1
|
Crooks K, Taylor K, Burns K, Campbell S, Degeling C, Williams J, Andrews R, Massey P, McVernon J, Miller A. Having a real say: findings from first nations community panels on pandemic influenza vaccine distribution. BMC Public Health 2023; 23:2377. [PMID: 38037021 PMCID: PMC10691077 DOI: 10.1186/s12889-023-17262-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Recent deliberations by Australian public health researchers and practitioners produced an ethical framework of how decisions should be made to distribute pandemic influenza vaccine. The outcome of the deliberations was that the population should be considered in two categories, Level 1 and Level 2, with Level 1 groups being offered access to the pandemic influenza vaccine before other groups. However, the public health researchers and practitioners recognised the importance of making space for public opinion and sought to understand citizens values and preferences, especially First Nations peoples. METHODS We conducted First Nations Community Panels in two Australian locations in 2019 to assess First Nations people's informed views through a deliberative process on pandemic influenza vaccination distribution strategies. Panels were asked to make decisions on priority levels, coverage and vaccine doses. RESULTS Two panels were conducted with eighteen First Nations participants from a range of ages who were purposively recruited through local community networks. Panels heard presentations from public health experts, cross-examined expert presenters and deliberated on the issues. Both panels agreed that First Nations peoples be assigned Level 1 priority, be offered pandemic influenza vaccination before other groups, and be offered two doses of vaccine. Reasons for this decision included First Nations people's lives, culture and families are important; are at-risk of severe health outcomes; and experience barriers and challenges to accessing safe, quality and culturally appropriate healthcare. We found that communication strategies, utilising and upskilling the First Nations health workforce, and targeted vaccination strategies are important elements in pandemic preparedness and response with First Nations peoples. CONCLUSIONS First Nations Community Panels supported prioritising First Nations peoples for pandemic influenza vaccination distribution and offering greater protection by using a two-dose full course to fewer people if there are initial supply limitations, instead of one dose to more people, during the initial phase of the vaccine roll out. The methodology and findings can help inform efforts in planning for future pandemic vaccination strategies for First Nations peoples in Australia.
Collapse
Affiliation(s)
- Kristy Crooks
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.
- Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.
| | - Kylie Taylor
- Population Health, Hunter New England Local Health District, Tamworth, NSW, Australia
| | - Kiara Burns
- Wuchopperen Health Service, Cairns, QLD, Australia
| | - Sandy Campbell
- Faculty of Health, Charles Darwin University, Casuarina, NT, Australia
| | - Chris Degeling
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, School of Health and Society, Wollongong, NSW, Australia
| | - Jane Williams
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, School of Health and Society, Wollongong, NSW, Australia
| | - Ross Andrews
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Peter Massey
- Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
| | - Jodie McVernon
- Victorian Infectious Disease Reference Laboratory Epidemiology Unit, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Adrian Miller
- Office of Indigenous Engagement, Central Queensland University, Townsville, QLD, Australia
| |
Collapse
|
2
|
Marcato AJ, Smith MZ, Fielding JE, Massey PD, McVernon J. Evaluation of the Australian first few X household transmission project for COVID-19. BMC Public Health 2023; 23:41. [PMID: 36609291 PMCID: PMC9817235 DOI: 10.1186/s12889-023-14979-3] [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: 07/22/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The Australian First Few X (FFX) Household Transmission Project for COVID-19 was the first prospective, multi-jurisdictional study of its kind in Australia. The project was undertaken as a partnership between federal and state health departments and the Australian Partnership for Preparedness Research on Infectious Disease Emergencies (APPRISE) and was active from April to October 2020. METHODS We aimed to identify and explore the challenges and strengths of the Australian FFX Project to inform future FFX study development and integration into pandemic preparedness plans. We asked key stakeholders and partners involved with implementation to identify and rank factors relating to the strengths and challenges of project implementation in two rounds of modified Delphi surveys. Key representatives from jurisdictional health departments were then interviewed to contextualise findings within public health processes and information needs to develop a final set of recommendations for FFX study development in Australia. RESULTS Four clear recommendations emerged from the evaluation. Future preparedness planning should aim to formalise and embed partnerships between health departments and researchers to help better integrate project data collection into core public health surveillance activities. The development of functional, adaptable protocols with pre-established ethics and governance approvals and investment in national data infrastructure were additional priority areas noted by evaluation participants. CONCLUSION The evaluation provided a great opportunity to consolidate lessons learnt from the Australian FFX Household Transmission Project. The developed recommendations should be incorporated into future pandemic preparedness plans in Australia to enable effective implementation and increase local utility and value of the FFX platform within emergency public health response.
