Mandatory vaccination against COVID-19 would be supported by less than fifty per cent: A Twitter poll analysis on public health opinion. (Preprint)

BACKGROUND On January 30, 2020, the World Health Organization (WHO) Emergency Committee declared the rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) a global health emergency. By December 2020, the safety and efficacy of the first COVID-19 vaccines had been demonstrated. However, global vaccination coverage rates have remained below expectations. Mandatory vaccination is now being controversially discussed and has been enacted in some developed countries, while the vaccination rate is very low in many developing countries. We used the Twitter survey system as a viable method to quickly and comprehensively gather international public health insights on mandatory vaccination against COVID-19. OBJECTIVE The purpose of this study was to understand better the public's perception of mandatory COVID-19 vaccination in real-time utilizing Twitter polls. METHODS Two Twitter polls were developed to seek the public's opinion on the possibility of mandatory vaccination. The polls were pinned to the Digital Health and Patient Safety Platform's Twitter timeline for one week in mid-November 2021, three days after the official public announcement of mandatory COVID-19 vaccination in Austria. Twitter users were asked to participate and retweet the polls to reach the largest possible audience. RESULTS Our Twitter polls revealed two extremes on the topic of mandatory vaccination against COVID-19. Almost half of the respondents (49% [1,246/2,545]) favour mandatory vaccination, at least in certain areas. This attitude is in contrast to the 45.7% (1,162/2,545) who categorically reject mandatory vaccination. 26.3% (621/2,365) of participating Twitter users said they would never get vaccinated, which is reflected by the current vaccination coverage rate. Concatenating interpretation of these two polls needs to be done cautiously as participating populations might greatly differ. CONCLUSIONS Mandatory vaccination against COVID-19 (in at least certain areas) is favoured by less than 50%, whereas it is vehemently opposed by almost half of the surveyed Twitter users. Since (social) media strongly influences public perceptions and views through and social media discussions and surveys specifically susceptible to the "echo chamber effect", the results can be seen as a momentary snapshot. Therefore, the results of this study need to be complemented by long-term surveys to maintain their validity.

Tracking the uptake and trajectory of COVID-19 vaccination coverage in 15 West African countries: an interim analysis

The African Union Bureau of Heads of State and Government endorsed the COVID-19 Vaccine Development and Access Strategy to vaccinate at least 60% of each country’s population with a safe and efficacious vaccine by 2022, to achieve the population-level immunity needed to bring the pandemic under control. Using publicly available, country-level population estimates and COVID-19 vaccination data, we provide unique insights into the uptake trends of COVID-19 vaccinations in the 15 countries that comprise the Economic Community of West Africa States (ECOWAS). Based on the vaccination rates in the ECOWAS region after three months of commencing COVID-19 vaccinations, we provide a projection of the trajectory and speed of vaccination needed to achieve a COVID-19 vaccination coverage rate of at least 60% of the total ECOWAS population. After three months of the deployment of COVID-19 vaccines across the ECOWAS countries, only 0.27% of the region’s total population had been fully vaccinated. If ECOWAS countries follow this trajectory, the sub-region will have less than 1.6% of the total population fully vaccinated after 18 months of vaccine deployment. Our projection shows that to achieve a COVID-19 vaccination coverage of at least 60% of the total population in the ECOWAS sub-region after 9, 12 and 18 months of vaccine deployment; the speed of vaccination must be increased to 10, 7 and 4 times the current trajectory, respectively. West African governments must deploy contextually relevant and culturally acceptable strategies for COVID-19 vaccine procurements, distributions and implementations in order to achieve reasonable coverage and save lives, sooner rather than later.

