scholarly journals How can the public health impact of vaccination be estimated?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Susy Echeverria-Londono ◽  
Xiang Li ◽  
Jaspreet Toor ◽  
Margaret J. de Villiers ◽  
Shevanthi Nayagam ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Health Impact ◽  
Activity Type ◽  
Yearly Variation ◽  
Vaccine Preventable Diseases ◽  
The Public ◽  
Full Effect ◽  
Impact Modelling ◽  
Vaccine Impact ◽  
The Impact

Abstract Background Deaths due to vaccine preventable diseases cause a notable proportion of mortality worldwide. To quantify the importance of vaccination, it is necessary to estimate the burden averted through vaccination. The Vaccine Impact Modelling Consortium (VIMC) was established to estimate the health impact of vaccination. Methods We describe the methods implemented by the VIMC to estimate impact by calendar year, birth year and year of vaccination (YoV). The calendar and birth year methods estimate impact in a particular year and over the lifetime of a particular birth cohort, respectively. The YoV method estimates the impact of a particular year’s vaccination activities through the use of impact ratios which have no stratification and stratification by activity type and/or birth cohort. Furthermore, we detail an impact extrapolation (IE) method for use between coverage scenarios. We compare the methods, focusing on YoV for hepatitis B, measles and yellow fever. Results We find that the YoV methods estimate similar impact with routine vaccinations but have greater yearly variation when campaigns occur with the birth cohort stratification. The IE performs well for the YoV methods, providing a time-efficient mechanism for updates to impact estimates. Conclusions These methods provide a robust set of approaches to quantify vaccination impact; however it is vital that the area of impact estimation continues to develop in order to capture the full effect of immunisation.

scholarly journals COVID-19 impact on routine immunisations for vaccine-preventable diseases: Projecting the effect of different routes to recovery

2022 ◽  
Author(s):  
Jaspreet Toor ◽  
Xiang Li ◽  
Mark Jit ◽  
Caroline Trotter ◽  
Susy Echeverria-Londono ◽  
...  
Keyword(s):  
Detrimental Effect ◽  
Routine Immunisation ◽  
Middle Income ◽  
Vaccine Preventable Diseases ◽  
The Road ◽  
Middle Income Countries ◽  
The Past ◽  
Impact Modelling ◽  
Vaccine Impact ◽  
The Impact

Introduction: Over the past two decades, vaccination programmes for vaccine-preventable diseases (VPDs) have expanded across low- and middle-income countries (LMICs). However, the rise of COVID-19 resulted in global disruption to routine immunisation (RI) activities. Such disruptions could have a detrimental effect on public health, leading to more deaths from VPDs, particularly without mitigation efforts. Hence, as RIs resume, it is important to estimate the effectiveness of different approaches for recovery. Methods: We apply an impact extrapolation method developed by the Vaccine Impact Modelling Consortium to estimate the impact of COVID-19-related disruptions with different recovery scenarios for ten VPDs across 112 LMICs. We focus on deaths averted due to RIs occurring in the years 2020- 2030 and investigate two recovery scenarios relative to a no-COVID-19 scenario. In the recovery scenarios, we assume a 10% COVID-19-related drop in RI coverage in the year 2020. We then linearly interpolate coverage to the year 2030 to investigate two routes to recovery, whereby the immunization agenda (IA2030) targets are reached by 2030 or fall short by 10%. Results: We estimate that falling short of the IA2030 targets by 10% leads to 11.26% fewer fully vaccinated persons (FVPs) and 11.34% more deaths over the years 2020-2030 relative to the noCOVID-19 scenario, whereas, reaching the IA2030 targets reduces these proportions to 5% fewer FVPs and 5.22% more deaths. The impact of the disruption varies across the VPDs with diseases where coverage expands drastically in future years facing a smaller detrimental effect. Conclusion: Overall, our results show that drops in RI coverage could result in more deaths due to VPDs. As the impact of COVID-19-related disruptions is dependent on the vaccination coverage that is achieved over the coming years, the continued efforts of building up coverage and addressing gaps in immunity are vital in the road to recovery.

scholarly journals Impact of the Affordable Care Act’s Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far?

