scholarly journals Mandatory COVID-19 vaccination for oral health professionals (OHPs) - Ethical appraisal

2021 ◽  
Vol 76 (1) ◽  
pp. 42-45
Author(s):  
Thembelihle M Mtolo ◽  
Pagollang D Motloba ◽  
Neil H Wood

The recently detected South African variant, Covid-19, 501Y.V2 is more transmissible, though not virulent as the initial strain.1 The morbidity and mortality rates due to this variant have risen exponentially, putting huge pressure on the healthcare system, locally and globally. As a consequence the South African government imposed hard lockdown measures (level 3) as a means to curb the pandemic. Governments around the world are scrambling to obtain and roll-out Covid-19 vaccination programs to save lives and livelihoods. Most developed countries have initiated inoculations, amid widespread misinformation and hesitancy. Literature indicate that healthcare professionals (HCPs) are generally complacent and hesitant about vaccination. The COVID-19 uptake is likely to be suboptimal among HCPs and the general populations. The voluntary immunization program will commence in February 2021, and the Healthcare professionals will be among the first to be vaccinated. It remains to be seen if this cohort will achieve the desired vaccinations rates. Failure for this influential group to vaccinate could derail the program and lead to failure to achieve herd immunity. In the face of emerging vaccine hesitancy among HCPs, should oral health professionals be compelled to vaccinate? Will any refusal by OHPs to be immunized be morally justified? Oral health professionals in this context of this paper, represent all oral health professionals involved in the management dental patients. No singular ethical framework is held as sufficient to resolve these questions. This paper interrogates aspect of clinical ethics, including the Hippocratic Oath, principilism, public health ethics (Utilitarianism) and Kantian deontology, to tackle the questions raised. We conclude that OHPs have a moral duty to be vaccinated against Covid-19.

2021 ◽  
Vol 32 (7) ◽  
pp. 282-287
Author(s):  
Alison While

Vaccine hesitancy is a concern both globally and within the UK. Alison While reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations.


2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
João Gentil

Abstract Background In 2019, WHO classified vaccine hesitancy as one of the top 10 threats to global health. Vaccination is an area of excellence in nursing that has gained a new focus and has become a challenge in the provision of care and in the management field. Vaccine hesitation raises questions about mandatory vaccination, individual versus collective freedom that are highlighted in the current context due to the emergence of new vaccines. In this paper, we want to analyze and update knowledge about vaccines hesitancy from an ethical and bioethical perspective. Methods A combination of literature reviews on vaccine refusal/hesitancy, ethics and COVID-19 vaccine confidence, accessed on SciELO and PubMed databases and analysis of documents from General Directorate of Health and Ordem dos Enfermeiros (National Nurses Association). Results Vaccination programs aim is a collective protection. The desirable effects at individual level do not have the same ethical value at collective level, leading to cost-benefit imbalances. Moral conflicts between the individual and the collective, cost-benefit imbalances and the insufficiency of bioethics principles, lead us to the use of other moral values and principles, such as responsibility, solidarity and social justice, as a tool for ethical reflection problems related to COVID-19 vaccines. Conclusions There are no perfect solutions to ethical dilemmas and some optimal solutions could depend the context. In a pandemic situation, one of the most relevant ethical issues is the herd immunity since it leaves public health at risk. Equity and the principle of justice in vaccination campaign are shown daily in the nursing profession.


2020 ◽  
Vol 11 ◽  
pp. 147-159
Author(s):  
Pushkar Singh Raikhola ◽  
Krishna Prasad Pathak ◽  
Tara Gaire

