Vaccination Record Research Articles

Protective Role of Vaccination against Tuberculosis and Hepatitis B in Prevention of Atopic Dermatitis: Report on Intermediate Results of Prospective Cohort Study

Background. Studies have shown that vaccination in the first hours/days after birth shifts the immune response from intrauterine Th2 towards Th1-type activation and reduces the risk of atopic conditions. However, we did not find published data from prospective studies on this topic.Objective. The aim of the study is to define the presence of negative correlation between vaccination against tuberculosis and hepatitis B in the first hours/days of life and atopic dermatitis development in infants.Methods. Continuous prospective study of children cohort born from April to June 2021 and observed in one outpatient’s clinic was carried out. Data from 307 infant’s records (F. 112/y), vaccination record cards (F. 063/y), prenatal and delivery records (F. 113/y-20, section № 3), and neonatal discharge summaries were analyzed for the decreed period. The child vaccination status (by the time of vaccination against tuberculosis and hepatitis B), presence of risk factors for allergic disease development, and presence of atopic dermatitis were evaluated.Results. Atopic dermatitis (AD) was significantly less likely to be diagnosed by the age of 1 year in infants from the group of BCG-M vaccinated at maternity hospital than in those vaccinated later or not vaccinated at all (15.2% versus 66% and 35.7%, respectively; p < 0,01). AD was less likely to develop in children with risk factors for allergic disease who were vaccinated against tuberculosis in the maternity hospital than in those vaccinated later or unvaccinated at all (18, 75 and 62.5%, respectively; p < 0.01). The ratio of children with diagnosed AD by the age of 12 months was significantly less in the group of children vaccinated against hepatitis B in the maternity hospital than in those vaccinated later or unvaccinated at all (17.6, 44.9 and 31.8%, respectively; p < 0.01). These ratios for children with risk of allergic disease development were 24%, 50% and 44.4%, respectively (p = 0.043). It has also been shown that timely vaccination with both vaccines in the early neonatal period significantly reduces the risk of AD in general infant population compared to non-vaccinated individuals or those who had only one vaccine (odds ratio [OR] 0.374; 95% confidence interval [CI] 0.253-0.552; p < 0.01). Whereas the disease development in children with allergic risk is less likely with timely vaccination (20.8% versus 53.3%; OR = 0.252; 95% CI 0.145–0.440; OR = 0.374; 95% CI 0,253–0,552; p < 0,01).Conclusion. The obtained results may indicate possible risk reduction for AD development due to timely preventive vaccination against tuberculosis and hepatitis B, especially in children with allergic risk. The study is currently ongoing.

Effect of women's literacy on maternal and child health: Evidence from demographic Health Survey data in Senegal.

Senegal has certainly made significant efforts in adult literacy and in the fight against maternal and infant mortality. However, a large proportion of the female population is illiterate, and the country's maternal and infant mortality rates are still higher than WHO recommendations. This article examined the effect of women's literacy on maternal and child health in Senegal. Data were extracted from the last Senegal Demographic and Health Surveys (DHS) collected in 2019. A binary logistic model was performed to assess the effect of women's literacy on ten outcomes of maternal and child health indicators. Results indicate that women's literacy has a positive and significant effect on nine of key indicators outcomes. For instance, women's literacy increases the odds of contraceptive use by 1.29 (95% Confidence Interval [CI], 1.13-1.48; p<0.01), compliance with the number of prenatal visits by 1.57 (95% CI, 1.35-1.83; p<0.01) and consultation in the first trimester of pregnancy by 1.52 (95% CI, 1.31-1.78; p<0.01). Literacy is associated with increased odds of breastfeeding up to six months (Odds Ratio [OR], 1.17; 95% CI, 0.97-1.42; p<0.1) and healthy birth interval (OR, 1.18; 95% CI, 0.97-1.44; p<0.1) only in rural areas. Women literacy reduces the risk of stunting by 0.81 (95% CI, 0.68-0.96; p<0.05) and the risk of underweight by 0.72 (95% CI, 0.59-0.87; p<0.01) among children under five years. The mother's ability to read and write favors compliance with the increase of odds of DPT vaccination record of her children, especially in rural areas (OR, 1.69; 95% CI, 1.05-2.74; p<0.05). Moreover, there are serval other factors influencing positively the maternal and child health, like health insurance access, media exposure, and clean water and improved sanitation facilities access. This study emphasizes on the need to strengthen adult literacy programs, especially for women in rural areas. Indeed, this could help generalize health insurance by income-sensitive premiums or exemptions for the poor as well as increased awareness campaigns to promote reproductive and maternal health benefits, via the radio or television. Furthermore, improving access to clean water supply and improved sanitation facilities would greatly ameliorate maternal and child health.

