The COVID-19 syndemic, with a disproportionately higher adverse impact on communities of color (i.e., COVID-19 infection and death), will likely exacerbate the existing health disparities in trauma-related symptoms between people of color (POC) and White Americans. However, no studies have examined the racial disparities in posttraumatic stress symptoms (PTSS) during COVID-19. Grounded in ecological theory and racial trauma framework, we investigated rates of racial disparities in PTSS and three possible mechanisms, 1) COVID stress, 2) direct racism, and 3) indirect racism, for these discrepancies using a large U.S. national sample (N = 2,019). Results indicated that POC reported higher levels of PTSS than White Americans (d =.21). The PTSS racial disparity was accounted more by direct and indirect racism than by the COVID-19-specific stressors, after controlling for age, gender, education, income, parent status, adverse childhood experiences (ACEs), and intimate partner violence (IPV). Additional fine-grained analyses for Hispanic/Latinx Americans (n = 283), Black/African Americans (n = 279), and Asian American and Pacific Islanders (n = 123) by and large corroborated the above findings. Our findings highlighted the deleterious impact of the ongoing racism pandemic on the POC community as a public health crisis in addition to the COVID-19 pandemic.

Background: The COVID-19 pandemic is a novel population-level stressor. As such, it is important to examine pandemic-related changes in mental health and to identify which individuals are at greatest risk of worsening symptoms. Methods: Online questionnaires were administered to 34,465 individuals in the UK, recruited from existing cohorts or via social media. Around one third (n = 12,718) with prior diagnoses of depression or anxiety completed pre-pandemic mental health assessments, allowing prospective investigation of symptom change. We examined changes in depression, anxiety and PTSD symptoms using prospective, retrospective and global ratings of change assessments. We also examined the effect of key risk factors on changes in symptoms. Outcomes: Prospective analyses showed small decreases in depression (PHQ-9: - .43 points) and anxiety symptoms (GAD-7: -.33 points), and increases in PTSD symptoms (PCL-6: .22 points). Conversely, retrospective analyses demonstrated large significant increases in depression (2.40 points) and anxiety symptoms (1.97 points) and 55% reported worsening mental health since the beginning of the pandemic on a global change rating. Using both prospective and retrospective symptom measures, regression analyses demonstrated that worsening depression, anxiety and PTSD symptoms were associated with i) prior mental health diagnoses, ii) female gender; iii) young age, and iv) unemployed or student status. Interpretation: We highlight the effect of prior mental health diagnoses on worsening mental health during the pandemic and confirm previously-reported sociodemographic risk factors. Discrepancies between prospective and retrospective measures of changes in mental health may be related to recall bias underestimating prior symptom severity.

The COVID-19 pandemic is increasing older people's existing challenges in engaging with their physical and social worlds, and is thereby likely to worsen their loneliness. Digital technology has been offered as a potential aid for social connectedness during social distancing/isolation. However, many popular digital communication tools have not been designed to specifically address the needs of older adults impacted by social isolation. We propose that the social identity approach to health and the Social Identity Model of Identity Change (SIMIC) could be a foundation for digital interventions to address loneliness. While SIMIC applies to maintaining wellbeing during life transitions, it has not previously been rigorously applied to digital interventions. There are known challenges to integrating psychological theory to the design of digital technology, such as efficacy, user-autonomy, and engagement. The interdisciplinary field of Human Computer Interaction has a history of drawing on models originating from psychology to improve the design of digital technology and to design technologies in an appropriate manner. Drawing on key lessons from this literature, we consolidate design guidelines that could assist in applying SIMIC to digital interventions for loneliness in older people affected by the pandemic.

While scholarly attention to date has focused almost entirely on individual-level drivers of vaccine confidence, we show that macro-level factors play an important role in understanding individual propensity to be confident about vaccination. We analyse data from the 2018 Wellcome Global Monitor survey covering over 120,000 respondents in 126 countries to assess how societal-level trust in science is related to vaccine confidence. In countries with a high aggregate level of trust in science, people are more likely to be confident about vaccination, over and above their individual-level scientific trust. Additionally, we show that societal consensus around trust in science moderates these individual-level and country-level relationships. In countries with a high level of consensus regarding the trustworthiness of science and scientists, the positive correlation between trust in science and vaccine confidence is stronger than it is in comparable countries where the level of social consensus is weaker.

Tedros Adhanom Ghebreyesus urges developed world to donate Covid vaccines to Covax programme

We study the changes in greeting behavior caused by the COVID-19 pandemic. We find that after the use of handshakes and social kissing as forms of greeting decreased drastically, they became common again already a few months after the outbreak. Nevertheless, a consistently large proportion of respondents (around 57%) plan to change their greeting behavior permanently, either because they simply became used to it or because they want to avoid the danger of contracting and transmitting infectious diseases. As can be seen from the results of the first survey wave in April, 2020, the belief in conspiracy theories about COVID-19 did not influence the greeting behavior of individuals, but it proved to have a strong impact in the second survey wave in September, 2020.

COVID-19 pandemic gave rise to numerous new conspiracy theories related to the virus. The aim of this study was to simultaneously investigate a range of individual predictors of beliefs in COVID-19 conspiracy theories that account for socio-demographic characteristics (age, gender, education, economic standard, the importance of religion and political self-identification), distinctive motivational orientations (social dominance and authoritarianism), relevant social attitudes (sense of political powerlessness and trust in science and scientists) and perceived personal risk (perceived risk for self and family members, concern of being infected and expected influence of pandemic on one’s own economic standard). Participants were 1060 adults recruited from the general public of Croatia. The sample was a probabilistic quota sample with gender, age, level of education, size of a place of living and region of the country as predetermined quotas. The regression model explained 42.2% of the individual differences in beliefs in COVID-19 conspiracy theories. Trust in science and scientists and political powerlessness were the strongest predictors, whereas fear of being infected had the weakest contribution in explaining variance of the criterion. Additionally, results revealed that the relation of authoritarianism with the belief in COVID-19 conspiracies was mediated by trust in science and scientists. The relation between social dominance and belief in conspiracies was also partially mediated by trust in science. Our results suggest that (re)building trust in science and lowering the sense of political helplessness might help in fighting potentially harmful false beliefs about the pandemic.

The complexity of COVID-19 and variation in control measures and containment efforts of different countries have caused difficulties in the prediction and modelling of the COVID-19 pandemic. We attempted to predict the scale of the latter half of the pandemic based on real data using the ratio between the early and latter halves from countries where the pandemic is largely over. We collected daily pandemic data from China, South Korea and Switzerland and subtracted ratio of pandemic days before and after the disease apex day of COVID-19. We obtained the ratio of pandemic data and created multiple regression models for the relationship between before and after the apex day. We then tested our models using data from the first wave of the disease from 14 countries in Europe and the US. We then tested the models using data of these countries from entire pandemics up to March 30, 2021. Results indicates that the actual number of cases of these countries during the first wave mostly fall in the predicted ranges of liner regression excepting Spain and Russia. Similarly, the actual death of these countries mostly falls into the range of predicted data. Using the accumulated data up to the day of apex and total accumulated data up to March 30, 2021, the data of case numbers in these countries are falling into the range of predicted data, except for data from Brazil. The actual number of deaths in all the countries are at or below the predicted data. In conclusion, liner regression model built with real data from countries or regions of early pandemics can predict pandemic scales of the countries which the pandemics occur late. Such a prediction with high degree of accuracy provides valuable information for governments and public.

Background: In response to the COVID-19 pandemic, physical distancing measures have been implemented globally. Canadians have been instructed to stay at home, which has likely resulted in significant changes in their physical activity. Using data from a national physical activity tracking app (PAC app), we aimed to determine device-measured physical activity levels immediately prior to and following the implementation of physical distancing measures in Canada to provide evidence for the development of physical activity recommendations for future pandemics or second wave infections. Methods: Demographic and physical activity data were extracted from the ParticipACTION app (PAC app), using a 10-week (10 February to 19 April 2020) quasi-experimental design to determine changes in physical activity 4 weeks pre-pandemic and 6 weeks post-pandemic declaration. Weekly physical activity levels were monitored through wearable fitness trackers and health apps linked to the PAC app, to record moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and steps. Repeated measure ANOVA was used to determine changes over time (mean ± SE). Findings: A total of 2,338 Canadians who were mostly 35–44 years old (26.6%) and female (90.2%) were included in the analysis. MVPA, LPA, and steps significantly declined immediately following the declaration of the pandemic (MVPA: pre-pandemic: 194.2 ± 5.2 min, post-pandemic: 176.7 ± 5.0 min, p < 0.001; LPA: pre-pandemic: 1,000.5 ± 17.0 min, post-pandemic: 874.1 ± 15.6 min, p < 0.001; steps: pre-pandemic: 48,625 ± 745 steps, post-pandemic: 43,395 ± 705 steps, p < 0.001). However, 6 weeks following pandemic declaration, MVPA (week 6: 204.4 ± 5.4 min, p = 0.498) had returned to pre-pandemic levels. LPA (week 6: 732.0 ± 14.3 min, p = < 0.001) and steps (week 6: 41,946 ± 763, p < 0.001) remained significantly lower than pre-pandemic levels at week 6. Interpretation: Although MVPA returned to pre-pandemic levels, significant and sustained declines in incidental LPA and steps were observed. Attenuating the loss of incidental physical activity should be a public health priority in response to future pandemics or a second wave of a COVID-19 infection, as it may have significant long-term implications for the physical and mental health of Canadians.

