1
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Meriggi NF, Voors M, Levine M, Ramakrishna V, Kangbai DM, Rozelle M, Tyler E, Kallon S, Nabieu J, Cundy S, Mobarak AM. Last-mile delivery increases vaccine uptake in Sierra Leone. Nature 2024; 627:612-619. [PMID: 38480877 PMCID: PMC10954551 DOI: 10.1038/s41586-024-07158-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/01/2024] [Indexed: 03/20/2024]
Abstract
Less than 30% of people in Africa received a dose of the COVID-19 vaccine even 18 months after vaccine development1. Here, motivated by the observation that residents of remote, rural areas of Sierra Leone faced severe access difficulties2, we conducted an intervention with last-mile delivery of doses and health professionals to the most inaccessible areas, along with community mobilization. A cluster randomized controlled trial in 150 communities showed that this intervention with mobile vaccination teams increased the immunization rate by about 26 percentage points within 48-72 h. Moreover, auxiliary populations visited our community vaccination points, which more than doubled the number of inoculations administered. The additional people vaccinated per intervention site translated to an implementation cost of US $33 per person vaccinated. Transportation to reach remote villages accounted for a large share of total intervention costs. Therefore, bundling multiple maternal and child health interventions in the same visit would further reduce costs per person treated. Current research on vaccine delivery maintains a large focus on individual behavioural issues such as hesitancy. Our study demonstrates that prioritizing mobile services to overcome access difficulties faced by remote populations in developing countries can generate increased returns in terms of uptake of health services3.
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Affiliation(s)
- Niccolò F Meriggi
- International Growth Centre, Freetown, Sierra Leone.
- Wageningen University and Research, Wageningen, The Netherlands.
- Centre for the Study of African Economies, Department of Economics, University of Oxford, Oxford, UK.
| | - Maarten Voors
- Wageningen University and Research, Wageningen, The Netherlands
| | | | | | | | - Michael Rozelle
- Wageningen University and Research, Wageningen, The Netherlands
| | - Ella Tyler
- Wageningen University and Research, Wageningen, The Netherlands
| | - Sellu Kallon
- Wageningen University and Research, Wageningen, The Netherlands
- University of Sierra Leone, Freetown, Sierra Leone
| | - Junisa Nabieu
- Wageningen University and Research, Wageningen, The Netherlands
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2
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Affiliation(s)
- Henrique Lopes
- Public Health Unit of the Institute of Health Sciences, Catholic University of Portugal
| | - Alison McCallum
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh
| | | | - John Middleton
- Wolverhampton University
- Association of Schools of Public Health in the European Region (ASPHER)
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3
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Abstract
Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus. Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms. Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid. Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea. Neurological complications are uncommon but serious, and can occur during or soon after the acute disease (eg, acute disseminated encephalomyelitis) or months or even years later (eg, measles inclusion body encephalitis and subacute sclerosing panencephalitis). Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea. There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention. However, despite the availability of a safe and effective vaccine, measles is still endemic in many countries and causes considerable morbidity and mortality, especially among children in resource-poor settings. The low case numbers reported in 2020, after a worldwide resurgence of measles between 2017 and 2019, have to be interpreted cautiously, owing to the effect of the COVID-19 pandemic on disease surveillance. Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat.
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Affiliation(s)
- Judith M Hübschen
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
| | - Ionela Gouandjika-Vasilache
- Laboratoire des Virus Entériques et de la Rougeole, Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Julia Dina
- Virology Department, Normandie University, UNICAEN, INSERM U1311 DynaMicURe, Caen University Hospital, Caen, France
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4
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Ovens W, Tomescu S, Harrison E, Crampton T, De Nooy A, Jassat W, Banoo S, Pisa P, Sanne I. Guiding equitable prioritisation of COVID-19 vaccine distribution and strategic deployment in South Africa to enhance effectiveness and access to vulnerable communities and prevent waste. S Afr Med J 2022; 112:13501. [PMID: 35139989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND In South Africa (SA), >2.4 million cases of COVID‑19 and >72 000 deaths were recorded between March 2020 and 1 August 2021, affecting the country's 52 districts to various extents. SA has committed to a COVID‑19 vaccine roll-out in three phases, prioritising frontline workers, the elderly, people with comorbidities and essential workers. However, additional actions will be necessary to support efficient allocation and equitable access for vulnerable, access-constrained communities. OBJECTIVES To explore various determinants of disease severity, resurgence risk and accessibility in order to aid an equitable, effective vaccine roll-out for SA that would maximise COVID‑19 epidemic control by reducing the number of COVID‑19 transmissions and resultant deaths, while at the same time reducing the risk of vaccine wastage. METHODS For the 52 districts of SA, 26 COVID‑19 indicators such as hospital admissions, deaths in hospital and mobility were ranked and hierarchically clustered with cases to identify which indicators can be used as indicators for severity or resurgence risk. Districts were then ranked using the estimated COVID‑19 severity and resurgence risk to assist with prioritisation of vaccine roll-out. Urban and rural accessibility were also explored as factors that could limit vaccine roll-out in hard-to-reach communities. RESULTS Highly populated urban districts showed the most cases. Districts such as Buffalo City, City of Cape Town and Nelson Mandela Bay experienced very severe first and second waves of the pandemic. Districts with high mobility, population size and density were found to be at highest risk of resurgence. In terms of accessibility, we found that 47.2% of the population are within 5 km of a hospital with ≥50 beds, and this percentage ranged from 87.0% in City of Cape Town to 0% in Namakwa district. CONCLUSIONS The end goal is to provide equal distribution of vaccines proportional to district populations, which will provide fair protection. Districts with a high risk of resurgence and severity should be prioritised for vaccine roll-out, particularly the major metropolitan areas. We provide recommendations for allocations of different vaccine types for each district that consider levels of access, numbers of doses and cold-chain storage capability.
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Affiliation(s)
- W Ovens
- Right to Care, Centurion, Pretoria, South Africa.
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5
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6
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Abstract
Zijian Feng and colleagues argue that sustained elimination of SARS-CoV-2 in China offers flexibility in covid-19 vaccination policy and discuss the anticipated challenges and systematic monitoring necessary to keep the immunisation component of the response on track
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Affiliation(s)
- Zhijie An
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fuzhen Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - An Pan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zundong Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lance Rodewald
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zijian Feng
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- Chinese Preventive Medicine Association, Beijing, China
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7
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Chinnaswamy S. Understanding the devastating second wave of COVID-19 pandemic in India. Am J Hum Biol 2021; 33:e23671. [PMID: 34469036 PMCID: PMC8646836 DOI: 10.1002/ajhb.23671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/15/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Sreedhar Chinnaswamy
- Infectious Disease GeneticsNational Institute of Biomedical GenomicsKalyaniWest BengalIndia
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8
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Choudhary OP, Choudhary P, Singh I. India's COVID-19 vaccination drive: key challenges and resolutions. The Lancet Infectious Diseases 2021; 21:1483-1484. [PMID: 34529961 PMCID: PMC8437681 DOI: 10.1016/s1473-3099(21)00567-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/20/2021] [Accepted: 08/16/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Om Prakash Choudhary
- Department of Veterinary Anatomy and Histology, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University Imphal, Selesih, Aizawl-796015, Mizoram, India.
| | - Priyanka Choudhary
- Type IV Quarter, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University Imphal, Selesih, Aizawl-796015, Mizoram, India
| | - Indraj Singh
- Community Health Centre, Deoband, Saharanpur-247554, Uttar Pradesh, India
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9
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Smith TE, Rodgers IT, Silverman DJ, Dreslin SR, Olfson M, Dixon LB, Wall MM. COVID-19 Case Rates After Surveillance and Vaccinations in a Statewide Psychiatric Hospital System. Am J Public Health 2021; 111:1780-1783. [PMID: 34529451 PMCID: PMC8561174 DOI: 10.2105/ajph.2021.306444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 11/04/2022]
Abstract
Individuals with serious mental illness are particularly vulnerable to COVID-19. The New York State (NYS) Office of Mental Health implemented patient and staff rapid testing, quarantining, and vaccination to limit COVID-19 spread in 23 state-operated psychiatric hospitals between November 2020 and February 2021. COVID-19 infection rates in inpatients and staff decreased by 96% and 71%, respectively, and the NYS population case rate decreased by 6%. Repeated COVID-19 testing and vaccination should be priority interventions for state-operated psychiatric hospitals. (Am J Public Health. 2021;111(10):1780-1783. https://doi.org/10.2105/AJPH.2021.306444).
