Covid-19 Vaccines and Institutional Trust

Major public and private laboratories entered into a race to find an effective Covid-19 vaccine. With the arrival of the vaccines, governments have to implement vaccination programs to achieve the necessary immunization levels to prevent further transmission of the disease. In this context, the ethical dilemma of compulsory vaccination vs. voluntary vaccination has been raised. Underlying this dilemma lies the problem of the ethical models on which the political decisions of governments in health matters based. The chapter proposes and argues the need to base health policy decisions on an ethical “first person” model, based on personal responsibility, that allows us to move from a normative ethic to an ethic of responsible behavior. This change in the ethical model, together with certain proposals for political action, will help us to restore institutional trust, so that the necessary levels of collective immunity against Covid-19 can be achieved through the voluntary vaccination of the citizens.

National narcissism and support for voluntary vaccination policy: The mediating role of vaccination conspiracy beliefs

We investigate the relationship between vaccination hesitancy and the way people feel about their national groups. Antivaccination attitudes are associated with conspiracy beliefs, which have been linked to group-based defensiveness. Thus, we hypothesized that defensiveness about one’s national identity, operationalized as collective narcissism measured in relation to one’s national group, might be related to antivaccination attitudes. We found that national narcissism, but not national identification, predicted support for a voluntary vaccination policy both in a general population sample ( N = 361) and among visitors of antivaccination discussion forums ( N = 178). In two further studies involving national quota samples, national narcissism was also related to vaccination conspiracy beliefs ( N = 1,048), and these beliefs mediated its association with support for a voluntary vaccination policy ( N = 811). By highlighting the link between antiscience attitudes and collective narcissism, we demonstrate that group defensiveness can be linked to support for decisions that may undermine the health and well-being of present and future ingroup members.

A behavioural modelling approach to assess the impact of COVID-19 vaccine hesitancy

In this paper we introduce a compartmental epidemic model describing the transmission of the COVID-19 disease in presence of non-mandatory vaccination. The model takes into account the hesitancy and refusal of vaccination. To this aim, we employ the information index, which mimics the idea that individuals take their decision on vaccination based not only on the present but also on the past information about the spread of the disease. Theoretical analysis and simulations show clearly as a voluntary vaccination can certainly reduce the impact of the disease but it is unable to eliminate it. We also show how the information-related parameters affect the dynamics of the disease. In particular, the hesitancy and refusal of vaccination is better contained in case of large information coverage and small memory characteristic time. Finally, the possible influence of seasonality is also investigated.

Is vaccination a viable method to control Johne’s disease caused by Mycobacterium avium subsp. paratuberculosis? Data from 12 million ovine vaccinations and 7.6 million carcass examinations in New South Wales, Australia from 1999–2009

Background Mycobacterium avium subsp. paratuberculosis (MAP) causes Johne’s disease (or paratuberculosis), a chronic wasting disease of ruminants and other animals resulting from granulomatous enteritis. There are increasing concerns that MAP is zoonotic. The prevalence of Johne’s disease is increasing worldwide. In an attempt to control an epidemic of ovine Johne’s disease (OJD) in New South Wales (NSW), a government/industry sponsored voluntary vaccination/on-farm management program commenced in 2000. We report herein an observational study of changes in disease prevalence as vaccination progressed, based on abattoir surveillance data for OJD from 1999 to 2009. We also discuss the epidemiological, policy, regulatory, research, economic and sociological elements that contributed to the development of a mature control program, whose aim was to halt the epidemic spread of OJD in a naïve sheep population. Methods NSW was divided into areas of “High” (HPA), “Medium” (MPA) and “Low” (LPA) OJD prevalence. A killed whole cell vaccine (Gudair®) was administered to sheep from 2000 to 2009. Trained examiners evaluated the viscera of adult sheep carcasses at slaughter for gross evidence of OJD. MAP infection was confirmed by histopathology. Principal findings From 2000–2009, 12 million vaccine doses were administered in NSW (91%; 10.9 million in the HPA). Many of the vaccinated flocks were suffering > 5% annual mortality in adult sheep, with some individual flocks with 10–15% losses attributable to OJD. A total of 7.6 million carcasses were examined (38%; 2.9 million from the HPA). Overall, 16% of slaughter consignments (sheep consigned to the abattoir from a single vendor) were positive for OJD, of which 94% were from the HPA. In the HPA, the percentage of animals with lesions attributable to OJD at slaughter fell progressively from 2.4% (10,406/432,860) at commencement of vaccination in 2000 to 0.8% (1,573/189,564) by 2009. Herd immunity from vaccination in the HPA was estimated at 70% by 2009, the target commonly espoused for an effective control program based on vaccination. This coincided with a progressive decrease in reports of clinical disease and mortalities in vaccinated flocks. Significance We show a decrease in the prevalence of lesions attributable to OJD in NSW concomitant with initiation of voluntary vaccination, on-farm management plans, abattoir monitoring and feedback of animal prevalence data to sheep producers. We conclude that a target of ≤ 1% regional prevalence of OJD affected sheep at slaughter is achievable using these interventions.

