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Makanjuola S, Shantikumar S. The impact of the COVID-19 pandemic on non-COVID-associated mortality: A descriptive longitudinal study of UK data. PUBLIC HEALTH IN PRACTICE 2024; 7:100489. [PMID: 38562991 PMCID: PMC10982561 DOI: 10.1016/j.puhip.2024.100489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/09/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Background It has been previously reported in the literature that the COVID-19 pandemic resulted in overall excess deaths and an increase in non-COVID deaths during the pandemic period.Specifically, our research elucidates the impact of the COVID-19 pandemic on non-COVID associated mortality. Study aim To compare mortality rates in non-COVID conditions before and after the onset of the COVID-19 pandemic in England and Wales. Study design Annual mortality data for the years 2011-2019 (pre-pandemic) and 2020 (pandemic) in England and Wales were retrieved from the Office for National Statistics (ONS). These data were filtered by ICD-10 codes for nine conditions with high associated mortality. We calculated mortality numbers - overall and age stratified (20-64 and 65+ years) and rates per 100 000, using annual mid-year population estimates. Methods Interrupted time series analyses were conducted using segmented quasi-Poisson regression to identify whether there was a statistically significant change (p < 0.05) in condition-specific death rates following the pandemic onset. Results Eight of the nine conditions investigated in this study had significant changes in mortality rate during the pandemic period (2020). All-age mortality rate was significantly increased in: 'Symptoms Signs and Ill-defined conditions', 'Cirrhosis and Other Diseases of the Liver', and 'Malignant Neoplasm of the Breast', whereas 'Chronic Lower Respiratory Disorders' saw a significant decrease. Age-stratified analyses also revealed significant increases in the 20-64 age-group in: 'Cerebrovascular Disorders', 'Dementia and Alzheimer's Disease', and 'Ischaemic Heart Diseases'. Conclusion Trends in non-COVID condition-specific mortality rates from 2011 to 2020 revealed that some non-COVID conditions were disproportionately affected during the pandemic. This may be due to the direct impact COVID-19 had on these conditions or the effect the public health response had on non-COVID risk factor development and condition-related management. Further work is required to understand the reasons behind these disproportionate changes.
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Nyachoti DO, Fwelo P, Springer AE, Kelder SH. Association between Gross National Income per capita and COVID-19 vaccination coverage: a global ecological study. BMC Public Health 2023; 23:2415. [PMID: 38049821 PMCID: PMC10696801 DOI: 10.1186/s12889-023-17241-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 11/16/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Coronavirus 2019 (COVID-19) pandemic has claimed over six million lives and infected more than 650 million people globally. Public health agencies have deployed several strategies, including rolling out vaccination campaigns to curb the pandemic, yet a significant proportion of the global population has not received the COVID-19 vaccine. We assessed differences in COVID-19 vaccination coverage by Gross National Income (GNI) per capita of WHO members (i.e., countries, areas, and territories, n = 192) and by WHO member regions (n = 6). METHODS Using an ecological study design, we analyzed publicly available data from the WHO website merged with the World Bank's GNI per capita data. We included a total of 192 WHO members and six WHO regions in the analysis. We utilized negative binomial regression to assess the associations between the GNI per capita and COVID-19 vaccination coverage (cumulative number of persons fully vaccinated and/or received at least one dose of the vaccine per 100 population), and ANOVA test to assess the differences in vaccination coverage per WHO regions. RESULTS Low GNI per capita WHO members had significantly lower full vaccination coverage (aRR 0.30, 95% CI 0.22-0.40) compared to high GNI per capita WHO members. These members were also 66% less likely to receive at least one dose of the vaccine (aRR 0.34, 0.26-0.44) relative to high GNI per capita WHO members. Africa region had a significantly lower fully vaccination coverage (aRR 0.71, 95% CI 0.36-0.54) and received at least one dose of the COVID-19 vaccine (aRR 0.78, 95% CI 0.62-0.99) than Europe region. Conversely, the Western Pacific region had significantly higher fully vaccination coverage (aRR 1.40 95% CI 1.12-1.74) and received at least one dose of COVID-19 vaccines (aRR 1.40 95% CI 1.14-1.73) relative to European region. CONCLUSION WHO members with low GNI per capita and the African region reported significantly lower COVID-19 vaccination coverage than those with high GNI per capita or other regions. Efforts to strengthen and promote COVID-19 vaccination in low-income WHO countries and African region should be scaled up.
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Affiliation(s)
- Dennis Ogeto Nyachoti
- Texas Department of State Health Services, Epidemiology and Surveillance Unit, Austin, TX, USA.
