Search

Aims This article explores the care British nurses provided to victims of typhus during the Second World War. Background Typhus is associated with poverty and overcrowding. During wars in the pre-antibiotic era, civilians were particularly susceptible to epidemics, which military governments feared would spread to their troops. Design This discussion paper draws on archival data from three typhus epidemics in the Second World War to examine the expert work of British nurses in caring for victims during these potential public health disasters. Data Sources The published sources for the paper include material from nursing and medical journals published between 1940-1947. Archival sources come from the National Archives in Kew, the Wellcome Library and the Army Medical Services Museum, between 1943-1945. Of particular interest is the correspondence with Dame Katharine Jones from nurses on active service overseas. Implications for Nursing Whilst epidemics of typhus are now rare, nurses in the present day may be required to care for the public in environments of extreme poverty and overcrowding, where life-threatening infectious diseases are prevalent. This article has demonstrated that it is possible for expert and compassionate nursing to alleviate suffering and prevent death, even when medical technologies are unavailable. Conclusion Expert and compassionate care, adequate nutrition and hydration and attention to hygiene needs are crucial when there are limited pharmacological treatments and medical technologies available to treat infectious diseases. The appreciation of this could have implications for nurses working in current global conflicts. [ABSTRACT FROM AUTHOR]

Presents the study entitled "Parasites Genetics and the Immune Host: A Novel Strategy in the Search for a Vaccine Against Eimeria ssp," at the 2004 Spring Meeting of the WPSA UK Branch.

Objectives: To investigate serological correlates of protection against SARS-CoV-2 B.1.617.2 (Delta) infection after two vaccinations., Methods: We performed a case-control study, where cases were Delta infections after the second vaccine dose and controls were vaccinated, never infected participants, matched by age, gender and region. Sera were tested for anti-SARS-CoV-2 Spike antibody levels (anti-S) and neutralising antibody titres (nAbT), using live virus microneutralisation against Ancestral, Delta and Omicron (BA.1, B.1.1.529). We modelled the decay of anti-S and nAbT for both groups, inferring levels at matched calendar times since the second vaccination. We assessed differences in inferred antibody titres between groups and used conditional logistic regression to explore the relationship between titres and odds of infection., Results: In total, 130 sequence-confirmed Delta cases and 318 controls were included. Anti-S and Ancestral nAbT decayed similarly between groups, but faster in cases for Delta nAbT (p = 0.02) and Omicron nAbT (p = 0.002). At seven days before infection, controls had higher anti-S levels (p < 0.0001) and nAbT (p < 0.0001; all variants) at matched calendar time. A two-fold increase in anti-S levels was associated with a 29% ([95% CI 14-42%]; p = 0.001) reduction in odds of Delta infection. Delta nAbT>40 were associated with reduced odds of Delta infection (89%, [69-96%]; p < 0.0001), with additional benefits for titres >100 (p = 0.009) and >400 (p = 0.007)., Conclusions: We have identified correlates of protection against SARS-CoV-2 Delta, with potential implications for vaccine deployment, development, and public health response., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. All authors confirmed they have no completing interest to declare., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Vaccines and treatments produced during the global coronavirus crisis demonstrated the importance of university research and teaching. There was widespread celebration of university–industry partnerships and collaborations across disciplines and geographical locations. However, simultaneously, higher education institutions in England faced serious financial and organisational challenges throughout the pandemic, which has implications for the relationship between teaching and research, for who undertakes each, and for the students' experience of teaching and learning (some of whom become the next generation of researchers). The rapid movement to online learning created further tensions within an already demoralised, precarious and divided workforce. This paper considers the potential social good of universities' two core missions, research and teaching in a post-pandemic world, exploring the inherently political nature of the link, as well as its encoded inequalities and dysfunctions. Drawing on documentary and secondary data analysis, this paper explores, first, the long-standing sectoral and institutional discrepancies through analysing trends in student recruitment rates and research funding. Second, it investigates how student and staff experiences of the link between research and teaching were changing in the pandemic, pointing to substantive equity issues in how the pandemic response affected access to research opportunities and to research-led teaching. The paper argues that a more equitable and inclusive university that appreciates the research-teaching nexus and is flexible and collaborative in nature is key to contribute to tackling global and local challenges, such as environmental destruction, climate change, conflict and socio-economic inequities. [ABSTRACT FROM AUTHOR]

Aim: The aim of the paper is to enhance understanding of how members of the public make sense of the Covid-19 vaccines and to understand the factors influencing their attitudes towards such artefacts of pandemic governance. Methods: The paper draws on 23 online in-depth interviews with members of the UK public and builds on relevant literature to examine participants' perceptions of the benefits and risks of Covid-19 vaccines, the sources that have shaped their attitudes, and the level of trust they have towards the government's handling of the pandemic through vaccines. Results: The findings indicate that participants generally felt that the benefits of having the vaccine outweigh the risks and that Covid-19 vaccines are a crucial mechanism for enabling society to return to normal. Vaccine acceptance was, for some, strongly linked to a sense of social responsibility and the duty to protect others. However, some participants expressed concerns with regard to the side-effects of Covid-19 vaccines and their perceived potential impact on fertility and DNA makeup. Participants used various sources of information to learn about Covid-19 vaccines and understand their function, benefits, and risks. The majority of participants criticised the government's response during the early stages of the pandemic yet felt positive about the vaccine rollout. Conclusion: Just as with any other vaccination programme, the success of the Covid-19 immunisation campaigns does not only depend on the efficacy of the vaccines themselves or the ability to secure access to them, but also on a myriad of other factors which include public compliance and trust in governments and health authorities. To support an effective immunisation campaign that is capable of bringing the pandemic to an end, governments need to understand public concerns, garner trust, and devise adequate strategies for engaging the public and building more resilient societies. [ABSTRACT FROM AUTHOR]