2017 ◽  
Vol 75 (2) ◽  
pp. 131-152 ◽  
Author(s):  
Joshua Breslau ◽  
Bradley D. Stein ◽  
Bing Han ◽  
Shoshanna Shelton ◽  
Hao Yu
Keyword(s):  
Public Health ◽  
Health Status ◽  
Insurance Coverage ◽  
Health Impact ◽  
Care Utilization ◽  
The Public ◽  
Behavioral Health Treatment ◽  
Coverage Expansion ◽  
Dependent Coverage ◽  
The Impact

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders’ children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.

Pollen, Allergens, and Human Health

2019 ◽  
Author(s):  
Rachel N. McInnes
Keyword(s):  
Management Practices ◽  
Dna Analysis ◽  
Pollen Grains ◽  
Health Impact ◽  
Meteorological Conditions ◽  
Day Length ◽  
Allergenic Pollen ◽  
Pollen Production ◽  
The Public ◽  
The Impact

Allergenic pollen is produced by the flowers of a number of trees, grasses, and weeds found throughout the world. Human exposure to such pollen grains can exacerbate pollen-related asthma and allergenic conditions such as allergic rhinitis (hay fever). While allergenic pollen comes from three main groups of plants—certain trees, grasses, and weeds—many people are sensitive to pollen from one or a few taxa only. Weather, climate, and environmental conditions have a significant impact on the levels and varieties of pollen grains present in the air. These allergenic conditions significantly reduce the quality of life of affected individuals and have been shown to have a major economic impact. Pollen production depends on both the current meteorological conditions (including day length, temperature, irradiation, precipitation, and wind speed/direction), and the water availability and other environmental and meteorological conditions experienced in the previous year. The climate affects the types of vegetation and taxa that can grow in a particular location through availability of different habitats. Land-use or land management is also crucial, and so this field of study has implications for vegetation management practices and policy. Given the influential effects of weather and climate on pollen, and the significant health impacts globally, the total effect of any future environmental and climatic changes on aeroallergen production and spread will be significant. The overall impact of climate change on pollen production and spread remains highly uncertain, and there is a need for further understanding of pollen-related health impact information. There are a number of ways air quality interacts with the impact of pollen. Further understanding of the risks of co-exposure to both pollen and air pollutants is needed to better inform public health policy. Furthermore, thunderstorms have been linked to asthma epidemics, especially during the grass pollen seasons. It is thought that allergenic pollen plays a role in this “thunderstorm asthma.” To reduce the exposure to, or impact from, pollen grains in the air, a number of adaptation and mitigation options may be adopted. Many of these would need to be done either through policy changes, or at a local or regional level, although some can be done by individuals to minimize their exposure to pollen they are sensitive to. Improved aeroallergen forecast models could be developed to provide detailed taxon-specific, localized information to the public. One challenge will be combining the many different sources of aeroallergen data that are likely to become available in future into numerical forecast systems. Examples of these potential inputs are automated observations of aeroallergens, real-time phenological observations and remote sensing of vegetation, social sensing, DNA analysis of specific aeroallergens, and data from symptom trackers or personal monitors. All of these have the potential to improve the forecasts and information available to the public.

Government intervention in the market for electronic nicotine delivery systems (ENDS). The known, the unknown and challenges

2020 ◽  
Vol 20 (3) ◽  
pp. 283-294
Author(s):  
Ayda A. Yurekli ◽  
Patricia Kovacevic ◽  
Emil Sunley ◽  
Karthik Ranganathan
Keyword(s):  
Simulation Analysis ◽  
Health Impact ◽  
Delivery Systems ◽  
Economic Research ◽  
Electronic Nicotine Delivery Systems ◽  
Content Type ◽  
The Public ◽  
Premature Deaths ◽  
Nicotine Delivery ◽  
The Impact

