Vaccines

It has been proposed that teachers, like healthcare workers, constitute a strategic target for COVID-19 vaccine programs as immunization is a key element in protecting both them and their pupils. The present study examined vaccine uptake among primary-school teachers and sought to identify factors associated with it. A sample was recruited from 553 Polish primary schools, and data were collected at two time points: December 2020 and March 2021. Associations between vaccine uptake among teachers and their attitudes toward COVID-19 vaccination were assessed through multivariate logistic regression. 6152 participants completed both baseline and follow-up surveys. Of these, 4502 (73.2%) reported their intention at baseline to receive a COVID-19 vaccination, if available; at follow-up, 3894 (86.5%) of the same 4502 reported having received the vaccination. A significant association was revealed between vaccine uptake and perceived severity, self-efficacy, and social norms. The principal driver for vaccine acceptance was the wish to avoid contracting the disease. Conversely, the principal driver for vaccine refusal was concern about side effects and safety. A strong association exists between intention to receive the COVID-19 vaccine and actual uptake. Future COVID-19 immunization programs may benefit from a stronger understanding of the factors associated with vaccine uptake among this cohort.

BackgroundThe objectives of this study were to compare the cumulative incidence, hospitalizations and mortality, by country and age group, in child and young people (CYP) from the beginning of the pandemic to January 2022, and to describe the differences and similarities and justification in the measures adopted in relation to CYP vaccination against SARS-CoV-2. MethodsA descriptive quantitative summary of the available data on the impact of the COVID-19 on children and adolescents (<18y) from 7 countries (Chile, Colombia, Paraguay, Nigeria, Ghana, Spain) or regions (Kocaeli, Turkey), based on official published data was performed. Outcome measures were: available data on incidence, admission to hospital and to intensive care units (ICU), and deaths, by country or region; vaccination plans, including age, type of vaccine and official justification about the proposal. ResultsAll countries analyzed data showed variable incidence rate, and relatively low ICU hospitalizations and deaths. Vaccines used and age at starting were also variable, i.e. starting at 3-5y in some Latin American countries, while in other countries proposal starts at 15y old. Almost all justifications were based on the idea to promote collective protection, and that vaccination is important as it -directly and indirectly-protect the rest of the population. ConclusionsThe results reinforce the idea of the urgent need to prioritize globally and equitably distribution of vaccines in the population at greatest risk, and to apply the precautionary principle in CYP before deciding to massively vaccinate it. What is knownThe child population has less severe infections and seems to transmit the infection less than the adult population. Published data from the Randomized Clinical Trials (RCT) of vaccines in minors presented short follow-up than in the adult population and basically studied the incidence of infection as the main endpoint What this study addsMortality in the child population due to COVID-19 since the start of the pandemic has been low in all the countries analyzed The vaccines used as well as the vaccination guidelines shows high variability in these countries The results of the study reinforce the need to establish global and equitable mechanisms for the distribution of vaccines and prioritize the population at greatest risk, such as older people. In the child population, it is necessary to apply the precautionary principle before establishing massive vaccination plans

The genus Neisseria includes two major human pathogens: N. meningitidiscausing bacterial meningitis/septicemia and N. gonorrhoeae causing gonorrhoea. Mathematical models have been used to simulate their transmission and control strategies, and the recent observation of a meningitis vaccine being partially effective against gonorrhoea has led to an increased modeling interest. Here we conducted a systematic review of the literature, focusing on studies that model vaccination strategies against Neisseria incidence and antimicrobial resistance. Using journal, preprint, and grey literature repositories, we identified 52 studies that we reviewed for validity, model approaches and assumptions. Most studies showed a good quality of evidence, and the variety of approaches along with their different modeling angles, was assuring especially for gonorrhoea studies. We identified options for future research, including the combination of both meningococcal and gonococcal infections in studies to have better estimates for vaccine benefits, and the spill over of gonorrhoea infections from the heterosexual to the MSM community and vice versa. Cost-effectiveness studies looking at at-risk and the wider populations can then be used to inform vaccine policies on gonorrhoea, as they have for meningococcal disease.

