COVID-19 Vaccination Campaign Research Articles

Medical doctor association Surabaya chapter’s COVID-19 vaccination acts: community service for the protection of surabaya medical doctors’ health

Background: The COVID-19 pandemic has affected many people, including healthcare workers who are at risk of infection. It has been reported that deaths mainly occurred among doctors (51.4%, n = 525). Aims: This community service project was done to report the coverage of the COVID-19 vaccination conducted by the Medical Doctor Association Surabaya Chapter (Ikatan Dokter Indonesia (IDI) Surabaya Chapter). This was done in cooperation with the Surabaya Health Office with the vaccination targets being medical staff and their families. Community service: This project aims to protect their health while treating COVID-19 patients, the Medical Doctor Association Surabaya Chapter in collaboration with the Surabaya Health Office held COVID-19 vaccinations on August 6th, 7th, 25th, and 30th, 2023. These vaccinations were targeted to be given to healthcare workers, and 26, 12, 19, and 36 vials were administered on every date. The Moderna vaccine (mRNA-based COVID-19 vaccine) was administered to 727 participants on August 6th, 336 participants on August 7th, 265 participants on August 25th, and 489 participants on August 30th, 2023. The most frequent participants were general practitioners (72.5%) and specialists (22%). The COVID-19 vaccinations were held by the Medical Doctor Association Surabaya Chapter and also involved medical students from several universities in Surabaya, including Universitas Airlangga, Wijaya Kusuma, Nahdlatul Ulama, Muhammaddiyah, Hang Tuah, and Ciputra. The COVID-19 vaccination covered 69.90% of the intended targets. Conclusion: The Medical Doctor Association Surabaya Chapter in collaboration with the Surabaya Health Office successfully held a COVID-19 vaccination campaign that reached 69.90% of their targets.

Combating misinformation with internet culture: the case of Brazilian public health organizations and their COVID-19 vaccination campaigns

Purpose This study investigates the communication behavior of public health organizations on Twitter during the COVID-19 vaccination campaign in Brazil. It contributes to the understanding of the organizational framing of health communication by showcasing several instances of framing devices that borrow from (Brazilian) internet culture. The investigation of this case extends the knowledge by providing a rich description of the organizational framing of health communication to combat misinformation in a politically charged environment.Design/methodology/approach The authors collected a Twitter dataset of 77,527 tweets and analyzed a purposeful subsample of 536 tweets that contained information provided by Brazilian public health organizations about COVID-19 vaccination campaigns. The data analysis was carried out quantitatively and qualitatively by combining social media analytics techniques and frame analysis.Findings The analysis showed that Brazilian health organizations used several framing devices that have been identified by previous literature such as hashtags, links, emojis or images. However, the analysis also unearthed hitherto unknown visual framing devices for misinformation prevention and debunking that borrow from internet culture such as “infographics,” “pop culture references” and “internet-native symbolism.”Research limitations/implications First, the identification of framing devices relating to internet culture add to our understanding of the so far little addressed framing of misinformation combat messages. The case of Brazilian health organizations provides a novel perspective to knowledge by offering a notion of internet-native symbols (e.g. humor, memes) and popular culture references for misinformation combat, including misinformation prevention. Second, this study introduces a frontier of political contextualization to misinformation research that does not relate to the partisanship of the spreaders but that relates to the political dilemmas of public organizations with a commitment to provide accurate information to citizens.Practical implications The findings inform decision-makers and public health organizations about framing devices that are tailored to internet-native audiences and can guide strategies to carry out information campaigns in misinformation-laden social media environments.Social implications The findings of this case study expose the often-overlooked cultural peculiarities of framing information campaigns on social media. The report of this study from a country in the Global South helps to contrast several assumptions and strategies that are prevalent in (health) discourses in Western societies and scholarship.Originality/value This study uncovers unconventional and barely addressed framing devices of health organizations operating in Brazil, which provides a novel perspective to the body of research on misinformation. It contributes to existing knowledge about frame analysis and broadens the understanding of frame devices borrowing from internet culture. It is a call for a frontier in misinformation research that deals with internet culture as part of organizational strategies for successful misinformation combat.

Lessons Learned from the COVID-19 Vaccination Campaigns in Veneto Region: Population Vaccination Centers as Support for the Traditional Outpatient Model.

