Low COVID-19 Research Articles

Detection and Characterization of Web-Based Pediatric COVID-19 Vaccine Discussions and Racial and Ethnic Minority Topics: Retrospective Analysis of Twitter Data.

Despite pediatric populations representing a smaller proportion of COVID-19 cases and having a less severe prognosis, those belonging to racial and ethnic minority groups are at an increased risk of developing more severe COVID-19-related outcomes. Vaccine coverage is crucial to pandemic mitigation efforts, yet since the start of the COVID-19 pandemic, vaccine hesitancy has increased and routine pediatric immunizations have decreased. Limited research exists on how vaccine hesitancy may contribute to low pediatric COVID-19 vaccine uptake among racial and ethnic minority populations. This study aimed to characterize COVID-19 vaccine-related discussion and sentiment among Twitter users, particularly among racial and ethnic minority users. We used the Twitter application programming interface to collect tweets and replies. Tweets were selected by filtering for keywords associated with COVID-19 vaccines and pediatric-related terms. From this corpus of tweets, we used the Biterm Topic Model to output topics and examined the top 200 retweeted tweets that were coded for pediatric COVID-19 vaccine relevance. Relevant tweets were analyzed using an inductive coding approach to characterize pediatric COVID-19 vaccine-related themes. Replies to relevant tweets were collected and coded. User metadata were assessed for self-reporting of race or ethnic group affiliation and verified account status. A total of 863,007 tweets were collected from October 2020 to October 2021. After outputting Biterm Topic Model topics and reviewing the 200 most retweeted tweets, 208,666 tweets and 3905 replies were identified as being pediatric COVID-19 vaccine related. The majority (150,262/208,666, 72.01%) of tweets expressed vaccine-related concerns. Among tweets discussing vaccine confidence, user replies expressing agreement were significantly outweighed by those expressing disagreement (1016/3106, 32.71% vs 2090/3106, 67.29%; P<.001). The main themes identified in the Twitter interactions were conversations regarding vaccine-related concerns including adverse side effects, concerns that the vaccine is experimental or needs more testing and should not be tested on pediatric populations, the perception that the vaccine is unnecessary given the perceived low risk of pediatric infection, and conversations associated with vaccine-related confidence (ie, the vaccine is protective). Among signal tweets and replies, we identified 418 users who self-identified as a racial minority individual and 40 who self-identified as an ethnic minority individual. Among the subcodes identified in this study, the vaccine being protective was the most discussed topic by racial and ethnic minority groups (305/444, 68.7%). Vaccine-related concerns can have negative consequences on vaccine uptake and participation in vaccine-related clinical trials. This can impact the uptake and development of safe and effective vaccines, especially among racial and ethnic minority populations.

2382. Sociodemographic and Occupational Characteristics Associated with Delayed and Low COVID-19 Vaccine Uptake Among Healthcare Personnel: Monroe County, NY