Previously, we have demonstrated that ACIS KEPTIDE, a chemically modified peptide, selectively binds to ACE-2 receptor and prevents the entry of SARS-CoV2 virions in vitro in primate kidney Cells. However, it is not known if ACIS KEPTIDE attenuates the entry of SARS-CoV2 virus in vivo in lung and kidney tissues, protects health, and prevent death once applied through intranasal route. In our current manuscript, we demonstrated that the intranasal administration of SARS-CoV2 (1*106) strongly induced the expression of ACE-2, promoted the entry of virions into the lung and kidney cells, caused acute histopathological toxicities, and mortality (28%). Interestingly, thirty-minutes of pre-treatment with 50 g/Kg Body weight ACIS normalized the expression of ACE-2 via receptor internalization, strongly mitigated that viral entry, and prevented mortality suggesting its prospect as a prophylactic therapy in the treatment of COVID-19. On the contrary, the peptide backbone of ACIS was unable to normalize the expression of ACE-2, failed to improve the health vital signs and histopathological abnormalities. In summary, our results suggest that ACIS is a potential vaccine-alternative, prophylactic agent that prevents entry of SARS-CoV2 in vivo, significantly improves respiratory health and also dramatically prevents acute mortality in K18-hACE2 humanized mice. HighlightsO_LIACIS KEPTIDE stimulates the internalization of ACE-2 receptor (Fig. 2) and buffers the membrane localization of ACE-2 receptors (Fig. 2, 6 & 8). Intranasal inoculation of SARS-CoV2 upregulates the expression of ACE-2 in lung epithelium (Fig.6) and kidney tubular cells (Fig.8). ACIS KEPTIDE normalizes the expression of ACE-2 in the kidney tubular cells of virus-treated K18-hACE2mice (Fig. 8). C_LIO_LIACIS KEPTIDE completely prevents the entry of SARS-CoV2 in Bronchiolar epithelium (Fig.6), alveolar parenchyma (Fig. 6), and kidney tubular cells (Fig.8). C_LIO_LIACIS KEPTIDE improves the pulmonary (Fig. 5) and renal pathological changes (Fig. 7) caused by the SARS-CoV2 virus insult. C_LIO_LIIntranasal administration of 0.05% Beta-propiolactone ({beta}PL)-inactivated SARS-CoV2 (1 *106) causes significant death (28%) in K18-hACE2 humanized mice after 24 hrs of intranasal inoculation (Supplemental videos) suggesting that SARS-CoV2 does not require its infective properties and genetic mechanism to be functional to cause mortality. C_LIO_LIThe peptide backbone of ACIS KEPTIDE provides much less and insignificant protection in the prevention of pathological changes in Lungs (Fig.5 & 6) and Kidney (Fig.7 & 8). Peptide failed to normalize the upscaled expression of ACE-2 in kidney tubular cells (Fig.8) of SARS-CoV2-treated K18-hACE2 mice. C_LI O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=122 SRC="FIGDIR/small/378257v1_fig2.gif" ALT="Figure 2"> View larger version (51K): org.highwire.dtl.DTLVardef@15c9911org.highwire.dtl.DTLVardef@453819org.highwire.dtl.DTLVardef@65f8a0org.highwire.dtl.DTLVardef@a602d8_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOFig. 2.C_FLOATNO Effect of KEPTIDE on the Expression of ACE-2 Receptor on the Membrane of CALU-3 Human Lung Cells. Human lung epithelial cells. CALU-3 cells were grown in complete DMEM cells for 2 days until it reached 70% confluency followed by starving with serum for 2 hrs. After that, 25 M of ACIS KEPTIDE were treated for 30 mins, 1 hr, 2 hrs and 6 hrs. After each time point cells were fixed and stained for ACE-2 (Green; Rabbit anti-ACE-2 antibody; Abcam; 1:250 dilution) and KEPTIDE (blue). Thirty minutes of KEPTIDE treatment significantly stimulated the internalization of ACE-2 along with KEPTIDE. Subsequent incubation periods displayed significant down-regulation of ACE-2 receptors. Experiments were confirmed after three different experiments. C_FIG O_FIG O_LINKSMALLFIG WIDTH=154 HEIGHT=200 SRC="FIGDIR/small/378257v1_fig6.gif" ALT="Figure 6"> View larger version (98K): org.highwire.dtl.DTLVardef@104bd7forg.highwire.dtl.DTLVardef@34ecc1org.highwire.dtl.DTLVardef@a3ac74org.highwire.dtl.DTLVardef@18f0570_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOFig. 6.C_FLOATNO Protective effect of ACIS KEPTIDE on the expression of ACE-2 and the entry of SARS-CoV2 virions in lung of SARS-CoV2-insulted K18-hACE2 mice. (A-D) Dual IHC staining of ACE-2 (red) and SARS-CoV2 (brown) in bronchiolar epithelium in (A) vehicle-treated (0.05% PL-inactivated VEROE6 sup, (B)virus, (C) virus + KEPTIDE, and (D) virus + peptide-treated K18-hACE2 mice (n= 7-8). (a-h) Magnified views of outer layers and inner layers of bronchiolar epithelia of respective images enclosed in a dotted squares. Arrows