Global Vaccination Programs Research Articles

Analysis of Relative Average Length of Telomeres in Leukocytes of Women with COVID-19.

Coronavirus disease (COVID-19) is an acute infectious disease of the respiratory tract caused by a new SARS-CoV-2 coronavirus. A global vaccination program against SARS-CoV-2 continues, and the incidence of COVID-19 worldwide is significantly decreasing. However, among millions of those who survived COVID-19, numerous groups will need assistance due to increased clinical consequences after COVID-19. Currently, there is a need to search for molecular biomarkers for monitoring the onset and progression of post-COVID syndrome. For this purpose, the relative average length of chromosome regions was studied in the groups of women of reproductive age: in the group of patients (n = 64) recovered from COVID-19 and in the control group (n = 42) of women of the same age. The analysis was carried out using a method of multiplex monochrome quantitative real-time PCR on DNA samples isolated from the peripheral blood leukocytes. According to the results of the study, it was established that the relative average length of chromosomes in the peripheral blood leukocytes was statistically significantly lower in the group of patients with COVID-19 than in the control group (p < 0.05). The results obtained allow one to state that the observed shortening of the relative average length of telomeres in the group of patients that recovered from COVID-19 can indicate that SARS-CoV-2 infection can directly cause the erosion of telomeres in the blood cells, particularly, in leukocytes. Thus, the determination of the relative average length of telomeres can be an informative prognostic marker for estimating the risk of the severity of COVID-19 disease and the development of post-COVID syndrome.

What are the barriers and facilitators to polio vaccination and eradication programs? A systematic review.

Global efforts to eradicate polio by the Global Polio Eradication Initiative agency partners and country-level stakeholders have led to the implementation of global polio vaccination programs. This study presents the findings of existing studies regarding the barriers and facilitators that countries face when implementing polio interventions. A comprehensive search was conducted in OVID Medline, OVID Embase, EBSCO CINAHL Plus, and Web of Science. Eligible studies underwent quality assessment. A qualitative evidence synthesis approach was conducted and aligned to the Consolidated Framework for Implementation Research (CFIR). The search identified 4147 citations, and following the removal of duplicates and screening according to our inclusion/exclusion criteria, 20 articles were eligible for inclusion in the review. Twelve countries were represented in this review, with India, Nigeria, Pakistan, Ethiopia, and Afghanistan having the most representation of available studies. We identified 36 barriers and 16 facilitators. Seven themes emerged from these barriers and facilitators: fear, community trust, infrastructure, beliefs about the intervention, influential opinions, intervention design, and geo-politics. The most frequently cited CFIR constructs for the facilitators and barriers were knowledge and beliefs about the intervention, followed by available resources. This study identified a wide range of barriers and facilitators to polio vaccination implementation across the globe, adding to the scarce body of literature on these barriers and facilitators from an implementation perspective and using a determinant framework. The diversity of factors among different groups of people or countries highlights the relevance of contexts. Implementers should be conversant with the contexts within which polio eradication programs boost intervention coverage and capacity. This study provides policymakers, practitioners, and researchers with a tool for planning and designing polio immunization programs. Trial registration: A protocol for this systematic review was developed and uploaded onto the PROSPERO international prospective register of systematic reviews database (Registration number: CRD42020222115).

COVID-19 vaccines and filler reactions: Should it be considered as a concern?

Any implant or external material used in the body tissues can potentially be followed by autoimmune or inflammatory reactions. With the global vaccination program against COVID‐19, reports of tissue filler reactions would be increasingly demonstrated. Although the end of pandemic was announced, the necessity of continuing COVID vaccination in future mandates gathering data regarding safety of vaccines. Here in, we summarized the data regarding COVID vaccination and filler reactions and discussed its etiopathogenesis, management and importance.

The COVID-19 pandemic and its impact on esthetic dermatology.