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Affiliation(s)
- Thomas E Smith
- Thomas E. Smith, Ian T. Rodgers, Mark Olfson, Lisa B. Dixon, and Melanie M. Wall are with the New York State Psychiatric Institute, New York, NY. Daniel J. Silverman and Sally R. Dreslin are with the New York State Office of Mental Health, Albany, NY
| | - Ian T Rodgers
- Thomas E. Smith, Ian T. Rodgers, Mark Olfson, Lisa B. Dixon, and Melanie M. Wall are with the New York State Psychiatric Institute, New York, NY. Daniel J. Silverman and Sally R. Dreslin are with the New York State Office of Mental Health, Albany, NY
| | - Daniel J Silverman
- Thomas E. Smith, Ian T. Rodgers, Mark Olfson, Lisa B. Dixon, and Melanie M. Wall are with the New York State Psychiatric Institute, New York, NY. Daniel J. Silverman and Sally R. Dreslin are with the New York State Office of Mental Health, Albany, NY
| | - Sally R Dreslin
- Thomas E. Smith, Ian T. Rodgers, Mark Olfson, Lisa B. Dixon, and Melanie M. Wall are with the New York State Psychiatric Institute, New York, NY. Daniel J. Silverman and Sally R. Dreslin are with the New York State Office of Mental Health, Albany, NY
| | - Mark Olfson
- Thomas E. Smith, Ian T. Rodgers, Mark Olfson, Lisa B. Dixon, and Melanie M. Wall are with the New York State Psychiatric Institute, New York, NY. Daniel J. Silverman and Sally R. Dreslin are with the New York State Office of Mental Health, Albany, NY
| | - Lisa B Dixon
- Thomas E. Smith, Ian T. Rodgers, Mark Olfson, Lisa B. Dixon, and Melanie M. Wall are with the New York State Psychiatric Institute, New York, NY. Daniel J. Silverman and Sally R. Dreslin are with the New York State Office of Mental Health, Albany, NY
| | - Melanie M Wall
- Thomas E. Smith, Ian T. Rodgers, Mark Olfson, Lisa B. Dixon, and Melanie M. Wall are with the New York State Psychiatric Institute, New York, NY. Daniel J. Silverman and Sally R. Dreslin are with the New York State Office of Mental Health, Albany, NY
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10
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Moyce S, Ruff J, Galloway A, Shannon S. Implementation of a COVID-19 Mass Vaccination Clinic to College Students in Montana. Am J Public Health 2021; 111:1776-1779. [PMID: 34499538 PMCID: PMC8561196 DOI: 10.2105/ajph.2021.306435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 11/04/2022]
Abstract
We describe a large-scale collaborative intervention of practice measures and COVID-19 vaccine administration to college students in the priority 1b group, which included Black or Indigenous persons and other persons of color. In February 2021, at this decentralized vaccine distribution site at Montana State University in Bozeman, we administered 806 first doses and 776 second doses by implementing an interprofessional effort with personnel from relevant university units, including facilities management, student health, communications, administration, and academic units (e.g., nursing, medicine, medical assistant program, and engineering). (Am J Public Health. Published online ahead of print September 9, 2021:1776-1779. https://doi.org/10.2105/AJPH.2021.306435).
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Affiliation(s)
- Sally Moyce
- All authors are with the College of Nursing, Montana State University, Bozeman
| | - Julie Ruff
- All authors are with the College of Nursing, Montana State University, Bozeman
| | - Ann Galloway
- All authors are with the College of Nursing, Montana State University, Bozeman
| | - Sarah Shannon
- All authors are with the College of Nursing, Montana State University, Bozeman
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11
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Coccolini F, Cicuttin E, Cremonini C, Tartaglia D, Viaggi B, Kuriyama A, Picetti E, Ball C, Abu-Zidan F, Ceresoli M, Turri B, Jain S, Palombo C, Guirao X, Rodrigues G, Gachabayov M, Machado F, Eftychios L, Kanj SS, Di Carlo I, Di Saverio S, Khokha V, Kirkpatrick A, Massalou D, Forfori F, Corradi F, Delibegovic S, Machain Vega GM, Fantoni M, Demetriades D, Kapoor G, Kluger Y, Ansari S, Maier R, Leppaniemi A, Hardcastle T, Vereczkei A, Karamagioli E, Pikoulis E, Pistello M, Sakakushev BE, Navsaria PH, Galeiras R, Yahya AI, Osipov AV, Dimitrov E, Doklestić K, Pisano M, Malacarne P, Carcoforo P, Sibilla MG, Kryvoruchko IA, Bonavina L, Kim JI, Shelat VG, Czepiel J, Maseda E, Marwah S, Chirica M, Biancofiore G, Podda M, Cobianchi L, Ansaloni L, Fugazzola P, Seretis C, Gomez CA, Tumietto F, Malbrain M, Reichert M, Augustin G, Amato B, Puzziello A, Hecker A, Gemignani A, Isik A, Cucchetti A, Nacoti M, Kopelman D, Mesina C, Ghannam W, Ben-Ishay O, Dhingra S, Coimbra R, Moore EE, Cui Y, Quiodettis MA, Bala M, Testini M, Diaz J, Girardis M, Biffl WL, Hecker M, Sall I, Boggi U, Materazzi G, Ghiadoni L, Matsumoto J, Zuidema WP, Ivatury R, Enani MA, Litvin A, Al-Hasan MN, Demetrashvili Z, Baraket O, Ordoñez CA, Negoi I, Kiguba R, Memish ZA, Elmangory MM, Tolonen M, Das K, Ribeiro J, O’Connor DB, Tan BK, Van Goor H, Baral S, De Simone B, Corbella D, Brambillasca P, Scaglione M, Basolo F, De’Angelis N, Bendinelli C, Weber D, Pagani L, Monti C, Baiocchi G, Chiarugi M, Catena F, Sartelli M. A pandemic recap: lessons we have learned. World J Emerg Surg 2021; 16:46. [PMID: 34507603 PMCID: PMC8430288 DOI: 10.1186/s13017-021-00393-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/29/2021] [Indexed: 02/08/2023] Open
Abstract
On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.
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Affiliation(s)
- Federico Coccolini
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Enrico Cicuttin
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Camilla Cremonini
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Dario Tartaglia
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Bruno Viaggi
- grid.24704.350000 0004 1759 9494Infectious Disease Department, Careggi Hospital, Florence, Italy
| | - Akira Kuriyama
- grid.415565.60000 0001 0688 6269Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, Japan
| | - Edoardo Picetti
- grid.411482.aDepartment of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy
| | - Chad Ball
- grid.414959.40000 0004 0469 2139Hepatobiliary and Pancreatic Surgery Trauma and Acute Care Surgery, Foothills Medical Center, Calgary, AB Canada
| | - Fikri Abu-Zidan
- grid.43519.3a0000 0001 2193 6666Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, UAE
| | - Marco Ceresoli
- grid.18887.3e0000000417581884General Surgery Department, Monza University Hospital, Monza, Italy
| | - Bruno Turri
- grid.414682.d0000 0004 1758 8744General Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
| | - Sumita Jain
- grid.416077.30000 0004 1767 3615Department of Surgery, SMS Medical College and Hospital, Jaipur, India
| | - Carlo Palombo
- grid.5395.a0000 0004 1757 3729Cardiology Division 1, Department of Surgical, Medical, Molecular Pathology, and Critical Medicine, School of Medicine, University of Pisa, Pisa, Italy
| | - Xavier Guirao
- grid.428313.f0000 0000 9238 6887Department of Surgery, Parc Tauli, Hospital Universitari, Sabadell, Spain
| | - Gabriel Rodrigues
- grid.415066.00000 0004 1805 8200Department of General Surgery, Kasturba Medical College and Hospital, Manipal, Karnataka India
| | - Mahir Gachabayov
- Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir City, Russia
| | - Fernando Machado
- General Surgery Department, Montevideo Hospital, Montevideo, Paraguay
| | | | - Souha S. Kanj
- grid.411654.30000 0004 0581 3406Antimicrobial Stewardship Program, American University of Beirut Medical Center, Beirut, Lebanon
| | - Isidoro Di Carlo
- grid.8158.40000 0004 1757 1969Department of Surgical Sciences and Advanced Technologies, General Surgery, University of Catania, Cannizzaro Hospital, Catania, Italy
| | - Salomone Di Saverio
- General Surgery, ASUR Marche 5, San Benedetto del Tronto General Hospital, San Benedetto del Tronto, Italy
| | | | - Andrew Kirkpatrick
- grid.414959.40000 0004 0469 2139General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB Canada
| | - Damien Massalou
- grid.410528.a0000 0001 2322 4179Acute Care Surgery, University Hospital of Nice (CHU de Nice)/Université Côte d’Azur, Nice, France
| | - Francesco Forfori
- grid.144189.10000 0004 1756 8209ICU Department, Pisa University Hospital, Pisa, Italy
| | - Francesco Corradi
- grid.144189.10000 0004 1756 8209ICU Department, Pisa University Hospital, Pisa, Italy
| | - Samir Delibegovic
- grid.412410.20000 0001 0682 9061General Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Gustavo M. Machain Vega
- grid.412213.70000 0001 2289 5077Servicio de Cirugia General, Universidad Nacional de Asuncion, Hospital de Clinicas Ii Cátedra de Clinica Quirúrgica, Asunción, Paraguay
| | - Massimo Fantoni
- grid.411075.60000 0004 1760 4193Dipartimento Di Scienze Di Laboratorio E Infettivologiche, Fondazione Policlinico Universitario Agostino Gemelli Irccs, Roma, Italy
| | - Demetrios Demetriades