were justified in the bottom of each image. Results are confirmed after three independent experiments. C_FIG O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=111 SRC="FIGDIR/small/378257v1_fig8.gif" ALT="Figure 8"> View larger version (87K): org.highwire.dtl.DTLVardef@ae105aorg.highwire.dtl.DTLVardef@1b39472org.highwire.dtl.DTLVardef@d6e3e9org.highwire.dtl.DTLVardef@ce6d6_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOFig. 8.C_FLOATNO Protective effect of ACIS KEPTIDE on the expression of ACE-2 and prevention of SARS-CoV2 entry in kidney of K18-hACE2 mice twenty-four hours post SARS-CoV2 inoculation. Eight to ten weeks old K18-hACE2 mice (n=7-8 per group) were intranasally administered with 50 g/kg Bwt KEPTIDE or 50 g/kg Bwt peptide for 30 mins followed by inoculation with PL-inactivated 1*106 virus. In group1 mice (n=8) were inoculated with vehicle only (0.05% PL-treated VEROE6 sup); in group 2, mice (n=7) were treated with virus only (0.05% PL-inactivated; in group 3, mice (n=8) were treated with virus +KEPTIDE; and, in group 4 mice (n=8) were treated with virus + PEPTIDE. (Results are confirmed after three independent experiments. (A-D) Dual IHC of ACE-2 (red) and SARS-CoV2 (brown) in tubular epithelium in (A) vehicle, (B) Virus, (C) Virus + KEPTIDE-, and (D) Virus + peptide-treated groups. (a) showed magnified view of kidney cortex vehicle-treated mouse with basal expression of ACE-2 (red), (b) magnified view of kidney of virus-tread animal. Upscaled expression of ACE-2(red) with degenerated Bowmans capsule and invasion of SARS CoV2 (Brown arrow). (c) Magnified view of Glomerulus of Virus + KEPTIDE-treated group. Significantly less ACE-2 expression (red arrow) and no virus-infiltration were noted. (d) Elevated expression of ACE-2 in virus +Peptide-treated group. Results were confirmed after three different experiments in 7-8 animals. C_FIG O_FIG O_LINKSMALLFIG WIDTH=190 HEIGHT=200 SRC="FIGDIR/small/378257v1_fig5.gif" ALT="Figure 5"> View larger version (123K): org.highwire.dtl.DTLVardef@1072b3aorg.highwire.dtl.DTLVardef@1a70702org.highwire.dtl.DTLVardef@bd227corg.highwire.dtl.DTLVardef@12335bd_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOFig. 5.C_FLOATNO ACIS KEPTIDE protects acute histopathological changes in Lungs of K18-hACE2 mice twenty-four hours post SARS-CoV2 inoculation. Eight to ten weeks old K18-hACE2 mice (n=7-8 per group) were intranasally administered with 50 g/kg Bwt KEPTIDE or 50 g /kg Bwt peptide for 30 mins followed by inoculation with PL-inactivated 1*106 virus. In group1 mice (n=8) were inoculated with vehicle only (0.05% PL-treated media); in group 2, mice (n=7 were treated with virus only (0.05% PL-inactivated; in group 3, mice (n=8) were treated with virus +KEPTIDE; and, in group 4 mice (n=8) were treated with virus + PEPTIDE. (A-D) Hematoxylin Background staining of small airway alveolar parenchyma. (E-H) H & E staining of Bronchiolar epithelium, surrounding cartilaginous and alveolar parenchyma. Magnified views of bronchiolar epithelia of (Ei) Control (orange arrow indicates intact epithelial lining: orange star demonstrates preserved connective tissue), (Fii) Virus only (thin red arrow indicates the degenerated bronchiolar epithelium), (Giii) Virus + KEPTIDE (thin blue arrow indicates protected epithelium), and (Hiv) Virus + Peptide-treated (thin green arrow indicates degenerated epithelium). Results are confirmed after three different experiments in 7-8 animals. C_FIG O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=179 SRC="FIGDIR/small/378257v1_fig7.gif" ALT="Figure 7"> View larger version (150K): org.highwire.dtl.DTLVardef@9d3c17org.highwire.dtl.DTLVardef@d40a51org.highwire.dtl.DTLVardef@f17652org.highwire.dtl.DTLVardef@8f3230_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOFig. 7.C_FLOATNO Effect of ACIS KEPTIDE on the protection of acute histopathological changes in Kidney of K18-hACE2 mice twenty-four hours post SARS-CoV2 inoculation. Eight to ten weeks old K18-hACE2 mice (n=7-8 per group) were intranasally administered with 50 g/kg Bwt KEPTIDE or 50 g/kg Bwt peptide for 30 mins followed by inoculation with PL-inactivated 1*106 virus. In group1 mice (n=8) were inoculated with vehicle only (0.05% PL-treated VEROE6 sup); in group 2, mice (n=7) were treated with virus only (0.05% PL-inactivated; in group 3, mice (n=8) were treated with virus +KEPTIDE; and, in group 4 mice (n=8) were treated with virus + PEPTIDE. (A-D) H & E staining of kidney cortex with detailed structures of glomeruli, tubular epithelium, and Bowmans capsule in all 4 groups. Results are confirmed after three independent experiments. C_FIG

