The role of social value orientation in modulating vaccine uptake in the COVID-19 pandemic: A cross-sectional study.

COVID-19 vaccination is the only pharmaceutical measure available to control the pandemic and move past the current crisis. As such, the Maldives, a small island country, invested heavily on securing and vaccinating the eligible population through an intensive risk communication campaign to create awareness on vaccination benefits. This paper reports on the vaccine coverage after a year of COVID-19 vaccine being introduced into the country, based on data obtained from the Values in Crisis Survey - Wave Two among Maldivian adults (n = 497). The findings show a vaccine coverage of 94%, with only 2.2% of the respondents indicating they will not get vaccinated. No significant differences were observed by age, gender, income earning, educational status or residential area. No significant relationship was observed in vaccine behaviour and confidence in government, health sector and experts. Social value orientations, particularly conservation and self-transcendence value orientations determined positive vaccine behaviour (r s = 0.180, p < 0.01 and 0.136 p < 0.01 respectively), yet conservation was the only predictor that contributed significantly to the regression model (B = 0.158, p < 0.01). The findings indicate that, despite the uncertainties around COVID-19 vaccinations, the prosocial value orientations were instrumental in achieving a high COVID-19 vaccine coverage. Further theoretical and conceptual exploration of vaccine behaviour in crisis situations is needed to inform future pandemic situations. The vaccination rollout and behaviour change strategies also need an examination of social value orientations in order to achieve a high coverage and sustain pro-vaccine behaviour post-pandemic.

A sero-epidemiological study after two waves of the COVID-19 epidemic.

BACKGROUND: The COVID-19 situation in Maldives have evolved since the epidemic began in March 2020 with unprecedented increase in cases since mid-July 2019 with over 8000 cases at the end of August 2020. OBJECTIVE: The aim of the sero-epidemiological investigation is to obtain a sense of the population exposure to the SARS-CoV-2 by measuring the seroprevalence of antibodies to COVID-19 in the general population. METHODS: A population-based, age-stratified prospective method was employed to find out the key epidemiological and serologic characteristics of COVID-19 virus in this study. RESULTS: The results showed that seroprevalence in the population was 13%. The factors that were associated with antibody results included age (OR: 4.0, CI: 1.7-9.0), nationality (OR: 12.9, CI: 8.3-19.7), being diagnosed for COVID-19 (OR: 24.7, CI: 15.9-38.4) and having symptoms of COVID-19 (OR: 2.0, CI: 1.5-2.8). There was a gradual decrease in the antibody levels from 19 days to 250 days. The mean duration of the presence of antibodies in this study was found to be 124 days. CONCLUSIONS: While the seroprevalence provides a measure that can be used to predict community transmission risk of the disease, the extent of functional immunity provided by antibody titres is still not clear. It is acknowledged that other mechanisms of protection such as T cell mediated immunity will play an important role in providing individual protection.

Maternal Depression and Breastfeeding Practices in the Maldives.

OBJECTIVES: To assess associations between maternal depression and breastfeeding practices in mothers in the Maldives. DESIGN: A prospective cohort study. The validated questionnaires contained information on demographics, breastfeeding initiation, breastfeeding duration, and the Edinburgh Postnatal Depression Scale. Logistic regression analyses were used to assess association between Edinburgh Postnatal Depression Scale score and breastfeeding practices while adjusting for lifestyle determinants. Cox regression was done to measure the association between maternal depression and breastfeeding duration. SETTINGS: Antenatal clinic at Indira Gandhi Memorial and ADK Hospitals in Male', Maldives. SUBJECTS: A total of 458 mothers from the antennal clinics were interviewed at 36 weeks of gestation and again at 1, 3, and 6 months after birth. RESULTS: Antenatal depression at 36 weeks of gestation was associated with late initiation of breastfeeding (adjusted odds ratio = 3.0, 95% confidence interval = 1.3-6.8). Postnatal depression was associated with shorter duration of exclusive, full, and any breastfeeding ( P < .001). CONCLUSION: Depression is negatively associated with breastfeeding practices. There is a need to manage antenatal postnatal depression in mothers in order to encourage them to initiate breastfeeding earlier and to breastfeed for longer.