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Isiguzo GC, Stefanovics E, Unamba NN, Mbam TT, Anyaehie UG, Chukwu CC, Anyaehie UB, Osy-Eneze C, Ibezim EO, Okoro UG, Njoku PO, Adimekwe AI, Ibediro K, Stefanovics G, Iheanacho T. Perceptions of the COVID-19 Vaccine and Willingness to Receive Vaccination among Health Workers in Nigeria: A Cross-sectional Study. Niger J Clin Pract 2024; 27:102-108. [PMID: 38317042 DOI: 10.4103/njcp.njcp_537_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/01/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND COVID-19 vaccine hesitancy is a major barrier to vaccine uptake, and the achievement of herd immunity is required to reduce morbidity and mortality and protect the most vulnerable populations. In Nigeria, COVID-19 vaccine hesitancy has been high, and uptake remains very low. Healthcare workers (HCWs) in Nigeria can help support public health efforts to increase vaccine uptake. AIM This study evaluates Nigerian HCWs' acceptance and intent to recommend the COVID-19 vaccine. SUBJECTS AND METHODS Cross-sectional survey among 1,852 HCWs in primary, secondary, and tertiary care settings across Nigeria. Respondents included doctors, nurses, pharmacy workers, and clinical laboratory professionals who have direct clinical contact with patients in various healthcare settings. A 33-item questionnaire was used in the study, with two of the questions focused on the COVID-19 vaccine. The responses to the two questions were analyzed using Chi-square (c2) tests and independent t-tests to determine the acceptance of the vaccine. RESULTS The majority of respondents were younger than 34 years (n = 1,227; 69.2%) and primarily worked in hospitals (n = 1,278; 72.0%). Among the respondents, 79.2% (n = 1,467) endorsed the COVID-19 vaccine as a critical tool in reducing the impact of the disease, and 76.2% (n = 1,412) will accept and recommend the vaccine to their patients. The younger HCWs were more likely to endorse and recommend the vaccine to their patients. CONCLUSION There is a moderately high COVID-19 vaccine acceptance rate among HCWs surveyed in our study. The confidence of HCWs in its use and their willingness to recommend it to their patients can provide a potentially useful element in increasing acceptance by the larger population in Nigeria.
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Affiliation(s)
- G C Isiguzo
- Department of Medicine, Alex Ekwueme Federal University Teaching Hospital/Ebonyi State University Abakaliki, Ebonyi State, Nigeria
| | - E Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
| | - N N Unamba
- Division of Cardiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - T T Mbam
- Department of Otorhinolaryngology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - U G Anyaehie
- National Orthopedic Hospital Enugu, Enugu State, Nigeria
| | - C C Chukwu
- Department of Radiology, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | - U B Anyaehie
- Department of Physiology, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - C Osy-Eneze
- Colchester GP Vocational Training Scheme, NHS, England, UK
| | - E O Ibezim
- College of Medicine, Imo State University, Owerri, Imo State, Nigeria
| | - U G Okoro
- Family Practice Department, Franciscan Physician Network, Crown Point, Indiana, United States
| | - P O Njoku
- Department of Internal Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - A I Adimekwe
- Northallerton GP Vocational Training Scheme, NHS, England, UK
| | - K Ibediro
- Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - G Stefanovics
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
| | - T Iheanacho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center, West Haven, CT, USA
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Suhail MK, Moinuddin A. Evaluation of strategies against vaccine hesitancy in the COVID-19 and Indian context-A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:142. [PMID: 37397096 PMCID: PMC10312413 DOI: 10.4103/jehp.jehp_1376_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 10/27/2022] [Indexed: 07/04/2023]
Abstract
The world has been severely affected by the COVID-19 pandemic in terms of loss of lives, health, and its socioeconomic consequences; however, the true magnitude and extent of the damage from COVID-19 is still elusive till date. With the advent of many efficacious vaccines, one of the most effective ways to get to grips with the pandemic is mass vaccination. However, due to vaccine hesitancy (VH), it remains a colossal challenge globally thereby causing serious threat to the pandemic response efforts. This review intends to identify evaluated interventions and evidence to support recommendation of specific strategies to address VH from an Indian context. A systematic review was conducted to synthesize relevant literature around the evaluation of strategies to tackle VH for effectiveness or impact in India. Electronic databases were searched using specific keywords and predefined inclusion-exclusion criteria. A total of 133 articles were screened, 15 were assessed for eligibility, and two were included in the final review. There is a paucity of research on evaluation of vaccine hesitancy interventions in India. Evidence is not strong enough to recommend one specific strategy or intervention. Together, a permutation of multicomponent and tailored interventions has been found most effective in repressingVH in India.
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Affiliation(s)
- Mohammed K. Suhail
- Doctoral Researcher, School of Health and Life Sciences, Teesside University-Middlesbrough, United Kingdom
| | - Arsalan Moinuddin
- Vascular Health Researcher, School of Sport and Exercise, University of Gloucestershire-Gloucester, United Kingdom
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3
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Negative ageism and compassionate ageism in news coverage of older people under COVID-19: how did the pandemic progression and public health responses associate with different news themes? AGEING & SOCIETY 2023. [DOI: 10.1017/s0144686x22001490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Abstract
Previous studies have found negative ageing narratives in the media during the COVID-19 pandemic. However, few have focused on compassionate ageism and how the news responded to the progression of the COVID-19 pandemic. We investigated (a) media themes of negative and compassionate ageism and (b) their relationships with COVID-19 parameters and the public health response. The sample included 1,197 articles relevant to COVID-19 and older people in Hong Kong published between January and December 2020. We used thematic analysis to identify themes from the news articles and structural equation modelling to explore these themes' relationship with the number of older people infected, effective reproduction number, number of COVID-19 deaths and public health response parallel in time. Pandemic-related variables were lagged for a day – the time needed to be reflected in the news. Two negative ageism themes portrayed older people as vulnerable to COVID-19 but counterproductive in combating the pandemic. Two compassionate ageism themes depicted older people as a homogenous group of passive assistance recipients. The theme blaming older people was associated with the number of confirmed infections (β = 0.418, p = 0.002) but vulnerability of older people was not associated with pandemic-related variables. The theme helping older people was negatively associated with the percentage of older people in confirmed infections (β = −0.155, p = 0.019). The theme resources available was negatively associated with confirmed infections (β = −0.342, p < 0.001) but positively associated with the Containment and Health Index (β = 0.217, p = 0.005). Findings suggested that negative and compassionate ageism were translated into narratives about older people in the media as the pandemic evolved but did not address the actual risk they faced. Media professionals should be aware of the potential negative and compassionate ageism prompted by the news agenda and promote adequate health behaviours and responses.
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Owusu SA. Ethical implications for children's exclusion in the initial COVID-19 vaccination in Ghana. Glob Bioeth 2023; 34:1-11. [PMID: 36703864 PMCID: PMC9873277 DOI: 10.1080/11287462.2023.2168170] [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: 07/01/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
Bioethics provides various models of fair allocation of scarce health resources like COVID-19 vaccines. Even though these models are grounded in some ethical principles like justice and beneficence, there were severe inequalities in global access to COVID-19 vaccines. In Ghana, about 21.5 million COVID-19-doses have been administered but comprise mainly members of the adult population. As a result, ethical issues related to vaccinating children have been largely ignored in the country. This paper explores some of the ethical implications related to children's exclusion in the initial COVID-19 vaccination programs in Ghana. It provides a general overview of the COVID-19 pandemic in Ghana and how it related to children and discusses the risks to which Ghanaian children were exposed by delaying their COVID-19 vaccination. A guide to facilitating the full rollout of COVID-19 vaccination in Ghana for children has been proposed that indicates that a fair vaccine distribution for children should prioritize children on admission at health facilities, those diagnosed with severe underlying health conditions, and children who could play an instrumental role in promoting vaccine uptake. It concludes that children must not be placed at the peripheries of the COVID-19 vaccination program in Ghana.