Abstract Background Healthcare personnel (HCP) have remained at high risk for SARS-CoV-2 infection during the COVID-19 pandemic. High and timely COVID-19 vaccine uptake is crucial to protect this at-risk population. Our study aims to characterize HCP who delayed initiation of the primary series, and those who did not receive a booster dose. Methods Data for this analysis came from a cohort of HCP working at a large healthcare system in Monroe County, NY identified between 12/28/2020-12/01/2022. HCP were enrolled as part of the CDC Emerging Infections Program COVID-19 vaccine effectiveness study using a test-negative case-control design. Participants completed a standardized questionnaire assessing demographic and occupational characteristics. Verified COVID-19 vaccination history for each HCP was collected during the study period. HCP were categorized as having early or delayed vaccine initiation if they received their 1st mRNA COVID-19 vaccine between 12/14/2020-03/30/2021 (early) or 04/01/2021-09/28/2021 (delayed) after which employee vaccine mandates were implemented at this hospital system. HCP were also categorized as having received a 3rd mRNA COVID-19 booster dose or not after 09/24/2021. Logistic regression models were run to identify characteristics of HCP who delayed 1st dose receipt or did not receive a booster dose. Results Across the study period, 3,471 HCP were enrolled. Of these, 86.0% had early initiation of their 1st mRNA COVID-19 vaccine, and 82.8% received an mRNA booster dose. Low education, low household income, younger age (&amp;lt; 50), non-White race and public health insurance were all significant predictors of delayed receipt of 1st dose and lack of uptake of a booster. However, advanced professional role was only found to be a significant predictor of early 1st dose receipt (Figure 1). Sensitivity analyses, run by changing dates of early vs delayed initiation to later time points, validated these results.Figure 1.Sociodemographic and Occupational Characteristics Associated with COVID-19 Vaccine Coverage Among Healthcare Personnel (N=3,471) +Adjusted for gender, race/ethnicity, and education. ++Adjusted for gender and race/ethnicity. *Adjusted for professional role, educational attainment, and race/ethnicity. **Adjusted for gender, age, educational attainment, professional role, annual household income, and health insurance type. Other Role with Moderate or Minimal Patient Contact includes: Nonphysician behavioral health provider, chaplain, care coordinator, dietician, environmental services personnel, food services personnel, patient transport personnel, research personnel, social worker, student, facilitates maintenance personnel, medical equipment technician, laboratory personnel or pharmacist. Other Role with Substantial Patient Contact includes: Dental healthcare provider, emergency medical services personnel, occupational therapist, physical therapist or assistant, phlebotomist, respiratory therapist, radiology technician, speech-language pathologist, and surgical, medical or emergency technician. Conclusion Sociodemographic characteristics, rather than occupational, were predictive of high and timely vaccine uptake. Continual monitoring of COVID-19 vaccine uptake among HCP to identify those less likely to receive new booster doses will be crucial for maintaining high vaccination rates in this important population. Disclosures Ghinwa Dumyati, MD, Pfizer: Grant/Research Support

The Social Contagion Potential of Pro-Vaccine Messages on Black Twitter

ABSTRACT Black Americans in the US not only suffered from disproportionately high hospitalization and death rates throughout the pandemic but also from the consequences of low COVID-19 vaccination rates. This pattern of disparity is linked to distrust of public health systems that originates from a history of medical atrocities committed against Black people. For that reason, mitigation of race-based inequity in COVID-19 impacts might find more success in grassroots information contagion than official public health campaigns. While Black Twitter is well-positioned as a conduit for such information contagion, little is known about message characteristics that would afford it. Here, we tested the impact of four different message frames (personalization, interactive, fear appeal, neutral) on the social contagion potential of bi-modal social media messages promoting COVID-19 vaccinations and finding personalized messages to be the most shareable. Wary of recommending personalization as the blueprint for setting a social contagion health campaign in motion, we probed further to understand the influence of individual-level variables on the communicability of personalized messages. Subsequently, regression models and focus group data were consulted, revealing that thinking styles, vaccine confidence levels, and attitudes toward social media were significant factors of influence on the contagion potential of personalized messages. We discussed the implications of these results for health campaigns.

Factors Related to Low COVID-19 Vaccination Rate in Pregnant and Postpartum Women with and without COVID-19.

This study focused on pregnant and postpartum women during the COVID-19 pandemic, aiming to determine the attitudes and behaviors of vaccinated and unvaccinated groups, and the vaccination behaviors in the groups with and without the disease. The reasons for refusing the vaccine were also questioned. This cross-sectional study was performed from September 2021 to October 2021. The study data were collected using a face-to-face questionnaire. The participants were pregnant women who applied to the hospital for routine antenatal care and were hospitalized, and women in the postpartum period. Additionally, pregnant and postpartum patients who were diagnosed with COVID-19 at the time of admission and were hospitalized and admitted to the intensive care unit due to this disease were also included in the study. A total of 1,146 pregnant and postpartum women who completed the questionnaire were included in our study. Only 43 (3.8%) of the participants were vaccinated; 154 (13.4%) of the participants had comorbidities. The number of COVID-19-positive patients was 153. The lack of sufficient information about the safety of the COVID-19 vaccine is the most common reason for the refusal. Vaccine refusal can significantly delay or hinder herd immunity, resulting in higher morbidity and mortality. Considering the adverse effects of COVID-19 on pregnancy, it is essential to understand pregnant and postpartum women's perceptions toward vaccination to end the pandemic.