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, El Paso, TX, USA.
| | - Pierre Fwelo
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Andrew E Springer
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Steven H Kelder
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
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Ambrogi I, Brito L, Griner A, Bull S. Gender inequity and COVID-19 vaccination policies for pregnant women in the Americas. Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18939.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
The region of the Americas has been the epicenter of the COVID-19 pandemic’s worst outcome in terms of number of deaths due to COVID-19. SARS-CoV-2 infection during pregnancy and the postpartum period has been found to be associated with increased risk of mortality and severe disease. Several Latin American and Caribbean countries have disproportionally high maternal mortality rates due to COVID-19. Although this region achieved relatively high vaccination rates among the general adult population, there were differing restrictions regarding the vaccination of those who were pregnant. In a pandemic, policies reflect political priorities in responses to the threats posed to populations and play an important role in promoting gender equity. This paper reports the results of an ethical analysis of 45 national COVID-19 vaccination public policies from seven countries – Argentina, Brazil, Canada, Colombia, Mexico, Peru, and United States. The analysis drew on reproductive justice and feminist bioethics frameworks, paying close attention to whether and how gender and social and economic inequities were addressed. It found that exclusionary approaches in immunization policies which restricted access to vaccination during pregnancy were often justified on the basis of a lack of evidence about the effects of immunization of pregnant persons, and on the grounds of medical expertise, to the detriment of women’s autonomy and agency. As such these policies reiterate patriarchal moral understandings of women, pregnancy and motherhood. In practice, they counter human rights gender equity and equality principles, and became lethal, particularly to racialized women in Latin America. During an emerging lethal disease, policies and policy development must consider the intersection of oppressive structures to protect and guarantee rights of women, girls, and pregnant persons.
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Worabo HJ, Salt R, Grubesic R, Farokhi MR. Promoting social justice through experiential learning at an interprofessional refugee clinic. NURSE EDUCATION TODAY 2023; 121:105699. [PMID: 36542871 PMCID: PMC9760404 DOI: 10.1016/j.nedt.2022.105699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 11/27/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Heidi J Worabo
- University of Texas Health Science Center San Antonio School of Nursing, 7703 Floyd Curl Drive, Mail code 7951, San Antonio, TX 78229-3900, USA.
| | - Rebekah Salt
- University of Texas Health Science Center San Antonio School of Nursing, 7703 Floyd Curl Drive, Mail code 7951, San Antonio, TX 78229-3900, USA.
| | - Ruth Grubesic
- University of Texas Health Science Center San Antonio School of Nursing, 7703 Floyd Curl Drive, Mail code 7951, San Antonio, TX 78229-3900, USA.
| | - Moshtagh R Farokhi
- University of Texas Health Science Center San Antonio School of Dentistry, 7703 Floyd Curl Drive, Mail Code 7914, San Antonio, TX 78229-3900, USA.
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Panahi Y, Ghanei M, Rahimi M, Samim A, Vahedian‐Azimi A, Atkin SL, Sahebkar A. Evaluation the efficacy and safety of N-acetylcysteine inhalation spray in controlling the symptoms of patients with COVID-19: An open-label randomized controlled clinical trial. J Med Virol 2023; 95:e28393. [PMID: 36495185 PMCID: PMC9878233 DOI: 10.1002/jmv.28393] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/07/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate the effect and safety of N-acetylcysteine (NAC) inhalation spray in the treatment of patients with coronavirus disease 2019 (COVID-19). This randomized controlled clinical trial study was conducted on patients with COVID-19. Eligible patients (n = 250) were randomly allocated into the intervention group (routine treatment + NAC inhaler spray one puff per 12 h, for 7 days) or the control group who received routine treatment alone. Clinical features, hemodynamic, hematological, biochemical parameters and patient outcomes were assessed and compared before and after treatment. The mortality rate was significantly higher in the control group than in the intervention group (39.2% vs. 3.2%, p < 0.001). Significant differences were found between the two groups (intervention and control, respectively) for white blood cell count (6.2 vs. 7.8, p < 0.001), hemoglobin (12.3 vs. 13.3, p = 0.002), C-reactive protein (CRP: 6 vs. 11.5, p < 0.0001) and aspartate aminotransferase (AST: 32 vs. 25.5, p < 0.0001). No differences were seen for hospital length of stay (11.98 ± 3.61 vs. 11.81 ± 3.52, p = 0.814) or the requirement for intensive care unit (ICU) admission (7.2% vs. 11.2%, p = 0.274). NAC was beneficial in reducing the mortality rate in patients with COVID-19 and inflammatory parameters, and a reduction in the development of severe respiratory failure; however, it did not affect the length of hospital stay or the need for ICU admission. Data on the effectiveness of NAC for Severe Acute Respiratory Syndrome Coronavirus-2 is limited and further research is required.
