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Simple Summary: Immunity combined with ferroptosis is being considered as a new tumor treatment modality, and its regulation in head and neck squamous cell carcinoma is still unknown. The purpose of this study was to look into the potential molecular biological roles of immune ferroptosis genes in head and neck squamous cell carcinoma. The 12-IFRM signatures were successfully constructed and classified into high- and low-risk groups using the TCGA database and related data resources. In patients with head and neck squamous cell carcinoma, feature-based risk scores were more predictive of survival than traditional clinicopathological features. Furthermore, the expression of CD8+T cells and macrophage M0 differed significantly between the two groups. The expression of TNFSF9 and CD44 in the high-risk groups was significantly increased compared with the low-risk groups. Next, we found a higher proportion of high-risk mutations than in the low-risk group. In addition, the high-risk group was more sensitive to some chemotherapy drugs. Finally, we performed correlation analysis on the model genes. In this paper, the 12-IFRM signatures was developed with promising application prospects for predicting the clinical outcomes and treatment outcomes in head and neck squamous cell carcinoma. Ferroptosis is a new type of programmed cell death that plays a pivotal role in a variety of tumors. Moreover, immunity is closely related to ferroptosis. However, immune-ferroptosis-related mRNAs (IFRMs) are still not fully understood in the regulation of head and neck squamous cell carcinoma (HNSC). The purpose of this paper was to investigate the IFRMs prediction of HNSC and its possible molecular biological role. RNA-Seq and related clinical data were mined from the TCGA database, ImmPort database, GeneCards database, FerrDb database, and previous data. In R software, the "DESeq2" package was used to analyze the differential expression of IFRMs. We used univariate Cox analysis to judge the prognosis of the IFRMs. Using the least absolute shrinkage and selection operator (LASSO) and Cox regression, a prediction model for 12 IFRMs was established. In this study, the Kaplan–Meier survival curve and receiver operating characteristic (ROC) curve analysis were used to evaluate the prediction results. Moreover, factors such as immune landscape, somatic mutations, and drug susceptibility are also discussed. We successfully constructed the signature of 12-IFRMs. The two risk groups were classified according to the risk score obtained by this signature. Compared with conventional clinicopathological features, the characteristic-based risk score was more predictive of survival in patients with HNSC. Furthermore, the expression of CD8+T cells and macrophage M0 differed significantly between the two groups. Moreover, the expression of TNFSF9 and CD44 in high-risk groups was significantly increased compared with the low-risk groups. Then, we found a higher proportion of high-risk mutations than in the low-risk group. Next, the high-risk group was more sensitive to chemotherapy drugs such as bosutinib, docetaxel, erlotinib, gefitinib, imatinib, lapatinib, and sorafenib. Finally, an in-depth analysis of the association and potential value of the 12 genes was performed. In summary, the 12-IFRM signatures established in this paper had good application prospects and could be effectively used to predict the clinical outcome and treatment response of head and neck squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic presented substantial challenges to public health stakeholders working to vaccinate populations against the disease, particularly among vaccine hesitant individuals in low- and middle-income countries. Data on the determinants of vaccine hesitancy are scarce, and often available only at the national level. In this paper, our goal is to inform programmatic decision making in support of local vaccine uptake. Our analytical objectives to support this goal are to (1) reliably estimate attitudinal data at the hyperlocal level, and (2) estimate the loss of data heterogeneity among these attitudinal indicators at higher levels of aggregation. With hyperlocal attitudinal data on the determinants of vaccine hesitancy, public health stakeholders can better tailor interventions aimed at increasing uptake sub-nationally, and even down to the individual vaccination site or neighborhood. Methods: We estimated attitudinal data on the determinants of vaccine hesitancy as framed by the WHO's Confidence, Complacency, and Convenience ("3Cs") Model of Vaccine Hesitancy using a nationally and regionally representative household survey of 4,922 adults aged 18 and above, collected in February 2022. This custom survey was designed to collect information on attitudes towards COVID-19 and concerns about the COVID-19 vaccine. A machine learning (ML) framework was used to spatially interpolate metrics representative of the 3Cs at a one square kilometer (1km2) resolution using approximately 130 spatial covariates from high-resolution satellite imagery, and 24 covariates from the 2018 Nigeria Demographic and Health Survey (DHS). Results: Spatial interpolated hyperlocal estimates of the 3Cs captured significant information on attitudes towards COVID-19 and COVID-19 vaccines. The interpolated estimates held increased heterogeneity within each subsequent level of disaggregation, with most variation at the 1km2 level. Conclusions: Our findings demonstrate that a) attitudinal data can be successfully estimated at the hyperlocal level, and b) the determinants of COVID-19 vaccine hesitancy have large spatial variance that cannot be captured through national surveys alone. Access to community level attitudes toward vaccine safety and efficacy; vaccination access, time, and financial burden; and COVID-19 beliefs and infection concerns presents novel implications for public health practitioners and policymakers seeking to increase COVID-19 vaccine uptake through more customized community-level interventions. [ABSTRACT FROM AUTHOR]

Attacks on networks is a very important issue in developing strategies of eradicating spreads of malicious phenomena in networks, such as epidemics and fake information. This field of research is referred to as networks immunization. The traditional approach to evaluating the effectiveness of attacks on networks focuses on measuring macro parameters related to the entire attack, such as the critical probability of a percolation occurrence in the network p c and the relative size of the largest component in the network, known as the giant component, but not considering the attack on a micro perspective, which is the analysis of node removals, during an attack, themselves, their characteristics and results. In this paper we present and apply the last method of focusing on the micro scale of an attack. Based on the theory of percolation in networks, we analyze the phenomenon of an avalanche which results due to a single node removal from a network. An avalanche is a state in which a removal of a single node from the giant component of a network leads to the disconnection of additional nodes. This process significantly contributes to the fragmentation (immunization) of the network, comparing to the impact of the initial node removal alone. Specifically, we focus on the size parameter of an avalanche, which is the number of nodes that are disconnected from the giant component due to a single node removal. Relating to a random attack on a network of the type of Cayley tree, we derive analytically the distribution of the sizes of avalanches that occur during the entire attack on it, until the network is dismantled (immunized) and the attack is terminated. [ABSTRACT FROM AUTHOR]

Background: Several economic obstacles can deter the development and use of vaccines. This can lead to limited product options for some diseases, delays in new product development, and inequitable access to vaccines. Although seemingly distinct, these obstacles are actually interrelated and therefore need to be addressed through a single over-arching strategy encompassing all stakeholders. Methods: To help overcome these obstacles, we propose a new approach, the Full Value of Vaccines Assessments (FVVA) framework, to guide the assessment and communication of the value of a vaccine. The FVVA framework is designed to facilitate alignment across key stakeholders and to enhance decision-making around investment in vaccine development, policy-making, procurement, and introduction, particularly for vaccines intended for use in low- and middle-income countries. Results: The FVVA framework has three key elements. First, to enhance assessment, existing value-assessment methods and tools are adapted to include broader benefits of vaccines as well as opportunity costs borne by stakeholders. Second, to improve decision-making, a deliberative process is required to recognize the agency of stakeholders and to ensure country ownership of decision-making and priority setting. Third, the FVVA framework provides a consistent and evidence-based approach that facilitates communication about the full value of vaccines, helping to enhance alignment and coordination across diverse stakeholders. Conclusions: The FVVA framework provides guidance for stakeholders organizing global-level efforts to promote investment in vaccines that are priorities for LMICs. By providing a more holistic view of the benefits of vaccines, its application also has the potential to encourage greater take-up by countries, thereby leading to more sustainable and equitable impacts of vaccines and immunization programmes. Highlights: 1. What is already known on this subject? While existing 'pull' and 'push' mechanisms to incentivize new vaccine development can enhance coordination across multiple stakeholders with different agendas, these mechanisms have not fully addressed interrelated obstacles for the optimal development, use, and impact of vaccines and immunization programmes in an integrated and holistic way. 2. What this study adds? This paper presents a conceptual framework, the Full Value of Vaccine Assessments (FVVA), which outlines coherent, organizing principles to guide the assessment of the value of vaccines, promote communication across stakeholders, and facilitate more informed country ownership of decision-making. Application of the FVVA approach has the potential to expand the sustainable and equitable impact of vaccines and immunization programmes. 3. Policy implications The FVVA approach outlined here will inform global-level efforts to enhance coordination among diverse stakeholders involved in policy- and decision-making related to the development and implementation of new vaccines. [ABSTRACT FROM AUTHOR]

