International Journal of Environmental Research and Public Health

2023

Jump to: 2022, 2021

13 pages, 1856 KiB

Open AccessReview

Long-Term Consequences of Asymptomatic SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

by Yirui Ma, Jie Deng, Qiao Liu, Min Du, Min Liu and Jue Liu

Int. J. Environ. Res. Public Health 2023, 20(2), 1613; https://doi.org/10.3390/ijerph20021613 - 16 Jan 2023

Cited by 15 | Viewed by 2985

Abstract

Little is known about the long-term consequences of asymptomatic infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to review the data available to explore the long-term consequences of asymptomatic SARS-CoV-2 infection in the real world. We searched observational cohort [...] Read more.

Little is known about the long-term consequences of asymptomatic infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to review the data available to explore the long-term consequences of asymptomatic SARS-CoV-2 infection in the real world. We searched observational cohort studies that described the long-term health effects of asymptomatic SARS-CoV-2 infections. Random-effects inverse-variance models were used to evaluate the pooled prevalence (PP) and its 95% confidence interval (CI) of long-term symptoms. Random effects were used to estimate the pooled odds ratios (OR) and its 95%CI of different long-term symptoms between symptomatic and asymptomatic infections. Five studies involving a total of 1643 cases, including 597 cases of asymptomatic and 1043 cases of symptomatic SARS-CoV-2 infection were included in this meta-analysis. The PPs of long-term consequences after asymptomatic SARS-CoV-2 infections were 17.13% (95%CI, 7.55–26.71%) for at least one symptom, 15.09% (95%CI, 5.46–24.73%) for loss of taste, 14.14% (95%CI, −1.32–29.61%) for loss of smell, and 9.33% (95%CI, 3.07–15.60) for fatigue. Compared with symptomatic SARS-CoV-2 infection, asymptomatic infection was associated with a significantly lower risk of developing COVID-19-related sequelae (p < 0.05), with 80% lower risk of developing at least one symptom (OR = 0.20, 95%CI, 0.09–0.45), 81% lower risk of fatigue (OR = 0.19, 95%CI, 0.08–0.49), 90% lower risk of loss of taste/smell (OR = 0.10, 95%CI, 0.02–0.58). Our results suggested that there were long-term effects of asymptomatic SARS-CoV-2 infection, such as loss of taste or smell, fatigue, cough and so on. However, the risk of developing long-term symptoms in asymptomatic SARS-CoV-2 infected persons was significantly lower than those in symptomatic SARS-CoV-2 infection cases. Full article

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2022

Jump to: 2023, 2021

8 pages, 657 KiB

Open AccessArticle

COVID-19—Infections and Immunization of Inmates in Penitentiary Institutions in Poland in 2021

by Anna Augustynowicz, Beata Bachurska, Michał Wójcik, Mariola Borowska, Aleksandra Czerw, Janusz Opolski, Karolina Słabicka and Jarosław Pinkas

Int. J. Environ. Res. Public Health 2022, 19(21), 13725; https://doi.org/10.3390/ijerph192113725 - 22 Oct 2022

Cited by 2 | Viewed by 1345

Abstract

Susceptibility to infection and the risk of a severe course of the disease caused by SARS-CoV-2 among inmates are greater than in the general population. Therefore, it is extremely important to control infections in penitentiary institutions and to vaccinate as many inmates as [...] Read more.

Susceptibility to infection and the risk of a severe course of the disease caused by SARS-CoV-2 among inmates are greater than in the general population. Therefore, it is extremely important to control infections in penitentiary institutions and to vaccinate as many inmates as possible. The objectives of the study are to present the number and percentage of inmates quarantined, infected with the SARS CoV-2 virus, and vaccinated against COVID-19 in 2021, and to describe the rules and organization of immunization. The information presented in the study was obtained from the Ministry of Justice in the form of access to public information. In 2021, 2065 cases of SARS CoV-2 infection were detected among inmates, and 5707 people were quarantined. The waves of infections among inmates in Poland ran parallel to those in the general population. Immunization of inmates began at the turn of February and March 2021. It took place in accordance with the provisions of the National COVID-19 Immunization Program. The program ensured equality of the inmates’ population with the group to which individual inmates belong in the community. In 2021, nearly half of the inmates were covered by the full vaccination course. Inmates were vaccinated immediately after the vaccines were made available. There have been cases of refusals among inmates. There are no data that could determine the magnitude of the phenomenon and its exact causes. Full article

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12 pages, 1630 KiB

Open AccessSystematic Review

Effect of COVID-19 Vaccines on Reducing the Risk of Long COVID in the Real World: A Systematic Review and Meta-Analysis

by Peng Gao, Jue Liu and Min Liu

Int. J. Environ. Res. Public Health 2022, 19(19), 12422; https://doi.org/10.3390/ijerph191912422 - 29 Sep 2022

Cited by 71 | Viewed by 21168

Abstract

The coronavirus disease 2019 (COVID-19) is still in a global pandemic state. Some studies have reported that COVID-19 vaccines had a protective effect against long COVID. However, the conclusions of the studies on the effect of COVID-19 vaccines on long COVID were not [...] Read more.

