Priority For Vaccination Research Articles

Is compassion the flip side of punitiveness? Incorporating COVID-19 crisis in experimental vignettes to examine support for visitation and vaccination in prison.

ObjectivesThe public hold both punitive and pragmatic attitudes toward prison policy. Yet it is unclear whether the public supports compassionate efforts that do not directly relate to recidivism. This study explores the role of exclusionary symbolic aims (prioritizing non-prisoner groups), inclusionary symbolic aims (minimizing health risk for the vulnerable), and cost (taxes).MethodsUsing a quota-based national sample fielded in spring 2021 (N=1260), we embedded two experimental vignettes to assess support for vaccination priorities and personal protective equipment (PPE) for in-person visitation. We also examine respondent experiences (e.g., exposure to COVID-19, vaccine status, personal or vicarious arrest) and beliefs (e.g., political ideology, racial resentment, stigma).ResultsConsistent with dominant exclusionary symbolic aims, respondents showed strong preferences for non-prisoner groups in facilitating safe in-person visits (in long-term care facilities) and vaccine priorities (to prison guards). Inclusionary symbolic aims were less clear when examining risk from vaccine side effects or helping vulnerable populations (the elderly). High cost reduced support for compassionate policy.ConclusionsPublic support for policies aimed at maintaining the health of individuals who are incarcerated may be motivated by similar factors as punishment preferences.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11292-022-09523-z.

Diagnosing COVID-19, Prioritizing Treatment, and Planning Vaccination Priority via Fuzzy Parameterized Fuzzy Soft Matrices

In the fight against the COVID-19 pandemic, it is vital to rapidly diagnose possible contagions, treat patients, plan follow-up procedures with correct and effective use of resources and ensure the formation of herd immunity. The use of machine learning and statistical methods provides great convenience in dealing with too many data produced during research. Since access to the PCR test used for the diagnosis of COVID-19 may be limited, the test is relatively too slow to yield results, the cost is high, and its reliability is controversial; thus, making a symptomatic classification before the PCR is timesaving and far less costly. In this study, by modifying a state-of-the-art classification method, namely Comparison Matrix-Based Fuzzy Parameterized Fuzzy Soft Classifier (FPFS-CMC), an effective method is developed for a rapid diagnosis of COVID-19. The paper then presents the accuracy, sensitivity, specificity, and F1-score values that represent the diagnostic performances of the modified method. The results show that the modified method can be adopted as a competent and accurate diagnosis procedure. Afterwards, a tirage study is performed by calculating the patients’ risk scores to manage inpatient overcrowding in healthcare institutions. In the subsequent section, a vaccine priority algorithm is proposed to be used in the case of a possible crisis until the supply shortage of a newly developed vaccine is over if a possible variant of COVID-19 that is highly contagious is insensitive to the vaccine. The accuracy of the algorithm is tested with real-life data. Finally, the need for further research is discussed.

Criticism, Compassion, and Conspiracy Theories: A Thematic Analysis of What Twitter Users Are Saying About COVID-19 in Correctional Settings.

We examined Twitter data using thematic analysis to understand public perceptions of the impact of COVID-19 on incarcerated people and reactions to including incarcerated populations in the early phases of the vaccine rollout. Our findings from n = 513 Tweets yielded six themes: Twitter as usual, Advocacy, Deserve to suffer, Vaccine priority debate, Inadequate response, and Misinformation. Stigma-laden statements cut across themes, highlighting the role pathologizing beliefs play in forming opinions about incarcerated people in public health crises. Trust of government response and buy-in to public health communication are positively associated with adherence to guidelines. Although public health decisions are derived from logic and research, our findings indicate that public perception may be driven by personal morals and stigma associated with justice-involved individuals. We recommend that attention be turned toward effective policy messaging, and use of social media, to increase trust and decrease stigma that tends to dominate societal perception.