The evidence indicates that pregnancy is associated with increased severity of some infectious diseases. Given the high maternal morbidity associated with influenza in pregnancy and the high neonatal morbidity and mortality associated with pertussis, the traditionally two recommended vaccines during pregnancy were those against influenza and Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis) vaccines. The recent COVID‐19 pandemic introduced a third vaccine that after much debate is now recommended for all pregnant women. Other vaccines can be offered based for high‐risk pregnant women, and only when the benefits of receiving them outweigh the risks. The soon expected vaccines against group B streptococcus infection and respiratory syncytial virus infection will be a breakthrough in reducing perinatal mortality. In this paper, the recommendations for administration of each vaccine during pregnancy are discussed. Synopsis: Women should be counseled to receive the influenza, Tdap and COVID‐19 vaccines during pregnancy. Other vaccines can be offered to a high‐risk population of pregnant women. [ABSTRACT FROM AUTHOR]

In 2014, the Global Alignment on Immunization safety Assessment in pregnancy consortium (GAIA) was formed, with the goal of developing a harmonized, globally‐concerted approach to actively monitor the safety of vaccines in pregnancy. A total of 26 standardized definitions for the classification of adverse events have been developed. The aim of this review was to identify and describe studies undertaken to assess the performance of these definitions. A literature search was undertaken to identify published studies assessing the performance of the definitions, and reference lists were snowballed. Data were abstracted by two investigators and a narrative review of the results is presented. Four studies that have evaluated 13 GAIA case definitions (50%) were identified. Five case definitions have been assessed in high‐income settings only. Recommendations have been made by the investigators to improve the performance of the definitions. These include ensuring consistency across definitions, removal of the potential for ambiguity or variations in interpretation and ensuring that higher‐level criteria are acceptable at lower levels of confidence. Future research should prioritize the key case definitions that have not been assessed in low‐ and middle‐income settings, as well as the 13 that have not undergone any validation. Synopsis: This review paper summarizes the research conducted assessing performance of standardized case definitions developed to actively monitor the safety of maternal vaccines globally. [ABSTRACT FROM AUTHOR]

Preterm birth (PTB) and stillbirth remain two of the most important causes of death, morbidity, and disability in childhood. Despite efforts to reduce PTB and stillbirth worldwide, rates of these adverse outcomes remain persistently elevated, independent of income setting. There is an urgent need for more effective interventions to reduce associated neonatal and early childhood morbidity and mortality. Maternal vaccines are a well‐established strategy used for prevention of pathogen‐specific disease in mothers and infants through transplacental antibody transfer. Beyond these pathogen‐specific benefits, some studies have also identified non‐specific effects (NSEs) of maternal vaccination protecting against several adverse birth outcomes, including PTB and stillbirth. This paper will review the evidence supporting the NSEs of maternal vaccination on birth outcomes, describe the possible underlying mechanisms, outline the research gaps, and summarize the significance from a global health perspective. Synopsis: Vaccines are given primarily for pathogen‐specific effects but may benefit pregnant women through non‐specific mechanisms, providing opportunities to improve outcomes including preterm birth and stillbirth. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis B continues to be a serious occupational concern for dental healthcare practitioners, with the possibility of transmission occurring during patient care practices. The incidence of hepatitis B amongst dentists, the factors raising their occupational risk, and the efficiency of vaccination programs in reducing this risk are all examined in this paper’s methodical evaluation of the body of prior research. This study addresses the important confluence of hepatitis B infection, occupational exposure, and vaccination status amongst dentists. In addition, it provides methods for improving the protection of dental professionals against hepatitis B infection by summarizing major findings and highlighting gaps in current knowledge, assuring the safety of both healthcare workers and their patients. The main objective of the study is to assess the relationship between Hepatitis B vaccination status and immunization level as measured by anti-HBs titer among a population of 192 dentists in Lebanon. Materials & Methods: 192 dentists, underwent the anti-HBs titer blood test. This test, which is Elecsys Anti-HBs, was used for the quantitative assessment of antibodies against the HBsAg. Results: The chi-square test was used to assess the association between being vaccinated against Hepatitis B and being immunized against the disease. A significant association was found between vaccination and immunity status. Among those vaccinated against Hepatitis B, 86.7% were found to be immune based on the blood test results versus 36.0% of those not vaccinated (p<0.001). Conclusion: the current study’s It highlights how crucial it is to keep up efforts to increase vaccination rates and promote immunization in order to improve population health and well-being in general. A dentist can play a part in hepatitis prevention by treating each and every patient as a possible hepatitis carrier. [ABSTRACT FROM AUTHOR]

Individuals with a history of coronavirus disease 2019 (COVID-19) exhibit memory immunity acquired during natural infection. However, a decline in immunity after infection renders these individuals vulnerable to re-infection, in addition to a higher risk of infection with new variants. This systematic review examined related studies to elucidate the antibody response in these infected individuals after messenger ribonucleic acid (mRNA) vaccination. Hence, the focus of this review was to ascertain differences in the concentration of binding and neutralising antibodies of previously infected individuals in comparison to those of infection-naïve individuals after administration of two doses of mRNA vaccination through available case-control and cohort studies. Positive reverse transcriptase-polymerase chain reaction (RT-PCR) test or detectable anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies at the baseline in included studies showed categorisation of infected and uninfected individuals. This review utilised three online databases: PubMed, Scopus and Cochrane with the following keywords: (COVID-19 OR 'Coronavirus Disease 2019' OR SARS-CoV-2) AND Immun* AND (Pfizer OR BioNTech OR BNT162b2 OR Comirnaty OR Moderna OR mRNA-1273) from January 2019 to July 2021. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) 2020 guidelines and assessment based on the Crowe Critical Appraisal Tool (CCAT), we included 13 related qualified papers of observational studies discerning the binding and neutralising antibody concentrations of infected and uninfected individuals after administration of mRNA vaccines, such as the BNT162b2 and mRNA-1273 vaccine. The mRNA vaccines induced robust binding and neutralising antibody responses in both groups. However, infected individuals showed induction of higher antibody responses in a shorter time compared to uninfected individuals. Hence, a single dose of mRNA vaccination for infected individuals may be sufficient to reach the same level of antibody concentration as that observed in uninfected individuals after receiving two doses of vaccination. [ABSTRACT FROM AUTHOR]