Purpose This paper aims to describe the various government measures that regulate the market for novel tobacco harm reduction products (THRPs), with an emphasis on e-cigarettes [electronic nicotine delivery systems (“ENDS”)], and evaluates the public health impact of excise taxes levied on these products. Design/methodology/approach The paper reviews the economic research on the impact ENDS. Using cited evidence, the paper compares the tax treatment of ENDS and cigarettes and provides a simulation of potential lives that can be saved under alternative tax treatment of ENDS. Findings ENDS are considerably less harmful than cigarettes. Imposing the same tax burden on them (per unit of “harm”) as on cigarettes leads to poorer health outcomes. Differential tax treatment of ENDS will encourage more cigarette smokers to switch to ENDS and could save millions of lives worldwide. Research limitations/implications Country experiences with regulatory measures on ENDS are limited to those with high THRP penetration. The paper’s simulation analysis used evidence from a limited number of studies. Rigorous economic analysis is needed to understand how ENDS could save lives and could prevent expected one billion premature deaths by the end of this century. Originality/value The paper uses research evidence in its analysis of the impact that the differential taxation of cigarettes and ENDS would have. It also provides a rough estimate of the number of lives that could be saved if more smokers who are trying to quit can make the switch to ENDS.

scholarly journals The Public Health Implications of Brexit: A Health Impact Assessment Approach

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Green
Keyword(s):  
Public Health ◽  
Impact Assessment ◽  
Health Impact Assessment ◽  
Health Impact ◽  
Complex Nature ◽  
The Public ◽  
Wide Range ◽  
The Impact ◽  
The Eu ◽  
Public Bodies

Abstract On March 29th 2019, the United Kingdom (UK) was due to exit the EU in a process known informally as ’Brexit’. This exit and entry into a 2-year transition is a period of unprecedented political and social upheaval - with many unknowns and much uncertainty attached to the outcomes and future impact. In preparation for Brexit, Public Health Wales commissioned the Wales HIA Support Unit to carry out a health impact assessment of Brexit in Wales to support and inform its and other public bodies planning and future work. This paper examines the unique HIA carried out between July and December 2018 on the impact of the UK withdrawal from the EU in Wales. It discusses the robust, participatory process undertaken, the stakeholders involved and the benefits reaped from this. It highlights the evidence gathered and analysed including the collection methods, the complex nature of the work and disseminates the main findings from the HIA including the potential determinants of health and population groups identified. Finally, it describes the challenges faced, how these were overcome, and the huge benefits, impact and influence it has had to date across a wide range of UK and Welsh organisations and public bodies. This work demonstrates continued leadership in the field of impact assessment and spearheads the requirement for public bodies to carry out HIAs as part of the forthcoming statutory requirements of the Public Health (Wales) Act 2017 an can inform practice at a global level. Key messages HIA can inform and influence action in response to important strategic decisions. The Brexit HIA is a unique example which can inform international HIA practice.

scholarly journals Low 2018/19 vaccine effectiveness against influenza A(H3N2) among 15–64-year-olds in Europe: exploration by birth cohort

2019 ◽  
Vol 24 (48) ◽  
Author(s):  
Esther Kissling ◽  
Francisco Pozo ◽  
Silke Buda ◽  
Ana-Maria Vilcu ◽  
Alin Gherasim ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Influenza A ◽  
Influenza Infection ◽  
Age Groups ◽  
Health Impact ◽  
Vaccine Effectiveness ◽  
Aged Group ◽  
The Public ◽  
Cohort Differences ◽  
Negative Study

Introduction Influenza A(H3N2) clades 3C.2a and 3C.3a co-circulated in Europe in 2018/19. Immunological imprinting by first childhood influenza infection may induce future birth cohort differences in vaccine effectiveness (VE). Aim The I-MOVE multicentre primary care test-negative study assessed 2018/19 influenza A(H3N2) VE by age and genetic subgroups to explore VE by birth cohort. Methods We measured VE against influenza A(H3N2) and (sub)clades. We stratified VE by usual age groups (0–14, 15–64, ≥ 65-years). To assess the imprint-regulated effect of vaccine (I-REV) hypothesis, we further stratified the middle-aged group, notably including 32–54-year-olds (1964–86) sharing potential childhood imprinting to serine at haemagglutinin position 159. Results Influenza A(H3N2) VE among all ages was −1% (95% confidence interval (CI): −24 to 18) and 46% (95% CI: 8–68), −26% (95% CI: −66 to 4) and 20% (95% CI: −20 to 46) among 0–14, 15–64 and ≥ 65-year-olds, respectively. Among 15–64-year-olds, VE against clades 3C.2a1b and 3C.3a was 15% (95% CI: −34 to 50) and −74% (95% CI: −259 to 16), respectively. VE was −18% (95% CI: −140 to 41), −53% (95% CI: −131 to −2) and −12% (95% CI: −74 to 28) among 15–31-year-olds (1987–2003), 32–54-year-olds (1964–86) and 55–64-year-olds (1954–63), respectively. Discussion The lowest 2018/19 influenza A(H3N2) VE was against clade 3C.3a and among those born 1964–86, corresponding to the I-REV hypothesis. The low influenza A(H3N2) VE in 15–64-year-olds and the public health impact of the I-REV hypothesis warrant further study.