The present case study describes a co-produced and theoretically informed workshop wherein messages were co-designed to increase the uptake of future COVID-19 vaccines in the United Kingdom. Co-design can enhance the legitimacy and effectiveness of public interventions, but many researchers, service providers, and policymakers may be uncertain where to start. This demonstrative example applies behavioural science and design thinking theory, illustrating how others can integrate theoretically informed co-design into similar and more complex projects efficiently. The workshop brought together members of the public, immunisers, and public health specialists. A narrative analysis was conducted to identify themes related to vaccine hesitancy. The workshop's supporting materials are made available as supplemental materials, which can be modified for future workshops. The discussion encourages additional workshops to be conducted, including diverse members of the public, to co-design novel solutions to improve public health more generally., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Ethnic minority communities in the UK have been disproportionately affected by the pandemic, with increased risks of infection, severe disease, and death. Hesitancy around the COVID-19 vaccine may be contributing to disparities in vaccine delivery to ethnic minority communities. This systematic review aims to strengthen understanding of COVID-19 vaccine concerns among ethnic minorities in the UK. Five databases were searched in February 2022, yielding 24 peer-reviewed studies reporting on vaccine hesitancy or acceptance in ethnic minority groups. Data were extracted using a standardised form, and quality assessment was carried out using the Standard Quality Criteria. There were three key themes: (1). Prevalence of vaccine hesitancy; (2). Reasons for vaccine hesitancy and acceptance; and (3). Recommendations to address vaccine concerns. Vaccine hesitancy, which was more common among some ethnic minority groups, is a complex phenomenon, driven by misinformation, mistrust, concerns about safety and efficacy, and structural and systemic inequities. Community engagement and tailored communication may help to address vaccine concerns. Robust data disaggregated by ethnicities are needed to better understand barriers and facilitators for COVID-19 vaccine delivery in ethnic minority communities. Strategies to address structural disadvantage need to be inclusive, comprehensive, and behaviorally informed and foster confidence in healthcare systems and governments. Community leaders and health care practitioners may prove to be the most important agents in creating an environment of trust within ethnic minority groups., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Vaccine market access (VMA) pathways across the European Union (EU) and the United Kingdom (UK) are complex, lengthy, and heterogeneous, particularly when compared with pharmaceuticals. The knowledge base to inform recommendations for optimization of VMA is lacking. We therefore conducted a comprehensive evaluation of EU VMA pathways., Methods: Research in two phases included: (1) mapping VMA pathways in each EU member state (including the UK) based on a literature review, expert interviews, and mathematical archetyping; and (2) interviews with vaccine experts to identify barriers, drivers, and recommendations for regional VMA alignments., Results: Key steps in VMA across the EU include horizon scanning, early advice, National Immunization Technical Advisory Group (NITAG) recommendation for inclusion in national immunization programs, health technology assessment (HTA), final decision and procurement. We found significant complexity and heterogeneity, particularly for early advice, and in the roles, decision-making criteria, and transparency of NITAGs and HTA bodies. The most important drivers for rapid VMA included demonstration of disease burden and vaccine benefit (e.g., efficacy, safety, economic). Key barriers were budget limitations and complexity/clarity of VMA processes (e.g., need for national-regional consensus, clarity on process initiation, and clarity on the role of HTA). Recommendations for alignment at EU and member-state levels include information sharing, joint clinical assessment, initiatives to address funding and political barriers, and improved transparency by decision-making bodies. Early engagement with vaccine stakeholders was a key recommendation for manufacturers., Conclusions: There is significant potential for alignment, collaboration, and improvement of VMA across the EU. Roles, responsibilities, and transparency of key bodies can be clarified. The COVID-19 pandemic response should stimulate policies to improve access to all vaccines, including routine ones, and form the foundation upon which a consistent vaccine ecosystem can be created for the EU, one that is resilient, consistent between member states, and fit for purpose., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives : No studies describing UK patient Yellow Card reports have been published since the evaluation of the first two years of direct patient reporting (2005-7), when 5,180 reports were analyzed. Methods : Patient Yellow Card reports submitted July-December 2015 for vaccines and other drugs were analyzed. Comparisons to the initial evaluation were made of: reporting method, number of suspect drugs, proportion classed as serious. Factors affecting seriousness of reports were examined. Results : There were 3,060 patient Yellow Card reports analyzed. Vaccine reports have increased from very few in 2005-7 to 25% of reports. The proportion of reports citing one drug (94.3%) and the proportion considered serious (70.3%) increased from the 84% and 58% respectively found in 2005-7. The main method of reporting had changed from paper (61%) to internet (88.5%). Serious reports were more common in females, for vaccines in young persons, but in adults for other drugs, and included more reaction terms than non-serious reports. Conclusion : Patient reporting, in particular to vaccines, has increased dramatically since 2005-7. Increases in the proportion of reports concerning one drug and the proportion considered serious could indicate that the usability of patient reports may have improved in comparison to early reporting.

