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Community health projects have played a crucial role in improving health issues. Listening to communities' voices and achieving community ownership are essential for conducting effective health projects. However, there are limited studies on the frameworks for collecting, aggregating, and operationalizing community preferences and values. In this study, we selected two cases of community field surveys from Japan and Cambodia to discuss who may represent a community and propose a practical approach to achieving community ownership. Both cases involved various stakeholders. From the insights of these two cases, we suggested the following three key components in the community project: the community representative, the communicator, and the institute outside the community. Notably, the community representative's role as the community's direct voice should be properly recognized and institutionalised to establish community ownership. We proposed the following key terms of the qualifications of community representatives: they should be able to represent voices from the community, should have extensive experience to decide the project direction and manage the project, and should be independent of outside actors. Our theoretical model of the structure of different stakeholder groups in community-based projects will be helpful to accelerate community capacity strengthening; moreover, it can help build the appropriate community institution and process, including multi-stakeholder groups to promote community ownership in health programs.
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Academias e Institutos , Propiedad , Cambodia , Instituciones de Salud , Promoción de la SaludRESUMEN
We aimed to investigate the type and frequency of adverse events over 7 days following the first and second BNT162b2 vaccination. This observational and historical cohort study included patients aged 5-11 years who received two doses of BNT162b2 and provided consent along with their guardians. We collected data on sex, age, height, weight, blood type, history of Bacille Calmette-Guerin vaccination, allergic disease, medication, history of coronavirus disease 2019 (COVID-19), and adverse reactions 7 days following the first and second BNT162b2 vaccination using a questionnaire. Our results were compared with previously reported results for individuals aged 12-15 years. A total of 421 participants were eligible for this study. Among the 216 patients with allergic disease, 48 (22.2%) had experienced worsening of their chronic diseases, and the frequency of fatigue and dizziness after the second dose was higher than that of healthy individuals. The experience of systemic adverse reactions was associated with asthma. The frequency of headache, diarrhea, fatigue, muscle/joint pain, and fever after the second BNT162b2 vaccination was lower in individuals aged 5-11 years than in those aged 12-15 years. Fever was the only systemic adverse reaction that lasted longer than 5 days (1.0% of participants). CONCLUSIONS: Individuals with allergic diseases, who are potentially susceptible to COVID-19, may experience worsening of their chronic diseases and more frequent adverse reactions after BNT162b2 vaccination than healthy individuals. To ensure that children with allergic diseases receive the vaccine safely, further information needs to be collected. WHAT IS KNOWN: ⢠Adverse reactions after BNT162b2 vaccination among individuals aged 5-11 years are generally nonserious, more common after second vaccination, and substantially less common compared to those observed among individuals aged 12-15 years. WHAT IS NEW: ⢠Individuals with allergic diseases experienced worsening of their chronic diseases and more frequent adverse reactions after BNT162b2 vaccination than healthy individuals. ⢠Systemic adverse reactions were associated with asthma. Fever was the only systemic adverse reaction that lasted longer than 5 days.
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Asma , COVID-19 , Hipersensibilidad , Niño , Humanos , Vacuna BNT162 , Estudios de Cohortes , COVID-19/prevención & control , Fiebre , Hipersensibilidad/epidemiología , Hipersensibilidad/etiología , Vacunación/efectos adversos , Vacunas contra la COVID-19/efectos adversosRESUMEN
Responding to the radiation-related concerns of parents/guardians with infants/small children is an important public health issue for regional recovery after radioactive contamination. This study summarizes the results of a systematic internal contamination screening of infants/small children, aged 0-6 years, using BABYSCAN and individual counselling sessions with physicians about radiation concerns from 2014 to 2018 in Minamisoma City. Of 3,114 participants, no one was found to have internal contamination with radioactive caesium with a detection limit of 50 Bq/body. The questionnaire survey showed a decreasing trend of concerns about food contamination and playing outside as possible causes of internal contamination over time. Because people's concerns were diverse in counselling sessions, individual responses are required. This study showed that examinations using BABYSCAN provide an opportunity for direct dialogue between the parents/guardians of infants/small children and experts. This can be considered a model case for risk communication conducted by the local government after a radioactive contamination incident.