The extraordinary vaccination campaigns of the COVID-19 pandemic era put organizational and operational systems to the test in numerous territorial contexts. In the Veneto region, the activation of population vaccination centers (CVPs) guaranteed the provision of vaccines to mountain areas. These centers, drive-in and building-based, improved the efficiency of dose administration in relation to similar conditions where healthcare workers (HCWs) were routinely involved in clinics. Overall, a comparison of the two models investigated, with the same numbers of HCWs involved and the same opening hours for the vaccination sites, has shown that the CVPs are able to guarantee three times as many vaccines administered, compared with the traditional outpatient model. This study aims to provide a detailed analysis of the adopted organizational model, highlighting the best practices and improvements required to guarantee a timely and effective public health response, and evaluating the opportunities to deploy these innovative methods actively in a standard context.

XBB.1.5 spike protein COVID-19 vaccine induces broadly neutralizing and cellular immune responses against EG.5.1 and emerging XBB variants

Monovalent SARS-CoV-2 Prototype (Wuhan-Hu-1) and bivalent (Prototype + BA.4/5) COVID-19 vaccines have demonstrated a waning of vaccine-mediated immunity highlighted by lower neutralizing antibody responses against SARS-CoV-2 Omicron XBB sub-variants. The reduction of humoral immunity due to the rapid evolution of SARS-CoV-2 has signaled the need for an update to vaccine composition. A strain change for all authorized/approved vaccines to a monovalent composition with Omicron subvariant XBB.1.5 has been supported by the WHO, EMA, and FDA. Here, we demonstrate that immunization with a monovalent recombinant spike protein COVID-19 vaccine (Novavax, Inc.) based on the subvariant XBB.1.5 induces neutralizing antibodies against XBB.1.5, XBB.1.16, XBB.2.3, EG.5.1, and XBB.1.16.6 subvariants, promotes higher pseudovirus neutralizing antibody titers than bivalent (Prototype + XBB.1.5) vaccine, induces SARS-CoV-2 spike-specific Th1-biased CD4 + T-cell responses against XBB subvariants, and robustly boosts antibody responses in mice and nonhuman primates primed with a variety of monovalent and bivalent vaccines. Together, these data support updating the Novavax vaccine to a monovalent XBB.1.5 formulation for the 2023–2024 COVID-19 vaccination campaign.

Attitudes and perceptions of Italian Students in Healthcare Settings on COVID-19 vaccines and vaccinations strategies, one year after the immunization campaign.

The topic of vaccine confidence is increasingly relevant, particularly due to the COVID-19 pandemic and the global distribution of COVID-19 vaccines. This issue is even more critical for students in healthcare settings, given their future role not only as vaccine recipients but also as advocates for vaccination. In light of this, achieving a good level of vaccine acceptance is crucial. Hence, the aim of our study was to evaluate the attitudes and perceptions of healthcare students regarding vaccines and COVID- 19 vaccination. Medical and pharmaceutical area students attended an Elective Teaching Activity on COVID-19 vaccines and vaccination campaign, organized at the University of Florence (Italy) and participated in filling two anonymous questionnaires. The first questionnaire was submitted before the Elective Teaching Activity was focused on students' attitudes and perceptions toward vaccines. The second questionnaire was designed to evaluate the students' satisfaction with the course topics. Both descriptive and inferential analyses were performed on the results. In addition, the Vaccine Confidence Index was calculated to evaluate the propensity of students toward vaccinations. A total of 423 students attended the Elective Teaching Activity in the early beginnings of 2022. Overall, students have shown greater confidence in vaccines, compared to COVID-19 vaccines, especially as regards the safety profile. Students' Vaccine Confidence Index was very close to 0.25 value, which indicates being in favor of vaccinations. Nevertheless, in the satisfaction questionnaire filled in at the end of the course, the percentage of students in favor of COVID-19 vaccination increased for both medical (from 94% to 99%) and pharmaceutical area students (from 81% to 97%). Our study suggests that educational activities such as this Elective Teaching Activity, could be considered an effective teaching strategy to improve vaccine acceptance rates among students in healthcare settings.