Koronavírusvakcina-vademecum

Összefoglaló. A SARS-CoV-2 okozta megbetegedés (COVID–19) a cikk megírásáig a világon több mint 82 millió embert érintett, a halálos áldozatok száma 1,8 millió (2,2%). Hazánkban eddig 300 000 feletti esetszámot regisztráltak, a cikk megjelenésének idején már várhatóan több mint 10 000 halottal (3%). Habár a megbetegedésnek oki gyógyszeres terápiája egyelőre nincs, egyes antivirális szerek és a rekonvaleszcens plazma alkalmazása a tapasztalatok szerint csökkentik a vírusterhelést, és ezzel hozzájárulnak a beteg gyógyulásához. Az eddig példa nélküli epidemiológiai rendelkezések nem tudták megállítani, csak lelassítani a betegség terjedését, ezért a megelőzés tűnik az egyetlen, a közeljövőben tömegek számára is elérhető megoldásnak. A jelen cikk nem egy virológiai vagy biotechnológiai szakmunka, sokkal inkább egy összefoglaló házi- és általános orvosok számára, amely ismerteti a jelenleg engedélyezett, illetve a közeljövőben forgalomba kerülő védőoltások előnyeit és hátrányait a COVID–19 tágabb kontextusában. Írásunkban bemutatjuk a leggyakoribb álhíreket, rémhíreket is, valamint ezek cáfolatát is annak érdekében, hogy kollégáink felkészültebben tudják betegeiket informálni, valamint segíteni a vakcináció fontosságával kapcsolatos döntéshozatalt. Egy járvány megfékezésének legkézenfekvőbb módja a társadalmi szintű védettség megvalósítása. A nyájimmunitás kialakulása nélkül nagy valószínűséggel e jelenlegi pandémia sem állítható meg. Amennyiben egyéni és társadalmi szinten is vissza szeretnénk térni a vírus előtti életünkhöz, újra élvezve az akadálytalan áru- és kereskedelmi forgalom jelentette előnyöket, akkor a tömeges oltás tűnik a leghatékonyabb eszköznek ennek eléréséhez. A fertőző betegségek számának és mortalitásának a 20. században tapasztalt jelentős csökkenése egyértelműen a társadalmi szintű átoltottságnak, valamint a higiénés körülmények javulásának köszönhető. Az oltás ugyan önkéntes, de felvételének kérdése pandémiás helyzetben valószínűleg nemcsak egyéni döntés, de társadalmi felelősségvállalás kérdése is. Orv Hetil. 2021; 162(8): 283–292. Summary. Out of more than 82 million people worldwide, 1.8 million (2.2%) succumbed to SARS-CoV-2 disease (COVID–19). In 2020, more than 300 000 cases were registered in Hungary, and by the time of publication of this article, the death toll would probably exceed 10 000 (3%). Currently no causative drug therapy is available, however, observational evidence suggests that certain antivirals and the use of convalescent plasma may change the disease course. The unprecedented, strict epidemiological provisions managed to slow down the spread of the disease though they could not stop it. It seems that prevention remains the only readily available option to beat COVID–19. This is not a virology or biotechnology paper, but an unbiased review for general practitioners, aiming to summarize the advantages/disadvantages of the (emergency) authorized and soon-to-be-launched vaccines in the wider context of COVID–19. We also intended to address and debunk the most common misconceptions, aiming to help both doctors and patients to make a fact-based, informed decision about vaccination. Herd immunity is paramount to combat COVID pandemic. Without population-level vaccination, we are unlikely to regain the quality of life, the freedom of travel and the unrestricted economy/commerce we enjoyed before. It is obvious that the significant reduction in morbity/mortality of infectious diseases in the 20th century was achieved through advancements in vaccinology and improved hygiene. Albeit voluntary, vaccination in a pandemic situation is probably not only an individual decision, but social responsibility as well. Orv Hetil. 2021; 162(8): 283–292.