In recent years behavioural science has quickly become embedded in national level governance. As the contributions of behavioural science to the UK’s COVID-19 response policies in early 2020 became apparent, a debate emerged in the British media about its involvement. This served as a unique opportunity to capture public discourse and representation of behavioural science in this fast-track, high-stake context. Aimed at identifying elements which foster and detract from trust and credibility in emergent scientific contributions to policy making, in Study 1 we use corpus linguistics and network analysis to map the narrative around the key behavioural science actors and concepts which were discussed in the 647 news articles extracted from the 15 most read British newspapers over the 12-week period surrounding the first hard UK lockdown of 2020. We report and discuss 1) the salience of key concepts and actors as the debate unfolded, 2) quantified changes in the polarity of the sentiment expressed toward them and their policy application contexts, and 3) patterns of co-occurrence via network analyses. To establish public discourse surrounding identified themes, in Study 2 we investigate how salience and sentiment of key themes and relations to policy on original Twitter chatter (N = 2,187). In Study 3, we complement these findings with a qualitative analysis of the subset of news articles which contained the most extreme sentiments (N = 111), providing an in-depth perspective of sentiments and discourse developed around keywords, as either promoting or undermining their credibility in, and trust toward behaviourally informed policy. We discuss our findings in light of the integration of behavioural science in national policy making under emergency constraints.

As covid-19 vaccines begin to arrive in the Andean highlands in Colombia, Maria Pito, a leader of the Nasa people, is reluctant to receive one. “As a nurse, I will be required by the clinic where I work to be vaccinated but if I had the choice, I would not take it and would continue to rely on traditional medicine,” she says. “I and many others don’t trust this untransparent government.”

Vaccine confidence will be the casualty of Europe’s war of words over the AstraZeneca–Oxford vaccine.

Avoid unwarranted certainty, neat narratives and partisan presentation; strive to inform, not persuade.

Background: COVID-19 continues to ravage the world with economies and life significantly and negatively affected. Fortunately, there has been significant progress in the production of vaccines to stem the infection. However, with controversies and myths surrounding vaccinations, it is timely to examine individuals’ willingness to vaccinate. The present study developed and validated the Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) and assessed the acceptance of COVID-19 vaccination utilizing the cognitive model of empowerment (CME). Methods: A total of 3145 university students (mean age=20.80 years; SD=2.09) were recruited for the present study between January 5 and 16, 2021. Two MoVac-COVID19S scales (9-item and 12-item) were adapted from the MoVac-Flu Scale, an instrument developed using CME. Psychometric tests were conducted to ascertain reliability and validity properties. Results: The findings indicated that the MoVac-COVID19S had high internal consistency in both the 9-item version (ω=0.921) and 12-item version (ω=0.898). The factor structure of the MoVac-COVID19S (9-item and 12-item versions) corresponded well with CME theory. All the fit indices were satisfactory (CFI=0.984, TLI=0.971, RMSEA=0.088, SRMR=0.058) but the 9-item MoVac-COVID had better fit indices than the 12-item MoVac-COVID due to the negative wording effects existing in the 12-item MoVac-COVID19S. The scale had satisfactory known-group validity in both 9-item and 12-item versions. Conclusions: The MoVac-COVID19S has promising psychometric properties based on internal consistency, factor structure, and known-group validity.

Introduction: Vaccines against COVID-19 have been developed in unprecedented time. However, the effectiveness of any vaccine is dictated by the proportion of the population willing to be vaccinated. In this observational population-based study we examined intentions to be vaccinated against COVID-19 throughout the pandemic. Methods: In November, 2020 we analyzed longitudinal data from a nationally representative sample of 7,547 US adults enrolled in the Understanding America Study (UAS) using multinomial logistic regresion. Participants reporting being willing, undecided and unwilling to get vaccinated against coronavirus across 13 assessments conducted from April-October, 2020. Public attitudes to vaccination against the coronavirus were also assessed on a four-point Likert scale. Results: Willingness to vaccinate declined from 71% in April to 53.6% in October. This was explained by an increase in the percentage of participants undecided about vaccinating (from 10.5% to 14.4%) and the portion of the sample unwilling to vaccinate (from 18.5% to 32%). The population subgroups most likely to be undecided/unwilling to vaccinate were those without a degree (undecided: RRR=2.47, 95% CI: 2.04-3.00; unwilling: RRR=1.92, 95% CI:1.67-2.20), Black participants (undecided: RRR=2.18, 95% CI: 1.73-2.74; unwilling: RRR=1.98, 95% CI:1.63-2.42), and females (undecided: RRR=1.41, 95% CI:1.20-1.65; unwilling: RRR=1.29, 95% CI:1.14-1.46). Participants who were older or were on higher incomes were least likely to be undecided or unwilling to vaccinate. Concerns about potential side effects of a vaccine were common. Conclusions: Intentions to be vaccinated against coronavirus have declined rapidly during the pandemic and close to half of Americans are undecided or unwilling to be vaccinated.

Socioeconomic disparities in mental health have been reported during the COVID-19 pandemic. However, few studies have examined the mechanisms through which such disparities in mental health occurred. This pre-registered study aimed to examine socioeconomic disparities, as indexed by education levels, in the trajectory of mental health at the early stages of the COVID-19 pandemic and whether financial stress associated with the pandemic mediated socioeconomic disparities in mental health. Data were drawn from the Love in the Time of COVID project, of which we included four waves of data (N = 2,204) collected between March 27th and June 21st, 2020. Education was assessed at baseline, and mental health outcomes (i.e., eudaimonic well-being, positive affect, negative affect, depressive and anxious symptoms) and financial stress associated with the COVID-19 pandemic were assessed at each wave. Results indicated that there were educational disparities in eudaimonic well-being, negative affect, and depressive and anxiety symptoms at baseline, with those with lower education levels reporting poorer mental health. However, education did not amplify disparities in mental health outcomes over time, showing no associations with the rates of change in mental health outcomes. Financial stress mediated the associations between education and eudaimonic well-being, negative affect, and depressive and anxious symptoms at baseline, and there were no temporal variations in the mediation effects of financial stress. These results highlight persistent educational disparities in mental health at the early stages of the COVID-19 pandemic, and such educational disparities may be partially explained by financial stress associated with the COVID-19 pandemic.

It took just four months to reach this global milestone, and hitting to the two-billion mark could happen even faster, say scientists.

THE coronavirus pandemic has left children vulnerable to other infections, in part due to reduced interactions as a result of lockdowns and social distancing.

THE covid-19 situation in India is terrible and is likely to get worse. The country has set one new record after another for the most daily coronavirus cases reported in any country. Just as the world was hoping the worst of the pandemic was over, we are seeing its biggest outbreak.

The world has reached the milestone of administering one billion doses of COVID-19 vaccines, just four months after the World Health Organization (WHO) approved the first vaccine for emergency use, and roll-outs began in countries such as the United States and the United Kingdom. The speed at which they have been administered is remarkable, but unequal distribution of the vaccinations highlights global disparities, say researchers (see ‘Divided by doses’).

Using home monitoring and other efficiencies instead of dragging people into hospitals could improve clinical trials after the pandemic

What motivates human behaviour in social dilemmas? The results of public goods games are commonly interpreted as showing that humans are altruistically motivated to benefit others. However, there is a competing ‘confused learners’ hypothesis: that individuals start the game either uncertain or mistaken (confused) and then learn from experience how to improve their payoff (payoff-based learning). Here we (1) show that these competing hypotheses can be differentiated by how they predict contributions should decline over time; and (2) use metadata from 237 published public goods games to test between these competing hypotheses. We found, as predicted by the confused learners hypothesis, that contributions declined faster when individuals had more influence over their own payoffs. This predicted relationship arises because more influence leads to a greater correlation between contributions and payoffs, facilitating learning. Our results suggest that humans, in general, are not altruistically motivated to benefit others but instead learn to help themselves.

The authors conducted a close replication of a study by Georgiou et al (2020), who found amongst 660 (reported in abstract) or 640 (reported in participant section) participants that 1) Covid-19 related conspiracy theory beliefs were strongly related to broader conspiracy theory beliefs, that 2) Covid-19 related conspiracy beliefs were higher in those with lower levels of education, and that 3) Covid-19 related conspiracy beliefs were positively (although weakly) correlated with more negative attitudes towards different individual items measuring the government’s response. Finally, they find that 4) Covid-19 beliefs were unrelated to self-reported stress. In a pre-registered replication and extension in a study sufficiently well-powered to detect f2 = 0.05, at an alpha level of .05, with an a priori power of .95, and with 5 Predictors in a multiple regression analysis, we do not find the same results. First, we find that education level is unrelated to Covid-19 related conspiracy beliefs, that stress is related to Covid-19 related conspiracy beliefs, but that the government’s response is indeed related to Covid-19 related conspiracy beliefs. We point out measurement problems in measuring conspiracy beliefs, extend the study through supervised machine learning by finding that attachment avoidance and anxiety are important predictors of conspiracy beliefs (Covid-19-related and beyond). Part of the differences between their and our study are likely due to differences in analysis approach; others may be due to the errors in Georgiou et al.’s (2020 reporting.

We test the hypothesis that COVID-19 vaccine hesitancy is attributable to ‘distrustful complacency’ – an interactive and not just additive combination of concern and distrust. Across two studies, 9695 respondents across 13 different parts of Britain reported their level of concern about COVID-19, trust in the UK government, and intention to accept or refuse the vaccine. Multilevel regression analysis, controlling for geographic area and relevant demographics, confirmed the predicted interactive effect of concern and trust. Respondents with both low trust and low concern were 10%-22% more vaccine hesitant than respondents with either high trust or high concern, and 20%-29% more hesitant than respondents with both high trust and high concern. Results hold equally among White, Black, and Muslim respondents, consistent with the view that, regardless of mean level differences, a common process underlies vaccine hesitancy, underlining the importance of tackling distrustful complacency both generally and specifically amongst unvaccinated individuals and populations.