- grid.411409.90000 0001 0084 1895Division of Trauma, Emergency Surgery, and Surgical Critical Care, LAC+USC Medical Center, Los Angeles, USA
| | - Garima Kapoor
- grid.415285.fDepartment of Microbiology, Gandhi Medical College, Bhopal, India
| | - Yoram Kluger
- General Surgery Department, Rambam Medical Centre, Tel Aviv, Israel
| | - Shamshul Ansari
- grid.488411.00000 0004 5998 7153Department of Microbiology, Chitwan Medical College and Teaching Hospital, Bharatpur, Chitwan, Nepal
| | - Ron Maier
- grid.34477.330000000122986657Harborview Medical Center, University of Washington, Seattle, WA USA
| | - Ari Leppaniemi
- grid.15485.3d0000 0000 9950 5666HUS Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Timothy Hardcastle
- Trauma and Burns, Inkosi Albert Luthuli Central Hospital and DoH-KZN, Mayville, South Africa
| | - Andras Vereczkei
- grid.9679.10000 0001 0663 9479Department of Surgery, Medical School, University of Pécs, Pecs, Hungary
| | - Evika Karamagioli
- grid.5216.00000 0001 2155 0800Medical School, National and Kapodistrian University of Athens, (NKUA), Athens, Greece
| | - Emmanouil Pikoulis
- grid.5216.00000 0001 2155 0800Medical School, National and Kapodistrian University of Athens, (NKUA), Athens, Greece
| | - Mauro Pistello
- grid.5395.a0000 0004 1757 3729Department of Translational Research, University of Pisa, Pisa, Italy
| | - Boris E. Sakakushev
- grid.35371.330000 0001 0726 0380Research Institute at Medical University Plovdiv/University Hospital St George, Plovdiv, Bulgaria
| | - Pradeep H. Navsaria
- grid.7836.a0000 0004 1937 1151Trauma Center, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Rita Galeiras
- grid.488921.eCritical Care Unit, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Ali I. Yahya
- General Surgery Department, Zliten Medical Center, Zliten, Libya
| | - Aleksei V. Osipov
- Division of Emergency Surgery, Saint-Petersburg Research Institute of Emergency Medicine, Saint-Petersburg, Russian Federation
| | - Evgeni Dimitrov
- Department of Surgical Diseases, University Hospital “Prof. Dr. Stoyan Kirkovich”, 2A Gen. Stoletov Str., 6000 Stara Zagora, Bulgaria
| | | | - Michele Pisano
- 1St General Surgery Unit, Department of Emergency, ASST Papa Giovanni, Bergamo, Italy
| | - Paolo Malacarne
- grid.144189.10000 0004 1756 8209Department of Anaesthesia and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| | - Paolo Carcoforo
- grid.416315.4General and Emergency Surgery Unit, Sant’Anna University-Hospital, Ferrara, Italy
| | - Maria Grazia Sibilla
- grid.416315.4General and Emergency Surgery Unit, Sant’Anna University-Hospital, Ferrara, Italy
| | - Igor A. Kryvoruchko
- grid.445504.40000 0004 0529 6576Department of Surgery No2, Kharkiv National Medical University, Kharkiv, Ukraine
| | - Luigi Bonavina
- grid.4708.b0000 0004 1757 2822Division of General and Foregut Surgery, University of Milan, IRCCS Policlinico San Donato, Milan, Italy
| | - Jae Il Kim
- grid.411633.20000 0004 0371 8173Department of Surgery, Inje University, Ilsan Paik Hospital, Goyang-si, South Korea
| | - Vishal G. Shelat
- grid.240988.fDepartment of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Jacek Czepiel
- grid.5522.00000 0001 2162 9631Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Kraków, Poland
| | - Emilio Maseda
- Surgical Critical Care, Department of Anesthesia, Hospital Valdecilla Santander, Santander, Spain
| | - Sanjay Marwah
- grid.412572.70000 0004 1771 1642Post-Graduate Institute of Medical Sciences, Rohtak, 124001 India
| | - Mircea Chirica
- grid.410529.b0000 0001 0792 4829Department of Digestive Surgery, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - Giandomenico Biancofiore
- grid.5395.a0000 0004 1757 3729Operative Unit of Anesthesia and Transplant Resuscitation, University of Pisa, Pisa, Italy
| | - Mauro Podda
- grid.7763.50000 0004 1755 3242Department of Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Lorenzo Cobianchi
- grid.419425.f0000 0004 1760 3027Department of Clinical, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
- grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Luca Ansaloni
- grid.419425.f0000 0004 1760 3027Department of Clinical, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
- grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Paola Fugazzola
- grid.419425.f0000 0004 1760 3027Department of Clinical, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
- grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Charalampos Seretis
- grid.412924.80000 0004 0446 0530Department of General Surgery, George Eliot Hospital NHS Trust, Warwickshire, UK
| | | | - Fabio Tumietto
- Azienda Ospedaliero Universitaria Di Bologna, Unità Operativa Malattie Infettive, Bologna, Italy
| | - Manu Malbrain
- Internal Medicine – Intensive Care, AZ Jan Palfijn Gent, Gent, Belgium
- grid.411484.c0000 0001 1033 7158First Department of Anaesthesia and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Martin Reichert
- grid.411067.50000 0000 8584 9230Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany
| | - Goran Augustin
- grid.412688.10000 0004 0397 9648Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Bruno Amato
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, Medical School, University of Naples Federico II, Naples, Italy
| | - Alessandro Puzziello
- grid.11780.3f0000 0004 1937 0335Dipartimento Di Medicina, Chirurgia E Odontoiatria, Campus Universitario di Baronissi - Università Di Salerno, Salerno, Italy
| | - Andreas Hecker
- grid.411067.50000 0000 8584 9230Department of General and Thoracic Surgery, University Hospital of Giessen, Marburg, Germany
| | - Angelo Gemignani
- grid.5395.a0000 0004 1757 3729Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Arda Isik
- grid.411776.20000 0004 0454 921XGeneral Surgery Department, Istanbul Medeniyet University, Istanbul, Turkey
| | - Alessandro Cucchetti
- grid.6292.f0000 0004 1757 1758Department of Medical and Surgical Sciences – DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- grid.415079.e0000 0004 1759 989XGeneral Surgery of the Morgagni - Pierantoni Hospital, Forlì, Italy
| | - Mirco Nacoti
- grid.460094.f0000 0004 1757 8431Pediatric Intensive Care Unit, Department of Anesthesia and Intensive Care, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Doron Kopelman
- grid.469889.20000 0004 0497 6510Hepato-Billiary-Pancreatic (HPB) Surgery Center, Emek Medical Center, Afula, Israel
| | - Cristian Mesina
- grid.452359.cEmergency County Hospital of Craiova, Craiova, Romania
| | - Wagih Ghannam
- grid.10251.370000000103426662Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Offir Ben-Ishay
- grid.6451.60000000121102151The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Rambam Health Care Campus, Haifa, Israel
| | - Sameer Dhingra
- grid.419631.80000 0000 8877 852XDepartment of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur Vaishali, Bihar, India
| | - Raul Coimbra
- grid.488519.90000 0004 5946 0028Department of Surgery, Riverside University Health System, Moreno Valley, CA USA
- grid.43582.380000 0000 9852 649XSchool of Medicine, Loma Linda University, Loma Linda, CA USA
| | - Ernest E. Moore
- grid.239638.50000 0001 0369 638XShock Trauma Center at Denver Health, Denver, CO USA
| | - Yunfeng Cui
- grid.265021.20000 0000 9792 1228Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China
| | | | - Miklosh Bala
- grid.17788.310000 0001 2221 2926Trauma and Acute Care Surgery Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel
| | - Mario Testini
- grid.7644.10000 0001 0120 3326Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - Jose Diaz
- grid.411024.20000 0001 2175 4264University of Maryland School of Medicine, Baltimore, MD USA
| | - Massimo Girardis
- grid.413363.00000 0004 1769 5275Intensive Care Unit, University Hospital of Modena, Modena, Italy
| | | | - Matthias Hecker
- grid.411067.50000 0000 8584 9230Department of Respiratory and Critical Care Medicine, University Hospital Giessen, Giessen, Germany
| | - Ibrahima Sall
- grid.414281.aDepartment of General Surgery, Military Teaching Hospital, Hôpital Principal de Dakar, Dakar, Senegal
| | - Ugo Boggi
- grid.5395.a0000 0004 1757 3729Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Gabriele Materazzi
- grid.5395.a0000 0004 1757 3729Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Lorenzo Ghiadoni
- grid.144189.10000 0004 1756 8209Emergency Medical Department, Pisa University Hospital, Pisa, Italy
| | - Junichi Matsumoto
- grid.412764.20000 0004 0372 3116Department of Emergency and Critical Care Medicine, Saint-Marianna University School of Medicine, Kawasaki, Japan
| | - Wietse P. Zuidema
- grid.509540.d0000 0004 6880 3010Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Rao Ivatury
- grid.224260.00000 0004 0458 8737Professor Emeritus, Virginia Commonwealth University, Richmond, VA USA
| | - Mushira A. Enani
- grid.415277.20000 0004 0593 1832Infectious Diseases Section, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Andrey Litvin
- grid.410686.d0000 0001 1018 9204Immanuel Kant Baltic Federal University, Regional Clinic Hospital, Kaliningrad, Russia