Selection Effects and COVID-19 Mortality Risk after Pfizer vs. Moderna Vaccination: Evidence from Linked Mortality and Vaccination Records

Selection Effects and COVID-19 Mortality Risk after Pfizer vs. Moderna Vaccination: Evidence from Linked Mortality and Vaccination Records

Online Appendix for Selection Effects and Covid-19 Mortality Risk after Pfizer vs. Moderna Vaccination: Evidence from Linked Mortality and Vaccination Records

Online Appendix for Selection Effects and Covid-19 Mortality Risk after Pfizer vs. Moderna Vaccination: Evidence from Linked Mortality and Vaccination Records

National Vaccine Coverage Survey 2020: methods and operational aspects.

The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage.

INFLAMMATORY BIOMARKERS DIFFER AMONG HOSPITALIZED VETERANS INFECTED WITH COVID-19 VARIANTS

Abstract The SARS-CoV-2 infection pathogenesis reported a complex interplay between virus and host immune response. In this study, we hypothesized that Omicron variant causes less inflammation and cytokine release than Delta and Alpha variants as measured by the first laboratory biomarkers during hospitalization. This is a retrospective cohort study of veterans who tested positive for COVID-19 and were hospitalized at the Veterans Health Administration due to COVID-19 infection. We defined three groups of patients based on highly likely period representing variants: Alpha (12/01/2020-05/31/2021), Delta (09/01/2021-11/30/2021), and Omicron (02/01/2022-07/11/2022). The risk of abnormality levels in biomarkers (C-reactive protein [CRP], ferritin, albumin, alanine aminotransferase [ALT], aspartate transaminase [AST], and lactate), as well as in-hospital mortality, were calculated using logistic regression adjusted by age, sex, body-mass-index, race, Charlson comorbidity index, VA frailty index, and vaccine record status. Of 414,213 Veterans tested for COVID-19, 74,342 Veterans (age: 67.8±14.3 years, BMI: 29.4±7.1 kg/m2) met the criteria: Alpha, 18,159 (34.4%); Delta, 23,414 (44.4%); Omicron, 11,207 (21.2%). Compared with Omicron, we observed significantly higher odds of abnormality levels in CRP (Alpha, adjusted odds ratio (aOR)=1.38; Delta, aOR=1.74), ferritin (Alpha, aOR=2.02; Delta, aOR=2.33), albumin (Alpha, aOR=1.16; Delta, aOR=1.15), ALT (Alpha, aOR=1.13; Delta, aOR=1.12), AST (Alpha, aOR=1.31; Delta, aOR=1.57), and lactate (Alpha, aOR=1.62; Delta, aOR=2.27) as well as mortality (Alpha, aOR=2.19; Delta, aOR=2.95). Veterans infected with Omicron showed less severe biomarkers’ responses compared to Alpha and Delta and lower mortality risk. Understanding the biomarkers’ responses of each patient across the different variants could be used to enhance acute patients’ management.