Adherence to government COVID-19-related instructions is important in preventing, detecting, treating and emerging successfully from the acute phase of the pandemic. Public adherence to instructions has been high but will only remain so as long as people’s capabilities, opportunities and motivations are supported. Policy makers should ensure that strategies are developed that will prevent people’s capabilities, opportunities and motivations from being undermined. Men, younger people, and people with black, Asian and minority ethnic backgrounds represent important targets for such interventions.

Worldwide, higher education institutions made quick and often unprepared shifts from on-site to online examination in 2020 due to the COVID-19 health crisis. This development sparked an ongoing debate on whether this development made it easier for students to cheat. We investigated whether students indeed cheated more often in online than in on-site exams and whether the use of online exams was also associated with higher rates of other behaviors deemed as academic dishonesty. To answer our research questions, we questioned 1,608 German students from a wide variety of higher education institutions about their behavior during the summer semester of 2020. The participating students reported that they cheated more frequently in online than in on-site exams. Effects on other measures of academic dishonesty were more negligible. These results speak for the notion that the swift application of ad-hoc online testing during 2020 has led to negative consequences for academic integrity.

Facial emotion recognition is crucial for social interaction. However, in times of a global pandemic, where wearing a face mask covering mouth and nose is widely encouraged to prevent the spread of disease, successful emotion recognition may be challenging. In Study 1, we investigated whether emotion recognition, assessed by a validated emotion recognition task, is impaired for faces wearing a mask compared to uncovered faces, in a sample of 790 participants between 18 and 89 years. Additionally, perception of threat for faces with and without mask was assessed. We found impaired emotion recognition for faces wearing a mask compared to faces without mask, especially for those depicting anger, sadness and disgust. Further, we observed that perception of threat was altered for faces wearing a mask. In Study 2, we compared emotion recognition performance for faces with and without face mask to faces that are occluded by something other than a mask, i.e. a bubble as well as only showing the upper part of the faces. We found that, for most emotions and especially for disgust, there seems to be an effect that can be ascribed to the face mask specifically, both for emotion recognition performance and perception of threat. Methodological constraints as well as the importance of wearing a mask despite temporarily compromised social interaction are discussed.

India’s huge wave of Covid-19 infections has hit the international shipping industry, which relies on the country for seafarers, as crews come down with the disease and ports deny entry to vessels.Ports including Singapore and Fujairah in the United Arab Emirates have barred ships from changing crew members who have recently travelled from India, notices from maritime authorities show. Zhoushan in China has banned the entry of ships or crew that have visited India or Bangladesh in the past three months, according to Wilhelmsen Ship Management, a crew provider.Industry executives also said that crews coming from India were testing positive for Covid-19 on ships, despite quarantining and testing negative before boarding.

Will the UK’s decision to offer an alternative to the Oxford/AstraZeneca covid-19 vaccine for under-30s, following safety signals, impact vaccine up-take, ask Pauline Paterson and Ed Pertwee 

Authorities act to counter rumours out-of-date shots are being used as people drag their heels over being vaccinated

Countries ranging from Laos to Nepal have all been reporting surges in cases, in a sign the pandemic is far from over

We study how publicity in the science press, in the form of highlighting, affects the citations of research papers. Using multiple linear regression, we quantify the citation advantage associated with several highlighting platforms for papers published in Physical Review Letters (PRL) from 2008-2018. We thus find that the strongest predictor of citation accrual is a Viewpoint in Physics magazine, followed by a Research Highlight in Nature, an Editors' Suggestion in PRL, and a Research Highlight in Nature Physics. A similar hierarchical pattern is found when we search for extreme, not average, citation accrual, in the form a paper being listed among the top-1% cited papers in physics by Clarivate Analytics. The citation advantage of each highlighting platform is stratified according to the degree of vetting for importance that the manuscript received during peer review. This implies that we can view highlighting platforms as predictors of citation accrual, with varying degrees of strength that mirror each platform's vetting level.

The story of COVID-19 vaccines and vaccination in Africa is slowly unfolding, as more and more countries across the continent receive shipments of the long-awaited vaccines.

Facebook announced a community review program in December 2019 and Twitter launched a community-based platform to address misinformation, called Birdwatch, in January 2021. We provide an overview of the potential affordances of such community based approaches to content moderation based on past research. While our analysis generally supports a community-based approach to content moderation, it also warns against potential pitfalls, particularly when the implementation of the new infrastructures does not promote diversity. We call for more multidisciplinary research utilizing methods from complex systems studies, behavioural sociology, and computational social science to advance the research on crowd-based content moderation.

Few states collect sexual orientation or gender identity data, so no one knows how many people in some communities are getting vaccinated.

GENEVA -- The World Health Organization urged rich countries on Friday to reconsider plans to vaccinate children and instead donate COVID-19 shots to the COVAX scheme that shares them with poorer nations.

Singapore further tightened its COVID-19 measures as it seeks to control an increase in untraceable coronavirus infections in the city-state.

Jerome Kim, director of the International Vaccine Institute in South Korea, told DW that successfully producing and distributing complex vaccines in developing countries will take more than access to biotech secrets.

Epidemiological models have been a source of continual controversy from the start of the pandemic, often blamed for fearmongering and inaccuracy. How well have they done?

The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the public’s attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project tracks the dynamic nature of public opinion as vaccine development and distribution unfold, including vaccine confidence and acceptance, information needs, trusted messengers and messages, as well as the public’s experiences with vaccination.

The Vaccine Confidence Project, an interdisciplinary and international research group at the London School of Hygiene & Tropical Medicine specialising in monitoring public confidence in vaccines, providing insights and informing strategies to address emerging risks, today announced that they would be joining The Trinity Challenge as its newest member.

The longer it takes for the United States to lead a global response, the more the risks compound.

In some of these countries where geography imbued its people with a false sense of security and insulation, lawmakers tried to close their countries from the dangerous world that lay beyond their literal shores. Iceland, Australia, and New Zealand have all been the lockdown media’s darlings, as if what these countries experienced – comparatively low infections and deaths – stemmed from wise policy choices that were equally available to the world’s transportation hubs (London, New York) or highly connected countries with next to no ability to restrict movement across borders (U.K., European Union member states or the states of the United States). 

A new rodent model of COVID-19 promises an easier and quicker way to test treatments and vaccines.

A new variant stealthily took hold on two continents, highlighting the need for global genomic surveillance.

The number of people infected with the coronavirus in England has fallen by half since the end of March. These findings from the Imperial College London-led REACT study are based on over 127,000 home swab tests taken between 15th April and 3rd May. The results show that 0.1% of the population is currently infected, or 1 in 1,000. This compares with the study’s previous testing round when 0.2% or 1 in 500 had the virus as of 30th March.

A new study led by Public Health England and NHS Test and Trace will help increase understanding of how effective daily contact testing could be for people who are contacts of positive COVID-19 cases. It is to be used as an alternative to self-isolation.

Test results, often required to fly across borders, can be easily manipulated

Determining policies to end the SARS-CoV-2 pandemic will require an understanding of the efficacy and effectiveness (hereafter, efficacy) of vaccines. Beyond the efficacy against severe disease and symptomatic and asymptomatic infection, understanding vaccine efficacy against transmission will help model epidemic trajectory and determine appropriate control measures. Recent studies have proposed using random virologic testing in individual randomized controlled trials to improve estimation of vaccine efficacy against infection. We propose to further use the viral load measures from these tests to estimate efficacy against transmission. This estimation requires a model of the relationship between viral load and transmissibility and assumptions about the vaccine effect on transmission and the progress of the epidemic. We describe these key assumptions, potential violations of them, and solutions that can be implemented to mitigate these violations. Assessing these assumptions and implementing this random sampling, with viral load measures, will enable better estimation of the crucial measure of vaccine efficacy against transmission.

Early on in the pandemic Germany committed to purchasing all vaccines through the EU despite delays. Now some want to make an exception for the Russian vaccine Sputnik V.

Carlson knows anti-vaxxers have become a big part of Trump’s Republican Party and that they are easy marks as he hustles to up the ante and amp up the outrage.

This document outlines how the national and NHS England region estimates of the reproduction number (R) and growth rate are produced and subsequently published on GOV.UK: section 1 below outlines how each academic group produces their individual estimates, using a mixture of data sources and modelling techniques section 2 below outlines how these estimates are statistically combined to form a single consensus range section 3 below outlines the approval and quality assurance process that the individual and combined estimates go through to ensure they are robust and reliable section 4 below outlines how the final consensus range is communicated

Laplace to be for new & veteran Bayesians alike

Political polarization appears to be on the rise, as measured by voting behavior, general affect towards opposing partisans and their parties, and contents posted and consumed online. Research over the years has focused on the role of the Web as a driver of polarization. In order to further our understanding of the factors behind online polarization, in the present work we collect and analyze Web browsing histories of tens of thousands of users alongside careful measurements of the time spent browsing various news sources. We show that online news consumption follows a polarized pattern, where users' visits to news sources aligned with their own political leaning are substantially longer than their visits to other news sources. Next, we show that such preferences hold at the individual as well as the population level, as evidenced by the emergence of clear partisan communities of news domains from aggregated browsing patterns. Finally, we tackle the important question of the role of user choices in polarization. Are users simply following the links proffered by their Web environment, or do they exacerbate partisan polarization by intentionally pursuing like-minded news sources? To answer this question, we compare browsing patterns with the underlying hyperlink structure spanned by the considered news domains, finding strong evidence of polarization in partisan browsing habits beyond that which can be explained by the hyperlink structure of the Web.

