UAE efforts in promoting COVID-19 vaccination and building vaccine confidence

Vaccine Hesitancy and Associated Factors Amongst Health Professionals: A Scoping Review of the Published Literature

Background/Objectives: Healthcare professionals (HCPs) hold significant influence over public attitudes toward vaccinations. Studies suggest that HCPs are hesitant towards the coronavirus disease 2019 (COVID-19) vaccines. This hesitancy could lead to lower vaccination rates in the community. Therefore, this scoping review aimed to assess the extent of hesitancy towards COVID-19 booster doses among HCPs and identify the associated factors. Methods: A comprehensive search was conducted in the PubMed and Scopus databases from April to August 2024, using keywords related to COVID-19, vaccine hesitancy, HCPs, and booster vaccination. Studies that had been peer-reviewed, published in English after 2022, and focused on the hesitancy of the COVID-19 booster dose hesitancy among HCPs were included. Out of the 6703 studies screened, 24 studies were included. Results: Most of the HCPs have received their initial series of COVID-19 vaccinations. However, there is a lower rate of uptake for booster doses, with hesitancy rates ranging from 12% to 66.5%. Hesitancy rates varied significantly across continents, with Asia, Africa, and Europe ranging from 19.7% to 66.5%, 27% to 46.1%, 14% to 60.2%, respectively. Hesitancy was reported to be influenced by various factors, including concerns about vaccine safety, necessity, and effectiveness of these vaccines. In addition, the hesitancy regarding booster doses was also found to be influenced by factors like age, gender, profession, and previous COVID-19. Physicians, nurses, and pharmacists exhibited vaccine hesitancy rates ranging from 12.8% to 43.7%, 26% to 37%, and 26% to 34.6%, respectively. Conclusions: Our review underscores the hesitancy among HCPs towards receiving booster doses across countries around the world and explores the underlying factors. These findings provide valuable insights for the design of future pandemic vaccination programs.

Vaccination coverage and access among children and adult migrants and refugees in the Middle East and North African region: a systematic review and meta-analysis

Background

The Middle East and North African (MENA) region is a major global hotspot for migration with more than 40 million migrants, who may be an under-vaccinated group because of barriers to vaccination within countries of origin, transit, and destination. We systematically synthesised the evidence on coverage, acceptance, drivers of uptake, and policies pertaining to vaccination for children and adult migrants in the region, in order to explore tailored interventions for these groups.

Methods

We searched six databases (including Medline, Embase) for peer-reviewed literature, and other websites (including WHO, IOM, ministries of health) for grey literature on coverage, acceptance, drivers of uptake and policies for any vaccination in migrants in the MENA region from between 2000 and 27 August 2024 in any language. We included studies reporting primary data on coverage, acceptance, and drivers of uptake, and any relevant articles on policies. We defined migrants as individuals who move away from their place of habitual residence, within or across international borders, temporarily or permanently. Studies without disaggregated migrant data were excluded. Primary outcomes were coverage (% individuals receiving ≥1 doses of any vaccine) and acceptance (% individuals accepting any vaccine). We separately synthesised data on children (<18 years) and adults (≥18). Estimates were pooled using a random-effects meta-analysis where possible or narratively synthesised, and drivers of uptake were synthesised using the WHO Behavioural and Social Drivers model. PROSPERO protocol: CRD42023401694.

Findings

We identified 6088 database and 282 grey literature records and included 55 studies and 1,906,975 migrants across 15 countries (including mostly refugees in the Middle East and expatriates in Gulf Cooperation Council countries). COVID-19 vaccination was reportedly provided free of charge to migrants in all countries whereas childhood vaccinations were reportedly provided to migrant children in seven countries. However, for adolescents and adults, there were wide variations across countries, and we found no policies relating to catch-up vaccination. Coverage for childhood vaccination amongst migrants was reportedly low, with only 36.0% of 589 migrant children fully vaccinated according to national schedules (95% CI 35.0%-43.0%, I 2 = 67%; data from migrants in Lebanon, Morocco, Sudan). Likewise, data on specific routine vaccines in children was generally low: measles containing vaccines (MCV): MCV dose 1 63.9%-66.9%; MCV dose 2 25.4%-85.6%; oral polio vaccine (OPV): OPV dose 3 65.1%-76.4%; diphtheria, tetanus and pertussis (DTP) containing vaccines: DTP dose 1 81.8%-86.7%; DTP dose 3 59.7%-76.6%). Drop-out rates across all routine vaccines for subsequent vaccine doses ranged from 12.4 to 38.5%, suggesting that migrants face a range of barriers to vaccine uptake beyond the first dose, that need to be better considered when designing interventions. For adults, we found eleven studies on coverage (including 9 on COVID-19) showing that COVID-19 vaccination coverage ranged 33.5-84.8% in migrants and 25.0-59.0% in host populations. Drivers of uptake of childhood vaccination in migrants included limited availability of vaccines and vaccination personnel, communication and administrative barriers, financial difficulties, lack of caregiver knowledge about services, and concerns expressed by caregivers around safety and benefits. For adults, drivers were mainly related to the COVID-19 vaccine and included concerns around safety, quality, side effects, and mistrust in vaccines and the systems that deliver them.