The Philippines is one of the single largest nationality groups in the maritime and shipping sectors; as a result, the nation's efforts to modernize the skills of the engine cadets are significant. This study aimed to assess the engine cadets' skill level in relation to the requisite 21st-century skills while they were receiving shipboard training at TORM Shipping Philippines Inc. It used a sequential explanatory mixed-methods design. The paper used mean, standard deviation, and Mann-Whitney for comparing differences between two independent groups for the statistical treatment analyses of the quantitative data. Thematic analysis of the descriptive data provided by the interviewees involved coding and identifying common themes, patterns, and responses. The findings revealed that the engine cadets were competent in three (3) areas but needed to be more competent in the remaining area (inventive thinking). This signified that the engine cadets need supplemental training in the areas where they are less apt to improve their skills in all variables, especially 21st-century skills. The management of maritime schools and policymakers must address the common factors that prevent engine cadets from acquiring 21st-century skills, according to the study. [ABSTRACT FROM AUTHOR]

The purpose of this qualitative case study is to explore the potential value of an innovative business model on pediatric immunization record management which will serve as the basis for the development of a digital platform for the use of pediatric consultants and medical secretaries at a private secondary hospital in Quezon City. The study utilized a qualitative case study involving the pediatric consultants and medical secretaries of a private secondary hospital in Quezon City. Qualitative data for this study were gathered through in-depth, semi-structured interviews, focus group discussions, documents, journaling, and observations. Results have shown that pediatric consultants and medical secretaries follow only one way of arranging patients' records which is through alphabetical order using the surname. Many clinics and hospitals still rely on paper-based medical records to document patients' information. All participants shared the same difficulties and sentiments when it comes to the problems they have in the current way they deal with immunization records. Based from the statements of the participants, results revealed that pediatric consultants and medical secretaries support and are in favor of the use of a web-based record management system. However, some participants stated their apprehensions for the security of patient information. Further study that focuses on formal training is recommended to increase the confidence of the healthcare workers in utilizing digital record management systems and intense exploration of the potential challenges in adapting a digitized records management system must be conducted. [ABSTRACT FROM AUTHOR]

The central objective of this paper is to distinguish the impact of different cell phone applications on child vaccination completion. A systematic literature review was conducted to determine how mobile applications have improved the acceptance, education, and fulfillment of vaccines. To this end, an analysis of the aspects, objectives, and differentiated technologies that have fostered the growth of mobile applications and new technologies in childhood immunization is presented. In addition, the obstacles to achieving positive results reported in the scientific literature are identified. Lastly, suggestions are made for future work to improve childhood immunization coverage. [ABSTRACT FROM AUTHOR]

This article presents the World Health Organization's (WHO) recommendations for pain mitigation at the time of vaccination from the WHO position paper on reducing pain at the time of vaccination: WHO position paper—September 2015, recently published in the Weekly Epidemiological Record [1] . This position paper summarizes the evidence and integrates information pertaining to the reduction of pain, distress and fear during immunization across all age groups. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact, and on vaccination-related policy questions particularly concerning the use of vaccines in large-scale immunization programmes. They summarize essential background information and conclude with the current WHO position. This position paper addresses a cross-cutting issue which is relevant for all injectable vaccines and reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2015 meeting. The evidence presented at the meetings can be accessed at http://www.who.int/immunization/sage/previous/en/index.html . [ABSTRACT FROM AUTHOR]

Public health policy often involves a trade-off between promoting population health and protecting the interests of identifiable individuals. This paper analyses this tradeoff as it arises in the context of decisions about the vaccination of children against Covid-19, where vaccination may be in the interests of society as a whole, as a means to stopping transmission, but not in the interests of individual children. The paper argues that the UK's Joint Committee on Vaccination and Immunisation resolved this tension by appeal to a version of a non-maleficence principle. It argues that, while this principle can be a useful guide to some public health policy decision-making, it is inappropriate in the case of vaccination. [ABSTRACT FROM AUTHOR]

• Community pharmacies continued to serve as immunization sites during the pandemic. • Types of vaccines administered in 2020 and 2019 were similar. • 95% of pharmacies continued to offer vaccines to walk-in patients in 2020. • 48% of pharmacies made vaccines available through appointments in 2020. • 50% of pharmacies offered vaccines outside the pharmacy (e.g.: curbside) in 2020. Immunization rates for seasonal and non-seasonal vaccines dropped during the COVID-19 pandemic. Little is known about the extent to which community pharmacies in the USA continued to serve as immunization sites during the pandemic. This study compared 1) the types and perceived changes in non-COVID-19 vaccine doses administered at rural community pharmacies in 2020 (during the pandemic) to 2019 (pre-pandemic) and 2) the delivery of non-COVID-19 immunization services in 2020 to 2019. A mixed-mode (paper/electronic) survey of a convenience sample of 385 community pharmacies operating in rural settings and have administered ≥1 vaccine in 2019 and 2020 was distributed in May-August 2021. Survey development was informed by relevant literature, pre-tested with three individuals, and pilot-tested with 20 pharmacists. Non-response bias was assessed, and survey responses were analyzed using descriptive and bivariate statistics. Of the 385 community pharmacies, 86 qualified pharmacies completed the survey (Response Rate = 23.8%). The percentage of pharmacies offering a given vaccine in 2019 and 2020 were similar; with one exception, a higher percentage of pharmacies reported having MMR administered for adults in the pharmacy in 2020 (McNemar's test; p-value = 0.0253). For each given vaccine, the majority of respondents did not perceive a change in the number of doses administered in 2020 compared to 2019. Further, the majority reported no difference in how they delivered immunization services during and pre-pandemic. However, a small percentage of respondents (6.0–22.0%) adapted their services by adopting several measures to ensure the safety and continuity of immunizations during the pandemic. Findings highlight the importance of community pharmacies as immunization sites during the pandemic. Community pharmacies continued immunization delivery at community pharmacies during the pandemic with almost no noticeable change to types and doses of vaccines compared to pre-pandemic nor the process of vaccine delivery. [ABSTRACT FROM AUTHOR]

Objective: To determine the proportion of staff employed in smaller Victorian public acute healthcare facilities with evidence of immunity to hepatitis B. Methods: For optimal long-term immunity, a completed hepatitis B vaccination course and post vaccination hepatitis B surface antibody (anti-HBs) level ≥10 mIU/mL is desirable for all high-risk staff employed in healthcare facilities. For the financial years 2016/17–2019/20, a standardised surveillance module developed by the Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre was completed by the smaller Victorian public acute healthcare facilities (individual hospitals with <100 acute care beds or their multi-site health service). Staff were assessed as having evidence or no evidence of optimal immunity to hepatitis B. Those without optimal evidence were sub-classified as 'incomplete vaccination course', 'no serology', 'contraindicated', 'non-responder', 'declined' or 'unknown'. Data were analysed to determine trends over time for healthcare facilities that participated more than once. Results: A total of 88 healthcare facilities reported hepatitis B immunity status of high-risk (Category A) staff (n = 29 920) at least once over 5 years; 55 healthcare facilities reported more than once. The aggregate proportion with evidence of optimal immunity was 66.3%. Healthcare facilities with 100–199 Category A staff employed reported the lowest evidence of optimal immunity (59.6%). Of all Category A staff with no evidence of optimal immunity, the majority had 'unknown' status (19.8%), with only 0.6% overall who declined vaccination. Conclusions: Our study found evidence of optimal staff hepatitis B immunity in only two-thirds of Category A staff working in surveyed healthcare facilities. What is known about the topic? Non-immune healthcare staff are at risk of acquiring hepatitis B in the event of an occupational exposure to blood-borne pathogens. What does this paper add? An update about the proportion of staff employed in healthcare facilities with evidence of optimal long-term immunity to hepatitis B. What are the implications for practitioners? To mitigate risk, enhanced immunisation policies and programs are needed to actively support healthcare staff hepatitis B vaccination and serological testing; this includes documented follow up of those staff whose immune status is currently reported as unknown. [ABSTRACT FROM AUTHOR]

