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Wubshet AK, Werid GM, Teklue T, Zhou L, Bayasgalan C, Tserendorj A, Liu J, Heath L, Sun Y, Ding Y, Wang W, Zaberezhny AD, Liu Y, Zhang J. Foot and mouth disease vaccine efficacy in Africa: a systematic review and meta-analysis. Front Vet Sci 2024; 11:1360256. [PMID: 38903686 PMCID: PMC11187330 DOI: 10.3389/fvets.2024.1360256] [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: 12/22/2023] [Accepted: 05/06/2024] [Indexed: 06/22/2024] Open
Abstract
Background Several factors, such as diverse serotypes, vaccination methods, weak biosecurity, and animal movements, contribute to recurrent Foot-and-Mouth Disease Virus (FMDV) outbreaks in Africa, establishing endemicity. These outbreaks cost over $2 billion annually, prompting a high-priority focus on FMDV vaccination. Despite extensive efforts, vaccine efficacy varies. This study aims to evaluate routine foot and mouth disease (FMD) vaccines in Africa via systematic review and meta-analysis. Methods A systematic review and meta-analysis were carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Meta-analysis was conducted to assess the efficacy of FMDV vaccination using the meta for package of R. Results Vaccinated animals have roughly a 69.3% lower chance of FMDV infection compared to unvaccinated animals, as indicated by the pooled results from the random-effects model, which showed a risk ratio (RR) of 0.3073. There was a statistically significant heterogeneity (p < 0.05) across all of the included articles. Conclusion Overall findings suggest that if properly planned and implemented, FMDV vaccination programs and strategies in Africa could help control the spread of the disease throughout the continent and beyond.
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Affiliation(s)
- Ashenafi Kiros Wubshet
- State Key Laboratory of Veterinary Etiological Biology, National/OIE Foot and Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
- Department of Veterinary Basics and Diagnostic Sciences, College of Veterinary Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Gebremeskel Mamu Werid
- Davies Livestock Research Centre, School of Animal & Veterinary Sciences, University of Adelaide, Roseworthy, SA, Australia
| | | | - Luoyi Zhou
- State Key Laboratory of Veterinary Etiological Biology, National/OIE Foot and Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
- Hebei Key Laboratory of Preventive Veterinary Medicine, College of Animal Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | | | - Ariunaa Tserendorj
- School of Veterinary Medicine, Mongolian University of Life Sciences, Ulaanbaatar, Mongolia
| | - Jinjin Liu
- Hebei Key Laboratory of Preventive Veterinary Medicine, College of Animal Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | - Livio Heath
- Transboundary Animal Diseases Programme, Onderstepoort Veterinary Research, Agricultural Research Council, Onderstepoort, South Africa
| | - Yuefeng Sun
- State Key Laboratory of Veterinary Etiological Biology, National/OIE Foot and Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Yaozhong Ding
- State Key Laboratory of Veterinary Etiological Biology, National/OIE Foot and Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Wenxiu Wang
- Shandong Binzhou Animal Science and Veterinary Medicine Academy, Binzhou, China
| | - Alexei D. Zaberezhny
- Federal State Budgetary Scientific Institution “All-Russian Research and Technological Institute of Biological Industry” (FSBSI VNITIBP), Moscow, Russia
| | - Yongsheng Liu
- Hebei Key Laboratory of Preventive Veterinary Medicine, College of Animal Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | - Jie Zhang
- State Key Laboratory of Veterinary Etiological Biology, National/OIE Foot and Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
- Hebei Key Laboratory of Preventive Veterinary Medicine, College of Animal Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
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Epstein D, Pérez-Troncoso D, Ruiz-Adame M, Castañeda JA. Public Acceptance of Measures to Control Infectious Diseases Under Different Scenarios of Severity and Transmissibility. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:562-569. [PMID: 38401797 DOI: 10.1016/j.jval.2024.01.021] [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: 01/09/2023] [Revised: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES Public health measures to control future epidemic threats of contagious disease, such as new variants of COVID-19, may be usefully informed by evidence about how acceptable they are likely to be, and the circumstances that condition this acceptance. This study considers how the acceptability of nonpharmaceutical interventions (NPIs) might depend on scenarios about the severity and transmissibility of the disease. METHODS A telephone survey was conducted among a representative cross-sectional sample of the Spanish adult population. Each respondent was randomly assigned to 1 of 4 possible hypothetical scenarios about the severity and transmissibility of the disease. Participants' responses about the acceptability of 11 NPI under this scenario were analyzed using multivariate regression and latent class cluster analysis. RESULTS A high risk of severe disease increases the acceptability of mask wearing, social distancing outdoors, lockdown, and isolation of infected cases, close contacts, and the vulnerable. A scenario in which the disease is highly transmissible would increase the acceptability of NPI that restrict movement and isolation. Most respondents would broadly accept most NPI in situations when either the severity or transmissibility was high. CONCLUSIONS This study showed that people are more willing to accept NPIs such as mask wearing, social distancing outdoors, lockdown, and isolation in severe disease scenarios. A highly transmissible disease scenario increases the acceptability of NPIs that isolate. A majority would broadly accept NPIs to counter public health emergencies, whereas 3% to 9% of the population would always be strongly against.