Interpretation

Migrants have unique risk factors for under-immunisation in the MENA region and have low vaccination coverage despite some level of entitlement to services. Data on vaccination coverage, drivers of uptake and policies for migrants in the MENA region is limited to small-scale studies among accessible groups, mostly focusing on COVID-19 compared to routine childhood and adult vaccination. There is an urgent need to strengthen data collection to better understand coverage across different migrant groups, ages, and MENA countries, especially on adult and catch-up vaccinations for routine immunisations, and develop innovative co-designed strategies to address specific drivers of vaccine uptake among this group.

Funding

La Caixa, LCF/PR/SP21/52930003.

Level and factors of support for the Living with the Virus policy in a Chinese adult general population: a mediation analysis via positive and negative attitudes toward the policy

Background

This study investigated the public's support for the Living with the Virus (LWV) policy, its associated factors, and related mediations at a time when more countries were considering adopting the LWV policy amid the COVID-19 pandemic.

Methods

A random, population-based telephone survey was conducted among 500 Chinese adults in Hong Kong during March/April 2022.

Results

39.6% of the participants were supportive/strongly supportive of the LWV policy. Perceived efficacy of the control measures was negatively associated with the support and was partially mediated via the perception that the policy would greatly improve the economy/daily life of the policy. Perceived physical harms of the Omicron variant was negatively associated with the support and was fully mediated via perceived negative impacts of the policy. 26.2%/54.6% believed that the policy would improve the economy/daily life greatly; about 40% perceived negative impacts on deaths and the medical system due to the policy. COVID-19 ever infection did not significantly moderate the studied associations.

Conclusion

The public was split regarding the support for the LWV policy and whether it would cause better economy/daily life, unnecessary deaths, and the collapse of the medical system. Health communication is needed in shifting toward the LWV policy.

The Worrying Phenomenon of COVID-19 Vaccine Hesitancy and Its Negative Impact on Pandemic Control Efforts: Common Themes that Emerged in the Middle East and North Africa (MENA) Region

Since the declaration of coronavirus disease 2019 (COVID-19) as a pandemic, intensive measures were taken to mitigate its negative health, psychological, social, and economic impact. COVID-19 continues to pose serious threats globally, with vaccination as the central safe strategy to control the pandemic. However, COVID-19 vaccine hesitancy is a major concern, especially in the Middle East and North Africa (MENA). Concerns regarding vaccine safety, efficacy, and misinformation contribute to vaccine hesitancy. Addressing these concerns and providing accurate information is crucial for increasing COVID-19 vaccine acceptance and uptake in this region, where the coverage is low. Variable rates of COVID-19 vaccine hesitancy were found in the numerous studies conducted in the region. Complex factors contributed to vaccination hesitancy in the region including concerns about COVID-19 vaccine safety and efficacy, low trust in healthcare systems, complacency toward the risks of COVID-19, constraints hindering access to COVID-19 vaccination services, as well as the circulation of misinformation and conspiracy beliefs about COVID-19 and its vaccination. Effective approaches to address COVID-19 vaccine hesitancy in the MENA region rely on developing evidence-based communication strategies that are recommended to build trust in vaccination, highlight the disease risks, and counter COVID-19 vaccine-related misinformation. Ensuring COVID-19 vaccine affordability is also necessary besides the cautious consideration of implementing COVID-19 vaccine mandates. Based on the preceding discussion, this chapter aims to identify the common themes of COVID-19 vaccine hesitancy in the MENA region. In addition, the chapter highlights the importance of understanding the root causes of COVID-19 vaccination hesitancy and its associated determinants to develop effective strategies for promoting COVID-19 vaccine acceptance and uptake in the MENA region. To build community trust, promote community education and awareness, and counter misinformation for better COVID-19 vaccine coverage in the region, it is recommended to involve healthcare professionals and policymakers.

