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Salamat A, Kosar N, Mohyuddin A, Imran M, Zahid MN, Mahmood T. SAR, Molecular Docking and Molecular Dynamic Simulation of Natural Inhibitors against SARS-CoV-2 Mpro Spike Protein. Molecules 2024; 29:1144. [PMID: 38474656 DOI: 10.3390/molecules29051144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
The SARS-CoV-2 virus and its mutations have affected human health globally and created significant danger for the health of people all around the world. To cure this virus, the human Angiotensin Converting Enzyme-2 (ACE2) receptor, the SARS-CoV-2 main protease (Mpro), and spike proteins were found to be likely candidates for the synthesis of novel therapeutic drug. In the past, proteins were capable of engaging in interaction with a wide variety of ligands, including both manmade and plant-derived small molecules. Pyrus communis L., Ginko bibola, Carica papaya, Syrian rue, and Pimenta dioica were some of the plant species that were studied for their tendency to interact with SARS-CoV-2 main protease (Mpro) in this research project (6LU7). This scenario investigates the geometry, electronic, and thermodynamic properties computationally. Assessing the intermolecular forces of phytochemicals with the targets of the SARS-CoV-2 Mpro spike protein (SP) resulted in the recognition of a compound, kaempferol, as the most potent binding ligand, -7.7 kcal mol-1. Kaempferol interacted with ASP-187, CYS-145, SER-144, LEU 141, MET-165, and GLU-166 residues. Through additional molecular dynamic simulations, the stability of ligand-protein interactions was assessed for 100 ns. GLU-166 remained intact with 33% contact strength with phenolic OH group. We noted a change in torsional conformation, and the molecular dynamics simulation showed a potential variation in the range from 3.36 to 7.44 against a 45-50-degree angle rotation. SAR, pharmacokinetics, and drug-likeness characteristic investigations showed that kaempferol may be the suitable candidate to serve as a model for designing and developing new anti-COVID-19 medicines.
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Affiliation(s)
- Aqsa Salamat
- Department of Chemistry, University of Management and Technology (UMT), C-II, Johar Town, Lahore 54770, Pakistan
| | - Naveen Kosar
- Department of Chemistry, University of Management and Technology (UMT), C-II, Johar Town, Lahore 54770, Pakistan
| | - Ayesha Mohyuddin
- Department of Chemistry, University of Management and Technology (UMT), C-II, Johar Town, Lahore 54770, Pakistan
| | - Muhammad Imran
- Department of Chemistry, Faculty of Science, King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia
| | - Muhammad Nauman Zahid
- Department of Biology, College of Science, University of Bahrain, Sakhir P.O. Box 32038, Bahrain
| | - Tariq Mahmood
- Department of Chemistry, COMSATS University Islamabad, Abbottabad Campus, Abbottabad 22060, Pakistan
- Department of Chemistry, College of Science, University of Bahrain, Sakhir P.O. Box 32038, Bahrain
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Mazidimoradi A, Allahqoli L, Salehiniya H. The ambiguous future of the COVID-19 pandemic in the presence of a vaccine. Health Sci Rep 2023; 6:e1207. [PMID: 37064306 PMCID: PMC10090269 DOI: 10.1002/hsr2.1207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/13/2023] [Accepted: 03/29/2023] [Indexed: 04/18/2023] Open
Affiliation(s)
| | | | - Hamid Salehiniya
- Department of Epidemiology and Biostatistics, School of Health, Social Determinants of Health Research CenterBirjand University of Medical SciencesBirjandIran
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Tharwat S, Saad AM, Nassar MK, Nassar DK. Acceptance and hesitancy to receive COVID-19 vaccine among university students in Egypt: a nationwide survey. Trop Med Health 2023; 51:16. [PMID: 36895057 PMCID: PMC9995735 DOI: 10.1186/s41182-023-00509-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/25/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The public's willingness to be vaccinated will determine the success of the COVID-19 vaccination program. The aim of this study was to identify acceptance and hesitancy to receive COVID-19 vaccine among university students in Egypt, assess their level of knowledge about COVID-19 vaccine and identify factors that influence their intention towards COVID-19 vaccination. METHODS A standardized and self-administered questionnaire was distributed among university students allover Egypt. The questionnaire included sociodemographic data, intention to receive COVID-19 vaccine, knowledge and beliefs about it and status of COVID-19 vaccination. Logistic regression analysis was used to determine factors associated with COVID-19 vaccine acceptancy. RESULTS A total of 1071 of university students were involved, with a mean age of 20.51 years (SD = 1.66) and 68.2% were females. COVID-19 vaccination acceptability rate was 69.0% while hesitancy was 20.8% and resistancy was 10.2%. Median knowledge score of 4 out of 8 (IQR = 8). The main motivation for vaccine acceptance was fear of being infected (53.6%) and desire to get back to normal life (51.0%) while the main barriers against getting vaccinated were being afraid of serious side effects. Univariate regression analysis revealed an increasing likelihood of vaccine acceptancy associated with an active lifestyle (OR 1.35, 95% CI 1.04-1.75, p = 0.025), a high knowledge score (OR 1.53, 95% CI 1.42-1.66, p < 0.001), and positive vaccine beliefs. CONCLUSION There is a high rate of acceptability of COVID-19 vaccination among university students. Vaccine acceptability is associated with an active lifestyle, a high knowledge score and positive vaccine beliefs. Educational campaigns and efforts aiming to raise awareness about safety and efficacy of COVID-19 vaccines need to be directed to this important population.