| | - Majdi N. Al-Hasan
- grid.254567.70000 0000 9075 106XDepartment of Internal Medicine, University of South Carolina School of Medicine, Prisma Health-Midlands, Columbia, SC USA
| | - Zaza Demetrashvili
- grid.412274.60000 0004 0428 8304Department of Surgery, Tbilisi State Medical University, Kipshidze Central University Hospital, Tbilisi, Georgia
| | - Oussama Baraket
- Department of Surgery, Bizerte Hospital, Bizerte, Tunisia
- grid.265234.40000 0001 2177 9066Faculty of Medicine, Tunis University, Tunis ElManar, Tunisia
| | - Carlos A. Ordoñez
- grid.8271.c0000 0001 2295 7397Division of Trauma and Acute Care Surgery, Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Ionut Negoi
- grid.8194.40000 0000 9828 7548General Surgery Department, Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ronald Kiguba
- grid.11194.3c0000 0004 0620 0548Department of Pharmacology and Therapeutics, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Ziad A. Memish
- grid.411335.10000 0004 1758 7207King Saud Medical City, Ministry of Health and College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Matti Tolonen
- grid.15485.3d0000 0000 9950 5666HUS Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Korey Das
- General Surgery, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
| | - Julival Ribeiro
- grid.414433.5Infection Control Coordinator, Hospital de Base Do Distrito Federal /IGESDF, Brasilia, Brazil
| | - Donal B. O’Connor
- grid.8217.c0000 0004 1936 9705Department of Surgery, Trinity College Dublin, Dublin, Ireland
| | - Boun Kim Tan
- Infection Prevention and Control Unit, Centre des Massues, French-Red Cross, Lyon, France
| | - Harry Van Goor
- grid.10417.330000 0004 0444 9382Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Suman Baral
- General Surgery, Dirghayu Pokhara Hospital, Pokhara, Nepal
| | - Belinda De Simone
- grid.418056.e0000 0004 1765 2558Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy, Saint Germain en Laye, France
| | | | | | - Michelangelo Scaglione
- grid.144189.10000 0004 1756 8209Orthopedic and Traumatology Department, Pisa University Hospital, Pisa, Italy
| | - Fulvio Basolo
- grid.5395.a0000 0004 1757 3729Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Nicola De’Angelis
- grid.412116.10000 0001 2292 1474General Surgery, Department, Henri Mondor Hospital, Paris, France
| | - Cino Bendinelli
- grid.414724.00000 0004 0577 6676Department of Surgery, John Hunter Hospital, Newcastle, Australia
- grid.266842.c0000 0000 8831 109XUniversity of Newcastle, Callaghan, Australia
| | - Dieter Weber
- grid.1012.20000 0004 1936 7910General Surgery, Royal Perth Hospital, The University of Western Australia, Perth, Australia
| | - Leonardo Pagani
- grid.415844.8Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy
| | - Cinzia Monti
- Radiology Department, Gavazzeni Hospital, Bergamo, Italy
| | - Gianluca Baiocchi
- grid.419450.dGeneral Surgery Department, Cremona Hospital, Cremona, Italy
| | - Massimo Chiarugi
- grid.144189.10000 0004 1756 8209General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744General Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
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12
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Lu MC, Shia BC, Kao YW, Lin SC, Wang CY, Lin WC, Chen SY. The impact of rotavirus vaccination in the prevalence of gastroenteritis and comorbidities among children after suboptimal rotavirus vaccines implementation in Taiwan: A population-based study. Medicine (Baltimore) 2021; 100:e25925. [PMID: 34160381 PMCID: PMC8238267 DOI: 10.1097/md.0000000000025925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 04/19/2021] [Indexed: 01/04/2023] Open
Abstract
In Taiwan, rotavirus vaccination was implemented in 2006 in the private sector. The population-based impact of rotavirus vaccination on gastroenteritis and comorbidities of children remains under-investigated.We analyzed the annual prevalence of rotavirus-related disease, including gastroenteritis, convulsions, epilepsy, type I diabetes mellitus, intussusception, and biliary atresia among children under 5 years of age. Data were collected from Taiwan's National Health Insurance Research Database, a nationwide population-based database. A 16-year retrospective cohort study was conducted between 2000 and 2015.Among children <5 years of age, the prevalence of gastroenteritis decreased after 2012 (44,259.69 per 100 thousands) and remained lower through 2015 (39,931.11per 100 thousands, P < .001). The prevalence of convulsions rose steadily and significantly from 2007 (775.90 per 100 thousands) to 2015 (962.17 per 100 thousands, P < .001). The prevalence of epilepsy decreased significantly until reaching a nadir in 2013 (from 501.56 to 293.53 per 100 thousands, P < .001). The prevalence of biliary atresia tended upward, and surged suddenly in 2007 with a peak in 2013 (18.74 per 100 thousands). Among infants (<1 year of age) from 2000 to 2015, the prevalence of gastroenteritis declined steadily, and more rapidly after 2007 (22,513 to 17,285 per 100 thousands).In Taiwan, after introducing rotavirus vaccination, gastroenteritis in young children decreased, especially in infancy. However, gastroenteritis is still common in children, given other emerging pathogens. Our results highlight the impact of rotavirus vaccines on children's health in Taiwan and provide indications for future preventive medicine and healthcare strategies in children.
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Affiliation(s)
- Meng-Che Lu
- Division of Allergy, Asthma and Immunology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City
| | - Ben-Chang Shia
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City
| | - Yi-Wei Kao
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City
- Research Center of Big Data, College of management
| | - Sheng-Chieh Lin
- Division of Allergy, Asthma and Immunology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Chuan-Yu Wang
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei
- Division of Pediatric Neurology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City
| | - Wen-Chuan Lin
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei
- Division of Pediatric Infectious Disease, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City
| | - Shih-Yen Chen
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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13
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Affiliation(s)
- Makoto Kosaka
- Medical Governance Research Institute, Tokyo 108-0074, Japan.
| | | | - Akihiko Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | | | - Masahiro Kami
- Medical Governance Research Institute, Tokyo 108-0074, Japan
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14
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Viana J, van Dorp CH, Nunes A, Gomes MC, van Boven M, Kretzschmar ME, Veldhoen M, Rozhnova G. Controlling the pandemic during the SARS-CoV-2 vaccination rollout. Nat Commun 2021; 12:3674. [PMID: 34135335 PMCID: PMC8209021 DOI: 10.1038/s41467-021-23938-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023] Open
Abstract
There is a consensus that mass vaccination against SARS-CoV-2 will ultimately end the COVID-19 pandemic. However, it is not clear when and which control measures can be relaxed during the rollout of vaccination programmes. We investigate relaxation scenarios using an age-structured transmission model that has been fitted to age-specific seroprevalence data, hospital admissions, and projected vaccination coverage for Portugal. Our analyses suggest that the pressing need to restart socioeconomic activities could lead to new pandemic waves, and that substantial control efforts prove necessary throughout 2021. Using knowledge on control measures introduced in 2020, we anticipate that relaxing measures completely or to the extent as in autumn 2020 could launch a wave starting in April 2021. Additional waves could be prevented altogether if measures are relaxed as in summer 2020 or in a step-wise manner throughout 2021. We discuss at which point the control of COVID-19 would be achieved for each scenario.
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Affiliation(s)
- João Viana
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Christiaan H van Dorp
- Theoretical Biology and Biophysics (T-6), Los Alamos National Laboratory, Los Alamos, NM, USA
| | - Ana Nunes
- Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
- BioISI-Biosystems & Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Manuel C Gomes
- Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Michiel van Boven
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mirjam E Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marc Veldhoen
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Ganna Rozhnova
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
- BioISI-Biosystems & Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.