Vaccination remains the most successful and effective mechanism of pathogen control. However, their development and deployment in epidemic settings have been limited, and the 2015 Ebola outbreak in West Africa identified several bottlenecks linked to a lack of investment in pathogen research, infrastructure or regulation. Shortly after this outbreak, the UK Government established the UK Vaccine Network to ensure the UK is better prepared to respond to pathogens outbreaks of epidemic potential. As part of their work, the network commissioned the creation of a Vaccine Development Tool (http://www.vaccinedevelopment.org.uk/) to serve as a guide to the key stages in vaccine development. The tool also set out to capture the key, rate-limiting bottlenecks in the development of vaccines against emerging infectious disease such that corrective action could be taken, be it through research, funding, infrastructure and policy, both in the UK and internationally. The main research bottlenecks were related to understanding pathogen biology, identification of appropriate animal models and investment in the manufacturing sciences, especially into process development. Infrastructure gaps in GMP manufacturing and fill-finish were also identified and limitations in GMO regulation and regulatory and ethical approvals, especially for outbreak pathogens required new policy initiatives. The UK Vaccine Network has since begun work to correct for these limitations with a series of funding calls and development programmes. This paper seeks to summarise the Vaccine Development Tool and its key findings., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Rapid vaccine-induced population immunity is the key global strategy to control COVID-19 pandemic. However, coordination of the deployment of the vaccination programmes varies significantly between countries. In the meantime, we have witnessed an unprecedented media coverage of the deployment of the COVID-19 vaccination programmes. Unfortunately, most of those reports were incomplete, poorly understood, and misguided -- often fuelling growing vaccine hesitancy among the public caused by unfounded fears and confusion. For the last 10 years the author of this paper has lived and worked as a healthcare professional in the UK. In December 2019 he has volunteered to support the rollout of the mass vaccination programme against COVID-19 -- the largest civilian logistical operation ever conducted in Britain. This article describes his personal observations on how Poles living in the UK approach the vaccination programme, and the challenges related to immunisation of Polish citizens in the UK, including vaccine (mis)information. [ABSTRACT FROM AUTHOR]

This paper examines the successful campaign in Britain to develop canine distemper vaccine between 1922 and 1933. The campaign mobilized disparate groups around the common cause of using modern science to save the nation's dogs from a deadly disease. Spearheaded by landed patricians associated with the country journal The Field, and funded by dog owners and associations, it relied on collaborations with veterinary professionals, government scientists, the Medical Research Council (MRC) and the commercial pharmaceutical house the Burroughs Wellcome Company (BWC). The social organization of the campaign reveals a number of important, yet previously unexplored, features of interwar science and medicine in Britain. It depended on a patronage system that drew upon a large base of influential benefactors and public subscriptions. Coordinated by the Field Distemper Fund, this system was characterized by close relationships between landed elites and their social networks with senior science administrators and researchers. Relations between experts and non-experts were crucial, with high levels of public engagement in all aspects of research and vaccine development. At the same time, experimental and commercial research supported under the campaign saw dynamic interactions between animal and human medicine, which shaped the organization of the MRC's research programme and demonstrated the value of close collaboration between veterinary and medical science, with the dog as a shared object and resource. Finally, the campaign made possible the translation of ‘laboratory’ findings into field conditions and commercial products. Rather than a unidirectional process, translation involved negotiations over the very boundaries of the ‘laboratory’ and the ‘field’, and what constituted a viable vaccine. This paper suggests that historians reconsider standard historical accounts of the nature of patronage, the role of animals, and the interests of landed elites in interwar British science and medicine. [ABSTRACT FROM PUBLISHER]

Objectives: It has been estimated that vaccines can accrue a relatively large part of their value from patient and carer productivity. Yet, productivity value is not commonly or consistently considered in health economic evaluations of vaccines in several high-income countries. To contribute to a better understanding of the potential impact of including productivity value on the expected cost-effectiveness of vaccination, we illustrate the extent to which the incremental costs would change with and without productivity value incorporated. Methods: For two vaccines currently under development, one against Cloistridioides difficile (C. difficile) infection and one against respiratory syncytial disease (RSV), we estimated their incremental costs with and without productivity value included and compared the results. Results: In this analysis, reflecting a UK context, a C. difficile vaccination programme would prevent £12.3 in productivity costs for every person vaccinated. An RSV vaccination programme would prevent £49 in productivity costs for every vaccinated person. Conclusions: Considering productivity costs in future cost-effectiveness analyses of vaccines for C. difficile and RSV will contribute to better-informed reimbursement decisions from a societal perspective. [ABSTRACT FROM AUTHOR]

We have previously reported that the recombinant African Swine Fever (ASF) vaccine candidate ASFV-G-Δ9GL/ΔUK efficiently induces protection in domestic pigs challenged with the virulent strain Georgia 2010 (ASFV-G). As reported, ASFV-G-Δ9GL/ΔUK induces protection, while intramuscularly (IM), administered at doses of 104 HAD50 or higher, prevents ASF clinical disease in animals infected with the homologous ASFV g strain. Like other recombinant vaccine candidates obtained from ASFV field isolates, ASFV-G-Δ9GL/ΔUK stocks need to be produced in primary cultures of swine macrophages, which constitutes an important limitation in the production of large virus stocks at the industrial level. Here, we describe the development of ASFV-G-Δ9GL/ΔUK stocks using IPKM (Immortalized Porcine Kidney Macrophage) cells, which are derived from swine macrophages. We show that ten successive passages of ASFV-G-Δ9GL/ΔUK in IPKM cells induced small changes in the virus genome. The produced virus, ASFV-G-Δ9GL/ΔUKp10, presented a similar level of replication in swine macrophages cultures to that of the original ASFV-G-Δ9GL/ΔUK (ASFV-G-Δ9GL/ΔUKp0). The protective efficacy of ASFV-G-Δ9GL/ΔUKp10 was evaluated in pigs that were IM-inoculated with either 104 or 106 HAD50 of ASFV-G-Δ9GL/ΔUKp10. While animals inoculated with 104 HAD50 present a partial protection against the experimental infection with the virulent parental virus ASFV-G, those inoculated with 106 HAD50 were completely protected. Therefore, as was just recently reported for another ASF vaccine candidate, ASFV-G-ΔI177L, IPKM cells are an effective alternative to produce stocks for vaccine strains which only grow in swine macrophages. [ABSTRACT FROM AUTHOR]