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Affiliation(s)
- Samar Tharwat
- Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, El Gomhouria St, Mansoura, Dakahlia Governorate, Egypt.
| | | | - Mohammed Kamal Nassar
- Mansoura Nephrology & Dialysis Unit (MNDU), Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Dalia Kamal Nassar
- Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Alqurashi A, Sindy EA, Dosh H, Khayat SZ, Alqarna LM, Sodagar WM, Samannodi M, Alwafi H, Salawati E, Almatrafi MA, Ekram R, Bagadood RM, Alsafi R, Assaggaf HM. Perception and Acceptance of Using Different Generic Types of COVID-19 Vaccine, the "Mix-and-Match" Strategy, in Saudi Arabia: Cross-Sectional Web-Based Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13889. [PMID: 36360769 PMCID: PMC9657038 DOI: 10.3390/ijerph192113889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
Background: Soon after the COVID-19 pandemic was declared, a pharmaceutical company expressed rapid interest in developing a safe and effective vaccine candidate to contain the spread of SARS-CoV-2 infections. The FDA approved the Pfizer-BioNTech, AstraZeneca, Moderna, and Janssen vaccines. Here, we investigated the attitude and acceptance of using different generic types of COVID-19 vaccines in Saudi Arabia. Methods: This study is a cross-sectional study using an online survey conducted in Saudi Arabia from the 19th of October to the 6th of December 2021. The questionnaire was distributed using social media platforms such as Twitter, WhatsApp, and Facebook. The inclusion criteria to participate in this study were adults who live in Saudi Arabia (Saudis or non-Saudis) and had two doses of COVID-19 vaccinations. Result: 3486 participants were included in this study, and 67.5% of the participants had side effects after the first dose. Similarly, 66.7% of the study participants had side effects after administering the second dose. Our data showed that most participants were unsure if the heterologous COVID-19 vaccination could cause severe side effects. In addition, 47.6% of the participants refused to receive a different generic type of COVID-19 vaccine due to fear of health problems. However, most participants obtained information regarding COVID-19 vaccination from the Saudi Ministry of Health. Conclusions: We found a low level of acceptance for receiving different generic types of vaccines if the participants had a choice. Therefore, plans should focus on increasing the acceptance level among the Saudi population through official platforms such as the Saudi Ministry of Health and private clinics.
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Affiliation(s)
| | - Enas A. Sindy
- Collage of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Heba Dosh
- Collage of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Sumaya Z. Khayat
- Collage of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Lujain M. Alqarna
- Collage of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Wafa M. Sodagar
- Collage of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | | | - Hassan Alwafi
- Collage of Medicine, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Emad Salawati
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22254, Saudi Arabia
| | | | - Rakan Ekram
- School of Public Health and Health Informatics, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Rehab M. Bagadood
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Radi Alsafi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Hamza M. Assaggaf
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia
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Singhal C, Aremu TO, Garg P, Shah K, Okoro ON. Awareness of the Malaria Vaccine in India. Cureus 2022; 14:e29210. [PMID: 36262953 PMCID: PMC9574518 DOI: 10.7759/cureus.29210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/05/2022] Open
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Miao Y, Li Y, Zhang W, Wu J, Gu J, Wang M, Wei W, Ye B, Miao C, Tarimo CS, Dong W. The Psychological Experience of COVID-19 Vaccination and Its Impact on the Willingness to Receive Booster Vaccines among the Chinese Population: Evidence from a National Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095464. [PMID: 35564859 PMCID: PMC9100074 DOI: 10.3390/ijerph19095464] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/22/2022] [Accepted: 04/28/2022] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to assess the psychological experience of COVID-19 basic vaccination, the willingness to receive booster vaccines, and to determine their relationships among Chinese people. Between 6 August 2021 and 9 August 2021, a research firm performed a national cross-sectional online survey among Chinese individuals (aged over 18), using the snowball sampling approach, with 26,755 participants. Factor analysis and binary logistic regression were used to evaluate the existing associations. The overall COVID-19 vaccination psychological experience score of the participants was 25.83 (25.78~25.89; scores ranged from 7–35). A total of 93.83% (95%CI = 93.54~94.12) of respondents indicated a willingness to receive booster vaccines. After classifying psychological experiences associated with COVID-19 vaccination into positive and negative experiences and adjusting for confounding factors, for the former, the willingness to receive booster vaccines for participants with the highest scores of 13–15 was 3.933 times higher (OR = 3.933, 95%CI = 3.176~4.871) than participants who obtained scores of 3–9, and for the latter, the willingness to receive booster vaccines for participants with the highest scores of 19–20 was 8.871 times higher (OR = 8.871, 95%CI = 6.240~12.612) than participants who obtained scores of 4–13. Our study suggests that a good psychological experience with vaccination is positively associated with an increased willingness to receive booster vaccines.