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15
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Kunkel A, Jeon S, Joseph HC, Dilius P, Crowdis K, Meltzer MI, Wallace R. The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis. Sci Rep 2021; 11:12476. [PMID: 34127783 PMCID: PMC8203735 DOI: 10.1038/s41598-021-92067-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/25/2021] [Indexed: 11/04/2022] Open
Abstract
Dog vaccination is a cost-effective approach to preventing human rabies deaths. In Haiti, the last nation-wide dog vaccination campaign occurred in 2018. We estimated the number of human lives that could be saved by resuming dog vaccination in 2021 compared to 2022 and compared the cost-effectiveness of these two scenarios. We modified a previously published rabies transmission and economic model to estimate trends in dog and human rabies cases in Haiti from 2005 to 2025, with varying assumptions about when dog vaccinations resume. We compared model outputs to surveillance data on human rabies deaths from 2005 to 2020 and animal rabies cases from 2018 to 2020. Model predictions and surveillance data both suggest a 5- to 8-fold increase in animal rabies cases occurred in Haiti's capital city between Fall 2019 and Fall 2020. Restarting dog vaccination in Haiti in 2021 compared to 2022 could save 285 human lives and prevent 6541 human rabies exposures over a five-year period. It may also decrease program costs due to reduced need for human post-exposure prophylaxis. These results show that interruptions in dog vaccination campaigns before elimination is achieved can lead to significant human rabies epidemics if not promptly resumed.
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Affiliation(s)
- Amber Kunkel
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Seonghye Jeon
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases , Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Haim C Joseph
- Ministry of Agriculture, Rural Development, and Natural Resources, Port-au-Prince, Haiti
| | - Pierre Dilius
- Ministry of Agriculture, Rural Development, and Natural Resources, Port-au-Prince, Haiti
| | | | - Martin I Meltzer
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases , Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ryan Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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16
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Patel MD, Rosenstrom E, Ivy JS, Mayorga ME, Keskinocak P, Boyce RM, Hassmiller Lich K, Smith RL, Johnson KT, Delamater PL, Swann JL. Association of Simulated COVID-19 Vaccination and Nonpharmaceutical Interventions With Infections, Hospitalizations, and Mortality. JAMA Netw Open 2021; 4:e2110782. [PMID: 34061203 PMCID: PMC8170542 DOI: 10.1001/jamanetworkopen.2021.10782] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/27/2021] [Indexed: 12/22/2022] Open
Abstract
Importance Vaccination against SARS-CoV-2 has the potential to significantly reduce transmission and COVID-19 morbidity and mortality. The relative importance of vaccination strategies and nonpharmaceutical interventions (NPIs) is not well understood. Objective To assess the association of simulated COVID-19 vaccine efficacy and coverage scenarios with and without NPIs with infections, hospitalizations, and deaths. Design, Setting, and Participants An established agent-based decision analytical model was used to simulate COVID-19 transmission and progression from March 24, 2020, to September 23, 2021. The model simulated COVID-19 spread in North Carolina, a US state of 10.5 million people. A network of 1 017 720 agents was constructed from US Census data to represent the statewide population. Exposures Scenarios of vaccine efficacy (50% and 90%), vaccine coverage (25%, 50%, and 75% at the end of a 6-month distribution period), and NPIs (reduced mobility, school closings, and use of face masks) maintained and removed during vaccine distribution. Main Outcomes and Measures Risks of infection from the start of vaccine distribution and risk differences comparing scenarios. Outcome means and SDs were calculated across replications. Results In the worst-case vaccination scenario (50% efficacy, 25% coverage), a mean (SD) of 2 231 134 (117 867) new infections occurred after vaccination began with NPIs removed, and a mean (SD) of 799 949 (60 279) new infections occurred with NPIs maintained during 11 months. In contrast, in the best-case scenario (90% efficacy, 75% coverage), a mean (SD) of 527 409 (40 637) new infections occurred with NPIs removed and a mean (SD) of 450 575 (32 716) new infections occurred with NPIs maintained. With NPIs removed, lower efficacy (50%) and higher coverage (75%) reduced infection risk by a greater magnitude than higher efficacy (90%) and lower coverage (25%) compared with the worst-case scenario (mean [SD] absolute risk reduction, 13% [1%] and 8% [1%], respectively). Conclusions and Relevance Simulation outcomes suggest that removing NPIs while vaccines are distributed may result in substantial increases in infections, hospitalizations, and deaths. Furthermore, as NPIs are removed, higher vaccination coverage with less efficacious vaccines can contribute to a larger reduction in risk of SARS-CoV-2 infection compared with more efficacious vaccines at lower coverage. These findings highlight the need for well-resourced and coordinated efforts to achieve high vaccine coverage and continued adherence to NPIs before many prepandemic activities can be resumed.
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Affiliation(s)
- Mehul D. Patel
- Department of Emergency Medicine, School of Medicine, University of North Carolina at Chapel Hill
| | - Erik Rosenstrom
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh
| | - Julie S. Ivy
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh
| | - Maria E. Mayorga
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh
| | - Pinar Keskinocak
- Department of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta
| | - Ross M. Boyce
- Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill
| | - Kristen Hassmiller Lich
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Raymond L. Smith
- Department of Engineering, College of Engineering and Technology, East Carolina University, Greenville, North Carolina
| | - Karl T. Johnson
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Paul L. Delamater
- Department of Geography, College of Arts and Sciences, University of North Carolina at Chapel Hill
| | - Julie L. Swann
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh
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17
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Nachega JB, Sam-Agudu NA, Masekela R, van der Zalm MM, Nsanzimana S, Condo J, Ntoumi F, Rabie H, Kruger M, Wiysonge CS, Ditekemena JD, Chirimwami RB, Ntakwinja M, Mukwege DM, Noormahomed E, Paleker M, Mahomed H, Tamfum JJM, Zumla A, Suleman F. Addressing challenges to rolling out COVID-19 vaccines in African countries. Lancet Glob Health 2021; 9:e746-e748. [PMID: 33713633 PMCID: PMC7946417 DOI: 10.1016/s2214-109x(21)00097-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 01/01/2023]
Affiliation(s)
- Jean B Nachega
- Department of Medicine and Center for Infectious Diseases, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Department of Epidemiology, Infectious Diseases and Microbiology, Center for Global Health, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria; Department of Pediatrics and Institute of Human Virology, School of Medicine, University of Maryland, Baltimore, MD, USA; Department of Pediatrics and Child Health, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Refiloe Masekela
- Department of Paediatrics and Child Health, School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Marieke M van der Zalm
- Department of Pediatrics and Child Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Jeanine Condo
- School of Public Health, University of Rwanda, Kigali, Rwanda; School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Helena Rabie
- Department of Pediatrics and Child Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Mariana Kruger
- Department of Pediatrics and Child Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Charles S Wiysonge
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - John D Ditekemena
- School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo
| | | | | | - Denis M Mukwege
- Panzi Hospital, Université Evangelique en Afrique, Bukavu, DR Congo
| | | | - Masudah Paleker
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Western Cape Department of Health, Cape Town, South Africa
| | - Hassan Mahomed
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Western Cape Department of Health, Cape Town, South Africa
| | - Jean-Jacques Muyembe Tamfum
- Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, Kinshasa, DR Congo; National Institute of Biomedical Research, Kinshasa, DR Congo
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Centre, University College London Hospitals, London, UK
| | - Fatima Suleman
- Discipline of Pharmaceutical Sciences, School of Health Sciences, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
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18
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Affiliation(s)
- Prabhat Jha
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, ON M581C8, Canada.
| | | | | | - John Bell
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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19
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Frieman M, Harris AD, Herati RS, Krammer F, Mantovani A, Rescigno M, Sajadi MM, Simon V. SARS-CoV-2 vaccines for all but a single dose for COVID-19 survivors. EBioMedicine 2021; 68:103401. [PMID: 34051441 PMCID: PMC8149267 DOI: 10.1016/j.ebiom.2021.103401] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/13/2021] [Accepted: 04/30/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Matthew Frieman
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, United States.
| | - Anthony D Harris
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, United States; Department of Medicine, Baltimore VA Medical Center, Baltimore, Maryland, United States.
| | | | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States.
| | - Alberto Mantovani
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Milan, Italy; The William Harvey Research Institute, Queen Mary University, London, United Kingdom.
| | - Maria Rescigno
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Milan, Italy.
| | - Mohammad M Sajadi
- Department of Medicine, Baltimore VA Medical Center, Baltimore, Maryland, United States; Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States; Global Virus Network, Baltimore, Maryland, United States.
| | - Viviana Simon
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Global Health Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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20
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Affiliation(s)
| | | | - José Esparza
- Academia Nacional de Medicina, Caracas 1012, Venezuela.