The coronavirus disease 2019 (COVID-19) is still in a global pandemic state. Some studies have reported that COVID-19 vaccines had a protective effect against long COVID. However, the conclusions of the studies on the effect of COVID-19 vaccines on long COVID were not consistent. This study aimed to systematically review relevant studies in the real world, and performed a meta-analysis to explore the relationship between vaccination and long COVID. We systematically searched PubMed, Embase, Web of science, and ScienceDirect from inception to 19 September 2022. The PICO (P: patients; I: intervention; C: comparison; O: outcome) was as follows: patients diagnosed with COVID-19 (P); vaccination with COVID-19 vaccines (I); the patients were divided into vaccinated and unvaccinated groups (C); the outcomes were the occurrence of long COVID, as well as the various symptoms of long COVID (O). A fixed-effect model and random-effects model were chosen based on the heterogeneity between studies in order to pool the effect value. The results showed that the vaccinated group had a 29% lower risk of developing long COVID compared with the unvaccinated group (RR = 0.71, 95% CI: 0.58–0.87, p < 0.01). Compared with patients who were not vaccinated, vaccination showed its protective effect in patients vaccinated with two doses (RR = 0.83, 95% CI: 0.74–0.94, p < 0.01), but not one dose (RR = 0.83, 95% CI: 0.65–1.07, p = 0.14). In addition, vaccination was effective against long COVD in patients either vaccinated before SARS-CoV-2 infection/COVID-19 (RR = 0.82, 95% CI: 0.74–0.91, p < 0.01) or vaccinated after SARS-CoV-2 infection/COVID-19 (RR = 0.83, 95% CI: 0.74–0.92, p < 0.01). For long COVID symptoms, vaccination reduced the risk of cognitive dysfunction/symptoms, kidney diseases/problems, myalgia, and sleeping disorders/problems sleeping. Our study shows that COVID-19 vaccines had an effect on reducing the risk of long COVID in patients vaccinated before or after SARS-CoV-2 infection/COVID-19. We suggest that the vaccination rate should be improved as soon as possible, especially for a complete vaccination course. There should be more studies to explore the basic mechanisms of the protective effect of COVID-19 vaccines on long COVID in the future. Full article

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13 pages, 936 KiB

Open AccessArticle

Acceptability of the Vaccine against COVID-19 in Spanish Health Sciences Students: A Cross-Sectional Study

by Noelia Rodríguez-Blanco, Nancy Vicente-Alcalde, Laura Cubero-Plazas, Jesús Sánchez-Más, Emilia Montagud, Raul Moragues, Eva Gabaldón-Bravo, Jose Antonio Hurtado-Sanchez and José Tuells

Int. J. Environ. Res. Public Health 2022, 19(19), 12244; https://doi.org/10.3390/ijerph191912244 - 27 Sep 2022

Cited by 1 | Viewed by 1698

Abstract

Healthcare professionals must play an exemplary role in the field of vaccinology. It is convenient that they are trained during their time at university. The objective of this study was to determine the acceptability of the vaccines against COVID-19 in health sciences students [...] Read more.

Healthcare professionals must play an exemplary role in the field of vaccinology. It is convenient that they are trained during their time at university. The objective of this study was to determine the acceptability of the vaccines against COVID-19 in health sciences students in Spanish universities. A cross-sectional study was performed regarding the acceptance of the vaccines against COVID-19 in students in the Health Sciences Degrees in Spanish universities was performed on a sample of students of nursing, medicine, and pharmacy during the spring of 2021, via an online questionnaire with 36 questions designed ad hoc, self-administered, anonymized, and standardized. There were 1222 students participating, of Spanish nationality (97.4%), women (80.5%) and with an average age of 22.0 ± 4.8 years old. Of those, 12.3% had had the disease, 44.0% had to quarantine, 70.8% had undergone diagnostic tests, out of which 14.1% were positive. In total, 97.5% of those surveyed indicated their desire of being vaccinated, if possible, with Comirnaty^® (74.9%). At the time of the study, 49.6% were already vaccinated. The reasons for vaccination differed according to the degree and the doubts about vaccine safety was the largest reason for reluctance. Some 37.7% suspected that there are unknown adverse effects and 85.6% of those vaccinated experienced some mild effects after injection. Vaccine acceptance and confidence in the recommendations given by health authorities is high in health sciences students. Full article

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11 pages, 643 KiB

Open AccessArticle

A Survey Exploring Reasons behind Immunization Refusal among the Parents and Caregivers of Children under Two Years Living in Urban Slums of Karachi, Pakistan

by Asif Khaliq, Alfaraz Ashraf Elahi, Asima Zahid and Zohra S. Lassi

Int. J. Environ. Res. Public Health 2022, 19(18), 11631; https://doi.org/10.3390/ijerph191811631 - 15 Sep 2022

Cited by 2 | Viewed by 1905

Abstract

This study assesses the experiences of parents/caregivers regarding the refusal to childhood immunization. A cross-sectional study was conducted among the parents/caregivers of children under two years old from January 2019 to June 2019 who were residents of either Pathan Colony or Orangi Town, [...] Read more.

