RESUMO
INTRODUCTION: Unvaccinated emergency medical services (EMS) personnel are at increased risk of contracting coronavirus disease 2019 (COVID-19) and potentially transmitting the virus to their families, coworkers, and patients. Effective vaccines for the severe acute respiratory syndrome coronavirus 2 virus exist; however, vaccination rates among EMS professionals remain largely unknown. Consequently, we sought to document vaccination rates of EMS professionals and identify predictors of vaccination uptake. METHODS: We conducted a cross-sectional survey of North Carolina EMS professionals after the COVID-19 vaccines were widely available. The survey assessed vaccination status as well as beliefs regarding COVID-19 illness and vaccine effectiveness. Prediction of vaccine uptake was modeled using logistic regression. RESULTS: A total of 860 EMS professionals completed the survey, of whom 74.7% reported receiving the COVID-19 vaccination. Most respondents believed that COVID-19 is a serious threat to the population, that they are personally at higher risk of infection, that vaccine side effects are outweighed by illness prevention, and the vaccine is safe and effective. Despite this, only 18.7% supported mandatory vaccination for EMS professionals. Statistically significant differences were observed between the vaccinated and unvaccinated groups regarding vaccine safety and effectiveness, recall of employer vaccine recommendation, perceived risk of infection, degree of threat to the population, and trust in government to take actions to limit the spread of disease. Unvaccinated respondents cited reasons such as belief in personal health and natural immunity as protectors against infection, concerns about vaccine safety and effectiveness, inadequate vaccine knowledge, and lack of an employer mandate for declining the vaccine. Predictors of vaccination included belief in vaccine safety (odds ratio [OR] 5.5, P=<0.001) and effectiveness (OR 4.6, P=<0.001); importance of vaccination to protect patients (OR 15.5, P=<0.001); perceived personal risk of infection (OR 1.8, P=0.04); previous receipt of influenza vaccine (OR 2.5, P=0.003); and sufficient knowledge to make an informed decision about vaccination (OR 2.4, P=0.024). CONCLUSION: In this survey of EMS professionals, over a quarter remained unvaccinated for COVID-19. Given the identified predictors of vaccine acceptance, EMS systems should focus on countering misinformation through employee educational campaigns as well as on developing policies regarding workforce immunization requirements.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Serviços Médicos de Emergência , Pessoal de Saúde , Vacinação , COVID-19/prevenção & controle , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , Vacinas contra COVID-19/provisão & distribuição , Estudos Transversais , Tomada de Decisões , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Vacinas contra Influenza/administração & dosagem , North Carolina , Saúde Ocupacional , Segurança do Paciente , Vacinação/legislação & jurisprudência , Vacinação/psicologia , Vacinação/estatística & dados numéricosAssuntos
Vacinas contra COVID-19/provisão & distribuição , COVID-19 , Controle de Doenças Transmissíveis , Saúde Global , Cobertura Vacinal/organização & administração , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/legislação & jurisprudência , Controle de Doenças Transmissíveis/organização & administração , Regulamentação Governamental , Iniquidades em Saúde , Humanos , Agências Internacionais , Determinação de Necessidades de Cuidados de Saúde/legislação & jurisprudência , SARS-CoV-2Assuntos
Vacinas contra COVID-19/provisão & distribuição , COVID-19 , Saúde Global/ética , Cooperação Internacional , Invenções , Cobertura Vacinal/organização & administração , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Propriedade Intelectual , Invenções/ética , Invenções/tendências , Determinação de Necessidades de Cuidados de Saúde , SARS-CoV-2RESUMO
Patients with mental illness are at an increased risk of COVID-19 infection, morbidity, and mortality, and prioritisation of this group for COVID-19 vaccination programmes has therefore been suggested. Vaccine uptake may, however, be compromised by vaccine hesitancy amongst patients with mental illness, posing a critical public health issue. We conducted two surveys to provide weighted estimates of vaccine willingness amongst patients with mental illness and the general population of Denmark. Vaccine willingness was high in both groups, but slightly lower amongst patients with mental illness (84.8%), compared with the general population (89.5%) (p < .001). Based on these findings, vaccine hesitancy does not appear to be a major barrier for vaccine uptake amongst patients with mental illness in Denmark, but may be so in other countries with lower general vaccine willingness. Replication of the present study in other countries is strongly warranted.
Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/psicologia , Transtornos Mentais/imunologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/provisão & distribuição , Estudos de Casos e Controles , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/mortalidade , Transtornos Mentais/virologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Inquéritos e QuestionáriosAssuntos
Pesquisa Biomédica/organização & administração , Pesquisa Biomédica/tendências , Vacinas/provisão & distribuição , África/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/economia , Vacinas contra COVID-19/provisão & distribuição , Países Desenvolvidos/economia , Países em Desenvolvimento/economia , Indústria Farmacêutica/tendências , Humanos , Setor Público , Pesquisadores , Vacinas/economia , Organização Mundial da Saúde/organização & administraçãoAssuntos
Vacinas contra COVID-19/provisão & distribuição , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/organização & administração , Prioridades em Saúde , Cobertura Vacinal/economia , Cobertura Vacinal/organização & administração , Comitês Consultivos , HumanosRESUMO
BACKGROUND: The equality in the distribution of vaccines between and within countries along with follow sanitation tips and observe social distance, are effective strategies to rid the world of COVID-19 pandemic. Inequality in the distribution of COVID-19 vaccine, in addition to causing inequity to the population health, has a significant impact on the process of economic recovery. METHODS: All published original papers on the inequality of Covid-19 vaccine distribution and the factors affecting it were searched in PubMed, Web of Science, Scopus and ProQuest databases between December 2020 to 30 May 2022. Selection of articles, extraction of their data and qualitative assessment (by STROBE) were performed by two researchers separately. Data graphing form was used to extract detailed data from each study and then, the collected data were classified. RESULTS: A total of 4623 articles were evaluated. After removing duplicates and screening the title, abstract and full text of articles, 22 articles were selected and entered into the study. Fifteen (68.17%) studies were conducted in the United States, three (13.64%) in Europe, three (13.64%) in Asia and one (6.66%) in Oceania. Factors affecting the inequality in the distribution of COVID-19 vaccine were classified into macro and micro levels determinants. CONCLUSION: Macro determinants of inequality in the Covid-19 vaccine distribution were consisted of economic (stability and country's economic status, Gross Domestic Product (GDP) per capita, financial support and human development index), infrastructure and health system (appropriate information system, functional cold chains in vaccine transport, transport infrastructure, medical and non-medical facilities per capita, healthcare access and quality), legal and politics (vaccination allocation rules, health policies, political ideology and racial bias), and epidemiologic and demographic factors (Covid-19 incidence and deaths rate, life expectancy, vulnerability to Covid-19, working in medical setting, comorbidities, social vulnerability, incarceration and education index). Moreover, micro/ individual level factors were included in economic (household's income, home ownership, employment, poverty, access to healthy food and residency in the deprived areas) and demographic and social characteristics (sex, age, race, ethnic, religion, disability, location (urban/rural) and insurance coverage).
Assuntos
Vacinas contra COVID-19 , COVID-19 , Disparidades em Assistência à Saúde , Ásia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/provisão & distribuição , Demografia , Europa (Continente) , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Oceania , Fatores Socioeconômicos , Estados UnidosAssuntos
Vacinas contra COVID-19 , COVID-19 , SARS-CoV-2 , COVID-19/imunologia , COVID-19/prevenção & controle , COVID-19/virologia , Vacinas contra COVID-19/genética , Vacinas contra COVID-19/imunologia , Vacinas contra COVID-19/provisão & distribuição , Humanos , SARS-CoV-2/classificação , SARS-CoV-2/genética , SARS-CoV-2/imunologiaRESUMO
With limited availability of vaccines, an efficient use of the limited supply of vaccines in order to achieve herd immunity will be an important tool to combat the wide-spread prevalence of COVID-19. Here, we compare a selection of strategies for vaccine distribution, including a novel targeted vaccination approach (EHR) that provides a noticeable increase in vaccine impact on disease spread compared to age-prioritized and random selection vaccination schemes. Using high-fidelity individual-based computer simulations with Oslo, Norway as an example, we find that for a community reproductive number in a setting where the base pre-vaccination reproduction number R = 2.1 without population immunity, the EHR method reaches herd immunity at 48% of the population vaccinated with 90% efficiency, whereas the common age-prioritized approach needs 89%, and a population-wide random selection approach requires 61%. We find that age-based strategies have a substantially weaker impact on epidemic spread and struggle to achieve herd immunity under the majority of conditions. Furthermore, the vaccination of minors is essential to achieving herd immunity, even for ideal vaccines providing 100% protection.
Assuntos
Vacinas contra COVID-19/provisão & distribuição , COVID-19/prevenção & controle , COVID-19/genética , COVID-19/imunologia , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/farmacologia , Epidemias , Humanos , Imunidade Coletiva/imunologia , Modelos Teóricos , SARS-CoV-2/imunologia , SARS-CoV-2/patogenicidade , Vacinação , VacinasAssuntos
Vacinas contra COVID-19/provisão & distribuição , União Europeia , Cooperação Internacional , Patentes como Assunto/legislação & jurisprudência , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/economia , Humanos , Cooperação Internacional/legislação & jurisprudência , Licenciamento , Organizações , Fatores de TempoAssuntos
Vacinas contra COVID-19 , COVID-19/prevenção & controle , Educação em Saúde , Campos de Refugiados , Refugiados , Saúde da Mulher , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/provisão & distribuição , Comunicação , Feminino , Humanos , Programas de Imunização , Masculino , Distribuição por Sexo , Fatores SexuaisAssuntos
Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/provisão & distribuição , COVID-19/prevenção & controle , Saúde Global , Programas de Imunização , COVID-19/imunologia , COVID-19/mortalidade , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Saúde Global/estatística & dados numéricos , Saúde Global/tendências , Objetivos , Humanos , Programas de Imunização/estatística & dados numéricos , Programas de Imunização/tendências , Instalações Industriais e de Manufatura/provisão & distribuição , Fatores de Tempo , Hesitação Vacinal/estatística & dados numéricos , Populações VulneráveisAssuntos
Vacinas contra COVID-19 , COVID-19/prevenção & controle , Países em Desenvolvimento , Pesquisa Biomédica , COVID-19/economia , COVID-19/epidemiologia , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/provisão & distribuição , Uso do Telefone Celular , Controle de Doenças Transmissíveis , Humanos , Índia/epidemiologia , Máscaras , Cobertura Vacinal , Hesitação VacinalAssuntos
Anticorpos Monoclonais/uso terapêutico , Tratamento Farmacológico da COVID-19 , Vacinas contra COVID-19/provisão & distribuição , COVID-19 , Países em Desenvolvimento , Farmacorresistência Viral , Disparidades em Assistência à Saúde , Programas de Imunização/organização & administração , Anticorpos Monoclonais/farmacologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Transmissão de Doença Infecciosa , Quimioterapia Combinada , Humanos , Mutação , SARS-CoV-2/efeitos dos fármacos , Glicoproteína da Espícula de Coronavírus/genética , Desenvolvimento de VacinasRESUMO
Pathogen samples and scientific data are bargaining chips in a global argument about who gets what in a pandemic.