Supreme Court halts Biden's company vaccine mandates

Headline UNITED STATES: Court halts Biden's vaccine mandates

Patchwork of COVID-19 certificates to impede travel

Significance Despite this, there are no common standards for validating vaccination and COVID test results. This is hampering national-level disease containment efforts and also regional and international travel. Impacts Lack of state capacity to produce reliable health records is a major constraint for developing countries. The black market in fraudulent vaccination and test results will proliferate. Political divisions over vaccine mandates will intensify if digital certificates become mandatory in a wider variety of contexts.

COVID-19 vaccine intentions and uptake in a tertiary care healthcare system: A longitudinal study

Objective Healthcare workers (HCWs) are a high priority group for COVID-19 vaccination and serve as sources for information for the public. This analysis assessed vaccine intentions, factors associated with intentions, and change in uptake over time in HCWs. Methods A prospective cohort study of COVID-19 seroprevalence was conducted with HCWs in a large healthcare system in the Chicago area. Participants completed surveys (November 25, 2020-January 9, 2021 and April 24-July 12, 2021) on COVID-19 exposures, diagnosis and symptoms, demographics, and vaccination status. Results Of 4,180 HCWs who responded to a survey, 77.1% indicated they intended to get the vaccine; in this group, 23.2% had already received at least one dose of the vaccine (23.2%), 17.4% were unsure, and 5.5% reported that they would not get the vaccine. Factors associated with intention or vaccination were being exposed to clinical procedures (vs no procedures) and having a negative serology test for COVID-19 (vs no test) (adjusted odds ratio (AOR)=1.39, 95% Confidence Interval (CI) 1.16-1.65, AOR=1.46, 95% CI 1.24-1.73, respectively). Nurses (vs physicians, AOR=0.24 95% CI 0.17-0.33), non-Hispanic Black (vs Asians, AOR=0.35, 95% CI 0.21-0.59), and women (vs men, AOR=0.38, 95% CI 0.30-0.50) had lower odds of intention to get vaccinated. By 6-months follow-up, over 90% of those who had previously been unsure were vaccinated, while 59.7% of those who previously reported no intention of getting vaccinated, were vaccinated. Conclusions COVID-19 vaccination in HCWs was high, but variability in vaccination intention exists. Targeted messaging coupled with vaccine mandates can support uptake.

US vaccine mandates remain polarising as Omicron hits

Headline UNITED STATES: Omicron measures aim to buy time

Predictors of COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Southern California: Not Just “Anti” vs. “Pro” Vaccine

In this study, we evaluated the status of and attitudes toward COVID-19 vaccination of healthcare workers in two major hospital systems (academic and private) in Southern California. Responses were collected via an anonymous and voluntary survey from a total of 2491 participants, including nurses, physicians, other allied health professionals, and administrators. Among the 2491 participants that had been offered the vaccine at the time of the study, 2103 (84%) were vaccinated. The bulk of the participants were middle-aged college-educated White (73%), non-Hispanic women (77%), and nursing was the most represented medical occupation (35%). Political affiliation, education level, and income were shown to be significant factors associated with vaccination status. Our data suggest that the current allocation of healthcare workers into dichotomous groups such as “anti-vaccine vs. pro-vaccine” may be inadequate in accurately tailoring vaccine uptake interventions. We found that healthcare workers that have yet to receive the COVID-19 vaccine likely belong to one of four categories: the misinformed, the undecided, the uninformed, or the unconcerned. This diversity in vaccine hesitancy among healthcare workers highlights the importance of targeted intervention to increase vaccine confidence. Regardless of governmental vaccine mandates, addressing the root causes contributing to vaccine hesitancy continues to be of utmost importance.

Ethics of vaccination prioritization and compulsory vaccination: An integrative approach

Vaccine scarcity and availability distinguish two central ethics questions raised by the Covid-19 pandemic. First, in situations of scarcity, which groups of persons should receive priority? Second, in situations where safe and effective vaccines are available, what circumstances and reasons can support mandatory vaccination? Regarding the first question, normative approaches converge in prioritizing most-vulnerable groups. Though there is room for prudential judgement regarding which groups are most vulnerable, the human dignity principle is most relevant for prioritization consideration of both medical and non-medical issues. The second question concerning mandates is distinct from considerations about persons’ individual moral duty to receive vaccines judged reasonably safe and critical for individual and public health. While there is consensus regarding the potential normative support for mandated vaccination, the paternalistic government intervention of vaccine mandates requires a high bar of demonstrated vaccine safety and public health risk. We discuss stronger and weaker forms of paternalism to deal with the Covid-19 pandemic from an “integrative” approach that integrates leading normative approaches. We argue against a population-wide compulsory vaccination and support prudential measures to 1) protect vulnerable groups; 2) focus upon incentivizing vaccine participation; 3) maintain maximum-possible individual freedoms, and 4) allow schools, organizations, and enterprises to implement vaccine requirements in local contexts.