Experience in Growth Monitoring and Promotion Integrated With Immunization Services in a City Corporation of Bangladesh

ObjectivesWe aim to share the experience of the USAID's Strengthening Multi-sectoral Nutrition Programming through Implementation Science Activity (MSNP), which has been integrating Growth Monitoring (GMP) and Expanded Program of Immunization (EPI) for children under two years in Khulna City Corporation (KCC), Ministry of Local Government Rural Development and Cooperatives (LGRD), Bangladesh.MethodsThe team analyzed the GMP and EPI service data, observed client-provider interactions (service delivery) (n = 3 nutrition counselors), conducted semi-structured interview with health assistants (n = 6) and informal discussion with mothers (n = 10) who visited the GMP/EPI service facilities from October 2021 to January 2022.ResultsBoth health assistants and nutrition counselors delivered GMP and EPI services, serving as key enablers of EPI-GMP integration. Reminder text messages were sent by MSNP project to mothers of children lost-for-follow-up to encourage their service return. From October 2021 to January 2022 GMP-EPI integrated services were provided to 1518 children (October: 32; November: 281; December: 583; January: 622).Major challenges included coordination gaps between service activities; space constraints to conduct GMP; overburdening of health assistants to fulfil EPI lost-to-follow-up targets during COVID-19 pandemic and priority for vaccination of COVID-19 to EPI; lack of awareness among caregivers of the importance of appropriate nutrition during the child's first 1000 days for healthy physical and mental development.ConclusionsAlthough this experience suggests integration of GMP into EPI can work, improvements are needed. The MSNP project will increase coordination among donors, Ministry of Health and LGRD, KCC and partner NGOs, service providers and mothers to ensure sustained and effective GMP-EPI integration; provide need-based infant and young child feeding counseling and train caregivers on community-based management of acute malnutrition, and strengthen service provision by providing supportive supervision to them.Funding SourcesUnited States Agency for International Development (USAID).

Inequity in inequity: Disproportional mortality risk in patients with cancer with COVID-19 in Brazil - a call to action

Inequity in inequity: Disproportional mortality risk in patients with cancer with COVID-19 in Brazil - a call to action

The assistance gaps in combating COVID-19 in Brazil: for whom, where and when vaccination occurs

BackgroundFollowing the emergence of the COVID-19 pandemic, the number of infected Brazilian people has increased dramatically since February 2020, with Brazil being amongst the countries with the highest number of cases and deaths. Brazilian vaccination began in January 2021, aimed at priority groups. This study analysed the spatial and temporal evolution of vaccination in Brazil between the 3rd and 21st epidemiological weeks (EW) of 2021.MethodsSpatial and temporal analyses were performed comprising 19 EW. Cases were structured into priority groups—elderly population (EP); healthcare workers (HW); indigenous and quilombola populations (I/Q), dose, vaccine (CoronaVac or AstraZeneca), and place of vaccination. A sweep test was performed to identify vaccination rate clusters. Vaccination rates (VR) were calculated according to a spatial window for each Health Region, indicating clusters above/below expected VR. Based on the discrete Poisson probability model, spatial analysis was performed to detect high/low VR clusters, which were converted into Kernel maps. Points were generated from SaTScan analyses associated with Health Region centroids. Temporal analysis of VR was carried out to identify significant trends, and results were converted into temporal cluster graphs. P-value ≤ 0.05 was adopted.ResultsSoutheast region concentrated most of the vaccines of EP and HW, followed by the Northeast. The latter region had the largest contingent of I/Q vaccinated. In all priority age groups and all regions, a higher percentage of complete CoronaVac vaccination schedules were observed compared with AstraZeneca. The temporal analysis identified high VR clusters of CoronaVac first and second dose in the early weeks, except for the EP; of AstraZeneca first dose, only for HW in the early weeks, and for EP and I/Q in the final weeks; of AstraZeneca second dose for all priority groups in the final weeks. I/Q populations had the lowest general VR. The spatial profile of VR indicated significant regional cluster differences between the priority groups.ConclusionThis study highlights the importance of establishing vaccination priority groups, considering the asymmetries that a pandemic can trigger, notably in vast geographic areas, to contemplate the main objective of vaccination: to prevent casualties.

Thrombosis, cancer, and COVID-19.