PENINGKATAN PERAN REMAJA DI SMAN 1 BEKASI DALAM OPTIMALISASI NEW NORMAL MELALUI DESAIN INFOGRAFIS PROGRAM VAKSINASI

The Covid-19 pandemic has been going on for more than a year in Indonesia. Positive and death rates vary over time. The government has issued several policies regarding the prevention of the transmission of this disease, one of which is vaccination. The level of public confidence in the effectiveness of the vaccine is still very low. Unfortunately, Indonesian people often get wrong information from online media, so the vaccination coverage rate is still very far from the expectation of achieving herd immunity. The current young generation during the pandemic is spending more time using social media as a means of communication. However, not many youths use social media as a means of disseminating correct information about vaccination. Information in the form of infographics is usually preferred because it is easier to understand. The community service team felt the need to empower the role of youth to spread the true news about vaccination through social media using infographics. Therefore, the service team collaborated with SMAN 1 Tambun Selatan, Bekasi to provide training on making infographics and counseling about vaccination as part of the new way of life after the pandemic. Training and counseling are carried out in one Zoom forum. After the training and counseling students were asked to make infographics about the Covid-19 vaccination and upload them to their respective social media accounts. There is an increase in the skills of making infographics and knowledge about vaccination. It is hoped that these students will continue to be creative in making infographics to share on social media about current issues. Indonesia telah mengalami Pandemi Covid-19 lebih dari setahun. Angka positif dan kematian bervariasi dari waktu ke waktu. Pemerintah mengeluarkan beberapa kebijakan menyangkut pencegahan penularan penyakit ini, salah satunya adalah dengan vaksinasi. Tingkat kepercayaan masyarakat terhadap efektifitas vaksin masih sangat rendah. Sayangnya masyarakat Indonesia seringkali mendapatkan informasi yang salah dari media online, sehingga angka ketercakupan vaksinasi masih sangat jauh dari harapan mencapai kondisi herd immunity. Generasi muda saat ini seiring masa pandemi meluangkan lebih banyak waktunya untuk memanfaatkan media sosial sebagai sarana berkomunikasi. Namun pemanfaatan media sosial belum banyak dilakukan oleh para remaja sebagai sarana menyebarkan informasi yang benar tentang vaksinasi. Informasi dalam bentuk infografis biasanya lebih disukai karena lebih mudah dipahami. Tim pengabdi merasa perlu memberdayakan peran remaja untuk menyebarkan berita benar tentang vaksinasi melalui sosial media dengan menggunakan infografis. Oleh karena itu tim pengabdi bekerjasama dengan SMAN 1 Tambun Selatan, Bekasi untuk memberikan pelatihan membuat infografis dan penyuluhan tentang vaksinasi sebagai bagian dari tatanan hidup baru setelah pandemi. Pelatihan dan penyuluhan dilaksanakan dalan satu forum Zoom. Setelah pelatihan dan penyuluhan siswa diminta untuk membuat infografis tentang vaksinasi Covid-19 dan dibagikan ke akun Instagram masing-masing atau media sosial lainnya. Terdapat peningkatan keterampilan membuat infografis dan pengetahuan tentang vaksinasi. Diharapkan siswa ini akan terus kreatif membuat infografis untuk berbagi di media sosial mengenai isu terkini.

Rotavirus gastroenteritis hospitalizations in provinces with different vaccination coverage rates in Spain, 2013–2018

Background Rotavirus (RV) vaccines are available in Spain since 2006 but are not included in the National Immunization Program. RV vaccination has reached an intermediate vaccination coverage rate (VCR) but with substantial differences between provinces. The aim of this study was to assess the ratio of RV gastroenteritis (RVGE) admissions to all-cause hospitalizations in children under 5 years of age in areas with different VCR. Methods Observational, multicenter, cross-sectional, medical record-based study. All children admitted to the study hospitals with a RVGE confirmed diagnosis during a 5-year period were selected. The annual ratio of RVGE to the total number of all-cause hospitalizations in children < 5 years of age were calculated. The proportion of RVGE hospitalizations were compared in areas with low (< 30%), intermediate (31–59%) and high (> 60%) VCR. Results From June 2013 to May 2018, data from 1731 RVGE hospitalizations (16.47% of which were nosocomial) were collected from the 12 study hospitals. RVGE hospital admissions accounted for 2.82% (95 CI 2.72–3.00) and 43.84% (95% CI 40.53–47.21) of all-cause and Acute Gastroenteritis (AGE) hospitalizations in children under 5 years of age, respectively. The likelihood of hospitalization due to RVGE was 56% (IC95%, 51–61%) and 27% (IC95%, 18–35%) lower in areas with high and intermediate VCR, respectively, compared to the low VCR areas. Conclusions RVGE hospitalization ratios are highly dependent on the RV VCR. Increasing VCR in areas with intermediate and low coverage rates would significantly reduce the severe burden of RVGE that requires hospital management in Spain. Clinical trial registration Not applicable

Predictors of real-world parents acceptance to vaccinate their children against the COVID-19