COVID-19 vaccination–related cardiovascular complications

The global response to the COVID-19 pandemic has led to rapid vaccine development and distribution. As vaccination efforts continue, concerns have arisen regarding potential adverse events associated with COVID-19 vaccination. This article examines emerging evidence on adverse events, including myocarditis, pericarditis, and thrombotic complications, in relation to COVID-19 vaccination. Reports of myocarditis and pericarditis cases following messenger RNA vaccines have sparked interest, with discussions revolving around potential mechanisms and genetic predispositions. The contrasting findings on pericarditis risk postvaccination highlight the complexity of studying this phenomenon. Thrombotic events, particularly vaccine-induced thrombotic thrombocytopenia, have garnered attention, prompting investigations into antibody responses and mechanisms. This article underscores the importance of ongoing research, collaboration, and data analysis for accurately understanding adverse events. While the COVID-19 vaccination campaign may have ended, it is still vital to maintain vigilance, collect comprehensive data and foster interdisciplinary collaboration to uphold vaccine safety and steer public health strategies in the upcoming period.

Gender and citizenship disparities in the COVID-19 vaccination campaign in Italy

Abstract Background The literature identifies several cultural, religious, and gender-related factors associated with vaccine hesitancy. To guide a fair and more effective vaccination campaign, we investigated the association between these factors and adherence to COVID-19 vaccination in the 815,000 population assisted by the Local Health Authority (LHA) of Tuscany South-East, Italy. Methods Anonymized data on the vaccination status of patients (≥5 years) assisted by the LHA from December 2020 to January 2022 were extracted from the Health Information System of Collective Prevention. We evaluated vaccination coverage (≥2 doses, also considering any previous or subsequent infections) by age, gender and nationality. We performed logistic regression with STATA/MP13, setting the significance level at p < 0.05. Results Adherence to vaccination was significantly lower among foreign patients (68.1% vs 86.6% p < 0.01); after adjusting for age and nationality, a significantly lower propensity to vaccination was observed among women (adjOR 0.90 CI95% 0.89-0.91), also of Italian nationality (aOR 0.94 0.93-0.95). The gender difference was more marked among non-Italian citizens (aOR 0.82 0.79-0.84) and is accentuated in specific ethnic groups: Macedonian (aOR 0.61 0.52-0.71), Kosovar (aOR 0.53 0.45-0.61), Pakistani (aOR 0.63 0.52-0.75), Nigerian (aOR 0.49 0.38-0.64). Conclusions Lower vaccination coverage in women, particularly of foreign nationality, can be due to lower participation in social and working life, as it was decisive by law to access jobs with regular contracts. Public health has the task of removing these barriers and protecting the health of all citizens equally. According to our findings, we implemented equity-oriented measures, such as vaccination sessions without an appointment and with the presence of a cultural mediator, specific awareness campaigns aimed at personal assistants, dissemination of information material translated into several languages. Key messages • Women, especially of foreign nationality, have lower vaccination coverage. • Gender is a determinant of health: Public health has the task of removing these barriers and protecting the health of all citizens equally.

The COVID-19 Movement Restrictions and Impact on Shelter Accessibility: Central African Republic

Abstract Background The coronavirus disease(COVID-19) has been spread worldwide since 2019, posing significant challenges to the socio-economies and healthcare system of many countries. During COVID-19, sanitation facilities such as water, shelter, food, and health service are required to prevent the spread of coronaviruses and others. However, The multiple factors of Central African Republic(CAR) such as low human development index, limitation of health resources, and unstable financial capacity are a barrier to stopping the spread of the COVID-19. Also the government conducting the COVID-19 vaccination campaign since 2021, experiencing difficulties due to poor road conditions and insecurity. These cannot appropriately response to the coronavirus spread. Therefore, this study was conducted to investigate the effect of COVID-19 movement restrictions on shelter accessibility in CAR. Methods This study analyzed 11,723 crisis-affected households from the 2020 Central African Republic Multi-Cluster Needs Assessment survey data. This survey was conducted between June to August 2020 by the Racial and Ethnic Approaches to Community Health(REACH) Initiative and geographically covered all sub-prefectures of the country. Complex sampling design weighted multivariable binary logistic regression analysis was performed. Results It was found that shelter accessibility was possible when there was a movement restriction (p < 0.05). In the case of IDPs compared to HOST (p < 0.01), and the higher the number of household members (p < 0.05), the more difficult it was to access shelter. Conclusions In response to the spread of COVID-19 in CAR, humanitarian actors have conducted a variety of preparedness activities. Relief agencies have also adjusted operations to continue the delivery of shelter, food, health, livelihoods, and including movement restrictions. Therefore, although movement restrictions were implemented, the other activities such as increasing accessibility to shelter was also conducting. Key messages • This study was conducted to investigate the effect of COVID-19 movement restrictions on shelter accessibility in CAR. • There are many preparedness activities for stop the spread of COVID-19 in CAR. So even if the covid-19 movement restriction was conducting, the relief work (delivery of shelter) also implemented.