In general, the world population interest has increased for maintaining youthfulness and having better appearance since this leads to a better mental wellbeing and self‐estimate. The coronavirus disease 2019 (COVID‐19) pandemic has revolutionized every field of medicine. As every specialty has been affected by limitations caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), this branch of medicine has also needed certain precautions for safer practice in the COVID era. With the global vaccination program against COVID‐19, reports of some cutaneous reactions in patients have been undergone various esthetic procedures including filler or botox injection would be increasingly demonstrated. Although the end of pandemic was announced, the necessity of continuing COVID vaccination in future mandates gathering data regarding safety of vaccines. Herein, we presented a comprehensive review on various aspects of association between esthetic medicine or cosmetic dermatology and COVID‐19.

Intrinsic Kidney Pathology in Children and Adolescents Following COVID-19 Vaccination: A Systematic Review.

Global COVID-19 vaccination programs for children and adolescents have been developed with international clinical trial data confirming COVID-19 mRNA vaccine safety and efficacy for the pediatric population. The impact of COVID-19 vaccination in the kidneys is thought to be explained by a complex immune-mediated relationship between the two, although the pathophysiological mechanisms of how COVID-19 vaccination potentially induces kidney pathology are not presently well known. Whilst intrinsic kidney pathologies following COVID-19 vaccination have been reported in adults, such cases are only being recently reported with greater frequency in children and adolescents. Conforming to the PRISMA checklist, we conducted a systematic review of the current literature to provide an overview on the range of intrinsic kidney pathologies that have been reported following COVID-19 vaccination in children and adolescents. All English language research articles published on or before 30 June 2022 reporting new-onset or relapsed intrinsic kidney pathology in children or adolescents (≤18 years) following COVID-19 vaccination were selected for qualitative analysis. Out of 18 cases from the 13 published articles selected, there were 10 cases of IgA nephropathy (1 case of rapidly progressive glomerulonephritis requiring acute hemodialysis), 5 cases of minimal change disease (MCD), 1 case of concurrent MCD/tubulointerstitial nephritis (TIN) and 2 cases of TIN. There is no indication currently to avoid vaccination, unless specific circumstances exist, as the benefits of COVID-19 vaccination far outweigh its risks. Concluding the findings from our systematic review based on preliminary evidence, potential adverse effects to the kidney from COVID-19 vaccination affects a small number of children and adolescents among the many who have been vaccinated. There remains good reason at present to support vaccination of children and adolescents with a greater morbidity status, such as those living with preexisting chronic kidney disease. Close observation of all children and adolescents receiving COVID-19 vaccination is recommended, particularly in those with preceding intrinsic kidney pathology to identify risks of relapsed disease.

Adapted digital health literacy and health information seeking behavior among lower income groups in Malaysia during the COVID-19 pandemic.

BackgroundMisinformation has had a negative impact upon the global COVID-19 vaccination program. High-income and middle-income earners typically have better access to technology and health facilities than those in lower-income groups. This creates a rich-poor divide in Digital Health Literacy (DHL), where low-income earners have low DHL resulting in higher COVID-19 vaccine hesitancy. Therefore, this cross-sectional study was undertaken to assess the impact of health information seeking behavior on digital health literacy related to COVID-19 among low-income earners in Selangor, Malaysia.MethodsA quantitative cross-sectional study was conducted conveniently among 381 individuals from the low-income group in Selangor, Malaysia. The remote data collection (RDC) method was used to gather data. Validated interviewer-rated questionnaires were used to collect data via phone call. Respondents included in the study were 18 years and older. A normality of numerical variables were assessed using Shapiro-Wilk test. Univariate analysis of all variables was performed, and results were presented as means, mean ranks, frequencies, and percentages. Mann-Whitney U test or Kruskal Wallis H test was applied for the comparison of DHL and health information seeking behavior with characteristics of the participants. Multivariate linear regression models were applied using DHL as dependent variable and health information seeking behavior as independent factors, adjusting for age, gender, marital status, educational status, employment status, and household income.ResultsThe mean age of the study participants was 38.16 ± 14.40 years ranging from 18 to 84 years. The vast majority (94.6%) of participants stated that information seeking regarding COVID-19 was easy or very easy. Around 7 percent of the respondents cited reading information about COVID-19 on the internet as very difficult. The higher mean rank of DHL search, content, reliability, relevance, and privacy was found among participants who were widowed, had primary education, or unemployed. An inverse relationship was found between overall DHL and confidence in the accuracy of the information on the internet regarding COVID-19 (β = −2.01, 95% CI = −2.22 to −1.79).ConclusionIt is important to provide support to lower-income demographics to assist access to high-quality health information, including less educated, unemployed, and widowed populations. This can improve overall DHL.

