scholarly journals Global acceptance and hesitancy of COVID-19 vaccination: A narrative review

Narra J ◽  
2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Wardah Hassan ◽  
Syeda K. Kazmi ◽  
Muhammad J. Tahir ◽  
Irfan Ullah ◽  
Hibban Ar Royan ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Vaccine Coverage ◽  
Herd Immunity ◽  
Acceptance Rate ◽  
Vaccine Acceptance ◽  
Middle Income ◽  
Vaccination Programs ◽  
Effective Strategies ◽  
Middle Income Countries ◽  
Global Population

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major global health threat to human civilization and has disrupted many aspects of the community around the globe. Vaccination is one of the prominent measures to control the COVID-19 pandemic. More than 120 vaccines have entered human clinical trials and at least 8 vaccines have been fully approved. However, the success of the COVID-19 vaccination programs depends on how the community accepts the vaccines. Despite COVID-19 vaccination having been initiated for a while now, more than 50% of the global population have not been vaccinated. In some low- and middle-income countries (LMICs), the vaccine coverage is less than 20%. Since the decision to accept the new vaccine is complex, understanding the factors underpinning vaccine acceptance is critical. This review aimed to summarize the COVID-19 vaccine acceptance rate around the globe as well as its associated determinants. Information from this study might be important to formulate effective strategies to increase the COVID-19 vaccine coverage, and to be able to achieve herd immunity.

scholarly journals Cost-effectiveness of COVID-19 vaccination in low- and middle-income countries

2021 ◽  
Author(s):  
Mark J. Siedner ◽  
Christopher Alba ◽  
Kieran P. Fitzmaurice ◽  
Rebecca F. Gilbert ◽  
Justine A. Scott ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vaccine Coverage ◽  
Economic Benefits ◽  
Middle Income ◽  
Vaccination Programs ◽  
Middle Income Countries ◽  
One Year ◽  
The Cost ◽  
Benefits And Costs ◽  
Low And Middle Income

Despite the advent of safe and highly effective COVID-19 vaccines, pervasive inequities in global distribution persist. In response, multinational partners have proposed programs to allocate vaccines to low- and middle-income countries (LMICs). Yet, there remains a substantial funding gap for such programs. Further, the optimal vaccine supply is unknown and the cost-effectiveness of investments into global vaccination programs has not been described. We used a validated COVID-19 simulation model8 to project the health benefits and costs of reaching 20%-70% vaccine coverage in 91 LMICs. We show that funding 20% vaccine coverage over one year among 91 LMICs would prevent 294 million infections and 2 million deaths, with 26 million years of life saved at a cost of US$6.4 billion, for an incremental cost effectiveness ratio (ICER) of US$250/year of life saved (YLS). Increasing vaccine coverage up to 50% would prevent millions more infections and save hundreds of thousands of additional lives, with ICERs below US$8,000/YLS. Results were robust to variations in vaccine efficacy and hesitancy, but were more sensitive to assumptions about epidemic pace and vaccination costs. These results support efforts to fund vaccination programs in LMICs and complement arguments about health equity, economic benefits, and pandemic control11.

scholarly journals A framework for designing medical devices resilient to low-resource settings

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Davide Piaggio ◽  
Rossana Castaldo ◽  
Marco Cinelli ◽  
Sara Cinelli ◽  
Alessia Maccaro ◽  
...  
Keyword(s):  
Delphi Study ◽  
Middle Income ◽  
Low Resource Settings ◽  
Health Technologies ◽  
Low Resource ◽  
Middle Income Countries ◽  
High Resource ◽  
International Experts ◽  
Global Population ◽  
Different Parts