435. Investigation of the cause of low measles seroprevalence among young healthcare workers in South Korea

Abstract Background After a large measles outbreak in 2000∼2001, national measles vaccination program was implemented in Korea, and more than 95% of people born after 1985 have been vaccinated with 2-dose MMR. But sporadic outbreaks have continued to occur mainly in adults in their 20’s and 30’s in 2014 and 2019. Although low prevalence in young adults have been reported, there are limited data regarding the cause of low seropositivity (positive vaccine failure vs. secondary vaccine failure). We aimed to evaluate the cause of low seroprevalence of measles. Methods This study was performed in a 2743-bed tertiary-care hospital in South Korea. At 1-month after MMR vaccination in healthcare workers (HCWs) who were seronegative for measles, we performed measles antibody test(enzyme immunoassay), IgM/IgG index ratio, and avidity test. Results Of the 1,698 new HCWs in 2020 and, 1,686 in 2021, 54 HCWs with negative measles IgG at their entering at our hospital were enrolled in this study. Of these, 36(67%) were female, and the median age was 25 (IQR, 24-27) years. Of 43 HCWs who measured IgM/IgG index 1 month after MMR vaccination, 38 HCWs had IgM/IgG index of less than 1 and remaining 5 had negative IgG results (seroconversion rate of 88%). All 54 healthcare workers who performed avidity test showed high avidity index Measles vaccination record in KCDA showed that 45 had documented vaccination record during their childhood (of these, 11 received MMR vaccine again during their adult age) and remaining 9 had no documented vaccination record during their childhood. Of these 9 healthcare workers without record in their childhood, 3 had a history of vaccination at adult. Analyzing 48 healthcare workers with vaccination record, they received MMR vaccination median 18 years (IQR, 7-20) before. Therefore, at least 48 received at least 2 dose MMR vaccination, and 11 received at least 3 dose MMR vaccination. Conclusion Secondary vaccine failure may be the reason for vaccine failure in young adults in Korea. Therefore, HCWs with negative measles antibody who were born after 1985 may receive 1 dose booster vaccination rather than 2 dose vaccination. Disclosures All Authors: No reported disclosures.

Study of thyroid function among COVID-19-affected and non-affected people during pre and post-vaccination.

The novel coronavirus COVID-19 has caused a global pandemic with many long-ranging effects on the physiological balance of the human body. The impact of COVID-19 on the thyroid axis remains uncertain. Our aim was to assess the long-term consequences of COVID-19 infection and its vaccination with thyroid hormones. Thirty laboratory-confirmed COVID-19-positive patients with no vaccination record, thirty COVID-19-negative patients with vaccination records, and ten healthy subjects were retrospectively, and cross-sectionally enrolled in this study. An ELISA assay was performed to evaluate thyroid function tests, including the total triiodothyronine (TT3), total thyroxine (TT4), and thyroid stimulating hormone (TSH). We found decreased levels of TT3, average or low plasma T4 levels, and standard or slightly decreased TSH levels in unvaccinated COVID-19-positive patients than in the healthy group, while the vaccinated COVID-19-negative group had normal thyroid hormone levels compared to controls. The correlation between TT3 and TSH levels gradually shifted from no association to a negative pattern in the unvaccinated COVID-19-positive group. Again, a highly significant negative correlation between TSH and TT3 was observed on days above 150, although a slight fluctuation was noted on day 90. This pilot study from Bangladesh shows that abnormalities in thyroid function can be observed during COVID-19 infection and after vaccination, which gradually recovers over time.

Protection from previous natural infection compared with mRNA vaccination against SARS-CoV-2 infection and severe COVID-19 in Qatar: a retrospective cohort study