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Affiliation(s)
- Samuel Asiedu Owusu
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
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5
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A KOUSOULISA, F. GRANTI, A DUNCANJ, J. LARSONH. REVISITING THE EBOLA EPIDEMIC IN WEST AFRICA: THE ROLE OF EMOTIONAL DETERMINANTS IN PUBLIC RESPONSES. Afr J Infect Dis 2023; 17:14-22. [PMID: 37151757 PMCID: PMC10158957 DOI: 10.21010/ajidv17i2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 05/09/2023] Open
Abstract
Background The 2014-2016 Ebola epidemic was largely restricted to the three nations of Guinea, Liberia and Sierra Leone, yet it tested the world's ability to address a potential global pandemic. This study provides an in-depth examination of the role of emotions in the response to the outbreak and engagement with public health measures, and the contextual factors which influenced them. Methods Historical research methods were utilised in the examination of primary and secondary sources. A multi-faceted SPEECH (Society and Politics, Economy, Epidemiology, Culture, Healthcare and Public Health) framework was developed to aid data synthesis and analysis. Results The outbreak occurred in a region still reeling from years of civil war, where poverty was widespread and healthcare severely underfunded. Internationally, global health security had been politically neglected. After a slow start, the international response to the outbreak was strong, yet the lack of community engagement and inadequate consideration of local culture and traditional beliefs, fueled fear and hindered engagement with professionals and uptake of public health measures. Improved collaboration and communication with rural communities in the latter phases of the response was crucial in effectively addressing the outbreak. Conclusion This study illustrates the importance of effective collaboration between international crisis responders, in-country public health practitioners and local communities in addressing public emotional responses to the Ebola outbreak. It highlights how community engagement and communications tactics can effectively be utilised to soothe and educate the public, abating counterproductive extreme emotional responses, and in turn improving uptake of public health measures.
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Affiliation(s)
- KOUSOULIS Antonis A
- Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, London, UK
- Mental Health Foundation, London, UK
- Corresponding Author’s E-Mail:
| | | | | | - LARSON Heidi J.
- Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, London, UK
- Dept. Health Metrics Sciences, University of Washington, Seattle, USA
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Chatio ST, Ganle JK, Adongo PB, Beisel U. Factors affecting trust in clinical trials conduct: Views of stakeholders from a qualitative study in Ghana. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001178. [PMID: 36963012 PMCID: PMC10022335 DOI: 10.1371/journal.pgph.0001178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023]
Abstract
Evidence exists that scientists' dehumanization and exploitation of people in the name of science led to suspicion and mistrust in clinical trials conduct. In Ghana, there are equally signs of public distrust in the conduct of biomedical research. Typical examples are the unsuccessful conduct of the Ebola vaccine trial and the initial refusal of parents to allow their children to receive the recently piloted malaria vaccine in Ghana. Therefore, this study explored participants' views on factors affecting trust in clinical trials conduct in Ghana. This was a cross-sectional exploratory study using qualitative research approach. Forty-eight in-depth interviews and Key informant interviews were conducted with stakeholders. Purposive sampling technique was used to select participants. All the interviews were recorded, transcribed and coded into themes using QSR Nvivo 12 software to aid thematic analysis. Overall, participants saw the need for the conduct of clinical trials in Ghana because clinical trial studies enable scientists to come out with effective medicines for the management of diseases. Pre-implementation factors such as inadequate stakeholder engagement, rumours and negative influence affected trust. Implementation factors such as perceived risks about clinical trials medicines, apprehensions on drawing and use of blood samples, poor informed consent administration and perceived no illness all negatively affected trust in clinical trials conduct. Trust is a fundamental factor affecting a successful conduct of clinical trials. Thus, there is need for collective efforts by all stakeholders including research institutions and clinical trial regulatory bodies to take the issue of trust in clinical trials conduct seriously.
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Affiliation(s)
- Samuel Tamti Chatio
- Department of Social Science, Navrongo Health Research Centre, Navrongo, Ghana
| | - John Kuumuori Ganle
- School of Public Health, Colleague of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Philip Baba Adongo
- School of Public Health, Colleague of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Ulrike Beisel
- Department of Geography, University of Berlin, Berlin, Germany
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Improving community participation in clinical trials in Ghana; factors to consider. Contemp Clin Trials Commun 2022; 30:101012. [PMID: 36262802 PMCID: PMC9574414 DOI: 10.1016/j.conctc.2022.101012] [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: 03/15/2022] [Revised: 07/23/2022] [Accepted: 10/01/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Clinical trials are an essential part of drug and vaccine development, as well as the development of new biomedical devices, and medical procedures. Successful enrolment of human volunteers is important to the success of any clinical trial anywhere around the globe. Enrolment is however affected by a number of factors including knowledge, attitudes, and perceptions (KAPs). We aimed to determine factors that are deemed important in improving participation in clinical trials within a Ghanaian community. Method This was a cross-sectional study that employed a structured questionnaire within the New Juaben South Municipal Assembly (NJSMA). Participants who were 18 years and above were included in this study. There were a total of 639 participants in this study. Participants' demographics were collected and various questions were asked to assess their KAP towards participation in clinical trials. Results The mean age of participants was 29.03 ± 8.95 years, there were more males (51.96%) than females, 42.35% had tertiary education, 38.03% were artisans, 74.80% were Christians and 14.40% had previously participated in a clinical trial. Participants had average knowledge about clinical trials (CT) with a mean score of 7.56 ± 1.76 (63%). A significant association between knowledge levels and education was observed (χ2 = 100.3, p < 0.0001). Helping in advancing the medical knowledge was the key reason for participation in CT while mistrust of the medical system was the key setback in participation in CT. There was a generally positive attitude and a neutral perception towards participation in CTs. Conclusion Groups intending to conduct CT should highlight the benefits of CT and address the perception of mistrust in the conduct of CTs in their education and sensitization programs before initiation of CTs in Ghana.