Turbott consulted the WHO expert committee on vaccines in 1954 about the triple vaccine, but the issues regarding pertussis potency were not resolved until 1960 when the vaccine was finally cleared by WHO. This paper will consider the deployment of the vaccine in New Zealand, the key role played by general practitioners and how the Health Department's cautious approach shaped its public usage, in contrast to vaccines for illnesses such as diphtheria, and how that approach facilitated the pertussis vaccine's eventual acceptance. 35 Making the pertussis vaccine available to parents through the double and, later, triple vaccines led to wider acceptance, and meant that the vaccine reached many more children than it did as a single, unpromoted vaccine. 42 GPs once more led the initiative, offering parents a triple vaccine years before the Health Department finally authorised its placement on the "free list", and they were instrumental in gaining public acceptance for the pertussis vaccine through their use of the double and triple vaccines. [Extracted from the article]

Background: There are clear inequalities in COVID − 19 vaccination rates amongst marginalised groups, with lower rates for some minoritised ethnic and religious groups, younger people, those living in more deprived areas, and with lower socio-economic status. Existing research focuses on psychological and socio-economic factors that influence vaccine uptake and does not explore broader social and historical contexts. Understanding inequalities in COVID-19 vaccine uptake requires a critical examination of the drivers of, and barriers to, vaccination. Methods: We present findings from a co-designed qualitative research study undertaken during the COVID-19 pandemic. Focus groups and interviews were used to examine the context underpinning responses to the COVID-19 vaccination in Greater Manchester, particularly focussing on experiences of marginalisation. Thematic framework analysis was used to analyse the data. Results: We found that the public's responses to the COVID-19 vaccination programme are intertwined with a longstanding history of institutional distrust and disenfranchisement, resulting from experiences of marginalisation and social inequalities. This was exacerbated further by the disproportionate impacts of the COVID-19 pandemic on minoritised ethnic groups, younger people, and those with existing health conditions. Conclusions: Histories of structural inequalities experienced by minoritised groups invoked feelings of suspicion and scepticism at the motivations of the agencies behind the vaccination rollout. This highlights the need for a contextualised analysis of attitudes to vaccines, considering pre-existing inequalities, which may be especially relevant for conceptualising public responses to the vaccination programme. Finally, our study shows the important ways in which public (dis)trust can impact public health policies. We recommend this should be incorporated into responses to future public health crises. [ABSTRACT FROM AUTHOR]

• Process Flow Charts providing guidance on how to develop and licence a new veterinary vaccine. • The importance of producing a clear Target Product Profile (TPP) for a new veterinary vaccine. • What is required in order to move a new vaccine project from discovery through to development. • The differences between the human and veterinary vaccine development processes. • The commercial vaccine regulatory process leading to a marketing authorisation for a new product. • Identification of potential bottlenecks to the rapid development of a new veterinary vaccine. The UK Government recognised the importance of vaccines in the control of new emerging disease threats and in 2015 established the UK Vaccine Network to focus on specific areas of need. One of these was the understanding of what is involved in the development of a new vaccine and what are the potential bottlenecks to a rapid response in the face of an epidemic such as Ebola, MERS and more recently COVID-19. A Working Group was established to initially produce a Vaccine Development Process Map for a Human Vaccine. However, in view of the importance of animal wellbeing and the significant impact of diseases with Zoonotic potential, a similar Map has been created outlining the Veterinary Vaccine Development Process. This paper describes the production of that Map and covers the process from the generation of a Target Product Profile (TPP) through Discovery and Feasibility, and on to Product Development and Registration. [ABSTRACT FROM AUTHOR]

The popularisation of complex biomedical concepts brought about by COVID-19 has led to the rapid proliferation and diffusion of scientific misinformation, particularly among individuals with inadequate levels of scientific and digital literacy. A cross-sectional online survey of a UK population sample was conducted to address three key aims: to verify whether there is a correlation between participants' belief in false information around COVID-19 and adherence to preventive measures; to investigate whether participants' scientific misinformation and preventive behaviour are associated with their demographic characteristics; and to evaluate whether participants' scientific misinformation and preventive behaviour can predict their likelihood of having contracted COVID-19. Non-parametric data analysis highlighted a strong negative correlation between participants' belief in misinformation and their trust in preventive measures. Both variables were significantly associated with participants' education levels, but not with their religious beliefs. Remarkably, neither science misinformation levels nor the trust in preventive measures were statistically associated with the likelihood of having contracted COVID-19. Taken together, these findings reinforce the urgency of ensuring that the population is equipped with adequate scientific literacy to enable them to evaluate the reliability of scientific information and recognise the importance of individual preventive behaviours to minimise community spread of infectious diseases. [ABSTRACT FROM AUTHOR]

Editorial. Presents information on nursing in Great Britain. Development of vaccines against HIV/AIDS; Concerns for health care system; Issues on nursing practice.

The article offers information about several papers discussed at a symposium on the early development of vaccines and its efficacy in preventing the spread of communicable diseases. The symposium featured several papers by prominent people in the immunology and allergy practice including G. Schild, M. Mackett, and F. Hay, among others.