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21
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Affiliation(s)
- Eric Goralnick
- From Ariadne Labs at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health (E.G., A.A.G.), Boston; the Departments of Emergency Medicine (E.G.) and Surgery (A.A.G.), Brigham and Women's Hospital and Harvard Medical School, Boston; and CIC Health, Cambridge (E.G., C.K., A.A.G.) - all in Massachusetts
| | - Christoph Kaufmann
- From Ariadne Labs at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health (E.G., A.A.G.), Boston; the Departments of Emergency Medicine (E.G.) and Surgery (A.A.G.), Brigham and Women's Hospital and Harvard Medical School, Boston; and CIC Health, Cambridge (E.G., C.K., A.A.G.) - all in Massachusetts
| | - Atul A Gawande
- From Ariadne Labs at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health (E.G., A.A.G.), Boston; the Departments of Emergency Medicine (E.G.) and Surgery (A.A.G.), Brigham and Women's Hospital and Harvard Medical School, Boston; and CIC Health, Cambridge (E.G., C.K., A.A.G.) - all in Massachusetts
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Kaseje N, Oruenjo K, Kaseje D, Evans TG, Tanner M, Haines A, Nyikal J. Leveraging latent assets to strengthen the COVID-19 response and vaccine roll-out in Africa. BMJ Glob Health 2021; 6:e006289. [PMID: 34045185 PMCID: PMC8727652 DOI: 10.1136/bmjgh-2021-006289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/18/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
| | | | - Dan Kaseje
- Tropical Institute of Community Health and Development, Kisumu, Kenya
| | | | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Andy Haines
- London School of Hygiene and Tropical Medicine, London, UK
| | - James Nyikal
- Parliament of the Republic of Kenya, Nairobi, Kenya
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Affiliation(s)
- Ingrid T Katz
- From the Department of Medicine, Brigham and Women's Hospital (I.T.K., R.W.), Harvard Medical School (I.T.K., R.W., A.M.B.), Massachusetts General Hospital Center for Global Health (I.T.K.), and Ariadne Labs (R.W.) - all in Boston; the Harvard Global Health Institute (I.T.K., A.M.B.), and Harvard University (A.M.B.) - both in Cambridge, MA; and the Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa (L.-G.B.)
| | - Rebecca Weintraub
- From the Department of Medicine, Brigham and Women's Hospital (I.T.K., R.W.), Harvard Medical School (I.T.K., R.W., A.M.B.), Massachusetts General Hospital Center for Global Health (I.T.K.), and Ariadne Labs (R.W.) - all in Boston; the Harvard Global Health Institute (I.T.K., A.M.B.), and Harvard University (A.M.B.) - both in Cambridge, MA; and the Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa (L.-G.B.)
| | - Linda-Gail Bekker
- From the Department of Medicine, Brigham and Women's Hospital (I.T.K., R.W.), Harvard Medical School (I.T.K., R.W., A.M.B.), Massachusetts General Hospital Center for Global Health (I.T.K.), and Ariadne Labs (R.W.) - all in Boston; the Harvard Global Health Institute (I.T.K., A.M.B.), and Harvard University (A.M.B.) - both in Cambridge, MA; and the Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa (L.-G.B.)
| | - Allan M Brandt
- From the Department of Medicine, Brigham and Women's Hospital (I.T.K., R.W.), Harvard Medical School (I.T.K., R.W., A.M.B.), Massachusetts General Hospital Center for Global Health (I.T.K.), and Ariadne Labs (R.W.) - all in Boston; the Harvard Global Health Institute (I.T.K., A.M.B.), and Harvard University (A.M.B.) - both in Cambridge, MA; and the Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa (L.-G.B.)
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24
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Affiliation(s)
- Paul L Simpson
- School of Population Health, University of New South Wales, Sydney (UNSW Sydney), New South Wales, Australia
| | - Michael Levy
- Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney (UNSW Sydney), New South Wales, Australia
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Affiliation(s)
- C Buddy Creech
- Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Shannon C Walker
- Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Robert J Samuels
- Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
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Affiliation(s)
- John P Moore
- Weill Cornell Medicine, Cornell University, New York, New York
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He Z, Ren L, Yang J, Guo L, Feng L, Ma C, Wang X, Leng Z, Tong X, Zhou W, Wang G, Zhang T, Guo Y, Wu C, Wang Q, Liu M, Wang C, Jia M, Hu X, Wang Y, Zhang X, Hu R, Zhong J, Yang J, Dai J, Chen L, Zhou X, Wang J, Yang W, Wang C. Seroprevalence and humoral immune durability of anti-SARS-CoV-2 antibodies in Wuhan, China: a longitudinal, population-level, cross-sectional study. Lancet 2021; 397:1075-1084. [PMID: 33743869 PMCID: PMC7972311 DOI: 10.1016/s0140-6736(21)00238-5] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Wuhan was the epicentre of the COVID-19 outbreak in China. We aimed to determine the seroprevalence and kinetics of anti-SARS-CoV-2 antibodies at population level in Wuhan to inform the development of vaccination strategies. METHODS In this longitudinal cross-sectional study, we used a multistage, population-stratified, cluster random sampling method to systematically select 100 communities from the 13 districts of Wuhan. Households were systematically selected from each community and all family members were invited to community health-care centres to participate. Eligible individuals were those who had lived in Wuhan for at least 14 days since Dec 1, 2019. All eligible participants who consented to participate completed a standardised electronic questionnaire of demographic and clinical questions and self-reported any symptoms associated with COVID-19 or previous diagnosis of COVID-19. A venous blood sample was taken for immunological testing on April 14-15, 2020. Blood samples were tested for the presence of pan-immunoglobulins, IgM, IgA, and IgG antibodies against SARS-CoV-2 nucleocapsid protein and neutralising antibodies were assessed. We did two successive follow-ups between June 11 and June 13, and between Oct 9 and Dec 5, 2020, at which blood samples were taken. FINDINGS Of 4600 households randomly selected, 3599 families (78·2%) with 9702 individuals attended the baseline visit. 9542 individuals from 3556 families had sufficient samples for analyses. 532 (5·6%) of 9542 participants were positive for pan-immunoglobulins against SARS-CoV-2, with a baseline adjusted seroprevalence of 6·92% (95% CI 6·41-7·43) in the population. 437 (82·1%) of 532 participants who were positive for pan-immunoglobulins were asymptomatic. 69 (13·0%) of 532 individuals were positive for IgM antibodies, 84 (15·8%) were positive for IgA antibodies, 532 (100%) were positive for IgG antibodies, and 212 (39·8%) were positive for neutralising antibodies at baseline. The proportion of individuals who were positive for pan-immunoglobulins who had neutralising antibodies in April remained stable for the two follow-up visits (162 [44·6%] of 363 in June, 2020, and 187 [41·2%] of 454 in October-December, 2020). On the basis of data from 335 individuals who attended all three follow-up visits and who were positive for pan-immunoglobulins, neutralising antibody levels did not significantly decrease over the study period (median 1/5·6 [IQR 1/2·0 to 1/14·0] at baseline vs 1/5·6 [1/4·0 to 1/11·2] at first follow-up [p=1·0] and 1/6·3 [1/2·0 to 1/12·6] at second follow-up [p=0·29]). However, neutralising antibody titres were lower in asymptomatic individuals than in confirmed cases and symptomatic individuals. Although titres of IgG decreased over time, the proportion of individuals who had IgG antibodies did not decrease substantially (from 30 [100%] of 30 at baseline to 26 [89·7%] of 29 at second follow-up among confirmed cases, 65 [100%] of 65 at baseline to 58 [92·1%] of 63 at second follow-up among symptomatic individuals, and 437 [100%] of 437 at baseline to 329 [90·9%] of 362 at second follow-up among asymptomatic individuals). INTERPRETATION 6·92% of a cross-sectional sample of the population of Wuhan developed antibodies against SARS-CoV-2, with 39·8% of this population seroconverting to have neutralising antibodies. Our durability data on humoral responses indicate that mass vaccination is needed to effect herd protection to prevent the resurgence of the epidemic. FUNDING Chinese Academy of Medical Sciences & Peking Union Medical College, National Natural Science Foundation, and Chinese Ministry of Science and Technology. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Zhenyu He
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Lili Ren
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences, Beijing, China
| | - Juntao Yang
- State Key Laboratory of Medical Molecular Biology, Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Li Guo
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences, Beijing, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chao Ma
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xia Wang
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Zhiwei Leng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xunliang Tong
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center for Gerontology, Institute of Geriatric Medicine of Chinese Academy of Medical Sciences, Beijing, China
| | - Wang Zhou
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Geng Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences, Beijing, China
| | - Ting Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yan Guo
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Chao Wu
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Manqing Liu
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Conghui Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Mengmeng Jia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xuejiao Hu
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Ying Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xingxing Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Rong Hu
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Jingchuan Zhong
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jin Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Juan Dai
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Lan Chen
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoqi Zhou
- Wuhan Center for Disease Control & Prevention, Wuhan, China
| | - Jianwei Wang
- National Health Commission Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences, Beijing, China.
| | - Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Chen Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China; National Center for Respiratory Medicine, Beijing, China; Chinese Academy of Engineering, Beijing, China.