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Affiliation(s)
- Yunes Panahi
- Pharmacotherapy Department, School of PharmacyBaqiyatallah University of Medical SciencesTehranIran
| | - Mostafa Ghanei
- Chemical Injuries Center, Systems Biology and Poisoning InstituteBaqiyatallah University of Medical SciencesTehranIran
| | - Morteza Rahimi
- Chemical Injuries Center, Systems Biology and Poisoning InstituteBaqiyatallah University of Medical SciencesTehranIran
| | - Abbas Samim
- Chemical Injuries Center, Systems Biology and Poisoning InstituteBaqiyatallah University of Medical SciencesTehranIran
| | - Amir Vahedian‐Azimi
- Trauma Research Center, Nursing FacultyBaqiyatallah University of Medical SciencesTehranIran
| | - Stephen L. Atkin
- School of Postgraduate Studies and ResearchRCSI Medical University of BahrainBusaiteenKingdom of Bahrain
| | - Amirhossein Sahebkar
- Applied Biomedical Research CenterMashhad University of Medical SciencesMashhadIran,Biotechnology Research Center, Pharmaceutical Technology InstituteMashhad University of Medical SciencesMashhadIran,Department of Biotechnology, School of PharmacyMashhad University of Medical SciencesMashhadIran
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6
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Wang Q, Qu Z, Tu S, Chen X, Hou Z. The whole-of-society approach of mass COVID-19 vaccination in China: a qualitative study. Health Res Policy Syst 2022; 20:142. [PMID: 36585666 PMCID: PMC9802023 DOI: 10.1186/s12961-022-00947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Many countries have an inefficient vaccination system, which hinders global exit from the COVID-19 pandemic. It is vital to summarize COVID-19 vaccination practices in countries with high vaccination coverage and provide implications for other countries. This study aimed to investigate China's COVID-19 vaccination system and to summarize its implementation experience from a health system perspective. METHODS We conducted key informant interviews in five representative cities of China in late 2021. Guided by the health systems framework proposed by WHO, we developed our interview guidelines which included seven building blocks-leadership and governance, health workforce, vaccination service delivery, vaccination mobilization and communication, financing, access to vaccines, and information systems. Semi-structured interviews and COVID-19 vaccination policy documents were collected and coded using a thematic analysis approach. RESULTS A total of 61 participants (nine vaccination programme directors of the local Center for Disease Control and Prevention, four government staff and 48 vaccination service workers) were interviewed. We found that China adopted a whole-of-society approach with adequate government engagement and linked health and non-health sectors to promote COVID-19 vaccination. Key measures included the collaboration of multiple systems and departments from a governance perspective, allocating sufficient health workers and resources, large-scale vaccination mobilization and communication, expansion of vaccine financing channels, localized production and digital information systems. With the vaccination system strengthening, the two-doses vaccination coverage reached 89.5% for the total population but relatively lower coverage for older adults as of July 2022. CONCLUSIONS Our study highlights the importance of a government-led whole-of-society approach to promote mass vaccination. The low vaccination coverage among older adults should be paid the greatest attention to. The experiences and lessons from China may serve as a reference for other countries.
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Affiliation(s)
- Qian Wang
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, 130 Dong’an Road, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Zhiqiang Qu
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, 130 Dong’an Road, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shiyi Tu
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, 130 Dong’an Road, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xi Chen
- grid.47100.320000000419368710Department of Health Policy and Management, Yale School of Public Health, City of New Haven, United States of America ,grid.47100.320000000419368710Department of Economics, Yale University, City of New Haven, United States of America
| | - Zhiyuan Hou
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, 130 Dong’an Road, Shanghai, 200032 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
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7
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Parker G, Pausé C, Gillon A, Gray L. Self-identified fat people’s understanding of the need for, and use of, long needles when being vaccinated against COVID-19: findings from a international online exploratory survey. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2159789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- George Parker
- Te Wāhanga Tātai Hauora Wellington Faculty of Health, Te Herenga Waka Victoria University of Wellington, Wellington, New Zealand
| | - Cat Pausé
- Graduate School of Education, Massey University, Palmerston North, New Zealand
| | - Ashlea Gillon
- School of Psychology, Te Wānanga o Waipapa, Auckland, New Zealand
- Research Fellow, School of Nursing, Waipapa Taumata Rau, University of Auckland, Auckland, New Zealand
- Fulbright Scholar, University of Hawaiʻi at Mānoa, Honolulu, Hawaiʻi
| | - Lesley Gray
- Te Whare Wānanga o Otāgo ki Te Whanga-Nui-a-TaraTel/Waea, University of Otago, Wellington, New Zealand
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8
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Bhuiyan S. COVID-19 vaccine equity in doldrums: Good governance deficits. PUBLIC ADMINISTRATION AND DEVELOPMENT : A JOURNAL OF THE ROYAL INSTITUTE OF PUBLIC ADMINISTRATION 2022; 42:293-304. [PMID: 36718258 PMCID: PMC9878060 DOI: 10.1002/pad.1999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/17/2022] [Accepted: 11/22/2022] [Indexed: 06/18/2023]
Abstract
This paper explores whether inequities in access to COVID-19 vaccines can be attributed to governance deficits, particularly for developing and emerging countries where poor governance is widespread, but also for developed countries, where governments' performance fell short of expectations. These shared performance deficits beg questions about the impact of governance quality as well as the interplay of ethics in governance when life-or-death decisions must be made. It also explores the impact of COVID-19 on development, especially in the areas of poverty and employment. The findings of the paper show that there is a positive correlation between vaccine equity and good governance, meaning that countries with higher scores in governance rankings have more access to vaccines and have vaccinated most of their populations. Similarly, countries with relatively lower scores in governance rankings have poor access to and distribution of vaccines and have only covered a limited number of their people. The paper further points to disastrous societal impacts of COVID-19 vaccine inequity on poverty and employment, which have hindered global development.