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Affiliation(s)
- David Epstein
- Department of Applied Economics, University of Granada, Granada, Spain
| | | | - Manuel Ruiz-Adame
- Department of Applied Economics, University of Granada, Campus of Melilla, Melilla, Spain.
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3
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Mancino C, Pollet J, Zinger A, Jones KM, Villar MJ, Leao AC, Adhikari R, Versteeg L, Tyagi Kundu R, Strych U, Giordano F, Hotez PJ, Bottazzi ME, Taraballi F, Poveda C. Harnessing RNA Technology to Advance Therapeutic Vaccine Antigens against Chagas Disease. ACS APPLIED MATERIALS & INTERFACES 2024; 16:15832-15846. [PMID: 38518375 PMCID: PMC10996878 DOI: 10.1021/acsami.3c18830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/24/2024]
Abstract
Chagas disease (CD) (American trypanosomiasis caused by Trypanosoma cruzi) is a parasitic disease endemic in 21 countries in South America, with increasing global spread. When administered late in the infection, the current antiparasitic drugs do not prevent the onset of cardiac illness leading to chronic Chagasic cardiomyopathy. Therefore, new therapeutic vaccines or immunotherapies are under development using multiple platforms. In this study, we assessed the feasibility of developing an mRNA-based therapeutic CD vaccine targeting two known T. cruzi vaccine antigens (Tc24─a flagellar antigen and ASP-2─an amastigote antigen). We present the mRNA engineering steps, preparation, and stability of the lipid nanoparticles and evaluation of their uptake by dendritic cells, as well as their biodistribution in c57BL/J mice. Furthermore, we assessed the immunogenicity and efficacy of two mRNA-based candidates as monovalent and bivalent vaccine strategies using an in vivo chronic mouse model of CD. Our results show several therapeutic benefits, including reductions in parasite burdens and cardiac inflammation, with each mRNA antigen, especially with the mRNA encoding Tc24, and Tc24 in combination with ASP-2. Therefore, our findings demonstrate the potential of mRNA-based vaccines as a therapeutic option for CD and highlight the opportunities for developing multivalent vaccines using this approach.