Efferent neuro-ophthalmic complications of coronavirus disease 2019.

We set out to describe efferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe syndromes affecting ocular motility and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, COVID-19 continues to pose an international threat that may rarely result in diplopia or nystagmus. Efferent complications include cranial nerve palsies leading to diplopia, either isolated or in association with Miller Fisher syndrome. Nystagmus has been observed in the setting of hemorrhagic acute necrotizing encephalopathy and brainstem infarcts, and opsoclonus syndrome has been described. Observed neuro-ophthalmic associations need to be confirmed through larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.

Identifying priority challenges and solutions for COVID-19 vaccine delivery in low- and middle-income countries: A modified Delphi study.

The rapid implementation of global COVID-19 vaccination programs has surfaced many challenges and inequities, particularly in low- and middle-income countries (LMICs). However, there continues to be a lack of consensus on which challenges are global priorities for action, and how to best respond to them. This study uses consensus-based methods to identify and rank the most important challenges and solutions for implementation of COVID-19 vaccination programs in LMICs. We conducted a three-round modified Delphi study with a global panel of vaccine delivery experts. In Round I, panelists identified broad topical challenges and solutions. Responses were collated and coded into distinct items. Through two further rounds of structured, iterative surveys panelists reviewed and ranked the identified items. Responses were analyzed qualitatively and quantitatively to achieve consensus on the most important COVID-19 vaccine delivery challenges and solutions. Of the 426 invited panelists, 96 completed Round I, 56 completed Round II, and 39 completed Round III. Across all three rounds there was equal representation by gender, and panelists reported work experience in all World Bank regions and across a variety of content areas and organizations. Of the 64 initially identified items, the panel achieved consensus on three challenges and 10 solutions. Challenges fell under themes of structural factors and infrastructure and human and material resources, while solutions also included items within themes of communication, community engagement, and access and planning, processes, and operations. COVID-19 vaccine delivery is challenged by long-standing and structural inequities that disadvantage health service delivery in LMICs. These findings can, and should, be used by global health organizations to efficiently and optimally direct resources to respond to these key challenges and solutions.

Monkeypox Goes North: Ongoing Worldwide Monkeypox Infections in Humans.

In the late 1970s, global vaccination programs resulted in the eradication of smallpox. The Monkeypox virus (MPXV), which is closely related to the smallpox-inducing variola virus, was previously endemic only in Sub-Saharan Africa but is currently spreading worldwide. Only older people who have been vaccinated against smallpox are expected to be sufficiently protected against poxviruses. Here I will summarize current knowledge about the virus, the disease caused by MPXV infections, and strategies to limit its spread.

Vaccination of pregnant women against COVID-19 under martial law: a narrative review

