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To compare and analyze COVID-19 control outcomes, including case severity, vaccination, and excess mortality, across 6 nations (USA, UK, China, Russia, Japan, and South Africa) from January 2020 to December 2022.
Methods
This study utilized data from the “Our World in Data” dataset to characterize the epidemiological features of COVID-19 across 6 countries. Generalized linear models (GLMs) were employed to examine the associations between Stringency Index (SI), vaccination coverage, and epidemiological outcomes.
Results
The USA had the highest median cases per million and the UK the highest deaths per million, while China reported the lowest for both. Hospitalization and ICU rates were highest in the UK and the USA, respectively, and lowest in Japan. Vaccination coverage was highest in China and lowest in South Africa. Excess mortality was highest in Russia and lowest in Japan. Generalized linear models indicated a negative association between the SI and cases in China (β = −40, P = 0.015), which became stronger after adjusting for vaccination (β = −311, P < 0.001), but positive associations were observed in the USA, UK, and South Africa. SI was negatively associated with excess mortality in most countries.
Conclusions
Effective pandemic control is highly context-dependent. The relationships among vaccination, variant prevalence, and health care burden were complex, shaped by implementation context, public compliance, and health care capacity.
This study aimed to evaluate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and inactivated virus vaccination on intracytoplasmic sperm injection (ICSI) outcomes in infertile couples. A retrospective case–control study was conducted at the Royan Institute from August 2020 to March 2022. The study included 90 couples in the COVID-19 infection phase and 31 in the vaccination phase. A total of 30 infected but unvaccinated couples were compared to a control group of 60 couples with no COVID-19 infection or vaccination history. Additionally, 31 couples underwent treatment before and after receiving the Sinopharm inactivated vaccine. Key variables analysed included sperm parameters (concentration, motility, progressive motility and morphology), ovarian parameters (antral follicle count, oocyte retrieval), embryological outcomes and pregnancy outcomes. SARS-CoV-2 infection significantly reduced sperm motility (P = 0.02) and progressive motility (P = 0.01) compared to controls. Sperm concentration and morphology showed non-significant declines. Post-vaccination analysis revealed similar but statistically insignificant changes in sperm parameters. Ovarian stimulation parameters and embryological outcomes remained unaffected by both infection and vaccination. Although biochemical, clinical pregnancy and live birth rates were lower among the infected group, these differences did not reach statistical significance (p = 0.16, 0.08 and 0.09). SARS-CoV-2 infection has been associated with impaired sperm progressive motility, which may negatively influence ICSI outcomes. In contrast, vaccination with an inactivated virus does not appear to impact fertility outcomes. These findings provide crucial guidance for physicians and infertile couples managing treatments during and after the pandemic, suggesting the need for extended recovery periods before ART procedures following COVID-19 infection.
In this article, I examine the history of the concept of herd immunity, beginning with British epidemiologists in the 1920s and ending with the controversy surrounding it during the COVID-19 pandemic. I argue that competing historical and contemporary understandings of herd immunity reveal an underlying tension between observing the effects of infection-acquired herd immunity on the population dynamics of infectious diseases and actively cultivating it through immunisation. Originally offering an explanatory mechanism for the rise and fall of epidemics, the concept soon became entangled with strategies of disease control and technologies for producing immunity, particularly as mass vaccination became more common in the postwar era. This tension between observing herd immunity and cultivating it has produced diverse interpretations ranging from the temporary abatement of an outbreak due to the accumulation of infection-acquired immunity to the principle undergirding disease elimination through mass vaccination. I close by suggesting that the scientific debates and uncertainties regarding the relevance of herd immunity to public health strategies during the COVID-19 pandemic reflect this long-running tension between observing and cultivating immunity in populations.
The COVID-19 pandemic significantly impacted Saskatchewan, resulting in high per capita case counts and COVID-19-related deaths. While vaccination mandates have been a key strategy to control the pandemic, their impact in Saskatchewan remains poorly documented. This study assessed the effect of COVID-19 vaccine mandates on the incidence of COVID-19 cases and deaths in Saskatchewan during the first year following vaccine rollout.