scholarly journals The global impact of the COVID-19 pandemic on the prevention, diagnosis and treatment of hepatitis B virus (HBV) infection

2021 ◽  
Vol 6 (1) ◽  
pp. e004275
Author(s):  
Caitlin M Pley ◽  
Anna L McNaughton ◽  
Philippa C Matthews ◽  
José Lourenço
Keyword(s):  
Public Health ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Low Income ◽  
Health Impact ◽  
Diagnosis And Treatment ◽  
Low Income Countries ◽  
The Public ◽  
B Virus ◽  
The Impact

The COVID-19 pandemic caused by the SARS-CoV-2 virus has resulted in a myriad of interventions with the urgent aim of reducing the public health impact of this virus. However, a wealth of evidence both from high-income and low-income countries is accruing on the broader consequences of such interventions on economic and public health inequalities, as well as on pre-existing programmes targeting endemic pathogens. We provide an overview of the impact of the ongoing COVID-19 pandemic on hepatitis B virus (HBV) programmes globally, focusing on the possible consequences for prevention, diagnosis and treatment. Ongoing disruptions to infrastructure, supply chains, services and interventions for HBV are likely to contribute disproportionately to the short-term incidence of chronic hepatitis B, providing a long-term source of onward transmission to future generations that threatens progress towards the 2030 elimination goals.

scholarly journals Estimating the health impact of vaccination against 10 pathogens in 98 low and middle income countries from 2000 to 2030

2019 ◽  
Author(s):  
Xiang Li ◽  
Christinah Mukandavire ◽  
Zulma M Cucunubá ◽  
Kaja Abbas ◽  
Hannah E Clapham ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Birth Cohort ◽  
Vaccine Coverage ◽  
Health Impact ◽  
Childhood Vaccination ◽  
Middle Income ◽  
Middle Income Countries ◽  
Life Years ◽  
The Impact ◽  
Low And Middle Income

AbstractBackgroundThe last two decades have seen substantial expansion of childhood vaccination programmes in low and middle income countries (LMICs). Here we quantify the health impact of these programmes by estimating the deaths and disability-adjusted life years (DALYs) averted by vaccination with ten antigens in 98 LMICs between 2000 and 2030.MethodsIndependent research groups provided model-based disease burden estimates under a range of vaccination coverage scenarios for ten pathogens: hepatitis B (HepB), Haemophilus influenzae type b (Hib), human papillomavirus (HPV), Japanese encephalitis (JE), measles, Neisseria meningitidis serogroup A (MenA), Streptococcus pneumoniae, rotavirus, rubella, yellow fever. Using standardized demographic data and vaccine coverage estimates for routine and supplementary immunization activities, the impact of vaccination programmes on deaths and DALYs was determined by comparing model estimates from the no vaccination counterfactual scenario with those from a default coverage scenario. We present results in two forms: deaths/DALYs averted in a particular calendar year, and in a particular annual birth cohort.FindingsWe estimate that vaccination will have averted 69 (2.5-97.5% quantile range 52-88) million deaths between 2000 and 2030 across the 98 countries and ten pathogens considered, 35 (29-45) million of these between 2000-2018. From 2000-2018, this represents a 44% (36-57%) reduction in deaths due to the ten pathogens relative to the no vaccination counterfactual. Most (96% (93-97%)) of this impact is in under-five age mortality, notably from measles. Over the lifetime of birth cohorts born between 2000 and 2030, we predict that 122 (96-147) million deaths will be averted by vaccination, of which 58 (39-75) and 38 (26-52) million are due to measles and Hepatitis B vaccination, respectively. We estimate that recent increases in vaccine coverage and introductions of additional vaccines will result in a 72% (61-79%) reduction in lifetime mortality caused by these 10 pathogens in the 2018 birth cohort.InterpretationIncreases in vaccine coverage and the introduction of new vaccines into LMICs over the last two decades have had a major impact in reducing mortality. These public health gains are predicted to increase in coming decades if progress in increasing coverage is sustained.

