The Role of Faith-Based Organizations in Improving Vaccination Confidence & Addressing Vaccination Disparities to Help Improve Vaccine Uptake: A Systematic Review.

The COVID-19 pandemic underscored the importance of vaccination to support individual health across the life-course, with vaccination playing a central strategy role in mitigating transmission and disease. This required unprecedented mobilization and coordination across all sectors to meet people where they are, enable equitable access, and build vaccination confidence. A literature search was conducted with combinations of the keywords and variations of vaccination and faith-based organizations (FBOs). Search inclusion criteria were: (1) FBO programs that supported public health emergency efforts, including vaccination efforts as the primary outcome; and (2) articles written in English language. A total of 37 articles met inclusion criteria (n = 26 focused on general public health campaigns, n = 11 focused on vaccination efforts). The findings related to public health campaigns fell into four themes: FBO's ability to (1) tailor public health campaigns; (2) mitigate barriers; (3) establish trust; and (4) disseminate and sustain efforts. The findings related to vaccine uptake efforts fell into three themes: (1) pre-pandemic influenza and HPV vaccination efforts, (2) addressing vaccine disparities in minority communities, and (3) enabling COVID-19 vaccination. This review demonstrated that FBOs have a vital role in both public health campaigns and vaccination initiatives to support high vaccine uptake and confidence.

[WEARING A MASK IS A PERSONAL PROTECTION AGAINST SARS-COV-2 INFECTION EVEN IN A VACCINATION-ON-BOARDING COUNTRY].

INTRODUCTION: Even with the advent of the COVID-19 vaccine, masks and social distancing are recommended as a precautionary measure to suppress SARS-CoV-2 infection and disease. In Israel, as in many other countries, despite official regulations and widespread availability and accessibility to affordable effective masks, the use of face masks is not consistent or universal. Physicians and other medical and health professionals have a vital role to play in communicating to the public about the importance of masking and encouraging people to wear face masks correctly and consistently. This review underscores the importance of masking as a protective public health mitigation measure. It describes types of face masks mainly used by the public and their effectiveness. It emphasizes the importance of identifying and addressing barriers (e.g., physical, social, economic) to encourage widespread and sustained appropriate use of masks. The article also proposes strategies to enhance masking, such as changing social norms through targeted local interventions and governmental control of mask quality and price.

Cutting-Edge Success in Preventing Heterosexual HIV Transmission in Africa: Voluntary Medical Male Circumcision Has Reached 15 Million Men.

Male circumcision is a minor surgery performed for religious and medical reasons. Three randomized clinical trials demonstrated it could reduce heterosexual HIV transmission from infected females to males by over 60%, paving the way in 2006 for multinational efforts to circumcise 27 million men in sub-Saharan Africa by 2021. It is estimated that by 2030 male circumcision will avert at least 500,000 HIV infections in Africa, saving lives and budgets. Voluntary medical male circumcision (VMMC) of adults and adolescents has challenged policy makers, implementers, funders, and civil society in bringing surgery to the frontline of HIV prevention. Five key challenges are discussed: policy, clinical, demand, supply, and scaling up. A unique Israel-Senegal-South Africa collaboration, which enhanced high-volume (100 VMMCs per day) and high-quality (less than 2% minor adverse events) procedures, is described, highlighting VMMC as one of the most impressive public health collaborative interventions in HIV/AIDS prevention globally.

A program evaluation report of a rapid scale-up of a high-volume medical male circumcision site, KwaZulu-Natal, South Africa, 2010-2013.