Cancer and coronavirus disease 2019 (COVID-19) have unusual similarities: they both result in a markedly elevated risk of thrombosis, exceptionally high D-dimer levels, and the failure of anticoagulation therapy in some cases. Cancer patients are more vulnerable to COVID-19 infection and have a higher mortality rate. Science has uncovered much about SARS-CoV-2, and made extraordinary and unprecedented progress on the development of various treatment strategies and COVID-19 vaccines. In this review, we discuss known data on cancer-associated thrombosis (CAT), SARS-CoV-2 infection, and COVID-19 vaccines and discuss considerations for managing CAT in patients with COVID-19. Cancer patients should be given priority for COVID-19 vaccination; however, they may demonstrate a weaker immune response to COVID-19 vaccines than the general population. Currently, the Centers for Disease Control and Prevention recommends an additional dose and booster shot of the COVID-19 vaccine after the primary series in patients undergoing active cancer treatment for solid tumors or hematological cancers, recipients of stem cell transplant within the last 2 years, those taking immunosuppressive medications, and those undergoing active treatment with high-dose corticosteroids or other drugs that suppress the immune response. The mainstay of thrombosis treatment in patients with cancer and COVID-19 is anticoagulation therapy.

Safety and Efficacy of the COVID-19 Vaccine in Kidney Transplant Recipients.

Background: Kidney transplant recipients appear to be at high risk for critical coronavirus disease 2019 (COVID-19) illness. They are considered a priority for COVID-19 vaccination. Only a few studies report on the safety and efficacy of the COVID-19 vaccine in these patients.Methods: In this prospective observational study, we measured anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike-specific IgG post first and second COVID-19 mRNA vaccines in 113 kidney transplant recipients and compared them to 62 healthy volunteers.Result: After the first COVID-19 vaccine, SARS-CoV-2-specific antibodies were undetectable in 38.9% of kidney transplant recipients, and after the second, it remained undetectable in 12.4%. SARS-CoV-2-specific antibodies were significantly lower in kidney transplant recipients. The average antibody titer after the first vaccine was 1243.6±4137.5 in kidney transplant recipients compared to 20012.2±44436.4 in the controls after the first dose (P=0.002), and 7965.5±12431.3 versus 82891.3±67418.7, respectively, after the second dose (P <0.001). The immune response to the COVID-19 vaccine seemed to be influenced by mycophenolate dose in kidney transplant recipients and pre-vaccination infection.Conclusion: Kidney transplant recipients are prone to have attenuated antibody responses (anti-spike IgGs) to mRNA COVID-19 vaccines. Patients on mycophenolate mofetil (2 gm daily) had significantly lower SARS-CoV-2 spike-specific IgG levels as compared to patients on no or reduced dose of mycophenolate. Hence, kidney transplant recipients need to continue all infection control precautionary measures against COVID-19 infection and should be considered a priority for a third COVID-19 vaccine.

Why Does COVID-19 Vaccine Acceptance Rate Remain Low Among Patients with Chronic Diseases? Evidences from Public Hospitals of Ethiopia.

BackgroundElders and patients with chronic diseases are more vulnerable to coronavirus disease 2019 (COVID-19) infection. In Ethiopia, these groups of people are given vaccination priorities amongst others. However, there is limited information on the acceptance of COVID-19 vaccine among patients with chronic diseases. Therefore, this study aimed to assess the acceptance of COVID-19 vaccine and associated factors among patients with chronic diseases visiting public hospitals in West Guji zone (Ethiopia).Methods and MaterialsFacility-based cross-sectional study was employed among 408 chronic disease patients visiting two public hospitals in Ethiopia from September to October 2021. Data was collected using structured questionnaire. Multivariable logistic regression was computed to identify factors associated with acceptance of COVID-19 vaccine. Independent variables with p-value less than 0.05 were considered statistically significantly associated with the acceptance of COVID-19 vaccine.ResultsThe acceptance of COVID-19 vaccine among patients with chronic diseases was 39.5% (95% CI: 35–44). Factors positively associated with the acceptance of COVID-19 vaccine were age ≥40 years (AOR = 2.84; 95% CI: 1.53–5.28), urban residence (AOR = 0.6; 95% CI: 0.38–0.95), having upper respiratory tract infection (AOR = 1.32; 95% CI: 1.03–2.8), previous COVID-19 infection (AOR = 2.1; 95% CI: 1.22–3.47), having health insurance (AOR = 2.55; 95% CI: 1.23–5.28), those not drinking alcohol (AOR = 1.95; 95% CI: 1.24–3.06), those not chewing Khat (AOR = 2.01; 95% CI: 1.27–3.2), and having good knowledge (AOR = 1.55; 95% CI: 1.03–2.87) and positive attitude (AOR = 2.05; 95% CI: 1.26–3.33) towards the vaccine.ConclusionThe overall proportion of COVID-19 vaccine acceptance is low among patients with chronic diseases. Therefore, to improve the acceptance of COVID-19 vaccine, the government and health professionals should provide continuous health education.