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Radioisótopos de Cesio/análisis , Recuento Corporal Total/estadística & datos numéricos , Niño , Preescolar , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Contaminación Radiactiva de Alimentos/estadística & datos numéricos , Accidente Nuclear de Fukushima , Humanos , Lactante , Recién Nacido , Japón , Masculino , Plantas de Energía Nuclear , Monitoreo de Radiación/estadística & datos numéricos , Liberación de Radiactividad Peligrosa/estadística & datos numéricos , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
Following the Fukushima incident, radiation doses from external exposure accounted for the majority of the total doses. Although countermeasures are being implemented, with the aim of reducing radiation exposure, little information is available on the effects of decontamination on individual doses among the residents of radioactively contaminated areas. To evaluate the effectiveness of the decontamination measures in reducing individual doses, and to examine the influence of the timing of decontamination and the district, data were analysed for 18 392 adults and 3 650 children in Minamisoma City, Fukushima, who participated in a voluntary screening programme using individual radiation dosimeters (Glass Badge) between June 2013 and September 2016. The dose reduction rates (DRR) were calculated for one year by comparing the first and last three-month measurement results between areas with and without decontamination. Using a regression approach and Monte Carlo simulation, the dose reduction rate by decontamination eliminating the effect of physical decay (DRRd') was also estimated as a function of the timing of the decontamination and the dose at the time of starting the decontamination. The annual DRR in areas with decontamination for both adults and children were significantly higher than those in areas without decontamination, depending on the timing of decontamination: 31%-36% for 2013-14 for adults in decontamination areas and 33%-35% for children in decontamination areas, compared to 12%-23% and 13%-23% for adults and children in areas without decontamination, respectively. There was a positive correlation between DRRd' and individual doses, and DRRd' was estimated at 30%-40% for adults and children with doses of 3 mSv y-1 in 2013 and 2014. This study demonstrated that decontamination does lower individual doses from external exposure. The higher the dose at the time of starting the decontamination, the greater the dose reduction rate by decontamination, regardless of the timing of the decontamination. Our study confirms that decontamination was useful for high-dose areas in the later phases of the incident.
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Descontaminación/métodos , Exposición a Riesgos Ambientales/análisis , Accidente Nuclear de Fukushima , Dosis de Radiación , Adolescente , Adulto , Anciano , Niño , Preescolar , Ciudades , Femenino , Humanos , Lactante , Recién Nacido , Japón , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Método de Montecarlo , Dosímetros de Radiación , Monitoreo de Radiación/métodos , Estudios RetrospectivosRESUMEN
ABSTRACT: Steady efforts for recovery and reconstruction after the accident at the Fukushima Daiichi Nuclear Power Plant have been underway for 12.5 y. The present study reports on the world's first-ever efforts for a gradual and safe return to areas contaminated with radiation fallout and reconstruction support by providing an overview of the actual situation regarding the strategy for return, especially with the transition after the lifting of the evacuation order by the Japanese government. A stage-by-stage progression of the evacuation order and lifting strategy is summarized chronologically in the following three phases: the Emergency Phase in 2011, the Reconstruction Phase from 2013 to 2020, and the Challenging Phase for Lifting All the Evacuation Zones from 2023. Through the lifting strategy of the government, the number of evacuees decreased significantly, especially during the Reconstruction Phase, from 152,113 in May 2013 to 37,826 in May 2020. It is crucial to strengthen support for reconstruction and convey an unbiased and accurate understanding of Fukushima Prefecture by developing a concrete strategy for community development and increasing the size of the exchange population.