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Affiliation(s)
- Shahjahan Bhuiyan
- Department of Public Policy and Administration, School of Global Affairs and Public Policy (GAPP)The American University in CairoNew CairoEgypt
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9
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Halliday A, Long AE, Baum HE, Thomas AC, Shelley KL, Oliver E, Gupta K, Francis O, Williamson MK, Di Bartolo N, Randell MJ, Ben-Khoud Y, Kelland I, Mortimer G, Ball O, Plumptre C, Chandler K, Obst U, Secchi M, Piemonti L, Lampasona V, Smith J, Gregorova M, Knezevic L, Metz J, Barr R, Morales-Aza B, Oliver J, Collingwood L, Hitchings B, Ring S, Wooldridge L, Rivino L, Timpson N, McKernon J, Muir P, Hamilton F, Arnold D, Woolfson DN, Goenka A, Davidson AD, Toye AM, Berger I, Bailey M, Gillespie KM, Williams AJK, Finn A. Development and evaluation of low-volume tests to detect and characterize antibodies to SARS-CoV-2. Front Immunol 2022; 13:968317. [PMID: 36439154 PMCID: PMC9682908 DOI: 10.3389/fimmu.2022.968317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/30/2022] [Indexed: 11/11/2022] Open
Abstract
Low-volume antibody assays can be used to track SARS-CoV-2 infection rates in settings where active testing for virus is limited and remote sampling is optimal. We developed 12 ELISAs detecting total or antibody isotypes to SARS-CoV-2 nucleocapsid, spike protein or its receptor binding domain (RBD), 3 anti-RBD isotype specific luciferase immunoprecipitation system (LIPS) assays and a novel Spike-RBD bridging LIPS total-antibody assay. We utilized pre-pandemic (n=984) and confirmed/suspected recent COVID-19 sera taken pre-vaccination rollout in 2020 (n=269). Assays measuring total antibody discriminated best between pre-pandemic and COVID-19 sera and were selected for diagnostic evaluation. In the blind evaluation, two of these assays (Spike Pan ELISA and Spike-RBD Bridging LIPS assay) demonstrated >97% specificity and >92% sensitivity for samples from COVID-19 patients taken >21 days post symptom onset or PCR test. These assays offered better sensitivity for the detection of COVID-19 cases than a commercial assay which requires 100-fold larger serum volumes. This study demonstrates that low-volume in-house antibody assays can provide good diagnostic performance, and highlights the importance of using well-characterized samples and controls for all stages of assay development and evaluation. These cost-effective assays may be particularly useful for seroprevalence studies in low and middle-income countries.
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Affiliation(s)
- Alice Halliday
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Anna E. Long
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Holly E. Baum
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
- School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Amy C. Thomas
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kathryn L. Shelley
- School of Chemistry, University of Bristol, Bristol, United Kingdom
- School of Biochemistry, Biomedical Sciences Building, University Walk, University of Bristol, Bristol, United Kingdom
| | - Elizabeth Oliver
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Kapil Gupta
- School of Biochemistry, Biomedical Sciences Building, University Walk, University of Bristol, Bristol, United Kingdom
| | - Ore Francis
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
| | | | - Natalie Di Bartolo
- School of Biochemistry, Biomedical Sciences Building, University Walk, University of Bristol, Bristol, United Kingdom
| | - Matthew J. Randell
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Yassin Ben-Khoud
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ilana Kelland
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Georgina Mortimer
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Olivia Ball
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Charlie Plumptre
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Kyla Chandler
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ulrike Obst
- School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Massimiliano Secchi
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Piemonti
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Vito Lampasona
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Joyce Smith
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Michaela Gregorova
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Lea Knezevic
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
| | - Jane Metz
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
- Department of Paediatric Immunology and Infectious Diseases, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Rachael Barr
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
- Department of Paediatric Immunology and Infectious Diseases, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Begonia Morales-Aza
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Jennifer Oliver
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lucy Collingwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Benjamin Hitchings
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Susan Ring
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, United Kingdom
| | - Linda Wooldridge
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
| | - Laura Rivino
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Nicholas Timpson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, United Kingdom
| | - Jorgen McKernon
- National Infection Service, UK Health Security Agency, Southmead Hospital, Bristol, United Kingdom
| | - Peter Muir
- National Infection Service, UK Health Security Agency, Southmead Hospital, Bristol, United Kingdom
| | - Fergus Hamilton
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, United Kingdom
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - David Arnold
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Derek N. Woolfson
- School of Chemistry, University of Bristol, Bristol, United Kingdom
- School of Biochemistry, Biomedical Sciences Building, University Walk, University of Bristol, Bristol, United Kingdom
- Bristol BioDesign Institute, University of Bristol, Bristol, United Kingdom
| | - Anu Goenka
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
