The ethics behind mandatory COVID-19 vaccination post-Omicron: The South African context

COVID-19 boosters and building trust among UK minority ethnic communities

Effectiveness of vaccination mandates in improving uptake of COVID-19 vaccines in the USA

The global fight against the COVID-19 pandemic has underscored the critical importance of widespread vaccination to mitigate the impact of the virus on public health. The current study aimed to investigate which social influences might be most important for predicting attitudes towards COVID-19 vaccination and vaccine uptake among young students in the UK. We focused on the cultural evolution and social transmission aspects, i.e., parent-to-child versus peer-to-peer, of attitudes and vaccine uptake during the COVID-19 pandemic. A sample of 192 UK students (aged 18 to 35 years old) filled in an online survey including measures for attitudes towards COVID-19 vaccination and vaccine uptake and/or intention, age, and gender. Participants were also asked about their mother's, father's, and best friend's attitudes towards COVID-19 vaccination and vaccine uptake. Finally, they provided a subjective measure of the quality relationship with their parents. Overall, our results suggest that both parents and very close friends are important agents in understanding the students' attitudes towards COVID-19 vaccination and vaccine uptake. More specifically, our findings suggest the mother's vaccine uptake as the most salient predictor of students' attitudes towards COVID-19 vaccination and vaccine uptake, particularly when the students report having a positive relationship with their parents. In cases where students' experience negative relationship with their parents, the best friend's vaccine uptake may supersede the mother's influence. Despite these nuances, a general trend emerges from our data suggesting that vaccine uptake could be primarily guided by vertical transmission (i.e., parent to child). Our results have the potential to influence public health strategies, communication campaigns, and targeted interventions to enhance vaccination uptake. Identifying key social predictors can enable policymakers and health authorities to tailor vaccination promotion efforts towards mothers' and peers' vaccine uptake to increase overall positive attitudes and vaccine uptake among young people.

Confronting the evolution and expansion of anti-vaccine activism in the USA in the COVID-19 era

Lessons Relearned? H1N1, COVID-19, and Vaccination Planning.

Reply

The quest for more COVID-19 vaccinations in Africa

Priorities for the COVID-19 pandemic at the start of 2021: statement of the Lancet COVID-19 Commission

The EU Response to COVID-19: From Reactive Policies to Strategic Decision-Making.

Repurposing the Ladder

COVID-19 vaccine hesitancy is widespread and may lead to refusal or delay of vaccination, eventually reducing the overall vaccination coverage rate and vaccine effectiveness. Willingness to receive COVID-19 vaccination among health care workers (HCWs) is diverse across different jurisdictions. To assess the COVID-19 vaccine willingness among HCWs in 3 Southeast Asian jurisdictions in the context of pandemic severity and vaccination policy. A cross-sectional online survey was conducted among frontline HCWs in Hong Kong, Nepal, and Vietnam from May to November 2021. Eligible participants were nurses and doctors aged 18 and older, working in public or private health care settings on a full-time or part-time basis. The COVID-19 pandemic and vaccination policy. COVID-19 vaccination willingness was defined as HCW willingness toward receiving the COVID-19 vaccine in full course or the first dose of the vaccine, and willingness to take the second dose. Information on sociodemographic characteristics, the history of seasonal influenza vaccination, attitudes toward vaccination, and opinions on strategies associated with vaccination uptake from the study participants. Among the 3396 eligible doctors and nurses who participated in the survey, 2834 (83.4%) were from Hong Kong, 328 (9.7%) were from Nepal, and 234 (6.9%) were from Vietnam. Most respondents were female (76.2% [2589 ]), aged 30 to 39 years (31.2% [1058]), and nurse HCWs (77.6% [2636]); the response rates were 11% (2834 of 25 000) in Hong Kong, 36% (328 of 900) in Nepal, and 13% (234 of 1800) in Vietnam. Overall, the prevalence rate of willingness to take the COVID-19 vaccine was highest in Nepal (95.4% [313 of 328]), followed by Vietnam (90.6% [212 of 234]), and lowest in Hong Kong (54.4% [1542 of 2834]), relating to their different attitudes and opinions toward the COVID-19 vaccination, and the pandemic severity and vaccination policy in the 3 jurisdictions. Doctors were more willing to take COVID-19 vaccination than nurses (odds ratio, 5.28; 95% CI, 3.96-7.04). Older age (odds ratios, 1.39-3.70), male gender (odds ratio, 1.41; 95% CI, 1.11-1.75), higher educational level (odds ratio, 1.48; 95% CI, 1.17-1.87), and having seasonal influenza vaccination uptake history (odds ratio, 2.15; 95% CI, 1.82-2.54) were found to be associated with increased willingness. Choice of vaccination brand with adequate information, immunity passport, time off from work for vaccination and subsidy for travel to inconvenient vaccination centers were considered as strategies to enhance vaccine willingness. In this survey study, vaccination unwillingness existed among HCWs in Southeast Asian regions, especially in Hong Kong. The findings of this study may have utility in the formulation of vaccination promotion strategies such as vaccination incentives. Attitudes toward vaccination in HCWs might be examples for the general population; however, changes over time should be further investigated.