I contend that virtue ethics provides the best ethical justification for vaccination programmes, and associated payment schemes for vaccine damaged individuals (which have been adopted in twenty-four countries and one province). Virtue ethics justifies vaccination programmes, as they contribute to the common good, and associated payment schemes, as they demonstrate compassion, justice and prudence in response to virtuous vaccination decisions by citizens. I also argue that the virtues of maturity and prudence justify voluntary vaccinations. I utilise several virtues to analyse, and suggest reforms to, the United Kingdom's (UK) Vaccine Damage Payment Scheme (VDPS). I also compare the UK VDPS with the schemes that have been adopted in other states, in particular the Vaccine Injury Compensation Programme (VICP) which has been adopted within the United States (US). [ABSTRACT FROM AUTHOR]

Universities' decisions during technology transfer may affect affordability, accessibility, and availability of COVID-19 health technologies downstream. We investigated measures taken by the top 35 publicly funded UK universities to ensure global equitable access to COVID-19 health technologies between January and end of October 2020. We sent Freedom Of Information (FOI) requests and analysed universities' websites, to (i) assess institutional strategies on the patenting and licensing of COVID-19-related health technologies, (ii) identify all COVID-19-related health technologies licensed or patented and (iii) record whether universities engaged with the Open COVID pledge, COVID-19 Technology Access Pool (C-TAP), or Association of University Technology Managers (AUTM) COVID-19 licensing guidelines during the time period assessed. Except for the Universities of Oxford and Edinburgh, UK universities did not update their institutional strategies during the first year of the pandemic. Nine universities licensed 22 COVID-19 health technologies. Imperial College London disclosed ten patents relevant to COVID-19. No UK universities participated in the Open COVID Pledge or C-TAP, but discussions were ongoing in autumn 2020. The University of Bristol endorsed the AUTM guidelines. Despite important COVID-19 health technologies being developed by UK universities, our findings suggest minimal engagement with measures that may promote equitable access downstream. We suggest universities review their technology transfer policies and implement global equitable access strategies for COVID-19 health technologies. We furthermore propose that public and charitable funders can play a larger role in encouraging universities to adopt such practices by making access and transparency clauses a mandatory condition for receiving public funds for research. [ABSTRACT FROM AUTHOR]

Objectives: A successful response to the COVID‐19 pandemic requires achieving high levels of vaccine uptake. We tested whether directly contrasting the high efficacy of COVID‐19 vaccines with the lower efficacy of the annual flu vaccine would increase intentions to take a COVID‐19 vaccine. Design: A pre‐registered online study of 481 participants compared four information conditions: (1) no information; (2) COVID‐19 Vaccine Information Only; and COVID‐19 Vaccine Information combined with flu vaccine information suggesting either (3) 60% efficacy or (4) 40% efficacy; we measured COVID‐19 and flu vaccine intentions along with several other vaccine‐related variables. Methods: The Prolific platform was used to recruit 481 UK participants (64% female; aged between 18 and 85 years) who had been pre‐screened to have intermediate levels of vaccine hesitancy. After reading a short text (~200 words) about COVID‐19 vaccines, participants were asked about their vaccination intentions. Results: Providing information about the safety and efficacy of the new COVID‐19 vaccines resulted in vaccination intentions that were, on average, 0.39 standard deviations (SDs) higher than those in the no information condition; providing the same COVID vaccine efficacy information in the context of information about flu vaccine efficacy resulted in a further significant increase in vaccination intentions that were 0.68 SD higher than those in the no information condition. This positive contrast effect for the COVID‐19 vaccine was not associated with reduced flu vaccine intentions. Conclusions: Vaccination intentions can be strengthened through a simple messaging intervention that utilizes context effects to increase perceived response efficacy. [ABSTRACT FROM AUTHOR]

Public health has a long history and a contested meaning. Furthermore, public health operates in a social context and its messages may be rejected by the public. Nurses who have a direct public health role, notably those working in the community and in primary care, need to be able to articulate and discuss public health theory and practice, particularly in the context of the coronavirus disease 2019 (COVID-19) pandemic. This article provides an overview of public health, including its meaning and historical development, and discusses six essential elements of public health theory and practice in the context of the COVID-19 pandemic. These six essential elements are related to public health interventions provided by nurses and to Platform 2 of the Nursing and Midwifery Council's standards of proficiency for registered nurses, which is particularly applicable to public health. The aim of the article is to support nurses to gain a better understanding of their role in public health. [ABSTRACT FROM AUTHOR]

Comments on Great Britain's meningococcal control program. Steps made by Great Britain to make conjugate meningococcal C vaccines available; Difficulty for Australia in emulating Great Britain's program; Challenges facing Great Britain's program.

Identifying and understanding COVID-19 vaccine hesitancy within distinct populations may aid future public health messaging. Using nationally representative data from the general adult populations of Ireland (N = 1041) and the United Kingdom (UK; N = 2025), we found that vaccine hesitancy/resistance was evident for 35% and 31% of these populations respectively. Vaccine hesitant/resistant respondents in Ireland and the UK differed on a number of sociodemographic and health-related variables but were similar across a broad array of psychological constructs. In both populations, those resistant to a COVID-19 vaccine were less likely to obtain information about the pandemic from traditional and authoritative sources and had similar levels of mistrust in these sources compared to vaccine accepting respondents. Given the geographical proximity and socio-economic similarity of the populations studied, it is not possible to generalize findings to other populations, however, the methodology employed here may be useful to those wishing to understand COVID-19 vaccine hesitancy elsewhere. Hesitancy and resistance towards vaccination is a challenge for public health. Here the authors determine psychological characteristics associated with COVID-19 vaccine hesitancy or resistance attitudes in the UK and Ireland. [ABSTRACT FROM AUTHOR]