Understanding protection conferred by natural SARS-CoV-2 infection versus COVID-19 vaccination is important for informing vaccine mandate decisions. We compared protection conferred by natural infection versus that from the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines in Qatar. We conducted two matched retrospective cohort studies that emulated target trials. Data were obtained from the national federated databases for COVID-19 vaccination, SARS-CoV-2 testing, and COVID-19-related hospitalisation and death between Feb 28, 2020 (pandemic onset in Qatar) and May 12, 2022. We matched individuals with a documented primary infection and no vaccination record (natural infection cohort) with individuals who had received two doses (primary series) of the same vaccine (BNT162b2-vaccinated or mRNA-1273-vaccinated cohorts) at the start of follow-up (90 days after the primary infection). Individuals were exact matched (1:1) by sex, 10-year age group, nationality, comorbidity count, and timing of primary infection or first-dose vaccination. Incidence of SARS-CoV-2 infection and COVID-19-related hospitalisation and death in the natural infection cohorts was compared with incidence in the vaccinated cohorts, using Cox proportional hazards regression models with adjustment for matching factors. Between Jan 5, 2021 (date of second-dose vaccine roll-out) and May 12, 2022, 104 500 individuals vaccinated with BNT162b2 and 61 955 individuals vaccinated with mRNA-1273 were matched to unvaccinated individuals with a documented primary infection. During follow-up, 7123 SARS-CoV-2 infections were recorded in the BNT162b2-vaccinated cohort and 3583 reinfections were recorded in the matched natural infection cohort. 4282 SARS-CoV-2 infections were recorded in the mRNA-1273-vaccinated cohort and 2301 reinfections were recorded in the matched natural infection cohort. The overall adjusted hazard ratio (HR) for SARS-CoV-2 infection was 0·47 (95% CI 0·45-0·48) after previous natural infection versus BNT162b2 vaccination, and 0·51 (0·49-0·54) after previous natural infection versus mRNA-1273 vaccination. The overall adjusted HR for severe (acute care hospitalisations), critical (intensive care unit hospitalisations), or fatal COVID-19 cases was 0·24 (0·08-0·72) after previous natural infection versus BNT162b2 vaccination, and 0·24 (0·05-1·19) after previous natural infection versus mRNA-1273 vaccination. Severe, critical, or fatal COVID-19 was rare in both the natural infection and vaccinated cohorts. Previous natural infection was associated with lower incidence of SARS-CoV-2 infection, regardless of the variant, than mRNA primary-series vaccination. Vaccination remains the safest and most optimal tool for protecting against infection and COVID-19-related hospitalisation and death, irrespective of previous infection status. The Biomedical Research Program and the Biostatistics, Epidemiology, and Biomathematics Research Core, Weill Cornell Medicine-Qatar; Qatar Ministry of Public Health; Hamad Medical Corporation; Sidra Medicine; Qatar Genome Programme; and Qatar University Biomedical Research Center.

Blockchain technology and vaccine supply chain: Exploration and analysis of the adoption barriers in the Indian context

The vaccine distribution system, being a bio-pharmaceutical cold chain, is a complicated and sensitive system that must be effectively managed and maintained due to its direct impact on public health. However, vaccine supply chains continue to be affected by concerns, including vaccine expiry, inclusion of counterfeit vaccines, and vaccine record fraud. The blockchain technology integrated with the Internet of Things (IoT) can create a solution for global vaccine distributions with improved trust, transparency, traceability, and data management, which will help monitor the cold chain, tackle counterfeit drugs, surveillance, and waste management. Several theoretical models for vaccine management with blockchain have recently been published, and a few pilot studies for COVID-19 vaccine management using blockchain have been started in India. Still, full-scale adoption of blockchain technology in vaccine distribution and management has yet to be achieved due to underlying barriers. This study explores the adoption barriers utilizing Technology-Organization-Environment (TOE) framework with the help of extant literature and inputs from administrators, academics, immunization, and blockchain experts and then analyzed using the Delphi and fuzzy Decision-Making Trial and Evaluation Laboratory (DEMATEL) techniques. The finding shows that the requirement of change in organizational structure and policies is the most prominent barrier, and the barrier related to requirement of large-scale IoT infrastructure and lack of technical expertise are the most impactful barriers. The theoretical contribution of this study lies in the identification and analysis of barriers that should be addressed to achieve blockchain technology adoption in the vaccine supply chain.

