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The coronavirus disease 2019 (Covid-19) pandemic has forced us to reconsider the relationship between public and private research and development (R&D). The policy issue is whether, over the next years, governments' only negotiating position on vaccines and biomedical technologies will be to sign one purchase contract after another and transfer value from taxpayers to investors in pharmaceutical companies. Knowledge and technologies that are crucial to Covid-19 messenger ribonucleic acid vaccine development and production were created with the R&D and financial contribution of governments. Patents filed by pharma companies do not protect the public interest arising from such earlier research. The paper offers a case study on the privatization of knowledge created in the first place by R&D in the public sector or supported by public funds and eventually being appropriated by pharmaceutical corporations. The privatization of knowledge is a more general mechanism, relevant in all industries where patents protect corporate R&D which in turn is supported by government direct or indirect subsidies. [ABSTRACT FROM AUTHOR]

This paper estimates the dynamic effect of vaccination on mortality from COVID-19 using weekly data from 26 European Union countries during 2021. Our analysis relies on the double machine learning method to control for multiple confounders, including nonpharmaceutical interventions, climate variables, mobility factors, variants of concern, country- and week-specific shocks. In our baseline specification, we show that a 10 percentage point increase in cumulative doses per hundred inhabitants averts 5.08 COVID-19 deaths per million inhabitants at the eight-week horizon and 26.41 deaths in the eight-week time window considered. The average reduction in mortality in this window is close to 50%. Further estimates reveal that the effect of doses administered to adults aged 18–59 does not statistically differ from that of doses received by people aged 60 and over. Finally, vaccine-specific estimates document that mRNA-1273 (Moderna) and Vaxzevria (AstraZeneca) are more cost-effective in saving lives than Comirnaty (Pfizer), while we are unable to demonstrate any effect of Ad26.COV2.S (Johnson & Johnson). [ABSTRACT FROM AUTHOR]

In response to the rapidly evolving coronavirus disease 2019 (COVID-19) pandemic, the All of Us Research Program longitudinal cohort study developed the COVID-19 Participant Experience (COPE) survey to better understand the pandemic experiences and health impacts of COVID-19 on diverse populations within the United States. Six survey versions were deployed between May 2020 and March 2021, covering mental health, loneliness, activity, substance use, and discrimination, as well as COVID-19 symptoms, testing, treatment, and vaccination. A total of 104,910 All of Us Research Program participants, of whom over 73% were from communities traditionally underrepresented in biomedical research, completed 275,201 surveys; 9,693 completed all 6 surveys. Response rates varied widely among demographic groups and were lower among participants from certain racial and ethnic minority populations, participants with low income or educational attainment, and participants with a Spanish language preference. Survey modifications improved participant response rates between the first and last surveys (13.9% to 16.1%, P  < 0.001). This paper describes a data set with longitudinal COVID-19 survey data in a large, diverse population that will enable researchers to address important questions related to the pandemic, a data set that is of additional scientific value when combined with the program's other data sources. [ABSTRACT FROM AUTHOR]

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has decreasing protection from acquiring any infection with emergence of new variants; however, vaccination continues to protect against progression to severe coronavirus disease 2019 (COVID-19). The impact of vaccination status on symptoms over time is less clear. Methods Within a randomized trial on early outpatient COVID-19 therapy testing metformin, ivermectin, and/or fluvoxamine, participants recorded symptoms daily for 14 days. Participants were given a paper symptom diary allowing them to circle the severity of 14 symptoms as none (0), mild (1), moderate (2), or severe (3). This is a secondary analysis of clinical trial data on symptom severity over time using generalized estimating equations comparing those unvaccinated, SARS-CoV-2 vaccinated with primary vaccine series only, or vaccine-boosted. Results The parent clinical trial prospectively enrolled 1323 participants, of whom 1062 (80%) prospectively recorded some daily symptom data. Of these, 480 (45%) were unvaccinated, 530 (50%) were vaccinated with primary series only, and 52 (5%) vaccine-boosted. Overall symptom severity was least for the vaccine-boosted group and most severe for unvaccinated at baseline and over the 14 days (P <.001). Individual symptoms were least severe in the vaccine-boosted group including cough, chills, fever, nausea, fatigue, myalgia, headache, and diarrhea, as well as smell and taste abnormalities. Results were consistent over Delta and Omicron variant time periods. Conclusions SARS-CoV-2 vaccine-boosted participants had the least severe symptoms during COVID-19, which abated the quickest over time. Clinical Trial Registration. NCT04510194. [ABSTRACT FROM AUTHOR]