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Accidente Nuclear de Fukushima , Japón/epidemiología , Plantas de Energía NuclearRESUMEN
This online survey of unvaccinated people living in Japan aimed to identify the reasons for declining vaccination and to develop effective countermeasures. We conducted a hierarchical class analysis to classify participants, examine factors influencing their classification, and provide the information they needed about coronavirus disease 2019 (COVID-19) and trusted sources of COVID-19 information for each group. A total of 262 participants were classified into three groups: Group 1 with no specific reason (28 participants, 10.69%); Group 2 with clear concerns about trust in the vaccine (85 participants, 32.44%), and Group 3 with attitudinal barriers, such as distrust of the vaccine and complacency towards COVID-19, and structural barriers, such as vaccination appointments (149 participants, 56.87%). For each group, females tended to be classified in Group 2 more than Group 1 (Odds ratio (OR) [95% confidential intervals (95%CI)] = 1.64 (0.63 to 2.66), p = 0.001) and in Group 3 more than Group 1 (OR [95%CI] = 1.16 (0.19 to 2.12), p = 0.019). The information that the participants wanted to know about COVID-19 was different among each group (Safety: p < 0.001, Efficacy: p < 0.001, Genetic effects: p < 0.001). Those who did not receive the COVID-19 vaccine also had lower influenza vaccination coverage (8.02%). Additionally, 38 participants (14.50%) were subject to social disadvantages because they had not received the COVID-19 vaccine. Countermeasures should be carefully tailored according to the target population, reasons for hesitancy, and specific context. The findings of this study may help develop individualized countermeasures to address vaccine hesitancy.
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BACKGROUND: Approximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs are limited. This study aimed to identify the effectiveness of a community-based simple educational program run by non-healthcare trained staff for several outcomes associated with NCDs in a resource-limited area. METHODS: Six villages in the Narail district in Bangladesh were selected, two each in the first and second intervention and the control groups, in the Narail district in Bangladesh were selected. Pre- and post-intervention survey data were collected. The first intervention group received the "strong" educational intervention that included a checklist poster on the wall, phone call messages, personalized advice papers, seminar videos, and face-to-face seminars. The second intervention group received a "weak" intervention that included only a checklist poster on the wall in their house. The outcome was the proportion of NCDs and changes in systolic blood pressure and blood sugar level. Confidential fixed-effects logistic regression and multiple linear regression were performed to identify the effectiveness of the intervention. RESULTS: Overall, 600 participants completed the baseline survey and the follow-up survey. The mean systolic blood pressure reduced by 7.3 mm Hg (95% confidence interval [CI] 4.6-9.9) in the first intervention group, 1.9 mm Hg (95% CI - 0.5-4.2) in the second intervention group, and 4.7 mm Hg (95% CI 2.4-7.0) in the control group. Multiple linear regression analysis showed that the between-group differences in the decline in systolic blood pressure were significant for the first intervention versus control (p = 0.001), but not for the second intervention versus control (p = 0.21). The between-group differences in the reduction in blood glucose after the intervention, were not significant on multiple linear regression analysis. CONCLUSIONS: Community-based educational interventions for NCDs provided by non-healthcare staff improved the outcomes of hypertension and risk behaviors. Well-designed community-based educational interventions should be frequently implemented to reduce NCDs in rural areas of low- and middle-income countries. Trial registration UMIN Clinical Trials Registry (UMIN-CTR; UMIN000050171) retrospectively registered on January 29, 2023.
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BackgroundLittle information is available on the role of community-based rehabilitation after a nuclear disaster. Here, we report the case of an older couple living in an area repopulated after the Fukushima nuclear disaster of 2011 who received outpatient rehabilitation.Case presentationAn 84-year-old woman underwent total hip arthroplasty (THA) after she fell and sustained a trochanteric fracture while caring for her husband with Alzheimer's disease. The 85-year-old husband experienced worsening behavioral and psychological symptoms of dementia (BPSD) following his wife's hospitalization. The couple received rehabilitation at an outpatient facility in a nearby village using a shuttle service. The woman's postoperative anxiety was relieved and her physical function improved. Moreover, the husband's BPSD symptoms decreased.ConclusionA wife and husband showed improvement in physical function after THA and alleviation of BPSD, respectively, following rehabilitation. In post-disaster, resource-scarce areas, older adults may benefit from utilizing the outpatient rehabilitation services available in the surrounding area.