COVID-19 vaccine hesitancy worldwide and its associated factors: a systematic review and meta-analysis

Introduction

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has taken a toll on humans, and the development of effective vaccines has been a promising tool to end the pandemic. However, for a vaccination program to be successful, a considerable proportion of the community must be vaccinated. Hence, public acceptance of coronavirus disease 2019 (COVID-19) vaccines has become the key to controlling the pandemic. Recent studies have shown vaccine hesitancy increasing over time. This systematic review aims to evaluate the COVID-19 vaccine hesitancy rate and related factors in different communities.

Method

A comprehensive search was performed in MEDLINE (via PubMed), Scopus, and Web of Science from January 1, 2019 to January 31, 2022. All relevant descriptive and observational studies (cross-sectional and longitudinal) on vaccine hesitancy and acceptance were included in this systematic review. In the meta-analysis, odds ratio (OR) was used to assess the effects of population characteristics on vaccine hesitancy, and event rate (acceptance rate) was the effect measure for overall acceptance. Publication bias was assessed using the funnel plot, Egger's test, and trim-and-fill methods.

Result

A total of 135 out of 6,417 studies were included after screening. A meta-analysis of 114 studies, including 849,911 participants, showed an overall acceptance rate of 63.1%. In addition, men, married individuals, educated people, those with a history of flu vaccination, those with higher income levels, those with comorbidities, and people living in urban areas were less hesitant.

Conclusion

Increasing public awareness of the importance of COVID-19 vaccines in overcoming the pandemic is crucial. Being men, living in an urban region, being married or educated, having a history of influenza vaccination, having a higher level of income status, and having a history of comorbidities are associated with higher COVID-19 vaccine acceptance.

Mitigating healthcare worker risk during the COVID-19 pandemic - experience from a large tertiary maternity centre in the United Arab Emirates

Since the beginning of the COVID-19 pandemic in 2020, healthcare workers (HCW) have been leading the charge in combating it, in spite of being disproportionately affected by the disease compared to the general population. This study describes the measures instituted at the largest maternity center in the United Arab Emirates during the pandemic to mitigate the risk of HCW contracting COVID-19, as well as the effectiveness of those measures. The incidence of COVID-19 amongst healthcare workers at the facility was compared to that in the general population over a 13-month period from February 2021 to February 2022. Data on population testing was obtained from the database maintained by the regional testing lab, while HCW testing data was obtained from the occupational health department at the hospital. The incidence of COVID-19 in HCWs and the general population was compared using summary statistics and charts. Several mitigation measures were instituted to protect HCW during the pandemic including patient traffic management, adequate provision of personal protective equipment, staff vaccination campaigns, infrastructure enhancement, workforce planning, and structured occupational health policies. During the study period the overall positivity rate in the general population was 5.78% (83,005/1.4 million tests) and that for staff was 1.19% (401/33,228 tests). The peaks and troughs on staff turning positive for COVID-19 coincided with peaks and troughs of the pandemic in the general population. The hospital instituted effective mitigation measures in protecting the staff and keeping COVID-19 rates well below the ones encountered in the general population.

Lessons Learned from the Pandemic in the UAE: Children COVID-19 Vaccine Hesitancy and Its Impact on the Choice of Distance versus Face-to-Face Learning Modalities: An In-Depth Analysis of a National Study

This study addresses the crucial aspect of childhood COVID-19 vaccination and its impact on parental decisions concerning learning modalities during the pandemic. This study aimed to gauge parental hesitancy towards vaccinating their children and its influence on choosing between distance and face-to-face learning options. Following STROBE guidelines for cross-sectional studies, this study surveyed 1973 parents in the United Arab Emirates using Google Forms during the COVID-19 pandemic. The results revealed that while more than half of the parents (51.6%) were willing to vaccinate their children if the COVID-19 vaccine was accessible and affordable, a significant majority (91.2%) expressed concerns about the rapid vaccine development process, which was the primary reason for vaccine rejection. Interestingly, a sizable portion (55.3%) had experienced online learning in the previous academic term, and, of those, 59.6% believed it negatively influenced their children's academic performance. Consequently, 66.4% expressed intent to shift their children back to face-to-face learning once feasible. Significantly, parents with medical backgrounds were more inclined (91.6%) to opt for face-to-face schooling compared to those without such backgrounds. Logistic regression analysis indicated associations between sociodemographic characteristics, educational level and background, and the decision to return children to face-to-face learning. Interestingly, when it comes to vaccine hesitancy, a noteworthy connection exists between the parents' reluctance to vaccinate their children and their preference for distance learning. In fact, parents who responded negatively to vaccinating their children against COVID-19, if the vaccine was available, showed a clear preference for the distance learning modality (p-value < 0.0001). This study underscores the complex interplay of factors and community perspectives shaping parental acceptance of childhood COVID-19 vaccination. The development pace of vaccines significantly influences parents' attitudes and beliefs about vaccination programs. Parents' medical backgrounds exhibit a clear correlation with their perceptions of sending children back to school safely. This highlights the potential impact of parental medical knowledge on decision making, emphasizing the need to consider parents' professional backgrounds when devising education- and vaccination-related policies.