STUDY QUESTION To what extent is preconception maternal or paternal coronavirus disease 2019 (COVID-19) vaccination associated with miscarriage incidence? SUMMARY ANSWER COVID-19 vaccination in either partner at any time before conception is not associated with an increased rate of miscarriage. WHAT IS KNOWN ALREADY Several observational studies have evaluated the safety of COVID-19 vaccination during pregnancy and found no association with miscarriage, though no study prospectively evaluated the risk of early miscarriage (gestational weeks [GW] <8) in relation to COVID-19 vaccination. Moreover, no study has evaluated the role of preconception vaccination in both male and female partners. STUDY DESIGN, SIZE, DURATION An Internet-based, prospective preconception cohort study of couples residing in the USA and Canada. We analyzed data from 1815 female participants who conceived during December 2020–November 2022, including 1570 couples with data on male partner vaccination. PARTICIPANTS/MATERIALS, SETTING, METHODS Eligible female participants were aged 21–45 years and were trying to conceive without use of fertility treatment at enrollment. Female participants completed questionnaires at baseline, every 8 weeks until pregnancy, and during early and late pregnancy; they could also invite their male partners to complete a baseline questionnaire. We collected data on COVID-19 vaccination (brand and date of doses), history of SARS-CoV-2 infection (yes/no and date of positive test), potential confounders (demographic, reproductive, and lifestyle characteristics), and pregnancy status on all questionnaires. Vaccination status was categorized as never (0 doses before conception), ever (≥1 dose before conception), having a full primary sequence before conception, and completing the full primary sequence ≤3 months before conception. These categories were not mutually exclusive. Participants were followed up from their first positive pregnancy test until miscarriage or a censoring event (induced abortion, ectopic pregnancy, loss to follow-up, 20 weeks' gestation), whichever occurred first. We estimated incidence rate ratios (IRRs) for miscarriage and corresponding 95% CIs using Cox proportional hazards models with GW as the time scale. We used propensity score fine stratification weights to adjust for confounding. MAIN RESULTS AND THE ROLE OF CHANCE Among 1815 eligible female participants, 75% had received at least one dose of a COVID-19 vaccine by the time of conception. Almost one-quarter of pregnancies resulted in miscarriage, and 75% of miscarriages occurred <8 weeks' gestation. The propensity score-weighted IRR comparing female participants who received at least one dose any time before conception versus those who had not been vaccinated was 0.85 (95% CI: 0.63, 1.14). COVID-19 vaccination was not associated with increased risk of either early miscarriage (GW: <8) or late miscarriage (GW: 8–19). There was no indication of an increased risk of miscarriage associated with male partner vaccination (IRR = 0.90; 95% CI: 0.56, 1.44). LIMITATIONS, REASONS FOR CAUTION The present study relied on self-reported vaccination status and infection history. Thus, there may be some non-differential misclassification of exposure status. While misclassification of miscarriage is also possible, the preconception cohort design and high prevalence of home pregnancy testing in this cohort reduced the potential for under-ascertainment of miscarriage. As in all observational studies, residual or unmeasured confounding is possible. WIDER IMPLICATIONS OF THE FINDINGS This is the first study to evaluate prospectively the relation between preconception COVID-19 vaccination in both partners and miscarriage, with more complete ascertainment of early miscarriages than earlier studies of vaccination. The findings are informative for individuals planning a pregnancy and their healthcare providers. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Health [R01-HD086742 (PI: L.A.W.); R01-HD105863S1 (PI: L.A.W. and M.L.E.)], the National Institute of Allergy and Infectious Diseases (R03-AI154544; PI: A.K.R.), and the National Science Foundation (NSF-1914792; PI: L.A.W.). The funders had no role in the study design, data collection, analysis and interpretation of data, writing of the report, or the decision to submit the paper for publication. L.A.W. is a fibroid consultant for AbbVie, Inc. She also receives in-kind donations from Swiss Precision Diagnostics (Clearblue home pregnancy tests) and Kindara.com (fertility apps). M.L.E. received consulting fees from Ro, Hannah, Dadi, VSeat, and Underdog, holds stock in Ro, Hannah, Dadi, and Underdog, is a past president of SSMR, and is a board member of SMRU. K.F.H. reports being an investigator on grants to her institution from UCB and Takeda, unrelated to this study. S.H.-D. reports being an investigator on grants to her institution from Takeda, unrelated to this study, and a methods consultant for UCB and Roche for unrelated drugs. The authors report no other relationships or activities that could appear to have influenced the submitted work. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

In high-income countries that were first to roll out coronavirus disease 2019 (COVID-19) vaccines, older adults have thus far usually been prioritized for these vaccines over younger adults. Age-based priority primarily resulted from interpreting evidence available at the time, which indicated that vaccinating the elderly first would minimize COVID-19 deaths and hospitalizations. The World Health Organization counsels a similar approach for all countries. This paper argues that some low- and middle-income countries that are short of COVID-19 vaccine doses might be justified in revising this approach and instead prioritizing certain younger persons when allocating current vaccines or future variant-specific vaccines. [ABSTRACT FROM AUTHOR]

The emergence of coronavirus disease-2019 (COVID-19) pandemic has stimulated governments to an extensive discussion on the necessity of COVID-19 vaccination certificate (CVC) to help monitor and manage the rollout of vaccinations and revive the economy. A recent correspondence highlighted the ethical issues concerning COVID-19 diagnostic test results and vaccination certificates. This paper highlights the potential benefits and harms of implementing CVC in the ASEAN region. [ABSTRACT FROM AUTHOR]

Summary: The occurrence of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) has been reported since the coronavirus disease 2019 (COVID-19) vaccination, but whether there is a causal relationship or coincidence remains to be verified. We combined the term COVID-19 vaccination with each word of AAV to search for case reports and case series published in PubMed, EMBASE, and Web of Science databases before 13 March 2023. A total of 56 patients who developed AAV after COVID-19 vaccination were identified from 44 research centers. Of the 56 subjects, 43 (76.7%) were vaccinated with the mRNA vaccine, followed by the adenovirus vaccine (14.3%) and inactivated vaccine (9.0%) (P = 0.015). Compared with relapsed AAV, new-onset AAV patients had at least two other diseases previously (P < 0.001). Twenty-five (44.6%) patients presented symptoms after the first injection, and the medium onset time was 12 (1–77) days, while Twenty-eight (50.0%) patients developed symptoms after the second dose, and their medium period was 14 (1–60) days. Forty-four (78.5%) patients achieved remission after immunosuppressive agents, plasma exchange, and hemodialysis. One (1.8%) patient died from progressive respiratory failure and nine (16.1%) did not recover, leaving five patients permanently dependent on hemodialysis. Pathogenic ANCA may be activated by enhanced immune response and epitope spreading after COVID-19 vaccination and induced the occurrence of AAV, especially in genetically susceptible populations. The occurrence of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) has been reported since the coronavirus disease 2019 (COVID-19) vaccination, but whether there is a causal relationship or coincidence remains to be verified. This paper explores the occurrence of AAV, especially in genetically susceptible populations. [ABSTRACT FROM AUTHOR]