Background: Global vaccination programs against the coronavirus illness of 2019 (COVID-19) have been established as the primary measure to minimise and control the effects of the COVID-19 pandemic. During pregnancy, it is assumed that the expectant mother and her fetus are both in danger from the possibility of a viral infection. Aim: to evaluate the safety and effectiveness of vaccination against COVID-19 for pregnant women and determine the impact of vaccination on pregnancy outcomes. Methods: In this review, English studies from common databases such as Pubmed/MEDLINE, Web of Science, Scopus, and the Cochrane Library with the keywords "Vaccination," "pregnancy," and "pregnant women," combined with keywords, involving "COVID-19," were involved. The end date for this review is March 2022. Scientific novelty: The main objective of this paper is to evaluate the effect of vaccination of pregnant women against COVID-19. Even though many studies assessed the efficacy of vaccination against COVID-19, most failed to determine the safety and effectiveness of COVID-19 vaccination for immunocompromised patients, especially pregnant women. Additionally, the impact of COVID-19 vaccination on neonatal outcomes was evaluated. The practical significance of the obtained result: Concerns have also been raised about potential risks associated with vaccination during pregnancy or breastfeeding. Given these uncertainties, it is important for healthcare providers to carefully consider the risks and benefits of COVID-19 vaccination for pregnant women and their babies. Further research is needed to better understand the effects of vaccination on perinatal outcomes and to inform clinical decision-making around vaccine use in this population. Conclusion: The COVID-19 vaccination is a safe and effective way to protect pregnant women from the virus. The benefits of getting vaccinated outweigh the risks, as pregnant women are at an increased risk of severe illness and complications from COVID-19. The Centers for Disease Control and Prevention (CDC) recommends that pregnant women get vaccinated, and many healthcare providers also recommend it. However, it is important for pregnant women to discuss their individual situation with their healthcare provider before making a decision about vaccination. Overall, getting vaccinated can help to protect both the mother and her unborn child from COVID-19. Background: Global vaccination programs against the coronavirus illness of 2019 (COVID-19) have been established as the primary measure to minimise and control the effects of the COVID-19 pandemic. During pregnancy, it is assumed that the expectant mother and her fetus are both in danger from the possibility of a viral infection. Aim: to evaluate the safety and effectiveness of vaccination against COVID-19 for pregnant women and determine the impact of vaccination on pregnancy outcomes. Methods: In this review, English studies from common databases such as Pubmed/MEDLINE, Web of Science, Scopus, and the Cochrane Library with the keywords "Vaccination," "pregnancy," and "pregnant women," combined with keywords, involving "COVID-19," were involved. The end date for this review is March 2022. Scientific novelty: The main objective of this paper is to evaluate the effect of vaccination of pregnant women against COVID-19. Even though many studies assessed the efficacy of vaccination against COVID-19, most failed to determine the safety and effectiveness of COVID-19 vaccination for immunocompromised patients, especially pregnant women. Additionally, the impact of COVID-19 vaccination on neonatal outcomes was evaluated. The practical significance of the obtained result: Concerns have also been raised about potential risks associated with vaccination during pregnancy or breastfeeding. Given these uncertainties, it is important for healthcare providers to carefully consider the risks and benefits of COVID-19 vaccination for pregnant women and their babies. Further research is needed to better understand the effects of vaccination on perinatal outcomes and to inform clinical decision-making around vaccine use in this population. Conclusion: The COVID-19 vaccination is a safe and effective way to protect pregnant women from the virus. The benefits of getting vaccinated outweigh the risks, as pregnant women are at an increased risk of severe illness and complications from COVID-19. The Centers for Disease Control and Prevention (CDC) recommends that pregnant women get vaccinated, and many healthcare providers also recommend it. However, it is important for pregnant women to discuss their individual situation with their healthcare provider before making a decision about vaccination. Overall, getting vaccinated can help to protect both the mother and her unborn child from COVID-19.

Inflammasomes and IL-1 family cytokines in SARS-CoV-2 infection: from prognostic marker to therapeutic agent

Despite global vaccination programs, infections with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) continue to cause severe disease with significant morbidity and mortality. Severe coronavirus disease 2019 (COVID-19) is characterized by an exuberant inflammatory response in the lung leading to acute lung injury and consequent gas exchange problems. Complete insights in this hyperinflammatory response are still lacking. However, a thorough understanding of immunopathogenesis of severe COVID-19 is needed to not only develop personalized targeted therapies, but also to identify biomarkers that predict disease outcome and therapeutic responses. Here we review the current evidence that SARS-CoV-2 activates the inflammasome, which is an intracellular multiprotein complex that leads to the activation and secretion of the interleukin (IL)-1 family cytokines, IL-1β and IL-18, and to a lytic form of cell death, called pyroptosis. Further we discuss the contribution of inflammasomes and IL-1 family cytokines to the immunopathogenesis of COVID-19 and its clinical implications.

Thrombotic Complications after COVID-19 Vaccination: Diagnosis and Treatment Options.