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Accidente Nuclear de Fukushima , Anciano de 80 o más Años , Femenino , Humanos , Pacientes AmbulatoriosRESUMEN
Introduction: Vaccination has been implemented as a useful measure to combat the COVID-19 pandemic. However, there is a tendency for individuals to avoid vaccination due to the possibility of adverse events, making it important to investigate the relationship between COVID-19 vaccines and their adverse events. This study explored longitudinal adverse event patterns and factors that influence adverse events following the second to fourth doses of the COVID-19 vaccine through a latent class analysis. Methods: Participants were recruited from the Fukushima Prefecture and included individuals who had completed four doses of the COVID-19 mRNA vaccine. This study utilized data from questionnaire surveys and blood collection conducted between September 2021 and November 2022. In the questionnaire, factors such as sex, age, medical history, medication, type of vaccine administered, and adverse events following vaccination were recorded. Additionally, in the blood data, serological tests [IgG(S)] and cellular immune responses (T-spot) were measured. Descriptive statistics, latent class analysis, multivariable logistic regression, and multiple regression analyses were performed to identify the longitudinal adverse event patterns and influencing factors. By analyzing adverse events over time, we identified two distinct groups: those less prone to experiencing adverse events (Group 1) and those more susceptible (Group 2) to latent class analysis. Results: A total of 1,175 participants were included after excluding those without any adverse events. The median age of the participants in Group 1 was 70 years, and in Group 2 it was 51 years. The proportion of female participants was 298 in Group 1 and 353 in Group 2. Patients in Group 2 were significantly younger (p < 0.001) and more likely to be female (p < 0.001) than those in Group 1. Furthermore, the median IgG(S) value after the fourth vaccination was 3,233 AU/mL in Group 1 and 4,059.39 AU/mL in Group 2. The median T-spot value was 15.4 in Group 1 and 28.5 in Group 2. Group 2 showed significantly higher IgG(S) and T-spot values after the fourth vaccination (p < 0.001). Discussion: Our findings suggest that factors other than age, particularly sex and a history of allergies, significantly influence the likelihood of experiencing adverse events. Groups categorized by latent class analysis for longitudinal adverse events are expected to be valuable for optimizing vaccination strategies and formulating public health measures.
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Vacunas contra la COVID-19 , COVID-19 , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Vacunas contra la COVID-19/administración & dosificación , Japón , Análisis de Clases Latentes , Estudios Longitudinales , Encuestas y Cuestionarios , Vacunación/efectos adversosRESUMEN
As we learned during the COVID-19 pandemic, vaccines are one of the most important tools in infectious disease control. To date, an unprecedentedly large volume of high-quality data on COVID-19 vaccinations have been accumulated. For preparedness in future pandemics beyond COVID-19, these valuable datasets should be analyzed to best shape an effective vaccination strategy. We are collecting longitudinal data from a community-based cohort in Fukushima, Japan, that consists of 2,407 individuals who underwent serum sampling two or three times after a two-dose vaccination with either BNT162b2 or mRNA-1273. Using the individually reconstructed time courses of the vaccine-elicited antibody response based on mathematical modeling, we first identified basic demographic and health information that contributed to the main features of the antibody dynamics, i.e., the peak, the duration, and the area under the curve. We showed that these three features of antibody dynamics were partially explained by underlying medical conditions, adverse reactions to vaccinations, and medications, consistent with the findings of previous studies. We then applied to these factors a recently proposed computational method to optimally fit an "antibody score", which resulted in an integer-based score that can be used as a basis for identifying individuals with higher or lower antibody titers from basic demographic and health information. The score can be easily calculated by individuals themselves or by medical practitioners. Although the sensitivity of this score is currently not very high, in the future, as more data become available, it has the potential to identify vulnerable populations and encourage them to get booster vaccinations. Our mathematical model can be extended to any kind of vaccination and therefore can form a basis for policy decisions regarding the distribution of booster vaccines to strengthen immunity in future pandemics.