In this paper, we estimate the path of daily SARS-CoV-2 infections in England from the beginning of the pandemic until the end of 2021. We employ a dynamic intensity model, where the mean intensity conditional on the past depends both on past intensity of infections and past realized infections. The model parameters are time-varying, and we employ a multiplicative specification along with logistic transition functions to disentangle the time-varying effects of nonpharmaceutical policy interventions, of different variants, and of protection (waning) of vaccines/boosters. Our model results indicate that earlier interventions and vaccinations are key to containing an infection wave. We consider several scenarios that account for more infectious variants and different protection levels of vaccines/boosters. These scenarios suggest that, as vaccine protection wanes, containing a new wave in infections and an associated increase in hospitalizations in the near future may require further booster campaigns and/or nonpharmaceutical interventions. [ABSTRACT FROM AUTHOR]

Background vaccination uptake in the UK and increased care home testing are likely affecting care home visitation. With scant scientific evidence to date, the aim of this longitudinal qualitative study was to explore the impact of both (vaccination and testing) on the conduct and experiences of care home visits. Methods family carers of care home residents with dementia and care home staff from across the UK took part in baseline (October/November 2020) and follow-up interviews (March 2021). Public advisers were involved in all elements of the research. Data were analysed using thematic analysis. Results across 62 baseline and follow-up interviews with family carers (n  = 26; 11) and care home staff (n  = 16; 9), five core themes were developed: delayed and inconsistent offers of face-to-face visits; procedures and facilitation of visits; variable uptake of the COVID-19 vaccine; misinformation, education and free choice; frustration and anger among family carers. The variable uptake in staff, compared to family carers, was a key factor seemingly influencing visitation, with a lack of clear guidance leading care homes to implement infection control measures and visitation rights differently. Conclusions we make five recommendations in this paper to enable improved care home visitation in the ongoing, and in future, pandemics. Visits need to be enabled and any changes to visiting rights must be used as a last resort, reviewed regularly in consultation with residents and carers and restored as soon as possible as a top priority, whilst more education needs to be provided surrounding vaccination for care home staff. [ABSTRACT FROM AUTHOR]

India with a population of 1.3 billion has a unique health care system in its different states. Mental health care varies widely across the country and this became even more apparent after the COVID-19 pandemic set in. This paper examines the various strategies in response to COVID-19 adopted by the Government of India, the health departments of the individual states, and other private players such as on-government organizations and the civil society. The cessation of many services including outpatient and inpatient care and the scarcity of medicines were serious impacts of COVID-19. The prolonged lockdown in many parts of the country impeded access to mental health care services since public transport was unavailable. This led to many relapses in persons with serious mental disorders. The emergence of new cases of psychosis and an increase in suicides were also seen. Tele consultations came to the fore and many helplines were started offering counseling and guidance regarding the availability of mental health care facilities. While these helped the urban dwellers, those in remote and rural areas were unable to use these services effectively. Many mental health wards were used for COVID-19 patients and mental health professionals were deployed for COVID-19 related duty. The severely mentally ill, the homeless mentally ill, and the elderly were especially vulnerable. Based on our experience with COVID-19, we urge a strong call for action, in terms of strengthening the primary care facilities and increasing the manpower resources to deliver mental health care. [ABSTRACT FROM AUTHOR]

In previous correspondence, it was explained that faking COVID-19 diagnostic tests and vaccination certifications posits serious concerns for matters of ethics and economics. With this, we suggest, in this paper, the importance of giving emphasis to being truthful in declaring their COVID-19 diagnostic test results and vaccination certificates. Also, in being truthful, it is emphasized in this paper that honesty and transparency in regard to the said results and certificates are necessary in ensuring public health and promoting awareness during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Vaccination is considered to be one of the greatest public health achievements in the 20th century. The coronavirus disease 2019 (COVID-19) has triggered a worldwide debate and legal exemption of vaccination and its possible consequences. Now that COVID-19 vaccination programme has started, there is immense pressure from the general public. Following the recent correspondence where the authors have rightly stated the need to take seriously the ethical issues under the COVID-19 vaccination, this paper highlights the ethical and legal impediments of 'no-jab, no-job clause' arising in many countries. [ABSTRACT FROM AUTHOR]

The Coronavirus disease 2019 (COVID-19) vaccination hesitancy is a concern that the world faces. The government and private sectors are initiating measures to address this problem. Media plays a crucial role in information and extensive dissemination. This paper highlights the role of the agenda setting platform in shaping public opinion on COVID-19 vaccination program. Massive information dissemination through media can be an effective tool in educating the public regarding the efficacy of anti-COVID 19 vaccines both for self-preservation and promotion of the common good. [ABSTRACT FROM AUTHOR]

The article presents the discussion on relevance of poverty and inequality as factors affecting the spread and mortality of the COVID-19 pandemic in Latin America. Topics include Peruvians lacking mass diagnostic testing due to the limitations intrinsic to the health system and socioeconomic inequalities; and COVID-19 vaccine strategy against vaccine hesitancy ending the pandemic and achieving sustainable recovery.

The losses from the global Covid-19 pandemic have been staggering—trillions in economic costs, on top of significant losses of life, health, and well-being. The world made significant and successful investments in vaccines to mitigate the pandemic, yet there were missed opportunities, as well. We review what has been learnt about the value of vaccines, the speed at which vaccines can be developed, and the optimal and ethical approaches to vaccine distribution, as well as other issues related to pandemic and emergency preparedness. Surprisingly, spending on vaccines remains far below that which would be justified by the social return. We remain poorly prepared for future pandemics and other emergencies. [ABSTRACT FROM AUTHOR]

In a recent correspondence, vaccine hesitancy and its pressing issue in possible delaying of being triumphant in the pandemic was discussed. This paper highlights vaccine nationalism as a predicament that would not just delay but worsen the present situation of the pandemic. This study suggests a global response among countries that people must see the world as a global village and as one community it must save collectively. [ABSTRACT FROM AUTHOR]

In recent correspondences, authors emphasized the need to consider vulnerable groups such as migrants, refugees, prisoners, and persons with disabilities in the interventions and plans of government and health authorities in combatting coronavirus disease 2019 (COVID-19). This paper discusses the urgent call for government and health authorities to ensure that indigenous peoples, being distinct ethnic communities, are included in the rolling out of COVID-19 vaccines with considerations to their unique culture, beliefs and traditions. [ABSTRACT FROM AUTHOR]