IntroductionIsrael led a rapid vaccine rollout against COVID-19, leading to a local remission of the epidemic and rolling back of most public health measures. Further vaccination of 12-15-year-olds may be hindered by public perceptions of the necessity and safety of vaccination. Methodswe examined the considerations of vaccine hesitant parents (VHPs) regarding vaccination of children against COVID-19. The responses of 456 parents were surveyed and analyzed before FDA authorization of vaccination of children. Resultsparents who were vaccinated against COVID-19 were more likely to intend to vaccinate their children (r=-0.466, p<0.01). Low accessibility of vaccination may be a dissuading factor for VHPs more inclined to vaccinate. Vaccine efficacy and gaining a "Green Pass" were positively associated with an intention to vaccinate and statistically significant. VHPs inclined not to vaccinate indicated short development time and possible long term effects as dissuading factors. Discussionvaccine promotion should be tailored for VHPs positive and negative considerations for higher uptake.

IntroductionThe adaptive immune response plays a crucial role in resolution of viral infections; however, there is limited data on the T cell response to SARS-CoV-2 vaccines like Sinopharm (Sin), Sputnik-V (SpV), and especially for the heterologous combination Sputnik-V/mRNA-1273 (Spv/Mod) scheme. Furthermore, emerging variants may compromise the adaptive immune response established in the population. ObjectiveTo evaluate the T cell immune response induced by the Sin, SpV and SpV/Mod, against Wuhan, Gamma and Omicron viral variants. MethodsSerum levels of IgG antibodies were assessed by CMIA (Abbott Diagnostics, Abbott Park, Illinois). T cell responses against Wuhan, Gamma, and Omicron were evaluated through an activation-induced marker assay. Sixty individuals, evenly distributed across the Sin, SpV, and SpV/Mod groups, were included. ResultsThe median age of participants was 48 years (IQR: 34-56), with 58.3% (n=35) being female. Seventeen (28.3%) individuals had a prior confirmed COVID-19 infection. Spv/Mod scheme elicited significantly higher humoral responses (p<0.001). However, the three vaccination platforms showed consistent T cell responses across the different Wuhan, Gamma and Omicron stimuli tested. Particularly, all three schemes induced stronger CD8 responses against the Wuhan variant. In addition, more responders to Wuhan were observed in the Sin and Spv groups, while the Spv/Mod group showed a higher proportion of responders to Omicron. ConclusionThis study provides new data on effective humoral and cellular immune responses against Wuhan, Gamma, and Omicron variants. Moreover, memory CD4 and CD8 T cell responses remain protective, and the heterologous scheme may elicit stronger T cell responses against emerging variants. HighlightsO_LIStrong adaptive T cell responses were observed across all vaccination schemes and viral variants. C_LIO_LIHigher frequency of activated CD8 lymphocytes was detected compared to CD4 in response to SARS-CoV-2 C_LIO_LISinopharm and Sputnik-V showed a response biased toward the Wuhan variant. C_LIO_LISputnik-V/Moderna recipients showed higher T cell responses to Omicron. C_LIO_LIThe Sputnik-V/Moderna vaccination scheme induced significantly enhanced humoral immune responses. C_LI Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=188 HEIGHT=200 SRC="FIGDIR/small/24318016v1_ufig1.gif" ALT="Figure 1"> View larger version (62K): org.highwire.dtl.DTLVardef@198b7ddorg.highwire.dtl.DTLVardef@14f0efcorg.highwire.dtl.DTLVardef@160ec18org.highwire.dtl.DTLVardef@2c2ab9_HPS_FORMAT_FIGEXP M_FIG C_FIG

Aimwe examined the humoral immune response and antibody dynamics after primary and booster vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among patients with chronic liver disease (CLD). MethodsWe enrolled patients with confirmed CLD and SARS-CoV-2 vaccination primary or booster immunity. Following primary or booster immunity, serological samples were gathered to detect novel coronavirus neutralizing antibodies (nCoV NTAb) and novel coronavirus spike receptor-binding proteins (nCoV S-RBD). ResultsThe positive rate of nCoV NTAb was 60.1% in Primary and 87.6% in Booster (P<0.001). The median level of nCoV NTAb was 11.6 AU/mL in Primary and 31.6 AU/mL in Booster (P<0.001). The positive rate of nCoV S-RBD was 70.0% in Primary and 91.2% in Booster (P<0.001). The median level of nCoV S-RBD was 21.7 AU/mL in Primary and 110.6 AU/mL in Booster (P<0.001). Compared to the antibody level of primary immunity, 21 patients in whom SARS-CoV-2 vaccine antibodies were detected after both primary and booster immunizations showed an increase of 4.4 and 5.9 times in nCoV NTAb and nCoV S-RBD, respectively. ConclusionPatients with CLD show improved humoral immune response after completing primary and booster immunity of SARS-CoV-2 vaccines, while booster immunity further improves the positive rate and antibody level of patients with CLD.

The rapid development of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has proved to make an important contribution in reducing both viral transmission and disease burden. In this study, we tracked the COVID-19 vaccine equity, distribution, and cases in global south countries using country-level data from Our World in Data using an event study analysis. We used data from 149 global south and 59 non-global south countries from January 2020 to May 2022. All non-global south and 90.32% of global south countries had universal availability of vaccines. The median time since the introduction of the first COVID-19 vaccine in the global south was almost eight weeks later than in non-global south countries. The median number of people fully vaccinated per hundred (68.8 vs 50.31), and the total number of boosters administered per hundred (45.7 vs. 13.02) were higher in non-global south countries compared to global south countries. Using the event study analysis, we found a significant reduction of COVID-19 new cases and deaths after the first COVID-19 vaccination rollout compared to the baseline in global south countries, average coefficient p-value <0.001. Programs aiming at improving vaccine access and distribution to global south countries are essential to effectively control COVID-19.