Methods
A single-group interrupted time series analysis with multiple intervention points was conducted using aggregated daily COVID-19 incidence and mortality rates as outcome variables. The models accounted for confounding effects of daily total vaccine doses administered and public health countermeasures, including the stringency index and economic support index, from April 1, 2020 to January 20, 2022. Average daily COVID-19 incidence and mortality rates were estimated for the pre-vaccine rollout period (April 1 to December 14, 2020), and the post-rollout period (December 15, 2020 to January 20, 2022). In addition, nine supplementary initiatives were introduced during the implementation phase. All estimated effects reflected cumulative changes in trend relative to the pre-vaccination period.
Results
Cumulatively, COVID-19 incidence increased faster than the pre-vaccination trend, likely driven by successive variant surges from wild-type to Omicron, while COVID-19–related deaths remained stable across the same period. The implementation of vaccine rollout, prioritization of vaccines for high-risk populations, and proof-of-vaccination policy were effective in reducing daily COVID-19 incidence and deaths in Saskatchewan. Economic support and an increased number of daily vaccine doses administered were also associated with an improved provincial COVID-19 response. Conversely, surges in COVID-19 incidence and deaths occurred following the introduction of the centralized virtual booking system and booster doses. These surges may reflect accessibility challenges, increased testing, emergence of immune-escape variants, relaxation of public health measures before achieving herd immunity, and waning immunity over time.
Conclusions
Economic support, policy measures, and vaccination efforts played important roles in managing public health crises, hence the need for an integrated approach to managing public health crises. However, temporary surges following certain interventions underscore the need for accessible, adaptable strategies that account for variant emergence, immunity waning and public adherence.
Many countries have permitted community pharmacists to administer vaccines to increase the immunization rate. The policy of Thailand has recently expanded and permitted pharmacists to play a role in immunization.
Aim:
The objective of this study was to survey the opinion and readiness of community pharmacists as immunizers.
Methods:
This study was a prospective, mixed-methods questionnaire and semi-structured interview. The study included community pharmacists in Hatyai, Songkhla, Thailand. A Likert scale questionnaire to evaluate readiness, opinions, and barriers to providing vaccines was distributed online. The volunteer pharmacists were interviewed about their opinions, distress, and benefits of vaccination services.
Findings:
An online survey was completed by 146 pharmacists, and 12 community pharmacists agreed to be interviewed. More than 65% of respondents agreed that vaccination services in community pharmacies are easily accessible to patients. Approximately 46% of pharmacist respondents were willing to be immunizers, and 45% of respondents showed readiness with the availability of pharmacy space for handling vaccinations, their storage, and disposing of sharp objects. Almost all of the respondents showed readiness with knowledge of adverse events following immunization (AEFI) and management. However, most of the concerns were vaccine administration skills, the conflict with other professionals, and the cost of setup and management. The pharmacists required training in vaccine administration skills before providing the service.
Conclusions:
The community pharmacies were willing and ready to provide vaccination services for the National List of Essential Vaccines. Vaccine administration skills were the main barriers to vaccination. The training should be done in faculty classes or workshops.
The Secretary of the US Department of Health & Human Services, Robert Kennedy Jr is leading a political agenda against vaccination. This is undermining the delivery of life-saving vaccination programmes and provision of evidence-based information on the safety and effectiveness of vaccines for the public and health professionals. Inconsistent and conflicting messaging between health practitioners and government health agencies erodes trust in public health programmes, creating a vacuum which is often filled with mis/disinformation that presents severe consequences for families. Due to the transnational spread of diseases, we consider the implications of events in the US for routine childhood vaccination programmes in the UK. Public health agencies across the world need to be ‘Kennedy ready’; pragmatic steps must be taken to mitigate threats posed to vaccine confidence and the control of vaccine preventable diseases.
The COVID-19 pandemic, which has killed millions of people worldwide, continues to be marked by waves of reinfections. We aimed to assess the incidence and clinical characteristics of reinfection in COVID- 19 cohort.
Material and Methods
A single-center descriptive study was conducted. Data were collected from all patients who tested positive for SARS-CoV-2 via PCR from March 18, 2020, the onset of the first major COVID-19 wave, until the end of 2020. All PCR-positive patients were followed-up, and those who had SARS-CoV-2 PCR positivity again at least 90 days after the initial onset were contacted via telemedicine.
Results
5814 patients diagnosed with COVID-19 with PCR positive in the first wave were included. The incidence of reinfection among the cohort of patients infected with SARS-CoV-2 during the initial wave of COVID-19 was 0.73%. Among healthcare workers, the 1-year reinfection rate was 2.14%, 3.9 times higher than non-healthcare workers. We observed that the clinical course was milder and less complicated in patients who had reinfection. In cases of reinfection among fully vaccinated individuals, statistically significantly fewer symptoms were observed.
