vaccine series or a 1-dose adenoviral vector SARS-CoV-2 vaccine. Results Overall preintervention and postintervention complete vaccination rates were 83.7% and 93.5%, respectively. Of those employees who identified as a certain race, black employees demonstrated the greatest percentage difference increase, 18.5% (preintervention, 72.1%; postintervention, 90.6%), followed by Hispanic employees, 14.1% (preintervention, 79.4%; postintervention, 93.5%), and employees who identify as 2 or more races, 13.9% (preintervention, 78.7%; postintervention, 92.6%) Conclusions We found that a multimodal approach to improving vaccination uptake in employees was feasible. For organizations addressing vaccine requirements for their workforce, we recommend a multimodal strategy to increase vaccine confidence and uptake.
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Affiliation(s)
- Dominic K Chan
- Department of Pharmacy, Legacy Health, Portland, OR, United States
| | - Brittany D Alegria
- Department of Human Resources, Legacy Health, Portland, OR, United States
| | - Smitha R Chadaga
- Department of Internal Medicine Service, Legacy Health, Portland, OR, United States
| | - Lisa J Goren
- Department of Human Resources, Legacy Health, Portland, OR, United States
| | - Traci J Mikasa
- Department of Emanuel Internal Medicine Residency, Legacy Health, Portland, OR, United States
| | - Anna M Pearson
- Department of Strategy & Business Development, Legacy Health, Portland, OR, United States
| | - Seth R Podolsky
- Department of Office of Clinical Transformation, Legacy Health, Portland, OR, United States
| | - Regina S Won
- Department of Infectious Disease, Legacy Health, Portland, OR, United States
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Hernandez Acosta RA, Esquer Garrigos Z, Marcelin JR, Vijayvargiya P. COVID-19: Pathogenesis and Clinical Manifestations. Infect Dis Clin North Am 2022; 36:231-249. [PMID: 35636898 PMCID: PMC8806149 DOI: 10.1016/j.idc.2022.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
| | | | - Jasmine R Marcelin
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - Prakhar Vijayvargiya
- Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, USA.
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Campbell HE. The (Contrasted) Ethics of Covid-19 and HIV: Will the Favor be Returned? JOURNAL OF HEALTHCARE, SCIENCE AND THE HUMANITIES 2021; 11:107-121. [PMID: 36818213 PMCID: PMC9930501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
With 118,000 cases in 114 countries and 4291 global mortalities, the World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020. The origins were believed to be from Wuhan, China, and SARS CoV-2, a coronavirus, was quickly identified as the causative organism. Researchers at the National Institute of Health Vaccine Research Center identified the spike protein as the critical portion of the virus that allows for attachment to human cells. In just 66 days after identifying the genetic sequence, the first COVID-19 vaccine candidate began the enrollment of human subjects into a Phase I clinical trial. This accelerated effort was due to a collective and collaborative global response. Currently, one COVID-19 vaccine has been approved and two others have received an emergency use authorization (EUA) from the United States Food and Drug Administration (FDA). Thus, there has been a clear comparison of the COVID-19 response efforts and that which was utilized in addressing the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. For over four decades, the HIV/AIDS epidemic has been historically defined by a disproportionate number of infections and related mortalities amongst racially and ethnically minoritized individuals, including those that identify as homosexual. While novel drug therapies have been developed for the treatment of HIV/AIDS; there have been key components employed amid the global health response to COVID-19, that have been absent from the management of the HIV/AIDS epidemic. Majorly, the development and availability of vaccine against HIV/AIDS. Many of the ideas and initiatives that have resulted in a positive COVID-19 response and the eventual successful vaccination development; have been those learned from the trial and error of mitigating increasing global rates of HIV/AIDS infections. Hence, the question remains as to whether the lessons and approaches learned during the COVID-19 pandemic, namely vaccination development, will be applied to managing the HIV/AIDS epidemic. Herein, we aim to compare the HIV/AIDS epidemic and COVID-19 pandemic, by describing how the fight against HIV/AIDs equipped global scientific leaders with effective strategies to overcome future public health crises (COVID-19), discuss the ethical considerations associated with the differences in the global health responses to the HIV/ AIDS epidemic versus the COVID-19 pandemic, and finally, identify lessons learned from the COVID-19 pandemic that can be applied to the quest for an HIV/AIDS vaccine..
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