The public's trust in the COVID-19 vaccination program is still a problem, especially in the Philippines. Many have suggested that the government and even healthcare workers should exhaust all their efforts to educate the public about the nature of the vaccines. However, rebuilding public trust is not only a governmental concern, but should also be taken as a personal responsibility. Thus, this paper argues that mindfulness through critical thinking is a necessary key in boosting the vaccination program. [ABSTRACT FROM AUTHOR]

The pandemic's recessive effect on the global economy created a 'de-globalized' process that detrimentally causes financial turmoil to countries whose economy depends on tourism, urban passenger transport services and civil aviation, among others. The need to help the most vulnerable industries non-resilient to the pandemic reopen to aid economic recovery amid the pandemic's threat is a very urgent concern. With the move to start the vaccination program against the threat of Covid-19, faking Covid-19 diagnostic testing certification pose a severe problem to matters of ethics and economics. If not taken seriously, falsifying documents that certify a person who has undergone Covid-19 vaccination could also happen. This paper argues that everyone's collective effort could be the real embodiment of hope toward a new normal world immune from the virus and malpractices. [ABSTRACT FROM AUTHOR]

Due to the expedited production of the COVID-19 vaccines and other issues related to it, many Filipinos are hesitant to receive the inoculation program set by the government. Because of this, it is crucial to gain public trust for the COVID-19 vaccines. This paper argues that the Catholic Church, being an influential institution in the Philippines, can help in building public trust in COVID-19 vaccines in the country. [ABSTRACT FROM AUTHOR]

The article discusses COVID-19 vaccination rollout strategies developed and disseminated the World Health Organization referencing recent correspondence of Cordero. Topics discussed include role of government in COVID-19 vaccines procurement and rollout which is to be proactive, transparent and efficient; analyzes the urgent need to harness the Philippine government's strategic policy-making; and efficient implementation of COVID-19 vaccination rollout in Philippines.

COVID-19 is an infectious disease caused by a new coronavirus named SARS-CoV-2. The prevalence of the virus on a global scale led to a global health crisis which prompted countries like the Philippines to address the issue through the implementation of various health-related protocols, legislative laws, and COVID-19 mass vaccination programs for the establishment of herd immunity. Such government actions are undeniably significant in resolving the booming positive cases but the subjects (or who should receive the services) are, to some extent, unclear and overlooked the situation of 'Others' – the homeless. The author argues that the Philippine government, other social institutions, and organizations must consider the well-being of this group as one of the hidden disadvantaged individuals amid the crisis. [ABSTRACT FROM AUTHOR]

In a recent correspondence, the author discussed the issues of 'no-jab, no job' policy, which is planned to be implemented by governments and companies in many countries. This paper highlights the business sectors' initiatives in ensuring the implementation of health and safety protocols and vaccination program among employees during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background Tailored coronavirus disease 2019 (COVID-19) prevention strategies are needed for urban refugee youth in resource-constrained contexts. We developed an 8-wk interactive informational mobile health intervention focused on COVID-19 prevention practices informed by the Risk, Attitude, Norms, Ability, Self-regulation—or RANAS—approach. Methods We conducted a pre-post trial with a community-recruited sample of refugee youth aged 16–24 y in Kampala, Uganda. Data were collected before (T1) and immediately following (T2) the intervention, and at the 16-wk follow up (T3), to examine changes in primary (COVID-19 prevention self-efficacy) and secondary outcomes (COVID-19 risk awareness, attitudes, norms and self-regulation practices; depression; sexual and reproductive health [SRH] access; food/water security; COVID-19 vaccine acceptability). Results Participants (n=346; mean age: 21.2 [SD 2.6] y; cisgender women: 50.3%; cisgender men: 48.0%; transgender persons: 1.7%) were largely retained (T2: n=316, 91.3%; T3: n=302, 87.3%). In adjusted analyses, COVID-19 prevention self-efficacy, risk awareness, attitudes and vaccine acceptance increased significantly from T1 to T2, but were not sustained at T3. Between T1 and T3, COVID-19 norms and self-regulation significantly increased, while community violence, water insecurity and community SRH access decreased. Conclusions Digital approaches for behaviour change hold promise with urban refugee youth but may need booster messaging and complementary programming for sustained effects. [ABSTRACT FROM AUTHOR]

Background: High rates of vaccination are worldwide required to establish a herd immunity stopping the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. Methods: A systematic literature search was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Multiple databases were searched, namely PubMed and Web of Science, on February 24th, 2021 using a set of developed keywords. Inclusion criteria included the study to be 1) conducted in English; 2) investigated attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; 3) utilized validated measurements techniques; 4) have the full text paper available and 5) be peer-reviewed prior to final publication. The Newcastle Ottawa (NOS) scale for cross sectional studies was used to assess the quality of the studies. Results: 73 studies were included in qualitative synthesis. Overall, vaccine acceptance rates ranged from 23.6% in Kuwait to 94.3% in Malaysia and Nepal. A variety of different factors contributed to increased hesitancy, some of which included having negative perception of vaccine efficacy, safety, convenience and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, less educated, with lower income, with no insurance, living in the rural area and self-identified as a racial/ethnic minority. Conclusions: Vaccine hesitancy rates against COVID-19 vaccine ranged widely among across different populations. Identifying the factors that interplay and result in high hesitancy rates among a population can allow formulating a directed intervention to increase their vaccination uptake rates. Key messages: • It is necessary to understand the factors that contribute to the COVID-19 vaccine hesitancy. • It is important to inform policy-makers and formulate direct intervention measures that will successfully handle the pandemic. [ABSTRACT FROM AUTHOR]

There has been a stigma and hesitancy regarding COVID-19 vaccination in the Philippines. Many Filipinos are still hesitant to be vaccinated. This paper highlights the role of the Catholic Church as a powerful institution which can influence the people not only in spiritual aspect but also in promoting public health by motivating locals to get vaccinated. This task can be specifically done through the efforts of Catholic Higher Education Institutions (HEI) that place prominence and priority on social work and mission. [ABSTRACT FROM AUTHOR]