Background: Despite the proven effectiveness of vaccinations, vaccination uptake is limited in Nigeria. According to the Multiple Indicator Cluster Survey (MICS), one of the main barriers is the lack of accurate knowledge of the vaccination schedule. This study evaluates caregivers’ knowledge of the vaccination schedule and their ability to read the immunization card.Methods: The study evaluated the knowledge of caregivers in 11 settlements in the Jada local government area of Adamawa State in September 2019. The change in knowledge among caregivers before and after referring to the immunization card was evaluated using a simple statistical hypothesis testing (chi-square test). We also used logistic regression analysis to evaluate the determinants of vaccination knowledge, as well as the correlation between knowledge and actual vaccination behaviors.Results: More than half of the women had correct knowledge of the vaccination schedule for critical vaccines. However, the knowledge of the caregivers did not improve after referring to the immunization card which contained the information. Caregivers who brought their children to the clinic for vaccination recently were more likely to know the vaccination schedule correctly. Accurate knowledge was highly correlated with the actual vaccination behaviors.Conclusion: Reference to the immunization card did not improve the knowledge of vaccination schedule, especially among the less-educated population. To increase the demand for vaccinations, one potential policy is to target the uneducated population and help them increase their knowledge.

BackgroundEarly childhood vaccination is an essential global public health practice that saves two to three million lives each year, but many children do not receive all the recommended vaccines. To achieve and maintain appropriate coverage rates, vaccination programmes rely on people having sufficient awareness and acceptance of vaccines.Face‐to‐face information or educational interventions are widely used to help parents understand why vaccines are important; explain where, how and when to access services; and address hesitancy and concerns about vaccine safety or efficacy. Such interventions are interactive, and can be adapted to target particular populations or identified barriers.This is an update of a review originally published in 2013.ObjectivesTo assess the effects of face‐to‐face interventions for informing or educating parents about early childhood vaccination on vaccination status and parental knowledge, attitudes and intention to vaccinate.Search methodsWe searched the CENTRAL, MEDLINE, Embase, five other databases, and two trial registries (July and August 2017). We screened reference lists of relevant articles, and contacted authors of included studies and experts in the field. We had no language or date restrictions.Selection criteriaWe included randomised controlled trials (RCTs) and cluster‐RCTs evaluating the effects of face‐to‐face interventions delivered to parents or expectant parents to inform or educate them about early childhood vaccination, compared with control or with another face‐to‐face intervention. The World Health Organization recommends that children receive all early childhood vaccines, with the exception of human papillomavirus vaccine (HPV), which is delivered to adolescents.Data collection and analysisWe used standard methodological procedures expected by Cochrane. Two authors independently reviewed all search results, extracted data and assessed the risk of bias of included studies.Main resultsIn this update, we found four new studies, for a total of ten studies. We included seven RCTs and three cluster‐RCTs involving a total of 4527 participants, although we were unable to pool the data from one cluster‐RCT. Three of the ten studies were conducted in low‐ or middle‐ income countries.All included studies compared face‐to‐face interventions with control. Most studies evaluated the effectiveness of a single intervention session delivered to individual parents. The interventions were an even mix of short (ten minutes or less) and longer sessions (15 minutes to several hours).Overall, elements of the study designs put them at moderate to high risk of bias. All studies but one were at low risk of bias for sequence generation (i.e. used a random number sequence). For allocation concealment (i.e. the person randomising participants was unaware of the study group to which participant would be allocated), three were at high risk and one was judged at unclear risk of bias. Due to the educational nature of the intervention, blinding of participants and personnel was not possible in any studies. The risk of bias due to blinding of outcome assessors was judged as low for four studies. Most studies were at unclear risk of bias for incomplete outcome data and selective reporting. Other potential sources of bias included failure to account for clustering in a cluster‐RCT and significant unexplained baseline differences between groups. One cluster‐RCT was at high risk for selective recruitment of participants.We judged the certainty of the evidence to be low for the outcomes of children's vaccination status, parents' attitudes or beliefs, intention to vaccinate, adverse effects (e.g. anxiety), and immunisation cost, and moderate for parents' knowledge or understanding. All studies had limitations in design. We downgraded the certainty of the evidence where we judged that studies had problems with randomisation or allocation concealment, or when outcomes were self‐reported by participants who knew whether they'd received the intervention or not. We also downgraded the certainty for inconsistency (vaccination status), imprecision (intention to vaccinate and adverse effects), and indirectness (attitudes or beliefs, and cost).Low‐certainty evidence from seven studies (3004 participants) suggested that face‐to‐face interventions to inform or educate parents may improve vaccination status (risk ratio (RR) 1.20, 95% confidence interval (CI) 1.04 to 1.37). Moderate‐certainty evidence from four studies (657 participants) found that face‐to‐face interventions probably slightly improved parent knowledge (standardised mean difference (SMD) 0.19, 95% CI 0.00 to 0.38), and low‐certainty evidence from two studies (179 participants) suggested they may slightly improve intention to vaccinate (SMD 0.55, 95% CI 0.24 to 0.85). Low‐certainty evidence found the interventions may lead to little or no change in parent attitudes or beliefs about vaccination (SMD 0.03, 95% CI ‐0.20 to 0.27; three studies, 292 participants), or in parents’ anxiety (mean difference (MD) ‐1.93, 95% CI ‐7.27 to 3.41; one study, 90 participants). Only one study (365 participants) measured the intervention cost of a case management strategy, reporting that the estimated additional cost per fully immunised child for the intervention was approximately eight times higher than usual care (low‐certainty evidence). No included studies reported outcomes associated with parents’ experience of the intervention (e.g. satisfaction).Authors' conclusionsThere is low‐ to moderate‐certainty evidence suggesting that face‐to‐face information or education may improve or slightly improve children's vaccination status, parents' knowledge, and parents' intention to vaccinate.Face‐to‐face interventions may be more effective in populations where lack of awareness or understanding of vaccination is identified as a barrier (e.g. where people are unaware of new or optional vaccines). The effect of the intervention in a population where concerns about vaccines or vaccine hesitancy is the primary barrier is less clear. Reliable and validated scales for measuring more complex outcomes, such as attitudes or beliefs, are necessary in order to improve comparisons of the effects across studies.

BackgroundImmunization rates for children and adults are rising, but coverage levels have not reached optimal goals. As a result, vaccine‐preventable diseases still occur. In an era of increasing complexity of immunization schedules, rising expectations about the performance of primary care, and large demands on primary care providers, it is important to understand and promote interventions that work in primary care settings to increase immunization coverage. One common theme across immunization programs in many nations involves the challenge of implementing a population‐based approach and identifying all eligible recipients, for example the children who should receive the measles vaccine. However, this issue is gradually being addressed through the availability of immunization registries and electronic health records. A second common theme is identifying the best strategies to promote high vaccination rates. Three types of strategies have been studied: (1) patient‐oriented interventions, such as patient reminder or recall, (2) provider interventions, and (3) system interventions, such as school laws. One of the most prominent intervention strategies, and perhaps best studied, involves patient reminder or recall systems. This is an update of a previously published review.ObjectivesTo evaluate and compare the effectiveness of various types of patient reminder and recall interventions to improve receipt of immunizations.Search methodsWe searched CENTRAL, MEDLINE, Embase and CINAHL to January 2017. We also searched grey literature and trial registers to January 2017.Selection criteriaWe included randomized trials, controlled before and after studies, and interrupted time series evaluating immunization‐focused patient reminder or recall interventions in children, adolescents, and adults who receive immunizations in any setting. We included no‐intervention control groups, standard practice activities that did not include immunization patient reminder or recall, media‐based activities aimed at promoting immunizations, or simple practice‐based awareness campaigns. We included receipt of any immunizations as eligible outcome measures, excluding special travel immunizations. We excluded patients who were hospitalized for the duration of the study period.Data collection and analysisWe used the standard methodological procedures expected by Cochrane and the Cochrane Effective Practice and Organisation of Care (EPOC) Group. We present results for individual studies as relative rates using risk ratios, and risk differences for randomized trials, and as absolute changes in percentage points for controlled before‐after studies. We present pooled results for randomized trials using the random‐effects model.Main resultsThe 75 included studies involved child, adolescent, and adult participants in outpatient, community‐based, primary care, and other settings in 10 countries.Patient reminder or recall interventions, including telephone and autodialer calls, letters, postcards, text messages, combination of mail or telephone, or a combination of patient reminder or recall with outreach, probably improve the proportion of participants who receive immunization (risk ratio (RR) of 1.28, 95% confidence interval (CI) 1.23 to 1.35; risk difference of 8%) based on moderate certainty evidence from 55 studies with 138,625 participants.Three types of single‐method reminders improve receipt of immunizations based on high certainty evidence: the use of postcards (RR 1.18, 95% CI 1.08 to 1.30; eight studies; 27,734 participants), text messages (RR 1.29, 95% CI 1.15 to 1.44; six studies; 7772 participants), and autodialer (RR 1.17, 95% CI 1.03 to 1.32; five studies; 11,947 participants). Two types of single‐method reminders probably improve receipt of immunizations based on moderate certainty evidence: the use of telephone calls (RR 1.75, 95% CI 1.20 to 2.54; seven studies; 9120 participants) and letters to patients (RR 1.29, 95% CI 1.21 to 1.38; 27 studies; 81,100 participants).Based on high certainty evidence, reminders improve receipt of immunizations for childhood (RR 1.22, 95% CI 1.15 to 1.29; risk difference of 8%; 23 studies; 31,099 participants) and adolescent vaccinations (RR 1.29, 95% CI 1.17 to 1.42; risk difference of 7%; 10 studies; 30,868 participants). Reminders probably improve receipt of vaccinations for childhood influenza (RR 1.51, 95% CI 1.14 to 1.99; risk difference of 22%; five studies; 9265 participants) and adult influenza (RR 1.29, 95% CI 1.17 to 1.43; risk difference of 9%; 15 studies; 59,328 participants) based on moderate certainty evidence. They may improve receipt of vaccinations for adult pneumococcus, tetanus, hepatitis B, and other non‐influenza vaccinations based on low certainty evidence although the confidence interval includes no effect of these interventions (RR 2.08, 95% CI 0.91 to 4.78; four studies; 8065 participants).Authors' conclusionsPatient reminder and recall systems, in primary care settings, are likely to be effective at improving the proportion of the target population who receive immunizations.