BACKGROUND: Male circumcision can provide life-long reduction in the risk of acquiring HIV infection. In South Africa, the KwaZulu-Natal Provincial Department of Health committed to rolling out circumcision programs to address the HIV epidemic. The Department of Health enlisted the help of St. Mary's Hospital in Mariannhill and the Operation Abraham Collaborative. METHODS: St. Mary's Hospital and the Operation Abraham Collaborative partnered to establish a voluntary medical male circumcision facility, called Asiphile, and to train surgeons, nurses and health clinic staff to serve KwaZulu-Natal. RESULTS: Over the course of the implementation period, 9,980 circumcisions were conducted at the Asiphile facility. The uptake numbers increased throughout 2010 and 2011 and began to level off as the demand of early adopters may have been met. Uptake spiked during school vacations and staff training sessions. Additionally, 92 % of clients returned for post-operation follow-up and only 2 % of clients experienced any adverse event. CONCLUSION: St. Mary's Hospital and the Operation Abraham Collaborative were able to cooperate and successfully implement a voluntary medical male circumcision facility in KwaZulu-Natal. Although uptake was lower than projected, lessons learned from efforts to overcome challenges in recruitment, transportation, and coordination can help inform and improve new and existing population-based male circumcision programs.

Complications of circumcision in male neonates, infants and children: a systematic review.

BACKGROUND: Approximately one in three men are circumcised globally, but there are relatively few data on the safety of the procedure. The aim of this paper is to summarize the literature on frequency of adverse events following pediatric circumcision, with a focus on developing countries. METHODS: PubMed and other databasess were searched with keywords and MeSH terms including infant/newborn/pediatric/child, circumcision, complications and adverse events. Searches included all available years and were conducted on November 6th 2007 and updated on February 14th 2009. Additional searches of the Arabic literature included searches of relevant databases and University libraries for research theses on male circumcision.Studies were included if they contained data to estimate frequency of adverse events following neonatal, infant and child circumcision. There was no language restriction. A total of 1349 published papers were identified, of which 52 studies from 21 countries met the inclusion criteria. The Arabic literature searches identified 46 potentially relevant papers, of which six were included. RESULTS: Sixteen prospective studies evaluated complications following neonatal and infant circumcision. Most studies reported no severe adverse events (SAE), but two studies reported SAE frequency of 2%. The median frequency of any complication was 1.5% (range 0-16%). Child circumcision by medical providers tended to be associated with more complications (median frequency 6%; range 2-14%) than for neonates and infants. Traditional circumcision as a rite of passage is associated with substantially greater risks, more severe complications than medical circumcision or traditional circumcision among neonates. CONCLUSIONS: Studies report few severe complications following circumcision. However, mild or moderate complications are seen, especially when circumcision is undertaken at older ages, by inexperienced providers or in non-sterile conditions. Pediatric circumcision will continue to be practiced for cultural, medical and as a long-term HIV/STI prevention strategy. Risk-reduction strategies including improved training of providers, and provision of appropriate sterile equipment, are urgently needed.

[Male circumcision and HIV/AIDS: convincing evidence and their implication for the state of Israel].

The results of recent controlled trials documenting the protective effect of male circumcision on HIV infection in young adults pose significant challenges to a country like Israel. Circumcision is performed in close to 100% of new born males, mostly as a religious act in Judaism and Islam. Christian Israelis follow societal norms suggesting that circumcision contributes to better hygiene and cleanliness. Complications in infant circumcision in Israel are rare, despite the surgery being preformed most often by nonmedical circumcisers (a "Mohel") on the eighth day of birth. Reported complication rates are between 0.34% and 2%, with bleeding and infections being the most common. In the last 10 years and due to massive migration of Eastern Europeans into Israel, impressive experience was gained in Israel with adults seeking male circumcision for various reasons including: religious, societal pressure, sexual and economical. Over 21,800 adult male circumcisions have been monitored between 1998 and 2006 alone. Complication rates (mostly bleeding) were 1.75% on an average. This review matches the new data emerging from the African controlled trials with previous observational studies and the Jewish and Israeli experience. We present three challenges to policy makers in Israel: (a) the need to intensify education and information sharing on male circumcision and HIV/AIDS among healthcare workers; (b) developing an information campaign for non-circumcised migrants and adequate service to scale up on potential demand; (c) developing intensified educational campaigns for circumcised males so that they do not abandon other protective interventions (e.g. condoms) when needed for HIV prevention.