- Department of Paediatric Immunology and Infectious Diseases, Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Andrew D. Davidson
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Ashley M. Toye
- School of Biochemistry, Biomedical Sciences Building, University Walk, University of Bristol, Bristol, United Kingdom
- Bristol BioDesign Institute, University of Bristol, Bristol, United Kingdom
- Bristol Institute of Transfusion Sciences, NHS Blood and Transplant Filton, Bristol, United Kingdom
| | - Imre Berger
- School of Chemistry, University of Bristol, Bristol, United Kingdom
- School of Biochemistry, Biomedical Sciences Building, University Walk, University of Bristol, Bristol, United Kingdom
- Bristol BioDesign Institute, University of Bristol, Bristol, United Kingdom
| | - Mick Bailey
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
| | - Kathleen M. Gillespie
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alistair J. K. Williams
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Adam Finn
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Paediatric Immunology and Infectious Diseases, Bristol Royal Hospital for Children, Bristol, United Kingdom
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10
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Zhang M, Zhang P, Liang Y, Du B, Li L, Yu Z, Wang H, Wang Q, Zhang X, Zhang W. A systematic review of current status and challenges of vaccinating children against SARS-CoV-2. J Infect Public Health 2022; 15:1212-1224. [PMID: 36257126 PMCID: PMC9557115 DOI: 10.1016/j.jiph.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/22/2022] [Accepted: 10/04/2022] [Indexed: 12/04/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has inflicted immense damage to countries, economies and societies worldwide. Authorized COVID-19 vaccines based on different platforms have been widely inoculated in adults, showing up to 100% immunogenicity with significant efficacy in preventing SARS-CoV-2 infections and the occurrence of severe COVID-19. It has also greatly slowed the evolution of SARS-CoV-2 variants, as shown in clinical trials and real-world evidence. However, the total dosage of COVID-19 vaccines for children is much smaller than that for adults due to limitations from parental concern of vaccine safety, presenting a potential obstacle in ending the COVID-19 pandemic. SARS-CoV-2 not only increases the risk of severe multisystem inflammatory syndrome (MIS-C) in children, but also negatively affects children's psychology and academics, indirectly hindering the maintenance and progress of normal social order. Therefore, this article examines the clinical manifestations of children infected with SARS-CoV-2, the status of vaccination against COVID-19 in children, vaccination-related adverse events, and the unique immune mechanisms of children. In particular, the necessity and challenges of vaccinating children against SARS-CoV-2 were highlighted from the perspectives of society and family. In summary, parental hesitancy is unnecessary as adverse events after COVID-19 vaccination have been proven to be infrequent, comprise of mild symptoms, and have a good prognosis.
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Affiliation(s)
- Mengxin Zhang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - Pin Zhang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - Ying Liang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - Bang Du
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - Lifeng Li
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - Zhidan Yu
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - Huanmin Wang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China
| | - Qionglin Wang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China.
| | - Xianwei Zhang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China.
| | - Wancun Zhang
- Henan Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, China.
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11
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Pattanshetty S, Pardesi M, Gudi N. A Comparative Analysis on the Social Determinants of COVID-19 Vaccination Coverage in Fragile and Conflict Affected Settings and Non-fragile and Conflict Affected Settings. Int J Health Policy Manag 2022; 12:6830. [PMID: 36300252 PMCID: PMC10125044 DOI: 10.34172/ijhpm.2022.6830] [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: 10/02/2021] [Accepted: 09/06/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has coerced various resources of all the countries. While the high-income nations redirected financial and human resources to understand specific determinants of vaccination coverage, fragile and conflict-affected setting (FCS) nations were waiting for global bodies to cater to their ever-growing need for vaccines and other lifesaving drugs. This study aimed to determine various factors influencing vaccine coverage in the FCS context. METHODS World Bank's classification of FCS states was the primary source for country classification. The study utilized data from various other open sources. The study models cross-country inequities in COVID-19 vaccine coverage and we have employed multi-variate log-linear regressions to understand the relationship between COVID-19 vaccine coverage and cross-country macro-level determinants. The analysis was conducted on two samples, non-FCS Countries and the FCS countries. RESULTS Socio-economic determinants such as gross domestic product (GDP) per capita, socioeconomic resilience; health system determinants such as density of human resources, government spending on health expenditure; and political determinants such as effective government, more power to regional governments, political stability and absence of violence play a pivotal role in vaccine coverage. We also found that FCS countries with a higher share of people strongly believing in the vaccine effectiveness have a positive association with COVID-19 vaccine coverage. CONCLUSION The study confirmed that political factors, government effectiveness and political stability are also important determinants of vaccine coverage. The result further draws attention to few policy implications such as promoting future research to explore the linkages between the perceived equality before the law and individual liberty and its effect on vaccination coverage in the FCS.