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Objectives: The purpose of this research is to describe the social demographics and chief complaints of users of a free medical consultation application in Ibaraki Prefecture, where a free medical consultation application was released. Methods: The present study included users of a telehealth application in Ibaraki Prefecture between April 9 and May 17, 2020, during the state of emergency. User background characteristics were descriptively analyzed to clarify individual factors with the potential to act as barriers to equally using innovative solutions. Additionally, the age and consultation time distribution by sex were examined for those who used the application for COVID-19 and non-COVID-19 issues. Results: Most of the participants were in their thirties. Moreover, 72% were female, with most being in their thirties (86%) and the least being in their sixties (45%). The number of consultations was concentrated between 6 p.m. and 10 p.m., with the least between 1 a.m. and 5 a.m. The telehealth application users were mainly females in their thirties and forties. Conclusions: To prevent the widening of health disparities due to the rapid introduction of telehealth, further research is required to identify why the use of the application did not spread beyond the aforementioned user groups.
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This cross-sectional observational study examined the cluster groups of risk behaviors and beliefs associated with non-communicable diseases (NCDs) and the demographic factors that influence these cluster groups. The questionnaire survey was conducted in Lohagara Upazila in Narail District, Bangladesh and included basic demographics and items associated with NCDs. The inclusion criteria for the participants in this study included those who were aged between 20 and 80 years and both sexes. The survey items were based on risk behavior, belief, and improvement behavior. To identify the several cluster groups based on NCD-related behavior and belief patterns, a log-likelihood latent class analysis was conducted. Then, a multinomial regression analysis was performed to identify the factor associated with each cluster group. Of the 600 participants, 231 (38.5%) had hypertension, 87 (14.5%) had diabetes, and 209 (34.8%) had a body mass index of 25 or more. Finally, risk behaviors and beliefs associated with NCDs were classified into three cluster groups: (1) very high-risk group (n = 58); (2) high-risk group (n = 270); and (3) moderate-risk group (n = 272). The very high-risk group was significantly associated with female gender, older age, fewer years spent in education, and the absence of daily medication compared to the moderate-risk group. Educational interventions in rural Bangladesh should be immediately implemented to improve the risk behaviors and beliefs associated with NCDs.
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Many people wish to return to where they used to live after evacuation due to disaster. After the Fukushima nuclear accident in 2011, many residents were forced to evacuate due to concerns about radiation. Subsequently, the evacuation order was lifted, and the government promoted a return policy. However, it has been reported that a considerable number of residents living in evacuation sites or other areas wish to return but are unable to do so. Here, we report three cases of Japanese men and one woman who evacuated after the 2011 nuclear accident in Fukushima. These cases reveal the rapid aging of residents and their health issues. These issues suggest that enhancing medical supply systems and access to medical care can aid in post-disaster reconstruction and residents' returning.