Abstract Background To date (April 2021), medical device (MD) design approaches have failed to consider the contexts where MDs can be operationalised. Although most of the global population lives and is treated in Low- and Middle-Income Countries (LMCIs), over 80% of the MD market share is in high-resource settings, which set de facto standards that cannot be taken for granted in lower resource settings. Using a MD designed for high-resource settings in LMICs may hinder its safe and efficient operationalisation. In the literature, many criteria for frameworks to support resilient MD design were presented. However, since the available criteria (as of 2021) are far from being consensual and comprehensive, the aim of this study is to raise awareness about such challenges and to scope experts’ consensus regarding the essentiality of MD design criteria. Results This paper presents a novel application of Delphi study and Multiple Criteria Decision Analysis (MCDA) to develop a framework comprising 26 essential criteria, which were evaluated and chosen by international experts coming from different parts of the world. This framework was validated by analysing some MDs presented in the WHO Compendium of innovative health technologies for low-resource settings. Conclusions This novel holistic framework takes into account some domains that are usually underestimated by MDs designers. For this reason, it can be used by experts designing MDs resilient to low-resource settings and it can also assist policymakers and non-governmental organisations in shaping the future of global healthcare.

scholarly journals Effective Strategies for Global Health Training Programs A Systematic Review of Training Outcomes in Low and Middle Income Countries

2016 ◽  
Vol 8 (11) ◽  
pp. 278 ◽  
Author(s):  
Aprill Z. Dawson ◽  
Rebekah J. Walker ◽  
Jennifer A. Campbell ◽  
Leonard E. Egede
Keyword(s):  
Medical Training ◽  
Skills Training ◽  
High Income ◽  
Training Methods ◽  
Middle Income ◽  
Training Outcomes ◽  
Effective Strategies ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Low And Middle Income

<p><strong>INTRODUCTION: </strong>Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.</p><p><strong>METHODS: </strong>Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.</p><p><strong>RESULTS: </strong>Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.</p><p><strong>DISCUSSION:</strong> Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.</p>

scholarly journals EXPLORING COVID-19 VACCINE ACCEPTANCE AND HESITANCY DETERMINANTS

2021 ◽  
Vol 03 (01) ◽  
pp. 80-91
Author(s):  
Tauheed Zahra ◽  
◽  
Farhan Ahmad Faiz ◽  
Farrah Ahmed ◽  
◽  
...  
Keyword(s):  
Educational Background ◽  
Vital Role ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Social Worlds ◽  
Vaccine Acceptance ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Health Organization

The World Health Organization recognizes vaccine related myths and conspiracies as the world's top threat to public health safety, particularly in low middle-income countries. The current study aims to explore the beliefs of the general public towards the vaccine acceptance and the hesitancy. The study explicates the COVID 19 vaccine acceptance and hesitancy determinants through an in-depth qualitative approach. A total of 30 male and female millennials from different education backgrounds were interviewed through an interview guide. This study reveals that people have different beliefs related to the vaccine authenticity which plays a vital role in the reluctance towards it. Findings from paper is similar to literature that people from good educational background have similar thoughts towards COVID 19 vaccination. Disregard for the vaccine was caused by various factors, such as misinformation, safety concerns, and personal knowledge. This level of distrust was associated with the social worlds that participants experienced during the pandemic. COVID-19 vaccine hesitancy is a complex relationship that involves the spread of misinformation. Vaccine programs should provide a focused, localized, and empathetic response to counter misinformation. Keywords: COVID-19, vaccines, myths, hesitancy, vaccines awareness, pandemic, conspiracy, corona virus

scholarly journals Determinants of COVID-19 Vaccine Acceptance in Six Lower- and Middle-Income Countries

2021 ◽  
Author(s):  
Adugna Kebede ◽  
Robert Kanwagi ◽  
Asrat Dibaba Tolossa ◽  
Md Abul Kalam ◽  
Thomas Davis ◽  
...  
Keyword(s):  
Perceived Risk ◽  
P Value ◽  
Negative Consequences ◽  
Vaccine Acceptance ◽  
Middle Income ◽  
Perceived Safety ◽  
Middle Income Countries ◽  
Advantages And Disadvantages ◽  
Vaccine Refusal ◽  
Behavioural Determinants