The aim of this review was to synthesize the aggregated studies aimed at improving health care knowledge, detection practices and management of dementia among healthcare professionals (HPs). Healthcare professionals play a key role in the detection and management of dementia. However, there is a gap in the literature as to what represents best practice with regard to educating HPs in this area. We searched citation index Google scholar, Scopus and Pub Med, Medline, were searched for relevant articles from 2000-2019 without data limit. Inclusion criteria were (1) intervention studies aimed at improving HPs practices concerning dementia care (2) the educational intervention focused on knowledge, detection practice and management of dementia, and (3) peer-reviewed and written in English. Of 4968 articles identified, only 13 articles (six GPs, two clinical/organization care based, one nurse, one physician and affiliated staff and one with physician, manager and therapists based studies) were suitable for inclusion and these all were from developed countries. Seven studies were randomized controlled trials (RCTs), 1 prospective, 2 GPs and supervisors intervention, 1 cohort study, and 2 clinical /organizational care services clustered randomized study. Overall, the methodological quality of these studies was poor, particularly with regard to the methods utilized and sample sizes however, combined programs of, practice based workshops with community and multi-faced educational program were the most effective. The continuous educational intervention program can improve the health professionals’ diagnosis and management knowledge, confidents and negative perception of dementia. HPs should be Interventions Aimed at Improving Knowledge, Detection Practices and Management of Dementia among Health Professionals. Dr. Pushkar Singh Raikhola1 Dr. Krishna Prasad Pathak2 Tara Gaire3 1 Monitoring Directorate, Tribhuban University, Nepal 2 Nepal Open University, Nepal. Alzheimer Related Dementia Society Nepal. 3 Department of Nursing, Innovative health science college THE SAPTAGANDAKI JOURNAL 2055 B.S. Review Article148 The Saptagandaki Journal / Vol.Xi / Issue 11/ November 2020 / ISSN 2594-3243 (Print) supported to improve their knowledge, tackle behavioral problems associated with dementia, be made aware of services and be enabled to engage in more early diagnosis in primary care. Further intervention program should address the cultural change to facilitate long term improvements. Educational intervention program is crucial to the health professionals to get close to the diagnostic confidence.


2021 ◽  
Author(s):  
Xiao Chen ◽  
Hanwei Huang ◽  
Jiandong Ju ◽  
Ruoyan Sun ◽  
Jialiang Zhang

Abstract Governments worldwide are implementing mass vaccination programs in an effort to end the novel coronavirus (COVID-19) pandemic. Here, we evaluated the effectiveness of the COVID-19 vaccination program and predicted the path to herd immunity in the U.S. We estimated that vaccination reduced the total number of new cases by 4.4 million (from 33.0 to 28.6 million), prevented approximately 0.12 million hospitalizations (from 0.89 to 0.78 million), and decreased the population infection rate by 1.34 percentage points (from 10.10–8.76%). We built a Susceptible-Infected-Recovered (SIR) model with vaccination to predict herd immunity. Our model predicts that the U.S. can achieve herd immunity by the last week of July 2021, with a cumulative vaccination coverage of 60.2%. Herd immunity could be achieved earlier with a faster vaccination pace, lower vaccine hesitancy, and higher vaccine effectiveness. These findings improve our understanding of the COVID-19 vaccination and can inform future public health policies.


2021 ◽  
Vol 26 (6) ◽  
pp. 278-282
Author(s):  
Alison While

Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield ‘herd’ immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations. A second article will review the evidence relating to strategies to address vaccine hesitancy and promote vaccination acceptance.


Author(s):  
Daniel Carbone

Over the past 30 years the health framework in which doctors and other healthcare professionals practise has changed relatively little in comparison with the enormous changes seen in transport, manufacturing, and telecommunications (Yellowlees & Brooks, 1999). In Australia, the health system, like others in developed countries worldwide, is deteriorating quickly. Productivity commission reports, parliamentary inquiries, and numerous academic papers describe the current waste and lack of focus on outcomes in our health system (Weyden & Armstrong, 2004), at a time when communities and dedicated health professionals are screaming for the resources to provide acceptable care for their communities (Jackson, 2005).