scholarly journals Understanding the Potential Impact of Different Drug Properties On SARS-CoV-2 Transmission and Disease Burden: A Modelling Analysis

2021 ◽  
Author(s):  
Charles Whittaker ◽  
Oliver J Watson ◽  
Carlos Alvarez-Moreno ◽  
Nasikarn Angkasekwinai ◽  
Adhiratha Boonyasiri ◽  
...  
Keyword(s):  
Public Health ◽  
Supportive Care ◽  
Low Income ◽  
Health Impact ◽  
Public Health Impact ◽  
The Public ◽  
Hospitalised Patients ◽  
Potential Impact ◽  
The Impact ◽  
Potential Therapeutics

Abstract Background The public health impact of the COVID-19 pandemic has motivated a rapid search for potential therapeutics, with some key successes. However, the potential impact of different treatments, and consequently research and procurement priorities, have not been clear. Methods Using a mathematical model of SARS-CoV-2 transmission, COVID-19 disease and clinical care, we explore the public-health impact of different potential therapeutics, under a range of scenarios varying healthcare capacity, epidemic trajectories; and drug efficacy in the absence of supportive care. Results The impact of drugs like dexamethasone (delivered to the most critically-ill in hospital and whose therapeutic benefit is expected to depend on the availability of supportive care such as oxygen and mechanical ventilation) is likely to be limited in settings where healthcare capacity is lowest or where uncontrolled epidemics result in hospitals being overwhelmed. As such, it may avert 22% of deaths in high-income countries but only 8% in low-income countries (assuming R=1.35). Therapeutics for different patient populations (those not in hospital, early in the course of infection) and types of benefit (reducing disease severity or infectiousness, preventing hospitalisation) could have much greater benefits, particularly in resource-poor settings facing large epidemics. Conclusions Advances in the treatment of COVID-19 to date have been focussed on hospitalised-patients and predicated on an assumption of adequate access to supportive care. Therapeutics delivered earlier in the course of infection that reduce the need for healthcare or reduce infectiousness could have significant impact, and research into their efficacy and means of delivery should be a priority.

scholarly journals THE IMPACT OF COVID-19 ON THE PERFORMANCE OF INTERNATIONAL COMMERCIAL CONTRACTS FOR THE SALE OF GOODS – FORCE MAJEURE AND HARDSHIP

2020 ◽  
Author(s):  
Ljuben Kocev
Keyword(s):  
International Trade ◽  
Negative Impact ◽  
Health Impact ◽  
Sales Contracts ◽  
Legal Perspective ◽  
Full Effect ◽  
Force Majeure ◽  
Entire World ◽  
The Impact ◽  
International Sales

The outbreak of COVID-19 has had massive negative impact across all industries and fields in the entire world. While the negative health impact is slowly stabilizing, the economic impact is in full effect and the harm is yet to be evaluated. On macroeconomic level, the necessary measures for combating the pandemic which were undertaken by governments have significantly restricted international trade. On microeconomic level, merchants and businesses are faced with inability or extreme obstacles in their daily operations and particularly in performing their international sales contracts. Failure to perform results in contractual breach and unwanted claims for damages. The paper addresses the impact which COVID-19 has on the performance of international commercial contracts for the sale of goods. The paper considers the impediments which may arise due to the pandemic outbreak and evaluates them from a legal perspective under the UN Convention on Contracts for the International Sale of Goods from 1980 (CISG), which is the main legal instrument governing international sales contracts. Particularly, the paper focuses on the question of exemption from liability in a situation where either of the contractual parties fails to perform and breaches an obligation. The evaluation is conducted through interpretation of the concepts of force majeure and hardship, as grounds for non-performance or contract renegotiation in light of the current situation.

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