Hesitancy toward vaccination against COVID-19: A scoping review of prevalence and associated factors in the Arab world

Despite widespread availability of vaccines against SARS-CoV-2 virus, the cause of Coronavirus Disease 2019 (COVID-19), its uptake in many Arab countries is relatively low. This literature review aimed to scope evidence on COVID-19 vaccine hesitancy (VH) in the Arab world. A total of 134 articles reporting prevalence of COVID-19 VH and associated factors, conducted in any of the 22 Arab League countries, were reviewed. COVID-19 VH prevalence ranged from 5.4% to 83.0%. Female gender, young age, low education level and lack of previous influenza vaccine uptake were most commonly reported to be associated with COVID-19 VH. The most-reported personal concerns contributing toward VH were related to the rapid development, safety and side effects of vaccine, as well as an overall lack of trust in government policies toward pandemic control and widespread conspiracy theories. Tailored interventions to enable the distribution of trusted information and enhance public acceptance of immunization are warranted.

The Psychological Antecedents to COVID-19 Vaccination among Community Pharmacists in Khartoum State, Sudan

Background and Objectives: Little is known regarding the 5C psychological antecedents to COVID-19 vaccination among pharmacists in low- and middle-income countries. This study aimed to assess the acceptance of COVID-19 vaccination and its psychological antecedents among community pharmacists in Khartoum State, Sudan. Materials and Methods: A cross-sectional study was conducted from July to September 2022. A self-administered questionnaire was used to collect data about sociodemographic and health status characteristics, vaccine acceptance, and the 5C psychological antecedents to vaccination. Stepwise logistic regression analysis was conducted, and results were presented using odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results: A total of 382 community pharmacists participated in the current study, with a mean age of 30.4 ± 5.6 years. Nearly two-thirds of the participants (65.4%) were females, and the majority (74.9%) have received or intended to receive the COVID-19 vaccination. Vaccine acceptance was significantly associated with the following psychological antecedents to vaccination: confidence, complacency, constraints, and calculation (p < 0.001). Results of the logistic regression showed that confidence in vaccines [OR = 6.82 (95% CI = 3.14-14.80)], conspiracy beliefs [OR = 0.44 (95% CI = 0.23-0.85)], and constraints to vaccination [OR = 0.18 (95% CI = 0.06-0.56)] were the significant determinants of vaccine acceptance. Conclusion: The study revealed important predictors of COVID-19 vaccine acceptance that can be used to guide policymakers in designing target-oriented interventions that can improve the vaccine acceptance rate among community pharmacists in Sudan. These findings suggest that interventions to promote vaccine acceptance among pharmacists should focus on building confidence in vaccines and providing accurate information about the safety and efficacy of the COVID-19 vaccine, and reducing constraints to vaccination.

COVID-19 Breakthrough Infection Among Vaccinated Population in the United Arab Emirates

BACKGROUND

Despite significant efforts to contain the Coronavirus Disease 2019 (COVID-19) pandemic through mass vaccination, numerous nations throughout the world have recorded breakout infections. The incidence and severity of COVID-19 breakthrough infections in the United Arab Emirates (UAE) remain unknown despite extensive COVID-19 vaccine coverage. The goal of this research is to establish the characteristics of COVID-19 breakthrough infections in the UAE's vaccinated population.

METHODS

Between February and March 2022, we conducted a descriptive cross-sectional study in the UAE with 1533 participants to examine the characteristics of COVID-19 breakthrough infection among the vaccinated population.

RESULTS

The vaccination coverage was 97.97%, and the COVID-19 breakthrough infection rate was 32.1%, requiring hospitalization in 7.7% of cases. The bulk of the 492 COVID-19 breakthrough infections reported was among young adults (67%), with the majority experiencing mild to moderate symptoms (70.7%) or remaining asymptomatic (21.5%).

CONCLUSIONS

COVID-19 breakthrough infection were reported in younger age, male sex, non-healthcare professions, vaccination with inactivated whole virus vaccine (Sinopharm), and not receiving a booster dose. Information on breakthrough infection in the UAE might influence public health decisions and motivate measures such as providing additional booster doses of the vaccines to the people.