Author(s):  
Serhat Sirekbasan

I would like to mention an issue discussed constantly these days in the light of scientific data. It would be best to start by answering a question everyone is curious about before we start the main topic. Will this virus go away? The answer is simply “No”. The virus will probably continue to exist together with us; however, one day, the pandemic will end. The only answer we can give to the question of how this pandemic will end is “scientific and social fight”. All countries throughout the entire world are fighting to control the spread of SARS-CoV-2. The most important among these global fights is proper medical treatment in addition to an early, rapid and accurate diagnosis. Besides, another aspect that will crown this fight is the vaccination programs. The success of this fight depends on people’s accepting the vaccines. A total of 10 of the vaccine candidates, which numbered more than 165 developed within a record time period, have achieved approval after their final stages of effectiveness tests on a large scale as of March when the whole world mobilized to produce vaccines to stop the pandemic. Unfortunately; however, a vaccine against COVID-19 is unlikely to provide full protection. Also, even if a safe and effective vaccine comes to be known, it will not be possible to reach adequate distribution worldwide within a short time period. It is estimated that the time for the distribution of a safe and effective vaccine to the population will be between the end of 2020 and early 2022. However, even in the presence of adequate vaccines, vaccination of a sufficient number of population cannot be guaranteed due to hesitations, indecisiveness, and oppositions to the vaccine. Although vaccination is considered to be one of the most successful public health measures, an increasingly growing number of people perceive it as unsafe and unnecessary. The lack of trust in vaccines comes before us as a threat to the success of vaccination programs. Hesitation, indecision, and opposition to vaccines is an extremely important issue and requires to be dealt with. As a matter of fact, vaccines, which save approximately 2-3 million lives each year, are among the greatest achievements of the past two centuries. Vaccines, which eliminated the smallpox disease successfully, also reduced the prevalence of many important diseases greatly, such as polio and measles. Today, more than 30 infectious diseases can be controlled on a worldwide scale with the existing licensed vaccines; and it is prevented that the limited public healthcare resources are spent in vain by decreasing the burden of infectious diseases that are preventable with vaccines on the healthcare system. The way to eliminate the detrimental effects of this pandemic depends on the implementation of effective and safe vaccines as soon as possible, and on maintaining this at high rates. An overall “herd immunity”, which will be achieved with high vaccination rates, will also limit the ability of the virus to spread. Of course, how long the protective immunity to vaccines will last will determine our future regarding the virus; however, it must be kept in mind that the uncertainty we are experiencing now regarding the condition of the pandemic stems from our attitudes about vaccine rejection rather than the immune response. In conclusion, the potential of vaccines to prevent diseases and save lives has never been more remarkable throughout history. However, the magnitude of the hesitations regarding the vaccines was not at such dimensions. As misinformation about vaccines spreads, public confusion also increases, and various hesitations occur against the vaccine. These hesitations prevent the success of scientists and the attempts to spread the vaccine. Attention should be paid not to spread misguiding information regarding the safety and effectiveness of immunization, explanations that may be misunderstood of especially those who do not know about the subject should be prevented, and necessary information should be provided regularly regarding the concerns of the public. In any case, the potential benefit of the existing effective vaccines depends on the adequate acceptance of them by society. For this reason, the most important task that stands out before us is to raise public awareness by informing society to eliminate hesitations regarding the vaccines to increase vaccine adaptation rates in the entire population.


2021 ◽  
Author(s):  
Naveen Siddique Sheikh ◽  
Mumtaz Touseef ◽  
Riddah Sultan ◽  
Kanwal Hassan Cheema ◽  
Sidra Shafiq Cheema ◽  
...  