Background: As the COVID-19 pandemic continues to threaten public health, the vaccination of children against the disease appears to be a key factor to control the pandemic. Objective: To investigate the prevalence of parents who have vaccinated their children against the COVID-19 and the factors influencing this decision. Methods: We conducted a web-based cross-sectional study in Greece during the first week of September 2021. The study questionnaire was distributed through social media and a convenience sample was obtained. Only parents with children aged 12-17 years old could participate in the study. We collected socio-demographic data of parents and we measured their attitudes towards vaccination and COVID-19 pandemic. Results: Study population included 656 parents. Mean age of parents was 45.5 years, while most of them were mothers with a high level of education. Regarding vaccination, 27.1% of parents had their children vaccinated against the COVID-19, while almost all children had a complete vaccination history (98.9%). The most important reasons for decline of COVID-19 vaccination were doubts about the safety and effectiveness of COVID-19 vaccines (45.3%) and fear of side effects (36.6%). Regarding the information about the COVID-19 vaccines, parents showed more trust in family doctors than in scientists and the government. Multivariate regression analysis identified that increased parents age, increased trust in COVID-19 vaccines, and positive attitude of parents towards vaccination had a positive effect on children vaccination. Conclusions: Understanding the factors influencing parents' decision to vaccinate their children against the COVID-19 is crucial to increase the COVID-19 vaccination coverage rate. Implementation of public health policies is necessary to spread knowledge about COVID-19 vaccines and to regain vaccine confidence.

Willingness and SARS-CoV-2 Vaccination Coverage among Healthcare Workers in China: A Nationwide Study

Background: The SARS-CoV-2 vaccine has been widely rolled out globally in the general populations. However, specific data on vaccination confidence, willingness or coverage among health care workers (HCWs) has been less reported. Methods: A cross-sectional online survey was conducted to specify the basic data and patterns of vaccination confidence, willingness and coverage among HCWs nationwide. Results: In total, 2386 out of 2583 (92.4%) participants were enrolled for analysis, and the rates of confidence in vaccine, professional institutes and government were 75.1%, 85.2% and 85.4%, respectively. The overall vaccination coverage rate was 63.6% which was adjusted as 82.8% for participants under current medical conditions or having contraindications. Confidence in vaccine safety was shown to be the most related factor to willingness among doctors, nurses, medical technicians and hospital administrators, while confidence in vaccine effectiveness as well as trust in government played the key role in formulating public health employees’ willingness. 130 (7.1% of 1833) participants reporting willingness still not been vaccinated regardless of contraindications. Multivariate analysis among willingness participants showed that males, aged over 30 years, public health employees and higher vaccination confidence had significantly higher vaccination rates with ORs (95% confidence intervals) as 1.64 (1.08–2.49), 3.14 (2.14–4.62), 2.43 (1.46–4.04) or 2.31 (1.24–4.33). Conclusions: HCWs’ confidence, willingness and coverage rates to the vaccine were generally at high levels. Heterogeneity among HCWs should be considered for future vaccination promotion strategies. The population’s confidence in vaccination is not only the determinant to their willingness, but also guarantees their actual vaccine uptake.

Trends and determinants of vaccination among children aged 06–59 months in Bangladesh: country representative survey from 1993 to 2014

Background Vaccination has important consequences for childhood development, mortality, and inequalities in health and well-being. This research explores the trend of vaccinations coverage from 1993 to 2014 and determines the significant factors for vaccinations coverage in Bangladesh, considering geospatial, socioeconomic, and demographic characteristics. Methods This study uses a secondary dataset extracted from the Bangladesh Demographic and Health Survey (BDHS) from 1992 to 93 to 2014. The association between selected independent variables and vaccination coverage of children was examined through the Chi-square test. In addition, unadjusted and adjusted logistic regression approaches were applied to determine the effects of covariates on vaccination status by using the BDHS-2014 dataset. Results The results reveal that the trend of the vaccination coverage rate has gradually been increased over the study period. The coverage rate of BCG is observed maximum while the lowest for Measles vaccination among all types of vaccinations. The findings revealed that the significantly lower coverage of all vaccination had been observed in the Sylhet region. Children of higher educated mothers (OR 10.21; CI: 4.10–25.37) and father (OR 8.71; CI: 4.03–18.80), born at health facilities (OR 4.53; CI: 2.4–8.55) and whose mother has media exposure (OR 3.20; CI: 2.22–4.60) have more chance of receiving BCG vaccine. For DPT vaccination coverage, there is a significant difference from children whose mothers have primary (OR 1.7; CI: 1.35–2.15), secondary (OR 3.5; CI: 2.75–4.45), and higher (OR 9.6; CI: 5.28–17.42) educational qualification compared to children of illiterate mothers. Findings demonstrated that children born in wealthier households have a higher likelihood of being immunized against DPT, Polio, and Measles vaccination than children born in the poorest households. Conclusions The findings reveal that to enhance and make sustainable the overall country’s vaccination coverage, we should pay more attention to the mother’s education, socioeconomic condition, children’s age, birth order number, having media exposure, place of residence, and religion. The authors think that this finding would be helpful to accelerate the achievement target of Sustainable Development Goals (SDGs) for children’s health in Bangladesh.