Vaccination and risk compensation during the COVID-19 pandemic in France

Abstract Vaccination has played a key role in reducing the health burden of COVID-19 (World Health Organisation (WHO), 2022), however, concern has been raised worldwide that risk compensation, a process whereby feelings of security arising from being vaccinated may lead people to reduce their engagement in other protective behaviours (Hedlund, 2000), could detract from the overall health benefit of the COVID-19 vaccination campaign (WHO, 2020). We explored whether COVID-19 vaccination elicited risk compensation and whether this changed over time by conducting a repeated cross-sectional study at seven intervals over the initial months of the vaccine rollout in France (February–September, 2021). Participants (N = 14,003) completed an online survey measuring vaccination status, vaccination intention and engagement in four preventive behaviours: mask wearing, avoidance of physical contact, hand hygiene, and avoiding social gatherings. Risk compensation was measured indirectly by comparing levels of engagement in protective behaviours according to vaccination status, with those unvaccinated but intending to vaccinate serving as a baseline. Risk compensation did not occur systematically and was mostly observed towards the end of the vaccine rollout for two of the four protective behaviours: avoiding social gatherings and wearing a mask. Fully-vaccinated participants reported avoiding social gatherings less often than those intending to vaccinate in July (Adjusted Odds Ratio (AOR) = .72, p = .045), and in September (AOR = .54, p = .022). A similar trend was observed in September among participants vaccinated with one dose who reported wearing a mask less often than their unvaccinated-but-intending-to-vaccinate counterparts (AOR = .48, p = .029). Our findings suggest that whilst unlikely to impede the overall effectiveness of public health campaigns, risk compensation, particularly among certain groups, nonetheless merits attention when designing informed, targeted public health messages and policy. Key messages • Limited evidence of risk compensation was observed towards the end of the vaccination campaign in France. • Risk compensation may not negate overall health benefit of a vaccination campaign, however from a public health perspective, nonetheless merits attention.

Assistance and Delivery of COVID-19 Vaccinations to Patients with Rare Diseases.

The COVID-19 vaccination campaign has been fortified by the positive effects of immunization: data from official government organizations and communication channels show that infection rates, hospitalizations, and deaths have continued to fall since its implementation. In Brazil, the effective and free National Vaccination Program has failed to prioritize patients with rare diseases, who have extreme comorbidities, and who adhere to the calendar prepared by the government. The question is why these "rare people" were not considered priorities during the vaccination program. This study aims to understand the reasoning behind this decision and to resume the debate around the rights of patients with rare diseases based on regular descriptors issued by official government agencies and by critics of rare disease issues in scientific articles. The objectives of this study were as follows: to analyze the dispensed care of rare disease patients in the COVID-19 vaccination campaign; to identify the procedures implemented by the National Vaccination Plan for the Brazilian population over 18 years of age and to evaluate the effectiveness of the plan implemented from the perspective of a "rare person".

Generation, types and impacts of biomedical waste during COVID-19: Indian context.

India's already-stressed waste disposal system has been strained by the COVID-19 outbreak. The challenge of managing biomedical Waste (BMW) in India has become more complicated in recent years, mainly due to the sudden emergence of COVID-19. As a methodology, a literature review was carried out with the help of Google Scholar, Research Gate, PubMed, and academic journal databases. Additionally, publications from numerous non-academic sources (such as news websites etc.) and current guidelines, such as those from the Ministry of Health and Family Welfare, Government of India, were also accessed. The review study identifies that PPE (Personal Protective Equipment) made up the majority of biomedical waste, followed by vaccine waste, during the peak of the COVID-19 vaccination campaign. The increase in PPEs such as face masks, aprons, face shields, gloves, goggles, and sanitizers, as well as other medical waste like bandages, plastic containers, syringes, testing kits, and tissues, has significantly changed the makeup of the BMW. This pandemic has hampered the proper management of solid waste, which has now surfaced as a major threat to developing countries. In this paper, biomedical waste management strategies followed in India and its disposal methods, cost-effective and environment-friendly methods to treat medical waste are also discussed.