As COVID-19 cases rise in one of Southeast Asia's worst-hit nations, low public trust in vaccines will be a huge block in the government's vaccination program. In a recent survey in January 2021 which was conducted by Pulse Asia, nearly half of Filipinos said that they would not get vaccinated against COVID-19 due to safety concerns. A proposed solution would be a Multisectoral Approach (MSA). MSA refers to the deliberate collaboration among various stakeholder groups (e.g. government, civil society and private and religious sectors) and sectors (e.g. health, environment and economy) to achieve a policy outcome. By engaging multiple sectors, such as interfaith collaborations, governments can leverage knowledge, expertise, reach and resources, benefiting from their combined and varied strengths as they work toward the shared goal of building public trust on vaccines. [ABSTRACT FROM AUTHOR]

Background Knowing the duration of effectiveness of coronavirus disease 2019 (COVID-19) booster doses is essential to providing decision-makers with scientific arguments about the frequency of subsequent injections. We estimated the level of protection against COVID-19-related hospitalizations (Omicron BA.4-BA.5) over time after vaccination, accounting for breakthrough infections. Methods In this nationwide case–control study, all cases of hospitalizations for COVID-19 identified in the comprehensive French National Health Data System between June 1, 2022, and October 15, 2022, were matched with up to 10 controls by year of birth, sex, department, and an individual COVID-19 hospitalization risk score. Conditional logistic regressions were used to estimate the level of protection against COVID-19-related hospitalizations conferred by primary and booster vaccination, accounting for history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Results A total of 38 839 cases were matched to 377 653 controls; 19.2% and 9.9% were unvaccinated, respectively, while 68.2% and 77.7% had received ≥1 booster dose. Protection provided by primary vaccination reached 45% (95% CI, 42%–47%). The incremental effectiveness of booster doses ranged from 69% (95% CI, 67%–71%; ≤2 months) to 22% (95% CI, 19%–25%; ≥6 months). Specifically, the second booster provided an additional protection compared with the first ranging from 61% (95% CI, 59%–64%; ≤2 months) to 7% (95% CI, 2%–13%; ≥4 months). Previous SARS-CoV-2 infection conferred a strong, long-lasting protection (51% ≥20 months). There was no incremental effectiveness of a second booster among individuals infected since the first booster. Conclusions In the era of Omicron BA.4 and BA.5 predominance, primary vaccination still conferred protection against COVID-19 hospitalization, while booster doses provided an additional time-limited protection. The second booster had no additional protection in case of infection since the first booster. [ABSTRACT FROM AUTHOR]

Objectives To investigate the effect of either a booster vaccine (one dose) or revaccination (two doses 3 weeks apart) on the antibody response to the COVID-19 mRNA vaccines in patients with rheumatic disease (RD) treated with rituximab (RTX) who had not produced vaccine-reactive antibodies after the initial two vaccine doses. Further, to examine if B cell levels in peripheral blood predicted seroconversion. Methods We included 91 RTX-treated RD patients previously vaccinated against COVID-19. Patients were offered revaccination or a single booster vaccination with an mRNA vaccine. Serum total antibodies against SARS-CoV-2 spike protein were measured before and 6 weeks after the last vaccine dose. B cells (CD19+CD45+) were measured by flow cytometry at inclusion. Results Of RD patients with undetectable SARS-CoV-2 antibody levels before inclusion, seroconversion was seen in 38% 6 weeks after the booster dose and 32% after revaccination. Patients receiving revaccination had significantly higher antibody levels than patients receiving a booster dose (P  < 0.001). In both univariate and multivariate logistic regression analysis, only B cells higher than 10/µl before boost or revaccination were associated with seroconversion (P  = 0.009 and P  = 0.01, respectively). Seroconversion was independent of age, gender, diagnosis, cumulative RTX dose, RTX treatment time and time since last RTX treatment. Conclusion Continuously impaired humoral response to mRNA vaccines was found in most RTX-treated patients after a booster dose or revaccination. Seroconversion was observed in approximately one-third of the patients. Measurable B cells before boosting or revaccination was the strongest predictor of antibody response after boost or revaccination. [ABSTRACT FROM AUTHOR]

Health-care professionals (HCPs) are key trusted figures in addressing coronavirus disease 2019 (COVID-19) challenges. They are thought to influence others' health decisions by personal example. However, during the COVID-19 crisis, some HCPs hesitated to be vaccinated. We examined factors contributing to that decision. We performed 12 semi-structured interviews, between February and May 2021, with Israeli HCPs who had declined or delayed COVID-19 vaccination. Three coders conducted a combined top-down and bottom-up analysis. We identified four main themes shaping vaccine decision-making: (i) sources of information, (ii) perceptions of necessity and risks of the vaccine, (iii) individual versus collective responsibility and (iv) political climate and media influence. Participants were worried about long-term effectiveness and safety, and while many agreed that high-risk populations should be vaccinated, all considered themselves to be at low risk for serious disease. Some felt they should avoid taking a perceived risk (accepting a new vaccine) to protect society, although they felt pressured to do so. Vaccination campaign politization and the way the media approached the subject also contributed to mistrust and hesitancy to be vaccinated. These findings help us understand HCP beliefs and uncertainties about COVID-19 vaccinations. This study can help inform future campaigns targeted at HCPs to promote the acceptance of vaccines. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) vaccines are highly efficacious at preventing symptomatic infection, severe disease, and death. Most of the evidence that COVID-19 vaccines also reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is based on retrospective, observational studies. Specifically, an increasing number of studies are evaluating vaccine effectiveness against the secondary attack rate of SARS-CoV-2 using data available in existing health-care databases or contact-tracing databases. Since these types of databases were designed for clinical diagnosis or management of COVID-19, they are limited in their ability to provide accurate information on infection, infection timing, and transmission events. We highlight challenges with using existing databases to identify transmission units and confirm potential SARS-CoV-2 transmission events. We discuss the impact of common diagnostic testing strategies, including event-prompted and infrequent testing, and illustrate their potential biases in estimating vaccine effectiveness against the secondary attack rate of SARS-CoV-2. We articulate the need for prospective observational studies of vaccine effectiveness against the SARS-CoV-2 secondary attack rate, and we provide design and reporting considerations for studies using retrospective databases. [ABSTRACT FROM AUTHOR]