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Yin JDC. Media Data and Vaccine Hesitancy: Scoping Review. JMIR INFODEMIOLOGY 2022; 2:e37300. [PMID: 37113443 PMCID: PMC9987198 DOI: 10.2196/37300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/16/2022] [Accepted: 07/14/2022] [Indexed: 04/29/2023]
Abstract
Background Media studies are important for vaccine hesitancy research, as they analyze how the media shapes risk perceptions and vaccine uptake. Despite the growth in studies in this field owing to advances in computing and language processing and an expanding social media landscape, no study has consolidated the methodological approaches used to study vaccine hesitancy. Synthesizing this information can better structure and set a precedent for this growing subfield of digital epidemiology. Objective This review aimed to identify and illustrate the media platforms and methods used to study vaccine hesitancy and how they build or contribute to the study of the media's influence on vaccine hesitancy and public health. Methods This study followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A search was conducted on PubMed and Scopus for any studies that used media data (social media or traditional media), had an outcome related to vaccine sentiment (opinion, uptake, hesitancy, acceptance, or stance), were written in English, and were published after 2010. Studies were screened by only 1 reviewer and extracted for media platform, analysis method, the theoretical models used, and outcomes. Results In total, 125 studies were included, of which 71 (56.8%) used traditional research methods and 54 (43.2%) used computational methods. Of the traditional methods, most used content analysis (43/71, 61%) and sentiment analysis (21/71, 30%) to analyze the texts. The most common platforms were newspapers, print media, and web-based news. The computational methods mostly used sentiment analysis (31/54, 57%), topic modeling (18/54, 33%), and network analysis (17/54, 31%). Fewer studies used projections (2/54, 4%) and feature extraction (1/54, 2%). The most common platforms were Twitter and Facebook. Theoretically, most studies were weak. The following five major categories of studies arose: antivaccination themes centered on the distrust of institutions, civil liberties, misinformation, conspiracy theories, and vaccine-specific concerns; provaccination themes centered on ensuring vaccine safety using scientific literature; framing being important and health professionals and personal stories having the largest impact on shaping vaccine opinion; the coverage of vaccination-related data mostly identifying negative vaccine content and revealing deeply fractured vaccine communities and echo chambers; and the public reacting to and focusing on certain signals-in particular cases, deaths, and scandals-which suggests a more volatile period for the spread of information. Conclusions The heterogeneity in the use of media to study vaccines can be better consolidated through theoretical grounding. Areas of suggested research include understanding how trust in institutions is associated with vaccine uptake, how misinformation and information signaling influence vaccine uptake, and the evaluation of government communications on vaccine rollouts and vaccine-related events. The review ends with a statement that media data analyses, though groundbreaking in approach, should supplement-not supplant-current practices in public health research.
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Affiliation(s)
- Jason Dean-Chen Yin
- School of Public Health Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China (Hong Kong)
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Larson HJ, Lin L, Goble R. Vaccines and the social amplification of risk. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:1409-1422. [PMID: 35568963 PMCID: PMC9347756 DOI: 10.1111/risa.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/20/2022] [Accepted: 03/06/2022] [Indexed: 05/13/2023]
Abstract
In 2019, the World Health Organization (WHO) named "Vaccine Hesitancy" one of the top 10 threats to global health. Shortly afterward, the COVID-19 pandemic emerged as the world's predominant health concern. COVID-19 vaccines of several types have been developed, tested, and partially deployed with remarkable speed; vaccines are now the primary control measure and hope for a return to normalcy. However, hesitancy concerning these vaccines, along with resistance to masking and other control measures, remains a substantial obstacle. The previous waves of vaccine hesitancy that led to the WHO threat designation, together with recent COVID-19 experience, provide a window for viewing new forms of social amplification of risk (SAR). Not surprisingly, vaccines provide fertile ground for questions, anxieties, concerns, and rumors. These appear in new globalized hyperconnected communications landscapes and in the context of complex human (social, economic, and political) systems that exhibit evolving concerns about vaccines and authorities. We look at drivers, impacts, and implications for vaccine initiatives in several recent historical examples and in the current efforts with COVID-19 vaccination. Findings and insights were drawn from the Vaccine Confidence Project's decade long monitoring of media and social media and its related research efforts. The trends in vaccine confidence and resistance have implications for updating the social amplification of risk framework (SARF); in turn, SARF has practical implications for guiding efforts to alleviate vaccine hesitancy and to mitigate harms from intentional and unintentional vaccine scares.
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Affiliation(s)
- Heidi J. Larson
- Department of Infectious Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
- Deparment of Health Metrics SciencesUniversity of WashingtonSeattleWashingtonUSA
| | - Leesa Lin
- Department of Infectious Disease EpidemiologyLondon School of Hygiene & Tropical MedicineLondonUK
- Laboratory of Data Discovery for Health Limited (D24H)Hong Kong Science Park, Hong Kong Special Administrative Region, China
- School of Public HealthThe University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Rob Goble
- George Perkins Marsh InstituteClark UniversityWorcesterMassachusettsUSA
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Bonner KE, Ssekyanzi H, Sicsic J, Mueller JE, Toomey T, Ulrich AK, Horvath KJ, Neaton JD, Banura C, Basta NE. What drives willingness to receive a new vaccine that prevents an emerging infectious disease? A discrete choice experiment among university students in Uganda. PLoS One 2022; 17:e0268063. [PMID: 35587501 PMCID: PMC9119467 DOI: 10.1371/journal.pone.0268063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 04/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background There is a critical need to identify the drivers of willingness to receive new vaccines against emerging and epidemic diseases. A discrete choice experiment is the ideal approach to evaluating how individuals weigh multiple attributes simultaneously. We assessed the degree to which six attributes were associated with willingness to be vaccinated among university students in Uganda. Methods We conducted a single-profile discrete choice experiment at Makerere University in 2019. Participants were asked whether or not they would be vaccinated in 8 unique scenarios where attributes varied by disease risk, disease severity, advice for or against vaccination from trusted individuals, recommendations from influential figures, whether the vaccine induced indirect protection, and side effects. We calculated predicted probabilities of vaccination willingness using mixed logistic regression models, comparing health professional students with all other disciplines. Findings Of the 1576 participants, 783 (49.8%) were health professional students and 685 (43.5%) were female. Vaccination willingness was high (78%), and higher among health students than other students. We observed the highest vaccination willingness for the most severe disease outcomes and the greatest exposure risks, along with the Minister of Health’s recommendation or a vaccine that extended secondary protection to others. Mild side effects and recommendations against vaccination diminished vaccination willingness. Interpretation Our results can be used to develop evidence-based messaging to encourage uptake for new vaccines. Future vaccination campaigns, such as for COVID-19 vaccines in development, should consider acknowledging individual risk of exposure and disease severity and incorporate recommendations from key health leaders.
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Affiliation(s)
- Kimberly E. Bonner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
- * E-mail:
| | - Henry Ssekyanzi
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Judith E. Mueller
- EHESP French School of Public Health, La Plaine St Denis, France
- Institute Pasteur, Paris, France
| | - Traci Toomey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Angela K. Ulrich
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Keith J. Horvath
- Department of Psychology, San Diego State University, United States of America
| | - James D. Neaton
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Cecily Banura
- Child Health and Development Centre, College of Health Sciences, School of Medicine, Makerere University, Kampala, Uganda
| | - Nicole E. Basta
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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11
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Grant J, Gyan T, Agbokey F, Webster J, Greenwood B, Asante KP. Challenges and lessons learned during the planning and early implementation of the RTS,S/AS01 E malaria vaccine in three regions of Ghana: a qualitative study. Malar J 2022; 21:147. [PMID: 35550113 PMCID: PMC9096766 DOI: 10.1186/s12936-022-04168-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2019, the RTS,S/AS01E malaria vaccine was introduced on a pilot basis in six regions of Ghana by the Ministry of Health/Ghana Health Service as part of the WHO-coordinated Malaria Vaccine Implementation Programme (MVIP). This is the first time a malaria vaccination programme has been implemented in any country. This paper describes the challenges faced, and lessons learned, during the planning and early implementation of the RTS,S/AS01E vaccine in three out of the six regions that implemented the programme in Ghana. METHODS Twenty-one in-depth interviews were conducted with regional and district health service managers and frontline health workers three months after the start of MVIP in May 2019. Data were coded using NVivo software version 12 and a coding framework was developed to support thematic analysis to identify the challenges and lessons learned during the RTS,S/AS01E implementation pilot, which were also categorized into the Consolidated Framework for Implementation Research (CFIR). RESULTS Participants reported challenges related to the characteristics of the intervention, such as issues with the vaccine schedule and eligibility criteria, and challenges related to how it was implemented as a pilot programme. Additionally, major challenges were faced due to the spread of rumours leading to vaccine refusals; thus, the outer setting of the CFIR was adapted to accommodate rumours within the community context. Health service managers and frontline health workers also experienced challenges with the process of implementing RTS,S/AS01E, including inadequate sensitization and training, as well as issues with the timeline. They also experienced challenges associated with the features of the systems within which the vaccine was being implemented, including inadequate resources for cold-chain at the health facility level and transportation at the district and health facility levels. This study identified the need for a longer, more intensive and sustained delivery of contextually-appropriate sensitization prior to implementation of a programme such as MVIP. CONCLUSIONS This study identified 12 main challenges and lessons learned by health service managers and health workers during the planning and early implementation phases of the RTS,S/AS01E pilot introduction in Ghana. These findings are highly relevant to the likely scale-up of RTS,S/AS01E within Ghana and possible implementation in other African countries, as well as to other future introductions of novel vaccines.