A comprehensive survey on the beliefs, perceptions, and clinical manifestations of pre and post Covid-19 vaccinations among physiotherapy students in the United Arab Emirates

The World Health Organization has defined Coronavirus Disease (COVID-19) as an infectious pandemic, caused by a newly discovered SARS-CoV-2 virus. Students relied heavily on the internet, social media, parents, and friends, in addition to medical advice for information on its presentation, complications, prevention, and management. It is evident from the literature that healthcare professionals including students who play an important role in the healthcare system may be lacking important information on COVID-19 vaccinations. Thus, the study aims to identify and compare the pre-post covid-19 vaccination-related essential information among Physical Therapy university students. A cross-sectional survey was conducted among physiotherapy university students in the United Arab Emirates using a self-administrated structured questionnaire. The questionnaire comprised three sections covering beliefs, perceptions, and clinical manifestations of the pre- and post-COVID- 19 vaccination. The survey was shared with more than 300 students through email and social platforms during the time between January 2022 till December 2022. Most of the physiotherapy students believed the vaccines to be safe (71.3%) due to multiple reasons while others did not believe in the effectiveness of the vaccine (28.7%). Some students did report unusual symptoms (painful periods, hair loss, forgetfulness) after the vaccine (10%). Similar findings were reported for family members as well (14%). Students had a positive perception of the vaccine and reported willingness to take it even if not mandatory (68%). Some students did believe in the safety of the vaccine due to multiple reasons while some did not due to fear of long-term side effects and personal choices. The finding of the study could be useful to create confidence as well as awareness among physiotherapy students as they are often invited to aid during medical pandemics such as Covid 19. Also, higher rates of vaccination among healthcare professionals will impart higher acceptance in the medical organization due to safety guidelines. This could also help to counsel other students against fear and apprehension towards the vaccination of such kind in the future.

COVID-19 Vaccination Hesitancy: A Review of the Literature and Recommendations

Vaccines are important to improve immunity against pathogens and diseases. The current COVID-19 disease is rapidly evolving and spreading among people; therefore, it is important to utilize a proper vaccination strategy against it. Currently, many approved vaccines are available and accessible; however, there is a reported hesitancy against taking them among the public and even the health care workers. Mainly, this is attributed to the fear of the possible side effects and complications. Moreover, inaccurate knowledge disseminated through the media/social media especially by those who lack the proper expertise, adds confusion and more fear that affects the vaccination decision. For such reasons, it is essential to find strategies to increase the acceptability of vaccines and enhance confidence in the vaccination process. This should be accompanied by sufficient efforts and proper clinical studies to confirm the value and the safety of the vaccines. Those strategies are important to avoid the further spread of the COVID-19 disease and abort the pandemic worldwide, especially when considering the likely approach towards a COVID-19 booster vaccination program, in which booster vaccines are re-taken along intervals to adequately contain the rapidly evolving nature of the virus. This review article highlights the factors influencing the acceptability of the COVID-19 vaccination and enrollment in clinical trials among the public and some specific populations. Furthermore, it summarizes the suggested strategies and recommendations to improve attitudes towards COVID-19 vaccination programs.

COVID-19: Psychological distress, fear, and coping strategies among community members across the United Arab Emirates

BACKGROUND

The COVID-19 pandemic impacted the psychosocial well-being of the United Arab Emirates [UAE] population like other communities internationally.

OBJECTIVES

We aimed to identify the factors associated with psychological distress, fear, and coping amongst community members across the UAE.

METHODS

We conducted a cross-sectional online survey across the UAE during November 2020. Adults aged ≥18 years, living in the UAE who were able to respond to an online questionnaire in English or Arabic were considered eligible to participate in the study. We used standard validated tools to measure psychological distress, fear and coping. Kessler Psychological Distress Scale [K10] was used to assess psychological distress, Fear of COVID-19 Scale [FCV-19S] was used to assess the level of fear, and Brief Resilient Coping Scale [BRCS] was used to assess the coping strategies.

