scholarly journals The biggest challenge in the fight against the COVID-19 pandemic: Vaccine hesitancy

2021 ◽  
pp. 3-5
Author(s):  
Serhat Sirekbasan
Keyword(s):  
Infectious Diseases ◽  
Large Scale ◽  
Public Awareness ◽  
Herd Immunity ◽  
Scientific Data ◽  
Vaccine Hesitancy ◽  
Effective Vaccine ◽  
Public Healthcare ◽  
Vaccination Programs ◽  
Time Period

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.

scholarly journals Estimating asymptomatic, undetected and total cases for the COVID-19 outbreak in Wuhan: a mathematical modeling study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xi Huo ◽  
Jing Chen ◽  
Shigui Ruan
Keyword(s):  
Disease Transmission ◽  
Large Scale ◽  
Transmission Rate ◽  
Control Strategies ◽  
Herd Immunity ◽  
Antibody Prevalence ◽  
Screening Process ◽  
Vaccination Programs ◽  
Prevalence Level ◽  
The Impact

Abstract Background The COVID-19 outbreak in Wuhan started in December 2019 and was under control by the end of March 2020 with a total of 50,006 confirmed cases by the implementation of a series of nonpharmaceutical interventions (NPIs) including unprecedented lockdown of the city. This study analyzes the complete outbreak data from Wuhan, assesses the impact of these public health interventions, and estimates the asymptomatic, undetected and total cases for the COVID-19 outbreak in Wuhan. Methods By taking different stages of the outbreak into account, we developed a time-dependent compartmental model to describe the dynamics of disease transmission and case detection and reporting. Model coefficients were parameterized by using the reported cases and following key events and escalated control strategies. Then the model was used to calibrate the complete outbreak data by using the Monte Carlo Markov Chain (MCMC) method. Finally we used the model to estimate asymptomatic and undetected cases and approximate the overall antibody prevalence level. Results We found that the transmission rate between Jan 24 and Feb 1, 2020, was twice as large as that before the lockdown on Jan 23 and 67.6% (95% CI [0.584,0.759]) of detectable infections occurred during this period. Based on the reported estimates that around 20% of infections were asymptomatic and their transmission ability was about 70% of symptomatic ones, we estimated that there were about 14,448 asymptomatic and undetected cases (95% CI [12,364,23,254]), which yields an estimate of a total of 64,454 infected cases (95% CI [62,370,73,260]), and the overall antibody prevalence level in the population of Wuhan was 0.745% (95% CI [0.693%,0.814%]) by March 31, 2020. Conclusions We conclude that the control of the COVID-19 outbreak in Wuhan was achieved via the enforcement of a combination of multiple NPIs: the lockdown on Jan 23, the stay-at-home order on Feb 2, the massive isolation of all symptomatic individuals via newly constructed special shelter hospitals on Feb 6, and the large scale screening process on Feb 18. Our results indicate that the population in Wuhan is far away from establishing herd immunity and provide insights for other affected countries and regions in designing control strategies and planing vaccination programs.

scholarly journals Vaccine refusal/hesitancy—the ethical point of view

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
João Gentil
Keyword(s):  
Ethical Issues ◽  
Vaccination Campaign ◽  
Herd Immunity ◽  
Cost Benefit ◽  
Point Of View ◽  
Vaccine Hesitancy ◽  
Moral Conflicts ◽  
Vaccination Programs ◽  
Individual Level ◽  
Vaccine Refusal

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.

scholarly journals Impact of Vaccination on the COVID-19 Pandemic: Evidence from U.S. States

2021 ◽  
Author(s):  
Xiao Chen ◽  
Hanwei Huang ◽  
Jiandong Ju ◽  
Ruoyan Sun ◽  
Jialiang Zhang
Keyword(s):  
Herd Immunity ◽  
Sir Model ◽  
Health Policies ◽  
Vaccine Hesitancy ◽  
The Novel ◽  
Vaccination Programs ◽  
Public Health Policies ◽  
Percentage Points ◽  
Novel Coronavirus ◽  
The U.S

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.

scholarly journals Brief exposure of skin to near-infrared laser augments early vaccine responses