Social preferences for adopting new vaccines in the national immunization program: A discrete choice experiment

Governments regularly have to decide whether new vaccines should be adopted in their national immunization program. These choices imply complex trade-offs of epidemiological, medical and socio-economic criteria. We investigated how the population in Flanders (Belgium) wants their government to set vaccine-funding priorities. In December 2019, we executed a discrete choice experiment in a sample of the Flemish population (N = 1636). In total, we analysed 16 360 choices between vaccines competing for funding, described in terms of eight characteristics. Using a panel mixed logit model, we quantified the relative importance of each characteristic and investigated differences in preferences across respondent groups. The observed vaccine priorities were different from those that would be identified through cost-effectiveness analysis. People valued the health impact from infectious diseases differently than their weight expressed in QALYs would suggest. Mortality and frequently occurring mild illness were valued higher, whereas lasting morbidity received lower weight. Contribution of the vaccine to disease eradication and uncertainty in vaccine effectiveness were both highly influential factors. Health equity impact was also important whereas the economic impact of the disease did not matter at all. Our results can be used to incorporate public values into vaccine decision-making.

COVID-19: PANDEMIC ERA BETWEEN "ASIA AND EUROPE"

Annotation: Covid -19-Covid 19 is a new viral infection that has a number of features, such as rapid spread rate, high mortality rate, significant social and economic consequences that destroy the usual way of life This article aimed at studying the basic differences in the pandemic era of both the continental (Europe and Asia) regions such as outbreak, vaccines, vaccine priorities, lockdown methodologies and use the same experience for solving upcoming pandemic crisis. Studying comparison of the numbers of cases and deaths due to SARS-CoV-2/COVID-19 showed that people in Central Europe are much more affected than people in East Asia that estimated to occur because of differences in (ACE2) receptor expression and mutations in the virus itself. These general differences between the pandemic era of both Europe and Asia could be differentially studied under the 4 hypotheses. According to the study it was discovered that the pandemic crisis among the European nations were more severe than that of the Asian countries because of the delayed responses and lately imposed lockdowns and safety precautions. This was the reason why Europe faced hurdles while tackling the global virus.

Impact of the first vaccine dose on COVID-19 and its complications in long-term care facilities and private residences for seniors in Québec, Canada.

Residents of long-term care facilities (LTCFs) and private residences for seniors (PRSs) were given priority for vaccination against coronavirus disease 2019 (COVID-19). Given the shortage of vaccine in the winter of 2021, the Comité sur l'immunisation du Québec recommended postponing the administration of second doses to ensure more rapid and widespread administration of first doses. The objective of this study was to measure the impact of first-dose vaccination on 1) the incidence of cases and complications in LTCFs and PRSs and 2) the frequency of outbreaks in LTCFs. In this ecological study, COVID-19 incidence and complications in residents of LTCFs and PRSs in Québec were compared with the general (community) population at a point in time when there was still only limited eligibility for vaccination. After vaccination in LTCFs, the incidence rate of COVID-19 decreased by 92% compared with 49% in the community, and deaths decreased by 95%. By six weeks post-vaccination, almost no facility reported five or more cases per 100 beds per week. The incidence rate decreased by 91% in PRSs compared with 2% in the community. Hospitalizations and deaths in PRSs decreased by 94% and 90%, respectively. As a result of 1) vaccination of residents with one dose, 2) natural immunity already acquired in LTCFs and PRSs, 3) vaccination of healthcare workers and 4) other non-pharmaceutical prevention measures implemented, the circulation of the coronavirus in these settings was largely interrupted.