Thromboembolic Events after COVID-19 Vaccination: An Italian Retrospective Real-World Safety Study.

Real-world safety studies can provide important evidence on the thromboembolic risk associated with COVID-19 vaccines, considering that millions of people have been already vaccinated against COVID-19. In this study, we aimed to estimate the incidence of thromboembolic events after COVID-19 vaccination and to compare the Oxford-AstraZeneca vaccine with other COVID-19 vaccines. We conducted a retrospective real-world safety study using data from two different data sources: the Italian Pharmacovigilance database (Rete Nazionale di Farmacovigilanza, RNF) and the Campania Region Health system (Sistema INFOrmativo saNità CampanIA, SINFONIA). From the start date of the COVID-19 vaccination campaign (27 December 2021) to 27 September 2022, information on COVID-19 vaccinations and thromboembolic events were extracted from the two databases. The reporting rate (RR) and its 95% confidence interval (95%CI) of thromboembolic events for 10,000 doses was calculated for each COVID-19 vaccine. Moreover, the odds of being vaccinated with the Oxford-AstraZeneca vaccine vs. the other COVID-19 vaccines in cases with thromboembolic events vs. controls without thromboembolic events were computed. A total of 12,692,852 vaccine doses were administered in the Campania Region, of which 6,509,475 (51.28%) were in females and mostly related to the Pfizer-BioNtech vaccine (65.05%), followed by Moderna (24.31%), Oxford-AstraZeneca (9.71%), Janssen (0.91%), and Novavax (0.02%) vaccines. A total of 641 ICSRs with COVID-19 vaccines and vascular events were retrieved from the RNF for the Campania Region, of which 453 (70.67%) were in females. Most ICSRs reported the Pfizer-BioNtech vaccine (65.05%), followed by Oxford-AstraZeneca (9.71%), Moderna (24.31%), and Janssen (0.91%). A total of 2451 events were reported in the ICSRs (3.8 events for ICSRs), of which 292 were thromboembolic events. The higher RRs of thromboembolic events were found with the Oxford-AstraZeneca vaccine (RR: 4.62, 95%CI: 3.50-5.99) and Janssen vaccine (RR: 3.45, 95%CI: 0.94-8.82). Thromboembolic events were associated with a higher likelihood of exposure to the Oxford-AstraZeneca vaccine compared to Pfizer-BioNtech (OR: 6.06; 95%CI: 4.22-8.68) and Moderna vaccines (OR: 6.46; 95%CI: 4.00-10.80). We observed a higher reporting of thromboembolic events with viral-vector-based vaccines (Oxford-AstraZeneca and Janssen) and an increased likelihood of being exposed to the Oxford-AstraZeneca vaccine compared to the mRNA vaccines (Pfizer-BioNtech and Moderna) among thromboembolic cases.

Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase

IntroductionThe impact of COVID-19 pandemic represents a serious challenge for ‘frail’ patients' populations with inflammatory autoimmune systemic diseases such as systemic sclerosis (SSc). We investigated the prevalence and severity of COVID-19, as well the effects of COVID-19 vaccination campaign in a large series of SSc patients followed for the entire period (first 38 months) of pandemic. Patients and methodThis prospective survey study included 1755 unselected SSc patients (186 M, 1,569F; mean age 58.7 ± 13.4SD years, mean disease duration 8.8 ± 7.3SD years) recruited in part by telephone survey at 37 referral centers from February 2020 to April 2023. The following parameters were carefully evaluated: i. demographic, clinical, serological, and therapeutical features; ii. prevalence and severity of COVID-19; and iii. safety, immunogenicity, and efficacy of COVID-19 vaccines. ResultsThe prevalence of COVID-19 recorded during the whole pandemic was significantly higher compared to Italian general population (47.3 % vs 43.3 %, p < 0.000), as well the COVID-19-related mortality (1.91 % vs 0.72 %, p < 0.001). As regards the putative prognostic factors of worse outcome, COVID-19 positive patients with SSc-related interstitial lung involvement showed significantly higher percentage of COVID-19-related hospitalization compared to those without (5.85 % vs 1.73 %; p < 0.0001), as well as of mortality rate (2.01 % vs 0.4 %; p = 0.002). Over half of patients (56.3 %) received the first two plus one booster dose of vaccine; while a fourth dose was administered to 35.6 %, and only few of them (1.99 %) had five or more doses of vaccine. Of note, an impaired seroconversion was recorded in 25.6 % of individuals after the first 2 doses of vaccine, and in 8.4 % of patients also after the booster dose. Furthermore, the absence of T-cell immunoreactivity was observed in 3/7 patients tested by QuantiFERON® SARSCoV-2 Starter Set (Qiagen). The efficacy of vaccines, evaluated by comparing the COVID-19-related death rate recorded during pre- and post-vaccination pandemic periods, revealed a quite stable outcome in SSc patients (death rate from 2.54 % to 1.76 %; p = ns), despite the significant drop of mortality observed in the Italian general population (from 2.95 % to 0.29 %; p < 0.0001). ConclusionsAn increased COVID-19 prevalence and mortality rate was recorded in SSc patients; moreover, the efficacy of vaccines in term of improved outcomes was less evident in SSc compared to Italian general population. This discrepancy might be explained by concomitant adverse prognostic factors: increased rate of non-responders to vaccine in SSc series, low percentage of individuals with four or more doses of vaccine, ongoing immunomodulating treatments, disease-related interstitial lung disease, and/or reduced preventive measures in the second half of pandemic. A careful monitoring of response to COVID-19 vaccines together with adequate preventive/therapeutical strategies are highly recommendable in the near course of pandemic in this frail patients’ population.

Drivers of vaccine hesitancy among vulnerable populations in India: a cross-sectional multi-state study.

India's Covid-19 vaccination campaign engaged frontline workers (FLWs) to encourage vaccination among vulnerable segments of society. The FLWs report encountering a variety of barriers to vaccination and are often unsuccessful despite multiple visits to the same person. This cross-sectional study aims to pinpoint which of these barriers drive vaccine hesitancy among these segments, to help streamline vaccine communication, including FLW training, to better safeguard the population. Trained field enumerators contacted 893 individuals from five states across India and collected self-reported assessments of fifteen vaccination barriers (identified through discussions with FLWs), current vaccination status and future vaccination intentions, and covariates (demographics/comorbidities). Factor analysis of the fifteen barriers yielded two factors, one relating to fear of vaccine adverse effects and a second focused on peripheral concerns regarding the vaccine. The covariates significantly associated with current vaccination status were combined under a latent class regime to yield three cluster types (health access, financial strength, and demographics). The primary analysis examined the effect of the two barrier factors, the covariate clusters, and comorbidity, on current vaccination status and future vaccine intentions. Fear of vaccine adverse effects was the primary driver of vaccine hesitancy; peripheral concerns frequently mentioned by the FLWs had no impact. Although cluster membership and the presence of comorbidities predicted vaccine uptake, neither of them materially altered the effect of fear of vaccine adverse effects with the following exception: fear of adverse effects was not associated with vaccination status among young Muslim men. Subject to limitations, these results indicate that interventions to decrease vaccine hesitancy should focus primarily on fear associated with vaccines rather than spend resources trying to address peripheral concerns.

Change in self-perceived vaccine confidence in France after the COVID-19 vaccination campaign: A cross-sectional survey in the French general population

