We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure [email protected]
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Vaccination during pregnancy is an effective route of protecting pregnant individuals, their fetuses, and neonates from morbidity and mortality of vaccine preventable diseases. There is sufficient epidemiologic safety data to support routine administration of influenza vaccine, Tdap, and COVID-19 vaccine, however there are poor rates of vaccine uptake in pregnancy due to low vaccine confidence and barriers to care. Routine inactivated childhood vaccines, travel vaccines, and live attenuated vaccine recommendations are reviewed, and recommendations are made based on weighing the risk of exposure, risk of the vaccination, and necessity of travel.
To examine opinions about incentives for vaccination against COVID-19.
Methods
A qualitative study was conducted in spring 2022. The study population consisted of pairs of university students and their parents throughout Serbia. The qualitative content analysis was applied.
Results
A total of 18 participants (9 student-parent pairs) were included. The following themes were identified: 1) Attitudes about financial incentives for vaccination, 2) Non-financial incentives for vaccination, and 3) Suggestions to enhance vaccination coverage. Theme 1 comprised several subthemes: General response to money, Dissatisfaction with financial incentives, Satisfaction with financial incentives and Amount of money to change people’s opinion. Most parents and some students expressed a clear dissatisfaction and disapproval of the concept of financial incentives for compliance with vaccination. Financial offers would not make our participants change their position on whether to receive the vaccine, as no major differences in attitude towards vaccinations between the vaccinated and the non-vaccinated study participants was observed. Non-financial incentives were more acceptable compared to financial ones, but they were also seen as beneficial for some and not others.
Conclusions
Financial incentive programs’ potential for inefficiency and public mistrust make other methods to boost vaccine uptake better public health choices for now.
The objectives of this study were to determine how university and surrounding area characteristics are associated with student vaccination rates and vaccine exemption stringency.
Methods
This study collected data from publicly available university-associated and government-associated websites. The university and surrounding area characteristics were evaluated to elucidate how they impact student vaccination rates and ease of exemption from vaccine mandates using statistical correlations and linear regression.
Results
Lower student-to-faculty ratios and stricter university exemption strategies were significantly correlated with higher vaccination rates. Schools that did not allow for personal exemptions to vaccine mandates had significantly higher vaccination rates as compared to schools without vaccine mandates. Certain university and surrounding area characteristics, such as regional location and surrounding area vaccination rates, might serve as underlying factors in inconsistent vaccination rates on university campuses.
Conclusions
Associations were seen between some of the explanatory variables and student vaccination rates. However, more research needs to be conducted to better understand how these discussed factors affect university vaccination rates. This will allow public health professionals to be more prepared as new health concerns arise in the future.
Health care comprises a major segment of the US economy and is a critical influence upon citizens’ quality of life. The quality of health care and access to it are negatively affected by corruption. So too is citizen compliance with public health policies, a fact that became apparent during the COVID-19 pandemic. Stay-at-home orders, for example, were significantly less effective in states with more extensive corruption. Low levels of trust in government contributed to those disparities. Such effects are more pronounced in poorer areas and Black communities. Racial contrasts in vaccine equity – access to vaccinations and related services – were pronounced and, again, reflected levels of corruption. Particularly intractable problems of collective action posed by structural corruption and structural racism must be addressed if disparities in the quality of health care are to be reduced.
Post COVID-19 condition (PCC) refers to persistent symptoms occurring ≥12 weeks after COVID-19. This living systematic review (SR) assessed the impact of vaccination on PCC and vaccine safety among those with PCC, and was previously published with data up to December 2022. Searches were updated to 31 January 2024 and standard SR methodology was followed. Seventy-eight observational studies were included (47 new). There is moderate confidence that two doses pre-infection reduces the odds of PCC (pooled OR (pOR) 0.69, 95% CI 0.64–0.74, I2 = 35.16%). There is low confidence for remaining outcomes of one dose and three or more doses. A booster dose may further reduce the odds of PCC compared to only a primary series (pOR 0.85, 95% CI 0.74–0.98, I2 = 16.85%). Among children ≤18 years old, vaccination may not reduce the odds (pOR 0.79, 95% CI 0.56–1.11, I2 = 37.2%) of PCC. One study suggests that vaccination within 12 weeks post-infection may reduce the odds of PCC. For those with PCC, vaccination appears safe (four studies) and may reduce the odds of PCC persistence (pOR 0.73, 95% CI 0.57–0.92, I2 = 15.5%).