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Affiliation(s)
- Jane Grant
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK.
| | - Thomas Gyan
- Research and Development Division, Kintampo Health Research Centre, Kintampo North Municipality, Kintampo, Ghana
| | - Francis Agbokey
- Research and Development Division, Kintampo Health Research Centre, Kintampo North Municipality, Kintampo, Ghana
| | - Jayne Webster
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
| | - Brian Greenwood
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK
| | - Kwaku Poku Asante
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK.,Research and Development Division, Kintampo Health Research Centre, Kintampo North Municipality, Kintampo, Ghana
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12
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SULEMANE NORDINO, ARMOCIDA BENEDETTA, VALENTE MARTINA, FORMENTI BEATRICE, BARIGAZZI SILVIA, USSAI SILVIA, MONASTA LORENZO, CASTELLI FRANCESCO, MISSONI EDUARDO. Vaccines hesitancy in Africa: how COVID-19 pandemic may affect malaria vaccination campaigns. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E1-E3. [PMID: 35647377 PMCID: PMC9121680 DOI: 10.15167/2421-4248/jpmh2022.63.1.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/02/2022] [Indexed: 11/16/2022]
Affiliation(s)
- NORDINO SULEMANE
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
- Correspondence: Nordino Sulemane, Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale A. Moro 5, 00185 Rome, Italy - E-mail:
| | - BENEDETTA ARMOCIDA
- Institute for maternal and child health - IRCCS “Burlo Garofolo”, Trieste, Italy
| | - MARTINA VALENTE
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - BEATRICE FORMENTI
- Department of Infectious and Tropical Diseases, University of Brescia and UNESCO Chair in “training and empowering human resources in low-income countries”, University of Brescia; Brescia, Italy
| | | | - SILVIA USSAI
- Clinical Pharmacology and Toxicology, University of Cagliari, Cagliari, Italy
| | - LORENZO MONASTA
- Institute for maternal and child health - IRCCS “Burlo Garofolo”, Trieste, Italy
| | - FRANCESCO CASTELLI
- Department of Infectious and Tropical Diseases, University of Brescia and UNESCO Chair in “training and empowering human resources in low-income countries”, University of Brescia; Brescia, Italy
| | - EDUARDO MISSONI
- Saluteglobale.it - Associazione di promozione sociale
- Centre for research on health and social care management (CERGAS), Bocconi University, Milan, Italy
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13
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Tabong PTN, Opoku Mensah K, Asampong E. Preparation for COVID-19 vaccines rollout: Interventions to increase trust, acceptability, and uptake in West African countries. Int J Health Plann Manage 2022; 37:1221-1228. [PMID: 35104374 PMCID: PMC9015502 DOI: 10.1002/hpm.3426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 09/13/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction The approval of COVID‐19 vaccines for use has come as a relief to West Africa and world. However, concerns raised about the vaccines in America and Europe have created anxiety among some citizens in Africa. These concerns are likely to affect the acceptance, and uptake of the COVID‐19 vaccines in West Africa. Methods Guided by the principles of effective community engagement, this research reviewed typical case studies of past vaccination exercises to document concerns, challenges and lessons learnt. These were then used to propose pre‐immunisation interventions in West Africa to increase the COVID‐19 vaccines acceptance and uptake. Results Concerns about safety can undermine the rollout of the COVID‐19 vaccines. These concerns can be addressed through effective community engagement. Community leaderships could be engaged through courtesy calls, workshops and durbars to sensitise them on immunisation. Engaging the scientific community can help build trust and reduce concerns about vaccine safety. In vaccines rollout, managing misinformation is important and the media can play a critical role in addressing these in their reportage. In addition, social media is an effective monitoring tool for vaccine‐related misinformation. Conclusion The analysis underscores the need for more community engagement before the importation and deployment of COVID‐19 vaccines in West Africa. Experiences from community responses to previous vaccination exercises for emerging and remerging infectious diseases should inform the current efforts and enhance the process to achieve high uptake and reduce vaccine hesitancy. Concerns about safety have often undermined the rollout of new vaccines High COVID‐19 vaccine hesitancy has been reported across the world Effective local community engagement strategies can reduce vaccine hesitancy Social media is an effective monitoring tool for vaccine‐related misinformation
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Affiliation(s)
- Philip Teg-Nefaah Tabong
- Department of Social and Behavioural Sciences, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Kwabena Opoku Mensah
- Department of Social and Behavioural Sciences, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emmanuel Asampong
- Department of Social and Behavioural Sciences, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
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14
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Abstract
Although rates of vaccination have increased worldwide, the rise in nonmedical exemptions for vaccination may have caused a resurgence of childhood vaccine-preventable diseases. Vaccine hesitancy plays an important role in the decreasing rates of vaccination and is considered by the World Health Organization as a top ten global threat to public health. Online vaccine misinformation is present in news outlets, websites, and social media, and its rapid and extensive dissemination is aided by artificial intelligence (AI). In combating online misinformation, public health experts, the medical community, and lay vaccination advocates can correct false statements using language that appeal to those who are undecided about vaccination. As the gatekeepers to online information, they can implement and enforce policy that limits or bans vaccine misinformation on their platforms. AI tools might also be used to address misinformation, but more research is needed before implementing this approach more broadly in health policy. This commentary examines the role that different online platforms appear to be playing in the spread of misinformation about vaccines. We also discuss the implications of online misinformation on attitudes about COVID-19 vaccine uptake and provide suggestions for ways to combat online misinformation.