Collapse
Affiliation(s)
- Adrian J. Marcato
- grid.1008.90000 0001 2179 088XDepartment of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, 3000 Australia
| | - Miranda Z. Smith
- grid.1008.90000 0001 2179 088XDepartment of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, 3000 Australia
| | - James E. Fielding
- grid.1008.90000 0001 2179 088XDepartment of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, 3000 Australia ,grid.1008.90000 0001 2179 088XVictorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, 3000 Australia
| | - Peter D. Massey
- grid.1011.10000 0004 0474 1797College of Medicine and Dentistry, James Cook University, Cairns, QLD Australia ,grid.3006.50000 0004 0438 2042Hunter New England Local Health District, Population Health, Tamworth, NSW Australia
| | - Jodie McVernon
- grid.1008.90000 0001 2179 088XDepartment of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, 3000 Australia ,grid.1008.90000 0001 2179 088XVictorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, 3000 Australia
| |
Collapse
|
3
|
The ongoing value of first few X studies for COVID-19 in the Western Pacific Region. Western Pac Surveill Response J 2022; 13:1-3. [PMID: 35402064 PMCID: PMC8989625 DOI: 10.5365/wpsar.2022.13.1.873] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
|
4
|
Roguski KM, Rolfes MA, Reich JS, Owens Z, Patel N, Fitzner J, Cozza V, Lafond KE, Azziz-Baumgartner E, Iuliano AD. Variability in published rates of influenza-associated hospitalizations: A systematic review, 2007-2018. J Glob Health 2021; 10:020430. [PMID: 33274066 PMCID: PMC7699004 DOI: 10.7189/jogh.10.020430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Influenza burden estimates help provide evidence to support influenza prevention and control programs at local and international levels. Methods Through a systematic review, we aimed to identify all published articles estimating rates of influenza-associated hospitalizations, describe methods and data sources used, and identify regions of the world where estimates are still lacking. We evaluated study heterogeneity to determine if we could pool published rates to generate global estimates of influenza-associated hospitalization. Results We identified 98 published articles estimating influenza-associated hospitalization rates from 2007-2018. Most articles (65%) identified were from high-income countries, with 34 of those (53%) presenting estimates from the United States. While we identified fewer publications (18%) from low- and lower-middle-income countries, 50% of those were published from 2015-2018, suggesting an increase in publications from lower-income countries in recent years. Eighty percent (n = 78) used a multiplier approach. Regression modelling techniques were only used with data from upper-middle or high-income countries where hospital administrative data was available. We identified variability in the methods, case definitions, and data sources used, including 91 different age groups and 11 different categories of case definitions. Due to the high observed heterogeneity across articles (I2>99%), we were unable to pool published estimates. Conclusions The variety of methods, data sources, and case definitions adapted locally suggests that the current literature cannot be synthesized to generate global estimates of influenza-associated hospitalization burden.
Collapse
Affiliation(s)
| | - Melissa A Rolfes
- US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Jeremy S Reich
- US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Zachary Owens
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, Georgia, USA
| | - Neha Patel
- US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Julia Fitzner
- World Health Organization, Global Influenza Programme, Geneva, Switzerland
| | - Vanessa Cozza
- World Health Organization, Global Influenza Programme, Geneva, Switzerland
| | - Kathryn E Lafond
- US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | | | - A Danielle Iuliano
- US Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| |
Collapse
|
5
|
Schoch-Spana M, Brunson EK, Gwon H, Regenberg A, Toner ES, Daugherty-Biddison EL. Influence of Community and Culture in the Ethical Allocation of Scarce Medical Resources in a Pandemic Situation: Deliberative Democracy Study. J Particip Med 2020; 12:e18272. [PMID: 33064107 PMCID: PMC7141421 DOI: 10.2196/18272] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Stark gaps exist between projected health needs in a pandemic situation and the current capacity of health care and medical countermeasure systems. Existing pandemic ethics discussions have advocated to engage the public in scarcity dilemmas and attend the local contexts and cultural perspectives that shape responses to a global health threat. This public engagement study thus considers the role of community and culture in the ethical apportionment of scarce health resources, specifically ventilators, during an influenza pandemic. It builds upon a previous exploration of the values and preferences of Maryland residents regarding how a finite supply of mechanical ventilators ought to be allocated during a severe global outbreak of influenza. An important finding of this earlier research was that local history and place within the state engendered different ways of thinking about scarcity. OBJECTIVE Given the intrastate variation in the themes expressed by Maryland participants, the project team sought to examine interstate differences by implementing the same protocol elsewhere to answer the following questions. Does variation in ethical frames of reference exist within different regions of the United States? What practical implications