The purpose of this study was to measure and examine the levels of IgG, IgM, and Spike antibody induced by inactivated vaccines, including CoronaVac and BBIBP-CorV.
Methods
Two groups of healthy adults over 18 years old (50 participants per group), who had previously received 1 dose of either BBIBP-CorV or CoronaVac and receiving either a homologous booster of BBIBP-CorV or a heterologous booster of CoronaVac. Serum IgG, IgM, and Spike antibody levels against SARS-COV-2 were measured using magnetic particle chemiluminescence immunoassay and the ELISA method.
Results
The results showed that both spike antibody and IgG/IgM antibodies elicited by a CoronaVac booster following 1 dose of BBIBP-CorV were significantly higher than those elicited by either a homologous BBIBP-CorV booster or a heterologous BBIBP-CorV booster. The Spike antibody against SARS-COV-2 induced by the heterologous CoronaVac booster reached 200.3, which is substantially greater than that induced by the homologous BBIBP-CorV booster (127.5 pg/mL). Conversely, the Spike antibody against SARS-COV-2 induced by the heterologous BBIBP-CorV booster reached 53.93 pg/mL, which is substantially greater than that induced by the homologous CoronaVac booster (9.60 pg/mL).
Conclusions
In summary, CoronaVac is immunogenic as a booster dose following 1 dose of BBIBP-CorV and is immunogenically superior to both the homologous booster and the heterologous BBIBP-CorV booster.
This chapter of the handbook posits utilitarianism as a standard of rational moral judgment. The author does not directly defend utilitarianism as a theory but investigates cases of apparent contradiction between people’s moral decisions (sometimes grounded in nonutilitarian principles) and the consequences of those decisions that they themselves would consider worse for themselves and everybody else. For example, when some people use a moral principle (e.g., bodily autonomy) to assertively make a decision (e.g., to not get vaccinated), it has negative moral consequences for others (e.g., infecting people) and for themselves (risking infection). The author asks whether such contradictions in moral reasoning can provide insights into some of the determinants of such reasoning. These insights, importantly, are valuable even for those who do not adopt utilitarianism as a normative model. From over a dozen candidate moral contradictions, the author concludes that many deviations from utilitarian considerations in moral contexts are reflections of familiar nonmoral cognitive biases, but some arise from adherence to strong moral rules or principles (e.g., protected or sacred values).
We present the case of a 31-year-old female with Fontan circulation who developed signs of protein-losing enteropathy 10 days after second COVID-19 vaccination. After standard investigations for identification of potential triggers for protein-losing enteropathy, we concluded that coronavirus disease 2019 (COVID-19) booster vaccination could have been the most probable underlying trigger. Prompt investigation of new symptoms post-vaccination in high-risk patients is necessary.
We studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination status among six ethnic groups in Amsterdam, the Netherlands. We analysed participants of the Healthy Life in an Urban Setting cohort who were tested for SARS-CoV-2 spike protein antibodies between 17 May and 21 November 2022. We categorized participants with antibodies as only infected, only vaccinated (≥1 dose), or both infected and vaccinated, based on self-reported prior infection and vaccination status and previous seroprevalence data. We compared infection and vaccination status between ethnic groups using multivariable, multinomial logistic regression. Of the 1,482 included participants, 98.5% had SARS-CoV-2 antibodies (P between ethnic groups = 0.899). Being previously infected and vaccinated ranged from 41.5% (95% confidence interval (CI) = 35.0–47.9%) in the African Surinamese to 67.1% (95% CI = 59.1–75.0%) in the Turkish group. Compared to participants of Dutch origin, participants of South-Asian Surinamese (adjusted odds ratio (aOR) = 3.31, 95% CI = 1.50–7.31)), African Surinamese (aOR = 10.41, 95% CI = 5.17–20.94), Turkish (aOR = 3.74, 95% CI = 1.52–9.20), or Moroccan (aOR = 15.24, 95% CI = 6.70–34.65) origin were more likely to be only infected than infected and vaccinated, after adjusting for age, sex, household size, trust in the government’s response to the pandemic, and month of study visit. SARS-CoV-2 infection and vaccination status varied across ethnic groups, particularly regarding non-vaccination. As hybrid immunity is most protective against coronavirus disease 2019, future vaccination campaigns should encourage vaccination uptake in specific demographic groups with only infection.