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Affiliation(s)
| | - Sean D Young
- Department of Emergency Medicine, University of
California, Irvine, CA 92697, USA
- University of California Institute for Prediction Technology,
Department of Informatics, University of California,
Irvine, CA, USA
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15
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Alhassan RK, Owusu-Agyei S, Ansah EK, Gyapong M. COVID-19 vaccine uptake among health care workers in Ghana: a case for targeted vaccine deployment campaigns in the global south. HUMAN RESOURCES FOR HEALTH 2021; 19:136. [PMID: 34742301 PMCID: PMC8571849 DOI: 10.1186/s12960-021-00657-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/10/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Health care workers (HCWs) are among the high-risk groups in contracting and dying from COVID-19. World Health Organization estimates that over 10,000 HCWs in Africa have been infected with COVID-19 making it a significant occupational health hazard to HCWs. In Ghana, over 100 HCWs have already been infected and dozen others died from the virus. Acceptability and uptake of the COVID-19 vaccine is therefore critical to promote health and safety of HCWs as the country battles out of a third wave of the pandemic. OBJECTIVE The study sought to ascertain the correlates of HCWs likelihood of participating in a COVID-19 vaccine trial and accepting the vaccine when given the opportunity. METHODS The study was a web-based cross-sectional survey among HCWs (n = 1605) in all sixteen (16) administrative regions in Ghana. Data were analyzed with STATA statistical analysis software (version 14). Chi-square (X2) and Fisher's exact tests were used to test for differences in categorical variables; bivariate probit regression analysis with Average Marginal Effect (AME) was employed to ascertain the determinants of HCWs' likelihood of participating in a COVID-19 vaccine trial and taking the vaccine. RESULTS It was found that 48% of HCWs will participate in a COVID-19 vaccine trial when given the opportunity; 70% will accept the COVID-19 vaccine; younger HCWs (AME = 0.28, SE = 0.16, p < 0.1), non-Christians (AME = 21, SE = 0.09, p < 0.05) and those who worked in faith-based health facilities (AME = 18, SE = 0.07, p < 0.05) were more likely to participate in a COVID-19 vaccine trial. Female HCWs (AME = - 11, SE = 0.04, p < 0.05) and those with lower educational qualification were less likely to accept a COVID-19 vaccine (AME = - 0.16, SE = 0.08, p < 0.1). Reasons cited for unwillingness to participate in a COVID-19 vaccine trial or uptake the vaccine were mainly fear, safety concerns, mistrust, uncertainty, spiritual and religious beliefs. CONCLUSIONS Acceptance of the COVID-19 vaccine appear to be high among HCWs; conversely, willingness to volunteer for the vaccine trial was low. Continuous targeted and integrated public health education for HCWs will enhance vaccine acceptability to promote safety and population health in the global south as Ghana intensifies efforts to produce COVID-19 vaccines locally.
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Affiliation(s)
- Robert Kaba Alhassan
- Institute of Health Research (IHR), University of Health and Allied Sciences, PMB 31, Volta Region, Ho, Ghana
| | - Seth Owusu-Agyei
- Institute of Health Research (IHR), University of Health and Allied Sciences, PMB 31, Volta Region, Ho, Ghana
| | - Evelyn Korkor Ansah
- Institute of Health Research (IHR), University of Health and Allied Sciences, PMB 31, Volta Region, Ho, Ghana
| | - Margaret Gyapong
- Institute of Health Research (IHR), University of Health and Allied Sciences, PMB 31, Volta Region, Ho, Ghana
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16
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Fernandez-Luque L, Kushniruk AW, Georgiou A, Basu A, Petersen C, Ronquillo C, Paton C, Nøhr C, Kuziemsky CE, Alhuwail D, Skiba D, Huesing E, Gabarron E, Borycki EM, Magrabi F, Denecke K, Peute LWP, Topaz M, Al-Shorbaji N, Lacroix P, Marcilly R, Cornet R, Gogia SB, Kobayashi S, Iyengar S, Deserno TM, Mettler T, Vimarlund V, Zhu X. Evidence-Based Health Informatics as the Foundation for the COVID-19 Response: A Joint Call for Action. Methods Inf Med 2021; 59:183-192. [PMID: 33975375 PMCID: PMC8279811 DOI: 10.1055/s-0041-1726414] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background
As a major public health crisis, the novel coronavirus disease 2019 (COVID-19) pandemic demonstrates the urgent need for safe, effective, and evidence-based implementations of digital health. The urgency stems from the frequent tendency to focus attention on seemingly high promising digital health interventions despite being poorly validated in times of crisis.
Aim
In this paper, we describe a joint call for action to use and leverage evidence-based health informatics as the foundation for the COVID-19 response and public health interventions. Tangible examples are provided for how the working groups and special interest groups of the International Medical Informatics Association (IMIA) are helping to build an evidence-based response to this crisis.
Methods
Leaders of working and special interest groups of the IMIA, a total of 26 groups, were contacted via e-mail to provide a summary of the scientific-based efforts taken to combat COVID-19 pandemic and participate in the discussion toward the creation of this manuscript. A total of 13 groups participated in this manuscript.
Results
Various efforts were exerted by members of IMIA including (1) developing evidence-based guidelines for the design and deployment of digital health solutions during COVID-19; (2) surveying clinical informaticians internationally about key digital solutions deployed to combat COVID-19 and the challenges faced when implementing and using them; and (3) offering necessary resources for clinicians about the use of digital tools in clinical practice, education, and research during COVID-19.
Discussion
Rigor and evidence need to be taken into consideration when designing, implementing, and using digital tools to combat COVID-19 to avoid delays and unforeseen negative consequences. It is paramount to employ a multidisciplinary approach for the development and implementation of digital health tools that have been rapidly deployed in response to the pandemic bearing in mind human factors, ethics, data privacy, and the diversity of context at the local, national, and international levels. The training and capacity building of front-line workers is crucial and must be linked to a clear strategy for evaluation of ongoing experiences.