Nanophotonics ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Shinya Yokomizo ◽  
Wataru Katagiri ◽  
Yohei Maki ◽  
Tomoya Sano ◽  
Kazumasa Inoue ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Leucine Zipper ◽  
Near Infrared ◽  
Immunoglobulin E ◽  
Critical Role ◽  
Herd Immunity ◽  
Emerging Infectious Diseases ◽  
Basic Leucine Zipper ◽  
Vaccination Programs ◽  
Nir Laser

Abstract Rapid establishment of herd immunity with vaccination is effective to combat emerging infectious diseases. Although the incorporation of adjuvant and intradermal (ID) injection could augment early responses to the vaccine, the current chemical or biological adjuvants are inappropriate for this purpose with their side effects and high reactogenicity in the skin. Recently, a near-infrared (NIR) laser has been shown to augment the immune response to ID vaccination and could be alternatively used for mass vaccination programs. Here, we determined the effect of NIR laser as well as licensed chemical adjuvants on the immunogenicity 1, 2, and 4 weeks after ID influenza vaccination in mice. The NIR laser adjuvant augmented early antibody responses, while the widely used alum adjuvant induced significantly  delayed responses. In addition, the oil-in-water and alum adjuvants, but not the NIR laser, elicited escalated TH2 responses with allergenic immunoglobulin E (IgE) responses. The effect of the NIR laser was significantly suppressed in the basic leucine zipper transcription factor ATF-like 3 (Batf3) knockout mice, suggesting a critical role of the cluster of differentiation 103+ (CD103)+ dendritic cells. The current preliminary study suggests that NIR laser adjuvant is an alternative strategy to chemical and biological agents to timely combat emerging infectious diseases. Moreover, its immunomodulatory property could be used to enhance the efficacy of immunotherapy for allergy and cancer.

scholarly journals Mathematical Epidemiological Model of the Propagation and Prevention of Infectious Diseases Considering COVID-19 Vaccination

2021 ◽  
Author(s):  
Kazumi Omata ◽  
Hiroaki Mitsuya
Keyword(s):  
Infectious Diseases ◽  
Time Scale ◽  
Reproduction Number ◽  
Herd Immunity ◽  
Epidemiological Studies ◽  
Human Populations ◽  
Future Scenarios ◽  
Vaccination Programs ◽  
Asymptotic Nature ◽  
Alternative Approach

Abstract The duration of the necessity of current restrictions and preventive countermeasures against the COVID-19 pandemic is of great concern. While several previous epidemiological studies have discussed controlling the course of the epidemic with regard to social distancing, vaccination, care capacities, and future scenarios, we adopt an alternative approach to provide insights into the time scale of epidemic propagation in human populations. We show that the reproduction number modified by preventive countermeasures Rm implies a threshold R~m to reach the herd immunity level at time Th. While Th varies moderately for large Rm, it increases sharply around Rm=R~m, and Th is infinite below Rm=R~m. The transition region for this increase is minute, demonstrating that prevention of infectious diseases must consider the relatively asymptotic nature of their propagation, which varies unpredictably between steady transmission and explosive outbreaks. These results suggest the continuation of preventive countermeasures to suppress the transmission of COVID-19 for many years; if they were discontinued or reduced such that Rm exceeded R~m, the disease would be transmitted throughout the considered community, and the required herd immunity level would be reached within 250 days if Rm > 1.6. However, the implementation of vaccination programs could drastically alter this dynamic.

scholarly journals COVID-19 Vaccination Efforts: Is Afghanistan Prepared?