Background and objectives: Vaccine hesitancy is a big obstacle for vaccination programs, as is anticipated for the COVID-19 vaccination program, resulting in low uptake of vaccines thereby hindering the process of reaching herd immunity. Bearing this in mind the current study was aimed to explore the determinants of vaccine hesitancy amongst the Pakistani population. Methodology: A cross-sectional study was carried out from the 23rd-31st January 2021. The conceptual framework of the study was based on the 3Cs (Confidence, Convenience, Complacency) model. Google-forms-based questionnaire was disseminated amongst the general population. Data collected were entered into SPSS version 26 and analyzed. Results: Of the 421 participants, 68.4% were females. Non-healthcare workers were 55.8% of respondents. Vaccine hesitant individuals, 26.13% reported they were very unlikely to get vaccinated. Vaccine was not safe as it came out too fast was agreed upon by 12.6% individuals, 50.6% were worried about experiencing side-effects, 18% believed vaccine will not offer protection and 5.9% believed vaccine would cause death. Low Practice of SOP in non-Healthcare workers was the strongest contributor to vaccine hesitancy (OR: 5.338, p=0.040, 95% CI: 1.082-26.330) followed by High complacency (p=0.026) and Moderate Complacency (OR: 0.212, p=0.007, 95% CI: 0.069-0.654) towards COVID-19 vaccination. In Healthcare workers the strongest contributor to vaccine hesitancy was having a Moderate Confidence (OR: 0.323, p=0.042, 95% CI: 0.109-0.958) in the vaccine followed by Moderate Convenience (OR: 0.304, p=0.049, 95% CI: 0.093-0.993) for vaccination Conclusion: Campaigning and communication strategies to reaffirm confidence in the COVID-19 vaccine and educating the general population about the vaccine could lead to increased perception of vaccine safety and effectiveness thereby restoring confidence in vaccine and decreasing vaccine hesitancy. Likewise, working to increase vaccine convenience and decreasing complacency towards the COVID-19 vaccine would translate into high vaccine uptake.


Author(s):  
Sara Fernández-Basanta ◽  
Manuel Lagoa-Millarengo ◽  
María-Jesús Movilla-Fernández

(1) Background: Health professionals play an important role in addressing parents who are hesitant or reluctant to immunise their children. Despite the importance of this topic, gaps remain in the literature about these experiences. This meta-ethnography aimed to synthesise the available body of qualitative work about the care experiences of community and hospital health professionals in encounters with parents hesitant or reluctant to vaccinate their children. The aim is to provide key information for the creation of strategies that address vaccine hesitancy or refusal and ensure public trust in vaccination programs, which are required in a pandemic context such as the current one. (2) Methods: Noblit and Hare’s interpretive meta-ethnography of 12 studies was followed. A line of argument synthesis based on a metaphor was developed. (3) Results: The metaphor “The stone that refuses to be sculpted”, accompanied by three themes, symbolises the care experiences of health professionals in their encounters with parents that hesitate or refuse to vaccinate their children. (4) Conclusions: The creation of clearer communication strategies, the establishment of a therapeutic alliance, health literacy and the empowerment of parents are recommended. The incorporation of health professionals in decision making and the strengthening of multidisciplinary teams interacting with such parents are also included.


2021 ◽  
Vol 12 ◽  
pp. 215013272110366
Author(s):  
Travis S. Dowdle ◽  
Jeff Dennis ◽  
Kenneth M. Nugent ◽  
Theresa Byrd

Objectives: Understanding vaccine intentions and attitudes of health professionals is critical as the Pfizer-BioNTech and the Moderna COVID19 vaccines are being administered throughout the United States. This study estimates the level of vaccine hesitancy at a health sciences center in West Texas prior to the distribution of the vaccines. Methods: An analytical cross-sectional study was performed via anonymous Qualtrics survey administered to approximately 4500 faculty, staff, postdoctoral research associates/medical residents, and employees at a multi-campus health sciences university in the United States. Respondents were asked demographic questions and intention to receive the vaccine. Factors associated with the intention to receive a vaccine were determined using logistic regression analysis. Results: A total sample of 2258 subjects were evaluated (50.0% response rate). Among all respondents, 64.6% reported that they would probably or definitely receive the COVID-19 vaccine. Men had higher levels of intention to receive the vaccine (OR = 2.11, 95% CI 1.64-2.71); respondents who indicated yearly influenza vaccines are necessary were also more likely to receive the vaccine (OR = 6.04, 95% CI 4.70-7.75). Eighty-three percent of faculty and 56% of the staff reported intention to receive the vaccine. Respondents who had previously tested positive for COVID-19 reported more interest in receiving the vaccine (58.5% yes vs 41.5% no). Conclusion: In this study, the intention to receive the COVID-19 vaccination at a United States health sciences center falls below the necessary herd immunity estimates. Public health initiatives must be developed to decrease vaccine hesitancy, especially among health professionals.


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