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Affiliation(s)
| | - Andre W Kushniruk
- School of Health Information Science, University of Victoria, Victoria, Canada
| | - Andrew Georgiou
- Australian Institute of Health Innovation, Macquarie University, Macquarie, New South Wales, Australia
| | - Arindam Basu
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Carolyn Petersen
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States
| | - Charlene Ronquillo
- Daphne Cockwell School of Nursing, Ryerson University, Ryerson, Toronto, Canada
| | - Chris Paton
- Department of Information Science, University of Otago, Dunedin, New Zealand.,Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Christian Nøhr
- Centre for Health Informatics and Technology, Maersk McKinney Moller Institute, University of Southern Denmark, Denmark
| | - Craig E Kuziemsky
- Office of Research Services, MacEwan University, Edmonton, AB, Canada
| | - Dari Alhuwail
- Department of Information Science, Kuwait University, Kuwait.,Health Informatics Unit, Dasman Diabetes Institute, Kuwait
| | - Diane Skiba
- University of Colorado, Denver, Colorado, United States
| | | | - Elia Gabarron
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Elizabeth M Borycki
- School of Health Information Science, University of Victoria, Victoria, Canada
| | - Farah Magrabi
- Australian Institute of Health Innovation, Macquarie University, Macquarie, New South Wales, Australia
| | - Kerstin Denecke
- Institute for Medical Informatics, Bern University of Applied Sciences, Bern, Switzerland
| | - Linda W P Peute
- Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Max Topaz
- Columbia University Medical Center, Data Science Institute, Columbia University, Columbia, United States
| | | | | | - Romaric Marcilly
- Univ. Lille, Inserm, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - Ronald Cornet
- Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Shashi B Gogia
- Society for Administration of Telemedicine and Healthcare Informatics, New Delhi, India
| | | | | | - Thomas M Deserno
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Tobias Mettler
- Swiss Graduate School of Public Administration, University of Lausanne, Lausanne, Switzerland
| | - Vivian Vimarlund
- Department of Computer and Information Science (IDA), School of Engineering and Technology, Linköping University, Linköping, Sweden
| | - Xinxin Zhu
- Center for Biomedical Data Science, Yale University, New Haven, Connecticut, United States
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17
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Chowdhury N, Khalid A, Turin TC. Understanding misinformation infodemic during public health emergencies due to large-scale disease outbreaks: a rapid review. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2021; 31:553-573. [PMID: 33968601 PMCID: PMC8088318 DOI: 10.1007/s10389-021-01565-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/14/2021] [Indexed: 12/13/2022]
Abstract
AIM The coronavirus disease 2019 (COVID-19) has caused hundreds of thousands of deaths, impacted the flow of life and resulted in an immeasurable amount of socio-economic damage. However, not all of this damage is attributable to the disease itself; much of it has occurred due to the prevailing misinformation around COVID-19. This rapid integrative review will draw on knowledge from the literature about misinformation during previous abrupt large-scale infectious disease outbreaks to enable policymakers, governments and health institutions to proactively mitigate the spread and effect of misinformation. SUBJECT AND METHODS For this rapid integrative review, we systematically searched MEDLINE and Google Scholar and extracted the literature on misinformation during abrupt large-scale infectious disease outbreaks since 2000. We screened articles using predetermined inclusion criteria. We followed an updated methodology for integrated reviews and adjusted it for our rapid review approach. RESULTS We found widespread misinformation in all aspects of large-scale infectious disease outbreaks since 2000, including prevention, treatment, risk factor, transmission mode, complications and vaccines. Conspiracy theories also prevailed, particularly involving vaccines. Misinformation most frequently has been reported regarding Ebola, and women and youth are particularly vulnerable to misinformation. A lack of scientific knowledge by individuals and a lack of trust in the government increased the consumption of misinformation, which is disseminated quickly by the unregulated media, particularly social media. CONCLUSION This review identified the nature and pattern of misinformation during large-scale infectious disease outbreaks, which could potentially be used to address misinformation during the ongoing COVID-19 or any future pandemic.
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Affiliation(s)
- Nashit Chowdhury
- Department of Family Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Ayisha Khalid
- Department of Family Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Tanvir C. Turin
- Department of Family Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
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18
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Kitonsa J, Ggayi AB, Anywaine Z, Kisaakye E, Nsangi L, Basajja V, Nyantaro M, Watson-Jones D, Shukarev G, Ilsbroux I, Robinson C, Kaleebu P. Implementation of accelerated research: strategies for implementation as applied in a phase 1 Ad26.ZEBOV, MVA-BN-Filo two-dose Ebola vaccine clinical trial in Uganda. Glob Health Action 2021; 13:1829829. [PMID: 33073737 PMCID: PMC7594841 DOI: 10.1080/16549716.2020.1829829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The 2013–2016 Ebola epidemic in West Africa is the worst ever caused by Ebolaviruses with over 28,000 human cases and 11,325 deaths. The World Health Organisation (WHO) declared the epidemic a public health crisis that required accelerated development of novel interventions including vaccines. The Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit (MRC/UVRI & LSHTM Uganda Research Unit) was among the African research sites that implemented the VAC52150EBL1004 Ebola vaccine trial. Objective We report on the strategies utilised by the Unit and sponsor in ensuring expedited clinical trial approval and accelerated conduct. Methods Janssen Vaccines and Prevention B.V. conducted a phase 1 trial to evaluate the safety, tolerability, and immunogenicity of heterologous two-dose vaccination regimens using Ad26.ZEBOV and MVA-BN-Filo, in healthy adults in Africa. Accelerated implementation strategies are hereby presented. Results Strategies included: holding the African Vaccine Regulatory Forum (AVAREF) joint review meeting; expedited review by institutional ethics and country-specific regulatory bodies; competitive recruitment between sites; electronic data capture (EDC); frequent study monitoring schedule; involvement of a community advisory board (CAB); and utilization of a ‘phased’ study information-sharing approach in community engagement and participant recruitment. These strategies enabled the site to acquire approvals within 2 months and enrol 47 participants within a spurn of five. The same milestone is usually acquired in at least 1 year without accelerated implementation. Conclusion The use of well-thought strategies by sponsors and research sites can enable the implementation of accelerated research. We recommend the use of similar strategies in other settings.
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Affiliation(s)
- Jonathan Kitonsa
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Abu-Baker Ggayi
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Zacchaeus Anywaine
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Eva Kisaakye
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Laura Nsangi
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Vincent Basajja
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | - Mary Nyantaro
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
| | | | - Georgi Shukarev
- Janssen Vaccines and Prevention B.V., Clinical Development , Leiden, The Netherlands
| | - Ine Ilsbroux
- Janssen Research & Development, Portfolio Delivery Operations, Global Development , Beerse, Belgium
| | - Cynthia Robinson
- Janssen Vaccines and Prevention B.V., Clinical Development , Leiden, The Netherlands
| | - Pontiano Kaleebu
- Medical Research Council, Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
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19
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Bhopal S, Nielsen M. Vaccine hesitancy in low- and middle-income countries: potential implications for the COVID-19 response. Arch Dis Child 2021; 106:113-114. [PMID: 32912868 DOI: 10.1136/archdischild-2020-318988] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Sunil Bhopal
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK .,Maternal & Child Health Intervention Research Group, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Maryke Nielsen
- Institute of Infection & Global Health, University of Liverpool, Liverpool, UK.,Early Life Infection Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.,Liverpool Health Partners, Liverpool, UK
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20
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Krubiner CB, Faden RR, Karron RA, Little MO, Lyerly AD, Abramson JS, Beigi RH, Cravioto AR, Durbin AP, Gellin BG, Gupta SB, Kaslow DC, Kochhar S, Luna F, Saenz C, Sheffield JS, Tindana PO. Pregnant women & vaccines against emerging epidemic threats: Ethics guidance for preparedness, research, and response. Vaccine 2021; 39:85-120. [PMID: 31060949 PMCID: PMC7735377 DOI: 10.1016/j.vaccine.2019.01.011] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/07/2019] [Indexed: 12/22/2022]
Abstract
Zika virus, influenza, and Ebola have called attention to the ways in which infectious disease outbreaks can severely - and at times uniquely - affect the health interests of pregnant women and their offspring. These examples also highlight the critical need to proactively consider pregnant women and their offspring in vaccine research and response efforts to combat emerging and re-emerging infectious diseases. Historically, pregnant women and their offspring have been largely excluded from research agendas and investment strategies for vaccines against epidemic threats, which in turn can lead to exclusion from future vaccine campaigns amidst outbreaks. This state of affairs is profoundly unjust to pregnant women and their offspring, and deeply problematic from the standpoint of public health. To ensure that the needs of pregnant women and their offspring are fairly addressed, new approaches to public health preparedness, vaccine research and development, and vaccine delivery are required. This Guidance offers 22 concrete recommendations that provide a roadmap for the ethically responsible, socially just, and respectful inclusion of the interests of pregnant women in the development and deployment of vaccines against emerging pathogens. The Guidance was developed by the Pregnancy Research Ethics for Vaccines, Epidemics, and New Technologies (PREVENT) Working Group - a multidisciplinary, international team of 17 experts specializing in bioethics, maternal immunization, maternal-fetal medicine, obstetrics, pediatrics, philosophy, public health, and vaccine research and policy - in consultation with a variety of external experts and stakeholders.