Public health restrictions, directives, and measures in Arctic countries in the first year of the COVID-19 pandemic

ABSTRACT Beginning January of 2020, COVID-19 cases detected in Arctic countries triggered government policy responses to stop transmission and limit caseloads beneath levels that would overwhelm existing healthcare systems. This review details the various restrictions, health mandates, and transmission mitigation strategies imposed by governments in eight Arctic countries (the United States, Canada, Greenland, Norway, Finland, Sweden, Iceland, and Russia) during the first year of the COVID-19 pandemic, through 31 January 2021s31 January 2021. We highlight formal protocols and informal initiatives adopted by local communities in each country, beyond what was mandated by regional or national governments. This review documents travel restrictions, communications, testing strategies, and use of health technology to track and monitor COVID-19 cases. We provide geographical and sociocultural background and draw on local media and communications to contextualise the impact of COVID-19 emergence and prevention measures in Indigenous communities in the Arctic. Countries saw varied case rates associated with local protocols, governance, and population. Still, almost all regions maintained low COVID-19 case rates until November of 2020. This review was produced as part of an international collaboration to identify community-driven, evidence-based promising practices and recommendations to inform pan-Arctic collaboration and decision making in public health during global emergencies.

COVID-19, breast cancer care, and social determinants of health: a cross-sectional study

Abstract The aims of this study were to explore the impact of COVID-19 on healthcare services and quality of life (QoL) in women living with and beyond BC in Ireland and whether the impact varied by social determinants of health (SDH). The survey study invited women diagnosed with BC to complete a questionnaire measuring the impact of COVID-19, disruption to BC services, QoL, SDH, and clinical covariates during a period of COVID-19 restrictions. The association between COVID-19 impact, disruption to BC services, and QoL was assessed using multivariable regression with adjustment for SDH and clinical covariates. An interaction between COVID-19 impact and health insurance status was assessed within each multivariable regression model. In total, 387 women completed the survey and 30.5% reported a high COVID-19 impact. Women who reported a high COVID-19 impact had significantly more disruption in BC services(OR = 4.54, CI = 2.15, 9.61, p &amp;lt; 0.001) and a lower QoL(β = -12.4, SE 3.31, p &amp;lt; 0.001) compared to women who reported a low COVID-19 impact. Finally, women with a high COVID-19 impact and no insurance experienced significantly more disruption to BC services(OR = 2.53, CI = 1.30, 4.92, p = 0.006) and lower QoL(β = -18.6, SE = 3.92, p &amp;lt; 0.001). There was a large disruption to BC services and decrease in QoL for women with BC in Ireland during the pandemic. However, the impact of COVID-19 was not the same for all women. It is important that women with BC are reintegrated back into BC care and their QoL is addressed through multidisciplinary support services. Key messages • Health systems must learn from the pandemic to improve services and to avoid detrimental impact of future disasters. • Health insurance status is a key determinant for women with breast cancer in Ireland.

Aviation Industry and Covid-19: New Normal in the Pandemic Era, the Experience of Passenger, Post-Pandemic Traveling, and Long-term Impact on the Airlines

The Covid-19 pandemic is currently ravaging the entire world and the aviation industry is one of the hardest hit industries. This paper aims to analyze and understand the change in consumers behavior with regards to the aviation industry due to the Covid-19 pandemic. A questionnaire was administered to 100 respondents to glean insights into passenger preferences and travel decisions. The results reveal a strong willingness among respondents to travel when a cure for COVID-19 becomes available, emphasizing the crucial role of medical solutions in boosting passenger confidence. Additionally, the importance of low COVID-19 case counts at destinations and the tension between safety measures and passenger freedom is evident. Moreover, the research highlights the value passengers place on convenience and adaptability, as well as their evolving expectations regarding personal space and hygiene. These findings provide comprehensive insights into the complex dynamics of passenger behavior and satisfaction within the aviation industry during the pandemic, offering valuable reference points for industry stakeholders and policymakers.