The two studies reported in the paper examined (1) the extended parallel process model's (EPPM; Witte 1992) ability to predict and explain college students' COVID-19 vaccination behavior, and (2) the EPPM-related reasons for college students' COVID-19 vaccine hesitancy. Study 1 was a longitudinal study that measured the EPPM constructs at Time 1 and COVID-19 vaccine behavior two months later at Time 2. For danger control, results indicate that perceived threat and perceived efficacy positively predicted intentions and that intentions positively predicted behavior. For fear control, results indicate that perceived threat positively predicted fear, that perceived efficacy did not predict fear, and that fear negatively predicted defensive avoidance, reactance, and fatalism. Study 2 was a cross-sectional survey that assessed EPPM-related reasons for vaccine hesitancy. Results indicate that the main reasons for vaccine hesitancy were related to response efficacy (i.e., participants were concerned about the safety and effectiveness of the vaccine). The theoretical and practical implications of these results are discussed. [ABSTRACT FROM AUTHOR]

With the onset of the COVID-19 pandemic in 2019–2020 and the rapid development of vaccines to prevent this disease came a rise in interest around vaccine hesitancy. Naturally, methods of combatting vaccine hesitancy and increasing vaccination rates are of paramount importance. One such method is building upon the trust and openness of one's relationship with their healthcare provider. Specifically, this paper examines how psychotherapist self-disclosure could facilitate effective health behaviors in patients, focusing on vaccines. Traditionally, mental health therapists have been encouraged to avoid self-disclosure of personal information due to the possibility of unbalancing or damaging the therapeutic relationship. However, research from medicine and other disciplines suggests that personal recommendation, self-disclosure of vaccination status, and expert encouragement may be effective methods of addressing vaccine hesitancy. In addition, recommendations for therapists in discussing vaccination and in working with vaccine-hesitant patients are provided. [ABSTRACT FROM AUTHOR]

This paper proposes a kinetic theory approach coupling together the modeling of crowd evacuation from a bounded domain with exit doors and infectious disease contagion. The spatial movement of individuals in the crowd is modeled by a proper description of the interactions with people in the crowd and the environment, including walls and exits. At the same time, interactions among healthy and infectious individuals may generate disease spreading if exposure time is long enough. Immunization of the population and individual awareness to contagion is considered as well. Interactions are modeled by tools of game theory, that let us propose the so-called tables of games that are introduced in the general kinetic equations. The proposed model is qualitatively studied and, through a series of case studies, we explore different scenarios related to crowding and gathering formation within indoor venues under the spread of a respiratory infectious disease, obtaining insights on specific policies to reduce contagion that may be implemented. [ABSTRACT FROM AUTHOR]

BACKGROUND: The recent COVID-19 pandemic like situation has killed a large numbers of people and caused havoc across the world. With the aim of providing the COVID-19 related updated information about facilities, availability, utilization of COVID-19 related resources like vaccines, hospitals, beds, oxygen to the people and preventing its surge, many websites were developed for health guidance to the general masses. OBJECTIVE: The objective of this paper is to investigate the accessibility and usability of websites providing COVID-19 information in India. METHODS: This study evaluates the 38 websites providing COVID-19 information in India using automated tools. RESULTS: It was found that digital healthcare information is far from accessibility conformance and none of the websites conformed to web content accessibility guidelines (WCAG) 2.0 completely. The website adhered to understandability with average errors of 2.8 while less compliant to perceivability with average errors of 30.5. It was also found that most of the websites were mobile friendly. [ABSTRACT FROM AUTHOR]

National immunization technical advisory groups (NITAGs) develop immunization-related recommendations and assist policy-makers in making evidence informed decisions. Systematic reviews (SRs) that summarize the available evidence on a specific topic are a valuable source of evidence in the development of such recommendations. However, conducting SRs requires significant human, time, and financial resources, which many NITAGs lack. Given that SRs already exist for many immunization-related topics, and to prevent duplication and overlap of reviews, a more practical approach may be for NITAGs to use existing SRs. Nevertheless, it can be challenging to identify relevant SRs, to select one SR from among multiple SRs, or to critically assess and effectively use them. To support NITAGs, the London School of Hygiene and Tropical Medicine, Robert Koch Institute and collaborators developed the SYSVAC project, which consists of an online registry of systematic reviews on immunization-related topics and an e-learning course, that supports the use of them (both freely accessible at https://www.nitag-resource.org/sysvac-systematic-reviews). Drawing from the e-learning course and recommendations from an expert panel, this paper outlines methods for using existing systematic reviews when making immunization-related recommendations. With specific examples and reference to the SYSVAC registry and other resources, it offers guidance on locating existing systematic reviews; assessing their relevance to a research question, up-to-dateness, and methodological quality and/or risk of bias; and considering the transferability and applicability of their findings to other populations or settings. [ABSTRACT FROM AUTHOR]

Vaccination is the most celebrated and denigrated achievement of medicine and public health – not only today, but since Edward Jenner's time (1798). In fact, the idea of injecting a mild form of "disease" into a healthy person was attacked even earlier than the discovery of vaccines. The forerunner of Jenner's vaccination with bovine lymph was the inoculation of smallpox material from person to person, which, known in Europe since the beginning of the eighteenth century, was a target of harsh criticism. The reasons for criticizing the Jennerian vaccination and its mandatory practice were medical, anthropological, biological (vaccination is not safe), religious and ethical (it is wrong to inoculate a healthy person with disease), and political (vaccination is a threat to individual freedom). As such, anti-vaccination groups emerged in England, where inoculation was adopted early, as well as overall in Europe and in the United States. This paper focuses on the lesser known debate that arose in Germany in the years 1852–53 about the medical practice of vaccination. This is an a important topic of public health that has aroused a wide debate and comparison especially in recent years and now with pandemic on Sars-Cov-2 (Covid-19) and will probably be the subject of further reflection and consideration in the coming years. [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]

A local immunization strategy, which is effective in huge no‐scale network, is proposed in the paper. When there is an outbreak of virus in network, vaccinating limit nodes can reduce the damage of virus by preventing the propagation. Immunization strategy, which has been a hot topic for years, manages to choose the proper nodes to vaccinate. However, with the modern network growing large rapidly, the classic immunization strategies, such as degree‐based strategies and betweenness‐based strategies, will face the efficiency problem and accuracy problem. To solve the problem, we have pro‐posed a local immunization strategy, which performs effectively in huge no‐scale network. Firstly, we train an unsupervised graph neural network to get the embedding of nodes. Then with the help of node's embedding, we find the nodes exposed to virus spreader most severely and choose them as the vaccinated target. The calculation of node's exposure is local and fast, and it can depict the node's suspicious exposure to the virus from the global view of the network, which makes our immunization strategy approximate the global optimal solution. In addition, the vaccinating targets are calculated timely according to real‐time distribution of virus spreaders, by this way, our strategy is adaptive to the fast changes in the propagation of virus. At last, we refine the time complexity to make our strategy practical in huge network. Compared with current method, our network immunization strategy shows privilege in the simulation experiment. © 2022 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Recurrent Miscarriages are seen in 2%–5% of women and 50% of these are labelled as unexplained as no underlying cause is found in them. Various studies have explained possible alloimmune basis in these couples. Lymphocyte Immunization Therapy (LIT) was the earliest immunomodulatory method suggested in these cases. The efficacy of LIT was questioned by REMIS study in 1999 and subsequent Cochrane reviews. However, recent meta‐analyses have shown that LIT is not only effective in the treatment of repeated miscarriages but it is also safe. Review of the odds ratio for live birth of various meta‐analyses of studies in recurrent miscarriages has also shown that newer meta‐analyses have shown higher odds ratios. The purpose of this paper is to put forward the current perspective of LIT in reproductive failure and bring forth the recent evidence. In addition, we share our experience with the use of LIT in women with recurrent pregnancy losses. However, large multicentric RCTs are required to further prove efficacy of LIT. [ABSTRACT FROM AUTHOR]