BackgroundAlthough vaccination has been proved to be a safe, efficacious, and cost-effective intervention, immunisation rates remain suboptimal in many European countries, resulting in poor control of many vaccine-preventable diseases.DiscussionThe Summit of Independent European Vaccination Experts focused on the perception of vaccines and vaccination by the general public and healthcare professionals and discussed ways to improve vaccine uptake in Europe.Despite the substantial impact and importance of the media, healthcare professionals were identified as the main advocates for vaccination and the most important source of information about vaccines for the general public. Healthcare professionals should receive more support for their own education on vaccinology, have rapid access to up-to-date information on vaccines, and have easy access to consultation with experts regarding vaccination-related problems. Vaccine information systems should be set up to facilitate promotion of vaccination.SummaryEvery opportunity to administer vaccines should be used, and active reminder systems should be set up. A European vaccine awareness week should be established.

Public trust in the safety and efficacy of vaccines is one key to the remarkable success of immunization programs within the United States and globally. Allegations of harm from vaccination have raised parental, political, and clinical anxiety to a level that now threatens the ability of children to receive timely, full immunization. Multiple factors have contributed to current concerns, including the interdependent issues of an evolving communications environment and shortfalls in structure and resources that constrain research on immunization safety (immunization-safety science). Prompt attention by public health leadership to spreading concern about the safety of immunization is essential for protecting deserved public trust in immunization.

The incidence, prevalence, morbidity and mortality rates of vaccine-preventable diseases have decreased drastically since the advent of modern vaccination by Edward Jenner at the end of the 18th century. In recent years, however, a growing number of parents have been refusing or delaying vaccination for their children for socioeconomical, medical, religious and/or philosophical reasons. This has resulted in a loss of herd immunity that has caused a resurgence of many infectious diseases. This article describes evidence-based methods by which a pediatric clinic can become a vaccine champion by aiming at vaccination rates of 100 percent. This goal can be attained by a team effort that addresses the challenges of vaccination by using every visit as a chance to vaccinate, educate, address the fears and the concerns of the parents and provide articles and other written documentations on the benefits and side effects of vaccines. A standardized system that identifies and tracks patients who need vaccines is also essential to find those who are seldom brought to medical attention. A consistent and systematic use of these evidence-based methods by a dedicated staff is essential to attain vaccination rates close to 100 percent.

This is the first in a series of two articles about childhood and adult immunization in the United States. Part 2 will discuss adult vaccination, the role of pharmacists, and considerations for P&T committees.

Background: Vaccination hesitancy and skepticism among parents hinders progress in achieving full vaccination coverage. Swedish measles, mumps and rubella (MMR) vaccine coverage is high however some areas with low vaccination coverage risk outbreaks. This study aimed to explore factors influencing the decision of Somali parents living in the Rinkeby and Tensta districts of Stockholm, Sweden, on whether or not to vaccinate their children with the measles, mumps and rubella (MMR) vaccine. Method: Participants were 13 mothers of at least one child aged 18 months to 5 years, who were recruited using snowball sampling. In-depth interviews were conducted in Somali and Swedish languages and the data generated was analysed using qualitative content analysis. Both written and verbal informed consent were obtained from participants. Results: Seven of the mothers had not vaccinated their youngest child at the time of the study and decided to postpone the vaccination until their child became older (delayers). The other six mothers had vaccinated their child for MMR at the appointed time (timely vaccinators). The analysis of the data revealed two main themes: (1) barriers to vaccinate on time, included issues surrounding fear of the child not speaking and unpleasant encounters with nurses and (2) facilitating factors to vaccinate on time, included heeding vaccinating parents’ advice, trust in nurses and trust in God. The mothers who had vaccinated their children had a positive impact in influencing other mothers to also vaccinate. Conclusions: Fear, based on the perceived risk that vaccination will lead to autism, among Somali mothers in Tensta and Rinkeby is evident and influenced by the opinions of friends and relatives. Child Healthcare Center nurses are important in the decision-making process regarding acceptance of MMR vaccination. There is a need to address mothers’ concerns regarding vaccine safety while improving the approach of nurses as they address these concerns.

U.S. media reports suggest that vastly disproportionate numbers of un‐ and under‐vaccinated children attend Waldorf (private alternative) schools. After confirming this statistically, I analyzed qualitative and quantitative vaccination‐related data provided by parents from a well‐established U.S. Waldorf school. In Europe, Waldorf‐related non‐vaccination is associated with anthroposophy (a worldview foundational to Waldorf education)—but that was not the case here. Nor was simple ignorance to blame: Parents were highly educated and dedicated to self‐education regarding child health. They saw vaccination as variously unnecessary, toxic, developmentally inappropriate, and profit driven. Some vaccine caution likely predated matriculation, but notable post‐enrollment refusal increases provided evidence of the socially cultivated nature of vaccine refusal in the Waldorf school setting. Vaccine caution was nourished and intensified by an institutionalized emphasis on alternative information and by school community norms lauding vaccine refusal and masking uptake. Implications for intervention are explored.

French president says US and UK should start exporting doses around the world instead

With the successful development and distribution of new vaccines, there is hope in the United States that the acute phase of the SARS-CoV-2 pandemic may soon end. 

A surge of attacks in one of Canada’s most multicultural cities during the pandemic is surfacing long-simmering racial tensions.

Even with vaccines, many older people and their relatives are weighing how to manage at-home care for those who can no longer live independently.

Slovakia conducted multiple rounds of population-wide rapid antigen testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2020, combined with a period of additional contact restrictions. Observed prevalence decreased by 58% (95% confidence interval: 57 to 58%) within 1 week in the 45 counties that were subject to two rounds of mass testing, an estimate that remained robust when adjusting for multiple potential confounders. Adjusting for epidemic growth of 4.4% (1.1 to 6.9%) per day preceding the mass testing campaign, the estimated decrease in prevalence compared with a scenario of unmitigated growth was 70% (67 to 73%). Modeling indicated that this decrease could not be explained solely by infection control measures but required the addition of the isolation and quarantine of household members of those testing positive.

The tempo-spatial patterns of Covid-19 infections are a result of nested personal, societal, and political decisions that involve complicated epidemiological dynamics across overlapping spatial scales. High infection “hotspots” interspersed within regions where infections remained sporadic were ubiquitous early in the outbreak, but the spatial signature of the infection evolved to affect most regions equally, albeit with distinct temporal patterns. The sparseness of Covid-19 infections in the United States was analyzed at scales spanning from 10 to 2,600 km (county to continental scale). Spatial evolution of Covid-19 cases in the United States followed multifractal scaling. A rapid increase in the spatial correlation was identified early in the outbreak (March to April). Then, the increase continued at a slower rate and approached the spatial correlation of human population. Instead of adopting agent-based models that require tracking of individuals, a kernel-modulated approach is developed to characterize the dynamic spreading of disease in a multifractal distributed susceptible population. Multiphase Covid-19 epidemics were reasonably reproduced by the proposed kernel-modulated susceptible–infectious–recovered (SIR) model. The work explained the fact that while the reproduction number was reduced due to nonpharmaceutical interventions (e.g., masks, social distancing, etc.), subsequent multiple epidemic waves still occurred; this was due to an increase in susceptible population flow following a relaxation of travel restrictions and corollary stay-at-home orders. This study provides an original interpretation of Covid-19 spread together with a pragmatic approach that can be imminently used to capture the spatial intermittency at all epidemiologically relevant scales while preserving the “disordered” spatial pattern of infectious cases.

All medical treatments have potential harms as well as potential benefits, and it's important to be able to weigh these against each other. With vaccines, the benefits are particularly complex as they can involve benefits to others as well as to ourselves - and the harms can feel particularly acute because we take vaccines when we are healthy, as a preventative measure.With the initial release of data from the MHRA on a specific type of blood clot recorded in the UK that might be associated with the Astra-Zeneca COVID-19 vaccine, the Winton Centre were asked to help communicate the risks. Now more data is available, we have updated our graphics.The blood-clot estimates are based on the MHRA’s yellow-card reports and so they have uncertainty around them, both because the small number of events mean there is uncertainty about the underlying risk, and that cases may yet to be reported. With very rare events like this we expect the rates to fluctuate as more data comes in so it’s not surprising to see changes from week to week.

Journals risk being used in place of regulators when they publish studies of novel vaccines that have not yet been authorised by a major regulator. Chris van Tulleken argues that peer review is inadequate to decide the risk-benefit ratio of new drugsIn August 2020 President Vladimir Putin announced Sputnik V, a vaccine developed by Russia’s Gamaleya National Center of Epidemiology and Microbiology. The president’s claim that it had gone through “all the necessary trials”1 did not seem to be backed up by the information on the Russian language registration certificate, which said that just 38 participants had received the vaccine.2International responses ranged from concern to derision. By granting approval to a vaccine before results from large phase III randomised trials were available, the Russian government seemed to be taking two immense risks. The first was a risk of direct harm to large numbers of people. Bad vaccines don’t just fail to protect, they might have serious adverse effects including making subsequent infection more dangerous through antibody associated disease enhancement, a phenomenon previously seen with SARS and MERS coronaviruses.3 Second, if people were harmed, public confidence in the vaccination programme and future investment in covid-19 vaccine development and uptake might be jeopardised. Trust in vaccines is easily bruised and recovers slowly.In September 2020, the first peer reviewed Sputnik V data were published in the Lancet: two non-randomised, open label studies, each of 38 people. No serious adverse events were reported, and the vaccine seemed to induce robust immune responses in participants.4

India’s only exit strategy is to urgently bring covid-19 infection rate down and to vaccinate as much of its population as quickly as possible, says Ami Banerjee

Get Back to Your Favorite Businesses and Venues with Digital Proof of Your COVID-19 Vaccination or Negative Test Results

If you are pregnant, you can receive a COVID-19 vaccine. There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems. However, data are limited about the safety of COVID-19 vaccines for people who are pregnant. CDC established the v-safe COVID-19 Vaccine Pregnancy Registry to learn more about this issue. The registry is collecting health information from people who received COVID-19 vaccination in the periconception period (within 30 days before last menstrual period) or during pregnancy. The information is critical to helping people and their healthcare providers make informed decisions about COVID-19 vaccination. Participation is voluntary, and participants may opt out at any time.