This study assesses the experiences of parents/caregivers regarding the refusal to childhood immunization. A cross-sectional study was conducted among the parents/caregivers of children under two years old from January 2019 to June 2019 who were residents of either Pathan Colony or Orangi Town, Karachi. In this study, the data collectors targeted parents/caregivers of 440 households who showed a refusal mark “R” in the Expanded Program of Immunization (EPI) H-chalking system. These households were approached using a 30 × 7 multistage-stratified-cluster random sampling technique and were interviewed using a structured questionnaire. The study sample produced two different types of refusals: true refusal (absence) and potential refusal (presence), based on the absence and presence of a vaccination card at the time of the survey. Multivariate logistic regression was used to analyze the data using Jamovi (V-1.6.13). A total of 230 households consented to participate in this study, of which 141 (61.3%) represented true refusals, while 89 (38.7%) represented potential refusals. More than half of the participants from both groups complained about fever and pain at the injection site following immunization. The use of alternative medicines and a history of adverse events following immunization (AEFI) were associated with increasing the odds of immunization refusals by four-to-five fold. However, advanced paternal age, a long distance to the clinic, a lack of trust in government, and the influence of community/religious leaders were associated with lower immunization refusal odds. Thus, an unawareness about self-limiting vaccine-related adverse events, the use of alternative medicines, and an increased concern about the safety and efficacy of vaccines were found to be barriers to immunization, which can be improved by increasing public awareness through media campaigns and policy reform. Full article

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19 pages, 4999 KiB

Open AccessArticle

Pan-Genome-Assisted Computational Design of a Multi-Epitopes-Based Vaccine Candidate against Helicobacter cinaedi

by Saba Ismail, Noorah Alsowayeh, Hyder Wajid Abbasi, Aqel Albutti, Muhammad Tahir ul Qamar, Sajjad Ahmad, Rabail Zehra Raza, Khulah Sadia and Sumra Wajid Abbasi

Int. J. Environ. Res. Public Health 2022, 19(18), 11579; https://doi.org/10.3390/ijerph191811579 - 14 Sep 2022

Cited by 7 | Viewed by 1779

Abstract

Helicobacter cinaedi is a Gram-negative bacterium from the family Helicobacteraceae and genus Helicobacter. The pathogen is a causative agent of gastroenteritis, cellulitis, and bacteremia. The increasing antibiotic resistance pattern of the pathogen prompts the efforts to develop a vaccine to prevent dissemination [...] Read more.

Helicobacter cinaedi is a Gram-negative bacterium from the family Helicobacteraceae and genus Helicobacter. The pathogen is a causative agent of gastroenteritis, cellulitis, and bacteremia. The increasing antibiotic resistance pattern of the pathogen prompts the efforts to develop a vaccine to prevent dissemination of the bacteria and stop the spread of antibiotic resistance (AR) determinants. Herein, a pan-genome analysis of the pathogen strains was performed to shed light on its core genome and its exploration for potential vaccine targets. In total, four vaccine candidates (TonB dependent receptor, flagellar hook protein FlgE, Hcp family type VI secretion system effector, flagellar motor protein MotB) were identified as promising vaccine candidates and subsequently subjected to an epitopes’ mapping phase. These vaccine candidates are part of the pathogen core genome: they are essential, localized at the pathogen surface, and are antigenic. Immunoinformatics was further applied on the selected vaccine proteins to predict potential antigenic, non-allergic, non-toxic, virulent, and DRB*0101 epitopes. The selected epitopes were then fused using linkers to structure a multi-epitopes’ vaccine construct. Molecular docking simulations were conducted to determine a designed vaccine binding stability with TLR5 innate immune receptor. Further, binding free energy by MMGB/PBSA and WaterSwap was employed to examine atomic level interaction energies. The designed vaccine also stimulated strong humoral and cellular immune responses as well as interferon and cytokines’ production. In a nutshell, the designed vaccine is promising in terms of immune responses’ stimulation and could be an ideal candidate for experimental analysis due to favorable physicochemical properties. Full article

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17 pages, 1400 KiB

Open AccessSystematic Review

Comparison of the Effectiveness and Safety of Heterologous Booster Doses with Homologous Booster Doses for SARS-CoV-2 Vaccines: A Systematic Review and Meta-Analysis

by Jie Deng, Yirui Ma, Qiao Liu, Min Du, Min Liu and Jue Liu

Int. J. Environ. Res. Public Health 2022, 19(17), 10752; https://doi.org/10.3390/ijerph191710752 - 29 Aug 2022

Cited by 25 | Viewed by 3467

Abstract

As vaccine resources were distributed unevenly worldwide, sometimes there might have been shortages or delays in vaccine supply; therefore, considering the use of heterogeneous booster doses for Coronavirus disease 2019 (COVID-19) might be an alternative strategy. Therefore, we aimed to review the data [...] Read more.

As vaccine resources were distributed unevenly worldwide, sometimes there might have been shortages or delays in vaccine supply; therefore, considering the use of heterogeneous booster doses for Coronavirus disease 2019 (COVID-19) might be an alternative strategy. Therefore, we aimed to review the data available to evaluate and compare the effectiveness and safety of heterologous booster doses with homologous booster doses for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. We searched relevant studies up to 27 April 2022. Random-effects inverse variance models were used to evaluate the vaccine effectiveness (VE) and its 95% confidence interval (CI) of COVID-19 outcomes and odds ratio (OR) and its CI of safety events. The Newcastle–Ottawa quality assessment scale and Cochrane Collaboration’s tool were used to assess the quality of the included cohort studies. A total of 23 studies involving 1,726,506 inoculation cases of homologous booster dose and 5,343,580 inoculation cases of heterologous booster dose was included. The VE of heterologous booster for the prevention of SARS-CoV-2 infection (VE_heterologous = 96.10%, VE_homologous = 84.00%), symptomatic COVID-19 (VE_heterologous = 56.80%, VE_homologous = 17.30%), and COVID-19-related hospital admissions (VE_heterologous = 97.40%, VE_homologous = 93.20%) was higher than homologous booster. Compared with homologous booster group, there was a higher risk of fever (OR = 1.930, 95% CI, 1.199–3.107), myalgia (OR = 1.825, 95% CI, 1.079–3.089), and malaise or fatigue (OR = 1.745, 95% CI, 1.047–2.906) within 7 days after boosting, and a higher risk of malaise or fatigue (OR = 4.140, 95% CI, 1.729–9.916) within 28 days after boosting in heterologous booster group. Compared with homologous booster group, geometric mean neutralizing titers (GMTs) of neutralizing antibody for different SARS-CoV-2 variants and response rate of antibody and gama interferon were higher in heterologous booster group. Our findings suggested that both homologous and heterologous COVID-19 booster doses had great effectiveness, immunogenicity, and acceptable safety, and a heterologous booster dose was more effective, which would help make appropriate public health decisions and reduce public hesitancy in vaccination. Full article