RESULTS

A total of 417 individuals participated in this study with a mean age of 29 [± 10.7] years. More than half of the participants experienced high to very high levels of psychological distress [55%] and a quarter experienced high levels of fear of COVID-19 [23.3%] with almost a third of them [36.2%] having low resilient coping. About 37.4% of the participants had work-related mental health impacts and 32.4% were perceived to have moderate to a great deal of distress due to a change of employment status during the pandemic. One in ten participants [9.4%] reported increased smoking. Increased smoking [AOR 8.66, 95% CIs 1.08-69.1,], increased alcohol drinking [AOR 2.39, 95% CIs 1.05-5.47] and higher levels of fear of COVID-19 [AOR 2.93, 95% CIs 1.83-4.67] were associated with moderate to very high levels of psychological distress. Being female [AOR 1.82, p = 0.030], having a pre-existing mental health condition [AOR 9.88, 95% p = 0.027], engaging in high-risk behaviors such as increased smoking [AOR 21.14, p = 0.003], increased alcohol drinking [AOR 1.48, p = 0.359] in the previous four weeks, and higher levels of fear of COVID-19 [AOR 4.18, p <0.001] were associated with moderate to very high levels of psychological distress. Also, being a smoker [AOR, 0.840, p = 0.011], and having a high level of fear [AOR 0.372, p = 0.001] were found to be associated with low resilient coping.

CONCLUSION

Community members in the UAE are at a higher risk of psychosocial distress and fear during the COVID-19 pandemic. Thus, healthcare providers and policymakers would need to be more alert to provide specific mental health support strategies for their wellbeing.

Responses to COVID-19 Threats: an Evolutionary Psychological Analysis

Responses to COVID-19 public health interventions have been lukewarm. For example, only 64% of the US population has received at least two vaccinations. Because most public health interventions require people to behave in ways that are evolutionarily novel, evolutionary psychological theory and research on mismatch theory, the behavioral immune system, and individual differences can help us gain a better understanding of how people respond to public health information. Primary sources of threat information during the pandemic (particularly in early phases) were geographic differences in morbidity and mortality statistics. We argue that people are unlikely to respond to this type of evolutionarily novel information, particularly under conditions of high uncertainty. However, because individual differences affect threat perceptions, some individual differences will be associated with threat responses. We conducted two studies (during Phase 1 and 2 years later), using data from primarily public sources. We found that state-level COVID-19 morbidity and mortality rates had no relationship with mental health symptoms (an early indicator of how people were responding to the pandemic), suggesting that people-in general-were not attending to this type of information. This result is consistent with the evolutionary psychological explanation that statistical information is likely to have a weak effect on the behavioral immune system. We also found that individual differences (neuroticism, IQ, age, and political ideology) affected how people responded to COVID-19 threats, supporting a niche-picking explanation. We conclude with suggestions for future research and suggestions for improving interventions and promoting greater compliance.

ACE2 polymorphisms impact COVID-19 severity in obese patients

A strong association between obesity and COVID-19 complications and a lack of prognostic factors that explain the unpredictable severity among these patients still exist despite the various vaccination programs. The expression of angiotensin converting enzyme 2 (ACE2), the main receptor for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is enhanced in obese individuals. The occurrence of frequent genetic single nucleotide polymorphisms (SNPs) in ACE2 is suggested to increase COVID-19 severity. Accordingly, we hypothesize that obesity-associated ACE2 polymorphisms increase the severity of COVID-19. In this study, we profiled eight frequently reported ACE2 SNPs in a cohort of lean and obese COVID-19 patients (n = 82). We highlight the significant association of rs2285666, rs2048683, rs879922, and rs4240157 with increased severity in obese COVID-19 patients as compared to lean counterparts. These co-morbid-associated SNPs tend to positively correlate, hence proposing possible functional cooperation to ACE2 regulation. In obese COVID-19 patients, rs2285666, rs879922, and rs4240157 are significantly associated with increased blood nitrogen urea and creatinine levels. In conclusion, we highlight the contribution of ACE2 SNPs in enhancing COVID-19 severity in obese individuals. The results from this study provide a basis for further investigations required to shed light on the underlying mechanisms of COVID-19 associated SNPs in COVID-19 obese patients.

Time-series COVID-19 policymaker analysis of the UAE, Taiwan, New Zealand, Japan and Hungary

There are two types of policy analysis: socioeconomic analysis and public policy outcome analysis. The socioeconomic analysis is used for understanding the relationship between COVID-19 incident and mortality and building effective governance. There are two types of policy outcome analysis: general policy analysis and time series policy analysis. This paper is a policy outcome analysis of COVID-19, not a policy analysis. This paper examines COVID-19 policy outcome analysis of five countries such as the UAE, Taiwan, New Zealand, Japan and Hungary. Two policy outcome analysis tools are used in this paper such as scorecovid to generate a snapshot list of sorted scores and time-series hiscovid to identify when policymakers made mistakes for correcting mistakes in the near future policy update. Scores in both tools are based on the population mortality rate: dividing the number of COVID-19 deaths by the population in millions. The lower the score, the better the policy. The higher the score, the more deaths that make people unhappy. COVID-19 death is the most unfortunate event in life and is caused by policy. The introduced time-series policy analysis tool, hiscovid discovered ten facts of five countries. Discovered ten facts will be detailed in this paper. Visualization of policy outcomes over time will play an important role in mitigating the COVID-19 pandemic.