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Affiliation(s)
- Chiara Mancino
- Center
for Musculoskeletal Regeneration, Houston
Methodist Academic Institute, Houston, Texas 77030, United States
| | - Jeroen Pollet
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
| | - Assaf Zinger
- Center
for Musculoskeletal Regeneration, Houston
Methodist Academic Institute, Houston, Texas 77030, United States
- Laboratory
for Bioinspired Nano Engineering and Translational Therapeutics, Department
of Chemical Engineering, Technion−Israel
Institute of Technology, Haifa 3200003, Israel
- Cardiovascular
Sciences Department, Houston Methodist Academic
Institute, Houston, Texas 77030, United States
- Neurosurgery
Department, Houston Methodist Academic Institute, Houston, Texas 77030, United States
| | - Kathryn M. Jones
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
- Department
of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas 77030, United States
| | - Maria José Villar
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
| | - Ana Carolina Leao
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
| | - Rakesh Adhikari
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
| | - Leroy Versteeg
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
- Cell Biology
and Immunology Group, Wageningen University
& Research, Wageningen 6708 PB, The Netherlands
| | - Rakhi Tyagi Kundu
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
| | - Ulrich Strych
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
| | - Federica Giordano
- Center
for Musculoskeletal Regeneration, Houston
Methodist Academic Institute, Houston, Texas 77030, United States
| | - Peter J. Hotez
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
- Department
of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas 77030, United States
- Department
of Biology, Baylor University, Waco, Texas 76798, United States
| | - Maria Elena Bottazzi
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
- Department
of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas 77030, United States
- Department
of Biology, Baylor University, Waco, Texas 76798, United States
| | - Francesca Taraballi
- Center
for Musculoskeletal Regeneration, Houston
Methodist Academic Institute, Houston, Texas 77030, United States
- Orthopedics
and Sports Medicine, Houston Methodist Hospital, Houston, Texas 77030, United States
| | - Cristina Poveda
- Department
of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine, Houston, Texas 77030, United States
- Texas
Children’s Hospital Center for Vaccine Development, Houston, Texas 77030, United States
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Vallée A. Geoepidemiological perspective on COVID-19 pandemic review, an insight into the global impact. Front Public Health 2023; 11:1242891. [PMID: 37927887 PMCID: PMC10620809 DOI: 10.3389/fpubh.2023.1242891] [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: 06/19/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
The COVID-19 pandemic showed major impacts, on societies worldwide, challenging healthcare systems, economies, and daily life of people. Geoepidemiology, an emerging field that combines geography and epidemiology, has played a vital role in understanding and combatting the spread of the virus. This interdisciplinary approach has provided insights into the spatial patterns, risk factors, and transmission dynamics of the COVID-19 pandemic at different scales, from local communities to global populations. Spatial patterns have revealed variations in incidence rates, with urban-rural divides and regional hotspots playing significant roles. Cross-border transmission has highlighted the importance of travel restrictions and coordinated public health responses. Risk factors such as age, underlying health conditions, socioeconomic factors, occupation, demographics, and behavior have influenced vulnerability and outcomes. Geoepidemiology has also provided insights into the transmissibility and spread of COVID-19, emphasizing the importance of asymptomatic and pre-symptomatic transmission, super-spreading events, and the impact of variants. Geoepidemiology should be vital in understanding and responding to evolving new viral challenges of this and future pandemics.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
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5
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Yamanis T, Carlitz R, Gonyea O, Skaff S, Kisanga N, Mollel H. Confronting 'chaos': a qualitative study assessing public health officials' perceptions of the factors affecting Tanzania's COVID-19 vaccine rollout. BMJ Open 2023; 13:e065081. [PMID: 36720575 PMCID: PMC9890278 DOI: 10.1136/bmjopen-2022-065081] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Mass COVID-19 vaccination in Africa is required to end the pandemic. In low-income settings, street-level bureaucrats (SLBs), or public officials who interact directly with citizens, are typically responsible for carrying out vaccination plans and earning community confidence in vaccines. The study interviewed SLBs to assess their perceptions of the factors affecting COVID-19 vaccination rollout in Tanzania. METHODS We interviewed 50 SLBs (19 rural; 31 urban) responsible for implementing COVID-19 vaccination microplans across four diverse regions and districts of Tanzania in September 2021. Moreover, we conducted six in-depth interviews with non-governmental organisation representatives and seven focus group discussions with health facility governing committees. We asked for their perceptions of factors facilitating and challenging vaccine rollout according to three preidentified domains: political, health system and community. We analysed translated transcripts using a thematic analysis approach. RESULTS Political factors facilitating mass vaccination included the executive leadership change from a denialist president to a president who accepted vaccines and promoted transparency. Global integration, commercially and politically, also motivated vaccine acceptance. Political challenges included community confusion that emerged from the consecutive presidents' divergent communications and messaging by prominent religious antivaccination leaders. Health system factors facilitating vaccination included scaling up of immunisation sites and campaigns. Urban district officials reported greater access to vaccination sites, compared with rural officials. Limited financial resources for paying healthcare workers and for transport fuel and a lack of COVID-19 testing compromised mass vaccination. Furthermore, SLBs reported being inadequately trained on COVID-19 vaccine benefits and side effects. Having community sources of accurate information was critical to mass vaccination. Challenges at the community level included patriarchal gender dynamics, low risk perception, disinformation that the vaccine has satanic elements, and lack of trust in coronavirus vaccines. CONCLUSION Mass COVID-19 vaccination in Tanzania will require greater resources and investment in training SLBs to mitigate mistrust, overcome misinformation, and engage communities.