Coronavirus disease 2019 (COVID-19) vaccines were developed a few months after the emergence of the pandemic. The first cases of vaccine-induced thrombotic complications after the use of adenoviral vector vaccines ChAdOx1 nCoV-19 by AstraZeneca, and Ad26.COV2.S by Johnson & Johnson/Janssen, were announced shortly after the initiation of a global vaccination program. In these cases, the occurrence of thrombotic events at unusual sites—predominantly located in the venous vascular system—in association with concomitant thrombocytopenia were observed. Since this new entity termed vaccine-induced thrombotic thrombocytopenia (VITT) shows similar pathophysiologic mechanisms as heparin-induced thrombocytopenia (HIT), including the presence of antibodies against heparin/platelet factor 4 (PF4), standard routine treatment for thrombotic events—arterial or venous—are not appropriate and may also cause severe harm in affected patients. Thrombotic complications were also rarely documented after vaccination with mRNA vaccines, but a typical VITT phenomenon has, to date, not been established for these vaccines. The aim of this review is to give a concise and feasible overview of diagnostic and therapeutic strategies in COVID-19 vaccine-induced thrombotic complications.

Determinants of COVID-19 Vaccine Acceptance in West Papua, Indonesia

BACKGROUND: A COVID-19 vaccine is available but acceptance in the community is still low. One of the causes of this is information, that is, lacking and cannot be understood by the community because it is not specific to the context of geography, culture, and sociodemography. AIM: The aim of this research is to understand the people’s desire for the COVID-19 vaccine in West Papua, Indonesia. METHODS: A web-based cross-sectional study was conducted using a snowball sampling strategy under a very limited environment. Questionnaires were designed and sent to study participants through social media forms. Study participants were recruited throughout West Papua. The main determinants predicting vaccine acceptance among respondents were modeled using logistic regression analysis. RESULTS: A total of 314 participants were willing to take the survey. Of the 314 participants, we found that education level, knowledge, and fear were the main factors predicting acceptance of the COVID-19 vaccine, respectively (p-value; 0.019, 0.018, and 0.031). CONCLUSIONS: Sociodemographic determinants related to COVID-19 vaccination to develop new effective interventions to increase information stability and identify key factors, health education interventions that are appropriate for the language, culture, and socioeconomics can help increase the uptake of global vaccination programs to cope with the future pandemics.

The Impact of the COVID-19 Pandemic on the Practice of Forensic Medicine: An Overview.

During the COVID-19 pandemic, forensic sciences, on the one hand, contributed to gaining knowledge about different aspects of the pandemic, while on the other hand, forensic professionals were called on to quickly adapt their activities to respond adequately to the changes imposed by the pandemic. This review aims to clarify the state of the art in forensic medicine at the time of COVID-19, discussing the following: the influence of external factors on forensic activities, the impact of autopsy practice on COVID-19 and vice-versa, the persistence of SARS-CoV-2 RNA in post-mortem samples, forensic personnel activities during the SARS-CoV-2 pandemic, the global vaccination program and forensic sciences, forensic undergraduate education during and after the imposed COVID-19 lockdown, and the medico-legal implications in medical malpractice claims during the COVID-19 pandemic. The COVID-19 pandemic has greatly influenced different aspects of human life, and, accordingly, the practical activities of forensic sciences that are defined as multidisciplinary, involving different expertise. Indeed, the activities are very different, including crime scene investigation (CSI), external examination, autopsy, and genetic and toxicological examinations of tissues and/or biological fluids. At the same time, forensic professionals may have direct contact with subjects in life, such as in the case of abuse victims (in some cases involving children), collecting biological samples from suspects, or visiting subjects in the case of physical examinations. In this scenario, forensic professionals are called on to implement methods to prevent the SARS-CoV-2 infection risk, wearing adequate PPE, and working in environments with a reduced risk of infection. Consequently, in the pandemic era, the costs involved for forensic sciences were substantially increased.

Unpacking the Implications of SARS-CoV-2 Breakthrough Infections on COVID-19 Vaccination Programs.