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8 pages, 304 KiB

Open AccessArticle

Vaccination against COVID-19 in Europe: A Typology Based on Cluster Analysis

by Darie Cristea, Irina Zamfirache and Raisa-Gabriela Zamfirescu

Int. J. Environ. Res. Public Health 2022, 19(14), 8603; https://doi.org/10.3390/ijerph19148603 - 14 Jul 2022

Cited by 2 | Viewed by 1649

Abstract

This study aims to identify a general typology for the EU27, and subsequently in Romania, regarding the hesitation, acceptance and refusal of vaccination against COVID-19. The analysis we propose below is based on the information contained in Eurobarometer 94.3, the data of which [...] Read more.

This study aims to identify a general typology for the EU27, and subsequently in Romania, regarding the hesitation, acceptance and refusal of vaccination against COVID-19. The analysis we propose below is based on the information contained in Eurobarometer 94.3, the data of which were collected at the beginning of most of the national vaccination campaigns in Europe. Based on the attitudes and opinions expressed by the respondents of the European states (EU27), we constructed with the help of the cluster k-means (SPSS) statistical analysis a typology with four categories on the subject of vaccination against COVID-19. Our study proposes a matrix with five items/scenarios on a scale from total agreement to total disagreement. We chose a typology with four attitudinal types (clusters). We subsequently compared the results of the general European analysis with the cluster typology resulting from the same Eurobarometer, the same set of questions, only for the case of Romania, to see if this analysis sheds a specific light on the fact that Romania had a very low vaccination rate compared to other EU Member States. Full article

11 pages, 662 KiB

Open AccessArticle

Differences in Immunological Evasion of the Delta (B.1.617.2) and Omicron (B.1.1.529) SARS-CoV-2 Variants: A Retrospective Study on the Veneto Region’s Population

by Silvia Cocchio, Federico Zabeo, Giacomo Facchin, Nicolò Piva, Giovanni Venturato, Thomas Marcon, Mario Saia, Michele Tonon, Michele Mongillo, Filippo Da Re, Francesca Russo and Vincenzo Baldo

Int. J. Environ. Res. Public Health 2022, 19(13), 8179; https://doi.org/10.3390/ijerph19138179 - 04 Jul 2022

Cited by 6 | Viewed by 1866

Abstract

In December 2021–January 2022 the Veneto region in Italy faced an unprecedented wave of SARS-CoV-2 infections, even though both the vaccine coverage and the number of previously infected individuals keep increasing. In this study we address the protection against the SARS-CoV-2 infection offered [...] Read more.

In December 2021–January 2022 the Veneto region in Italy faced an unprecedented wave of SARS-CoV-2 infections, even though both the vaccine coverage and the number of previously infected individuals keep increasing. In this study we address the protection against the SARS-CoV-2 infection offered by natural immunity and a three-dose regimen through a retrospective study based on Veneto’s regional databases. In particular, we compared these protection levels during two distinct periods respectively representative of the Delta (B.1.617.2) and the Omicron (B.1.1.529) variants, in order to investigate and quantify the immunological evasion, especially of the Omicron. For each period we compared the incidence rate of infection among the population with various immunological protections against SARS-CoV-2 and performed a multivariable proportional hazard Cox binomial regression to assess the effectiveness afforded by both forms of active immunization. We found out that a previous SARS-CoV-2 infection (irrespective of its timing) offers 85% (83–87%) and 36% (33–39%) protection against being reinfected by Delta and Omicron, respectively. In addition, we estimated the third dose to be more effective in both periods and to have a minor proportional loss of effectiveness due to the rise of the Omicron variant, with an afforded effectiveness against SARS-CoV-2 Delta and Omicron infection of 97% (96–97%) and 47% (45–48%), respectively. Our findings suggest that viral variant factors may affect any form of active immunization but that receiving a booster vaccination cycle is more effective and less variable than natural immunity in terms of afforded protection against SARS-CoV-2 infections. Full article

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2021

Jump to: 2023, 2022

18 pages, 4992 KiB

Open AccessArticle

Core-Proteomics-Based Annotation of Antigenic Targets and Reverse-Vaccinology-Assisted Design of Ensemble Immunogen against the Emerging Nosocomial Infection-Causing Bacterium Elizabethkingia meningoseptica

by Muhammad Idrees, Muhammad Yasir Noorani, Kalim Ullah Altaf, Eid A. Alatawi, Faris F. Aba Alkhayl, Khaled S. Allemailem, Ahmad Almatroudi, Murad Ali Khan, Muhammad Hamayun, Taimoor Khan, Syed Shujait Ali, Abbas Khan and Dong-Qing Wei

Int. J. Environ. Res. Public Health 2022, 19(1), 194; https://doi.org/10.3390/ijerph19010194 - 24 Dec 2021

Cited by 3 | Viewed by 3028

Abstract

Elizabethkingia meningoseptica is a ubiquitous Gram-negative emerging pathogen that causes hospital-acquired infection in both immunocompromised and immunocompetent patients. It is a multi-drug-resistant bacterium; therefore, an effective subunit immunogenic candidate is of great interest to encounter the pathogenesis of this pathogen. A protein-wide annotation [...] Read more.