Erysipelas, caused by the bacterium Erysipelothrix rhusiopathiae , is re-emerging in swine and poultry production systems worldwide. While the global genomic diversity of this species has been characterized, how much of this genomic and functional diversity is maintained at smaller scales is unclear. Specifically, while several key immunogenic surface proteins have been identified for E. rhusiopathiae , little is known about their presence among field strains and their divergence from vaccines, which could result in vaccine failure. Here, a comparative genomics approach was taken to determine the diversity of E. rhusiopathiae strains in pigs in Great Britain over nearly three decades, as well as to assess the field strains' divergence from the vaccine strain most commonly used in British pigs. In addition, the presence/absence and variability of 13 previously described immunogenic surface proteins was determined, including SpaA which is considered a key immunogen. We found a high diversity of E. rhusiopathiae strains in British pigs, similar to the situation described in European poultry but in contrast to swine production systems in Asia. Of the four clades of E. rhusiopathiae found globally, three were represented among British pig isolates, with Clade 2 being the most common. All British pig isolates had one amino acid difference in the immunoprotective domain of the SpaA protein compared to the vaccine strain. However, we were able to confirm using in silico structural protein analyses that this difference is unlikely to compromise vaccine protection. Of 12 other known immunogenic surface proteins of E. rhusiopathiae examined, 11 were found to be present in all British pig isolates and the vaccine strain, but with highly variable degrees of conservation at the amino acid sequence level, ranging from 0.3 to 27% variant positions. Moreover, the phylogenetic incongruence of these proteins suggests that horizontal transfer of genes encoding for antigens is commonplace for this bacterium. We hypothesize that the sequence variants in these proteins could be responsible for differences in the efficacy of the immune response. Our results provide the necessary basis for testing this hypothesis through in vitro and in vivo studies. [ABSTRACT FROM AUTHOR]

Background: The United Kingdom (UK) was the first European country to introduce a national immunisation program for shingles (2013–2014). That year, vaccination coverage ranged from 50 to 64% across the UK, but uptake has declined ever since. This study explored determinants of the acceptance of the shingles vaccine in the UK. Methods: Vaccinated and unvaccinated individuals, who were eligible for the last catch-up cohort of the 2014–2015 shingles vaccination campaign, were identified using the Clinical Practice Research Datalink (the National Health Service data research service) and invited to participate by their general practitioner (GP). An anonymised self-administered questionnaire was developed using the Health Belief Model as a theoretical framework, to collect data on demographic and socio-economic characteristics, health status, knowledge, influences, experiences and attitudes to shingles and the shingles vaccine. Multivariable logistic regression was used to identify the factors associated with vaccination. Physicians’ views concerning perceived barriers to vaccination were also assessed. Results: Of the 2,530 questionnaires distributed, 536 were returned (21.2%) from 69 general practices throughout the UK. The majority of responders were female (58%), lived in care homes (56%) and had completed secondary or higher education (88%). There were no differences between vaccinated and unvaccinated responders. Being offered the shingles vaccine by a GP/nurse (odds ratio (OR) = 2.3), and self-efficacy (OR = 1.2) were associated with being vaccinated (p<0.05). In contrast, previous shingles history (OR = 0.4), perceived barriers to vaccination (OR = 0.7) and perceived control of the disease (OR = 0.7) were associated with not being vaccinated against shingles (p<0.05). Less than half (44.0%) of GPs were aware of the local communication campaigns regarding shingles and the shingles vaccine. Conclusions: Socio-psychological factors largely influence shingles vaccination acceptance in this study. The results add to existing evidence that healthcare providers (HCPs) have a pivotal role against vaccine hesitancy. Campaigns focusing on GPs and accessible information offered to eligible members of the public can further enhance shingles vaccine uptake. [ABSTRACT FROM AUTHOR]

Background: In October 2017, the United Kingdom Joint Committee on Vaccination and Immunisation (JCVI) recommended removal of one primary dose of the 13-valent pneumococcal conjugate vaccine (PCV13) from the existing 2+1 schedule (2, 4, 12 months). We conducted a mathematical modelling study to investigate the potential impact of a 1+1 (3, 12 month) schedule on invasive pneumococcal disease (IPD) and pneumococcal community-acquired pneumonia (CAP). Our results and those from a 1+1 immunogenicity study formed the key evidence reviewed by JCVI.Methods and Findings: We developed age-structured, dynamic, deterministic models of pneumococcal transmission in England and Wales to describe the impact on IPD of 7-valent PCV (PCV7; introduced in 2006) and PCV13 (introduced in 2010). Key transmission and vaccine parameters were estimated by fitting to carriage data from 2001/2002 and post-PCV IPD data to 2015, using vaccine coverage, mixing patterns between ages, and population data. We considered various models to investigate potential reasons for the rapid increase in non-PCV13 (non-vaccine serotype [NVT]) IPD cases since 2014. After searching a large parameter space, 500 parameter sets were identified with a likelihood statistically close to the maximum and these used to predict future cases (median, prediction range from 500 parameter sets). Our findings indicated that the emergence of individual NVTs with higher virulence resulting from ongoing replacement was likely responsible; the NVT increase was predicted to plateau from 2020. Long-term simulation results suggest that changing to a 1+1 schedule would have little overall impact, as the small increase in vaccine-type IPD would be offset by a reduction in NVT IPD. Our results were robust to changes in vaccine assumptions in a sensitivity analysis. Under the base case scenario, a change to a 1+1 schedule in 2018 was predicted to produce 31 (6, 76) additional IPD cases over five years and 83 (-10, 242) additional pneumococcal-CAP cases, with together 8 (-2, 24) additional deaths, none in children under 15 years. Long-term continuation with the 2+1 schedule, or changing to a 1+1, was predicted to sustain current reductions in IPD cases in under-64-year-olds, but cases in 65+-year-olds would continue to increase because of the effects of an aging population. Limitations of our model include difficulty in fitting to past trends in NVT IPD in some age groups and inherent uncertainty about future NVT behaviour, sparse data for defining the mixing matrix in 65+-year-olds, and the methodological challenge of defining uncertainty on predictions.Conclusions: Our findings suggest that, with the current mature status of the PCV programme in England and Wales, removing one primary dose in the first year of life would have little impact on IPD or pneumococcal CAP cases or associated deaths at any age. A reduction in the number of priming doses would improve programmatic efficiency and facilitate the introduction of new vaccines by reducing the number of coadministered vaccines given at 2 and 4 months of age in the current UK schedule. Our findings should not be applied to other settings with different pneumococcal epidemiology or with immature programmes and poor herd immunity. [ABSTRACT FROM AUTHOR]