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Affiliation(s)
- Sanjay Pattanshetty
- Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Mantej Pardesi
- Department of Microeconomics and Public Economics, School of Business and Economics, Maastricht University, Maastricht, The Netherlands
| | - Nachiket Gudi
- Public Health Evidence South Asia, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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12
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Patón M, Al-Hosani F, Stanciole AE, Aden B, Timoshkin A, Sadani A, Najim O, Cherian CA, Acuña JM, Rodríguez J. Model-based evaluation of the COVID-19 epidemiological impact on international visitors during Expo 2020. Infect Dis Model 2022; 7:571-579. [PMID: 35990534 PMCID: PMC9375731 DOI: 10.1016/j.idm.2022.08.003] [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] [Received: 05/24/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 10/26/2022] Open
Abstract
The impact of the COVID-19 pandemic on large events has been substantial. In this work, an evaluation of the potential impact of international arrivals due to Expo 2020 in terms of potential COVID-19 infections from October 1st, 2021, until the end of April 2022 in the United Arab Emirates is presented. Our simulation results indicate that: (i) the vaccination status of the visitors appears to have a small impact on cases, this is expected as the small numbers of temporary visitors with respect to the total population contribute little to the herd immunity status; and (ii) the number of infected arrivals is the major factor of impact potentially causing a surge in cases countrywide with the subsequent hospitalisations and fatalities. These results indicate that the prevention of infected arrivals should take all precedence priority to mitigate the impact of international visitors with their vaccination status being of less relevance.
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Affiliation(s)
- Mauricio Patón
- Department of Epidemiology and Public Health, College of Medicine, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates.,Department of Chemical Engineering, College of Engineering, Khalifa University, SAN Campus, PO Box 127788, Abu Dhabi, United Arab Emirates.,Research and Data Intelligence Support Center (RDISC), Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | | | | | - Bashir Aden
- Department of Health, Abu Dhabi, United Arab Emirates
| | | | - Amrit Sadani
- Department of Health, Abu Dhabi, United Arab Emirates
| | - Omar Najim
- Department of Health, Abu Dhabi, United Arab Emirates
| | - Cybill A Cherian
- Department of Chemical Engineering, College of Engineering, Khalifa University, SAN Campus, PO Box 127788, Abu Dhabi, United Arab Emirates.,Research and Data Intelligence Support Center (RDISC), Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Juan M Acuña
- Department of Epidemiology and Public Health, College of Medicine, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates.,Research and Data Intelligence Support Center (RDISC), Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates.,Abu Dhabi Health Services Company - SEHA, PO Box 109090, Abu Dhabi, United Arab Emirates
| | - Jorge Rodríguez
- Department of Chemical Engineering, College of Engineering, Khalifa University, SAN Campus, PO Box 127788, Abu Dhabi, United Arab Emirates.,Research and Data Intelligence Support Center (RDISC), Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
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13
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Varkey S, Kandpal E, Neelsen S. Why addressing inequality must be central to pandemic preparedness. BMJ Glob Health 2022. [PMCID: PMC9453948 DOI: 10.1136/bmjgh-2022-010453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Sherin Varkey
- Health, Nutrition, and Population, World Bank Group, Washington, District of Columbia, USA
| | - Eeshani Kandpal
- Development Research Group, World Bank, Washington, District of Columbia, USA
| | - Sven Neelsen
- Health, Nutrition, and Population, World Bank Group, Washington, District of Columbia, USA
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14
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Flor LS, Friedman J, Spencer CN, Cagney J, Arrieta A, Herbert ME, Stein C, Mullany EC, Hon J, Patwardhan V, Barber RM, Collins JK, Hay SI, Lim SS, Lozano R, Mokdad AH, Murray CJL, Reiner RC, Sorensen RJD, Haakenstad A, Pigott DM, Gakidou E. Quantifying the effects of the COVID-19 pandemic on gender equality on health, social, and economic indicators: a comprehensive review of data from March, 2020, to September, 2021. Lancet 2022; 399:2381-2397. [PMID: 35247311 PMCID: PMC8890763 DOI: 10.1016/s0140-6736(22)00008-3] [Citation(s) in RCA: 100] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gender is emerging as a significant factor in the social, economic, and health effects of COVID-19. However, most existing studies have focused on its direct impact on health. Here, we aimed to explore the indirect effects of COVID-19 on gender disparities globally. METHODS We reviewed publicly available datasets with information on indicators related to vaccine hesitancy and uptake, health care services, economic and work-related concerns, education, and safety at home and in the community. We used mixed effects regression, Gaussian process regression, and bootstrapping to synthesise all data sources. We accounted for uncertainty in the underlying data and modelling process. We then used mixed effects logistic regression to explore gender gaps globally and by region. FINDINGS Between March, 2020, and September, 2021, women were more likely to report employment loss (26·0% [95% uncertainty interval 23·8-28·8, by September, 2021) than men (20·4% [18·2-22·9], by September, 2021), as well as forgoing work to care for others (ratio of women to men: 1·8 by March, 2020, and 2·4 by September, 2021). Women and girls were 1·21 times (1·20-1·21) more likely than men and boys to report dropping out of school for reasons other than school closures. Women were also 1·23 (1·22-1·23) times more likely than men to report that gender-based violence had increased during the pandemic. By September 2021, women and men did not differ significantly in vaccine hesitancy or uptake. INTERPRETATION The most significant gender gaps identified in our study show intensified levels of pre-existing widespread inequalities between women and men during the COVID-19 pandemic. Political and social leaders should prioritise policies that enable and encourage women to participate in the labour force and continue their education, thereby equipping and enabling them with greater ability to overcome the barriers they face. FUNDING The Bill & Melinda Gates Foundation.