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Affiliation(s)
- Christopher A Longhurst
- Office of the UC San Diego Health CEO, University of California, San Diego
- Department of Biomedical Informatics, University of California, San Diego
| | - Brendan Kremer
- Office of the UC San Diego Health CEO, University of California, San Diego
| | - Patricia S Maysent
- Office of the UC San Diego Health CEO, University of California, San Diego
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Abstract
Prioritized immunization is advised with the 2 COVID-19 vaccines. A third meningococcal ACWY vaccine is now the only one approved for those > 55 years.
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33
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Affiliation(s)
- Thomas H Lee
- From Press Ganey and Harvard Medical School - both in Boston (T.H.L.); and Covered California and the University of California San Francisco - both in San Francisco (A.H.C.)
| | - Alice H Chen
- From Press Ganey and Harvard Medical School - both in Boston (T.H.L.); and Covered California and the University of California San Francisco - both in San Francisco (A.H.C.)
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Affiliation(s)
| | | | - Shah Ebrahim
- London School of Hygiene and Tropical Medicine, London, UK
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36
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Affiliation(s)
- Lauren Z Waterman
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London SE5 8AZ, UK
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37
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Affiliation(s)
- Daniel Patten
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Adelle Green
- University Campus North Lincolnshire, Scunthorpe, UK
| | - Daniel Bown
- University Campus North Lincolnshire, Scunthorpe, UK
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Pandey A, Belbase P, Parajuli A. COVID-19 Vaccine Development to Vaccination. J Nepal Health Res Counc 2021; 18:807-809. [PMID: 33510536 DOI: 10.33314/jnhrc.v18i4.3351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
In the race for a safe and effective vaccine against Coronavirus disease-19 manufacturer plays a critical role throughout the development, clinical trial, manufacturing, supply, and vaccination phases. For the efficacy of Coronavirus disease-19 vaccine, proper transport, storage, vaccine carrier, adjuvant, dosage form and route of vaccine administration plays a crucial role for immune response. In the context of no more people were willing to pay for a Coronavirus disease-19 vaccine the logistics of manufacturing, storing and distributing the vaccine, and mass vaccination are essential. It is urgent to improve health promotion and reduce the barriers to Coronavirus disease-19 vaccination. Keywords: COVID-19; vaccine development; vaccination.
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Affiliation(s)
- Ashok Pandey
- Nepal Health Research Council, Ramshah Path Kathmandu, Nepal
| | - Pradeep Belbase
- Nepal Health Research Council, Ramshah Path Kathmandu, Nepal
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Alqudeimat Y, Alenezi D, AlHajri B, Alfouzan H, Almokhaizeem Z, Altamimi S, Almansouri W, Alzalzalah S, Ziyab AH. Acceptance of a COVID-19 Vaccine and Its Related Determinants among the General Adult Population in Kuwait. Med Princ Pract 2021; 30:262-271. [PMID: 33486492 PMCID: PMC8089409 DOI: 10.1159/000514636] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/21/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the acceptance of a coronavirus disease 2019 (COVID-19) vaccine among the general adult population in Kuwait and assess its determinants. SUBJECTS AND METHODS A web-based cross-sectional study was conducted by enrolling adults living in Kuwait (n = 2,368; aged ≥21 years). Acceptance of a COVID-19 vaccine was inferred if participants indicated that they "definitely or probably will accept vaccination against COVID-19 once a vaccine is available." Associations were explored by applying a modified Poisson regression to estimate and infer adjusted prevalence ratios (aPR) and their 95% confidence intervals (CI). RESULTS In total, 53.1% (1,257/2,368) of the participants were willing to accept a COVID-19 vaccine once available. Male subjects were more willing to accept a COVID-19 vaccine than females (58.3 vs. 50.9%, p < 0.001). Subjects who viewed vaccines in general to have health-related risks were less willing to accept vaccination (aPR = 0.39, 95% CI: 0.35-0.44). Moreover, participants who previously received an influenza vaccine were more likely to accept a COVID-19 vaccine (aPR = 1.44, 95% CI: 1.31-1.58). Willingness to get vaccinated against COVID-19 increased as the self-perceived chances of contracting the infection increased (p < 0.001). CONCLUSION Overall, 53.1% of the study participants demonstrated willingness to get vaccinated against COVID-19. We found several factors influencing the level of acceptance. Since vaccination appears to be an essential preventive measure that can halt the COVID-19 pandemic, factors relating to low vaccine acceptance need to be urgently addressed by public health strategies.
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Affiliation(s)
- Yosor Alqudeimat
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Deema Alenezi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Bedour AlHajri
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Heba Alfouzan
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Zain Almokhaizeem
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Saba Altamimi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Waleed Almansouri
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Sayed Alzalzalah
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Ali H Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
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Simmons EG, Waters AM, Robertson BD, Richards AM. Alternative Immunization Clinics to Improve Vaccination Access during the COVID-19 Pandemic. Med J (Ft Sam Houst Tex) 2021:122-127. [PMID: 33666924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The United States declared a national emergency on March 13, 2020, in response to the rapidly spreading COVID-19 pandemic after all 50 states reported laboratory-confirmed cases.1 The demand for ambulatory medical care in the US fell by almost 60% and immunization encounters at Walter Reed National Military Medical Center decreased by 76% as patients became concerned about the risk of coronavirus exposure within a clinic or hospital setting.2 Our vaccination initiatives aimed to increase our pediatric and adult immunization rates through offering two alternative immunization platforms aimed to reduce patient concerns about COVID exposure.
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Affiliation(s)
- Elizabeth G Simmons
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD
| | - Aubri M Waters
- Department of Allergy and Immunology, Walter Reed National Military Medical Center, Bethesda, MD
| | - Brian D Robertson
- Department of Allergy and Immunology and the Department of Sleep Medicine, Walter Reed National Military Medical Center, Bethesda, MD
| | - Autumns M Richards
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD
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Asgary A, Valtchev SZ, Chen M, Najafabadi MM, Wu J. Artificial Intelligence Model of Drive-Through Vaccination Simulation. Int J Environ Res Public Health 2020; 18:E268. [PMID: 33396526 PMCID: PMC7796369 DOI: 10.3390/ijerph18010268] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 01/07/2023]
Abstract
Planning for mass vaccination against SARS-Cov-2 is ongoing in many countries considering that vaccine will be available for the general public in the near future. Rapid mass vaccination while a pandemic is ongoing requires the use of traditional and new temporary vaccination clinics. Use of drive-through has been suggested as one of the possible effective temporary mass vaccinations among other methods. In this study, we present a machine learning model that has been developed based on a big dataset derived from 125K runs of a drive-through mass vaccination simulation tool. The results show that the model is able to reasonably well predict the key outputs of the simulation tool. Therefore, the model has been turned to an online application that can help mass vaccination planners to assess the outcomes of different types of drive-through mass vaccination facilities much faster.
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Affiliation(s)
- Ali Asgary
- Disaster & Emergency Management, School of Administrative Studies, York University, Toronto, ON M3J 1P3, Canada
- Advanced Disaster, Emergency and Rapid Response Simulation (ADERSIM), York University, Toronto, ON M3J 1P3, Canada; (M.M.N.); (J.W.)
| | - Svetozar Zarko Valtchev
- Department of Mathematics and Statistics and Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON M3J 1P3, Canada; (S.Z.V.); (M.C.)
| | - Michael Chen
- Department of Mathematics and Statistics and Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON M3J 1P3, Canada; (S.Z.V.); (M.C.)
| | - Mahdi M. Najafabadi
- Advanced Disaster, Emergency and Rapid Response Simulation (ADERSIM), York University, Toronto, ON M3J 1P3, Canada; (M.M.N.); (J.W.)
| | - Jianhong Wu
- Advanced Disaster, Emergency and Rapid Response Simulation (ADERSIM), York University, Toronto, ON M3J 1P3, Canada; (M.M.N.); (J.W.)
- Department of Mathematics and Statistics and Laboratory for Industrial and Applied Mathematics, York University, Toronto, ON M3J 1P3, Canada; (S.Z.V.); (M.C.)
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Gray G, Van der Heever A, Madhi SS, McIntyre J, Kana B, Stevens W, Sanne I, Richards G, Abdullah F, Mendelson M, Dasoo A, Nel J, Wulfsohn A, Blumberg L, Venter F. The Scientists' Collective 10-point proposal for equitable and timeous access to COVID-19 vaccine in South Africa. S Afr Med J 2020; 0:13163. [PMID: 33334389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023] Open
Affiliation(s)
- G Gray
- South African Medical Research Council.