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Affiliation(s)
- Carleigh B Krubiner
- Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Avenue, Baltimore, MD, USA.
| | - Ruth R Faden
- Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Avenue, Baltimore, MD, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ruth A Karron
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Margaret O Little
- Kennedy Institute of Ethics, Georgetown University, Washington, D.C., USA
| | - Anne D Lyerly
- University of North Carolina Center for Bioethics, Chapel Hill, NC, USA
| | - Jon S Abramson
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Richard H Beigi
- Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Anna P Durbin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | - Carla Saenz
- Pan American Health Organization, Washington, D.C., USA
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21
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de-Graft Aikins A, Akoi-Jackson B. Colonial Virus": COVID-19, creative arts and public health communication in Ghana. Ghana Med J 2020; 54:86-96. [PMID: 33976446 PMCID: PMC8087360 DOI: 10.4314/gmj.v54i4s.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Since March 2020, Ghana's creative arts communities have tracked the complex facets of the COVID-19 pandemic through various art forms. This paper reports a study that analysed selected 'COVID art forms' through arts and health and critical health psychology frameworks. Art forms produced between March and July 2020, and available in the public sphere - traditional media, social media and public spaces - were collated. The data consisted of comedy, cartoons, songs, murals and textile designs. Three key functions emerged from analysis: health promotion (comedy, cartoons, songs); disease prevention (masks); and improving the aesthetics of the healthcare environment (murals). Textile designs performed broader socio-cultural functions of memorialising and political advocacy. Similar to earlier HIV/AIDS and Ebola arts interventions in other African countries, these Ghanaian COVID art forms translated public health information on COVID-19 in ways that connected emotionally, created social awareness and improved public understanding. However, some art forms had limitations: for example, songs that edutained using fear-based strategies or promoting conspiracy theories on the origins and treatment of COVID-19, and state-sponsored visual art that represented public health messaging decoupled from socio-economic barriers to health protection. These were likely to undermine the public health communication goals of behaviour modification. We outline concrete approaches to incorporate creative arts into COVID-19 public health interventions and post-pandemic health systems strengthening in Ghana. FUNDING None declared.
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Affiliation(s)
- Ama de-Graft Aikins
- Institute of Advanced Studies, University College London, Gower Street, London WCIE 6BT
| | - Bernard Akoi-Jackson
- Department of Painting & Sculpture, Faculty of Art, College of Art and Built Environment, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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22
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Abstract
Vaccine trials for infectious diseases take place in a milieu of trust in which scientists, regulatory institutions, and volunteers trust each other to play traditional roles. This milieu of trust emerges from a combination of preexisting linkages embedded in the local and national political context. Using the case of failed vaccine trials in Hohoe, Ghana, we explore this milieu of trust by employing the concept of tandems of trust and control, with a particular focus on the perceived characteristics of the disease and the linkages formed. An analysis of qualitative interviews collected in Hohoe following the West Africa Ebola outbreak of 2014-2016 shows that the trust/control nexus in vaccine trials precedes the implementation of those trials, while both the characteristics of Ebola and the political context shaped the formation and breakdown of relationships in the trial network.
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23
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Sigfrid L, Maskell K, Bannister PG, Ismail SA, Collinson S, Regmi S, Blackmore C, Harriss E, Longuere KS, Gobat N, Horby P, Clarke M, Carson G. Addressing challenges for clinical research responses to emerging epidemics and pandemics: a scoping review. BMC Med 2020; 18:190. [PMID: 32586391 PMCID: PMC7315698 DOI: 10.1186/s12916-020-01624-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/07/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Major infectious disease outbreaks are a constant threat to human health. Clinical research responses to outbreaks generate evidence to improve outcomes and outbreak control. Experiences from previous epidemics have identified multiple challenges to undertaking timely clinical research responses. This scoping review is a systematic appraisal of political, economic, administrative, regulatory, logistical, ethical and social (PEARLES) challenges to clinical research responses to emergency epidemics and solutions identified to address these. METHODS A scoping review. We searched six databases (MEDLINE, Embase, Global Health, PsycINFO, Scopus and Epistemonikos) for articles published from 2008 to July 2018. We included publications reporting PEARLES challenges to clinical research responses to emerging epidemics and pandemics and solutions identified to address these. Two reviewers screened articles for inclusion, extracted and analysed the data. RESULTS Of 2678 articles screened, 76 were included. Most presented data relating to the 2014-2016 Ebola virus outbreak or the H1N1 outbreak in 2009. The articles related to clinical research responses in Africa (n = 37), Europe (n = 8), North America (n = 5), Latin America and the Caribbean (n = 3) and Asia (n = 1) and/or globally (n = 22). A wide range of solutions to PEARLES challenges was presented, including a need to strengthen global collaborations and coordination at all levels and develop pre-approved protocols and equitable frameworks, protocols and standards for emergencies. Clinical trial networks and expedited funding and approvals were some solutions implemented. National ownership and community engagement from the outset were a key enabler for delivery. Despite the wide range of recommended solutions, none had been formally evaluated. CONCLUSIONS To strengthen global preparedness and response to the COVID-19 pandemic and future epidemics, identified solutions for rapid clinical research deployment, delivery, and dissemination must be implemented. Improvements are urgently needed to strengthen collaborations, funding mechanisms, global and national research capacity and capability, targeting regions vulnerable to epidemics and pandemics. Solutions need to be flexible to allow timely adaptations to context, and research led by governments of affected regions. Research communities globally need to evaluate their activities and incorporate lessons learnt to refine and rehearse collaborative outbreak response plans in between epidemics.
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Affiliation(s)
- Louise Sigfrid
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LG, UK.
| | - Katherine Maskell
- Deparment for Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Peter G Bannister
- Deparment for Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
| | - Sharif A Ismail
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Shelui Collinson
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Sadie Regmi
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Claire Blackmore
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Eli Harriss
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Kajsa-Stina Longuere
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LG, UK
| | - Nina Gobat
- Nuffield Dep of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Peter Horby
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LG, UK
| | - Mike Clarke
- Evidence Aid, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Gail Carson
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Oxford, OX3 7LG, UK
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24
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Asante KP, Binka FN, Koram KA. Malaria vaccine deployment in Africa: focus on Ghana. Ghana Med J 2020; 53:90-91. [PMID: 31481803 PMCID: PMC6697768 DOI: 10.4314/gmj.v53i2.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Fred N Binka
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Kwadwo A Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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25
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Noad RJ, Simpson K, Fooks AR, Hewson R, Gilbert SC, Stevens MP, Hosie MJ, Prior J, Kinsey AM, Entrican G, Simpson A, Whitty CJM, Carroll MW. UK vaccines network: Mapping priority pathogens of epidemic potential and vaccine pipeline developments. Vaccine 2019; 37:6241-6247. [PMID: 31522809 PMCID: PMC7127063 DOI: 10.1016/j.vaccine.2019.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/01/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022]
Abstract
During the 2013-2016 Ebola outbreak in West Africa an expert panel was established on the instructions of the UK Prime Minister to identify priority pathogens for outbreak diseases that had the potential to cause future epidemics. A total of 13 priority pathogens were identified, which led to the prioritisation of spending in emerging diseases vaccine research and development from the UK. This meeting report summarises the process used to develop the UK pathogen priority list, compares it to lists generated by other organisations (World Health Organisation, National Institutes of Allergy and Infectious Diseases) and summarises clinical progress towards the development of vaccines against priority diseases. There is clear technical progress towards the development of vaccines. However, the availability of these vaccines will be dependent on sustained funding for clinical trials and the preparation of clinically acceptable manufactured material during inter-epidemic periods.