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Affiliation(s)
- Thespina Yamanis
- School of International Service, American University, Washington, DC, USA
| | - Ruth Carlitz
- Department of Political Science, University of Amsterdam, Amsterdam, Netherlands
| | - Olivia Gonyea
- Department of Health Studies, American University, Washington, DC, USA
| | - Sophia Skaff
- School of International Service, American University, Washington, DC, USA
| | - Nelson Kisanga
- Department of Health Systems Management, Mzumbe University, Mzumbe, Tanzania
| | - Henry Mollel
- Department of Health Systems Management, Mzumbe University, Mzumbe, Tanzania
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6
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Takoudjou Dzomo GR, Mbario E, Djarma O, Soumbatingar N, Madengar M, Djimera N, Djindimadje A, Nguemadjita C, Nassaringar G, Bernales M, Nangerngar T, Naissem D, Paningar E, Gomez-Virseda C, Lopez Barreda R, Robbins I, Cournil A, Visier L, Tuaillon E, Mennechet FJD. Predictors of COVID-19 vaccine hesitancy in Chad: A cross-sectional study. Front Public Health 2023; 10:1063954. [PMID: 36684864 PMCID: PMC9846328 DOI: 10.3389/fpubh.2022.1063954] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023] Open
Abstract
Vaccination against the COVID-19 virus is currently the best option to combat the SARS-CoV-2 pandemic worldwide. However, in addition to logistical and economic barriers, hesitancy to be vaccinated threatens to jeopardize efforts to contain the disease. An increasing number of people in Africa are delaying or rejecting recommended vaccines. Since their launch, COVID-19 vaccines have frequently faced rejection worldwide. In this study, we interviewed 5,174 participants from Chad that were representative of the general population, on their perception of COVID-19 vaccines. The survey was conducted from April to May 2021, before the rollout of the COVID-19 vaccination. We found that 47.9% of respondents were willing to receive the COVID-19 vaccine, 29.8% were undecided and 22.3% would not accept the vaccine. We found that urban residents were much more likely to refuse the vaccine than rural residents. We also observed that distrust of COVID-19 vaccines and mistaken beliefs played a crucial role in the reluctance to be vaccinated. Hesitancy to vaccinate against COVID-19 was strongly associated with lack of knowledge, and acceptance of vaccination was primarily associated with fear of the disease. Finally, we identified population profiles among the undecided and the refractors, which will help in developing strategies to combat COVID-19 vaccine resistance.
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Affiliation(s)
| | - Edmond Mbario
- Association for the Promotion of Village Health in Chad (APSVT), Bekamba, Chad
| | - Oumaima Djarma
- Republic of Chad, Ministry of Public Health and National Solidarity, N'Djamena, Chad
| | | | | | - Nadia Djimera
- University Hospital Complex “Le Bon Samaritain”, N'Djamena, Chad
| | | | | | | | - Margarita Bernales
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Denise Naissem
- University Hospital Complex “Le Bon Samaritain”, N'Djamena, Chad
| | - Ephrem Paningar
- University Hospital Complex “Le Bon Samaritain”, N'Djamena, Chad
| | - Carlos Gomez-Virseda
- Center for Biomedical Ethics and Law, Department of Public Health and Primary Care, University KU Leuven, Leuven, Belgium
| | | | - Ian Robbins
- The Institute of Molecular Genetics of Montpellier (IGMM), University of Montpellier, CNRS, Montpellier, France
| | - Amandine Cournil
- Institute of Research for Development (IRD), Montpellier, France
| | - Laurent Visier
- Center for Political and Social Studies (CEPEL), CNRS - University of Montpellier, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), INSERM U1058, University of Montpellier, French Blood Establishment (EFS), University of Antilles, Montpellier, France
- Montpellier University Hospital (CHU), Montpellier, France
| | - Franck J. D. Mennechet
- Pathogenesis and Control of Chronic and Emerging Infections (PCCEI), INSERM U1058, University of Montpellier, French Blood Establishment (EFS), University of Antilles, Montpellier, France
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7
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Aubourg MA, Bisimwa L, Bisimwa JC, Sanvura P, Williams C, Boroto R, Lunyelunye C, Timsifu J, Munyerenkana B, Endres K, Winch PJ, Bengehya J, Maheshe G, Cikomola C, Mwishingo A, George CM. A Qualitative Evaluation of COVID-19 Preventative Response Activities in South Kivu, Democratic Republic of the Congo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13424. [PMID: 36294005 PMCID: PMC9603344 DOI: 10.3390/ijerph192013424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE In this evaluation of COVID-19 preventative response programs in South Kivu, Democratic Republic of the Congo (DRC), we aimed to explore community understandings of COVID-19, assess operational successes and challenges of COVID response activities, and identify barriers to practicing COVID-19 preventative behaviors. METHODS Thirty-one semi-structured interviews were conducted from April to September 2021 in South Kivu, DRC, with community members (n = 16) and programmatic stakeholders (n = 15) (healthcare providers, government officials, and developmental