The availability of safe and effective vaccine alone does not save lives; it is the inoculation plus other public health measures that do. Recent reports suggest the growing trend in vaccine preferential bias in parts of the world but not much in Europe. The present paper aims to investigate the occurrence of COVID-19 vaccine preferential bias in Europe for effective vaccination planning and pandemic control. MethodData on vaccine delivered and vaccination campaigns of the EU member states was collected from Eu center for disease control (EUCDC) on COVID-19 vaccination radar. The data was processed for analysis on MS excel and both descriptive and statistical analysis was done with IBMs SPSS version 21. Analysis was performed at 95% confidence interval and statistically significant difference was considered at p < 0.05. ResultsWe observed statistically significantly lower vaccine uptake compared to the vaccine delivered doses in the present study (average at 62.678 +/-3.928%) (p< 0.05, CI = 95%). Great variances in uptake for Oxford-AstraZeneca vaccines (50.927 +/-4.626 %) compared to Pfizer-Biontech vaccine (86.285 +/- 2.1052 %) was observed compared to previous prospective study on the wiliness to receive COVID-19 vaccine in the region (75%). ConclusionPublic health practitioners and policy makers need to factor the existence of COVID-19 preferential bias based on vaccine type or manufacturer. This will enable them introduce policies including public educational campaigns to overcome biasness on the wiliness to inoculate thereby enhancing vaccine uptake for smooth and effective control of the pandemic.

Comprehending how individuals feel when they discuss the vaccine is important for the immunization campaign and outbreak management during a health emergency. Online conversations provide useful information for assessing sentimental and emotional reactions to the evolutions of the pandemic and immunization program. In this study, we employ a corpus of around 58 million English tweets from users in 17 countries that discuss vaccine-related topics in the year 2021. We apply Soft Dynamic Time Warping algorithm and Time Lag Cross-Correlation approach and find that the evolutions of sentiments closely mirror the pandemic statistics. We also examine five topics connected to vaccination and discover that trust is the most predominate feeling, followed by fear, anger, and joy. Some countries reported higher emotional scores on a theme than others (people in Cuba and the United States exhibit higher levels of trust, Pakistanis and Indians express higher levels of joy, Australians and Chinese express higher levels of fear, and Japanese and British people express higher levels of anger). This study report offers a viewpoint on the publics response to the epidemic and vaccination and aids policy-makers with preventive strategies for a future crisis.

The COVID-19 pandemic is the largest epidemic of the 21st century so far. Over 650 million people have already been infected with the SARS-CoV-2 virus. One of the ways to stop this pandemic, is to vaccinate the population and gain herd immunity. Many different vaccines are being used around the world, with differing efficacy. This review summarizes the 79 publications on the efficacy of the currently existing COVID-19 vaccines. It shows that there are eleven vaccines that have efficacy data published in a PubMed-indexed scientific journal. Most research has been done on the Pfizer/BioNTech BNT162B2 vaccine, and the eleven vaccines generally have a high efficacy in preventing illness. The Pfizer (86%-100%), Moderna (93.2%-94.1%), Sputnik-V (91.6%) and Novavax ([~]90%) vaccines show the highest efficacy, followed by the Sinovac (83.5%), QazCovid-in 82%) and Covaxin (77.8%) vaccines. The Oxford/AstraZeneca (69% - 81.5%) and Johnson & Johnson (66%) vaccines have lower efficacy in preventing illness. This overview also shows efficacies other than in preventing illness (e.g. asymptomatic, severe illness, hospitalization, death) in some cases. The results also show that the vaccines have specific effects on specific age groups (e.g. adolescents, adults, elderly) and people with diseases (e.g. leukemia, other cancers, HIV). Future research in this area will mostly focus on vaccine efficacy on specific strains of the SARS-CoV-2 virus (such as the Omicron variant) as well as the efficacy of booster vaccinations.

BackgroundThe presented meta-analysis was developed in response to the publication of several studies addressing COVID-19 vaccines hesitancy. We aimed to identify the proportion of vaccine acceptance and rejection, and factors affecting vaccine hesitancy worldwide especially with the fast emergency approval of vaccines. MethodsOnline database search was performed, and relevant studies were included with no language restriction. A meta-analysis was conducted using R software to obtain the random effect model of the pooled prevalence of vaccine acceptance and rejection. Eggers regression test was performed to assess publication bias. Quality assessment was assessed using Newcastle-Ottawa Scale quality assessment tool. ResultsThirty-nine out of 12246 articles met the predefined inclusion criteria. All studies were cross-sectional designs. The pooled proportion of COVID-19 vaccine hesitancy was 17% (95% CI: 14-20) while the pooled proportion of COVID-19 vaccine acceptance was 75% (95% CI: 71-79). The vaccine hesitancy and the vaccine acceptance showed high heterogeneity (I2=100%). Case fatality ratio and the number of reported cases had significant effect on the vaccine acceptance as the pooled proportion of vaccine acceptance increased by 39.95% (95% CI: 20.1-59.8) for each 1% increase in case fatality (P<0.0001) and decreased by 0.1% (95% CI: -0.2-0.01) for each 1000 reported case of COVID-19, P= 0.0183). ConclusionTransparency in reporting the number of newly diagnosed COVID-19 cases and deaths is mandatory as these factors are the main determinants of COVID-19 vaccine acceptance.