Impact of Prior Infection on Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Syrian Hamsters

Prior infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provides protective immunity against reinfection. However, whether prior infection blocks SARS-CoV-2 transmission is not yet clear. Here, we evaluated the impact of prior infection on SARS-CoV-2 transmission in Syrian hamsters. Our results showed that prior infection significantly reduced SARS-CoV-2 replication in Syrian hamsters, but sterilizing immunity was not achieved. Prior infection blocked the airborne transmission of SARS-CoV-2 from previously infected Syrian hamsters to naïve Syrian hamsters and previously infected Syrian hamsters. Moreover, prior infection substantially reduced the efficiency of direct contact transmission between previously infected Syrian hamsters. However, prior infection had limited impact on SARS-CoV-2 transmission from previously infected Syrian hamsters to naïve Syrian hamsters via direct contact in the early course of infection. Human reinfection and SARS-CoV-2 transmission between a previously infected population and a healthy population would be likely, and a higher vaccination coverage rate was needed to reach herd immunity. Our work will aid the implementation of appropriate public health and social measures to control coronavirus infectious disease 2019 (COVID-19) pandemic.

Epidemiological characteristics of hand, foot, and mouth disease in Yunnan Province, China, 2008–2019

Background Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and little is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the epidemiological characteristics of HFMD before and after the introduction of EV71 vaccination in Yunnan Province. Methods Surveillance data collected between 2008 and 2019 were analyzed to produce epidemiological distribution on cases, etiologic composition, and EV71 vaccination coverage, as well as to compare these characteristics before and after EV71 vaccination. Results A total of 1,653,533 children received EV71 vaccines from 2016 through 2019 in Yunnan. The annual EV71 vaccination coverage rate ranged from 5.53 to 15.01% among children ≤5 years old. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1 and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province. Conclusions Non-EV71/non-CV-A16 enteroviruses became the predominant strain and led to a higher incidence in Yunnan. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and detect and monitor emerging enteroviruses.

Influenza Vaccination Campaign during the COVID-19 Pandemic: The Experience of a Research and Teaching Hospital in Milan

Background: During the COVID-19 pandemic, more than ever, optimal influenza vaccination coverage among healthcare workers (HCWs) is crucial to avoid absenteeism and disruption of health services, as well as in-hospital influenza outbreaks. The aim of this study is to analyze the 2020 influenza vaccination campaign, comparing it with the previous year’s in a research and teaching hospital in Northern Italy. Methods: adopting an approach based on combined strategies, three interventions were deployed: a promotional and educational campaign, vaccination delivery through both ad hoc and on-site ambulatories, and a gaming strategy. Personal data and professional categories were collected and analyzed using univariate logistic regression. Vaccinated HCWs were asked to fill in a questionnaire to describe their reasons for vaccination adherence. Results: the vaccination coverage rate (VCR) was 43.1%, compared to 21.5% in 2019. The highest increase was registered among administrative staff (308.3%), while physicians represent the most vaccinated category (n = 600). Moreover, residents (prevalence ratio (PR): 1.12; 95% CI 1.04–1.20), as well as intensive care (PR: 1.44; 95% CI: 1.24–1.69) and newborn workers (PR: 1.41; 95% CI: 1.20–1.65) were, respectively, the categories most frequently vaccinated for the first time. Conclusion: the significant increase in vaccination coverage rate confirms the suitability of the combined strategy of delivering the flu vaccination campaign and represents a first step towards reaching WHO recommended vaccination rates.