and NGO staff engaged in COVID-19 response). FINDINGS Most community members were aware of COVID-19 and its global burden, but few were aware of local transmission in their area. Some community members attributed COVID-19 to actions of malevolent neighbors, miasma ("bad air"), or spirits. Awareness of COVID-19 preventative measures was widespread, largely because of radio and TV health promotion programs. Community members and programmatic stakeholders both said community-level non-compliance to COVID-19 preventative measures was high despite high awareness of preventative methods. Community members expressed concern that face masks distributed as part of preventative programs contained the COVID-19 virus. Programmatic stakeholders emphasized the need for broader health system strengthening with improved coordination, provision of resources to health facilities at the provincial level, and prioritization of research. Lessons learned from addressing Ebola were leveraged for COVID-19 health promotion, rapid training of healthcare personnel, and surveillance. CONCLUSIONS Community-informed approaches are needed for effective COVID-19 preventative response programs in South Kivu, DRC. Our study identified successes and challenges in COVID-19 response activities. Future research should assess the effectiveness of integrating preventive programs with COVID-19 vaccination efforts.
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Affiliation(s)
- Matthew A. Aubourg
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Lucien Bisimwa
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Jean Claude Bisimwa
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Presence Sanvura
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Camille Williams
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Raissa Boroto
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Claude Lunyelunye
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Jessy Timsifu
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Brigitte Munyerenkana
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Kelly Endres
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Peter J. Winch
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Justin Bengehya
- Bureau de l’Information Sanitaire, Surveillance Epidémiologique et Recherche Scientifique, Division Provinciale de la Santé Sud Kivu, Ministère de la Santé, Bukavu B.P 265, Democratic Republic of the Congo
| | - Ghislain Maheshe
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Cirhuza Cikomola
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Alain Mwishingo
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Christine Marie George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Suárez-Álvarez A, López-Menéndez AJ. Is COVID-19 vaccine inequality undermining the recovery from the COVID-19 pandemic? J Glob Health 2022; 12:05020. [PMID: 35604879 PMCID: PMC9126303 DOI: 10.7189/jogh.12.05020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background The devastating health and economic impact of the COVID-19 pandemic led to a global response in the development of effective vaccines to fight the disease in an extraordinarily short time. Both the development and the production of these vaccines opened a path of hope, but the inequality in vaccine distribution raises great concerns about the possibility of effectively eradicating the virus. Methods It is particularly important to analyse the extent to which vaccines are equally distributed and investigate the possible effects of vaccine inequalities as well as its major drivers. For this purpose, this paper investigates the extent of equitable vaccine distribution using some well-known inequality measures and disentangles the main drivers of the share of vaccination. In addition, the paper analyses the relationship between the vaccination rate, the GDP growth, and the incidence of the coronavirus disease, with the aim of providing empirical evidence on existing relationships worldwide. Results Our findings show that the situation is more challenging in less developed countries, especially African countries, due to weak health systems and low rates of vaccination. Moreover, we find a positive relationship between the share of vaccinated individuals and GDP. Consequently, the poorest, least developed countries with a lower rate of vaccine uptake will experience lower GDP growth. Conclusions Vaccines and the vaccination process reveal the existing inequalities between countries and how they, in turn, impact the well-being of their citizens. People who live in less developed countries have a lower probability of being vaccinated, which translates into a greater probability of dying from COVID. Countries are seeing their economic future compromised by low vaccination levels, given the positive and significant relationship between the vaccination rate and GDP growth. In short, while some countries are trying to get back to some sort of normality, even with some pandemic protocols, the situation in less developed countries is more challenging due to weak health systems and low rates of vaccination. Consequently, the poorest, least developed countries with a lower rate of vaccine penetration will experience lower GDP growth, and the pandemic will have a greater effect on their economy due to low vaccination rates.