IntroductionHigh COVID-19 vaccine coverage was obtained in France after theCOVID-19 vaccination campaign, in part due to the implementation of a COVID-19 vaccination pass, a kind of vaccine mandate. Vaccine mandates could lead to reactance and may affect confidence in vaccines. We aimed to evaluate the impact of the COVID-19 vaccination campaign on self-perceived vaccine confidence in France. MethodsBetween the 25th of April and the 9th of May 2022, we conducted a cross-sectional online survey among a representative sample of the French population aged 18 and over. The primary outcome was the perceived change in vaccine confidence after the COVID-19 vaccination campaign. We performed a multinomial regression analysis to identify factors associated with perceived decrease and increase in vaccine confidence in reference to no change. ResultsAmong the 1,928 respondents, decrease in vaccine confidence was reported by 579 (30 %) and increase in vaccine confidence by 259 (13.4%). Among the 1,711 vaccinated individuals, 693 (40.5%), 404 (23.6%) respectively reported that they felt strongly and a little coerced into getting vaccinated against COVID-19. Younger age, feeling coerced to get vaccinated, low confidence in health authorities, fears about vaccine side effects, and not considering vaccination as a collective responsibility were associated with perceived decrease in vaccine confidence in multivariable analysis. Men were more prone than women to report a gain in vaccine confidence. ConclusionVaccination campaign that included coercive measures to raise high COVID-19 vaccine coverage could have led to reactance and with an impact on vaccine confidence in general.

The Role of Vaccination Centers in a National Mass Immunization Campaign-Policymaker Insights from the German COVID-19 Pandemic Vaccine Roll-Out.

During the COVID-19 vaccination campaign, Germany, like other high-income countries, introduced mass vaccination centers for administering vaccinations. This qualitative study aimed to examine the role that these novel, temporary government healthcare structures played in a mass immunization roll-out and how they can be optimally deployed. In addition, learnings for general emergency preparedness were explored. A total of 27 high-level policymakers responsible for planning and implementing the COVID vaccination campaign at the national and state level in Germany were interviewed in May and June 2022. The semi-structured interviews were analyzed using thematic analysis. Interviewees indicated that mass vaccination structures played an essential role with respect to controllability, throughput, accessibility and openness in line with the key success criteria vaccination coverage, speed and accessibility. In contrast to the regular vaccination structures (private medical practices and occupational health services), public administration has direct authority over mass vaccination centers, allowing for reliable vaccine access prioritization and documentation. The deployment of vaccination centers should be guided by vaccine availability and demand, and vaccine requirements related to logistics, as well as local capacities, i.e., public-health-service strength and the physician density, to ensure effective, timely and equitable access. Improvements to the capacity use, scalability and flexibility of governmental vaccination structures are warranted for future pandemics.

Persuasive COVID-19 vaccination campaigns on Facebook and nationwide vaccination coverage in Ukraine, India, and Pakistan.

Social media platforms have a wide and influential reach, and as such provide an opportunity to increase vaccine uptake. To date, there is no large-scale, robust evidence on the offline effects of online messaging campaigns. We aimed to test whether pre-tested, persuasive messaging campaigns from UNICEF, disseminated on Facebook, influenced COVID-19 vaccine uptake in Ukraine, India, and Pakistan. In Ukraine, we deployed a stepped-wedge randomized controlled trial (RCT). Half of the 24 oblasts (provinces) received five weeks of the intervention, the other half ten weeks of the intervention. In India, an RCT with an augmented synthetic control was conducted in five states (Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan), whereby 40 out of 174 districts were randomized to receive six weeks of intervention. In Pakistan we deployed a pre-post design, whereby 25 city districts received six weeks of the intervention. Weekly COVID-19 vaccination data was sourced through government databases. Using Poisson regression models, the association between the intervention and vaccine uptake was estimated. In Ukraine we conducted a survey among Facebook users at three time points during the RCT, to ascertain vaccination intentions and trust in vaccines. The campaigns reached more than 110 million Facebook users and garnered 2.9 million clicks. In Ukraine, we found that the intervention did not affect oblast-level vaccination coverage (Relative Risk (RR): 0.93, 95% Confidence Interval (CI) 0.86-1.01). Similarly, in India and Pakistan we found no effect of our intervention (India: RR 0.85, 95% CI 0.70-1.04; Pakistan: RR 0.64, 95% CI 0.01-29.9). The survey among Facebook users in Ukraine showed that trust in vaccines and information sources was an important predictor of vaccination status and intention to get vaccinated. Our campaigns on Facebook had a wide reach, which did not translate in shifting behaviours. Timing and external events may have limited the effectiveness of our interventions.