Conclusions
We observed that healthcare workers are at approximately four times greater risk of reinfection. Reinfections generally presented with a milder clinical course.
Measles (rubeola) caused by measles virus is highly contagious and can be transmitted via respiratory droplets or can spread via sneezing or coughing of an infected person. In January 2025, two cases of measles associated with international travel seen in unvaccinated individuals of Harris County were reported by the Houston Health Department. This disease which was once declared eradicated from United States (US) in the year 2000, unfortunately has affected a total of 607 cases since January 2025, across the US, with highest number of cases recorded in Texas. Majority of the cases are witnessed in the paediatric population, especially the ones who are unvaccinated or have an uncertain vaccination history. Unfortunately, vaccine hesitancy is an important barrier in achieving measles eradication, and it is more imperative than ever to address this issue in a timely manner. There is an urgent need of virus containment measures to be taken by public health authorities to curb its spread, specifically by reinforcing the importance and safety of vaccinations, debunking myths and educating parents that the recommended two doses of vaccination not only serve as a safety net for their child but also for the community as a whole.
Human-embodied relations are being fundamentally transformed by increasingly globalised abstracting processes. Developments including the planetary reach of technoscience, cybercapitalism, and communications technologies. They are increasingly framing how we live our bodies. They enable phenomena as diverse as the global trade in body parts and the distribution of pharmaceuticals. However, there is also a less obvious reframing of our bodies going on. Biotechnologies have been steadily remaking the foundations of human procreation, gestation, and identity formation, albeit unevenly in different parts of the world. This enquiry weaves together related themes: modifying genetic organisms, reproducing human life, gestating a fetus, presenting sexual identity, and being vaccinated. In the case of COVID, a technoscientific fix is presented as necessary to mitigate the effects of a world turned upside down by the technologisation and exploitation of planetary ecology. Technoscience is displacing modern science. The chapter seeks to show how technoscientific intervention associated with ideologies of overcoming bodily constraint is remaking what it means to be human.
Vaccination during pregnancy is an effective route of protecting pregnant individuals, their fetuses, and neonates from morbidity and mortality of vaccine preventable diseases. There is sufficient epidemiologic safety data to support routine administration of influenza vaccine, Tdap, and COVID-19 vaccine, however there are poor rates of vaccine uptake in pregnancy due to low vaccine confidence and barriers to care. Routine inactivated childhood vaccines, travel vaccines, and live attenuated vaccine recommendations are reviewed, and recommendations are made based on weighing the risk of exposure, risk of the vaccination, and necessity of travel.
To examine opinions about incentives for vaccination against COVID-19.
Methods
A qualitative study was conducted in spring 2022. The study population consisted of pairs of university students and their parents throughout Serbia. The qualitative content analysis was applied.
Results
A total of 18 participants (9 student-parent pairs) were included. The following themes were identified: 1) Attitudes about financial incentives for vaccination, 2) Non-financial incentives for vaccination, and 3) Suggestions to enhance vaccination coverage. Theme 1 comprised several subthemes: General response to money, Dissatisfaction with financial incentives, Satisfaction with financial incentives and Amount of money to change people’s opinion. Most parents and some students expressed a clear dissatisfaction and disapproval of the concept of financial incentives for compliance with vaccination. Financial offers would not make our participants change their position on whether to receive the vaccine, as no major differences in attitude towards vaccinations between the vaccinated and the non-vaccinated study participants was observed. Non-financial incentives were more acceptable compared to financial ones, but they were also seen as beneficial for some and not others.
Conclusions
Financial incentive programs’ potential for inefficiency and public mistrust make other methods to boost vaccine uptake better public health choices for now.
The objectives of this study were to determine how university and surrounding area characteristics are associated with student vaccination rates and vaccine exemption stringency.
Methods
This study collected data from publicly available university-associated and government-associated websites. The university and surrounding area characteristics were evaluated to elucidate how they impact student vaccination rates and ease of exemption from vaccine mandates using statistical correlations and linear regression.
Results
Lower student-to-faculty ratios and stricter university exemption strategies were significantly correlated with higher vaccination rates. Schools that did not allow for personal exemptions to vaccine mandates had significantly higher vaccination rates as compared to schools without vaccine mandates. Certain university and surrounding area characteristics, such as regional location and surrounding area vaccination rates, might serve as underlying factors in inconsistent vaccination rates on university campuses.