Application of Geographic Information Systems in the Study of COVID-19 in Morocco

Introduction: The 2019 coronavirus disease (COVID-19) was first identified as a respiratory disease that originated in Wuhan, Hubei Province, China. The WHO declared the COVID-19 outbreak a public health emergency of international concern on 30 January 2020. Morocco reported its first coronavirus case on 2 March 2020. During the week of 9-15 March 2020, Morocco took steps to limit the spread of the epidemic. This article describes the use of spatial data applications in epidemiological research in Morocco, specifically its response to the COVID-19 epidemic. Methods: To conduct this study, we relied on the use and analysis of data provided by the Moroccan Ministry of Health for the study period from May to July 2021, as well as the geographical and administrative map of the Kingdom of Morocco. Spatial analysis of COVID-19 was performed using ArcGIS 10.8 and QGIS, a geographic information processing software. Health data for the 12 regions of the Moroccan territory were presented in the number of COVID-19 cases as a discrete quantitative variable and over time as a continuous time variable. Results: According to a map created using GIS, the concentration of COVID-19 cases appeared to be highest in the Casablanca Settat region. Depending on the number of documented COVID-19 cases, regions were ranked as follows: Casablanca-Settat&gt; Rabat-Sale-Kenitra&gt; Marrakech-Safi &gt; Fes-Meknes &gt; Tangier-Tetouan-Alhouceima&gt;Oriental&gt;Souss-Massa &gt; Béni Mellal-Khenifra&gt; Draa-Tafilalet&gt; Laayoune-Sakia El Hamra &gt;Guelmim-Oued Noun &gt; Dakhla-Oued Eddahab. The increase in cases in major cities was due to several factors, including demographic, social and environmental factors. This demonstrated the need to consider demographic contributions to environmental health. Demographic factors helped us understand the health of our environment empirically. Geography improved health decision-making and accountability. Incorporating the geographic context of the spread of COVID-19 helped decision-makers understand the impact of location on strategies and goals to combat this pandemic. Conclusion: This study identified areas with high and low COVID-19 clusters and hotspots. The produced maps can serve as an excellent management tool to control and effectively eliminate the COVID-19 pandemic, contributing to investments in epidemiological surveillance programs.

THU321 Indirect Effects Of COVID-19 On The Risk Of Gestational Diabetes And Factors Mediating Increased Risk

Abstract Disclosure: Y.J. Rhou: None. J. Elhindi: None. S.J. Melov: None. N. Cheung: None. D. Pasupathy: None. Aim: COVID-19 has had indirect effects on pregnancy outcomes. This study aimed to assess the risk of gestational diabetes (GDM) in distinct COVID-19 exposure periods and determine the potential factors contributing to increased risk of GDM in a multiethnic population. Methods: Multicentre, retrospective cohort study of singleton pregnancies at three hospitals two years pre-COVID-19 (January 2018 - January 2020), 1st year of COVID-19 with low COVID-19 pandemic burden and limited restrictions (February 2020 - January 2021), and 2nd year of COVID-19 with increased pandemic burden and stringent restrictions (February 2021 - January 2022). Baseline maternal characteristics, gestational weight gain (GWG) and pregnancy outcome data were compared between time periods. The primary outcome of GDM was assessed using univariate and multivariate generalized estimating equations models. Results: Of 28,207 pregnancies, 14,663 occurred in the two years pre-COVID-19, 6,890 in COVID-19 Year 1 and 6,654 in COVID-19 Year 2. The study population was diverse, comprising 82.5% of non-Caucasian ethnicity and 22.7% in the quintile of greatest socioeconomic disadvantage. Maternal age increased across exposure periods (30.7 ± 5.0 years pre-COVID-19 vs 31.0 ± 5.0 years COVID-19 Year 1 vs 31.3 ± 5 years COVID-19 Year 2; p&amp;lt;0.001). There were increases in prepregnancy BMI (25.5 ± 5.7 kg/m2 vs 25.7 ± 5.6 kg/m2 vs 26.1 ± 5.7 kg/m2; p&amp;lt;0.001), proportion who were obese (17.5% vs 18.1% vs 20.7%; p&amp;lt;0.001) and proportion with other traditional risk factors for GDM including South Asian ethnicity and prior history of GDM. Weekly rate of GWG and proportion exceeding recommended GWG increased across pandemic exposure periods (64.3% vs 66.0% vs 66.6%; p=0.009). GDM diagnosis increased across exposure periods (21.2% vs 22.9% vs 24.8%; p&amp;lt;0.001). Both COVID-19 Year 1 and Year 2 were associated with increased risk of GDM on univariate analysis, only COVID-19 Year 2 remaining significantly associated after adjusting for maternal baseline characteristics and GWG (OR 1.17 [1.06, 1.28], p=0.01). Conclusion: Diagnosis of GDM increased with pandemic exposure. Progressive sociodemographic changes and greater GWG may have contributed to increased risk. However, exposure to the 2nd year of COVID-19 remained independently associated with GDM after adjusting for shifts in baseline maternal characteristics and GWG. Presentation: Thursday, June 15, 2023