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Desastres , Accidente Nuclear de Fukushima , Masculino , Femenino , Humanos , JapónRESUMEN
BACKGROUND: After a disaster, it is essential to maintain the health care supply levels to minimize the health impact on vulnerable populations. During the 2011 Fukushima Daiichi Nuclear Power Plant accident, hospitals within a 20 km radius were forced to make an immediate evacuation, causing a wide range of short- and long-term health problems. However, there is limited information on how the disaster disrupted the continuity of health care for hospitalized patients in the acute phase of the disaster. CASE PRESENTATION: An 86-year-old Japanese man who needed central venous nutrition, oxygen administration, care to prevent pressure ulcers, skin and suctioning care of the trachea, and full assistance in the basic activities of daily living had been admitted to a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant and experienced Fukushima Daiichi Nuclear Power Plant accident. After the accident, the hospital faced a manpower shortage associated with hospital evacuation, environmental changes caused by infrastructure and medical supply disruptions, and the difficulty of evacuating seriously ill patients. As a result, antibiotics and suction care for aspiration pneumonia could not be appropriately provided to the patient due to lack of caregivers and infrastructure shortages. The patient died before his evacuation was initiated, in the process of hospital evacuation. CONCLUSIONS: This case illustrates that decline in health care supply levels to hospitalized patients before evacuation during the acute phase of a radiation-released disaster may lead to patient fatalities. It is important to maintain the health care supply level even in such situations as the radiation-released disaster; otherwise, patients may experience negative health effects.
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Accidente Nuclear de Fukushima , Masculino , Humanos , Anciano de 80 o más Años , Radio (Anatomía) , Plantas de Energía Nuclear , Actividades Cotidianas , Hospitales , Atención a la Salud , JapónRESUMEN
The objective of this study was to clarify the impact of adverse reactions on immune dynamics. We investigated the pattern of systemic adverse reactions after the second and third coronavirus disease 2019 (COVID-19) vaccinations and their relationship with immunoglobulin G against severe acute respiratory syndrome coronavirus 2 spike 1 protein titers, neutralizing antibody levels, peak cellular responses, and the rate of decrease after the third vaccination in a large-scale community-based cohort in Japan. Participants who received a third vaccination with BNT162b2 (Pfizer/BioNTech) or mRNA-1273 (Moderna), had two blood samples, had not had COVID-19, and had information on adverse reactions after the second and third vaccinations (n = 2198) were enrolled. We collected data on sex, age, adverse reactions, comorbidities, and daily medicine using a questionnaire survey. Participants with many systemic adverse reactions after the second and third vaccinations had significantly higher humoral and cellular immunity in the peak phase. Participants with multiple systemic adverse reactions after the third vaccination had small changes in the geometric values of humoral immunity and had the largest geometric mean of cellar immunity in the decay phase. Systemic adverse reactions after the third vaccination helped achieve high peak values and maintain humoral and cellular immunity. This information may help promote uptake of a third vaccination, even among those who hesitate due to adverse reactions.
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Vacuna BNT162 , COVID-19 , Humanos , Anticuerpos Antivirales , Vacuna BNT162/efectos adversos , Terapias Complementarias , COVID-19/prevención & control , Inmunidad Celular , Inmunidad Humoral , Vacunación/efectos adversosRESUMEN
Intensive vaccination is recommended for populations more vulnerable to COVID-19 infection, although data regarding the built of immunity after vaccination for dialysis patients are lacking. This prospective, observational cohort study of maintenance hemodialysis patients examined IgG antibody levels against the SARS-CoV-2 spike (S1) protein, neutralizing activity, and interferon gamma levels after the third dose of the BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) vaccine. Humoral immunity was repeatedly measured for up to two months. The study includes 58 patients on hemodialysis. Median neutralizing antibodies reached a maximum at 56 and 9 days after booster vaccination with BNT162b2 and mRNA-1273, respectively. The median IgG antibody titer reached a maximum of 3104.38 and 7209.13 AU/mL after 16 days of booster dose, and cellular immunity was positive in 61.9% and 100% of patients with BNT162b2 and mRNA-1273 vaccination, respectively. By repeating the measurements over a period of two months, we clarified the chronological aspects of the acquisition of humoral immunity in dialysis patients after a booster COVID-19 vaccination; most dialysis patients acquired not only humoral immunity, but also cellular immunity against SARS-CoV-2. Future research should investigate the continued long-term dynamics of antibody titers and cellular immunity after the third or further vaccinations, evaluating the need for additional vaccinations for hemodialysis patients.