Immunization is a global development success story, saving millions of lives yearly by reducing the risks of contracting an infectious disease and enabling the immune system within the body to build protection. The global eradication of smallpox in 1977 demonstrates the potential of well-designed immunization campaigns. Islamic teaching places attention on preserving life, encouraging Muslims to care for their bodies and overall health, because of its preventive function. However, vaccination of populations is not without challenges; for example, vaccine hesitancy or avoidance emerges for a variety of reasons in Muslim populations, increasing the risks of communicable diseases globally. Public health has a role to play in countering issues. Such issues include misinformation, acting with diplomacy when discussing immunization programs with Muslim community leaders, ensuring the availability of evidence-based accessible information, and educating populations about the necessity and protective ability of vaccines to prevent life-threatening diseases. It also has a role to play in educating non-Muslim professionals about culturally competent care.
As COVID-19 spread rapidly during the early months of the pandemic, many communities around the globe anxiously waited for a vaccine. At the start of the pandemic, it was widely believed that Africa would be a significant source of infection, and thus, vaccinating African communities became a primary goal among local and global health authorities. However, when the COVID-19 vaccine became available in March 2021 in Sierra Leone, many people viewed it with scepticism and hesitation. While much literature has focused on access and distribution-related challenges for vaccination in the region, a growing number of studies discuss vaccine hesitancy as driving low vaccine uptake. Shifting attention to understanding the determinants of vaccine hesitancy remains fundamental to increasing vaccination rates, as negative vaccine perceptions tend to delay or prevent vaccination. This study sought to do this by assessing, through semi-structured qualitative interviews, vaccine-related attitudes and experiences of residents of Sierra Leone’s Kono District. In contrast to studies that utilise “knowledge-deficit” models of belief, however, this study drew upon the vaccine anxieties framework (Leach and Fairhead, 2007), which views vaccines as being imbued with personal, historical, and political meaning. Findings suggest that important bodily, social, and political factors, including fear of side effects, the spread of misinformation prompted by poor messaging strategies, and distrust of government and international actors, influenced people’s COVID-19 vaccine attitudes and behaviours. It is hoped that the study’s findings will inform future policies and interventions related to vaccine uptake in Africa and globally.