Assessing the level of knowledge, uptake of hepatitis B virus vaccine, and its determinants among health workers across various levels of health facilities in Ondo, South West, Nigeria

Problem consideredResearch has shown that health care personnel is at higher risk of acquiring the disease than the general population. In spite of this challenge, there has been a low vaccination record among the Health WorkersThe aim of this study was to investigate the relationship between knowledge, attitude, perception, and practice of hepatitis B vaccination among health workers in Akure South Local Government Area of Ondo State, NigeriaMethodsAn institution-based cross-sectional study was conducted with 260 health professionals working at primary health centers (40), private hospitals (60), and tertiary health institutions (160). Data was collected by using self-administered questionnaires distributed at the participant’s work unit and analyzed using SPSS version 20.ResultsThe result showed that there was a statistically significant relationship between the knowledge of Health workers about the HBV vaccine and vaccine uptake.While all the non-vaccinated health workers showed interest in taking the vaccine, the majority of them (80.4 %) suggested that the vaccine should be given free to health workers.ConclusionThe study revealed that the health workers had a good knowledge of hepatitis infection but not the vaccination which affected vaccine uptake as a significant relationship exists between the two. Also, the greatest hindrance to the uptake of the vaccine is the cost of the vaccine. HBV vaccination should be made compulsory as part of occupational protection measures and made readily available gratis for all health workers.

A case of racemiform trichoblastoma in a dog

ABSTRACT Trichoblastoma, which is common in dogs, is now occurring with other cellular changes outside the recognized forms to warrant their continuous evaluation for proper elucidation even as their causes largely remain unknown. A case at hand involved a 9-year-old Caucasian dog, which weighed 35 kg with chief complaint of a progressive bleeding mass on the scalp. The dog had an up-to-date vaccination record and all vital parameters were within optimum ranges. The surgical excision of the firm, solitary, and alopecic mass with traumatized upper surface revealed the presence of a well-demarcated and unencapsulated mass composed of grapes-like nests of basaloid epithelial cells within follicular stroma devoid of stromal necrosis, inflammatory cellular infiltration, and neoplastic epidermal connection. However, there was tissue necrosis, hemorrhages, and inflammatory cellular infiltrates on the exposed upper part of the traumatized growth. Immunohistochemical analysis showed positive reactivity to AE1/AE3, CK5/6, and p63 but negative immunoreactivity to CK7, CK20, CEA, and TTF-1. The histomorphological and immunohistochemical evaluation of the mass on the scalp of the dog suggested a solitary racemiform trichoblastoma with a traumatized exposed upper part despite basal cell carcinoma mimicry where histological diagnosis currently hold sway over immunohistochemical evaluation.

Agreement Between Pregnant Individuals' Self-Report of Coronavirus Disease 2019 (COVID-19) Vaccination and Medical Record Documentation.

For public health research such as vaccine uptake or effectiveness assessments, self-reported coronavirus disease 2019 (COVID-19) vaccination status may be a more efficient measure than verifying vaccination status from medical records if agreement between sources is high. We assessed agreement between self-reported and medical record-documented COVID-19 vaccination status among pregnant individuals followed in a cohort during August 2020-October 2021. At end of pregnancy, participants completed questionnaires about COVID-19 vaccine receipt during pregnancy; staff verified vaccination status using medical records. Agreement was assessed between self-reported and medical record vaccination status using Cohen's kappa. There was high agreement between self-reported and medical record vaccination status (Kappa coefficient=0.94, 95% CI 0.91-0.98), suggesting that self-report may be acceptable for ascertaining COVID-19 vaccination status during pregnancy.