Varicella zoster virus (VZV) is a common illness that causes varicella (chickenpox) and shingles. It is prevalent mostly during childhood but there are additional co-morbidities from this disease for a woman and her fetus, if she contracts it during pregnancy. Many developed countries vaccinate children who have not acquired immunity to prevent their developing complicated varicella as adults. Countries that have implemented widespread vaccination have fewer hospital admissions for such complications. The UK does not have a national VZV vaccination programme and there is no strategy for reporting and documenting the incidence of the illness, so it is difficult to determine the potential prevalence of gestational VZV and its associated outcomes. The aim of this article is to provide an understanding of the aetiology of VZV and the potential health risks to unimmune women who may contact it during pregnancy, to advise them about their healthcare choices. [ABSTRACT FROM AUTHOR]

Despite increasing warnings about inaccurate information online, little is known about how social media contribute to the widespread diffusion of unverified health information. This study addresses this issue by examining the vaccine-autism controversy. By looking into a large dataset of Twitter, Reddit posts, and online news over 20 months in the US, Canada, and the UK, our time-series analysis shows that Twitter drives news agendas, and Reddit follows news agendas regarding the vaccine-autism debate. Additionally, the results show that both Twitter and Reddit are more likely to discuss the vaccine-autism link compared to online news content. [ABSTRACT FROM AUTHOR]

The incidence of cancers attributable to Human Papillomavirus (HPV) that affect males is on the rise. Currently in the UK teenage boys are not vaccinated against HPV while teenage girls are. The rationale for not vaccinating boys is that vaccinating girls should provide herd immunity to boys, however this does not protect men who have sex with men or men who have sex with unvaccinated women. The issue of whether to vaccinate boys or not is a controversial one with considerable lobbying taking place to change the existing policy. On one side of the debate are financial considerations while on the other side health equality is important. One avenue that has not been presented is the parental perspective. The current study uses a self-report questionnaire to explore what parents of teenage boys know about HPV and the vaccine and whether they want the vaccine for their sons. Only half of the parents had heard of HPV prior to completing the survey. Of those who had heard of HPV, knowledge about the health sequelae of HPV for men was poor relative to their knowledge about its impact on female health. Parents who would be willing to vaccinate their sons had higher levels of knowledge about HPV than those parents who would be unwilling or unsure. Irrespective of whether they had previously heard of HPV or not, once provided with a brief description of HPV, the majority of parents thought that boys should be offered the vaccination. There is a pressing need for public education about the potential impact of HPV on male health in order to facilitate uptake of the vaccine in the event of the vaccination programme being extended to men or to facilitate informed decision making about seeking the vaccine privately in the event that it isn’t. [ABSTRACT FROM AUTHOR]

Data obtained recently in the United Kingdom following a nationwide infant immunization program against serogroup B Neisseria meningitidis (MenB) reported >80% 4CMenB vaccine-mediated protection. Factor H-binding protein (fHbp) is a meningococcal virulence factor and a component of two new MenB vaccines. Here, we investigated the structural bases underlying the fHbp-dependent protective antibody response in humans, which might inform future antigen design efforts. We present the co-crystal structure of a human antibody Fab targeting fHbp. The vaccine-elicited Fab 1A12 is cross-reactive and targets an epitope highly conserved across the repertoire of three naturally occurring fHbp variants. The free Fab structure highlights conformational rearrangements occurring upon antigen binding. Importantly, 1A12 is bactericidal against MenB strains expressing fHbp from all three variants. Our results reveal important immunological features potentially contributing to the broad protection conferred by fHbp vaccination. Our studies fuel the rationale of presenting conserved protein epitopes when developing broadly protective vaccines. [ABSTRACT FROM AUTHOR]

Background: In 2015 meningococcal group W was declared endemic in the UK, with the meningococcal ACWY vaccination (MenACWY) subsequently introduced amongst adolescents and first-year university students. This study aimed to determine MenACWY uptake amongst students and to evaluate how this was influenced by demographics and via the Health Belief Model (HBM). Methods: This was a cross-sectional study conducted at a British university amongst first-year undergraduate students aged 18–25 years. Data collection was via an electronic questionnaire encompassing demographics, the HBM and vaccination status. Univariable analysis of the associations between demographics, health beliefs and vaccination was performed, followed by multiple logistic regression. Results: 401 participants were included in analysis. Vaccine uptake was 68.1%. Variables independently associated with vaccination upon multiple regression were age, gap-year, perceived effectiveness of the vaccine and knowledge about risk of meningitis. Compared to 18 year-olds, the odds of vaccination were reduced for 19 year-olds (aOR = 0.087, 95% CI = 0.010–0.729), 20 year-olds (aOR = 0.019, 95% CI = 0.002–0.161) and 21–25 year-olds (aOR = 0.003, 95% CI = <0.001–0.027). In contrast, taking a gap year (aOR = 2.939, 95% CI = 1.329–6.501), higher perceived vaccine effectiveness (aOR = 3.555, 95% CI = 1.787–7.073) and knowledge about meningitis risk (aOR = 2.481, 95% CI = 1.165–5.287) were independently associated with increased uptake. Conclusions: MenACWY uptake amongst students in this study and in other sources is above the national coverage for all adolescents (35.3%), indicating that this vaccination programme may be increasing health inequalities. Older students are less likely to become vaccinated due to differing vaccination policy in this age-group. In future, strategies that focus on specific student cohorts and that highlight vaccine effectiveness and the risk of meningitis should be considered. National evaluation of this vaccination programme is recommended to clarify its impact on health inequalities. [ABSTRACT FROM AUTHOR]

The article offers information related to the guidelines from the British HIV Association concerning the utilization of vaccines in adults with HIV positive in 2015. Topics discussed include the aspects of vaccine highlighted in the guidelines, the contraindication of the vaccines in people with severe adverse reaction or allergy, and the availability of the different type of meningococcal vaccine.