In this article, we aimed to evaluate the most recent information on the impact of the COVID-19 pandemic on the health of mothers and their babies. We conducted a literature search by utilizing online sources. Scientific papers that were written in English on the effects of COVID-19 on both mother and their newborn were assessed. COVID-19 can be fatal, especially in pregnant women with accompanying chronic diseases. The timing and mode of delivery should be decided by the status of the mother and fetus instead of SARS-CoV-2 positivity in pregnant women. At the nursery, routine separation of SARS-CoV-2 positive mothers and their infants is not recommended. However, it is important to take preventive measures to reduce the risk of transmission. The advantages of breastfeeding seem to outweigh the potential dangers of viral transmission. Neonatal COVID-19 infections may cause different clinical pictures from asymptomatic infections to life-threatening diseases. International health authorities specifically recommend that pregnant and lactating women get vaccinated to diminish the risk of transmission of the virus to the mother and fetus, not giving preference to a certain vaccine. It is prudent to apply universal screening only in populations with a high prevalence of COVID-19. Healthcare professionals should carefully manage the perinatal period during the COVID-19 outbreak, using the most up-to-date information to protect and promote maternal and newborn health. Further scientific studies are needed to clarify the early and long-term effects of the COVID-19 pandemic on maternal-neonatal morbidity and mortality. [ABSTRACT FROM AUTHOR]

Since 2007, the number of HIV diagnoses in Turkey has increased more than 600% and the AIDS-related deaths have more than doubled. Despite trans community being severely impacted by the growing epidemic, there exists a conspicuous absence of epidemiological data regarding the HIV burden of trans people. This paper examines the medical experiences of HIV-positive trans women who engage in sex work and the harmful violence they encounter at the hands of health providers. The paper emphasizes the urgent need for comprehensive interventions to address the intersecting issues of HIV risk, structural violence, and discrimination faced by HIV-positive trans sex workers, one of the most marginalized communities worldwide. To interpret better how transphobia and HIVphobia become deeply entangled in Turkish medical settings, the paper draws from the concepts of iatrogenesis , necropolitics, and immunity. By bringing together these conceptual tools with long-term ethnographic data and in-depth interviews, this paper demonstrates that trans women are treated by healthcare providers as though they are always-already infectious. The paper contends that aggressive immunitarian boundaries, erected between healthcare personnel and individuals deemed "contagious others," are central to doctors' denial of medical care and reluctance to touch, examine, or even admit trans patients, particularly when they are HIV-positive. • Social immunization lies at the core of doctors' refusal of care for trans patients. • Social immunization is central to the operation of necropolitics and iatrogenesis. • Doctors establish violent boundaries in an attempt to "protect" themselves. • Trans women are assumed to be inherently contagious by healthcare providers. • Trans communities are slowly debilitated through denial of healthcare services. [ABSTRACT FROM AUTHOR]

Historically, consent for treatment in the United Kingdom's National Health Service has been collected using traditional paper forms. For public health services, such as immunizations, this process involved significant time, space, paper, and staff resources. In a bid to provide a more modern, secure, cost‐effective and paperless service, an electronic consent (eConsent) form for the routine school aged immunization program was designed and successfully piloted for the HPV 1 vaccine in 25 schools during the summer of 2019, with an average of 80% return rate. This was not only significantly higher than paper consent returns, there was also a significantly quicker return rate. These factors resulted in the clinical record being updated more quickly than ever before which reduced clinical risk. Following the pilot, the program was launched countywide for all school aged immunizations in September 2020. Since its launch some minor issues have been identified but resolved quickly and efficiently. Although still in its early days it is felt that the eConsent system has promoted a more informed and easier collaboration across sectors and has reduced operating costs. Although the use of electronic consent needs to be used more widely, it is felt that this new practice is a success. [ABSTRACT FROM AUTHOR]

Introduction: Research on vaccines, and their later application to society, created the necessity of communication strategies, taking also into account the fake-news propaganda. All these with the sole purpose of keeping the population informed about the treatments against COVID-19. This leads to the reaction of the academic community, which has investigated and explained how these phenomena are developing. Objectives: To analyze the reaction of communication research areas on this inoculation matter based on the increasing of paper publications and citations in indexed journals on the Web of Science (WoS). Methodology: Quantitative analysis of the number of publications and citations on the vaccine topic by using the topic category Communication on WoS. It has been studied for the last 12 years and three months (January 2010 to March 2022), by comparing the state-of-the-art of this area earlier and after the COVID-19 pandemic. Results: It is corroborated that in the years 2020, 2021 and the first trimester of 2022 the number of publications and citations about vaccines in communication journals has experienced exponential growth approximately. Conclusions: The academic community that published in indexed journal on the communication category have reacted to the appearance of vaccines and the communication phenomena related to them. [ABSTRACT FROM AUTHOR]

Background: Childhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown. Aim: This study aimed to explore primary care practice nurses' (PNs) use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice. Methods: A questionnaire was developed and distributed to nurses throughout the UK via convenience sampling in paper and online formats. Questions assessed the frequency of pain management intervention use during infant immunisation and barriers to their use. Findings: A total of 255 questionnaire responses were received. Over 90% (n  = 226) of respondents never used topical anaesthetics or sweet solutions during immunisations, while 41.9% advised breastfeeding occasionally (n =  103). Parent-/caregiver-led distraction was the most frequently used intervention, with most nurses using it occasionally (47.9%, n =  116) or often (30.6%, n =  74). Most practices had no immunisation pain management policy (81.1%, n =  184), and most PNs' previous training had not included pain management (86.9%, n =  186). Barriers to intervention use included lack of time, knowledge and resources. Excluding distraction, pain management strategies were infrequently or never used during infant immunisation. Key barriers to using evidence-based strategies were lack of time, knowledge and resources. [ABSTRACT FROM AUTHOR]

The objective of this case study is to evaluate the effectiveness of the Wide Bay region coronavirus vaccination program in preventing hospitalisation for coronavirus disease 2019 (COVID-19). Population vaccination data and the vaccination status of patients hospitalised with confirmed COVID-19 have been used to evaluate preventable hospitalisations and risk reduction during and after a 2 month period following the outbreak of COVID-19 in Wide Bay after removal of public health measures in Queensland in December 2021. Wide Bay is a rural region of Queensland including K'Gari (formerly Fraser Island) to the east, the North Burnett farming region in the west and extending from the Fraser Coast to the Discovery Coast. Two local regional hospitals received and managed hospitalised COVID-19 patients. The region had, at this time, 171 365 people 20 years and older eligible for coronavirus vaccination. The risk reduction for hospitalisation of those receiving fewer than two vaccinations, two vaccinations and three vaccinations was calculated to determine the vaccination program effectiveness. The program achieved 90% effectiveness for people with two or more vaccinations (those with two vaccinations and those receiving boosters of third or more vaccination), and 97% effectiveness for those having received three vaccinations, in preventing hospitalisation for COVID-19 during the period. This translated into a significant risk reduction for hospitalisation for those receiving two or more vaccinations, preserving capacity to enable the health service to manage all cases locally. What is known about the topic? The real-world effectiveness of coronavirus vaccination program in preventing COVID-19 hospitalisation is 43–86% but this does not include regional programs and health services. What does this paper add? Individual absolute risk reduction for vaccinated local people was modest, but the overall local program effectiveness was substantial in preventing hospitalisations after removal of border quarantine. What are the implications for practitioners? Maintaining coronavirus vaccination programs in rural and regional areas is highly effective in preventing hospitalisations from COVID-19 after quarantine-based public health measures are removed. [ABSTRACT FROM AUTHOR]