Conclusions
Associations were seen between some of the explanatory variables and student vaccination rates. However, more research needs to be conducted to better understand how these discussed factors affect university vaccination rates. This will allow public health professionals to be more prepared as new health concerns arise in the future.
Health care comprises a major segment of the US economy and is a critical influence upon citizens’ quality of life. The quality of health care and access to it are negatively affected by corruption. So too is citizen compliance with public health policies, a fact that became apparent during the COVID-19 pandemic. Stay-at-home orders, for example, were significantly less effective in states with more extensive corruption. Low levels of trust in government contributed to those disparities. Such effects are more pronounced in poorer areas and Black communities. Racial contrasts in vaccine equity – access to vaccinations and related services – were pronounced and, again, reflected levels of corruption. Particularly intractable problems of collective action posed by structural corruption and structural racism must be addressed if disparities in the quality of health care are to be reduced.
Post COVID-19 condition (PCC) refers to persistent symptoms occurring ≥12 weeks after COVID-19. This living systematic review (SR) assessed the impact of vaccination on PCC and vaccine safety among those with PCC, and was previously published with data up to December 2022. Searches were updated to 31 January 2024 and standard SR methodology was followed. Seventy-eight observational studies were included (47 new). There is moderate confidence that two doses pre-infection reduces the odds of PCC (pooled OR (pOR) 0.69, 95% CI 0.64–0.74, I2 = 35.16%). There is low confidence for remaining outcomes of one dose and three or more doses. A booster dose may further reduce the odds of PCC compared to only a primary series (pOR 0.85, 95% CI 0.74–0.98, I2 = 16.85%). Among children ≤18 years old, vaccination may not reduce the odds (pOR 0.79, 95% CI 0.56–1.11, I2 = 37.2%) of PCC. One study suggests that vaccination within 12 weeks post-infection may reduce the odds of PCC. For those with PCC, vaccination appears safe (four studies) and may reduce the odds of PCC persistence (pOR 0.73, 95% CI 0.57–0.92, I2 = 15.5%).
The purpose of this study was to measure and examine the levels of IgG, IgM, and Spike antibody induced by inactivated vaccines, including CoronaVac and BBIBP-CorV.
Methods
Two groups of healthy adults over 18 years old (50 participants per group), who had previously received 1 dose of either BBIBP-CorV or CoronaVac and receiving either a homologous booster of BBIBP-CorV or a heterologous booster of CoronaVac. Serum IgG, IgM, and Spike antibody levels against SARS-COV-2 were measured using magnetic particle chemiluminescence immunoassay and the ELISA method.
Results
The results showed that both spike antibody and IgG/IgM antibodies elicited by a CoronaVac booster following 1 dose of BBIBP-CorV were significantly higher than those elicited by either a homologous BBIBP-CorV booster or a heterologous BBIBP-CorV booster. The Spike antibody against SARS-COV-2 induced by the heterologous CoronaVac booster reached 200.3, which is substantially greater than that induced by the homologous BBIBP-CorV booster (127.5 pg/mL). Conversely, the Spike antibody against SARS-COV-2 induced by the heterologous BBIBP-CorV booster reached 53.93 pg/mL, which is substantially greater than that induced by the homologous CoronaVac booster (9.60 pg/mL).
Conclusions
In summary, CoronaVac is immunogenic as a booster dose following 1 dose of BBIBP-CorV and is immunogenically superior to both the homologous booster and the heterologous BBIBP-CorV booster.
This chapter of the handbook posits utilitarianism as a standard of rational moral judgment. The author does not directly defend utilitarianism as a theory but investigates cases of apparent contradiction between people’s moral decisions (sometimes grounded in nonutilitarian principles) and the consequences of those decisions that they themselves would consider worse for themselves and everybody else. For example, when some people use a moral principle (e.g., bodily autonomy) to assertively make a decision (e.g., to not get vaccinated), it has negative moral consequences for others (e.g., infecting people) and for themselves (risking infection). The author asks whether such contradictions in moral reasoning can provide insights into some of the determinants of such reasoning. These insights, importantly, are valuable even for those who do not adopt utilitarianism as a normative model. From over a dozen candidate moral contradictions, the author concludes that many deviations from utilitarian considerations in moral contexts are reflections of familiar nonmoral cognitive biases, but some arise from adherence to strong moral rules or principles (e.g., protected or sacred values).