2021 ◽  
Author(s):  
Mohammad Faisal Wardak ◽  
Ali Rahimi ◽  
Attaullah Ahmadi ◽  
Shekiba Madadi ◽  
Shamim Arif ◽  
...  
Keyword(s):  
Public Health ◽  
Large Scale ◽  
Public Trust ◽  
Cold Chain ◽  
Vaccine Hesitancy ◽  
Successful Implementation ◽  
Cultural Issues ◽  
Vaccination Programs ◽  
Fully Integrated ◽  
Control And Prevention

A country’s preparedness for a prompt and successful implementation of vaccination programs plays a pivotal role in disease control and prevention. As it stands now, Afghanistan seems to be ill-prepared to embrace a successful implementation of the COVID-19 vaccination program because of a spate of challenges. These include, but are not limited to, the insufficient number of vaccinators, a dearth of fully integrated functioning cold chain, challenging geographical barriers, cultural issues, insecurity, and protracted conflict. The COVID-19 infodemic along with vaccine mistrust in the country will lead to a pervasive public vaccine hesitancy in Afghanistan, which will present serious obstacles to the COVID-19 immunization efforts. The politicization of the Ministry of Public Health (MoPH) and the complaints of embezzlement and misuse of the pandemic aid have already eroded public trust during the pandemic. To ensure a large-scale and equitable distribution of COVID-19 vaccines, the cold chain infrastructure should be strengthened, and the immunization personnel trained. Antivaccination propaganda and misinformation should be tackled with effective communication approaches and effective community engagement, which consider culturally relevant messages appropriate to the culture and people. The allegations of corruption should be addressed to revive public trust in public health interventions, including COVID-19 vaccination.

scholarly journals Understanding COVID-19 vaccine hesitancy in Pakistan: The paradigm of Confidence, Convenience and Complacency; A Cross-sectional study.

2021 ◽  
Author(s):  
Naveen Siddique Sheikh ◽  
Mumtaz Touseef ◽  
Riddah Sultan ◽  
Kanwal Hassan Cheema ◽  
Sidra Shafiq Cheema ◽  
...  
Keyword(s):  
General Population ◽  
Healthcare Workers ◽  
Herd Immunity ◽  
Population Data ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vaccination Programs

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.

scholarly journals Information about herd immunity and empathy promote COVID-19 vaccination intentions

2020 ◽  
Author(s):  
Stefan Pfattheicher ◽  
Michael Bang Petersen ◽  
Robert Böhm
Keyword(s):  
Herd Immunity ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Effective Vaccine ◽  
Evidence Based ◽  
High Uptake ◽  
Present Contribution ◽  
Uptake Rates ◽  
The Uk ◽  
Affective Information

Objective: An effective vaccine against COVID-19 is a desired solution to curb the spread of the disease. However, vaccine hesitancy might hinder high uptake rates and thus undermine efforts to eliminate COVID-19 once an effective vaccine is available. The present contribution addresses this issue by examining two promising ways of increasing the intention to get vaccinated against COVID-19.Methods: We conducted two pre-registered online studies (N = 2,315 participants from the UK) in which we either measured (Study 1) or manipulated (Study 2) knowledge about and beliefs in herd immunity, as well as empathy for those most vulnerable to the virus. As a dependent variable, we assessed individuals’ self-reported vaccination intention if a vaccine against COVID-19 became available.Results: We show that the motivation to get vaccinated against COVID-19 is related to and causally promoted by both mere information about herd immunity and by empathy. Thus, interventions that combine cognitive and affective information related to others’ potential suffering appear most effective in increasing the intention to get vaccinated against COVID-19.Conclusions: The present research provides a better understanding of the intention to get vaccinated against COVID-19 and highlights two evidence-based possibilities for policymakers in promoting vaccine uptake.

scholarly journals A Systems Map to Elucidate the Factors Influencing Vaccine Coverage

2019 ◽  
Vol 3 (1) ◽  
pp. 115-150
Author(s):  
Ellie Cassandra Clark ◽  
Florian De Rop ◽  
Iria Anne Jimenez Garcia ◽  
Ana Nogal Macho ◽  
Ruel Alexander Mannette ◽  
...  
Keyword(s):  
Decision Making ◽  
Vaccination Coverage ◽  
Vaccine Coverage ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Wicked Problem ◽  
Sources Of Information ◽  
Contributing Factors ◽  
Vaccination Programs ◽  
Vaccine Confidence