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Affiliation(s)
- Rob J Noad
- Pathobiology and Population Science, The Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, UK.
| | - Karl Simpson
- JKS Bioscience Ltd, 2 Midanbury Court, 44 Midanbury Lane, Southampton SO18 4HF, UK.
| | | | - Roger Hewson
- National Infection Service, Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK
| | - Sarah C Gilbert
- Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX3 7DQ, UK.
| | - Mark P Stevens
- The Roslin Institute & Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian EH25 9RG, UK.
| | - Margaret J Hosie
- MRC-University of Glasgow Centre for Virus Research, College of Veterinary, Medical and Life Sciences, Garscube Estate, Bearsden, Glasgow G61 1QH, UK.
| | - Joann Prior
- CBR Division, Dstl Porton Down, Wiltshire SP3 4DZ, UK.
| | - Anna M Kinsey
- Medical Research Council, One Kemble Street, London WC2B 4AN, UK.
| | - Gary Entrican
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik, Near Edinburgh, Scotland EH26 0PZ, UK.
| | - Andrew Simpson
- National Infection Service, Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK.
| | | | - Miles W Carroll
- National Infection Service, Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK.
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26
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Lévy Y, Lane C, Piot P, Beavogui AH, Kieh M, Leigh B, Doumbia S, D'Ortenzio E, Lévy-Marchal C, Pierson J, Watson-Jones D, Nguyen VK, Larson H, Lysander J, Lacabaratz C, Thiebaut R, Augier A, Ishola D, Kennedy S, Chêne G, Greenwood B, Neaton J, Yazdanpanah Y. Prevention of Ebola virus disease through vaccination: where we are in 2018. Lancet 2018; 392:787-790. [PMID: 30104048 PMCID: PMC6128979 DOI: 10.1016/s0140-6736(18)31710-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 08/11/2017] [Accepted: 07/19/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Yves Lévy
- French Institute for Health and Medical Research (Inserm), Paris, France.
| | - Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Peter Piot
- London School of Hygiene & Tropical Medicine, London, UK
| | - Abdul Habib Beavogui
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Mafèrinyah, Guinea
| | - Mark Kieh
- Partnership for Research on Ebola Virus in Liberia (PREVAIL), Monrovia, Liberia
| | - Bailah Leigh
- College of Medicine and Allied Health Sciences (COMAHS), University of Sierra Leone, Freetown, Sierra Leone
| | - Seydou Doumbia
- University of Sciences, Technique and Technology of Bamako, Bamako, Mali
| | - Eric D'Ortenzio
- French Institute for Health and Medical Research (Inserm), Paris, France
| | | | - Jerome Pierson
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | | | - Vinh-Kim Nguyen
- Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Heidi Larson
- London School of Hygiene & Tropical Medicine, London, UK
| | - Julia Lysander
- Partnership for Research on Ebola Virus in Liberia (PREVAIL), Monrovia, Liberia
| | | | - Rodolphe Thiebaut
- French Institute for Health and Medical Research (Inserm), Paris, France
| | - Augustin Augier
- The Alliance for International Medical Action, Dakar, Senegal
| | - David Ishola
- London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen Kennedy
- Partnership for Research on Ebola Virus in Liberia (PREVAIL), Monrovia, Liberia
| | - Geneviève Chêne
- French Institute for Health and Medical Research (Inserm), Paris, France
| | | | - James Neaton
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Yazdan Yazdanpanah
- French Institute for Health and Medical Research (Inserm), Paris, France
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27
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Kumar R, Amarchand R, Narayan VV, Saha S, Lafond KE, Kapoor SK, Dar L, Jain S, Krishnan A. Challenges in conducting a community-based influenza vaccine trial in a rural community in northern India. Hum Vaccin Immunother 2018; 14:1909-1913. [PMID: 29617177 PMCID: PMC6150048 DOI: 10.1080/21645515.2018.1460182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Evidence on influenza vaccine effectiveness from low and middle countries (LMICs) is limited due to limited institutional capacities; lack of adequate resources; and lack of interest by ministries of health for influenza vaccine introduction. There are concerns that the highest ethical standards will be compromised during trials in LMICs leading to mistrust of clinical trials. These factors pose regulatory and operational challenges to researchers in these countries. We conducted a community-based vaccine trial to assess the efficacy of live attenuated influenza vaccine and inactivated influenza vaccine in rural north India. Key regulatory challenges included obtaining regulatory approvals, reporting of adverse events, and compensating subjects for trial-related injuries; all of which were required to be completed in a timely fashion. Key operational challenges included obtaining audio-visual consent; maintaining a low attrition rate; and administering vaccines during a narrow time period before the influenza season, and under extreme heat. We overcame these challenges through advanced planning, and sustaining community engagement. We adapted the trial procedures to cope with field conditions by conducting mock vaccine camps; and planned for early morning vaccination to mitigate threats to the cold chain. These lessons may help investigators to confront similar challenges in other LMICs.
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Affiliation(s)
- Rakesh Kumar
- a All India Institute of Medical Sciences, Ansari Nagar , New Delhi , India
| | - Ritvik Amarchand
- a All India Institute of Medical Sciences, Ansari Nagar , New Delhi , India
| | | | - Siddhartha Saha
- b Centers for Disease Control and Prevention , 1600 Clifton Road, Atlanta , GA , USA
| | - Kathryn E Lafond
- b Centers for Disease Control and Prevention , 1600 Clifton Road, Atlanta , GA , USA
| | | | - Lalit Dar
- a All India Institute of Medical Sciences, Ansari Nagar , New Delhi , India
| | - Seema Jain
- b Centers for Disease Control and Prevention , 1600 Clifton Road, Atlanta , GA , USA
| | - Anand Krishnan
- a All India Institute of Medical Sciences, Ansari Nagar , New Delhi , India
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28
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Orr D, Baram-Tsabari A. Science and Politics in the Polio Vaccination Debate on Facebook: A Mixed-Methods Approach to Public Engagement in a Science-Based Dialogue. JOURNAL OF MICROBIOLOGY & BIOLOGY EDUCATION 2018; 19:jmbe-19-34. [PMID: 29904532 PMCID: PMC5969418 DOI: 10.1128/jmbe.v19i1.1500] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/15/2017] [Indexed: 05/26/2023]
Abstract
This study examines the ways in which the public discusses and debates the scientific issue of vaccinations in the online social media environment of Facebook. We apply a mixed-methods approach, where a qualitative analysis is combined with a quantitative analysis of the characteristics of the debate on polio vaccinations in a Facebook group dedicated to parental and professional dialogue. The qualitative analysis suggested that dialogue became more political than scientific overall, yet the quantitative analysis showed that the discussants did not abandon the scientific nature of the issue at hand.
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Affiliation(s)
- Daniela Orr
- Corresponding author. Mailing address: Faculty of Education in Science and Technology, Technion – Israel Institute of Technology, Technion City, Haifa 3200003, Israel. Phone: +972-52-8382567. Fax: +972-4-829-5634. E-mail:
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