We present the case of a 31-year-old female with Fontan circulation who developed signs of protein-losing enteropathy 10 days after second COVID-19 vaccination. After standard investigations for identification of potential triggers for protein-losing enteropathy, we concluded that coronavirus disease 2019 (COVID-19) booster vaccination could have been the most probable underlying trigger. Prompt investigation of new symptoms post-vaccination in high-risk patients is necessary.
We studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination status among six ethnic groups in Amsterdam, the Netherlands. We analysed participants of the Healthy Life in an Urban Setting cohort who were tested for SARS-CoV-2 spike protein antibodies between 17 May and 21 November 2022. We categorized participants with antibodies as only infected, only vaccinated (≥1 dose), or both infected and vaccinated, based on self-reported prior infection and vaccination status and previous seroprevalence data. We compared infection and vaccination status between ethnic groups using multivariable, multinomial logistic regression. Of the 1,482 included participants, 98.5% had SARS-CoV-2 antibodies (P between ethnic groups = 0.899). Being previously infected and vaccinated ranged from 36.2% (95% confidence interval (CI) = 28.3–44.1%) in the African Surinamese to 64.5% (95% CI = 52.9–76.1%) in the Ghanaian group. Compared to participants of Dutch origin, participants of South-Asian Surinamese (adjusted odds ratio (aOR) = 6.74, 95% CI = 2.61–17.45)), African Surinamese (aOR = 23.32, 95% CI = 10.55–51.54), Turkish (aOR = 8.50, 95% CI = 3.05–23.68), or Moroccan (aOR = 22.33, 95% CI = 9.48–52.60) origin were more likely to be only infected than infected and vaccinated, after adjusting for age, sex, household size, trust in the government’s response to the pandemic, and month of study visit. SARS-CoV-2 infection and vaccination status varied across ethnic groups, particularly regarding non-vaccination. As hybrid immunity is most protective against coronavirus disease 2019, future vaccination campaigns should encourage vaccination uptake in specific demographic groups with only infection.
Immunization is a global development success story, saving millions of lives yearly by reducing the risks of contracting an infectious disease and enabling the immune system within the body to build protection. The global eradication of smallpox in 1977 demonstrates the potential of well-designed immunization campaigns. Islamic teaching places attention on preserving life, encouraging Muslims to care for their bodies and overall health, because of its preventive function. However, vaccination of populations is not without challenges; for example, vaccine hesitancy or avoidance emerges for a variety of reasons in Muslim populations, increasing the risks of communicable diseases globally. Public health has a role to play in countering issues. Such issues include misinformation, acting with diplomacy when discussing immunization programs with Muslim community leaders, ensuring the availability of evidence-based accessible information, and educating populations about the necessity and protective ability of vaccines to prevent life-threatening diseases. It also has a role to play in educating non-Muslim professionals about culturally competent care.
As COVID-19 spread rapidly during the early months of the pandemic, many communities around the globe anxiously waited for a vaccine. At the start of the pandemic, it was widely believed that Africa would be a significant source of infection, and thus, vaccinating African communities became a primary goal among local and global health authorities. However, when the COVID-19 vaccine became available in March 2021 in Sierra Leone, many people viewed it with scepticism and hesitation. While much literature has focused on access and distribution-related challenges for vaccination in the region, a growing number of studies discuss vaccine hesitancy as driving low vaccine uptake. Shifting attention to understanding the determinants of vaccine hesitancy remains fundamental to increasing vaccination rates, as negative vaccine perceptions tend to delay or prevent vaccination. This study sought to do this by assessing, through semi-structured qualitative interviews, vaccine-related attitudes and experiences of residents of Sierra Leone’s Kono District. In contrast to studies that utilise “knowledge-deficit” models of belief, however, this study drew upon the vaccine anxieties framework (Leach and Fairhead, 2007), which views vaccines as being imbued with personal, historical, and political meaning. Findings suggest that important bodily, social, and political factors, including fear of side effects, the spread of misinformation prompted by poor messaging strategies, and distrust of government and international actors, influenced people’s COVID-19 vaccine attitudes and behaviours. It is hoped that the study’s findings will inform future policies and interventions related to vaccine uptake in Africa and globally.