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Mantovani A, Rescigno M, Forni G, Tognon F, Putoto G, Ictho J, Lochoro P. COVID-19 vaccines and a perspective on Africa. Trends Immunol 2023; 44:172-187. [PMID: 36709083 PMCID: PMC9832054 DOI: 10.1016/j.it.2023.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
Vaccines have dramatically changed the COVID-19 pandemic. Over 30 vaccines that were developed on four main platforms are currently being used globally, but a deep dissection of the immunological mechanisms by which they operate is limited to only a few of them. Here, we review the evidence describing specific aspects of the modes of action of COVID-19 vaccines; these include innate immunity, trained innate immunity, and mucosal responses. We also discuss the use of COVID-19 vaccines in the African continent which is ridden with inequality in its access to vaccines and vaccine-related immunological research. We argue that strengthening immunology research in Africa should inform on fundamental aspects of vaccination, including the relevance of genetics, trained innate immunity, and microbiome diversity.
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Affiliation(s)
- Alberto Mantovani
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy; William Harvey Research Institute, Queen Mary University, London EC1M 6BQ, UK.
| | - Maria Rescigno
- IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | | | | | - Giovanni Putoto
- Head of Planning and Operational Research, Doctors with Africa CUAMM, Italy
| | - Jerry Ictho
- Clinical Epidemiology, Doctors with Africa CUAMM, Uganda
| | - Peter Lochoro
- Health Service Management, Doctors with Africa CUAMM, Uganda.
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Paremoer L, Pollock A. "A passion to change the landscape and drive a renaissance": The mRNA Hub at Afrigen as decolonial aspiration. Front Public Health 2022; 10:1065993. [PMID: 36518568 PMCID: PMC9742483 DOI: 10.3389/fpubh.2022.1065993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
In global conversations about COVID-19 vaccine access, Africa has overwhelmingly been characterized as a site of lack. However, the successful reverse engineering of the Moderna vaccine by Afrigen at the mRNA Hub in Cape Town marks a more hopeful path forward. This paper introduces the mRNA Hub and puts it into context of broader decolonial aspirations for African futures in the face of rich countries' disregard. Highlighting ways in which Afrigen's Managing Director's articulations of the endeavor resonate with historical and contemporary calls to dismantle the unequal global order, we argue that the mRNA Hub provides an example of the potential for decolonial solidarity in the post/pandemic period.
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Affiliation(s)
- Lauren Paremoer
- Department of Political Studies, University of Cape Town, Cape Town, South Africa,*Correspondence: Lauren Paremoer
| | - Anne Pollock
- Department of Global Health and Social Medicine, King's College London, London, United Kingdom
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Njoga EO, Awoyomi OJ, Onwumere-Idolor OS, Awoyomi PO, Ugochukwu ICI, Ozioko SN. Persisting Vaccine Hesitancy in Africa: The Whys, Global Public Health Consequences and Ways-Out-COVID-19 Vaccination Acceptance Rates as Case-in-Point. Vaccines (Basel) 2022; 10:1934. [PMID: 36423029 PMCID: PMC9697713 DOI: 10.3390/vaccines10111934] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 08/29/2023] Open
Abstract
Vaccine hesitancy (VH) is the seventh among the WHO's top 10 threats to global public health, which has continued to perpetuate the transmission of vaccine preventable diseases (VPDs) in Africa. Consequently, this paper systematically reviewed COVID-19 vaccine acceptance rates (VARs)-including the vaccine uptake and vaccination intention-in Africa from 2020 to 2022, compared the rates within the five African regions and determined the context-specific causes of VH in Africa. Generally, COVID-19 VARs ranged from 21.0% to 97.9% and 8.2% to 92.0% with mean rates of 59.8 ± 3.8% and 58.0 ± 2.4% in 2021 and 2022, respectively. Southern and eastern African regions had the top two VARs of 83.5 ± 6.3% and 68.9 ± 6.6% in 2021, and 64.2 ± 4.6% and 61.2 ± 5.1% in 2022, respectively. Based on population types, healthcare workers had a marginal increase in their mean COVID-19 VARs from 55.5 ± 5.6% in 2021 to 60.8 ± 5.3% in 2022. In other populations, the mean VARs decreased from 62.7 ± 5.2% in 2021 to 54.5 ± 4% in 2022. As of 25 October 2022, Africa lags behind the world with only 24% full COVID-19 vaccinations compared to 84%, 79% and 63% reported, respectively, in the Australian continent, upper-middle-income countries and globally. Apart from the problems of confidence, complacency, convenience, communications and context, the context-specific factors driving COVID-19 VH in Africa are global COVID-19 vaccine inequality, lack of vaccine production/maintenance facilities, insecurity, high illiteracy level, endemic corruption, mistrust in some political leaders, the spreading of unconfirmed anti-vaccination rumors and political instability. With an overall mean COVID-19 acceptance rate of 58%, VH still subsists in Africa. The low VARs in Africa have detrimental global public health implications, as it could facilitate the emergence of immune invading SARS-CoV-2 variants of concern, which may spread globally. Consequently, there is a need to confront these challenges frontally and engage traditional and religious leaders in the fight against VH in Africa, to restore public trust in the safety and efficacy of vaccines generally. As the availability of COVID-19 vaccines improves, the vaccination of pets and zoo-animals from which reverse zoonotic transmission of SARS-CoV-2 have been reported is recommended, to limit the evolution and spread of new variants of concern and avert possible SARS-CoV-2 epizootic or panzootic diseases in susceptible animal species.
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Affiliation(s)
- Emmanuel O. Njoga
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
| | - Olajoju J. Awoyomi
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture, Abeokuta PMB 2240, Nigeria
| | - Onyinye S. Onwumere-Idolor
- Department of Animal Production, Faculty of Agriculture, Delta State University of Science and Technology, Ozoro PMB 005, Nigeria
| | - Priscilla O. Awoyomi
- Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria
| | - Iniobong C. I. Ugochukwu
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, University of Nigeria, Nsukka 410001, Nigeria
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, Universita degli Studi di Bari, 70010 Valenzano, Italy
| | - Stella N. Ozioko
- Institute of Aquaculture, Faculty of Natural Sciences, University of Stirling, Stirling FK9 4LA, UK
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Noushad M, Rastam S, Nassani MZ, Al-Saqqaf IS, Hussain M, Yaroko AA, Arshad M, Kirfi AM, Koppolu P, Niazi FH, Elkandow A, Darwish M, Abdalla Nassar AS, Abuzied Mohammed SO, Abdalrady Hassan NH, Abusalim GS, Samran A, Alsalhani AB, Demachkia AM, de Melo RM, Luddin N, Husein A, Habib A, Suleyman F, Osman HA, Al-Awar MS, Dimashkieh MR, Swapna LA, Barakat A, Alqerban A. A Global Survey of COVID-19 Vaccine Acceptance Among Healthcare Workers. Front Public Health 2022; 9:794673. [PMID: 35211453 PMCID: PMC8860987 DOI: 10.3389/fpubh.2021.794673] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives Even though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample. Methods A structured questionnaire prepared after consultation with experts in the field and guided by the “Report of the SAGE working group on vaccine hesitancy” was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine. Results Although 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines. Conclusions COVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs.
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Affiliation(s)
| | | | | | | | | | - Ali Ango Yaroko
- Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Adam Husein
- Universiti Sains Malaysia, Kelantan, Malaysia
| | - Adnan Habib
- College of Dentistry, Aleppo University, Aleppo, Syria
| | | | | | | | | | | | - Ali Barakat
- Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Ali Alqerban
- Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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