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Affiliation(s)
- Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Joseph Friedman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Cory N Spencer
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - John Cagney
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alejandra Arrieta
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Molly E Herbert
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Caroline Stein
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Julia Hon
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Vedavati Patwardhan
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ryan M Barber
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - James K Collins
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Rafael Lozano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Annie Haakenstad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - David M Pigott
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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15
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Poon PKM, Zhou W, Chan DCC, Kwok KO, Wong SYS. Recommending COVID-19 Vaccines to Patients: Practice and Concerns of Frontline Family Doctors. Vaccines (Basel) 2021; 9:1319. [PMID: 34835250 PMCID: PMC8624411 DOI: 10.3390/vaccines9111319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Recommendation from doctors is a well-recognized motivator toward vaccine uptake. Family doctors are in the prime position to advise the public on COVID-19 vaccination. We studied the practice and concerns of frontline family doctors concerning COVID-19 vaccination recommendations to patients. Methods: We conducted a cross-sectional online survey of all family doctors in the Hong Kong College of Family Physicians between June and July 2021. Their practice of making COVID-19 recommendation to patients was assessed. Based on the Health Belief Model, factors associated with doctors' recommendation practices were explored and examined. Multivariate logistic regression models were used to investigate the factors, including COVID-19 vaccine attributes, associated with doctors' practices in making recommendations. Their own vaccination status and psychological antecedents to vaccine hesitancy were measured. Results: A total of 312 family doctors responded (a 17.6% response rate). The proportion of doctors who had received COVID-19 vaccines was 90.1%. The proportion of doctors who would recommend all patients without contraindications for the vaccination was 64.4%. The proportion of doctors who would proactively discuss COVID-19 vaccines with patients was 52.9%. Multivariate logistic regression analysis showed that doctors' own COVID-19 vaccination status was the strongest predictor of family doctors making a recommendation to patients (aOR 12.23 95% CI 3.45-43.33). Longer duration of practice, willingness to initiate the relevant discussion with patients and less worry about vaccine side effects on chronic illness patients were the other factors associated with making a COVID-19 vaccination recommendation. Conclusions: Family doctors should be encouraged to get vaccinated themselves and initiate discussions with patients about COVID-19 vaccines. Vaccine safety data on patients with chronic illness, training and guidelines for junior doctors may facilitate the COVID-19 vaccination recommendation practices of family doctors.
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Affiliation(s)
- Paul Kwok Ming Poon
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 2/F, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; (P.K.M.P.); (W.Z.); (D.C.C.C.); (K.O.K.)
| | - Weiju Zhou
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 2/F, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; (P.K.M.P.); (W.Z.); (D.C.C.C.); (K.O.K.)
| | - Dicken Cheong Chun Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 2/F, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; (P.K.M.P.); (W.Z.); (D.C.C.C.); (K.O.K.)
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 2/F, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; (P.K.M.P.); (W.Z.); (D.C.C.C.); (K.O.K.)
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen 518057, China
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 2/F, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China; (P.K.M.P.); (W.Z.); (D.C.C.C.); (K.O.K.)
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16
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Gao X, Li H, He W, Zeng W. COVID-19 Vaccine Hesitancy Among Medical Students: The Next COVID-19 Challenge in Wuhan, China. Disaster Med Public Health Prep 2021; 17:e46. [PMID: 34496990 PMCID: PMC8564029 DOI: 10.1017/dmp.2021.291] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/16/2021] [Accepted: 09/05/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of this study was to explore the level of coronavirus disease 2019 (COVID-19) vaccine hesitancy among medical students in Wuhan, China, and to identify the factors and barriers associated with their vaccination decision. METHODS A cross-sectional survey was launched with 612 medical students recruited by convenience sampling from 6 universities. Data collection measures mainly included a demographic questionnaire, COVID-19 vaccine knowledge questionnaire, and the vaccine hesitancy scale. RESULTS A total of 58.2% of medical students reported vaccine hesitancy. The most common reasons for this were worrying about the side effects of vaccines (44.4%), uncertainty about vaccine safety (40.4%), and underestimating the risk of exposure to COVID-19 (27.9%). The main factors associated with COVID-19 vaccine hesitancy among participants were their knowledge about COVID-19 vaccine, training related to COVID-19 vaccines, family address, and education level (P < 0.05). CONCLUSIONS The government, health department and universities in China need to work together and actively communicate with vaccine-hesitant students, establish a standardized COVID-19 vaccine course, and provide on-campus vaccination services.