BackgroundThe rapid development of vaccines in response to the COVID-19 pandemic has provided an effective tool for the management of COVID-19. However, in Africa there has been a poor uptake of COVID-19 vaccines with only 15% vaccine coverage compared to the WHO global target of 70%. One of the important drivers has been vaccine hesitancy, understanding late adopters of vaccination can provide insights into the attitudes, motivations and influences that can enhance vaccine uptake. MethodsBetween January 4 - February 11, 2022, we conducted a survey among adults presenting for their first dose of a COVID-19 vaccine almost 12-months after the vaccination program began. Vaccines were free and provided at clinics and outreach centers in Harare, Zimbabwe. The questionnaire assessed environmental and individual factors (attitudes, barriers, motivations, key influencers, and information sources) that influenced the decision to present for vaccination. Baseline socio-demographic data and responses to survey questions were summarized using descriptive statistics. Binary logistic regression models were developed to understand factors associated with vaccine confidence. Results1016 adults were enrolled into the study, 508 (50%) were female, 126 (12.4%) had HIV co-infection. The median age was 30 years (IQR 22 - 39). Women were more likely to have negative views about the COVID-19 vaccine compared to men (OR 1.51 (95%CI 1.16, 1.97, p=0.002). Women compared to men and older adults ([&ge;] 40 years) compared with youth (18-25 years) were more likely to have major concerns about vaccines. Most concerns were about safety with 602 (59.3%) concerned about immediate and 520 (51.2%) about long-term health effects of vaccines. People living with HIV (PLWH) were more likely to perceive vaccines as safe (OR 1.71 (95%CI: 1.07, 2.74, p=0.025), effective (1.68 (95%CI: 1.07, 2.64, p=0.026) and to trust regulatory systems for approving vaccines (OR 1.79 (95% CI: 1.11, 2.89, p=0.017) compared to those without HIV. Internet users were less likely to perceive vaccines as safe (OR 0.72 (95% CI: 0.55, 0.95, p=0.021), effective (OR 0.61 (95% CI: 0.47, 0.80, p<0.001) or trust regulatory processes for approving vaccines (OR 0.64 (95% CI: 0.48, 0.85, p=0.002) compared to non-internet users. Social influence was a key factor in the decision to be vaccinated with family members being the primary key influencers for 560 (55.2%) participants. The most important reason for receiving the COVID-19 vaccine today for 715 (70.4%) participants was the protection of individual health. The most trusted source of information regarding the vaccine was the Ministry of Health (79.7%) and the radio, television and social media were the preferred sources for obtaining this information. Social media was a more likely source for youth and those with higher levels of education. ConclusionImproving vaccine coverage will need targeted communication strategies that address negative perceptions of vaccines and associated safety and effectiveness concerns. Leveraging normative behavior as a social motivator for vaccination will be important as close social networks are key influences of vaccination. Traditional media remains important for health communication in Africa and should be strengthened to counter social media-based misinformation that drives concerns about safety and effectiveness particularly among internet users.

Aim and backgroundCoronavirus disease-19 (Covid-19) is a highly spreadable respiratory system disease. Vaccination is a preventive approach to combat the pandemic. The aim of the study was to investigate vaccination pattern in Egypt compared to the world, evaluate the short-term side effects of different vaccines and to assess peoples knowledge, satisfaction, and tolerability of the vaccines. MethodsA cross-sectional, web-based online survey conducted using a Google Form-questionnaire to gather information from the general public regarding their knowledge, satisfaction, and tolerability to COVID-19 vaccine. Demographic data, previous infection with Covid-19, risk factors, type of vaccine received and side effects were collected and statistically analyzed. ResultsA total of 508 responses were included in the final analysis. Results showed that most of the participants were females (67.5%), between 20 and 40 years of age (68.3%), and from the medical field (51.1%). The main reported risk factors associated with Covid-19 infection were chronic diseases such as cardiovascular diseases (26.2%), followed by work environment (25%), respiratory conditions (18.2%), and advanced age (16.8%). 57.3% of the respondents received adequate information about the vaccine, 43.3% trusted the information provided while 24.2% required more information. Among all respondents, 78.5% received Covid-19 vaccine were SinoPharm BBIBP was the most administered vaccine (30.4%). Reported adverse effects were injection site pain (18.3%), headache (17.9%), fever (16.8%), fatigue (20.9%), muscle aches (15.1%), nausea (10.8%) and menstrual irregularities (0.2%). Seriousness of Covid-19 infection was the main reason for accepting Covid-19 vaccination (69.7%), followed by believing in the safety and efficacy of the vaccine (36%), while travel was reported with a percentage of 22.2%. ConclusionThe study showed that the participants generally had a good perception and acceptance of Covid-19 vaccination. The main adverse events reported were fever, fatigue and headache. Age is an independent profound variable influencing tolerability of Covid-19 vaccine. Impact of findings on practice statementsO_LIGood perception and acceptance of Covid-19 vaccination, depend on the factual information from trusted sources, mainly the ministry of health. C_LIO_LIAge significantly influenced tolerability of Covid-19 vaccine among participants. C_LIO_LIDemographic factors impact how people view and perceive Covid-19 vaccinations. C_LI