Mass vaccinations against COVID-19 through the use of technologies for the management of appointment scheduling and data of large volumes of vaccinated

Mass vaccination against COVID-19 using technologies to manage appointment scheduling and data in large volumes of vaccinated people Abstract Mass vaccination poses a challenge for health authorities due to the high volume of people who need to be vaccinated in a short period of time. Manual processes in vaccination centres to record and control vaccinations where the data is entered on paper result in delays in the timely input of information rendering the vaccination process inefficient. The proposed prototype, as a strategy for mass COVID-19 vaccination, to generate appointments, record, and control entry to vaccination centres, uses mobile technology, QR codes, and cloud computing to automate these data-driven processes. Technology-based processes help people by giving them the flexibility to choose the most convenient vaccination centre and provide health authorities with data-driven tools for management, control, and real-time decision-making.

Similar effectiveness of the inactivated vaccine BBIBP-CorV (Sinopharm) and the mRNA vaccine BNT162b2 (Pfizer-BioNTech) against COVID-19 related hospitalizations during the Delta outbreak in the UAE

Inactivated vaccine BBIBP-CorV {Sinopharm; 95% [95% confidence interval (CI): 94, 97%]} and the mRNA vaccine BNT162b2 [Pfizer-BioNTech; 98% (95% CI: 86, 99%)] demonstrated protection against COVID-19 related hospitalizations from the Delta (B.1.617.2) variant. Ongoing efforts are necessary to target vaccine hesitancy and to promote booster shots for protection against severe COVID-19 disease and arising variants of concern.

The demand for a COVID-19 vaccine

Taking willingness to pay as primitive, this paper establishes an analytical framework for demand estimation, where the estimator is robust to endogeneity of price. Applying the framework, this paper then estimates demand functions for a COVID-19 vaccine and compute the consumer surplus in both China and the UAE. We find that the price elasticities of demand are mostly greater than one in both countries. An elastic demand suggests subsidy is likely to be successful in promoting vaccination. The consumer surplus is sizeable, around 58 billion US$ in China and 646 million US$ in the UAE. The figures can inform policymakers in assessing their vaccine programs.

Vacunaciones masivas contra el COVID-19 mediante el uso de las tecnologías para la gestión de programación de citas y de datos de grandes volúmenes de vacunados

Las vacunaciones masivas son un desafío al que se enfrentan las autoridades sanitarias, debido al alto volumen de ciudadanos que deben de ser vacunados en un corto tiempo. Los procesos manuales en los centros de vacunación para el registro y control de las vacunas donde se emplea el papel como elemento repositorio de los datos, generan retrasos en la entrega oportuna de la información procesada y el proceso de vacunación se vuelve ineficiente. El prototipo propuesto como estrategia de vacunación masiva contra el COVID-19 para la generación de citas, registro y control del ingreso a los centros de vacunación utiliza las tecnologías móviles, código QR y Cloud Computing, para la automatización de estos procesos basados en datos. Los procesos apoyados en la tecnología ayudan al ciudadano por la flexibilidad de elegir el centro de vacunación más conveniente a su realidad y permiten a las autoridades sanitarias disponer de herramientas basadas en datos para la gestión, el control y la toma decisiones en tiempo real.

The Effect of COVID-19 Diagnosis on the Physical, Social, and Psychological Well-Being of People in the United Arab Emirates: An Explorative Qualitative Study

A positive COVID-19 infection may impact physical, mental, and social health. Different factors may influence these impacts on different levels due to personal circumstances. This study aimed to explore the impact of a positive COVID-19 diagnosis on the physical,mental, social, psychological health, and lifestyle practices of an individual in the United Arab Emirates. A sample of 28 participants was interviewed using online interviews. An interview guide was created based on the coping strategy model and conceptual framework of coping strategies. All interviews were recorded; then transcribed after obtaining written consent from participants. The NVivo software was used for thematic analysis based on both identified coping models. Major themes included the physical effects, social effects, psychological effects, spiritual effects, and lifestyle effects. Emerging themes include coping mechanisms, trust in authorities and the health care system, appreciation of the role of the government, conspiracy theories, and media roles. This study indicates that people diagnosed with COVID-19 have perceived very good support in terms of their physical health from the government and health authorities, but require social, psychological, and educational support during the infection period and post-recovery.