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Abstract
In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
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Lyon JO. Flu vaccination programme: could medical students be the answer? BMJ 2020; 370:m3698. [PMID: 32967860 DOI: 10.1136/bmj.m3698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jack O Lyon
- University of Manchester, Manchester M13 9PL, UK
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Saslow D, Andrews KS, Manassaram-Baptiste D, Smith RA, Fontham ETH. Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation. CA Cancer J Clin 2020; 70:274-280. [PMID: 32639044 DOI: 10.3322/caac.21616] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/19/2020] [Indexed: 01/12/2023] Open
Abstract
The American Cancer Society (ACS) presents an adaptation of the current Advisory Committee on Immunization Practices recommendations for human papillomavirus (HPV) vaccination. The ACS recommends routine HPV vaccination between ages 9 and 12 years to achieve higher on-time vaccination rates, which will lead to increased numbers of cancers prevented. Health care providers are encouraged to start offering the HPV vaccine series at age 9 or 10 years. Catch-up HPV vaccination is recommended for all persons through age 26 years who are not adequately vaccinated. Providers should inform individuals aged 22 to 26 years who have not been previously vaccinated or who have not completed the series that vaccination at older ages is less effective in lowering cancer risk. Catch-up HPV vaccination is not recommended for adults aged older than 26 years. The ACS does not endorse the 2019 Advisory Committee on Immunization Practices recommendation for shared clinical decision making for some adults aged 27 through 45 years who are not adequately vaccinated because of the low effectiveness and low cancer prevention potential of vaccination in this age group, the burden of decision making on patients and clinicians, and the lack of sufficient guidance on the selection of individuals who might benefit.
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Affiliation(s)
- Debbie Saslow
- Human Papillomavirus and Gynecologic Cancers, American Cancer Society, Atlanta, Georgia
| | - Kimberly S Andrews
- Guideline Development Process, American Cancer Society, Atlanta, Georgia
| | | | - Robert A Smith
- Cancer Screening, American Cancer Society, Atlanta, Georgia
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Abstract
Probably in the history of medicine, doctors were not as united as they are today, in that fight against COVID-19, when the pandemic spread incredibly fast - from East to West, from North to South. The COVID-19 pandemic is likely to have unprecedented and unforeseeable consequences, from those on a worldwide/global level to those at the local level - at the level of local communities and families, and individuals (and not just humans, but all other living beings), of which the future will testify in various ways. The consequences will be political, economic, social, but probably to the greatest degree, the consequences of a health nature - systemic and individual. The death toll is high, despite the therapy being applied. We do not currently have a specific and effective therapy against COVID-19. In addition, we do not have a single clinical study that would support prophylactic therapy that could affect COVID-19. All of the therapeutic options now available to us are based on the experience we have gained in treating SARS and MERS. When the vaccine is discovered, at that moment we will be able to say that we have an appropriate and effective method in fighting against COVID-19. Some historians of medicine believe that voluntary vaccination against COVID-19 would be, not only less politically risky but also more effective in protecting the population from coronavirus. It remains to be seen what the new wave of the COVID-19 pandemic, announced by WHO experts these days, and which is expected in the fall of 2020, will bring us.
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Affiliation(s)
- Izet Masic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Vjekoslav Gerc
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
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Ogawa T, Inoue T, Kasahara K, Konishi M, Mikasa K. Impact of vaccination on measles, mumps, and rubella antibody titers in Japanese healthcare workers: An observational study. PLoS One 2020; 15:e0230329. [PMID: 32208432 PMCID: PMC7092999 DOI: 10.1371/journal.pone.0230329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 02/27/2020] [Indexed: 11/18/2022] Open
Abstract
Given the complicated history of Japan’s National Immunization Program, a significant proportion of Japanese people including healthcare workers (HCWs) still lack adequate immunity against measles, mumps, and rubella (MMR), resulting in occasional outbreaks. In 2014, the Japanese Society of Infection Prevention and Control (JSIPC) published vaccination guidelines for HCWs. We evaluated antibody titers before and after MMR vaccination in HCWs at the Nara Medical University Hospital, the attainment rate of the target antibody titers defined by the JSIPC guidelines, and the safety of vaccines. We measured MMR antibody titers in HCWs, followed by inoculation with the respective monovalent vaccines and/or trivalent MMR (tMMR) vaccine according to the JSIPC guidelines. Among 467 HCWs evaluated, antibody titers against measles and mumps measured using the IgG-enzyme immunoassay increased from 11.0 [interquartile range (IQR): 8.0–13.6] to 13.7 (IQR: 11.3–16.9; P < 0.001) and from 2.8 (IQR: 2.1–3.5) to 4.8 (IQR: 3.7–5.7; P < 0.001), respectively. By evaluating a logarithmic value of log2(X + 1) converted from an antibody titer X, antibody titers against rubella measured using the hemagglutination assay increased from 3.2 (IQR: 0–4.1) to 6.0 (IQR: 4.6–8.0; P < 0.001). Antibody titer elevated following tMMR vaccination was lower than that following monovalent vaccination in a single dose of the measles-containing, a single dose of the mumps-containing, and two doses of rubella-containing vaccine groups (P = 0.01, 0.01, and <0.001, respectively). After vaccination, 20.0%, 61.5%, and 46.2% of HCWs attained target antibody titers specified by the JSIPC guidelines for measles, rubella, and mumps, respectively. The systemic response in female HCWs who underwent monovalent mumps vaccination was statistically higher than that in others. Although the vaccination program for HCWs according to the JSIPC guidelines caused increased MMR antibody titers, the rates of attaining the target criteria were low.
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Affiliation(s)
- Taku Ogawa
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
- * E-mail:
| | - Takashi Inoue
- Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Mitsuru Konishi
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
- Center for Health Control, Nara Medical University, Nara, Japan
| | - Keiichi Mikasa
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
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Mvundura M, Di Giorgio L, Vodicka E, Kindoli R, Zulu C. Assessing the incremental costs and savings of introducing electronic immunization registries and stock management systems: evidence from the better immunization data initiative in Tanzania and Zambia. Pan Afr Med J 2020; 35:11. [PMID: 32373262 PMCID: PMC7195915 DOI: 10.11604/pamj.supp.2020.35.1.17804] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 06/20/2019] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Poor data quality and use have been identified as key challenges that negatively impact immunization programs in low- and middle-income countries (LMICs). In addition, many LMICs have a shortage of health personnel, and staff available have demanding workloads across several health programs. In order to address these challenges, the Better Immunization Data (BID) Initiative introduced a comprehensive suite of interventions, including an electronic immunization registry aimed at improving the quality, reliability, and use of immunization data in Arusha Region, Tanzania, and Southern Province of Zambia. The objective of this study was to assess the incremental costs of implementing the BID interventions in immunization programs in these two countries. METHODS We conducted a micro-costing study to estimate the economic costs of service delivery and logistics for the immunization programs with and without the BID interventions in a sample of health facilities and district program offices in each country. Structured questionnaires were used to interview immunization program staff at baseline and post-intervention to assess annual resource utilization and costs. Cost outcomes were reported as annual cost per facility, cost per district and changes in resource costs due to the BID interventions (i.e., costs associated with health worker time, start-up costs, etc.). Sub-group analyses were conducted by health facility to assess variation in costs by volume served and location (rural versus urban). One-way sensitivity analyses were conducted to identify influential parameters. Costs were reported in 2017 US dollars. RESULTS In Tanzania, the average annual reduction in resource costs was estimated at US$10,236 (95% confidence interval: $7,606-$14,123) per health facility, while the average annual reduction in resource costs per district was estimated at $6,542. In Zambia, reductions in resource costs were modest at an estimated annual average of $628 (95% confidence interval: $209-$1,467) per health facility and $236 per district. Resource cost reductions were mainly attributable to reductions in time required for immunization service delivery and reporting. One-way sensitivity analyses identified key cost drivers, all related to reductions in health worker time. CONCLUSION The introduction of electronic immunization registries and stock management systems through the BID Initiative was estimated to result in potential time savings in both countries. Health worker time was the area most impacted by the interventions, suggesting that time savings gained could be utilized for patient care. Information generated through this work provides evidence to inform stakeholder decision-making for scale-up of the BID interventions in Tanzania and Zambia and to inform other Low-to-Middle-Income Countries (LMICs) interested in similar interventions.
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Affiliation(s)
- Mercy Mvundura
- Medical Devices and Health Technologies Program, PATH, Seattle, USA
| | - Laura Di Giorgio
- Medical Devices and Health Technologies Program, PATH, Seattle, USA
| | | | | | - Chipo Zulu
- Country Program Office, PATH, Lusaka, Zambia
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