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Although studies have demonstrated that infections with various viruses, bacteria, and parasites can modulate the immune system, no study has investigated changes in antibodies against microbial antigens after the COVID-19 mRNA vaccination. IgG antibodies against microbial antigens in the blood of vaccinees were comprehensively analyzed using microbial protein microarrays that carried approximately 5000 microbe-derived proteins. Changes in antibodies against microbial antigens were scrutinized in healthy participants enrolled in the Fukushima Vaccination Community Survey conducted in Fukushima Prefecture, Japan, after their second and third COVID-19 mRNA vaccinations. Antibody profiling of six groups stratified by antibody titer and the remaining neutralizing antibodies was also performed to study the dynamics of neutralizing antibodies against SARS-CoV-2 and the changes in antibodies against microbial antigens. The results showed that changes in antibodies against microbial antigens other than SARS-CoV-2 antigens were extremely limited after COVID-19 vaccination. In addition, antibodies against a staphylococcal complement inhibitor have been identified as microbial antigens that are associated with increased levels of neutralizing antibodies against SARS-CoV-2. These antibodies may be a predictor of the maintenance of neutralizing antibodies following the administration of a COVID-19 mRNA vaccine.
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Booster vaccination reduces the incidence of severe cases and mortality related to COVID-19, with cellular immunity playing an important role. However, little is known about the proportion of the population that has achieved cellular immunity after booster vaccination. Thus, we conducted a Fukushima cohort database and assessed humoral and cellular immunity in 2526 residents and healthcare workers in Fukushima Prefecture in Japan through continuous blood collection every 3 months from September 2021. We identified the proportion of people with induced cellular immunity after booster vaccination using the T-SPOT.COVID test, and analyzed their background characteristics. Among 1089 participants, 64.3% (700/1089) had reactive cellular immunity after booster vaccination. Multivariable analysis revealed the following independent predictors of reactive cellular immunity: age < 40 years (adjusted odds ratio: 1.81; 95% confidence interval: 1.19-2.75; p-value: 0.005) and adverse reactions after vaccination (1.92, 1.19-3.09, 0.007). Notably, despite IgG(S) and neutralizing antibody titers of ≥500 AU/mL, 33.9% (349/1031) and 33.5% (341/1017) of participants, respectively, did not have reactive cellular immunity. In summary, this is the first study to evaluate cellular immunity at the population level after booster vaccination using the T-SPOT.COVID test, albeit with several limitations. Future studies will need to evaluate previously infected subjects and their T-cell subsets.
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Physicians play an active role in public health. However, there is a limit to the knowledge and experience that can be gained through hospital work alone. This was a secondary data analysis from 100,000 doctors in Japan (15,677 respondents). The results of the analysis showed that 898 (8.4%) male and 190 (6.0%) female doctors worked 60 h or more in a week. The percentage of physicians whose spouse was a physician was found to be 31.4% (male) and 61.7% (female) (p < 0.001), and the rate of full-time working clinicians was 85.7% (male) and 30.0% (female) (p < 0.001). In the univariate analysis, female's working hours were affected by childbirth and childcare experience (p < 0.001, 95% CI - 10.3 to - 8.4, with "none" as reference) and specialty certification (p < 0.001, 95% CI - 3.5 to - 1.4, with "none" as reference). In the multivariate analysis, physician's working hours were associated with sex (coefficient, - 7.4; 95% CI - 8.3 to - 6.5, with "male as reference), childbirth/childcare (coefficient, - 2.2; 95% CI - 2.9 to - 1.4, with "possession" as reference), and specialty qualification (coefficient - 4.0, 95% CI - 5.0 to - 3.0, with "possession" as reference). To summarize the results of the analysis, work/study motivation of physicians will be facilitated by ensuring adequate learning opportunities and by developing support systems and environments.