COVID-19 vaccination uptake for half a million non-EU migrants and refugees in England: a linked retrospective population-based cohort study

BackgroundCOVID-19 has highlighted severe health inequities experienced by certain migrants. Despite evidence suggesting that migrants are at risk of under-immunisation, data are limited for migrants' COVID-19 vaccine uptake in England. MethodsWe did a retrospective population-based cohort study on COVID-19 vaccination uptake in England. We linked the Million Migrant cohort (which includes non-EU migrants and resettled refugees) to the national COVID-19 vaccination dataset, using a stepwise deterministic matching procedure adapted from NHS Digital, and compared migrants with the general population. For migrants who linked to at least one vaccination record, we estimate temporal trends in first dose uptake and differences in second and third dose uptake and consequent delays between Dec 8, 2020, and April 20, 2022, by age, visa type, and ethnicity. FindingsOf the 465 470 migrants who linked to one or more vaccination record, 427 073 (91·8%) received a second dose and 238 721 (51·3%) received a third. Migrants (>30 years) reached 75% first-dose coverage between 1 and 2 weeks after the general population in England, with the gap widening to 6 weeks for younger migrants (16–29 years). Refugees specifically had a higher risk of a delayed second dose (odds ratio 1·75 [95 CI% 1·62–1·88]) and third dose (1·41 [1·31–1·53]). Older migrants (>65 years) were at least four times more likely to have not received their second or third dose compared with those of the same age in England. InterpretationUptake of the first dose was slower across all age groups for migrants compared with the general population. Refugees and older migrants were more likely to have delayed uptake of COVID-19 vaccines and to not have received their second or third dose. Policymakers, researchers, and practitioners should consider how to best drive uptake of COVID-19 and other routine vaccine doses and understand and address personal and structural barriers to vaccination systems for diverse migrant populations. FundingWellcome Trust and UK Research and Innovation.

Inactivated Covid-19 vaccine did not undermine live birth and neonatal outcomes of women with frozen-thawed embryo transfer.

Does inoculation with inactivated vaccines against coronavirus disease 2019 (Covid-19) before frozen-thawed embryo transfer (FET) affect live birth and neonatal outcomes? Inactivated Covid-19 vaccines did not undermine live birth and neonatal outcomes of women planning for FET. Accumulating reports are now available indicating the safe use of mRNA vaccines against Covid-19 in pregnant and lactating women, and a few reports indicate that they are not associated with adverse effects on ovarian stimulation or early pregnancy outcomes following IVF. Evidence about the safety of inactivated Covid-19 vaccines is very limited. This is a retrospective cohort analysis from Reproductive Medical Center of a tertiary teaching hospital. Clinical records and vaccination record of 2574 couples with embryos transferred between 1 March 2021 and 30 September 2021 were screened for eligibility of this study. Clinical and vaccination data of infertile couples planning for FET were screened for eligibility of the study. The reproductive and neonatal outcomes of FET women inoculated with inactivated Covid-19 vaccines or not were compared. The primary outcomes were live birth rate per embryo transfer cycle and newborns' birth height and weight. Secondary outcomes included rates of ongoing pregnancy, clinical pregnancy, biochemical pregnancy and spontaneous miscarriage. Multivariate logistical regression and propensity score matching (PSM) analyses were performed to minimize the influence of confounding factors. Subgroup analyses, including single dose versus double dose of the vaccines and the time intervals between the first vaccination and embryo transfer, were also performed. Vaccinated women have comparable live birth rates (43.6% versus 45.0% before PSM, P = 0.590; and 42.9% versus 43.9% after PSM, P = 0.688), ongoing pregnancy rates (48.2% versus 48.1% before PSM, P = 0.980; and 52.2% versus 52.7% after PSM, P = 0.875) and clinical pregnancy rate (55.0% versus 54.8% before PSM, P = 0.928; and 54.7% versus 54.2% after PSM, P = 0.868) when compared with unvaccinated counterparts. The newborns' birth length (50.0 ± 1.6 versus 49.0 ± 2.9 cm before PSM, P = 0.116; and 49.9 ± 1.7 versus 49.3 ± 2.6 cm after PSM, P = 0.141) and birth weight (3111.2 ± 349.9 versus 3030.3 ± 588.5 g before PSM, P = 0.544; and 3053.8 ± 372.5 versus 3039.2 ± 496.8 g after PSM, P = 0.347) were all similar between the two groups. Neither single dose nor double dose of vaccines, as well as different intervals between vaccination and embryo transfer showed any significant impacts on reproductive and neonatal outcomes. The main findings might be limited by retrospective design. Besides, inoculations of triple dose of Covid-19 vaccines were not available by the time of data collection, thus the results cannot reflect the safe use of triple dose of inactivated Covid-19 vaccines. Finally, history of Covid-19 infection was based on patients' self-report rather than objective laboratory tests. Eligible individuals of inactivated vaccines against Covid-19 should not postpone vaccination plan because of their embryo transfer schedule, or vice versa. This study was supported by the Medical Key Discipline of Guangzhou (2021-2023). All authors had nothing to disclose. N/A.