does evidence of sameness and difference possess for pandemic planners and policymakers at local and national levels? METHODS Research using the same deliberative democracy process from the Maryland study was conducted in Central Texas in March 2018 among 30 diverse participants, half of whom identified as Hispanic or Latino. Deliberative democracy provides a moderated process through which community members can learn facts about a public policy matter from experts and explore their own and others' views. RESULTS Participants proposed that by evenly distributing supplies of ventilators and applying clear eligibility criteria consistently, health authorities could enable fair allocation of scarce lifesaving equipment. The strong identification, attachment, and obligation of persons toward their nuclear and extended families emerged as a distinctive regional and ethnic core value that has practical implications for the substance, administration, and communication of allocation frameworks. CONCLUSIONS Maryland and Central Texas residents expressed a common, overriding concern about the fairness of allocation decisions. Central Texas deliberants, however, more readily expounded upon family as a central consideration. In Central Texas, family is a principal, culturally inflected lens through which life and death matters are often viewed. Conveners of other pandemic-related public engagement exercises in the United States have advocated the benefits of transparency and inclusivity in developing an ethical allocation framework; this study demonstrates cultural competence as a further advantage.
Collapse
Affiliation(s)
- Monica Schoch-Spana
- Johns Hopkins Center for Health Security, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Emily K Brunson
- Department of Anthropology, Texas State University, San Marcos, TX, United States
| | - Howard Gwon
- Department of Environmental Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Alan Regenberg
- Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, United States
| | - Eric S Toner
- Johns Hopkins Center for Health Security, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Elizabeth L Daugherty-Biddison
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| |
Collapse
|
6
|
Dueger E, Peters L, Ailan L. Marking the 1918 influenza pandemic centennial: addressing regional influenza threats through the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies. Western Pac Surveill Response J 2019; 9:1-4. [PMID: 31832245 PMCID: PMC6902656 DOI: 10.5365/wpsar.2018.9.5.000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Western Pacific Region (WPR) is home to nearly 1.9 billion people. Over the past decades, the Region has experienced a number of significant emerging infectious disease events, including human infections with avian influenza viruses. Health security threats continue and become even more complex in this highly interconnected world. With humans and animals living in close proximity, the Western Pacific region provides an ideal environment for influenza viruses to pass from animals to humans, potentially mutate and spread globally in a rapid manner. In efforts to prevent or mitigate the next pandemic, WPR has been working together to ensure a strong regional human-animal-environmental influenza surveillance system is in place for rapid detection, identification, reporting and response to any events with pandemic potential.
Collapse
Affiliation(s)
- Erica Dueger
- WHO Health Emergencies Programme, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Lisa Peters
- WHO Health Emergencies Programme, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Li Ailan
- WHO Health Emergencies Programme, WHO Regional Office for the Western Pacific, Manila, Philippines
| |
Collapse
|
7
|
McHugh L, Crooks K, Creighton A, Binks M, Andrews RM. Safety, equity and monitoring: a review of the gaps in maternal vaccination strategies for Aboriginal and Torres Strait Islander women. Hum Vaccin Immunother 2019; 16:371-376. [PMID: 31368832 DOI: 10.1080/21645515.2019.1649552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Influenza and pertussis infections are disproportionately higher among Aboriginal and Torres Strait Islander women and their infants compared to other Australians. These infections are potentially preventable through vaccination in pregnancy; however, there is a lack of systematic monitoring and therefore knowledge of vaccine uptake, safety and effectiveness in Australia, and specifically among Aboriginal and Torres Strait Islander women. The limited data available suggest there is a lower uptake of maternal vaccination among Aboriginal and Torres Strait Islander women compared to non-Aboriginal and Torres Strait Islander women, and this review seeks to explore potential reasons and the knowledge gaps in this regard. Other key gaps include the equitable access to quality antenatal care for Aboriginal and Torres Strait Islander women; and pregnancy loss <20 weeks gestation. Furthermore, our review highlights the importance of addressing these gaps in maternal vaccination strategies in partnership with Aboriginal and Torres Strait Islander peoples.
Collapse
Affiliation(s)
- Lisa McHugh
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Kristy Crooks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia.,Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Amy Creighton
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Michael Binks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia.,Department of Population Health, National Centre for Epidemiology, Australian National University, Canberra, Australian Capital Territory, Australia
| |
Collapse
|