Although young adults are not at great risk of becoming severely ill with COVID-19, their willingness to get vaccinated affects the whole community. Vaccine hesitancy has increased during recent years, and more research is needed on its situational determinants. This paper reports a preregistered experiment (N = 654) that examined whether communicating descriptive social norms – information about what most people do – is an effective way of influencing young people's intentions and reducing their hesitancy to take the COVID-19 vaccine. We found weak support for our main hypothesis that conveying strong (compared to weak) norms leads to reduced hesitancy and stronger intentions. Furthermore, norms did not produce significantly different effects compared to standard vaccine information from the authorities. Moreover, no support was found for the hypothesis that young people are more strongly influenced by norms when the norm reference group consists of other young individuals rather than people in general. These findings suggest that the practical usefulness of signaling descriptive norms is rather limited, and may not be more effective than standard appeals in the quest of encouraging young adults to trust and accept a new vaccine. [ABSTRACT FROM AUTHOR]

Since the outbreak of the novel coronavirus disease 2019 (COVID-19) in Wuhan, China, many health care systems have been heavily engaged in treating and preventing the disease, and the year 2020 may be called as "historic COVID-19 vaccine breakthrough". Due to the COVID-19 pandemic, many companies have initiated investigations on developing an efficient and safe vaccine against the virus. From Moderna and Pfizer in the United States to PastocoVac in Pasteur Institute of Iran and the University of Oxford in the United Kingdom, different candidates have been introduced to the market. COVID-19 vaccine research has been facilitated based on genome and structural information, bioinformatics predictions, epitope mapping, and data obtained from the previous developments of severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1) and middle east respiratory syndrome coronavirus (MERS-CoV) vaccine candidates. SARS-CoV genome sequence is highly homologous to the one in COVID-19 and both viruses use the same receptor, angiotensin-converting enzyme 2 (ACE2). Moreover, the immune system responds to these viruses, partially in the same way. Considering the on-going COVID-19 pandemic and previous attempts to manufacture SARS-CoV vaccines, this paper is going to discuss clinical cases as well as vaccine challenges, including those related to infrastructures, transportation, possible adverse reactions, utilized delivery systems (e.g., nanotechnology and electroporation) and probable vaccine-induced mutations. [ABSTRACT FROM AUTHOR]

Crises like the COVID-19 pandemic bring along challenges for individuals and society. In the case of Germany, vaccination against COVID-19 was identified as the primary measure to overcome the pandemic. This put those individuals in the spotlight who did not decide for it. This paper aims to analyze how vaccinated people perceived the group of unvaccinated individuals and whether they wished to punish those who did not contribute to ending the pandemic by vaccination. For this purpose, an online survey was conducted in the spring of 2022. Two hundred eighty-five answered the questionnaire. As a result, many respondents tried to make the best of the pandemic, although many reported negative emotions. Stereotypes of unvaccinated individuals revealed prejudices. Data also demonstrate an attempt to reduce contact with unvaccinated individuals as far as possible and an openness to discrimination or a desire for punishment. Although data result from a relatively small study, they can provide an illustrative example that can stimulate considerations of possible consequences and to further research. [ABSTRACT FROM AUTHOR]

Introduction: Already in its first implementation, the introduction of the Covid‐19 immunity certificate has generated some debate among the public. This debate might be a hindrance to the effective realization of this policy. This study aimed to systematically review published research evaluating public feeling of the Covid‐19 immunity certificate policy measure and to find which factors might influence its acceptance. Methods: We followed the scoping review methods manual by the Joanna Briggs Institute. We included studies with no time limits that presented novel data, and no exclusions have been made based on study design. We excluded articles that presented just expert opinions. Results: We found and reviewed 17 articles. The included studies were conducted in two main countries (the United Kingdom and Switzerland), with the rest from Israel, Italy, Spain, Germany, Australia, Taiwan and China. Both qualitative and quantitative studies were included, and nonrepresentative samples were mostly used to explore the public feeling about the Covid‐19 immunity certification. The included studies showed that public views on immunity certification are quite contradictory and influenced by age, gender, ethnicity, political orientation and attitudes towards Covid‐19 vaccination. The topic more often addressed by the included studies was the public's views on the positive and negative implications of the Covid‐19 immunity certificate in terms of ethical, legal and behavioural consequences of this measure. Conclusion: The varying acceptance rates are notable and may partly be linked to differences in demographics, Covid‐19 concerns and ideological beliefs, as seen in other health‐related tracking policies. Moreover, dominant factors behind the (un)success of this policy are complex and entangled with the cultural and political dimensions rather than being just technical. For this reason, it is important to expand psychosocial research to better understand the concerns behind health certifications and allow planning of culturally based and ethically sound suitable strategies. This would be very relevant to increasing public approval and compliance with this public health measure. Patient or Public Contribution: This does not apply to our work as it was a review paper. [ABSTRACT FROM AUTHOR]

Despite vaccination being one of the most effective public health interventions, there are persisting inequalities and inequities in immunisation. Understanding the differences in subnational vaccine impact can help improve delivery mechanisms and policy. We analyse subnational vaccination coverage of measles first-dose (MCV1) and estimate patterns of inequalities in impact, represented as deaths averted, across 45 countries in Africa. We also evaluate how much this impact would improve under more equitable vaccination coverage scenarios. Using coverage data for MCV1 from 2000–2019, we estimate the number of deaths averted at the first administrative level. We use the ratio of deaths averted per vaccination from two mathematical models to extrapolate the impact at a subnational level. Next, we calculate inequality for each country, measuring the spread of deaths averted across its regions, accounting for differences in population. Finally, using three more equitable vaccination coverage scenarios, we evaluate how much impact of MCV1 immunisation could improve by (1) assuming all regions in a country have at least national coverage, (2) assuming all regions have the observed maximum coverage; and (3) assuming all regions have at least 80% coverage. Our results show that progress in coverage and reducing inequality has slowed in the last decade in many African countries. Under the three scenarios, a significant number of additional deaths in children could be prevented each year; for example, under the observed maximum coverage scenario, global MCV1 coverage would improve from 76% to 90%, resulting in a further 363(95%CrI:299–482) deaths averted per 100,000 live births. This paper illustrates that estimates of the impact of MCV1 immunisation at a national level can mask subnational heterogeneity. We further show that a considerable number of deaths could be prevented by maximising equitable access in countries with high inequality when increasing the global coverage of MCV1 vaccination. [ABSTRACT FROM AUTHOR]

The world continues to face the effects of the SARS-CoV-2 pandemic. COVID-19 vaccines are safe and effective in protecting recipients, decreasing the risk of COVID-19 acquisition, transmission, hospitalization, and death. Transplant recipients may be at greater risk for severe SARS-CoV-2 infection. As a result, transplant programs have begun instituting mandates for COVID-19 vaccine for transplant candidacy. While the question of mandating COVID-19 vaccine for adult transplant candidates has garnered attention in the lay and academic press, these discussions have not explicitly addressed children who may be otherwise eligible for kidney transplants. In this paper we seek to examine the potential ethical justifications of a COVID-19 vaccine mandate for pediatric kidney transplant candidacy through an examination of relevant ethical principles, analogous cases of the use of mandates, differences between adult and pediatric kidney transplant candidates, and the role of gatekeeping in transplant vaccine mandates. At present, it does not appear that pediatric kidney transplant centers are justified to institute a COVID-19 vaccine mandate for candidates. Finally, we will offer suggestions to be considered prior to the implementation of a COVID-19 vaccine mandate. [ABSTRACT FROM AUTHOR]