COVID-19 vaccine effectiveness against hospitalizations in Paraguay, May 2021—April 2022: A test-negative design

BackgroundVaccine effectiveness (VE) estimates vary by population characteristics and circulating variants. North America and Europe have generated many COVID-19 VE estimates but relied heavily on mRNA vaccines. Fewer estimates are available for non-mRNA vaccines and from Latin America. We aimed to estimate the effectiveness of several COVID-19 vaccines in preventing SARS-CoV-2-associated severe acute respiratory infection (SARI) in Paraguay from May 2021 to April 2022. MethodsUsing sentinel surveillance data from four hospitals in Paraguay, we conducted a test-negative case-control study to estimate COVID-19 vaccine effectiveness against SARI by vaccine type/brand and period of SARS-CoV-2 variant predominance (Gamma, Delta, Omicron). We used multivariable logistic regression adjusting for month of symptom onset, age group, and presence of ≥1 comorbidity to estimate the odds of COVID-19 vaccination in SARS-CoV-2 test-positive SARI case-patients compared to SARS-CoV-2 test-negative SARI control-patients. ResultsOf 4,229 SARI patients, 2,381 (56%) were SARS-CoV-2-positive case-patients and 1,848 (44%) were SARS-CoV-2-negative control-patients. A greater proportion of case-patients (73%; 95% CI: 71–75) than of control-patients (40%; 95% CI: 38–42) were unvaccinated. During the Gamma variant-predominant period, VE estimates for partial vaccination with mRNA vaccines and Oxford/AstraZeneca Vaxzevria were 90.4% (95% CI: 66.4–97.6) and 52.2% (95% CI: 25.0–69.0), respectively. During the Delta variant-predominant period, VE estimates for complete vaccination with mRNA vaccines, Oxford/AstraZeneca Vaxzevria, or Gamaleya Sputnik V were 90.4% (95% CI: 74.3–97.3), 83.2% (95% CI: 67.8–91.9), and 82.9% (95% CI: 53.0–95.2), respectively. The effectiveness of all vaccines declined substantially during the Omicron variant-predominant period. ConclusionsThis study contributes to our understanding of COVID-19 VE in Latin America and to global understanding of vaccines that have not been widely used in North America and Europe. VE estimates from Paraguay can parameterize models to estimate the impact of the national COVID-19 vaccination campaign in Paraguay and similar settings.

Socioeconomic Differences in SARS-CoV-2 Infection and Vaccination in Germany: A Seroepidemiological Study After One Year of COVID-19 Vaccination Campaign.

Objective: To evaluate the socioeconomic patterns of SARS-CoV-2 antigen contacts through infection, vaccination or both ("hybrid immunity") after 1year of vaccination campaign. Methods: Data were derived from the German seroepidemiological Corona Monitoring Nationwide study (RKI-SOEP-2; n = 10,448; November 2021-February 2022). Combining serological and self-report data, we estimated adjusted prevalence ratios (PR) of SARS-CoV-2 infection, COVID-19 vaccination, basic immunization (at least two SARS-CoV-2 antigen contacts through vaccination and/or infection), and three antigen contacts by education and income. Results: Low-education groups had 1.35-times (95% CI 1.01-1.82) the risk of SARS-CoV-2 infection compared to high-education groups. COVID-19 vaccination (at least one dose) and basic immunization decreased with lower education and income. Low-education and low-income groups were less likely to have had at least three antigen contacts (PR low vs. high education: 0.74, 95% CI 0.65-0.84; PR low vs. high income: 0.66, 95% CI 0.57-0.77). Conclusion: The results suggest a lower level of protection against severe COVID-19 for individuals from low and medium socioeconomic groups. Pandemic response and vaccination campaigns should address the specific needs and barriers of these groups.

Medical Expert Endorsement Fails to Reduce Vaccine Hesitancy in U.K. Residents

In this report we outline the null findings of a pre-registered experiment on vaccine hesitancy in the United Kingdom. The experiment targeted vaccine misconceptions common among participants by presenting a correction to such claims endorsed by a group of medical experts. The experiment had the aim to increase vaccination intention and actual uptake during the 2021 COVID-19 vaccination campaign. Our results revealed that, contrary to a similar study conducted with Italian residents, our intervention was unsuccessful in changing participants’ attitudes and behaviour towards COVID-19 vaccines. The report concludes with a discussion of the potential reasons for these null findings.