Foreign Supply Shocks and the Structure of Trade in a Small Open Economy

We evaluate how imports of a small open economy adjusted to foreign supply disruptions in the first year of the COVID-19 pandemic. Exploiting information on the timing, stringency, and persistence of coronavirus containment measures, we estimate their impact on the value and composition of imports. About half of the total contraction is attributed to foreign supply-sided disruptions. Contractions were more pronounced in concentrated import markets, but more severe contractions were prevented by trade partner substitution. We document systematic reallocation of market shares towards countries with large supply capacity and low COVID-19 incidence rates in the second half of 2020.

Effect of the COVID-19 pandemic on life expectancy in Australia, 2020-22.

Australia provides a valuable international case study of life expectancy during the pandemic. In contrast to many other countries, it experienced relatively stringent restrictions and low COVID-19 mortality during 2020-21, followed by relaxation of these restrictions when high vaccination rates were achieved. This study measures Australia's life expectancy trends and the contributions of age group and causes of death, during the pandemic. Trends in life expectancy at birth in Australia and its states and territories were measured from 2020 to 2022. The contributions of age group and cause of death to these trends were measured using decomposition methods. Life expectancy was compared with other high-income countries. Australia's life expectancy fell by more than half a year in 2022, following a sharp increase in 2020 and moderate decline in 2021. For the 3 years 2020 to 2022, life expectancy was 0.13 years (95% confidence interval 0.07-0.19) higher for males and 0.09 years (0.03-0.14) higher for females versus 2017-19. Australia's life expectancy increase in 2020 was larger than that in the vast majority of other high-income countries, but its decline in 2022 was greater than in other countries whose life expectancy rose in the first year of the pandemic. The small negative contribution of COVID-19 deaths to life expectancy in Australia was more than offset by lower non-communicable disease mortality. There were only small differences in life expectancy change between the states with the most stringent restrictions (Victoria and New South Wales) and the rest of Australia. Australia's life expectancy trends during 2020-22 were relatively favourable compared with other high-income countries, with the exception of its sharp decline in 2022 once restrictions were loosened.

Temporal Relationship between Daily Reports of COVID-19 Infections and Related GDELT and Tweet Mentions

Social media platforms are valuable data sources in the study of public reactions to events such as natural disasters and epidemics. This research assesses for selected countries around the globe the time lag between daily reports of COVID-19 cases and GDELT (Global Database of Events, Language, and Tone) and Twitter (X) COVID-19 mentions between February 2020 and April 2021 using time series analysis. Results show that GDELT articles and tweets preceded COVID-19 infections in Australia, Brazil, France, Greece, India, Italy, the U.S., Canada, Germany, and the U.K., while for Poland and the Philippines, tweets preceded and GDELT articles lagged behind COVID-19 disease incidences, respectively. This shows that the application of social media and news data for surveillance and management of pandemics needs to be assessed on a case-by-case basis for different countries. It also points towards the applicability of time series data analysis for only a limited number of countries due to strict data requirements (e.g., stationarity). A deviation from generally observed lag patterns in a country, i.e., periods with low COVID-19 infections but unusually high numbers of COVID-19-related GDELT articles or tweets, signals an anomaly. We use the seasonal hybrid extreme Studentized deviate test to detect such anomalies. This is followed by text analysis of news headlines from NewsBank and Google on the date of these anomalies to determine the probable event causing an anomaly, which includes elections, holidays, and protests.