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9
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Jecker NS, Lederman Z. Three for me and none for you? An ethical argument for delaying COVID-19 boosters. JOURNAL OF MEDICAL ETHICS 2021; 48:medethics-2021-107824. [PMID: 34620703 PMCID: PMC8507405 DOI: 10.1136/medethics-2021-107824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
This paper argues in support of the WHO's proposal to forego COVID-19 booster shots until 10% of people in every country are fully vaccinated. The Ethical Argument section shows that we save the most lives and ensure the least amount of suffering by allocating doses first to unvaccinated people. It also argues that there is a duty to support decent lives and to promote health equity, which establish that refraining from boosters is a requirement of justice, not charity. The Replies to Objections section answers objections that appeal to pragmatism, nationalism, ownership, scientific advancement, self-interest, semantics and futility. The Conclusion section emphasizes that for now, wealthy nations should not boost vaccinated people's immunity and should instead send doses to poorer nations where they are most urgently needed.
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Affiliation(s)
- Nancy S Jecker
- University of Washington School of Medicine, Department of Bioethics & Humanities, Seattle, Washington, USA
| | - Zohar Lederman
- Medical Ethics and Humanities Unit, Rambam Health Care Campus, Haifa, Israel
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Duarte G, Coutinho CM, Rolnik DL, Quintana SM, Rabelo E Silva AC, Poon LC, Costa FDS. Perspectives on administration of COVID-19 vaccine to pregnant and lactating women: a challenge for low- and middle-income countries. AJOG GLOBAL REPORTS 2021; 1:100020. [PMID: 34494014 PMCID: PMC8413092 DOI: 10.1016/j.xagr.2021.100020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/13/2022] Open
Abstract
Women who are in the pregnancy-puerperal cycle or are lactating have been deliberately excluded from participating in COVID-19 vaccine clinical trials that aimed to evaluate either the efficacy of the vaccines in inducing the formation of neutralizing antibodies or the investigational products' safety profile. The exclusion of pregnant and lactating women from such studies certainly and inequitably denies these women access to COVID-19 vaccines, since these products have become increasingly available to nonpregnant people and even to those who are pregnant and are in high-income settings. In this clinical opinion article, we discuss some aspects of the prolonged pandemic, the emergence of viral variants, the risks of severe complications of COVID-19 in pregnant women, and the disproportionate impact of the above on low- and middle-income countries. We argue that the decision to receive the COVID-19 vaccine should be a joint decision between the pregnant or lactating women and the healthcare providers, while considering the available data on vaccine efficacy, safety, the risks of SARS-CoV-2 infection in pregnant women, and the women's individual risks for infection and serious illness. The various types of vaccines that are already in use and their safety, effectiveness, and the potential risks and benefits of their administration to pregnant or lactating women are also reviewed.
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Affiliation(s)
- Geraldo Duarte
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil (Drs Duarte, Coutinho, and Quintana and Ms Silva)
| | - Conrado Milani Coutinho
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil (Drs Duarte, Coutinho, and Quintana and Ms Silva)
| | - Daniel Lorber Rolnik
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia (Dr Rolnik)
| | - Silvana Maria Quintana
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil (Drs Duarte, Coutinho, and Quintana and Ms Silva)
| | - Ana Cláudia Rabelo E Silva
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil (Drs Duarte, Coutinho, and Quintana and Ms Silva)
| | - Liona C Poon
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong SAR, China (Dr Poon)
| | - Fabrício da Silva Costa
- Maternal-Fetal Medicine Unit, Gold Coast University Hospital and School of Medicine, Griffith University, Gold Coast, Queensland, Australia (Dr Costa)
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