Abstract Background: While a vaccine is the only clinical preventive measure to control the infection and mortality caused by SARS-CoV-2 (COVID-19), delayed acceptance or refusal of COVID-19 vaccines may increase and prolong the threat to global public health and the economy. Identifying behavioural determinants is considered a critical step in explaining and addressing the barriers of vaccine refusal, but there is a lack of evidence around COVID-19 vaccine refusal and delay from a behavioural perspective. This study aims to identify the behavioural determinants of COVID-19 vaccine acceptance and provide recommendations to design actionable interventions to increase the uptake of the COVID-19 vaccine in six lower-and-middle income countries. Methods: Taking into consideration the Health Belief Model (HBM), Theory of Reasoned Action (TRA), and other behavioural models, a Barrier Analysis (BA) approach was employed to examine twelve potential behavioural determinants of vaccine acceptance in Bangladesh, India, Myanmar, Kenya, the Democratic Republic of Congo, and Tanzania. In all six countries, at least 45 interviews with those who intended to take the vaccine (“Acceptors”) and another 45 or more interviews with those who did not (“Non-Acceptors”) were conducted, totalling 542 interviews. Data analysis was performed to find statistically significant (a p-value of less than 0.05) differences between Acceptors and Non-acceptors and to identify which beliefs were most highly associated with acceptance and non-acceptance of the behaviour based on estimated relative risk (ERR). Results: The analysis showed that perceived social norms, perceived positive and negative consequences, perceived risk of getting COVID-19, perceived severity of COVID-19, trust in COVID-19 vaccines, perceived safety of COVID-19 vaccines, and expected access to COVID-19 vaccines had the highest association with COVID-19 vaccine acceptance in Bangladesh, Kenya, Tanzania, and DRC. Additional behavioural determinants found to be significant in both Myanmar and India were perceived self-efficacy, trust in COVID-19 information provided by leaders, perceived divine will, and perceived action efficacy of the COVID-19 vaccines. The study also identified important perceptions and beliefs around COVID-19 and its severity, advantages and disadvantages of being vaccinated, and action efficacy of the vaccine to control the spread of the virus. Conclusion: Many of the determinants found to be significant and their level of significance varied from country to country. National and local plans should include messages and activities that address the behavioural determinants found in this study in order to significantly increase the uptake of COVID-19 vaccine across these countries.

scholarly journals Change in Measles Vaccine Coverage and Estimated Impact on Measles Mortality in Low and Middle Income Countries, 2020: An Investigation into Secondary Public Health Effects of the COVID-19 Pandemic Using the Lives Saved Tool

2021 ◽  
Author(s):  
Lucy Claire Gregory
Keyword(s):  
Public Health ◽  
Health Effects ◽  
Vaccine Coverage ◽  
Surveillance Systems ◽  
Measles Vaccine ◽  
Middle Income ◽  
Middle Income Countries ◽  
National Immunization ◽  
Lives Saved Tool ◽  
Low Middle Income Countries

With the global COVID-19 pandemic, many public health services were severely disrupted. Estimating the overall health effects of this is difficult as most disease surveillance systems have also been substantially affected during the pandemic. For some diseases, this effect is mitigated by the methods enacted to fight the pandemic, such as use of facial coverings, social distancing and quarantine, but measles is infectious to the degree that this mitigation is likely to be limited. Thus, outbreaks and an increase in global measles mortality are expected. However, the severity of this impact is not yet known. In early 2020, a study by Roberton and colleagues predicted an additional 12,360 to 37,920 deaths in children under-five worldwide from measles over the coming year based on three potential levels of vaccine coverage reductions ranging from 18.5 to 51.9%. Our study investigates the magnitude of the increase in measles mortality due to decreased vaccine coverage because of COVID-19, based on official estimates of 2020 measles vaccine coverage from WHO/UNICEF released in July 2021. Using the Lives Saved Tool (LiST), an interventions modeling program, we estimated measles mortality for low/middle income countries (LMICs) based on the 2020 WHO/UNICEF estimates of national immunization coverage (WUENIC). Because these calculations use actual reported vaccine coverage, they provide a more accurate picture of measles mortality related to COVID-19 disruptions in 2020. Using the WUENIC data, LiST predicted fewer additional deaths in 2020 due to decreases in measles vaccine coverage than estimations made by LiST based on Roberton, 2020 due to remarkable recovery efforts by national immunization programmes in the second half of 2020.

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