Background Immunization is a cost-effective public health strategy to reduce vaccine preventable disease, especially in childhood. Methods This paper reports the philosophy, service delivery, achievements and lessons learned from an immunization program in rural Nigeria privately financed via a corporate social responsibility initiative from GlaxoSmithKline Biologicals. Results The immunization program served the community for a 16-y period extending from 1998 until 2015, resulting in an increase in age-appropriate immunization coverage from 43% to 78%. Conclusion In its success, this immunization program exemplified the importance of early and sustained community engagement, integration of strategies to optimize implementation outcomes and effective team building well before some of these principles were accepted and codified in the literature. The project also underscores the important role that the private sector can bring to achieving critical immunization goals, especially among underserved populations and provides a model for successful public-private partnership. [ABSTRACT FROM AUTHOR]

This article approaches the emergence of social subjects – associativism – and the formation of horizontal circuits of solidarity, both of which were decisive processes for saving lives in favelas and suburbs in Rio de Janeiro during the Covid-19 pandemic. The impact of the pandemic has been enormous collective trauma that accentuated the collapse of health surveillance systems and generated a catastrophe and humanitarian crisis in the city. Solidarity and local collective cooperation processes had decisive effects as a new protagonism, generating synergy with health actions and social programmes. They contributed decisively to actions that made forms of immunological protection, food security, and access to basic care possible in adverse contexts with weak policies and severe limitations for social isolation. Highlighting the importance of collective health surveillance and assistance actions from local associations, this paper discusses public health actions in the favela territories that demonstrate how communities, universities, public officials, and public health networks can develop policies and projects to confront Covid-19 in the favelas. [ABSTRACT FROM AUTHOR]

Purpose: This paper study regional attractiveness through passive portfolio investment based on duration, immunization and convexity (in case of higher interest rate volatility) of municipal bonds by using data from Standard and Poor's. The massive variety of financial incentives to promote regional investment attractiveness is dependent on governmental strategy. Municipal bonds are the one of the most efficient ways of direct investments in the region, however, it is still a question of a good balance between a certain rate of return and an adequate risk. The purpose of this paper is to analyze the investment opportunities in municipal revenue bonds. Design/methodology/approach: This study developed a model of investing using municipal bonds with the case of their immunization and analyze attractiveness of such investment. The theoretical model assumes a situation where the local government finances its capital projects through municipal revenue bonds. Such situations influence strongly on regional or local competitiveness provided by local government policy. Findings: An analysis of the municipal bond market indicates that both municipal general and revenue bonds had stable and good level of yields to maturity in the past ten years. Their standard deviations were very low and in the past two years almost approached the level of standard deviations of treasury bonds. With the duration of 4–6 years on 5-year investment in municipal revenue bonds and their immunization, it is possible to provide good returns for investor. Research limitations/implications: The limitation of this study concerns theoretical situation where local government will use non-market-based policy to reduce the interest rates and that will influence on rise of municipal bond liquidity premium (price distortion). This situation will make municipality bonds less attractive for investing, especially because of lower liquidity on secondary market. Also, this model is applicable in regions that have developed financial markets. Practical implications: This research suggests governments a sustainable framework to use municipal bonds as a strategy for capital targeting in regions. Social implications: This research is related to professional investors' strategy with projects that have the highest investment potential; this is good way for an adequate allocation of resources (regional competitiveness). Originality/value: This paper analyzes very rare subject involving local government strategy of finance and portfolio investment in municipal bonds. There is a huge gap in the literature on this issue. Also, this study provides the model that can be used as a case for higher local competitiveness. [ABSTRACT FROM AUTHOR]

On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. [ABSTRACT FROM AUTHOR]

Background: Health and care workers (HCWs) are at the forefront of COVID-19 response, at high risk of infection, and as a result they are a priority group for COVID-19 vaccination. This paper presents the global patterns in COVID-19 vaccination coverage among HCWs in 2021, how HCWs were prioritized, and identifies factors associated with the early vaccination coverage. Methods: Using monthly data reported to the World Health Organization, the percentages of partially and fully vaccinated HCWs were computed. The rates of vaccination of HCWs for the first and second half of 2021 were compared in a stratified analysis using several factors. A multivariate analysis was used to investigate the independent associations of these factors with the percentage of HCWs fully vaccinated. Results: Based on data from 139 Member States, as of end of 2021, 82% HCWs were reported as fully vaccinated with important variations by income groups: 33% for low income countries, 83% for lower-middle income countries, 79% for upper-middle income countries and 88% for high income countries. Overall 76% of countries did not achieve 70% vaccination coverage of their HCWs in the first half of 2021, and 38% of countries by end of 2021. Compared with the general population, the rate of HCWs full vaccination was 3.5 times higher, in particular for low income countries (RR = 5.9). Stratified analysis showed that beyond income group, the availability of vaccine doses was a critical factor of HCWs vaccination coverage with medians of 59.1% and 88.6% coverage in the first and second half of 2021, respectively for countries with enough doses to cover 70% of their population, compared with 0.8% and 47.5% coverage, respectively for countries with doses to cover 40% of their population. The multivariate analysis confirmed this observation with a 35.9% overall difference (95%CI 15.1%; 56.9%) between these two groups. Conclusion: Despite being considered a priority group, more than a third of countries did not achieve 70% vaccination coverage of their HCWs at the end of 2021. Large inequities were observed with low income countries lagging behind. Additional efforts should be dedicated to ensure full protection of HCWs through vaccination. [ABSTRACT FROM AUTHOR]

Introduction: As global child vaccination coverage has plateaued, understanding how to increase routine child vaccination rates further is key to avoiding preventable disease and death. To analyse how community engagement strategies can increase child vaccination, we synthesise the results from formative evaluations of interventions that aimed to increase vaccination coverage in Ethiopia, Myanmar, Nigeria, and Pakistan Methods: This paper uses an inductive qualitative approach to synthesise the results from the six evaluations, gathering lessons for designing context appropriate interventions that are feasible to implement and acceptable to providers, communities, and caregivers. Results: Assessing contextual, caregiver-level and provider-level barriers to vaccination is key to identifying appropriate engagement strategies. Across all contexts, low knowledge about the schedule of vaccines and the importance of timeliness represented a barrier to child immunisation. Despite the variability in how studies measured and reported caregiver attitudes, vaccine hesitancy was not found to represent an important barrier to immunisation. Frontline health workers played a critical role in community engagement approaches to increase vaccination. Interventions successfully obtained community buy-in by centre-staging community members, especially leaders, ensuring their participation in monitoring, and making immunisation an agenda item on community platforms. Interventions were implemented through existing health systems with substantial assistance from research teams. Limited data was available about intervention costs. Conclusions: Interventions designed around community engagement strategies can be appropriate, acceptable, and feasible approaches to overcome barriers to vaccination in a variety of low- and middle-income country contexts. However, questions remain about the ability of health systems to implement interventions at scale, both from a cost perspective and a capacity perspective. [ABSTRACT FROM AUTHOR]