Motivational Factors to Receive the COVID-19 Vaccine in the United Arab Emirates: A Cross-Sectional Study

The United Arab Emirates has been very successful in its vaccination campaign for the COVID-19 injection, and vaccine hesitancy is not currently a major concern. Nevertheless, the motivations of residents in the UAE to receive the COVID-19 vaccine are varied. In this study with 426 vaccinated participants, 55% expressed health motivations to receive the vaccine, whereas 45% expressed non-health motivations. Nationality was a predictive factor in motivation, as expatriates from South Asian countries expressed the lowest motivation to get the vaccine on the basis of intrinsic health reasons, followed by expatriates from Arab countries, Emiratis, and expatriates from the rest of the world. The same nationality pattern was observed in vaccine readiness and vaccine knowledge. Both of these variables had a correlation with intrinsic health motivation in receiving the vaccine. No significant difference across nationalities was observed regarding vaccine conspiracy beliefs, and this variable only had a weak negative correlation with motivations to receive the vaccine.

Implications of social media misinformation on COVID-19 vaccine confidence among pregnant women in Africa

It has been over a year since the World Health Organization (WHO) declared the outbreak of COVID-19 as a Public Health Emergency of International Concern and subsequently a global pandemic. The world has experienced a lot of uncertainty since then as we all get used to this new ‘normal’ with social distancing measures, lockdowns, the emergence of new variants, and an array of hope with the development of vaccines. Having an abstract understanding of vaccine delivery, public perceptions of vaccines, and promoting acceptance of vaccines are critical to tackling the pandemic. The advent of the pandemic has led to the emergence of an ‘infodemic’ or rampant misinformation surrounding the virus, treatment, and vaccines. This poses a critical threat to global health as it has the potential to lead to a public health crisis by exacerbating disease spread and overwhelming healthcare systems. This ‘infodemic’ has led to rising vaccine hesitancy which is of paramount concern with the WHO even identifying it as one of the ten main threats to Global health almost 2 years before the approval of COVID-19 vaccines. Pregnant African women are one of the most vulnerable population groups in a region with an already burdened healthcare system. Currently, there isn’t ample research in the literature that explores vaccine hesitancy in this subpopulation and the impact of social media misinformation surrounding it. The aim of this paper is to highlight the implications of this ‘infodemic’ on the pregnant African population and suggest key recommendations for improved healthcare strategies.

A Global Map of COVID-19 Vaccine Acceptance Rates per Country: An Updated Concise Narrative Review

The delay or refusal of vaccination, which defines vaccine hesitancy, is a major challenge to successful control of COVID-19 epidemic. The huge number of publications addressing COVID-19 vaccine hesitancy necessitates periodic review to provide a concise summary of COVID-19 vaccine acceptance rates worldwide. In the current narrative review, data on COVID-19 vaccine acceptance rates were retrieved from surveys in 114 countries/territories. In East and Southern Africa (n = 9), the highest COVID-19 vaccine acceptance rate was reported in Ethiopia (92%), while the lowest rate was reported in Zimbabwe (50%). In West/Central Africa (n = 13), the highest rate was reported in Niger (93%), while the lowest rate was reported in Cameroon (15%). In Asia and the Pacific (n = 16), the highest rates were reported in Nepal and Vietnam (97%), while the lowest rate was reported in Hong Kong (42%). In Eastern Europe/Central Asia (n = 7), the highest rates were reported in Montenegro (69%) and Kazakhstan (64%), while the lowest rate was reported in Russia (30%). In Latin America and the Caribbean (n = 20), the highest rate was reported in Mexico (88%), while the lowest rate was reported in Haiti (43%). In the Middle East/North Africa (MENA, n = 22), the highest rate was reported in Tunisia (92%), while the lowest rate was reported in Iraq (13%). In Western/Central Europe and North America (n = 27), the highest rates were reported in Canada (91%) and Norway (89%), while the lowest rates were reported in Cyprus and Portugal (35%). COVID-19 vaccine acceptance rates ≥60% were seen in 72/114 countries/territories, compared to 42 countries/territories with rates between 13% and 59%. The phenomenon of COVID-19 vaccine hesitancy appeared more pronounced in the MENA, Europe and Central Asia, and Western/Central Africa. More studies are recommended in Africa, Eastern Europe and Central Asia to address intentions of the general public to get COVID-19 vaccination.