Socio-demographic factors associated with COVID-19 vaccine uptake and refusal among Ugandan women

BackgroundThis paper analyzes associations of socio-demographic factors with the uptake of COVID-19 vaccines, the refusal to get vaccinated against COVID-19, and various reasons stated for refusing vaccination against COVID-19 among a representative sample of Ugandan women.MethodsThis paper utilizes a representative cross-sectional survey collected among women aged 15-49 years in Uganda between September and November 2021. Regression analyses are used to study the associations of a broad range of socio-demographic characteristics with COVID-19 vaccine uptake, refusal of vaccination, and reasons for refusal among the respondents.Results4211 women were included in the analysis. 11% of them were vaccinated against COVID-19, 76% were willing to get vaccinated, 13% were unwilling to get vaccinated. Fear of side effects was the most commonly stated reason for refusing vaccination (69%). Factors significantly and positively associated with being vaccinated against COVID-19 were age, higher education, urban residency, having savings, partial instead of complete income loss during the pandemic, and usage of modern contraceptives. Factors significantly and positively associated with refusing vaccination against COVID-19 were urban residency and current pregnancy, while age, having savings, and using modern contraceptives were factors associated with a lower likelihood of refusing vaccination, albeit with varying statistical significance. Few factors were strongly related to the stated reasons for refusing the vaccines; the fear of side effects significantly increased with age, while having received negative information on the vaccines was significantly less common among women with higher education.ConclusionsThis study documents a low COVID-19 vaccination rate and a high willingness to get vaccinated among Ugandan women. Positive age and education gradients in vaccine uptake point to inequity in access to vaccination, potentially resulting from prioritizations of groups at particularly high risk. Refusal to be vaccinated was relatively low and systematic factors behind vaccine refusal were hardly to be found, even less so for particular reasons given for refusal.

Understanding low COVID-19 booster uptake among US adults

BackgroundVaccinations against SARS-CoV-2 have consistently been shown to reduce the risk of severe COVID-19 disease. However, uptake of boosters has stalled in the United States at less than 20% of the eligible population. The objective of this study was to assess the reasons for not having obtained a bivalent booster within an existing COVID-19 cohort. MethodsA total of 2196 adult participants from the Arizona CoVHORT, a population-based cohort in the United States established in May 2020, who had received at least one dose of the COVID-19 vaccine, responded to surveys administered between February 13 and March 29, 2023 querying receipt of a bivalent booster and if not, the reasons for not receiving it. Descriptive statistics were employed, including frequencies of responses by participant characteristics, and multivariable logistic regression was used to assess the association between participant characteristics and selected themes for not having received the bivalent booster. ResultsThe most commonly reported reason for not having been boosted was a prior SARS-CoV-2 infection (39.5%), followed by concern about vaccine side effects (31.5%), believing that the booster would not provide additional protection over the vaccines already received (28.6%), and concern about booster safety (23.4%) or that it would not protect from SARS-CoV-2 infection (23.1%). For themes related to reasons for not having been boosted, those 60 years of age or older were less likely to select items related to knowledge (OR: 0.24; 95% CI: 0.11–0.55) or logistical concerns (OR: 0.09; 95% CI: 0.03–0.30) about the vaccine; while those reporting Hispanic ethnicity were more likely to convey concerns about logistics than those reporting non-Hispanic ethnicity (OR: 2.15; 95% CI: 1.08–4.30). Finally, compared to college graduates, those with some college or technical school were significantly more likely to select items related to the risks and benefits of the bivalent vaccine not being clear as reasons for not having been boosted (OR: 2.41; 95% CI: 1.69–3.43). ConclusionsImprovement in booster uptake is necessary for optimal public health in the United States. The development of vaccines against SARS-CoV-2 occurred at an unprecedented speed, but vaccine uptake remains among the greatest current public health challenges as updated boosters continue to be developed and made available to the public. Interventions to improve vaccination rates require a variety of approaches.

The impact of the COVID-19 pandemic on parental vaccine hesitancy: A cross-sectional survey