Despite an array of preventive global public health interventions, SARS-CoV-2 has continued to spread significantly, infecting millions of people across the globe weekly. Newer variants of interest and concern have continued to emerge, placing the need for policymakers to rethink prevention strategies to end the pandemic. The approval of SARS-CoV-2 vaccines for public health use in December 2020 was seen as a significant development towards pandemic control and possibly ending the pandemic. However, breakthrough infections have continued to be observed among the ‘fully vaccinated’, and the duration and sustainability of vaccine-induced immunity has remained a topical public health discourse. In the absence of accurate public health communication, the breakthrough infections and waning immunity concepts have potential to further compound vaccine hesitancy. With this viewpoint, we discuss breakthrough SARS-CoV-2 infections, waning immunity, the need for COVID-19 booster shots, vaccine inequities, and the need to address vaccine hesitancy adequately to propel global vaccination programs forward.

A System View to the Risks of COVID-19 Vaccination Projects

The global vaccination program provides hope for ending the present worldwide pandemic. Due to the current pandemic, COVID-19 vaccines must be delivered and administered to communities once supplies are available. However, there are significant challenges in the sourcing, allocation, distribution, and uptake of vaccinations. A successful vaccination program would necessitate adequate risk management across the vaccination supply chain. This article has collected the predictable risks of the COVID-19 vaccines considered within the vaccine delivery system framework. The risks are presented based on relevant literature. Hence, this work’s framework is expected to contribute to better risk management of vaccination programs and similar future projects.

Declared Intention (Not) to Be Vaccinated against COVID-19, and Actual Behavior-The Longitudinal Study in the Polish Sample.

AIMS: The aim of the study was to investigate the relation between declared intention to get/not get vaccinated against COVID-19, prior to the start of the global vaccination program, and actual vaccine uptake. Moreover, reasons for getting vaccinated or rejecting it were measured along with declared intent and behavior. METHODS: Within a longitudinal design, a representative sample of 918 Polish people was surveyed in February 2021 and August 2021. In February 2021, participants were asked about their intention to get vaccinated against COVID-19 and the reasons behind it. In August 2021, the same group was asked about having been vaccinated, along with the reasons. RESULTS: A significant pro-vaccine shift from declared intent to behavior was observed, with many participants turning away from being anti-vaccine or undecided and getting vaccinated. Significant correlations with attitudes toward general mandatory vaccination of children were found. Increased support for anti-vaccine arguments was seen over time in the unvaccinated sample, and decreased support for pro-vaccine arguments was seen in the vaccinated sample. Several key arguments for and against vaccination were identified. CONCLUSIONS: Declared attitude toward COVID-19 vaccination is not fully consistent with vaccination behavior. Pro-vaccine changes in attitudes of previously anti-vaccine and undecided individuals indicate that these groups may be influenced to potentially accept the COVID-19 vaccination over time.

Beliefs, barriers, and acceptance associated with COVID-19 vaccination among Taif University students in Saudi Arabia.

Background:COVID-19 was declared a public health emergency of global concern by the World Health Organization (WHO) on January 30, 2020. Vaccination is one of the most effective methods for halting the pandemic and preventing complications. Vaccine hesitancy is a possible threat to global public health. Understanding the key determinants that influence the community's preferences and demands for a future vaccine may aid in the development of strategies to improve the global vaccination program. The aim of this study was to assess the beliefs, barriers, and acceptance of COVID-19 vaccination among Taif University students in Saudi Arabia.Materials and Method:This was a descriptive cross-sectional study, based study in Taif University, Saudi Arabia. Data was collected using a designed self-administered questionnaire that was shared as a link through social media. 332 students were considered eligible to participate voluntarily. Data were analyzed using the (SPSS) program version 25.Results:Out of 332 participants, 278 (83.7%) were accepting to take the covid vaccine, while 54 (16.3%) refused. Believes in vaccine safety and effectiveness and trust in the ability of the vaccine to prevent the complication, were all associated with high acceptance rate. Fear about side effects is considered a major factor for vaccination refusal.Conclusion:Most of the participants have the willingness to be vaccinated. The majority of students who agreed to take the vaccine were in the medical field, and that is mostly due to their high knowledge exposure. This indicates the importance of raising the awareness of the non-medical students.