BackgroundThroughout US history, chronic and infectious diseases have severely impacted minority communities due to lack of accessibility to quality healthcare, accurate information, and underlying racism. These fault lines in the care of minority communities in the US have been further exposed by the rise of COVID-19 pandemic. This study examined the factors associated with COVID-19 vaccine hesitancy among African American and Latinx communities in Eastern Pennsylvania (PA). MethodsSurvey data was collected in July 2021 in Philadelphia, Scranton, Wilkes-Barre, and Hazleton, PA. The 203 participants (38.7% Black, 27.5% Latinx) completed the 28-question survey of COVID-19 vaccination attitudes in either English or Spanish. ResultsOut of a total of 181 participants that met inclusion criteria of completed surveys, results indicate that 63.5% (n=115) were acceptant of the COVID-19 vaccine whereas the remainder 36.5% (n=66) were hesitant. Binary logistic regression results showed that age, concern for vaccine efficacy, race, knowledge on the vaccine, and belief that the COVID-19 virus is serious significantly influenced COVID vaccine hesitancy. Minorities were more likely to be hesitant toward vaccination (OR: 2.77, 95% CI: 1.13, 6.79) than non-Hispanic whites. Those who believed the COVID vaccine was ineffective (OR: 8.29, 95% CI: 3.78,18.2), and that the virus is not serious (OR: 8.28, 95% CI: 1.11, 61.8) showed the greatest odds of hesitancy. ConclusionsContributing factors of vaccine hesitancy in minority communities were age, concern for vaccine efficacy, and education. Understanding and addressing the barriers to COVID-19 vaccination in minority groups is essential to decreasing transmission and controlling this pandemic.

Four principal types of authorised COVID-19 vaccines include inactivated whole-virus vaccines, protein subunit vaccines, viral-vector vaccines and nucleic acid (mRNA and DNA) vaccines. Despite numerous Randomised Controlled Trials (RCTs), comprehensive systematic review and comparative meta-analysis have not been performed to validate the immunogenicity, safety and efficacy of COVID-19 vaccines in the healthy adult population. We aim to fulfil this unmet void. We searched for peer-reviewed articles about RCTs of the COVID-19 vaccines on healthy adults (18-64 years) available in eight major bibliographic databases (PubMed, EMBASE, Web of Science, Cochrane Library, Scopus, ScienceDirect, POPLINE, HINARI) till August 28, 2022. The Risk of Bias (RoB) was assessed using the Cochrane RoB-2. Random effects meta-analysis was conducted by pooling dichotomous outcomes using risk ratios (safety outcomes) and continuous outcomes using standardised mean differences (immunogenicity outcomes). Efficacy outcomes were summarised narratively. Moderate to high-quality evidence suggests that those receiving COVID-19 vaccines had significantly higher immune responses compared to placebo. Serious adverse events were rare, confirming that COVID-19 vaccines were safe and immunogenic for the healthy adult population. Remarkably, adverse events were the least common in inactivated vaccines, and nucleic acid vaccines were the most immunogenic. The efficacies of COVID-19 vaccines ranged from 21.9% to 95.9% in preventing COVID-19. We endorse all four types of COVID-19 vaccines for public health policy implementing taskforces. Yet, meta-analyses based on individual patient data are warranted for more extensive measurement of differential impacts of COVID-19 vaccines on different genders, ethnicities, comorbidities and types of vaccine jabbed.

To mitigate the unprecedented health, social, and economic damage of COVID-19, the Philippines implemented a nation-wide vaccine program to mitigate the effects of the global pandemic. In a previous study, we interrogated COVID-19 vaccine intent in the country by deploying a nationwide open-access online survey, two months before the initial rollout of the national vaccination program that began in March of 2021. In this follow-up study, we explored the influence of the ongoing vaccine rollout on vaccine intent by deploying a similar survey six months after the initial rollout of vaccines had begun throughout the archipelago. Our data suggests that the presence of vaccines and vaccinated individuals in a Filipino community predicts vaccination intent. When directly asked if they were more willing to receive a vaccination than six months prior, 92.26% agreed to some extent that they were indeed more willing. Finally, despite the changes in the numbers of respondents who were more open to the COVID-19 vaccines, there were no significant changes in the predictive power of our Health Belief Model (HBM) constructs. For the most part, the HBM factors that predicted vaccination intent in our earlier study also predicted vaccination intent in this current study.