Move expands inoculation program as vaccination rates slow

Initiative would park vans administering the Johnson & Johnson Covid vaccine in tourist locations across the city

Sinopharm jab will also be added to Covax programme for the developing world in the coming weeks

Vaccine hesitancy could undermine efforts to control COVID-19. We investigated the prevalence of COVID-19 vaccine hesitancy in the UK and identified vaccine hesitant subgroups. The ‘Understanding Society’ COVID-19 survey asked participants (n = 12,035) their likelihood of vaccine uptake and reason for hesitancy. Cross-sectional analysis assessed vaccine hesitancy prevalence and logistic regression calculated odds ratios. Overall vaccine hesitancy was low (18% unlikely/very unlikely). Vaccine hesitancy was higher in women (21.0% vs 14.7%), younger age groups (26.5% in 16–24 year olds vs 4.5% in 75 + ) and those with lower education levels (18.6% no qualifications vs 13.2% degree qualified). Vaccine hesitancy was high in Black (71.8%) and Pakistani/Bangladeshi (42.3%) ethnic groups. Odds ratios for vaccine hesitancy were 13.42 (95% CI:6.86, 26.24) in Black and 2.54 (95% CI:1.19, 5.44) in Pakistani/Bangladeshi groups (compared to White British/Irish) and 3.54 (95% CI:2.06, 6.09) for people with no qualifications versus degree. Urgent action to address hesitancy is needed for some but not all ethnic minority groups.

There is huge variation in the percentage of frontline NHS healthcare staff who have been vaccinated against Covid in England.More than 98% in the North East and South West have had a first dose - but only 79% in London, leaving around 35,000 staff unvaccinated there.Ministers are considering whether to make the jab mandatory for NHS staff.Health and social care workers across the UK were one of the first groups to be offered a vaccine. In England, NHS data suggests 93% of eligible frontline staff have been vaccinated - equivalent to one million doses. But, nearly three months after the vaccination programme began, up to 80,000 frontline staff have still not taken up the offer.

The largest country in Latin America now has states and cities where deaths are outpacing births

A people-to-people initiative to speed the spread of COVID-19 vaccines worldwide

The European Union has opted not to renew an order for AstraZeneca to supply its coronavirus vaccine after June.

WHO review finds many national vaccination plans exclude asylum seekers, refugees, migrants and IDPs

Among widespread calls for a public inquiry into England’s response to the covid-19 pandemic, the King’s Fund has proposed a potential framework for an inquiry under five key headings: “Intrinsic risk,” “Public health response,” “Healthcare system response,” “Measures in wider society,” and “Adult social care response.”1 All partly depend on the role of government and its agencies. I realise that a public inquiry can produce an evidenced narrative and recommendations, but the need and demand for one highlights a serious failure of open elected government and leadership at the highest levels.

Since vaccines to prevent the spread of COVID-19 were first approved only months ago, more than 40% of people living in the United States have received at least one dose. But in nations like Mozambique, Namibia, and Sudan, that number is closer to 2%. So far, the World Health Organization’s vaccine-sharing initiative, COVAX, has failed to close the gap.  President Biden recently came out in support of international efforts to convince the World Health Organization to lift intellectual property restrictions in order to allow local manufacturers to produce generic versions of the life-saving drugs.

Vaccine regulators have delivered a clear verdict: In most settings, the benefits of the COVID-19 vaccines made by AstraZeneca and Johnson & Johnson (J&J) far outweigh the small risk they will cause an unusual and sometimes deadly clotting disorder. But many questions remain about who is most at risk, how the risk-benefit calculus changes when cases fall, and what the side effects mean for the future of these vaccines, which use adenoviruses to ferry the gene for SARS-CoV-2’s spike protein into human cells.

Does boredom increase risk behaviors in real-world settings, and if so, might it contribute to failure to comply with public health guidelines during the COVID-19 pandemic? In a large cross-national sample of 63,336 community respondents from 116 countries, we examined the prevalence of lockdown-related boredom during the initial outbreak of COVID-19, as well as its demographic and situational predictors. Boredom was higher in countries with more COVID-19 cases, more stringent lockdown policies, and lower GDPs, as well as among men and less educated/younger adults. Additionally, we examined whether “pandemic boredom” predicted longitudinal decreases in social distancing behavior (and vice versa; n = 8031). We found little evidence that changes in boredom predict individual public health behaviors (handwashing, staying home, self-quarantining, avoiding crowds) over time, or that such behaviors had any reliable longitudinal effects on boredom itself. In summary, we found little evidence that boredom affects pandemic health behaviors.

Parents have experienced considerable challenges and stress during the COVID-19 pandemic, which may impact their well-being. This meta-analysis sought to identify: 1) the prevalence of depression and anxiety in parents of young children (< age 5) during the COVID-19 pandemic, and 2) sociodemographic (e.g., parent age, minority status) and methodological moderators (e.g., study quality) that explain heterogeneity among studies. A systematic search was conducted across four databases from January 1st, 2020 to March 3st, 2021. A total of 18 non-overlapping studies (9,101 participants), all focused on maternal mental health, met inclusion criteria. Random-effect meta-analyses were conducted. Pooled prevalence estimates for clinically significant depression and anxiety symptoms for mothers of young children during the COVID-19 pandemic were 27.4% (95% CI: 21.5-34.3) and 43.5% (95% CI:27.5-60.9), respectively. Prevalence of clinically elevated depression and anxiety symptoms were higher in Europe and North America and among older mothers. Clinically elevated depressive symptoms were lower in studies with a higher percentage of racial and ethnic minority individuals. In comparison, clinically elevated anxiety symptoms were higher among studies of low study quality and in samples with highly educated mothers. Policies and resources targeting improvements in maternal mental health are essential.

Risk occupies a central role in both the theory and practice of decision-making. Although it is deeply implicated in many conditions involving dysfunctional behavior and thought, modern theoretical approaches to understanding and mitigating risk, in either one-shot or sequential settings, have yet to permeate fully the fields of neural reinforcement learning and computational psychiatry. Here we use one prominent approach, called conditional value-at-risk (CVaR), to examine optimal risk-sensitive choice and one form of optimal, risk-sensitive offline planning. We relate the former to both a justified form of the gambler’s fallacy and extremely risk-avoidant behavior resembling that observed in anxiety disorders. We relate the latter to worry and rumination.

Nonpharmaceutical interventions to control SARS-CoV-2 spread have been implemented with different intensity, timing, and impact on transmission. As a result, post-lockdown COVID-19 dynamics are heterogeneous and difficult to interpret. We describe a set of contact surveys performed in four Chinese cities (Wuhan, Shanghai, Shenzhen, and Changsha) during the pre-pandemic, lockdown and post-lockdown periods to quantify changes in contact patterns. In the post-lockdown period, the mean number of contacts increased by 5 to 17% as compared to the lockdown period. However, it remains three to seven times lower than its pre-pandemic level sufficient to control SARS-CoV-2 transmission. We find that the impact of school interventions depends nonlinearly on the intensity of other activities. When most community activities are halted, school closure leads to a 77% decrease in the reproduction number; in contrast, when social mixing outside of schools is at pre-pandemic level, school closure leads to a 5% reduction in transmission.

The US has backed India and South Africa's bid to temporarily lift patent protection for COVID-19 vaccines. The support for an IP waiver by the WTO has left pharma companies dismayed and health activists asking for more.

Viruses need entry proteins to penetrate the cells where they will replicate. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) version is called the spike or S protein. The S protein, also the target of the current vaccines, is quickly adapting to its new human hosts. It took its first major step in this direction early in 2020, when its amino acid 614 (of 1297) changed from an aspartic acid (D) to a glycine (G). Viruses bearing this D614G mutation transmit among humans more rapidly and now form the majority in circulation

As of early April, 2021, more than 2·8 million individuals have died globally from COVID-19. However, tens of millions of patients have survived COVID-19 and returned to everyday life. Increasing evidence has shown that a considerable proportion of patients did not recover fully and had lasting sequelae, described by various terms without consensus, including long COVID, post-COVID condition or syndrome, postacute (or late) sequelae of COVID-19, and post-acute COVID syndrome.1Lerner AM Robinson DA Yang L et al.Toward understanding COVID-19 recovery: National Institutes of Health workshop on postacute COVID-19.Ann Intern Med. 2021; (published online March 30.)https://doi.org/10.7326/M21-1043Crossref PubMed Google Scholar,  2Nalbandian A Sehgal K Gupta A et al.Post-acute COVID-19 syndrome.Nat Med. 2021; 27: 601-615Crossref PubMed Scopus (1) Google Scholar Studies have mainly focused on patients with COVID-19 after hospital admission.3Huang C Huang L Wang Y et al.6-month consequences of COVID-19 in patients discharged from hospital: a cohort study.Lancet. 2021; 397: 220-232Summary Full Text Full Text PDF PubMed Scopus (51) Google Scholar,  4Morin L Savale L Pham T et al.Four-month clinical status of a cohort of patients after hospitalization for COVID-19.JAMA. 2021; (published online March 17.)https://doi.org/10.1001/jama.2021.3331PubMed Google Scholar One study with a small sample size and without a control group of people without COVID-19 described the long-term outcomes of patients with COVID-19 who did not require hospital admission.5Stavem K Ghanima W Olsen MK Gilboe HM Einvik G Persistent symptoms 1·5–6 months after COVID-19 in non-hospitalised subjects: a population-based cohort study.Thorax. 2020; 76: 405-407Crossref Scopus (8) Google Scholar

A form of the coronavirus variant first identified in India, which is now spreading in the UK, appears to be passed on at least as easily as the “Kent variant” that now dominates UK infections. The variant, called B.1.617.2, was designated a “variant of concern” on 7 May by health authorities in England. B.1.617.2 is one of three sub-lineages of B.1.617, the variant that has become common in India and which some have considered, but not proven, to be one potential factor behind the crisis India has been facing. On 10 May, the World Health Organization designated B.1.617 as a variant of concern. Advertisement googletag.cmd.push(function() { googletag.display('mpu-mid-article'); }); googletag.cmd.push(function() { googletag.display('video-mid-article'); }); Public Health England (PHE) has moderate confidence that the B.1.617.2 variant is on a par for transmissibility with B.1.1.7, which originated in the UK, said Sharon Peacock at the University of Cambridge at a press briefing today. The view is based on the variant’s mutations and its ability to circulate in the UK alongside the Kent variant. However, there is still much we don’t know about the Indian variants.