A recent correspondence highlighted the need to change the COVID-19 vaccine narrative to combat vaccine hesitancy by stressing that vaccination is a moral act. The said article was in response to another correspondence which said that science and religion must work together for vaccine promotion. This article presents a fundamental Christian argument for vaccine promotion by saying that God may have provided an answer to the pandemic through the COVID-19 vaccine. [ABSTRACT FROM AUTHOR]

The article discusses practice of religion through religious coping during Covid-19. Topics discussed include cooperation between psychiatry and religion showing that religious and spiritual practices can help people cope their stresses of life; governments' proposal on involuntary social isolation and downloads of top religious apps; and faith of people in the capacity of faith leaders to guide us in our spiritual journeys amidst one of the seminal events of the 21st century.

The article discusses vaccination hesitancy among people in Europe and U.S. with reference to the article published in "Journal of Public Health". Topics discussed include development of strategic approach against widespread misinformation and conspiracy theories on COVID-19 vaccines, research published by EU agency Eurofound on the vaccine hesitancy among adults in Europe, and progress on COVID-19 vaccination campaigns in US.

Ensuring global access for coronavirus disease-2019 (COVID-19) vaccines is key to avoiding severe COVID-19 disease and achieving herd immunity. This correspondence highlights the importance of advocating for effective and safe COVID-19 vaccines for low-income countries while ensuring equitable access to COVID-19 vaccines. Global access to COVID-19 vaccines for the common good is much needed. [ABSTRACT FROM AUTHOR]

A recently published correspondence proposed the involvement of private-owned companies in Coronavirus Disease 2019 (COVID-19) vaccination program. This article raises awareness that vaccine hesitancy could undermine the effectiveness of COVID-19 vaccination programs. This article proposes the idea of public participation: dialog-based approach, incentive-based (non-financial) approach and reminder-recall approach based on the World Health Organization guidelines. [ABSTRACT FROM AUTHOR]

Contemporary communication requires both a supply of content and a digital information infrastructure. Modern campaigns of misinformation are especially dependent on that back-end infrastructure for tracking and targeting a sympathetic audience and generating revenue that can sustain the campaign financially—if not enable profiteering. However, little is known about the political economy of misinformation, particularly those campaigns spreading misleading or harmful content about public health guidelines and vaccination programs. To understand the political economy of health misinformation, we analyze the content and infrastructure networks of 59 groups involved in communicating misinformation about vaccination programs. With a unique collection of tracker and communication infrastructure data, we demonstrate how the political economy of misinformation depends on platform monetization infrastructures. We offer a theory of communication resource mobilization that advances understanding of the communicative context, organizational interactions, and political outcomes of misinformation production. [ABSTRACT FROM AUTHOR]

Background The Omicron B.1.1.529 variant increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in doubly vaccinated individuals, particularly in the Oxford–AstraZeneca COVID-19 vaccine (ChAdOx1) recipients. To tackle infections, the UK's booster vaccination programmes used messenger ribonucleic acid (mRNA) vaccines irrespective of an individual's primary course vaccine type, and prioritized the clinically vulnerable. These mRNA vaccines included the Pfizer–BioNTech COVID-19 vaccine (BNT162b2) the Moderna COVID-19 vaccine (mRNA-1273). There is limited understanding of the effectiveness of different primary vaccination courses on mRNA booster vaccines against SARs-COV-2 infections and how time-varying confounders affect these evaluations. Methods Trial emulation was applied to a prospective community observational cohort in England and Wales to reduce time-varying confounding-by-indication driven by prioritizing vaccination based upon age, vulnerability and exposure. Trial emulation was conducted by meta-analysing eight adult cohort results whose booster vaccinations were staggered between 16 September 2021 and 05 January 2022 and followed until 23 January 2022. Time from booster vaccination until SARS-CoV-2 infection, loss of follow-up or end of study was modelled using Cox proportional hazard models and adjusted for age, sex, minority ethnic status, clinically vulnerability and deprivation. Results A total of 19 159 participants were analysed, with 11 709 ChAdOx1 primary courses and 7450 BNT162b2 primary courses. Median age, clinical vulnerability status and infection rates fluctuate through time. In mRNA-boosted adults, 7.4% (n  = 863) of boosted adults with a ChAdOx1 primary course experienced a SARS-CoV-2 infection compared with 7.7% (n  = 571) of those who had BNT162b2 as a primary course. The pooled adjusted hazard ratio (aHR) was 1.01 with a 95% confidence interval (CI) of: 0.90 to 1.13. Conclusion After an mRNA booster dose, we found no difference in protection comparing those with a primary course of BNT162b2 with those with a ChAdOx1 primary course. This contrasts with pre-booster findings where previous research shows greater effectiveness of BNT162b2 than ChAdOx1 in preventing infection. [ABSTRACT FROM AUTHOR]

Introduction Health care professionals cover the front line in the battle against infectious diseases. Vaccination of healthcare workers represents a vital element of the strategy for enhancing epidemic safety and improving the quality of health care, inter alia, by limiting microorganism transmission, and reducing patient morbidity and mortality. Method The study group consisted of all employees of the long-term health care centre in Lublin, Poland. Participants were requested to complete a questionnaire prepared for the purpose of the study, along with a mandatory COVID-19 vaccination interview questionnaire. Results The vaccination coverage rate for the group of medical workers was 77.3% and of non-medical 86%. The most frequently indicated sources of information on vaccination were the mass media. Males more often than females used the press as a source of information on vaccination. Scientific articles were the most common source of information for both people with higher education and medical professionals. The most common motive for vaccination for females is concern for the health of one's family, and for HCWs and people with at least secondary education-concern for the health of patients. Conclusion At least one assessed factor influences the decision to be vaccinated. The mass media are of the greatest importance in obtaining information about vaccination. [ABSTRACT FROM AUTHOR]