Tackling barriers to COVID-19 vaccine uptake in London: a mixed-methods evaluation.

BackgroundIn response to the COVID-19 pandemic, the first vaccine was administered in December 2020 in England. However, vaccination uptake has historically been lower in London than in other English regions.MethodsMixed-methods: This comprised an analysis of cumulative percentage uptake across London between 8 December 2020 and 6 June 2021 by vaccine priority cohorts and ethnicity. We also undertook thematic analyses of uptake barriers, interventions to tackle these and key learning from a qualitative survey of 27 London local authority representatives, vaccine plans from London’s five Integrated Care Systems and interviews with 38 London system representatives.ResultsVaccine uptake was lower in Black ethnic (57–65% uptake) compared with the White British group (90% uptake). Trust was a critical issue, including mistrust in the vaccine itself and in authorities administering or promoting it. The balance between putative costs and benefits of vaccination created uptake barriers for zero-hour and shift workers. Intensive, targeted and ‘hyper-local’ initiatives, which sustained community relationships and were not constrained by administrative boundaries, helped tackle these barriers.ConclusionsThe success of the national vaccination programme depended on conceding local autonomy, investing in responsive and long-term partnerships to engender trust through in-depth understanding of communities’ beliefs.

Clinical Epidemiology of Pediatric COVID-19 Delta Variant Cases From North Sumatra, Indonesia.

The Delta variant of SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) dominated the coronavirus disease 2019 (COVID-19) pandemic in 2021. Here we report the Delta variant among pediatric cases in North Sumatra, Indonesia, from June to July 2021. Whole-genome sequencing (WGS) from 18 new COVID-19 pediatric patients showed that six were B.1.459 and six were B.1.466.2, known variants in Indonesia in clade 20A. Six were the Delta variant B.1.617.2 of clade 21A, with five on one branch and one on a distant branch consistent with that patient's geographic separation, suggesting at least two introductions to the region. Variants tended to be spatially clustered, and four children with Delta variant had an adult infected household member, all of whom had lower real-time polymerase chain reaction cycle threshold (Ct) values compared with the child. No temporal trends were observed for Ct. These data support a paradigm shift with children being highly susceptible to the Delta variant and a priority for vaccination.

The Willingness of Elderly Taiwanese Individuals to Accept COVID-19 Vaccines after the First Local Outbreak.

Vaccination is the most effective intervention to prevent infection and subsequent complications from SARS-CoV-2. Because of their multiple comorbidities, the elderly population experienced the highest number of deaths from the COVID-19 pandemic. Although in most countries, older people have top priority for COVID-19 vaccines, their actual willingness and attitudes regarding vaccination are still unclear. Thus, we conducted a cross-sectional study to investigate their willingness, attitudes, awareness, and knowledge of COVID-19 through a web-based questionnaire after the first local outbreak of COVID-19 in Taiwan. A total of 957 questionnaires were completed, and 74.9% of elderly individuals were likely to receive COVID-19 vaccines. The results from a multiple logistic regression demonstrated that older people who need to visit the outpatient department and have a high level of concern about the safety of COVID-19 vaccines are prone to having a negative willingness to accept COVID-19 vaccines. The following items related to awareness of the COVID-19 pandemic were attributed to the acceptance of COVID-19 vaccines: “understanding the risk of being infected by SARS-CoV-2”, “understanding the effectiveness of COVID-19 vaccines”, “willingness to accept the COVID-19 vaccine for protecting others”, and “safety of COVID-19 vaccines is a key factor for you to accept them”. Furthermore, a positive association between COVID-19 vaccination and attitudes toward accepting booster doses of the COVID-19 vaccine was observed. Our results show that these factors could affect the willingness of older people to accept COVID-19 vaccines and that they are important for policymakers and medical staff to develop vaccination plans during the COVID-19 pandemic.

Covid-19 vaccination priorities defined on machine learning.

