Potential effects of a sugar-sweetened beverages tax on socioeconomic inequalities in health

Background

Sugar-Sweetened Beverages (SSBs) taxes have been implemented in several countries, however, little is known on how an SSBs tax may impact on low and high socioeconomic groups differently. Therefore, the aim of this study was to gain insight into the perceptions of different stakeholder groups in the Netherlands on (1) the contribution of an SSBs tax to socioeconomic inequalities in diet and health and (2) the mechanisms via which an SSBs tax may influence these inequalities.

Methods

Semi-structured interviews were held in the Netherlands in March-May 2019 with 27 participants from the following stakeholder groups: health and consumer organisations, health professional associations, advisory bodies, scientists, trade organisations, policy makers, and politicians. Interview transcripts were analysed following a thematic content approach.

Results

Participants from all stakeholder groups indicated that an SSBs tax would have a larger impact on the budget and SSB consumption of lower socioeconomic groups. With that, an SSBs tax could have larger health benefits among lower socioeconomic groups as a result of cutting down on SSBs. A few participants - from science and a health professional association - discussed possible unwanted effects of an SSBs tax (e.g. lower socioeconomic groups may compensate their lower SSB consumption with other unhealthy behaviour). Some participants emphasised that an SSB tax should only be introduced when accompanied by other measures (e.g. educational efforts, offering healthy alternatives).

Conclusions

Our results imply that most stakeholders agree that an SSBs tax could contribute to a reduction of socioeconomic inequalities in diet and health. However, in order to be effective and to prevent that an SSBs tax leads to a widening of inequalities, it is important to carefully monitor behavioural changes of socioeconomic groups in response to an SSBs tax, and to implement an SSBs tax as part of a comprehensive policy approach.

Key messages

An SSBs tax could contribute to a reduction of socioeconomic inequalities in health, according to Dutch stakeholders. It is important to carefully monitor behavioural changes of socioeconomic groups in response to an SSBs tax, and to implement an SSBs tax as part of a comprehensive policy approach.

Kinetics of humoral immune response after rabies VR-G oral vaccination of captive fox cubs (Vulpes vulpes) with or without maternally derived antibodies against the vaccine

In western Europe during the spring, the largest proportion of fox populations are cubs and the key to successful rabies oral vaccination campaigns is cub vaccination. In this paper we report on studies of the serology of 93 fox (Vulpes vulpes) cubs born to unvaccinated and orally vaccinated captive vixens, some of which were orally vaccinated at 30 or at 90 days of age with the vaccinia recombinant vaccine (VR-G) that expresses the rabies virus glycoprotein. The duration of cub passively acquired antibody, the development of immune responses to oral vaccination at either 30 or 90 days of age, possible interference between passive and active immunity to such vaccination and resistance to a potentially lethal rabies challenge dose when five months old were measured. The study showed that rabies neutralising antibody can be passed to their cubs by vixens orally vaccinated with VR-G during pregnancy. Maternally derived antibody titres in cubs declined with time and disappeared by 45-75 days after birth. Thirty days old cubs serologically responded to oral vaccination. No interference between antibody of maternal origin and active immunity conferred by VR-G oral vaccination or between antibody of maternal origin and protection was observed. Thus, very young cub immunisation against rabies with VR-G per os is possible whatever the immune status of their mothers. Provided a vaccine-bait suitable for such young cubs exists, oral vaccination at den entrances with VR-G is a feasibility.

Humoral and cell-mediated immune responses of foxes (Vulpes vulpes) after experimental primary and secondary oral vaccination using SAG2 and V-RG vaccines

Humoral and cell-mediated immune responses of 36 captive foxes to two oral vaccines against rabies currently used for foxes in Europe were studied. The Street Alabama Dufferin (SAD) mutant Gif (SAG2) vaccine has been selected by double mutation from the SAD virus. The vaccinia recombinant virus (V-RG) expresses the rabies glycoprotein. Both vaccines induce similar humoral and cell-mediated responses after primary and secondary oral administration. We observed a typical anamnestic response, although of a limited duration, after the booster vaccination. Therefore, our results suggested that two successive oral vaccination campaigns should not significantly improve the immunisation of foxes. Lymphocyte in vitro proliferative response to the SAD antigen highlighted the presence in blood of a T-cell specific memory 6 months after vaccination. The synthesis of several vulpine cytokines was detected in peripheral blood mononuclear cells (PBMC) stimulated by SAD antigen via reverse transcription polymerase chain amplification. The data showed a concomitant expression of interleukin (IL)-4 and interferon-gamma in PBMC of vaccinated foxes. No change was detected in the level of IL-2, IL-10 and IL-12 synthesis, whereas the pro-inflammatory cytokine tumour necrosis factor-alpha seemed involved in the activation of naive T lymphocytes.

Comparison of visual microscopic and computer-automated fluorescence detection of rabies virus neutralizing antibodies

The rapid fluorescent focus inhibition test (RFFIT) and the fluorescent antibody virus neutralization test (FAVNT) are both diagnostic tests for determining levels of rabies neutralizing antibodies. An automated method for determining fluorescence has been implemented to reduce the work time required for fluorescent visual microscopic observations. The automated method offers several advantages over conventional visual observation, such as the ability to rapidly test many samples. The antibody titers obtained with automated techniques were similar to those obtained with both the RFFIT (n = 165, r = 0.93, P < 0.001) and the FAVNT (n = 52, r = 0.99, P < 0.001).