Air travel choice, online meeting and passenger heterogeneity - An international study on travellers' preference during a pandemic.

This study empirically identifies business travellers’ preferences during the COVID-19 pandemic across different regions. A stated preference study was conducted during April to June 2021 on respondents in the U.S., the city of Shanghai in mainland China and Hong Kong. Generalised mixed multinomial logit (GMXL) models are estimated incorporating attributes of travel characteristics, severity levels of the pandemic, and health control measures at the airport. When an online meeting is inapplicable, respondents from Shanghai and Hong Kong highly value heath control measures, and are not sensitive to the time spent at airport health checkpoints. In comparison, U.S. respondents are averse to the time spent for health check, the reporting of personal information, travel history, symptoms, and the requirements of compulsory mask wearing and onsite sample testing. However, when online meeting is applicable, all the respondents show no appreciation for health control measures, while the U.S. respondents are twice more averse to the time spent at airport health checkpoints. Online meeting reduces the intention of international business travel amid the pandemic for passengers in Shanghai and Hong Kong, but imposes no significant effects on U.S. travellers. Such significant heterogeneity in traveller preference partly explains the different recovery patterns observed in various aviation markets, and justifies individualized travel arrangements and service priority in fulfilling pandemic control requirements across different regions. Our study also suggests that there are commonly accepted areas for global cooperation such as the sharing of vaccination record, and the option of online meeting calls for convenient travel arrangements amid pandemic to all countries.

Blockchain Powered Vaccine Efficacy for Pharma Sector.

Infectious and contagious diseases exist in humanity for many centuries which causes a curb in the growth of the population. Immunization plays a vital role to prevent mortality and morbidity against infectious diseases. COVID-19 pandemic continues to rage the urgency of developing a vaccine that should ensure the safety, efficacy, swift and fair deployment, implementation, and monitoring of vaccines across the globe. In the present context, the vaccine production to immunization campaign is a critical challenge. Therefore, an effective vaccine supply chain mechanism is required to address issues such as counterfeit vaccines, reduce vaccine wastages, and vaccine record fraud. In this paper, a blockchain-enabled vaccine supply chain is proposed to ensure the correctness, transparency, trust, and immutable log and improve the efficiency of vaccine distribution in the cold chain. The uniqueness of the proposed system is to provide distributed system to verify the reliability and efficacy of the vaccine from production to end beneficiaries' feedback about the vaccine. Our proposed system gives a clear view to the users as well as to the healthcare provider about the vaccination and ensures the anticounterfeit vaccine. The proposed system minimizes counterfeit vaccines and records, provides transparent communication between stakeholders in the supply chain, and improves the security of the vaccine supply chain and immutable feedback system about the vaccine.