OBJECTIVE: To explore public attitudes to COVID-19 vaccines in the UK, focused on intentions and decisions around taking vaccines, views on ‘vaccine passports’, and experiences and perspectives on post-vaccination behaviour. DESIGN: Qualitative study consisting of 6 online focus groups conducted between 15th March – 22nd April 2021. SETTING: Online video conferencing PARTICIPANTS: 29 adult UK-based participants RESULTS: Three main groups regarding participants’ decision or intention to receive a COVID-19 vaccine were identified: (1) Accepters, (2) Delayers and (3) Refusers. Two reasons for vaccine delay were identified: delay due to a perceived need more information and delay until vaccine was “required” in the future. Three main facilitators (Vaccination as a social norm; Vaccination as a necessity; Trust in science) and six barriers (Preference for “natural immunity”; Concerns over possible side effects; Distrust in government; Perceived lack of information; Conspiracy theories; “Covid echo chambers”) to vaccine uptake were identified. For some delayers, 'vaccine passports' were perceived to be a reason why they would get vaccinated in the future. However, vaccine passports were controversial, and were framed in four main ways: as “a necessary evil”; as “Orwellian”; as a “human rights problem”; and as a source of confidence”. Participants generally felt that receiving a vaccine was not changing the extent to which people were adhering to COVID-19 measures. CONCLUSIONS: Overall positive sentiment around vaccines is high. However, there remains a number of potential barriers which might be leading to vaccine delay in some. ‘Vaccine delay’ might be a more useful and precise construct than vaccine hesitancy in explaining why some may initially ignore or be uncertain about vaccination invitations. Vaccine passports may increase or ‘nudge’ uptake in some delayers but may be unpopular in others. Earlier concerns that vaccination might reduce adherence to social distancing measures are not borne out in our data, with most people reporting adherence and caution.

Interacting with others wearing a face mask has become a regular worldwide practice since the beginning of the COVID-19 pandemic. However, the impact of face masks on cognitive mechanisms supporting social interaction is still largely unexplored. In the present work we focused on gaze cueing of attention, a phenomenon tapping the essential ability which allows individuals to orient their attentional resources in response to eye gaze signals coming from others. Participants from both a Western (i.e., Italy; Experiment 1) and an Asian (i.e., China; Experiment 2) country were involved, namely two countries in which the daily use of face masks before COVID-19 pandemic was either extremely uncommon or frequently adopted, respectively. Both samples completed a task in which a peripheral target had to be discriminated while a task irrelevant averted gaze face, wearing a mask or not, acted as a central cueing stimulus. Overall, a reliable and comparable gaze cueing emerged in both experiments, independent of the mask condition. These findings suggest that social attention is preserved even when the person perceived is wearing a face mask.

The German government said while they support global vaccine supplies, "the protection of intellectual property is a source of innovation and must remain so in the future."

Distance clouds perspective. The covid-19 pandemic is in a dangerous new phase, ripping through Brazil and India, two of the world’s emerging powers, with all middle and low income countries at risk. Neither country achieved herd immunity, as some politicians and scientists recklessly claimed. Yet the scale of death and fear feels distant from the UK. It shouldn’t. Just as the effects of environmental damage shouldn’t feel distant either. They already affect us directly.1 These aren’t merely other people’s problems. It is this “othering” that precipitated the failed pandemic responses of the UK, US, and much of Europe. Any isolationism or exceptionalism we sow today will reap a future harvest of premature death and worse health.

Analysis: US now supports waivers, but experts say on its own it will not have a decisive impact on vaccine inequality

Exclusive: Leaked emails show Public Health England assessment of ongoing risk from B16172 variant is ‘high’

Could today’s version of America have been able to win World War II? It hardly seems possible.That victory required national cohesion, voluntary sacrifice for the common good and trust in institutions and each other. America’s response to Covid-19 suggests that we no longer have sufficient quantities of any of those things. window.onload = function () { const target = document.querySelector('#push-signup'); const options = { channel: 'david-brooks', region: 'top-banner', productCode: 'PUDB', channelName: 'David Brooks', ctaMsg: 'Get alerts when we publish', subscribedMsg: 'You’re signed up to receive alerts from', }; const config = { target, options, }; pushSignup(config); }; In 2020 Americans failed to socially distance and test for the coronavirus and suffered among the highest infection and death rates in the developed world. Millions decided that wearing a mask infringed their individual liberty.

A confusing and unusually nasty fight broke out this week over the safety of a Russian COVID-19 vaccine known as Sputnik V after a Brazilian health agency declined on Monday to authorize its import because of quality and safety concerns. The stakes escalated yesterday when the Twitter account officially associated with the vaccine said “Sputnik V is undertaking a legal defamation proceeding” against Brazil’s regulators. In an online press conference several hours later, the Brazilian Health Regulatory Agency (Anvisa) defended its decision, maintaining that documentation from some of the Russian facilities making Sputnik V shows that one of its two doses contains adenoviruses capable of replication, a potential danger to vaccine recipients. The vaccine uses two different adenoviruses, which cause the common cold, to deliver the gene for the spike protein of SARS-CoV-2, the virus that causes COVD-19. Both are supposed to be stripped of a key gene that allows them to replicate.

There are a lot of ways Dr. Kent Bream would describe the lines of people waiting, sometimes for hours, for COVID-19 vaccines at his community health clinic in West Philadelphia. Eager. Impatient. Frustrated, even. But "hesitant" doesn't come to mind. As soon as the city started sending him doses, he says, demand was never an issue. In fact, Bream's clinic — which is located in a predominantly Black neighborhood — had more vaccines than it had staff to administer them. "I said, send me vaccine and I will show you that there is not the level of vaccine hesitancy you think there is," recalls the medical director of Sayre Health Center. Despite the high demand, the latest data show that 23% of vaccines are going to Black residents. Compare that to Philadelphia's total population, which is more than 40% Black. Vaccination rates for Black and Latino people in the city are still half what they are for whites.

We investigated laypersons’ agreement with technical claims about the spread of the Sars-CoV-2 virus and with claims about the risk from COVID-19 in the general public in Germany (N = 1,575) and compared these with the evaluations of scientific experts (N = 128). Using Latent Class Analysis, we distinguished four segments in the general public. Two groups (mainstream and cautious, 73%) are generally consistent with scientific experts in their evaluations. Two groups (doubters and deniers, 27%) differ distinctively from expert evaluations and tend to believe in conspiracies about COVID-19. Deniers (8%) are characterized by low risk assessments, anti-elitist sentiments and low compliance with containment measures. Doubters (19%) are characterized by general uncertainty in the distinction between true and false claims and by low scientific literacy in terms of cognitive ability and style. Our research indicates that conspiracy beliefs about COVID-19 cannot be linked to a single and distinct motivational structure.

Two studies showed the vaccine to be more than 95 percent effective at protecting against severe disease or death from the variants first identified in South Africa and the U.K.

Fake news, like conjuring, plays on our weaknesses — but with a little attention, we can fight back

In psychology, causal inference—both the transport from lab estimates to the real world and estimation on the basis of observational data—is often pursued in a casual manner. Underlying assumptions remain unarticulated; potential pitfalls are compiled in post-hoc lists of flaws. The field should move on to coherent frameworks of causal inference and generalizability that have been developed elsewhere.

When situations occur in which unwanted events are rightly or wrongly connected with vaccination, they may erode confidence in vaccines and the authorities delivering them. This document presents the scientific evidence behind WHO’s recommendations on building and restoring confidence in vaccines and vaccination, both in ongoing work and during crises. The evidence draws on a vast reserve of laboratory research and fieldwork within psychology and communication. It examines how people make decisions about vaccination; why some people are hesitant about vaccination; and the factors that drive a crisis, covering how building trust, listening to and understanding people, building relations, communicating risk and shaping messages to the audiences may mitigate crises. This document provides a knowledge base for stakeholders who develop communication strategies or facilitate workshops on communication and trust-building activities in relation to vaccines and immunization, such as immunization programme units, ministries of health, public relations and health promotion units, vaccine safety communication trainers and immunization advisory bodies

BackgroundIn high-income countries, substantial differences exist in vaccine uptake relating to socioeconomic status, gender, ethnic group, geographic location and religious belief. This paper updates a 2009 systematic review on effective interventions to decrease vaccine uptake inequalities in light of new technologies applied to vaccination and new vaccine programmes (eg, human papillomavirus in adolescents).MethodsWe searched MEDLINE, Embase, ASSIA, The Campbell Collaboration, CINAHL, The Cochrane Database of Systematic Reviews, Eppi Centre, Eric and PsychINFO for intervention, cohort or ecological studies conducted at primary/community care level in children and young people from birth to 19 years in OECD countries, with vaccine uptake or coverage as outcomes, published between 2008 and 2015.ResultsThe 41 included studies evaluated complex multicomponent interventions (n=16), reminder/recall systems (n=18), outreach programmes (n=3) or computer-based interventions (n=2). Complex, locally designed interventions demonstrated the best evidence for effectiveness in reducing inequalities in deprived, urban, ethnically diverse communities. There is some evidence that postal and telephone reminders are effective, however, evidence remains mixed for text-message reminders, although these may be more effective in adolescents. Interventions that escalated in intensity appeared particularly effective. Computer-based interventions were not effective. Few studies targeted an inequality specifically, although several reported differential effects by the ethnic group.ConclusionsLocally designed, multicomponent interventions should be used in urban, ethnically diverse, deprived populations. Some evidence is emerging for text-message reminders, particularly in adolescents. Further research should be conducted in the UK and Europe with a focus on reducing specific inequalities.