BackgroundIt is unclear how hesitancy towards pediatric vaccines has changed quantitatively since the onset of the COVID-19 pandemic, and if changes are more readily apparent in clusters of low COVID-19 vaccination. In this study, we assess how clusters of low COVID-19 vaccination correlate with changing parental beliefs about childhood vaccines. MethodsA cross-sectional, opt-in, internet-based survey of parents resident in the U.S. was conducted during August-September 2022. Our survey measured changes in beliefs about childhood vaccine safety, importance, and effectiveness since the start of COVID-19. We also measured parents’ perceived vaccination rates in the community, assessing its relationship with changing vaccination perceptions using Rao-Scott chi-square tests, and multinomial logistic regression models. ResultsAmong 310 parents of children 0–17 years old, 11 % (95 % CI: 7 %, 15 %) believed that childhood vaccines are less safe, 12 % (95 % CI: 8 %, 17 %) less important, and 13 % (95 % CI: 9 %, 18 %) less effective since the start of the COVID-19 pandemic. About 9 % (95 % CI: 5 %, 12 %) stated COVID-19 vaccination coverage was low in their community. Among those who stated COVID-19 vaccination coverage was low, 38 % reported believing childhood vaccines were less effective (vs 12 % of those who stated vaccination coverage was high). This corresponds to 4.34 times greater odds of believing childhood vaccines were less effective since the start of the pandemic (95 % CI: 1.38, 13.73) in those who believe COVID-19 vaccination coverage to be low in their community vs high. ConclusionOur study demonstrates that parental perceptions about childhood vaccines have been affected by the COVID-19 pandemic through geographic and social clustering of non-vaccination. Beliefs about the COVID-19 vaccine have spillover with beliefs about childhood vaccines, and more negative beliefs may be clustering in areas with low vaccination coverage, which could predispose the area to outbreaks of vaccine-preventable disease.

COVID-19 Vaccine Hesitancy in Cameroon: The Role of Medical Mistrust and Social Media Use

Most African countries report low COVID-19 vaccination rates (Msellati et al., 2022; WHO Africa; 2020). This study focuses on factors associated with vaccine hesitancy specifically in the country of Cameroon. Social media use and medical mistrust have been suggested as key variables that may increase vaccine hesitancy. Adopting the information-related perspective guided by the risk information seeking and processing model, the current research explored how social media use and medical mistrust are related to vaccine hesitancy among Cameroonians. Survey results from a sample of 1,000 Cameroonians fielded in early 2022 showed that social media use and medical mistrust were positively associated with belief in misinformation related to the COVID-19 vaccine. Belief in misinformation about the COVID-19 vaccine was negatively associated with perceived information insufficiency. A positive relationship between perceived information insufficiency and information seeking, as well as a negative relationship between information seeking and vaccine hesitancy were also found. Theoretical and practical implications are discussed.

Interlaboratory comparison using inactivated SARS-CoV-2 variants as a feasible tool for quality control in COVID-19 wastewater monitoring

Wastewater-based SARS-CoV-2 epidemiology (WBE) has proven as an excellent tool to monitor pandemic dynamics supporting individual testing strategies. WBE can also be used as an early warning system for monitoring the emergence of novel pathogens or viral variants. However, for a timely transmission of results, sophisticated sample logistics and analytics performed in decentralized laboratories close to the sampling sites are required. Since multiple decentralized laboratories commonly use custom in-house workflows for sample purification and PCR-analysis, comparative quality control of the analytical procedures is essential to report reliable and comparable results.In this study, we performed an interlaboratory comparison at laboratories specialized for PCR and high-throughput-sequencing (HTS)-based WBE analysis. Frozen reserve samples from low COVID-19 incidence periods were spiked with different inactivated authentic SARS-CoV-2 variants in graduated concentrations and ratios. Samples were sent to the participating laboratories for analysis using laboratory specific methods and the reported viral genome copy numbers and the detection of viral variants were compared with the expected values.All PCR-laboratories reported SARS-CoV-2 genome copy equivalents (GCE) for all spiked samples with a mean intra- and inter-laboratory variability of 19 % and 104 %, respectively, largely reproducing the spike-in scheme. PCR-based genotyping was, in dependence of the underlying PCR-assay performance, able to predict the relative amount of variant specific substitutions even in samples with low spike-in amount. The identification of variants by HTS, however, required >100 copies/ml wastewater and had limited predictive value when analyzing at a genome coverage below 60 %.This interlaboratory test demonstrates that despite highly heterogeneous isolation and analysis procedures, overall SARS-CoV-2 GCE and mutations were determined accurately. Hence, decentralized SARS-CoV-2 wastewater monitoring is feasible to generate comparable analysis results. However, since not all assays detected the correct variant, prior evaluation of PCR and sequencing workflows as well as sustained quality control such as interlaboratory comparisons are mandatory for correct variant detection.