Elizabethkingia meningoseptica is a ubiquitous Gram-negative emerging pathogen that causes hospital-acquired infection in both immunocompromised and immunocompetent patients. It is a multi-drug-resistant bacterium; therefore, an effective subunit immunogenic candidate is of great interest to encounter the pathogenesis of this pathogen. A protein-wide annotation of immunogenic targets was performed to fast-track the vaccine development against this pathogen, and structural-vaccinology-assisted epitopes were predicted. Among the total proteins, only three, A0A1T3FLU2, A0A1T3INK9, and A0A1V3U124, were shortlisted, which are the essential vaccine targets and were subjected to immune epitope mapping. The linkers EAAK, AAY, and GPGPG were used to link CTL, HTL, and B-cell epitopes and an adjuvant was also added at the N-terminal to design a multi-epitope immunogenic construct (MEIC). The computationally predicted physiochemical properties of the ensemble immunogen reported a highly antigenic nature and produced multiple interactions with immune receptors. In addition, the molecular dynamics simulation confirmed stable binding and good dynamic properties. Furthermore, the computationally modeled immune response proposed that the immunogen triggered a strong immune response after several doses at different intervals. Neutralization of the antigen was observed on the 3rd day of injection. Conclusively, the immunogenic construct produces protection against Elizabethkingia meningoseptica; however, further immunological testing is needed to unveil its real efficacy. Full article

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13 pages, 1308 KiB

Open AccessArticle

Predicted Impact of the Lockdown Measure in Response to Coronavirus Disease 2019 (COVID-19) in Greater Bangkok, Thailand, 2021

by Sonvanee Uansri, Titiporn Tuangratananon, Mathudara Phaiyarom, Nattadhanai Rajatanavin, Rapeepong Suphanchaimat and Warisara Jaruwanno

Int. J. Environ. Res. Public Health 2021, 18(23), 12816; https://doi.org/10.3390/ijerph182312816 - 05 Dec 2021

Cited by 14 | Viewed by 2589

Abstract

In mid-2021, Thailand faced a fourth wave of Coronavirus Disease 2019 (COVID-19) predominantly fueled by the Delta and Alpha variants. The number of cases and deaths rose exponentially, alongside a sharp increase in hospitalizations and intubated patients. The Thai Government then implemented a [...] Read more.

In mid-2021, Thailand faced a fourth wave of Coronavirus Disease 2019 (COVID-19) predominantly fueled by the Delta and Alpha variants. The number of cases and deaths rose exponentially, alongside a sharp increase in hospitalizations and intubated patients. The Thai Government then implemented a lockdown to mitigate the outbreak magnitude and prevent cases from overwhelming the healthcare system. This study aimed to model the severity of the outbreak over the following months by different levels of lockdown effectiveness. Secondary analysis was performed on data primarily obtained from the Ministry of Health; the data were analyzed using both the deterministic compartmental model and the system dynamics model. The model was calibrated against the number of daily cases in Greater Bangkok during June–July 2021. We then assessed the outcomes (daily cases, daily deaths, and intubated patients) according to hypothetical lockdowns of varying effectiveness and duration. The findings revealed that lockdown measures could reduce and delay the peak of COVID-19 cases and deaths. A two-month lockdown with 60% effectiveness in the reduction in reproduction number caused the lowest number of cases, deaths, and intubated patients, with a peak about one-fifth of the size of a no-lockdown peak. The two-month lockdown policy also delayed the peak until after December, while in the context of a one-month lockdown, cases peaked during the end of September to early December (depending on the varying degrees of lockdown effectiveness in the reduction in reproduction number). In other words, the implementation of a lockdown policy did not mean the end of the outbreak, but it helped delay the peak. In this sense, implementing a lockdown helped to buy time for the healthcare system to recover and better prepare for any future outbreaks. We recommend further studies that explore the impact of lockdown measures at a sub-provincial level, and examine the impact of lockdowns on parameters not directly related to the spread of disease, such as quality of life and economic implications for individuals and society. Full article

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26 pages, 4884 KiB

Open AccessArticle

Towards A Novel Multi-Epitopes Chimeric Vaccine for Simulating Strong Immune Responses and Protection against Morganella morganii

by Asad Ullah, Sajjad Ahmad, Saba Ismail, Zobia Afsheen, Muhammad Khurram, Muhammad Tahir ul Qamar, Naif AlSuhaymi, Mahdi H. Alsugoor and Khaled S. Allemailem

Int. J. Environ. Res. Public Health 2021, 18(20), 10961; https://doi.org/10.3390/ijerph182010961 - 19 Oct 2021

Cited by 28 | Viewed by 2740

Abstract

Morganella morganii is one of the main etiological agents of hospital-acquired infections and no licensed vaccine is available against the pathogen. Herein, we designed a multi-epitope-based vaccine against M. morganii. Predicted proteins from fully sequenced genomes of the pathogen were subjected to [...] Read more.

