Influenza vaccine acceptance by healthcare workers in Saudi Arabia: A questionnaire-based analysis.

The aim of this study was to gauge the reasons for accepting or declining influenza vaccine in healthcare staff in Saudi Arabia. A questionnaire was administered to healthcare workers in Saudi Arabia. In all, 633 respondents who provided gender, nationality and profession were included. Reasons for vaccine uptake or refusal were assessed according to profession and educational level. Uptake of vaccine was lower in the period from 2010 to 2014 (3-13.3%) compared to pre-2010 figures (20.7%), rising to 44.1% in 2015. Comparing data for 'never having been vaccinated' to 'being vaccinated in 2015', there was no significant difference in distribution between nurses (9.27% v 38.8%), physicians (13.9% v 56.0%) and laboratory technicians (15.9% v 33.5%) (p= 0.08). The top reason for vaccination was protection of self and family, while the top reason for refusal was not considering the vaccine to be necessary. Education level had no significant effect on the likelihood of being vaccinated. Improvement of healthcare worker vaccination levels in Saudi Arabia might be achieved by addressing staff concerns on vaccine safety and efficacy, emphasizing the potential dangers of influenza and capitalizing on the staff's focus on protecting themselves and their families.

A review of candidate therapies for Middle East respiratory syndrome from a molecular perspective.

There have been 2040 laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) in 27 countries, with a mortality rate of 34.9 %. There is no specific therapy. The current therapies have mainly been adapted from severe acute respiratory syndrome (SARS-CoV) treatments, including broad-spectrum antibiotics, corticosteroids, interferons, ribavirin, lopinavir-ritonavir or mycophenolate mofetil, and have not been subject to well-organized clinical trials. The development of specific therapies and vaccines is therefore urgently required. We examine existing and potential therapies and vaccines from a molecular perspective. These include viral S protein targeting; inhibitors of host proteases, including TMPRSS2, cathepsin L and furin protease, and of viral M(pro) and the PL(pro) proteases; convalescent plasma; and vaccine candidates. The Medline database was searched using combinations and variations of terms, including 'Middle East respiratory syndrome coronavirus', 'MERS-CoV', 'SARS', 'therapy', 'molecular', 'vaccine', 'prophylactic', 'S protein', 'DPP4', 'heptad repeat', 'protease', 'inhibitor', 'anti-viral', 'broad-spectrum', 'interferon', 'convalescent plasma', 'lopinavir ritonavir', 'antibodies', 'antiviral peptides' and 'live attenuated viruses'. There are many options for the development of MERS-CoV-specific therapies. Currently, MERS-CoV is not considered to have pandemic potential. However, the high mortality rate and potential for mutations that could increase transmissibility give urgency to the search for direct, effective therapies. Well-designed and controlled clinical trials are needed, both for existing therapies and for prospective direct therapies.