A key limiting factor in the scale up and sustainability of HIV care and treatment programmes is the global shortage of trained health care workers. This paper discusses why it is important to move beyond conceptualising health care workers simply as 'inputs' in the delivery of HIV treatment and care, and to also consider their roles as partners and agents in the process of health care. It suggests a framework for thinking about their roles and responses in HIV care, considers the current evidence base, and concludes by identifying key areas for future research on health care workers' responses in HIV treatment and care in low and middle income settings.

Ethical Considerations Surrounding Employment Mandated Coronavirus Disease 2019 Vaccination and Allergy Skin Testing for the Coronavirus Disease 2019 Vaccine.

Vaccination

Despite early fears that people living with HIV (PLWHs) in Africa would not be able to adhere to antiretrovirals (ARVs).1, 2 Research has shown that the proportion of PLWH reporting ≥95% adherence in sub-Saharan Africa is higher than in North America.3 However, maintaining adherence is a complex phenomenon and different ecological factors affect patient ability to access and adhere to ARVs: patient characteristics and context, ARV line regimen, clinical situation and the patient-health staff relationship. 4 In October 2008, the new minister of health announced that 550,000 PLWHs were on ARVs in South Africa, which is the highest number in the world.5 This achievement was recently tarnished by increasing alarm over the Free State public sector ARV programme. The Free State has the third highest HIV prevalence in the country (31%) 6. Since December 2008, the department of health has stopped initiating new patients on ARVs 7 because of drug stock-out and lack of funds. It is estimated that in this province 30 PLWHs are dying every day the moratorium continues.8While it is clear that this moratorium will increase morbidity and mortality, the loss of trust in the health system and the potential impact of the ARVs crisis on existing patient adherence should also be considered. Campero et.al. reported that patients already on ARVs share their medication with neighbors, relatives and/or friends who are delayed to start on ARVs 9. This practice could lead to drug resistance development in both people sharing the medication if they will have differential exposure to ARVs, 10-13 and on a public health level, raises serious concerns about drug failure, subsequent more expensive drug regimens and the spread of drug resistant strains of HIV. Patients’ perceptions of staff attitudes and waiting time were reported to be key factors for patients’ ARV adherence. 14 It is plausible that PLWHs will seek care in other provinces, and would consequently be required to return to outlying clinics on a monthly basis to pick-up their ARVs. Transport costs and the time needed to reach clinics are risk factors to both adherence and retention in care.15, 16 Patients currently on treatment – in the Free State and elsewhere - are understandably anxious about the health system’s ability to guarantee life-long access to ARVs. It was shown estimated that 300 000 people had died of AIDS in a preventable manner if the South African government had only responded to the AIDS crisis quickly in a coherent manner. 17 How the government now contains and repairs the damage being done in the Free State will be a litmus test for the long-term success of South Africa’s ARV programme.