Association of COVID-19 vaccination before conception with maternal liver function during early pregnancy: a cohort study of 7745 Chinese pregnant women

ABSTRACT Multicenter case series has reported patients with hepatic injury following COVID-19 vaccination, which raised concern for the possibility of vaccine-induced liver dysfunction. We aimed to assess the impact of COVID-19 vaccination on liver function of pregnant women, who may be uniquely susceptible to vaccine-induced liver dysfunction. We conducted a retrospective cohort study at a tertiary hospital in Shanghai, China. Vaccine administration was obtained from the electronic vaccination record. Serum levels of alanine transaminase (ALT), aspartate transaminase (AST), total bile acid (TBA) and total bilirubin (TBIL) in early pregnancy were determined by enzymatic methods. Among the 7745 included pregnant women, 3832 (49.5%) received at least two doses of an inactivated vaccine. COVID-19 vaccination was significantly associated with higher levels of maternal serum TBA. Compared with unvaccinated pregnant women, the mean TBA levels increased by 0.17 μmol/L (β = 0.17, 95% CI, 0.04, 0.31) for women who had been vaccinated within 3 months before the date of conception. Moreover, COVID-19 vaccination was significantly associated with an increased risk of maternal hyperbileacidemia. The risk of hyperbileacidemia increased by 113% (RR = 2.13; 95% CI, 1.17-3.87) for pregnant women who had been vaccinated within 3 months before conception compared with unvaccinated pregnant women. However, when the interval from complete vaccination to conception was prolonged to more than 3 months, COVID-19 vaccination was not associated with serum TBA levels or maternal hyperbileacidemia. Our findings suggest that vaccination with inactivated COVID-19 vaccines more than 3 months before conception have no detrimental effects on maternal liver function in early pregnancy.

Vaccination coverage of patients with type 2 diabetes mellitus: Challenging issues from an outpatient secondary care setting in Greece.

BackgroundIncreased morbidity/mortality due to vaccine preventable diseases (VPD) is encountered in type 2 diabetes (T2D) people. Aim of this study was to assess their vaccination coverage and describe trends possibly affecting compliance.MethodsInformation on vaccination coverage was retrieved from either documents or interview provided by patients, and/or their vaccination record card at a specialized outpatient diabetes center. The selection of the patients was arbitrary.ResultsAn increasing vaccination rate for influenza was observed from 2018 to 2020 among 372 participants. The vaccination coverage for S.pneumoniae was 67.2% (PCV13), 20.4% (PPSV23), 26.3% for herpes zoster in individuals ≥60 years, 1.9% for tetanus-diphtheria-pertussis and 1.1% for hepatitis B. A 10.2% of participants were found to be unvaccinated. Vaccination uptake for influenza and PCV13 was related to age, ≥3 comorbidities and long-term follow-up. T2D individuals consecutively vaccinated for influenza were 3.78 times more likely to be also vaccinated with PCV13.ConclusionsVaccination rates of patients with T2D show an increasing trend, especially for influenza and S. pneumoniae, although the one for S. pneumoniae was low. Older people seem more prone to vaccination, the one for herpes zoster was low with infected patients remaining unvaccinated while significantly low coverage was observed for other VPDs. The findings are important to improve effectiveness of preventative services.

Risk Factors Responsible for Canine Rabies in Zamfara State, Nigeria

The global community aims to eliminate human deaths from dog mediated Rabies by 2030. For Nigeria, a rabies endemic country to join the list of countries that have successfully eliminated rabies, there is need for more risk factor studies that addresses her peculiar environment. This study identifies risk factors responsible for rabies cases in Zamfara, Nigeria. A cross-sectional descriptive survey was carried out among dog owners in Zamfara State by administering questionnaires. Seventy questionnaires were administered directly to dog owners across fourteen Local Government Areas (LGAs) of Zamfara state to identify the possible risk factors and IBM SPSS 21 was used to determine the relative risk of Canine Rabies incidence across the state when exposed to each of the identified risk factors. The knowledge of rabies is very poor (17%) among the dog owners, with only 9% of the total respondents that were able to describe the clinical signs and symptoms of the disease in dogs. Only 5% of the respondents have record of previous vaccination of their dogs against Rabies. Extensive system of management increased the risk of the disease among dogs of the state by 80% and caused its spread from infected to un-infected dogs. Risk factors identified could be likely hindrances to eradicating Canine Rabies in the State. It is hoped that results of this study will encourage other States to carry out similar investigation to aid understanding the sustenance dynamics of the disease.