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Affiliation(s)
- Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Wanliang Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Jian Wu
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Jianqin Gu
- Research Center for Lifestyle Medicine, School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China;
| | - Meiyun Wang
- Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 450003, China; (M.W.); (W.W.)
| | - Wei Wei
- Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 450003, China; (M.W.); (W.W.)
| | - Beizhu Ye
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Chengyuan Miao
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Clifford Silver Tarimo
- Department of Health Management, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; (Y.M.); (Y.L.); (W.Z.); (J.W.); (B.Y.); (C.M.); (C.S.T.)
- Henan Research Center for HTA, Zhengzhou 450001, China
| | - Wenyong Dong
- Department of Hypertension, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 450003, China; (M.W.); (W.W.)
- Correspondence: author: ; Tel.: +86-187-037-17579
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Herzum A, Burlando M, Molle MF, Micalizzi C, Cozzani E, Parodi A. Lichen planus flare following COVID-19 vaccination: A case report. Clin Case Rep 2021; 9:e05092. [PMID: 34934493 PMCID: PMC8650756 DOI: 10.1002/ccr3.5092] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/03/2021] [Indexed: 01/29/2023] Open
Abstract
We report the third case of cutaneous lichen planus (LP) following COVID-19 BNT162b2 vaccination in a 59-year-old woman with previous LP. The reactivation of LP in patients with dormant LP suggests a possible vaccine-induced immune dysregulation. We suggest that the already described vaccine-induced upregulation of Th1 response may play a relevant role in LP reactivation, through an increase in inflammatory cytokines involved in the pathogenesis of LP. Interestingly, LP has already been associated with vaccinations and viral infections including COVID-19 disease. However, the exact mechanism underlying LP (re)activation after Pfizer-BiotNtech COVID-19 vaccination is still widely unknown and needs to be further investigated.
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Affiliation(s)
- Astrid Herzum
- Department of DermatologyDi.S.SalSan Martino Polyclinic Hospital IRCCSUniversity of GenoaGenoaItaly
| | - Martina Burlando
- Department of DermatologyDi.S.SalSan Martino Polyclinic Hospital IRCCSUniversity of GenoaGenoaItaly
| | - Mattia F. Molle
- Department of DermatologyDi.S.SalSan Martino Polyclinic Hospital IRCCSUniversity of GenoaGenoaItaly
| | - Claudia Micalizzi
- Department of DermatologyDi.S.SalSan Martino Polyclinic Hospital IRCCSUniversity of GenoaGenoaItaly
| | - Emanuele Cozzani
- Department of DermatologyDi.S.SalSan Martino Polyclinic Hospital IRCCSUniversity of GenoaGenoaItaly
| | - Aurora Parodi
- Department of DermatologyDi.S.SalSan Martino Polyclinic Hospital IRCCSUniversity of GenoaGenoaItaly
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Oxford COVID-19 Vaccine Hesitancy in School Principals: Impacts of Gender, Well-Being, and Coronavirus-Related Health Literacy. Vaccines (Basel) 2021; 9:vaccines9090985. [PMID: 34579222 PMCID: PMC8471420 DOI: 10.3390/vaccines9090985] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 01/04/2023] Open
Abstract
Purposes: To explore the associated factors of COVID-19 vaccine hesitancy and examine psychometric properties of the coronavirus-related health literacy questionnaire (HLS-COVID-Q22) and Oxford COVID-19 Vaccine Hesitancy questionnaire. Methods: An online survey was conducted from 23 June to 16 July 2021 on 387 school principals across Taiwan. Data collection included socio-demographic characteristics, information related to work, physical and mental health, COVID-19 related perceptions, sense of coherence, coronavirus-related health literacy, and vaccine hesitancy. Principal component analysis, correlation analysis, linear regression models were used for validating HLS-COVID-Q22, Oxford COVID-19 Vaccine Hesitancy, and examining the associations. Results: HLS-COVID-Q22 and Oxford COVID-19 Vaccine