Morganella morganii is one of the main etiological agents of hospital-acquired infections and no licensed vaccine is available against the pathogen. Herein, we designed a multi-epitope-based vaccine against M. morganii. Predicted proteins from fully sequenced genomes of the pathogen were subjected to a core sequences analysis, followed by the prioritization of non-redundant, host non-homologous and extracellular, outer membrane and periplasmic membrane virulent proteins as vaccine targets. Five proteins (TonB-dependent siderophore receptor, serralysin family metalloprotease, type 1 fimbrial protein, flagellar hook protein (FlgE), and pilus periplasmic chaperone) were shortlisted for the epitope prediction. The predicted epitopes were checked for antigenicity, toxicity, solubility, and binding affinity with the DRB*0101 allele. The selected epitopes were linked with each other through GPGPG linkers and were joined with the cholera toxin B subunit (CTBS) to boost immune responses. The tertiary structure of the vaccine was modeled and blindly docked with MHC-I, MHC-II, and Toll-like receptors 4 (TLR4). Molecular dynamic simulations of 250 nanoseconds affirmed that the designed vaccine showed stable conformation with the receptors. Further, intermolecular binding free energies demonstrated the domination of both the van der Waals and electrostatic energies. Overall, the results of the current study might help experimentalists to develop a novel vaccine against M. morganii. Full article

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17 pages, 1890 KiB

Open AccessArticle

Prioritization of the Target Population for Coronavirus Disease 2019 (COVID-19) Vaccination Program in Thailand

by Rapeepong Suphanchaimat, Titiporn Tuangratananon, Nattadhanai Rajatanavin, Mathudara Phaiyarom, Warisara Jaruwanno and Sonvanee Uansri

Int. J. Environ. Res. Public Health 2021, 18(20), 10803; https://doi.org/10.3390/ijerph182010803 - 14 Oct 2021

Cited by 14 | Viewed by 2487

Abstract

Thailand was hit by the second wave of Coronavirus Disease 2019 (COVID-19) in a densely migrant-populated province (Samut Sakhon). COVID-19 vaccines were known to be effective; however, the supply was limited. Therefore, this study aimed to predict the effectiveness of Thailand’s COVID-19 vaccination [...] Read more.

Thailand was hit by the second wave of Coronavirus Disease 2019 (COVID-19) in a densely migrant-populated province (Samut Sakhon). COVID-19 vaccines were known to be effective; however, the supply was limited. Therefore, this study aimed to predict the effectiveness of Thailand’s COVID-19 vaccination strategy. We obtained most of the data from the Ministry of Public Health. Deterministic system dynamics and compartmental models were utilized. The reproduction number (R) between Thais and migrants was estimated at 1.25 and 2.5, respectively. Vaccine effectiveness (VE) to prevent infection was assumed at 50%. In Samut Sakhon, there were 500,000 resident Thais and 360,000 resident migrants. The contribution of migrants to the province’s gross domestic product was estimated at 20%. Different policy scenarios were analyzed. The migrant-centric vaccination policy scenario received the lowest incremental cost per one case or one death averted compared with the other scenarios. The Thai-centric policy scenario yielded an incremental cost of 27,191 Baht per one life saved, while the migrant-centric policy scenario produced a comparable incremental cost of 3782 Baht. Sensitivity analysis also demonstrated that the migrant-centric scenario presented the most cost-effective outcome even when VE diminished to 20%. A migrant-centric policy yielded the smallest volume of cumulative infections and deaths and was the most cost-effective scenario, independent of R and VE values. Further studies should address political feasibility and social acceptability of migrant vaccine prioritization. Full article

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11 pages, 640 KiB

Open AccessArticle

Healthcare Staff Perceptions Following Inoculation with the BNT162b2 mRNA COVID-19 Vaccine at University Hospitals Coventry & Warwickshire NHS Trust

by Tim Robbins, Ioannis Kyrou, Cain Clark, Kavi Sharma, Steven Laird, Lisa Berry, Nina Morgan, Kiran Patel, Sailesh Sankar and Harpal Randeva

Int. J. Environ. Res. Public Health 2021, 18(17), 9378; https://doi.org/10.3390/ijerph18179378 - 06 Sep 2021

Cited by 2 | Viewed by 2454

Abstract

Background: COVID-19 vaccination programmes offer hope for a potential end to the acute phase of the COVID-19 pandemic. We present perceptions following from a cohort of healthcare staff at the UK NHS hospital, which first initiated the BNT162b2 mRNA COVID-19 (“Pfizer”) vaccination [...] Read more.