ABSTRACTOBJECTIVE Defining priority vaccination groups is a critical factor to reduce mortality rates.METHODS We sought to identify priority population groups for covid-19 vaccination, based on in-hospital risk of death, by using Extreme Gradient Boosting Machine Learning (ML) algorithm. We performed a retrospective cohort study comprising 49,197 patients (18 years or older), with RT-PCR-confirmed for covid-19, who were hospitalized in any of the 336 Brazilian hospitals considered in this study, from March 19th, 2020, to March 22nd, 2021. Independent variables encompassed age, sex, and chronic health conditions grouped into 179 large categories. Primary outcome was hospital discharge or in-hospital death. Priority population groups for vaccination were formed based on the different levels of in-hospital risk of death due to covid-19, from the ML model developed by taking into consideration the independent variables. All analysis were carried out in Python programming language (version 3.7) and R programming language (version 4.05).RESULTS Patients’ mean age was of 60.5 ± 16.8 years (mean ± SD), mean in-hospital mortality rate was 17.9%, and the mean number of comorbidities per patient was 1.97 ± 1.85 (mean ± SD). The predictive model of in-hospital death presented area under the Receiver Operating Characteristic Curve (AUC - ROC) equal to 0.80. The investigated population was grouped into eleven (11) different risk categories, based on the variables chosen by the ML model developed in this study.CONCLUSIONS The use of ML for defining population priorities groups for vaccination, based on risk of in-hospital death, can be easily applied by health system managers

COVID-19 Booster Vaccine Equity for Patients With Cancer

COVID-19 has caused greater than 300 million documented infections worldwide including over 5 million confirmed deaths. Patients with cancer are particularly vulnerable due to a combination of disease and therapy-related effects. Available vaccines were highly effective against the original viral strains in clinical trials. However, initial vaccination efforts in this vulnerable population were impacted by federal policy that created substantial vaccine scarcity and allocation difficulties by recommending prioritization of unmanageably large patient populations including the entire elderly population and patients over the age of 16 with broadly defined, high-risk medical conditions (including cancer). We found that these overly broad recommendations led nearly two-thirds of states to elect not to give adequate vaccination priority to patients with cancer, exposing this vulnerable population to potentially preventable infection. With the virulent omicron variant spreading rapidly, there is newfound concern about waning immunity, particularly in immunocompromised populations. To address this issue, the Centers for Disease Control is recommending boosters for patients who meet age, occupational exposure, or medical criteria, in similar fashion to recommendations during the initial vaccination phase. Thus, this approach raises the question of whether state-level decisions on how to sub prioritize may inadvertently once again result in delayed immunizations for particularly vulnerable subgroups – such as patients with cancer. We discuss the implications of this public health policy on the likelihood of timely re-vaccination of patients with cancer. With the omicron variant continuing its unchecked global spread, equitable distribution of booster immunizations is critical to minimizing inherent medical and socioeconomic inequities in COVID-related morbidity and mortality.

Access to COVID-19 vaccination for displaced Venezuelans in Latin America: a rapid scoping review