BackgroundPeople living with chronic disease, particularly seniors older than 60 years old, are lagging behind in the national vaccination campaign in China due to uncertainty of safety and effectiveness. However, this special population made up of most severe symptom and death cases among infected patients and should be prioritized in vaccination program. In this retrospective study, we assessed the safety and immunogenicity of the CoronaVac inactivated vaccines in people with underlying medical conditions to address the vaccine hesitation in this special population. MethodsIn this cohort study, volunteers aged 40 years and older, had received two doses of CoronaVac inactivated vaccines (3-5 weeks interval), been healthy or with at least one of the six diseases: coronary heart disease (CAD), hypertension, diabetes mellitus (DM), chronic respiratory disease (CRD), obesity and cancer, were recruited from 4 study sites in China. The primary safety outcome was the incidence of adverse events within 14 days after each dose of vaccination. The primary immunogenic outcome was geometric mean titer (GMT) of neutralizing antibodies to living SARS-CoV-2 virus at 14-28 days, 3 months, and 6 months after full two-dose vaccination. This study is registered with ChiCTR.org.cn (ChiCTR2200058281) and is active but no longer recruiting. FindingsAmong 1,302 volunteers screened between Jul 5 and Dec 30, 2021, 969 were eligible and enrolled in our cohort, including 740 living with underlying medical conditions and 229 as healthy control. All of them formed the safety cohort. The overall incidence of adverse reactions was 150 (20.27%) of 740 in the comorbidities group versus 32 (13.97%) of 229 in the healthy group, with significant difference (P=0.0334). The difference was mainly contributed by fatigue and injection-site pain in some groups. Most adverse reactions were mild (Grade 1). We did not observe any serious adverse events related to vaccination. By day 14-28 post vaccination, the seroconversion rates and GMT of neutralizing antibody showed no significant difference between disease group and healthy group, except CAD group (P=0.03) and CRD group (P=0.04) showed slight reduction. By day 90, the neutralizing antibody GMTs were significantly reduced in each group, with no significant difference between diseases and healthy group. By day 180, the neutralizing antibody continued to decrease in each group, but with slower declination. InterpretationFor people living with chronic disease especially seniors older than 60 years, the CoronaVac vaccines are as safe as in healthy people. Although the immunogenicity is slightly different in subgroup of some diseases compared with that of the healthy population, the overall trend was consistent. Our findings highlight the evidence to address vaccine hesitancy for seniors and people living with chronic diseases. FundingYunnan Provincial Science and Technology Department (202102AA100051 and 202003AC100010, China), Sinovac Biotech Ltd (PRO-nCOV-4004).

BackgroundThis study evaluated the effectiveness of Modernas updated mRNA-1273 vaccine targeting the KP.2 variant, compared to people who did not receive any 2024-2025 COVID-19 vaccine, in preventing COVID-19-associated hospitalizations and medically attended COVID-19 among adults aged [&ge;]18 years in the United States during the 2024-2025 season. MethodsData were extracted from linked administrative healthcare claims and electronic health records (EHR) for vaccinations from 23 August 2024 through 24 December 2024 and followed through 31 December 2024. We conducted a retrospective matched cohort study with propensity score weighting to adjust for differences between groups to assess vaccine effectiveness (VE) against COVID-19 outcomes. VE was calculated as 1 minus the hazard ratio (HR) from Cox proportional hazards models. ResultsOverall, 465,073 mRNA-1273 KP.2 vaccine recipients were matched 1:1 to unexposed adults. The mean (standard deviation) age was 63 (17) years, with more than half of the population being 65 years or older. Approximately 70% of individuals had an underlying medical condition making them high risk for severe outcomes for COVID-19. VE was 52.8% (95% confidence interval [CI], 34.8%, 65.8%) against COVID-19-related hospitalization and 39.4% (35.0%, 43.5%) against medically attended COVID-19 over a median follow-up of 57 (interquartile range: 33-78) days. ConclusionThe mRNA-1273 KP.2 vaccine demonstrated significant incremental effectiveness in preventing hospitalization with COVID-19 and medically attended COVID-19 in adults during the 2024-2025 season to date. These findings support ongoing vaccination efforts to mitigate the public health impact of COVID-19. FundingThis work was supported by Moderna Inc.

IntroductionSome hemodialysis patients are reluctant to COVID-19 for the development of adverse events (AEs). The aim of this study was to verify the safety of mRNA-1273 vaccine in hemodialysis patients. MethodsWe conducted a retrospective analysis of in-center hemodialysis patients who underwent mRNA-1273 vaccine from March 1st to April 30th, 2021. All AEs occurring after the first and the second doses were collected and classified as local or systemic. ResultsOverall, 126 patients on chronic maintenance dialysis without a prior COVID-19 diagnosis were vaccinated with two doses of mRNA-1273 vaccine. Mean age was 68 (IQR, 54,7-76) years and 53.6% of patients were aged [&ge;] 65 years. During the observational period of 68 (IQR, 66-70) days, AEs occurred in 57.9% and 61.9% of patients after the first dose and second dose, respectively. The most common AEs were: injection-site pain (61.9%), erythema (4.8%), itching (4.8%), swelling (16.7%), axillary swelling/tenderness (2.4%), fever (17.5%) headache (7.9%), fatigue (23.8%), myalgia (17.5%), arthralgia (12.7%), dyspnoea (2.4%), nausea/vomiting (7.1%), diarrhoea (5.6%), shivers (4%) and vertigo (1.6%). The rates of local AEs were similar after the first and second doses (P=0.8), whereas systemic AEs occurred more frequently after the second dose (P=0.001). Fever (P=0.03), fatigue (P=0.02) and nausea/vomiting (P=0.03) were significantly more frequent after the second dose of the vaccine. There were no age-related differences in the rate of AEs. Overall, vaccine-related AEs in hemodialysis patients seem to be lower than in the general population. ConclusionRNA-1273 vaccine was associated with the development of transient AEs after the first (57.9%) and second doses (61.9%) in patients on chronic maintenance hemodialysis. Systemic AEs were more common after the second dose. Overall, all AEs lasted for a few days, without any apparent sequelae.