Abstract This abstract is a report of the investigations by a transdisciplinary team working on the ‘Vaccine Confidence’ challenge (Supplement 1). Since their introduction, vaccines have been one of the most successful health interventions in medicine. Prior to vaccination programs against poliomyelitis, more than 350,000 cases of polio were reported annually worldwide, a number that decreased to just 33 reported cases in 20181. Additionally, between 2000 and 2017, the measles vaccination program is estimated to have prevented 21.1 million deaths.2 However, in 2018 more than 19 million children under one year of age did not receive the recommended WHO vaccines.3 A recent rise in anti-vaccine or vaccination-hesitant mentalities has led to decreasing vaccine coverage in several Western countries. The WHO identified three C’s as main determinants of vaccine hesitancy, namely Complacency, Convenience in accessing vaccines, and Confidence. However, the term ‘vaccine hesitancy’ tends to be interpreted as a lack of confidence in vaccines and vaccinations for various reasons. Nevertheless, the goal of vaccination is to reach herd immunity by reaching a high vaccination coverage (90‐95% vaccinated) to stop the circulation of vaccine preventable diseases. We wanted to give equal attention to the three C’s as they are equally important in reaching herd immunity. <target target-type="page-num" id="p-116"/>Therefore, we chose to present the problem as a challenge of ‘vaccine coverage,’ rather than ‘vaccine hesitancy’ or ‘vaccine confidence’. In order to understand the complexity of the problem, we have developed a systems map which relates different global factors that impact an individual’s vaccination decision-making, as well as their likelihood of receiving vaccinations (Supplement 2). To create this map we assembled the information for the variables and connections from literature studies of peer-reviewed articles and interviews with stakeholders, kept anonymous, in the field of vaccination or healthcare (Supplements 3 & 4). This approach was selected as it provides a wide perspective that allows academics, governmental authorities, and lawmakers to better assess the various factors that affect vaccine coverage, and how they are related. The work leading to the map was presented to the public at a symposium (Supplement 5). Our map identifies essential factors such as psychology, education, economy, vaccine technology, political and environmental sphere, sources of information, and healthcare in order to understand what governs vaccination coverage. The map emphasizes how various factors and determinants are often interrelated, as opposed to the isolated factors described in previous literature. We identified important discrepancies between developed and developing countries regarding the factors that drive vaccine-related decision-making and availability. The systems map could ultimately serve as a tool to better understand the multifaceted problem of suboptimal vaccination coverage. Vaccine hesitancy as a threat to vaccination coverage is a complex and wicked problem with many underlying contributing factors, as has been depicted in our systems map on vaccine coverage. Our systems map allows more in-depth insights, not only into which factors are contributing, but also into the relationship between factors. Solving the decrease in vaccination coverage will require different types of solutions which can be developed by using a transdisciplinary approach.

scholarly journals Assessing the distribution and determinants of vaccine underutilization in the United States

2017 ◽  
Author(s):  
Sandra Goldlust ◽  
Elizabeth C. Lee ◽  
Murali Haran ◽  
Pejman Rohani ◽  
Shweta Bansal
Keyword(s):  
United States ◽  
Large Scale ◽  
Herd Immunity ◽  
The United States ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Economic Determinants ◽  
Vaccine Preventable Diseases ◽  
Coverage Rates ◽  
Public Health Strategies

AbstractDespite advances in sanitation and immunization, vaccine-preventable diseases remain a significant cause of morbidity and mortality worldwide. In high-income countries such as the United States, coverage rates for vaccination against childhood infections remains high. However, the phenomenon of vaccine hesitancy makes maintenance of herd immunity difficult, impeding global disease eradication efforts. Reaching the ‘last mile’ will require early detection of vaccine hesitancy (driven by philosophical or religious choices), identifying pockets of susceptibility due to underimmunization (driven by vaccine unavailability, costs ineligibility), determining the factors associated with the behavior and developing targeted strategies to ameliorate the concerns. Towards this goal, we harness high-resolution medical claims data to geographically localize vaccine refusal and underimmunization (collectively, ‘underutilization’) in the United States and identify the socio-economic determinants of the behaviors. Our study represents the first large-scale effort for vaccination behavior surveillance and has the potential to aid in the development of targeted public health strategies for optimizing vaccine uptake.

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