BackgroundVenezuelan migration is the second largest international displacement in contemporary history. Yet, amid global calls for the inclusion of migrants and refugees in COVID-19 vaccination priority groups, little is known about how Latin American countries are prioritising COVID-19 vaccination for Venezuelans. This rapid scoping review addresses this gap, taking up a Latin American Social Medicine approach to assess the region's sociopolitical context and explore the extent to which Venezuelan migrants are considered in COVID-19 vaccination strategies in Latin America. MethodsWe conducted a three-phased rapid scoping review assessing peer-reviewed literature, gray literature, and government documents addressing COVID-19 vaccine access for displaced Venezuelans in Latin America. Documents published in English, Spanish, or Portuguese between January 2020 and June 2021 were included. Peer-reviewed literature search yielded 142 results and 13 articles included in the analysis; Gray literature screening resulted in 68 publications for full-text review and 37 were included; and official Ministry of Health policies in Argentina, Brazil, Chile, Colombia, Ecuador, and Peru were reviewed in-depth. Screening and data extraction used a combination of online platforms (Covidence, Google Forms, Zotero, and Excel) and the team met twice weekly to review, compare, discuss, analyse, and interpret data across a 6-week period. FindingsFindings from country-level policies revealed a heterogeneous and shifting policy landscape amid the COVID-19 pandemic, which strongly juxtaposed calls for a rights-based, social justice approach to COVID-19 vaccination evidenced in the peer-reviewed and gray literature. For example, under extreme resource constraints resulting from a chronically underfunded health system and mass Venezuelan migration. Colombia's vaccination plan excluded migrants with irregular migration status. Countries prioritised COVID-19 vaccines to certain “at-risk” groups defined by individual epidemiological factors rather than social vulnerability, limiting vaccine access for displaced Venezuelans in the region. Country-level policies differentiated, at times arbitrarily, between refugees, irregular migrants, and regular migrants, with important implications for vaccine access. While international right to health legislation prohibits discrimination based on migration status and urges states to refrain from denying access to preventive health services, these results suggest the need for further guidance on terminology to better contend with migrants' social vulnerabilities. InterpretationCOVID-19 is rapidly evolving and there is an urgent need for rights-based approaches to vaccination that consider sociopolitical contexts, especially impacts of mass migration. Findings underscore the need to better integrate Venezuelan migrants into vaccination strategies, not only as a matter of social justice, but a pragmatic public health strategy. FundingFunding provided by the Canadian Social Sciences and Humanities Research Council Insight Development Grant.

Disease burden and vaccination priorities in Colombia

IntroductionIn the context of the COVID-19 pandemic, vaccination is considered a potentially effective strategy for controlling the disease. The objective of this study is to estimate the number of people with a high risk of morbidity and those who should be prioritized in immunization planning in Colombia. Materials and methodsThe population at risk by age was identified from the national census data of 2018. Various sources were identified to obtain information on the number of patients with different comorbidities, including heart failure, diabetes, chronic kidney failure, cancers, HIV infection, and obesity. Sources were also identified to estimate the number of health workers, teachers and military and police force personnel. ResultsBy 2021, Colombia is estimated to have a total of 51,049,498 inhabitants, of whom 14% will be people over 60 years of age. Additionally, of the people with comorbidities younger than 60 years old, 5,233,241 inhabitants are expected to be obese, 592,726 are expected to have diabetes mellitus, 216,389 are expected to have chronic kidney disease, and 521,263 are expected to have heart failure, totaling 15,055,697 individuals. Combining the high-priority groups and health workers, a projected 20 million people will have mortality risk factors. ConclusionsFor Colombia’s vaccination strategy to have an impact on reducing mortality, population groups with risk factors, corresponding to approximately 15 million inhabitants, as well as essential workers should be prioritized.

Emphasizing the link between blood types in multi-ethnic disparities and COVID-19 infection in Makkah, Saudi Arabia.

Objectives:To analyze the impact and distribution of blood groups in different ethnicities and the extent of susceptibility to infection with COVID-19 in Makkah, Saudi Arabia.Methods:A retrospective study was performed on 4,609 COVID-19 patients from five ethnic groups to assess the impact and distribution of different blood types and susceptibility to COVID-19 infection. The study was carried out between November 2020 and June 2021 in the College of Medicine, Umm Al-Qura University in collaboration with the General Directorate of Health Affairs, Makkah, Saudi Arabia.Results:Blood group (A, B, and O) distributions in 2,617 COVID-19 patients with local control populations was done. Our study found that in both Saudi and non-Saudi populations, blood groups O and A were associated with higher infection rates, whereas blood group AB was associated with lower infection rates (p=0.0001). COVID-19 seems to be associated with blood groups A, B, and AB (RR=3.23, 95% CI=2.702-3.821, p=0.0001). COVID-19 risk was lower in people with O blood group (RR=0.783, 95% CI=0.733-0.836, p=0.0001). South Asians had higher odds of COVID-19 infection when compared to Saudi cases and other ethnic groups (OR=1.12, 95 % CI: 1.074-1.24, p=0.04).Conclusion:We emphasize that COVID-19 infection is not proportional among ethnically related blood groups. Notably, RhD-negative protect against COVID-19, whereas A and O blood types are more susceptible. Thus, when assessing COVID-19 prognosis and vaccination priority, blood groups A and O are critical.