IntroductionBeyond their impact on health, vaccines can lead to large economic benefits. While most economic evaluations of vaccines have focused on the health impact of vaccines at a national scale, it is critical to understand how their impact is distributed along population subgroups.MethodsWe build a financial risk protection model to evaluate the impact of immunisation against measles, severe pneumococcal disease and severe rotavirus for birth cohorts vaccinated over 2016–2030 for three scenarios in 41 Gavi-eligible countries: no immunisation, current immunisation coverage forecasts and the current immunisation coverage enhanced with funding support. We distribute modelled disease cases per socioeconomic group and derive the number of cases of: (1) catastrophic health costs (CHCs) and (2) medical impoverishment.ResultsIn the absence of any vaccine coverage, the number of CHC cases attributable to measles, severe pneumococcal disease and severe rotavirus would be approximately 18.9 million, 6.6 million and 2.2 million, respectively. Expanding vaccine coverage would reduce this number by up to 90%, 30% and 40% in each case. More importantly, we find a higher share of CHC incidence among the poorest quintiles who consequently benefit more from vaccine expansion.ConclusionOur findings contribute to the understanding of how vaccines can have a broad economic impact. In particular, we find that immunisation programmes can reduce the proportion of households facing catastrophic payments from out-of-pocket health expenses, mainly in lower socioeconomic groups. Thus, vaccines could have an important role in poverty reduction.

In the World Health Organization (WHO) European Region, differences in uptake rates of routine childhood immunisation persist within and among countries, with rates even falling in some areas. There has been a tendency among national programmes, policymakers and the media in recent years to attribute missed vaccinations to faltering demand or refusal among parents. However, evidence shows that the reasons for suboptimal coverage are multifactorial and include the social determinants of health. At the midpoint in the implementation of the European Vaccine Action Plan 2015–2020 (EVAP), national immunisation programmes should be aware that inequity may be a factor affecting their progress towards the EVAP immunisation targets. Social determinants of health, such as individual and household income and education, impact immunisation uptake as well as general health outcomes – even in high-income countries. One way to ensure optimal coverage is to make inequities in immunisation uptake visible by disaggregating immunisation coverage data and linking them with already available data sources of social determinants. This can serve as a starting point to identify and eliminate underlying structural causes of suboptimal uptake. The WHO Regional Office for Europe encourages countries to make the equitable delivery of vaccination a priority.

Background Cervical cancer disproportionately affects women from lower socioeconomic backgrounds. A human papillomavirus (HPV) vaccination programme was introduced in Scotland in 2008 with uptake being lower and inequitable in a catch-up cohort run for the first three years of the programme compared with the routine programme. The socioeconomic differences in vaccine uptake have the potential to further increase the inequality gap in regards to cervical disease.Methods Vaccination status was linked to demographic, cytological and colposcopic data, which are routinely collected by the Scottish HPV surveillance system. Incidence rates and relative risk of cervical intraepithelial neoplasia (CIN) 1, 2 and 3 in unvaccinated and vaccinated women were stratified by birth year and deprivation status using Poisson regression.Results Women who received three doses of HPV vaccine have significantly decreased risk of CIN 1, 2 and 3. Vaccine effectiveness was greater in those women from the most deprived backgrounds against CIN 2 and 3 lesions. Compared with the most deprived, unvaccinated women, the relative risk of CIN 3 in fully vaccinated women in the same deprivation group was 0.29 (95% CI 0.2 to 0.43) compared with 0.62 (95% CI 0.4 to 0.97) in vaccinated women in the least-deprived group.Conclusions The HPV vaccine is associated with significant reductions in both low-grade and high-grade CIN for all deprivation categories. However, the effect on high-grade disease was most profound in the most-deprived women. These data are welcoming and allay the concern that inequalities in cervical cancer may persist or increase following the introduction of the vaccine in Scotland.

The problem of antimicrobial resistance (AMR) and the associated morbidity and mortality due to antibiotic resistant bacterial pathogens is not new. However, AMR has been increasing at an alarming rate with appearances of diseases caused by bacteria exhibiting resistance to not just one but multiple classes of antibiotics. The World Health Organization (WHO) supported by governments, health ministries and health agencies has formulated global action plans to combat the rise in AMR, supporting a number of proven initiatives such as antimicrobial stewardship, investments in development of new classes of antibiotics, and educational programs designed to eliminate inappropriate antibiotic use. Vaccines as tools to reduce AMR have historically been under-recognized, yet the positive effect in reducing AMR has been well established. For example Haemophilus influenzae type B (Hib) as well as Streptococcus pneumoniae (pneumococcal) conjugate vaccines have impressive track records in not only preventing life threatening diseases caused by these bacteria, but also reducing antibiotic use and AMR. This paper will describe the drivers of antibiotic use and subsequent development of AMR; it will make the case how existing vaccines are already participating in combatting AMR, describe future prospects for the role of new vaccines in development to reduce AMR, and highlight challenges associated with future vaccine development to combat AMR.

In low-income countries, infectious diseases still account for a large proportion of deaths, highlighting health inequities largely caused by economic differences. Vaccination can cut health-care costs and reduce these inequities. Disease control, elimination or eradication can save billions of US dollars for communities and countries. Vaccines have lowered the incidence of hepatocellular carcinoma and will control cervical cancer. Travellers can be protected against “exotic” diseases by appropriate vaccination. Vaccines are considered indispensable against bioterrorism. They can combat resistance to antibiotics in some pathogens. Noncommunicable diseases, such as ischaemic heart disease, could also be reduced by influenza vaccination.Immunization programmes have improved the primary care infrastructure in developing countries, lowered mortality in childhood and empowered women to better plan their families, with consequent health, social and economic benefits.Vaccination helps economic growth everywhere, because of lower morbidity and mortality. The annual return on investment in vaccination has been calculated to be between 12% and 18%. Vaccination leads to increased life expectancy. Long healthy lives are now recognized as a prerequisite for wealth, and wealth promotes health. Vaccines are thus efficient tools to reduce disparities in wealth and inequities in health.

IntroductionThe WHO Regional Office for Europe developed the Guide to tailoring immunization programmes (TIP), offering countries a process through which to diagnose barriers and motivators to vaccination in susceptible low vaccination coverage and design tailored interventions. A review of TIP implementation was conducted in the European Region.Material and methodsThe review was conducted during June to December 2016 by an external review committee and was based on visits in Bulgaria, Lithuania, Sweden and the United Kingdom that had conducted a TIP project; review of national and regional TIP documents and an online survey of the Member States in the WHO European Region that had not conducted a TIP project. A review committee workshop was held to formulate conclusions and recommendations.ResultsThe review found the most commonly cited strengths of the TIP approach to be the social science research as well as the interdisciplinary approach and community engagement, enhancing the ability of programmes to “listen” and learn, to gain an understanding of community and individual perspectives. National immunization managers in the Region are generally aware that TIP exists and that there is strong demand for the type of research it addresses. Further work is needed to assist countries move towards implementable strategies based on the TIP findings, supported by an emphasis on enhanced local ownership; integrated diagnostic and intervention design; and follow-up meetings, advocacy and incentives for decision-makers to implement and invest in strategies.ConclusionsUnderstanding the perspectives of susceptible and low-coverage populations is crucial to improving immunization programmes. TIP provides a framework that facilitated this in four countries. In the future, the purpose of TIP should go beyond identification of susceptible groups and diagnosis of challenges and ensure a stronger focus on the design of strategies and appropriate and effective interventions to ensure long-term change.

Widely circulating coronavirus variants and persistent hesitancy about vaccines will keep the goal out of reach. The virus is here to stay, but vaccinating the most vulnerable may be enough to restore normalcy.

COVID-19 has brought an epidemic of information which has produced detrimental mental health effects for young people. This systematic review protocol outlines the approach to investigating the available literature which assesses the relationship between COVID-19 related news and mental health outcomes in young people.

The European Medicines Agency (EMA) has concluded that there is a possible link between rare but severe cases of blood clots (VITT) and the COVID-19 vaccine from Johnson & Johnson. As the COVID-19 epidemic in Denmark is currently under control, and the vaccination rollout is progressing satisfactorily with other available vaccines, the Danish Health Authority has decided to continue the national vaccination campaign without the COVID-19 vaccine from Johnson & Johnson.

If you keep calm, put things in context and remain curious, you stand a much better chance of protecting yourself during the Covid-19 pandemic and avoiding feeling overwhelmed by scary statistics

Observers say the Sputnik V jab is aimed more at sowing political division than fighting coronavirus

Coronavirus cases are surging in many countries, with the highest number of new cases now being reported in Asia. India alone reported 161,736 new cases on 12 April. In the Indian city of Surat, parts of gas furnaces used for cremations melted after being used non-stop. Meanwhile, millions have been gathering for festivals across the country.