Hesitancy were found with satisfactory construct validity (items loaded on one component with factor loading values range 0.57 to 0.81, and 0.51 to 0.78), satisfactory convergent validity (item-scale correlations range 0.60 to 0.79, and 0.65 to 0.74), high internal consistency (Cronbach’s alpha = 0.96 and 0.90), and without floor or ceiling effects (percentages of possibly lowest score and highest score <15%), respectively. Low scores of vaccine hesitancy were found in male principals (regression coefficient, B, −0.69; 95% confidence interval, 95%CI, −1.29, −0.10; p = 0.023), principals with better well-being (B, −0.25; 95%CI, −0.47, −0.03; p = 0.029), and higher HLS-COVID-Q22 (B, −1.22; 95%CI, −1.89, −0.54; p < 0.001). Conclusions: HLS-COVID-Q22 and Oxford COVID-19 Vaccine Hesitancy were valid and reliable tools. Male principals and those with better well-being, and higher health literacy had a lower level of vaccine hesitancy. Improving principals’ health literacy and well-being is suggested to be a strategic approach to increase vaccine acceptance for themselves, their staff, and students.
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Riccò M, Ferraro P, Peruzzi S, Balzarini F, Ranzieri S. Mandate or Not Mandate: Knowledge, Attitudes, and Practices of Italian Occupational Physicians towards SARS-CoV-2 Immunization at the Beginning of Vaccination Campaign. Vaccines (Basel) 2021; 9:889. [PMID: 34452014 PMCID: PMC8402502 DOI: 10.3390/vaccines9080889] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 12/21/2022] Open
Abstract
Vaccinations used to prevent coronavirus disease (COVID-19)-the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-are critical in order to contain the ongoing pandemic. However, SARS-CoV-2/COVID-19 vaccination rates have only slowly increased since the beginning of the vaccination campaign, even with at-risk workers (e.g., HCWs), presumptively because of vaccine hesitancy. Vaccination mandates are considered instrumental in order to rapidly improve immunization rates (but they minimize the impact of vaccination campaigns). In this study, we investigated the acceptance (i.e., knowledge, attitudes, and practices) from occupational physicians (OPs)) in regard to SARS-CoV-2/COVID-19 vaccination mandates. A total of 166 OPs participated in an internet-based survey by completing structured questionnaires. Adequate, general knowledge of SARS-CoV-2/COVID-19 was found in the majority of OPs. High perception of SARS-CoV-2 risk was found in around 80% of participants (79.5% regarding its occurrence, 81.9% regarding its potential severity). SARS-CoV-2/COVID-19 vaccination was endorsed by 90.4% of respondents, acceptance for SARS-CoV-2 vaccine was quite larger for mRNA formulates (89.8%) over adenoviral ones (59.8%). Endorsement of vaccination mandates was reported by 60.2% of respondents, and was more likely endorsed by OPs who exhibited higher concern for SARS-CoV-2 infection occurrence (odds ratio 3.462, 95% confidence intervals 1.060-11.310), who were likely to accept some sort of payment/copayment for SARS-CoV-2/COVID-19 vaccination (3.896; 1.607; 9.449), or who were more likely to believe HCWs not vaccinates against SARS-CoV-2 as unfit for work (4.562; 1.935; 10.753). In conclusion, OPs exhibited wide acceptance of SARS-CoV-2/COVID-19 vaccinations, and the majority endorsed vaccination mandates for HCWs, which may help improve vaccination rates in occupational settings.
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Affiliation(s)
- Matteo Riccò
- Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS di Reggio Emilia, I-42122 Reggio Emilia, RE, Italy
| | - Pietro Ferraro
- Hospital S Camillo De Lellis, Occupational Health and Safety Service, ASL Foggia, I-41121 Foggia, FG, Italy;
| | - Simona Peruzzi
- Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, I-42016 Guastalla, RE, Italy;
| | - Federica Balzarini
- Dipartimento P.A.A.P.S.S., Servizio Autorizzazione e Accreditamento, Agenzia di Tutela della Salute (ATS) di Bergamo, I-24121 Bergamo, BG, Italy;
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, I-43126 Parma, PR, Italy;
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