This study explored the effect of SARS-CoV-2 infection and COVID-19 vaccination during pregnancy on neonatal outcomes among women from the general Dutch population. VASCO is an ongoing prospective cohort study aimed at assessing vaccine effectiveness of COVID-19 vaccination. Pregnancy status was reported at baseline and through regular follow-up questionnaires. As an extension to the main study, all female participants who reported to have been pregnant between enrolment (May–December 2021) and January 2023 were requested to complete an additional questionnaire on neonatal outcomes. Multivariable linear and logistic regression analyses were used to determine the associations between self-reported SARS-CoV-2 infection or COVID-19 vaccination during pregnancy and neonatal outcomes, adjusted for age, educational level, and presence of a medical risk condition. Infection analyses were additionally adjusted for COVID-19 vaccination before and during pregnancy, and vaccination analyses for SARS-CoV-2 infection before and during pregnancy. Of 312 eligible participants, 232 (74%) completed the questionnaire. In total, 196 COVID-19 vaccinations and 115 SARS-CoV-2 infections during pregnancy were reported. Infections were mostly first infections (86; 75%), caused by the Omicron variant (95; 83%), in women who had received ≥1 vaccination prior to infection (101; 88%). SARS-CoV-2 infection during pregnancy was not significantly associated with gestational age (β = 1.7; 95%CI: −1.6–5.0), birth weight (β = 82; −59 to 223), Apgar score <9 (odds ratio (OR): 1.3; 0.6–2.9), postpartum hospital stay (OR: 1.0; 0.6–1.8), or neonatal intensive care unit admission (OR: 0.8; 0.2–3.2). COVID-19 vaccination during pregnancy was not significantly associated with gestational age (β = −0.4; −4.0 to 3.2), birth weight (β = 88; −64 to 240), Apgar score <9 (OR: 0.9; 0.4–2.3), postpartum hospital stay (OR: 0.9; 0.5–1.7), or neonatal intensive care unit admission (OR: 1.6; 0.4–8.6). In conclusion, this study did not find an effect of SARS-CoV-2 infection or COVID-19 vaccination during pregnancy on any of the studied neonatal outcomes among a general Dutch, largely vaccinated, population. Together with data from other studies, this supports the safety of COVID-19 vaccination during pregnancy.
High prevalence of long COVID symptoms has emerged as a significant public health concern. This study investigated the associations between three doses of COVID-19 vaccines and the presence of any and ≥3 types of long COVID symptoms among people with a history of SARS-CoV-2 infection in Hong Kong, China. This is a secondary analysis of a cross-sectional online survey among Hong Kong adult residents conducted between June and August 2022. This analysis was based on a sub-sample of 1,542 participants with confirmed SARS-CoV-2 infection during the fifth wave of COVID-19 outbreak in Hong Kong (December 2021 to April 2022). Among the participants, 40.9% and 16.1% self-reported having any and ≥3 types of long COVID symptoms, respectively. After adjusting for significant variables related to sociodemographic characteristics, health conditions and lifestyles, and SARS-CoV-2 infection, receiving at least three doses of COVID-19 vaccines was associated with lower odds of reporting any long COVID symptoms comparing to receiving two doses (adjusted odds ratio [AOR]: 0.69, 95% CI: 0.54, 0.87, P = .002). Three doses of inactivated and mRNA vaccines had similar protective effects against long COVID symptoms. It is important to strengthen the coverage of COVID-19 vaccination booster doses, even in the post-pandemic era.
Vaccination is the most important method to control the spread of SARS-CoV-2, the virus that causes COVID-19, and vaccination is key to this goal. This paper highlights considerations for policy development around vaccination attestation and proof requirements, specifically in rural Appalachia. Migrant and immigrant farmworkers are integral to the food and goods supply chain globally; they have been disproportionately impacted by COVID-19, therefore these policies need to take extensive precautions for farmworkers to systematically and easily comply with vaccination status submission procedures. In this paper, we present steps to equitably manage and implement vaccine mandates: (1) Develop and establish policies to support safe workplace standards for everyone, including vaccination policies; (2) Utilize equitable methods to collect vaccine verification; (3) Use effective and inclusive methods to implement the policies by using these techniques; (4) Integrate key populations to develop and strengthen policies to improve health equity.
Vaccines are not the only public health tool, but they are critical in routine and emergency settings. Achieving optimal vaccination rates requires timely access to vaccines. However, we have persistently failed to secure, distribute, and administer vaccines in a timely, effective, and equitable manner despite an enduring rhetoric of global health equity.