Background: The ongoing COVID-19 pandemic has shown a crystal-clear warning that nobody will be safe until everybody is safe against the pandemic. However, how everyone is safe when the pandemic's fat tail risks have broken every nerve of the global economy and healthcare facilities, including vaccine equity. Vaccine inequity has become one of the critical factors for millions of new infections and deaths during this pandemic. Against the backdrop of exponentially growing infected cases of COVID-19 along with vaccine in-equity, this paper will examine how multilateralism could play its role in mitigating vaccine equity through Global Health Diplomacy (GHD). Second, given the most affected developing countries' lack of participation in multilateralism, could GHD be left as an option in the worst-case scenario?. Methods: In this narrative review, a literature search was conducted in all the popular databases, such as Scopus, Web of Science, PubMed and Google search engines for the keywords in the context of developing countries and the findings are discussed in detail. Results: In this multilateral world, the global governance institutions in health have been monopolized by the global North, leading to COVID-19 vaccine inequities. GHD aids health protection and public health and improves international relations. Besides, GHD facilitates a broad range of stakeholders' commitment to collaborate in improving healthcare, achieving fair outcomes, achieving equity, and reducing poverty. Conclusion: Vaccine inequity is a major challenge of the present scenario, and GHD has been partly successful in being a panacea for many countries in the global south. [ABSTRACT FROM AUTHOR]

• Comprehensive review of recent literature on zero- or missed-dose children in Nigeria. • Risk factors are well-known and widely studied. • Literature on interventions was scattered, and focussed on campaigns and polio. • Gaps exist in investigating how to deliver sustainable immunization programs. • Further work is needed to operationalise findings of this review. 'Zero-dose' refers to a person who does not receive a single dose of any vaccine in the routine national immunization schedule, while 'missed dose' refers to a person who does not complete the schedule. These people remain vulnerable to vaccine-preventable diseases, and are often already disadvantaged due to poverty, conflict, and lack of access to basic health services. Globally, more 22.7 million children are estimated to be zero- or missed-dose, of which an estimated 3.1 million (∼14 %) reside in Nigeria. We conducted a scoping review to synthesize recent literature on risk factors and interventions for zero- and missed-dose children in Nigeria. Our search identified 127 papers, including research into risk factors only (n = 66); interventions only (n = 34); both risk factors and interventions (n = 18); and publications that made recommendations only (n = 9). The most frequently reported factors influencing childhood vaccine uptake were maternal factors (n = 77), particularly maternal education (n = 22) and access to ante- and perinatal care (n = 19); heterogeneity between different types of communities – including location, region, wealth, religion, population composition, and other challenges (n = 50); access to vaccination, i.e., proximity of facilities with vaccines and vaccinators (n = 37); and awareness about immunization – including safety, efficacy, importance, and schedules (n = 18). Literature assessing implementation of interventions was more scattered, and heavily skewed towards vaccination campaigns and polio eradication efforts. Major evidence gaps exist in how to deliver effective and sustainable routine childhood immunization. Overall, further work is needed to operationalise the learnings from these studies, e.g. through applying findings to Nigeria's next review of vaccination plans, and using this summary as a basis for further investigation and specific recommendations on effective interventions. [ABSTRACT FROM AUTHOR]

The paper presents the epizootic situation of rabies in Poland during the last decade. During this period, the annual oral immunisation of free-living foxes was continued, but in recent years it has only covered selected regions. This was due to the decreasing number of virus cases found in freeliving foxes, confirmed by 2019, when the virus was found in only one fox in the Lublin Province. The results indicate that despite high costs, oral fox immunisation (ORV) treatments have had the desired effect by eliminating rabies in terrestrial mammals. At the same time, an increasing tendency for virus occurrence in bats was noted during this period. These animals have now become the primary reservoir of the virus in Poland. In addition, in 2019 rabies in bats was found in voivodeships that were considered virus-free, and thus no preventive vaccination of foxes was carried out in them. This confirms the thesis that there are no geographical barriers to the spread of the virus. These elements are quite relevant and are very important in the field of epizootic threat as well as public health. [ABSTRACT FROM AUTHOR]

Objectives: In 2019 the United States experienced the largest outbreak of measles in 27 years, 19 years after the United States declared measles eliminated. The purpose of this paper was to present a population study of a measles outbreak within Orthodox Jewish communities in New York that led to the elimination of religious exemption for school mandated vaccines. Methods: Peer reviewed articles, news media, health department, and government resources were used to investigate environmental factors that led to this outbreak. State, county, and city immunization records were accessed to explore measles compliance rates before and after policy change. Results: Rockland County had low compliance rates compared to the rest of the state, and the elimination of religious exemptions raised compliance rate almost to state level. In all but one affected New York City zip codes, compliance following policy change rose to 97.95%–99.15%. Conclusions: Overall, changes in measles compliance rates reflect policy goals, but localized differences imply a need for more customized interventions for each unique community. Public health planning to promote vaccination should be sensitive to the concerns and perceptions of each community in order for health interventions to have a positive effect. [ABSTRACT FROM AUTHOR]

While African countries have improved access to immunization since the start of the millennium, progress has stagnated in the last few years. One in five African children is not vaccinated with life-saving vaccines, and recent outbreaks of vaccine-preventable diseases (VPDs) including yellow fever, measles, and meningitis, among others point to gaps in immunization coverage as well as disease surveillance. In 2017, African Heads of State endorsed the Addis Declaration on Immunization (ADI) at the 28th African Union Summit and committed to ensuring universal access to immunization across the continent. Since then, countries have taken several steps to translate the ADI commitments into tangible progress. However, the continent continues to face challenges in delivering immunization services, including limited vaccine-related funding, inequitable access to immunization services and weak surveillance systems. In the absence of concerted political will, COVID-19 threatens to reverse progress made so far. This paper reflects on the effects of political will in shaping the immunization agenda on the continent and the continued need for political commitment to deliver on the ADI commitments in a post-COVID world. Data were gathered from the regular national immunization reports, WHO/UNICEF estimates of immunization coverage as well as case studies of country implementation on ADI. [ABSTRACT FROM AUTHOR]

The 2019 Coronavirus Disease (COVID‐19) is dubbed as one of the deadliest and worst global pandemics. Many pandemic policies and programs were implemented in different countries across the globe, including the creation of vaccines that would enhance human immunity against the symptoms caused by the virus. Since then, debates on vaccines have emerged, citing vaccine hesitancy often associated with certain factors like socioeconomic status, beliefs, and vaccine awareness. This birthed to an intensive call for vaccine literacy as an effective means of encouraging people to get vaccinated against viruses. This paper uses the Walker and Avant's (2019, Strategies for theory construction in nursing, 6th edn. New York, NY: Pearson) approach of concept analysis with the help of its eight systematic stages. Results showed that vaccine literacy was adopted after the concept of health literacy. It is defined as a process of providing vaccine information, building communication, and increasing people's engagement about vaccines. The identified defining attributes of vaccine literacy include 'health literacy', 'disease prevention', 'education', and 'immunization'. Vaccine literacy is considered relevant in the nursing practice as knowledge on vaccine literacy easily advances nurses' practice roles through vaccination education, creating developmental policies about vaccines, and prescribing immunization to patients. [ABSTRACT FROM AUTHOR]

There is a significant potential demand around the world for a flexible product to manage individual longevity risk. However, annuity markets remain thin, driven by factors including lack of pricing transparency, high product loadings, bequest motives, loss aversion, and the difficulty to hedge the risk. This paper proposes an individual retirement product to allow flexible management of longevity risk. The product combines a lifetime income with a flexible death benefit to meet individual bequest needs. It also benefits the issuers by lower mortality risk due to the natural hedging, and thus lower capital cost as a risk margin. We apply actuarial models that provide transparent pricing for interest rate and mortality risk, the construction of immunized bond portfolios, and the determination of a loading and solvency margin for systematic longevity risk. We also quantify the natural hedging benefits arising from the flexible inclusion of both survival benefits and death benefits. [ABSTRACT FROM AUTHOR]