Background: COVID-19 vaccination programmes offer hope for a potential end to the acute phase of the COVID-19 pandemic. We present perceptions following from a cohort of healthcare staff at the UK NHS hospital, which first initiated the BNT162b2 mRNA COVID-19 (“Pfizer”) vaccination program. Methods: A paper-based survey regarding perceptions on the BNT162b2 mRNA COVID-19 vaccine was distributed to all healthcare workers at the University Hospitals Coventry & Warwickshire NHS Trust following receipt of the first vaccine dose. Results: 535 healthcare workers completed the survey, with a 40.9% response rate. Staff felt privileged to receive a COVID-19 vaccine. Staff reported that they had minimised contact with patients with confirmed or suspected COVID-19. Reported changes to activity following vaccination both at work and outside work were guarded. Statistically significant differences were noted between information sources used by staff groups and between groups of different ethnic backgrounds to inform decisions to receive vaccination. Conclusions: NHS staff felt privileged to receive the COVID-19 vaccine, and felt that their actions would promote uptake in the wider population. Concerns regarding risks and side effects existed, but were minimal. This research can be used to help inform strategies driving wider vaccine uptake amongst healthcare staff and the public. Full article

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10 pages, 348 KiB

Open AccessArticle

Using Influenza Vaccination Location Data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) to Expand COVID-19 Vaccination Coverage

by Victoria Fonzi, Kiran Thapa, Kishor Luitel, Heather Padilla, Curt Harris, M. Mahmud Khan, Glen Nowak and Janani Rajbhandari-Thapa

Int. J. Environ. Res. Public Health 2021, 18(15), 7753; https://doi.org/10.3390/ijerph18157753 - 22 Jul 2021

Cited by 3 | Viewed by 2630

Abstract

Effective COVID-19 vaccine distribution requires prioritizing locations that are accessible to high-risk target populations. However, little is known about the vaccination location preferences of individuals with underlying chronic conditions. Using data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we grouped 162,744 [...] Read more.

Effective COVID-19 vaccine distribution requires prioritizing locations that are accessible to high-risk target populations. However, little is known about the vaccination location preferences of individuals with underlying chronic conditions. Using data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we grouped 162,744 respondents into high-risk and low-risk groups for COVID-19 and analyzed the odds of previous influenza vaccination at doctor’s offices, health departments, community settings, stores, or hospitals. Individuals at high risk for severe COVID-19 were more likely to be vaccinated in doctor’s offices and stores and less likely to be vaccinated in community settings. Full article

15 pages, 648 KiB

Open AccessArticle

Willingness to Be Vaccinated against COVID-19 in Spain before the Start of Vaccination: A Cross-Sectional Study

by Noelia Rodríguez-Blanco, Sergio Montero-Navarro, José M. Botella-Rico, Antonio J. Felipe-Gómez, Jesús Sánchez-Más and José Tuells

Int. J. Environ. Res. Public Health 2021, 18(10), 5272; https://doi.org/10.3390/ijerph18105272 - 15 May 2021

Cited by 34 | Viewed by 4384

Abstract

Vaccine hesitancy has increased in the past few years, influenced by the socio-cultural differences, political populism, or concerns related to the effectiveness and safety of some vaccines, resulting a feeling of distrust. This feeling can become a barrier against the achievement of the [...] Read more.

Vaccine hesitancy has increased in the past few years, influenced by the socio-cultural differences, political populism, or concerns related to the effectiveness and safety of some vaccines, resulting a feeling of distrust. This feeling can become a barrier against the achievement of the immunity necessary to stop the expansion of COVID-19. The aim of this study was to evaluate the acceptance of the vaccine against COVID-19 in Spain, as well as to identify the factors that have an influence on the concerns and attitudes of people against accepting the vaccine in the months prior to the start of vaccination on December 2020. An online questionnaire was created to obtain information about (1) sociodemographic characteristics; (2) concerns and sources of information about vaccines; and (3) attitudes about vaccination and state of health. A multivariate logistic regression was performed to identify the influencing factors. Of the 2501 participants, 1207 (48.3%) would accept the COVID-19 vaccine, 623 (24.9%) were hesitant, and 671 (26.8%) would reject it. The logistic regression showed that being male, older than 60, married, retired, with a high level of education, or with a leftist political inclination, could increase the probability of accepting the COVID-19 vaccine. Disinformation and the lack of political consensus were the main sources of distrust. The patients with hypertension, immunodepression, hypercholesterolemia, or respiratory disease, or were overweight, showed a greater acceptance to the vaccine, while those with cancer took the longest to accept it. A low acceptance of the vaccine against COVID-19 was observed among the Spanish population in the phase prior to its availability, and the main fears of the population were identified. It is necessary to offer correct and transparent information about these vaccines to reduce the concerns and increase the trust of the population, to thereby guarantee the success of the vaccination campaigns. Full article

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11 pages, 331 KiB

Open AccessArticle

Sociodemographic, HIV-Related Characteristics, and Health Care Factors as Predictors of Self-Reported Vaccination Coverage in a Nationwide Sample of People Aging with HIV in Germany

by Jochen Drewes, Phil C. Langer, Jennifer Ebert, Dieter Kleiber and Burkhard Gusy

Int. J. Environ. Res. Public Health 2021, 18(9), 4901; https://doi.org/10.3390/ijerph18094901 - 04 May 2021

Cited by 5 | Viewed by 2224

Abstract

Preventing infectious diseases through vaccination becomes more significant among the growing population of people aging with HIV. Coverage rates for vaccinations and factors associated with vaccination utilization among this population in Germany are unknown. We assessed the coverage of eight recommended vaccinations in [...] Read more.