Objectives The effectiveness of the BNT162b2 mRNA COVID-19 vaccine for adolescents with juvenile-onset inflammatory or immune rheumatic diseases (IRDs) is unknown. Several studies have suggested attenuated immunogenicity in patients with IRD. This study evaluated the effectiveness of the BNT162b2 mRNA COVID-19 vaccine in preventing COVID-19 infection in adolescents with juvenile-onset IRD compared with controls without immune rheumatic disease. Methods We used data from Clalit Health Services, the largest health-care organization in Israel, to conduct an observational cohort study from February to December 2021, involving 12–18 year-old adolescents diagnosed with IRD. Study outcomes included documented COVID-19 infection in relation to vaccination status and immunomodulatory therapy. We estimated vaccine effectiveness as one minus the risk ratio. Adolescents aged 12–18 years without immune rheumatic disease served as controls. Results A total of 1639 adolescents with IRD (juvenile idiopathic arthritis, SLE, or familial Mediterranean fever) were included and compared with 524 471 adolescents in the same age range without IRD. There was no difference in COVID-19 infection rates after the second dose of vaccine between those with IRD and controls (2.1% vs 2.1% respectively, P  = 0.99). The estimated vaccine effectiveness for adolescents with IRD was 76.3% after the first dose, 94.8% after the second and 99.2% after the third dose. Conclusion We found that the BNT162b2 mRNA vaccine was similarly effective against COVID-19 infection in adolescents with and without IRD. Immunomodulatory therapy did not affect its effectiveness. These results can encourage adolescents with IRD to get vaccinated against COVID-19. [ABSTRACT FROM AUTHOR]

Objectives To analyse humoral and cellular immune response to mRNA COVID-19 vaccines in patients with GCA. Methods Consecutive patients with a diagnosis of GCA receiving two doses of BNT162b2 vaccine were assessed at baseline and 3 weeks from the second vaccine dose. Healthy subjects (n  = 51) were included as controls (HC). Humoral response was assessed with Spike-specific IgG antibody response (S-IgG) and neutralizing antibodies (NtAb). Specific T cell response was assessed by enzyme linked immunosorbent spot (ELISpot). Results Of 56 included patients with GCA, 44 were eligible after exclusion of previous evidence of COVID-19 and incomplete follow-up. A significant proportion of patients with GCA (91%) demonstrated antibody (S-IgG) response, but this was significantly lower than HCs (100%); P  < 0.0001. Neutralizing activity was not detected in 16% of patients with GCA. Antibody titres (S-IgG and NtAb) were significantly lower compared with HCs. Humoral response (S-IgG and NtAb) was significantly hampered by treatment with MTX. Cellular response was lacking in 30% of patients with GCA (vs 0% in HCs; P  < 0.0001). Cellular response was significantly influenced by the levels of baseline peripheral T-lymphocytes and by glucocorticoid treatment. Treatment with tocilizumab did not affect any level of the immune response elicited by vaccination. Conclusions Although patients with GCA apparently achieve a robust antibody seroconversion, there is a significant impairment of the neutralizing activity. MTX significantly reduced all levels of the humoral response. Up to one-third of patients do not develop a cellular immune protection in response to COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

However, third- and fourth-dose aVE estimates for comparable time points were not included, meaning it was impossible to determine whether the fourth dose returned people to the same or greater protection as a third dose for the equivalent time post-vaccination. We also account for the lack of data at comparable time periods by matching predicted third-dose aVE with reported fourth-dose rVE at an equivalent time (i.e. 3 weeks) since the last dose of vaccination. [Extracted from the article]

Background: Several SARS-CoV-2 vaccines have been shown to provide protection against COVID-19 hospitalization and death. However, some evidence suggests that notable waning in effectiveness against these outcomes occurs within months of vaccination. We undertook a pooled analysis across the four nations of the UK to investigate waning in vaccine effectiveness (VE) and relative vaccine effectiveness (rVE) against severe COVID-19 outcomes.Methods: We carried out a target trial design for first/second doses of ChAdOx1(Oxford-AstraZeneca) and BNT162b2 (Pfizer-BioNTech) with a composite outcome of COVID-19 hospitalization or death over the period 8 December 2020 to 30 June 2021. Exposure groups were matched by age, local authority area and propensity for vaccination. We pooled event counts across the four UK nations.Results: For Doses 1 and 2 of ChAdOx1 and Dose 1 of BNT162b2, VE/rVE reached zero by approximately Days 60-80 and then went negative. By Day 70, VE/rVE was -25% (95% CI: -80 to 14) and 10% (95% CI: -32 to 39) for Doses 1 and 2 of ChAdOx1, respectively, and 42% (95% CI: 9 to 64) and 53% (95% CI: 26 to 70) for Doses 1 and 2 of BNT162b2, respectively. rVE for Dose 2 of BNT162b2 remained above zero throughout and reached 46% (95% CI: 13 to 67) after 98 days of follow-up.Conclusions: We found strong evidence of waning in VE/rVE for Doses 1 and 2 of ChAdOx1, as well as Dose 1 of BNT162b2. This evidence may be used to inform policies on timings of additional doses of vaccine. [ABSTRACT FROM AUTHOR]

Background Molnupiravir was granted emergency use authorization for the treatment of mild to moderate coronavirus disease 2019 (COVID-19). In this study, we used population-based real-world data to evaluate the effectiveness of molnupiravir. Methods The database of the largest healthcare provider in Israel was used to identify all adults with first-ever positive test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) performed in the community during January–February 2022, who were at high risk for severe COVID-19, and had no contraindications for molnupiravir use. Patients were included regardless of SARS-CoV-2 vaccination status. A total of 2661 patients who received molnupiravir were propensity score matched with 2661 patients who have not received molnupiravir (control group). Patients were followed through 10 March 2022 for up to 28 days for the first occurrence of the composite severe COVID-19 or COVID-19-specific mortality. Results The composite outcome occurred in 50 patients in the molnupiravir group and 60 patients in the control group. Molnupiravir was associated with a nonsignificant reduced risk of the composite outcome: hazard ratio, 0.83 (95% confidence interval,.57–1.21). However, subgroup analyses showed that molnupiravir was associated with a significant decrease in the risk of the composite outcome in older patients 0.54 (0.34–0.86), in females 0.41 (0.22–0.77), and in patients with inadequate COVID-19 vaccination 0.45 (0.25–0.82). The results were similar when each component of the composite outcome was examined separately. Conclusions This study suggests that in the era of Omicron and in real-life setting, molnupiravir might be effective in reducing the risk of severe COVID-19 and COVID-19-related mortality, particularly in specific subgroups. [ABSTRACT FROM AUTHOR]