Background: The availability of new vaccines can prompt policy makers to consider changes to the routine childhood immunisation programme in the UK. Alterations to one aspect of the schedule may have implications for other areas of the programme (e.g. adding more injections could reduce uptake of vaccines featuring later in the schedule). Colleagues at the Department of Health (DH) in the UK therefore wanted to know whether assessing the impact across the entire programme of a proposed change to the UK schedule could lead to different decisions than those made on the current case-by-case basis. This work is a first step towards addressing this question.Methods: A novel framework for estimating the effective coverage against all of the diseases within a vaccination programme was developed. The framework was applied to the current (August 2015) UK childhood immunisation programme, plausible extensions to it in the foreseeable future (introducing vaccination against Meningitis B and/or Hepatitis B) and a "what-if" scenario regarding a Hepatitis B vaccine scare that was developed in close collaboration with DH.Results: Our applications of the framework demonstrate that a programme-view of hypothetical changes to the schedule is important. For example, we show how introducing Hepatitis B vaccination could negatively impact aspects of the current programme by reducing uptake of vaccines featuring later in the schedule, and illustrate that the potential benefits of introducing any new vaccine are susceptible to behaviour changes affecting uptake (e.g. a vaccine scare). We show how it may be useful to consider the potential benefits and scheduling needs of all vaccinations on the horizon of interest rather than those of an individual vaccine in isolation, e.g. how introducing Meningitis B vaccination could saturate the early (2-month) visit, thereby potentially restricting scheduling options for Hepatitis B immunisation should it be introduced to the programme in the future.Conclusions: Our results demonstrate the potential benefit of considering the programme-wide impact of changes to an immunisation schedule, and our framework is an important step in the development of a means for systematically doing so. [ABSTRACT FROM AUTHOR]

The increasing number of travellers from the UK has resulted in an increase in travel health-related consultations in a variety of locations. Providers of a travel health service must be competent not only in prescribing, but also in the processes of risk assessment and administering a variety of live and inactivated immunizations. Providers of such a service should ensure they have undertaken appropriate training and are involved with ongoing continuing professional development. [ABSTRACT FROM AUTHOR]

Objective: To estimate the potential cost-effectiveness of quadrivalent influenza vaccine compared with trivalent influenza vaccine in the UK. Methods: A lifetime, multi-cohort, static Markov model was constructed, with nine age groups each divided into healthy and at-risk categories. Influenza A and B were accounted for separately. The model was run in one-year cycles for a lifetime (maximum age: 100 years). The analysis was from the perspective of the UK National Health Service. Costs and benefits were discounted at 3.5%. 2010 UK vaccination policy (vaccination of people at risk and those aged ≥65 years) was applied. Herd effect was not included. Inputs were derived from national databases and published sources where possible. The quadrivalent influenza vaccine price was not available when the study was conducted. It was estimated at £6.72,15% above the trivalent vaccine price of £5.85. Sensitivity analyses used an incremental price of up to 50%. Results: Compared with trivalent influenza vaccine, the quadrivalent influenza vaccine would be expected to reduce the numbers of influenza cases by 1,393,720, medical visits by 439,852 complications by 167,357, hospitalisations for complications by 26,424 and influenza deaths by 16,471. The estimated base case incremental cost-effectiveness ratio (ICER) was £5,299/quality-adjusted life-year (QALY). Sensitivity analyses indicated that the ICER was sensitive to changes in circulation of influenza virus subtypes and vaccine mismatch; all other parameters had little effect. In 96% of simulations the ICER was <£20,000/QALY. Since this analysis was completed, quadrivalent influenza vaccine has become available in the UK at a list price of £9.94. Using this price in the model, the estimated ICER for quadrivalent compared with trivalent vaccination was £27,378/QALY, still within the NICE cost-effectiveness threshold (£20,000-£30,000). Conclusions: Quadrivalent influenza vaccine could reduce influenza disease burden and would be cost-effective compared with trivalent influenza vaccine in elderly people and clinical risk groups in the UK. [ABSTRACT FROM AUTHOR]

Immunisation decision making is not a straightforward process for parents. Many factors influence parental decision making on whether they immunise their child with the measles, mumps and rubella (MMR) vaccine. The feasibility study described in this article provides insight into influencing factors associated with decisions regarding the immunisation of children by parents. The study findings suggest that the practice nurse is a credible source of information for parents seeking informed decision making. At a time when the incidence of measles and mumps is rising in the UK, the provision of appropriate information by the practice nurse has the potential to increase uptake of the MMR vaccine. [ABSTRACT FROM AUTHOR]

Davison, Frankel, and Davey Smith (1989) conceptualised lay epidemiology as the process of interpreting health risks through considering non-traditional sources of information drawn from personal networks and from the public arena. We analysed 100 unsolicited letters received by professional epidemiologists studying the causes of autistic spectrum disorders (ASD). The correspondents sourced their ideas from an interaction between personal, social, media, and scientific sources, as well as conducting their own studies. Thus their correspondence represented a form of lay epidemiology in action, and as such provides a useful pointer to how 'lay expertise' may be harnessed in practice. The vast majority of the letters put forward theories and hypotheses about hazards related to early twenty-first century society, either medical technologies, unavoidable by-products of technology, or risks created by modern lifestyles. Given the conclusions of previous studies a surprisingly small minority put forward causes related to vaccines. This disparity is discussed. The findings shed light on the nature of public trust of institutions involved in the definition of risk. They underline the strength of public concern not just about vaccines, but more widely about risks of modern society and technology causing childhood disorders. [ABSTRACT FROM AUTHOR]