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Affiliation(s)
- Xudong Gao
- College of Medicine and Health Science, Wuhan Polytechnic University, Wuhan, China
| | - Haiyan Li
- Emergency Room, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenjie He
- Gastrointestinal Department, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen Zeng
- Department of Scientific research and Teaching, The Central Hospital of Shaoyang, Shaoyang, China
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17
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Christen P, Conteh L. How are mathematical models and results from mathematical models of vaccine-preventable diseases used, or not, by global health organisations? BMJ Glob Health 2021; 6:bmjgh-2021-006827. [PMID: 34489331 PMCID: PMC8422320 DOI: 10.1136/bmjgh-2021-006827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/15/2021] [Indexed: 11/29/2022] Open
Abstract
While epidemiological and economic evidence has the potential to provide answers to questions, guide complex programmes and inform resource allocation decisions, how this evidence is used by global health organisations who commission it and what organisational actions are generated from the evidence remains unclear. This study applies analytical tools from organisational science to understand how evidence produced by infectious disease epidemiologists and health economists is used by global health organisations. A conceptual framework that embraces evidence use typologies and relates findings to the organisational process of action generation informs and structures the research. Between March and September 2020, we conducted in-depth interviews with mathematical modellers (evidence producers) and employees at global health organisations, who are involved in decision-making processes (evidence consumers). We found that commissioned epidemiological and economic evidence is used to track progress and provides a measure of success, both in terms of health outcomes and the organisations’ mission. Global health organisations predominantly use this evidence to demonstrate accountability and solicit funding from external partners. We find common understanding and awareness across consumers and producers about the purposes and uses of these commissioned pieces of work and how they are distinct from more academic explorative research outputs. Conceptual evidence use best describes this process. Evidence is slowly integrated into organisational processes and is one of many influences on global health organisations’ actions. Relationships developed over time and trust guide the process, which may lead to quite a concentrated cluster of those producing and commissioning models. These findings raise several insights relevant to the literature of research utilisation in organisations and evidence-based management. The study extends our understanding of how evidence is used and which organisational actions are generated as a result of commissioning epidemiological and economic evidence.
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Affiliation(s)
- Paula Christen
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Lesong Conteh
- Department of Health Policy, The London School of Economics and Political Science, London, UK
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18
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Green H, Fernandez R, MacPhail C. The social determinants of health and health outcomes among adults during the COVID-19 pandemic: A systematic review. Public Health Nurs 2021; 38:942-952. [PMID: 34403525 PMCID: PMC8446962 DOI: 10.1111/phn.12959] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/29/2022]
Abstract
Objective To synthesize the best available evidence on the relationship between the social determinants of health and health outcomes among adults during the COVID‐19 pandemic. Introduction COVID‐19 has created widespread global transmission. Rapid increase in individuals infected with COVID‐19 prompted significant public health responses from governments globally. However, the social and economic impact on communities may leave some individuals more susceptible to the detrimental effects. Methods A three‐step search strategy was used to find published and unpublished papers. Databases searched included: MEDLINE, CINAHL, EMBASE, and Google Scholar. All identified citations were uploaded into Endnote X9, with duplicates removed. Methodological quality of eligible papers was assessed by two reviewers, with meta‐synthesis conducted in accordance with JBI methodology. Results Fifteen papers were included. Three synthesized‐conclusions were established (a) Vulnerable populations groups, particularly those from a racial minority and those with low incomes, are more susceptible and have been disproportionately affected by COVID‐19 including mortality; (b) Gender inequalities and family violence have been exacerbated by COVID‐19, leading to diminished wellbeing among women; and (c) COVID‐19 is exacerbating existing social determinants of health through loss of employment/income, disparities in social class leading to lack of access to health care, housing instability, homelessness, and difficulties in physical distancing. Conclusion Reflection on social and health policies implemented are necessary to ensure that the COVID‐19 pandemic does not exacerbate health inequalities into the future.
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Affiliation(s)
- Heidi Green
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,St George Hospital, Centre for Research in Nursing and Health, Kogarah, NSW, Australia.,Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia
| | - Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,St George Hospital, Centre for Research in Nursing and Health, Kogarah, NSW, Australia.,Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia
| | - Catherine MacPhail
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
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19
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Bonati M, Benelli E. Vaccinating adolescents wisely against COVID-19. BMJ Paediatr Open 2021; 5:e001191. [PMID: 34493988 PMCID: PMC8413465 DOI: 10.1136/bmjpo-2021-001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/14/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Maurizio Bonati
- Department of Public Health, Laboratory for Mother and Child Health, Mario Negri Institute for Pharmacological Research, Milano, Italy
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