Background Although several coronavirus disease 2019 (COVID-19) vaccines initially showed high efficacy, there have been concerns because of waning immunity and the emergence of variants with immune escape capacity. Methods A test-negative design case-control study was conducted in 16 healthcare facilities in Japan during the Delta-dominant period (August-September 2021) and the Omicron-dominant period (January-March 2022). Vaccine effectiveness (VE) against symptomatic severe acute respiratory syndrome coronavirus 2 infection was calculated for 2 doses for the Delta-dominant period and 2 or 3 doses for the Omicron-dominant period compared with unvaccinated individuals. Results The analysis included 5795 individuals with 2595 (44.8%) cases. Among vaccinees, 2242 (55.8%) received BNT162b2 and 1624 (40.4%) received messenger RNA (mRNA)-1273 at manufacturer-recommended intervals. During the Delta-dominant period, VE was 88% (95% confidence interval [CI], 82–93) 14 days to 3 months after dose 2 and 87% (95% CI, 38–97) 3 to 6 months after dose 2. During the Omicron-dominant period, VE was 56% (95% CI, 37–70) 14 days to 3 months since dose 2, 52% (95% CI, 40–62) 3 to 6 months after dose 2, 49% (95% CI, 34–61) 6+ months after dose 2, and 74% (95% CI, 62–83) 14+ days after dose 3. Restricting to individuals at high risk of severe COVID-19 and additional adjustment for preventive measures (ie, mask wearing/high-risk behaviors) yielded similar estimates, respectively. Conclusions In Japan, where most are infection-naïve, and strict prevention measures are maintained regardless of vaccination status, 2-dose mRNA vaccines provided high protection against symptomatic infection during the Delta-dominant period and moderate protection during the Omicron-dominant period. Among individuals who received an mRNA booster dose, VE recovered to a high level. [ABSTRACT FROM AUTHOR]

Background Pregnancy represents a physiological state associated with increased vulnerability to severe outcomes from infectious diseases, both for the pregnant person and developing infant. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic may have important health consequences for pregnant individuals, who may also be more reluctant than nonpregnant people to accept vaccination. Methods We sought to estimate the degree to which increased severity of SARS-CoV-2 outcomes can be attributed to pregnancy using a population-based SARS-CoV-2 case file from Ontario, Canada. Because of varying propensity to receive vaccination, and changes in dominant circulating viral strains over time, a time-matched cohort study was performed to evaluate the relative risk of severe illness in pregnant women with SARS-CoV-2 compared to other SARS-CoV-2 infected women of childbearing age (10–49 years old). Risk of severe SARS-CoV-2 outcomes was evaluated in pregnant women and time-matched nonpregnant controls using multivariable conditional logistic regression. Results Compared with the rest of the population, nonpregnant women of childbearing age had an elevated risk of infection (standardized morbidity ratio, 1.28), whereas risk of infection was reduced among pregnant women (standardized morbidity ratio, 0.43). After adjustment for confounding, pregnant women had a markedly elevated risk of hospitalization (adjusted odds ratio, 4.96; 95% confidence interval, 3.86–6.37) and intensive care unit admission (adjusted odds ratio, 6.58; 95% confidence interval, 3.29–13.18). The relative increase in hospitalization risk associated with pregnancy was greater in women without comorbidities than in those with comorbidities (P for heterogeneity,.004). Conclusions Given the safety of SARS-CoV-2 vaccines in pregnancy, risk-benefit calculus strongly favors SARS-CoV-2 vaccination in pregnant women. [ABSTRACT FROM AUTHOR]

Background Little is currently known about vaccine effectiveness (VE) for either 2 doses of Oxford-AstraZeneca (ChAdOx1) viral vector vaccine or CoronaVac (Instituto Butantan) inactivated viral vaccine followed by a third dose of mRNA vaccine (Pfizer/BioNTech) among healthcare workers (HCWs). Methods We conducted a retrospective cohort study among HCWs (aged ≥18 years) working in a private healthcare system in Brazil from January to December 2021. VE was defined as 1 – incidence rate ratio (IRR), with IRR determined using Poisson models with the occurrence of laboratory-confirmed coronavirus disease 2019 (COVID-19) infection as the outcome, adjusting for age, sex, and job type. We compared those receiving viral vector or inactivated viral primary series (2 doses) with those who received an mRNA booster. Results A total of 11 427 HCWs met the inclusion criteria. COVID-19 was confirmed in 31.5% of HCWs receiving 2 doses of CoronaVac vaccine versus 0.9% of HCWs receiving 2 doses of CoronaVac vaccine with mRNA booster (P <.001) and 9.8% of HCWs receiving 2 doses of ChAdOx1 vaccine versus 1% among HCWs receiving 2 doses of ChAdOx1 vaccine with mRNA booster (P <.001). In the adjusted analyses, the estimated VE was 92.0% for 2 CoronaVac vaccines plus mRNA booster and 60.2% for 2 ChAdOx1 vaccines plus mRNA booster, when compared with those with no mRNA booster. Of 246 samples screened for mutations, 191 (77.6%) were Delta variants. Conclusions While 2 doses of ChAdOx1 or CoronaVac vaccines prevent COVID-19, the addition of a Pfizer/BioNTech booster provided significantly more protection. [ABSTRACT FROM AUTHOR]