COVID-19 vaccines and anti-consumption: Understanding anti-vaxxers hesitancy.

Anti‐vaccination sentiment and vaccine hesitancy are on the rise. This is unfortunate given the world's coronavirus disease 2019 (COVID‐19) pandemic response plan relies on a global vaccination program the likes of which has never been attempted. Using an anti‐consumption lens, this study utilizes a qualitative approach and 53 interviews revolving around people's attitudes towards the COVID‐19 vaccination plan. The findings reveal that COVID‐19 vaccination hesitancy comes from two major factors: stable factors and contextual factors. Stable factors refer to factors that are consistently found in anti‐vaccination movements and include political and philosophical opposition. Contextual factors refer to factors that are highly dependent on the COVID‐19 situation and relates to a negative benefit to risk ratio informed by information overload and the influence of marketing phenomena such as branding and country of origin effects. Finally, theoretical and managerial contributions are offered for public policymakers and social marketers.

An open, non-randomised, phase 1/2 trial on the safety, tolerability, and immunogenicity of single-dose vaccine "Sputnik Light" for prevention of coronavirus infection in healthy adults.

SummaryBackgroundWhile the world is experiencing another wave of COVID-19 pandemic, global vaccination program is hampered by an evident shortage in the supply of licensed vaccines. In an effort to satisfy vaccine demands we developed a new single-dose vaccine based on recombinant adenovirus type 26 (rAd26) vector carrying the gene for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) glycoprotein – “Sputnik Light”.MethodsWe conducted an open label, prospective, non-randomised phase 1/2 trial aimed to assess safety, tolerability, and immunogenicity of “Sputnik Light” vaccine in a single center in Russia. Primary outcome measures were antigen-specific humoral immunity (Anti-RBD-SARS-CoV-2 antibodies measured by ELISA on days 1, 10, 28, and 42) and safety (number of participants with adverse events monitored throughout the study). Secondary outcome measures were antigen-specific cellular immunity (measured by antigen-dependent CD4+ and CD8+ T-cell proliferation, number of antigen-specific interferon-γ-producing cells as well as interferon-γ concentration upon antigen restimulation) and change in neutralizing antibodies (measured in SARS-CoV-2 neutralization assay).FindingsMost of the solicited adverse reactions were mild (66·4% from all vaccinees), few were moderate (5·5%). No serious adverse events were detected. Assessment of Anti-RBD-SARS-CoV-2 antibodies revealed a group with pre-existing immunity to SARS-CoV-2. Upon this finding we separated all safety and immunogenicity data based on pre-existing immunity to SARS-CoV-2. There were notable differences in the vaccine effects on immunogenicity by the groups. Vaccination of seropositive (N=14) volunteers rapidly boosted RBD-specific IgGs from reciprocal geometric mean titer (​GMT) 594·4 at a baseline up to 26899 comparing to 29·09 in seronegative group (N=96) by day 10. By day 42 seroconversion rate reached 100% (93/93) in seronegative group with GMT 1648. At the same time, in the seropositive group, seroconversion rate by day 42 was 92·9% (13/14) with GMT 19986. Analysis of neutralizing antibodies to SARS-CoV-2 showed 81·7% (76/93) and 92·9% (13/14) seroconversion rates by day 42 with median reciprocal GMT 15·18 and 579·7 in the seronegative and seropositive groups, respectively. Antigen-specific T cell proliferation, formation of IFNy-producing cells, and IFNy secretion were observed in 96·7% (26/27), 96% (24/25), and 96% (24/25) of the seronegative group respectively and in 100% (3/3), 100% (5/5), and 100% (5/5) of the seropositive vaccinees, respectively.InterpretationThe single-dose rAd26 vector-based COVID-19 vaccine “Sputnik Light” has a good safety profile and induces a strong humoral and cellular immune responses both in seronegative and seropositive participants.FundingRussian Direct Investment Fund.