Association of Serum Zinc Level and Clinical Outcome in Patients with COVID19 Virus

Abstract Background Zinc, one of the anti-inflammatory and antioxidant micronutrient found in food with well-established role in immunity, is currently being used in some clinical trials against COVID-19. Objective The aim of our study was to assess the association between mean levels of Zinc in the patients and mortality caused by COVID-19. Patients and Methods This was a comparative cross-sectional study that was performed on 60 Egyptian patients at Ain Shams University Quarantine field hospital, Ain Shams University Quarantine hospital In Al OboUr, and outpatient clinics at Ain shams university hospitals for 6 months period This study patients were divided according to clinical outcome into: Group I that included patients admitted to ICU and Group II that included patients admitted to ward. Results There was no statistically significant difference found between two groups regarding Sex, Age and Special habits, and there was no statistically significant difference found between two groups regarding CO-RADS classification, and there was statistically highly significant difference found found between two groups regarding Medical history. There was statistically significant difference found between two groups regarding Zinc level. There was statistically no significant difference found between two groups regarding Lymphocytes, Hemoglobin, Platelets, BUN, S. Creatinine, Total Bilirubin and S. Albumin, and there was statistically significant difference found between two groups regarding Neutrophil- Lymphocyte ratio, CRP, ESR, AST, ALT, FERRITIN and LDH, and there was statistically highly significant difference found between two groups regarding TLC, Neutrophils, D-DIMER and VIT D. Conclusion This study concluded a correlation between low SZC and COVID-19 severity and mortality. The cause is likely to be a combination of immune system imbalance and a direct benefit of viral replication. Thus, we propose SZC as a novel and additional parameter to predict COVID19 outcome.

Are People Willing to Take Regular COVID-19 Vaccines? Prevalence and Determinants of Hesitancy for Regular COVID-19 Vaccination: A Random Population-Based Survey in Hong Kong.

The emergence of new coronavirus variants and evidence of waning immunity offered by COVID-19 vaccines draw attention to the need for regular vaccination. Vaccine hesitancy is one of the top ten threats to global health. There is a dearth of knowledge on people's hesitancy to take regular COVID-19 vaccines. This study aimed to investigate the prevalence and determinants of hesitancy for regular COVID-19 vaccination. A population-based, random telephone survey was performed in Hong Kong in April 2022 (n = 1213). The age-standardized hesitancy rate for regular COVID-19 vaccines among Hong Kong adults was 39.4% (95% CI = 35.3-44.1%), exhibiting a sloping S-shape with age. Regression analyses revealed that females, young adults, self-perceived fair/bad health, low COVID-19 vaccine uptake, and believing there are better ways for prevention of infection were positive determinants of hesitancy for regular vaccination. Vaccine confidence, perceived severity and availability, trust in manufacturers and government, and civic duty inclination were negative determinants. Tailored vaccine promotions are needed for females, young adults, and people perceiving poor health and receiving fewer doses. Information on infection severity, vaccine availability, and trust in suppliers, products, and governments are key attitude-change facilitators to decrease hesitancy for regular COVID-19 vaccination and cope with future pandemics.

Direct medical cost of COVID-19 in children hospitalized at a tertiary referral healthcare center in Mexico City.

Despite the end of the COVID-19 pandemic being declared by the WHO, the economic consequences are far from over. One of these implications was the cost of inpatient care for health institutions. To date, some studies have examined the economic burden of COVID-19 in the adult population but only a few have focused on child populations. To estimate the direct medical costs of COVID-19, focusing on children in Mexico. Data about resources consumed during hospital stays were extracted from the medical records of patients hospitalized at a Mexican tertiary healthcare institution. Other sources of information were the unit prices of inputs and the salaries of health personnel. A micro-costing methodology was used to obtain cost results by age group over different hospital areas. Data analysis was performed with descriptive statistics and regression models to evaluate the predictors of total cost. One hundred and ten medical records were reviewed of which 57.3% corresponded to male patients and the mean age was 7.2 years old. The estimated average cost per patient was US$5,943 (95% CI: US$4,249-7,637). When the costs of the three clinical areas were summed, only the 5-10 years old group showed a maximum cost of US$14,000. The regression analysis revealed the following factors as significant: sex, age, staying at an emergency room, having a positive bacterial culture, and having comorbidities. The cost results were somewhat similar to those reported in children from the USA, but only regarding low severity COVID-19 cases. However, comparability between these types of studies should be done with caution due to the huge differences between the healthcare systems of countries. The study cost results may help public decision-makers in budget planning and as inputs for future cost-effectiveness studies about interventions regarding COVID-19.