Many governments employed mandates for COVID-19 vaccines, imposing consequences upon unvaccinated people. Attitudes towards these policies have generally been positive, but little is known about how discourses around them changed as the characteristics of the disease and the vaccinations evolved. Western Australia (WA) employed sweeping COVID-19 vaccine mandates for employment and public spaces whilst the state was closed off from the rest of the country and world, and mostly with no COVID-19 in the community. This article analyses WA public attitudes during the mandate policy lifecycle from speculative to real. Qualitative interview data from 151 adults were analysed in NVivo 20 via a novel chronological analysis anchored in key policy phases: no vaccine mandates, key worker vaccine mandates, vaccine mandates covering 75% of the workforce and public space mandates. Participants justified mandates as essential for border reopening and, less frequently, for goals such as protecting the health system. However, public discourse focusing on ‘getting coverage rates up’ may prove counter-productive for building support for vaccination; governments should reinforce end goals in public messaging (reducing suffering and saving lives) because such messaging is likely to be more meaningful to vaccination behaviour in the longer term.
This chapter deals with Occupational Health and how to protect healthcare workers from acquiring infections (e.g. HAV, HBV, HIV, HCV, VZV, influenza, Covid-19, measles, mumps, rubella, polio, TB, diphtheria, meningococcal infection and tetanus) while at work. It describes how healthcare workers can be protected by providing pre-exposure vaccinations and post-exposure treatments, as well as discussing responses to outbreaks and routes of infection.
This chapter deals with public health and pandemic preparedness. It recognises the five stages of a new pandemic (detection, assessment, treatment, escalation and recovery). The chapter also deals with the issue of laboratory preparedness and the need to maintain a critical mass of laboratory and skilled staff expertise at all times in order to be able to respond rapidly and effectively to a new emerging pandemic.
Vaccination is one of the most recognised strategies in public health for preventing the spread of epidemics, and the availability of a vaccine is often expected by health actors to be a ‘game-changer’. However, the COVID-19 (coronavirus disease 2019) vaccine in Senegal was not the magic bullet that the international community expected. A very low vaccination coverage rate (less than 10% by April 2023) was observed in this country, once considered a model in West Africa for its epidemic response. Beyond the population’s alleged hesitancy to be vaccinated, was a lack of preparedness to blame? Previous analyses show that outbreak preparation limited to standard interventions is not sufficient in the face of the social, cultural, and political configurations of each epidemic context and that uncertainty limits response capacity. This paper examines the social life of the COVID-19 vaccine to identify the forms and contextual dimensions of uncertainty related to immunisation in Senegal. The authors explore how vaccination was implemented and compare experiences with the preparedness process, to offer insight on uncertainties. Using Stirling’s theoretical model that defines various expressions of incertitude, the authors identify four nexuses at various stages of the social life of COVID-19 vaccine in Senegal: (1) material uncertainty related to vaccine availability, (2) ambiguity of the population about the purpose of vaccination and the risks of the disease, (3) uncertainty related to side effects, and (4) uncertainty about vaccination strategies shared by scientific and health authorities. These uncertainties were only partly considered in the preparedness process, for they are related to systemic structural dimensions and reflect the impact of global/regional powers on the local level. The findings of this research are relevant not only to support better communication around vaccines in Senegal but also more generally to the prevention of emerging epidemics shaped by human behaviours.
Australia’s approach to its biosecurity and borders has always been two-pronged – quarantine first, vaccination second. This article asks what this combination looked like in practice by exploring two neglected smallpox vaccination campaigns directed towards Indigenous peoples in the early twentieth century. We argue these were important campaigns because they were the first two pre-emptive, rather than reactionary, vaccination programs directed towards First Nations people. Second, both episodes occurred in Australia’s northern coastline, where the porous maritime geography and proximity to Southeast Asia posed a point of vulnerability for Australian health officials. While smallpox was never endemic, (though epidemic), in Australia, it was endemic at various times and places across Southeast Asia. This shifting spectre of smallpox along the northern coastline was made even more acute for state and federal health officials because of the existing polyethnic relationships, communities, and economies. By vaccinating Indigenous peoples in this smallpox geography, they were envisioned and embedded into a ‘hygienic’ border for the protection of white Australia, entwining the two-prongs as one approach. In this article, we place public health into a recent scholarship that has ‘turned the map upside down’ to re-spatialise Australia’s history and geography to the north and its global connections, while demonstrating how particular coastlines and their connections were drawn into a national imaginary through a health lens.