Preventing infectious diseases through vaccination becomes more significant among the growing population of people aging with HIV. Coverage rates for vaccinations and factors associated with vaccination utilization among this population in Germany are unknown. We assessed the coverage of eight recommended vaccinations in a certain time frame in our convenience sample of 903 people living with HIV aged 50 years and older. We analysed coverage rates and used bivariate and multiple linear regression analyses to identify factors associated with number of reported vaccinations. Coverage rates in our sample ranged between 51.0% for meningococcus disease and 84.6% for the triple vaccination against tetanus, diphtheria, and pertussis. All rates were higher compared to the German general population. Seven factors were related to the number of vaccinations in multiple regression analysis: sexual orientation, education, relationship status, CD4 count, time since last visit to HIV specialist, type of HIV specialist, and distance to HIV specialist. Vaccination coverage among people aging with HIV in Germany is high, but not optimal. To improve vaccination uptake, strengthened efforts need to be focused on female and heterosexual male patients, socioeconomically disadvantaged patients, and patients with barriers to access regular HIV care. Full article

13 pages, 1692 KiB

Open AccessArticle

Low COVID-19 Vaccine Acceptance Is Correlated with Conspiracy Beliefs among University Students in Jordan

by Malik Sallam, Deema Dababseh, Huda Eid, Hanan Hasan, Duaa Taim, Kholoud Al-Mahzoum, Ayat Al-Haidar, Alaa Yaseen, Nidaa A. Ababneh, Areej Assaf, Faris G. Bakri, Suzan Matar and Azmi Mahafzah

Int. J. Environ. Res. Public Health 2021, 18(5), 2407; https://doi.org/10.3390/ijerph18052407 - 01 Mar 2021

Cited by 121 | Viewed by 11187

Abstract

Vaccination to prevent coronavirus disease 2019 (COVID-19) emerged as a promising measure to overcome the negative consequences of the pandemic. Since university students could be considered a knowledgeable group, this study aimed to evaluate COVID-19 vaccine acceptance among this group in Jordan. Additionally, [...] Read more.

Vaccination to prevent coronavirus disease 2019 (COVID-19) emerged as a promising measure to overcome the negative consequences of the pandemic. Since university students could be considered a knowledgeable group, this study aimed to evaluate COVID-19 vaccine acceptance among this group in Jordan. Additionally, we aimed to examine the association between vaccine conspiracy beliefs and vaccine hesitancy. We used an online survey conducted in January 2021 with a chain-referral sampling approach. Conspiracy beliefs were evaluated using the validated Vaccine Conspiracy Belief Scale (VCBS), with higher scores implying embrace of conspiracies. A total of 1106 respondents completed the survey with female predominance (n = 802, 72.5%). The intention to get COVID-19 vaccines was low: 34.9% (yes) compared to 39.6% (no) and 25.5% (maybe). Higher rates of COVID-19 vaccine acceptance were seen among males (42.1%) and students at Health Schools (43.5%). A Low rate of influenza vaccine acceptance was seen as well (28.8%), in addition to 18.6% of respondents being anti-vaccination altogether. A significantly higher VCBS score was correlated with reluctance to get the vaccine (p < 0.001). Dependence on social media platforms was significantly associated with lower intention to get COVID-19 vaccines (19.8%) compared to dependence on medical doctors, scientists, and scientific journals (47.2%, p < 0.001). The results of this study showed the high prevalence of COVID-19 vaccine hesitancy and its association with conspiracy beliefs among university students in Jordan. The implementation of targeted actions to increase the awareness of such a group is highly recommended. This includes educational programs to dismantle vaccine conspiracy beliefs and awareness campaigns to build recognition of the safety and efficacy of COVID-19 vaccines. Full article

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17 pages, 360 KiB

Open AccessArticle

Knowledge, Beliefs and Attitudes towards the Influenza Vaccine among Future Healthcare Workers in Poland

by Sylwia Kałucka, Agnieszka Głowacka, Elżbieta Dziankowska-Zaborszczyk and Izabela Grzegorczyk-Karolak

Int. J. Environ. Res. Public Health 2021, 18(4), 2105; https://doi.org/10.3390/ijerph18042105 - 22 Feb 2021

Cited by 9 | Viewed by 2905

Abstract

The flu vaccine is the best treatment for avoiding the flu and its complications. The aim of the study was to evaluate the knowledge of the flu vaccine and attitude towards the influenza vaccine among medical students in four majors of study (Nursing, [...] Read more.

The flu vaccine is the best treatment for avoiding the flu and its complications. The aim of the study was to evaluate the knowledge of the flu vaccine and attitude towards the influenza vaccine among medical students in four majors of study (Nursing, Midwifery, Pharmacy, and Public health) in all years of study. A total number of 1137 subjects took part in the study. Most of the vaccinated students assessed the flu vaccine positively (78.5%, 73.7%, 60.7%, and 65.1%, according to their respective majors) and reported that they did not get the flu during the period of vaccination (90.4%, 92.1%, 87.4%, and 97.7%, respectively). Therefore, 65% of the students of Pharmacy, 78% of Midwifery, and 83% of Nursing who were vaccinated once in the last three years recommended the influenza vaccination, and 100% of all students received a regular vaccination every year. The univariate and multivariate logistic regressions showed that a maximum of four factors had a significant impact on the students’ knowledge of the influenza vaccine. Knowledge about the flu vaccine was the highest among Pharmacy students and lowest among Public health students. Final-year students answered the questions better than the younger ones (p < 0.05). Their place of residence and flu vaccination status also appeared to influence their answers. Although all students demonstrated good knowledge of the flu vaccine and demonstrated positive attitudes towards the vaccine, their rate of immunization was low. Therefore, health promotion programs are needed to improve immunization coverage among medical students who are future healthcare workers. Full article

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