Tag: vaccine hesitancy

Just Ask: Many Patients in the ED are Open to Flu Vaccination

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Simply asking patients to get the flu vaccine, and combining it with helpful video and print messages, is enough to persuade many who visit emergency departments to roll up their sleeves, according to a new study published in NEJM Evidence.

Researchers led by UC San Francisco found a 32% vaccine uptake in patients who were asked if they’d be interested in getting the flu shot and told their health providers would be informed.

They saw a 41% uptake for those who were asked about receiving a flu shot and received a pamphlet, watched a three-minute video of a physician with a similar ethnic background discussing the vaccine and were told about the benefits of the vaccine.

The researchers say this type of systematic approach could lead to more underserved people receiving vaccines, especially those whose primary health care occurs in emergency departments.

Flu can be fatal

Annual mortality rates from flu are typically in the tens of thousands in the U.S., especially when combined with pneumonia – but vaccination is particularly low among underserved populations and those whose primary care occurs in emergency departments.

Such patients often face general vaccine hesitancy or a lack of opportunities for the flu shot.

“This research arose from our desire to address the health disparities that we see every day in our emergency department, especially among homeless persons, the uninsured and immigrant populations,” said first author, Robert M. Rodriguez, MD, a professor of Emergency Medicine with the UCSF School of Medicine.

The researchers designed the clinical trial to span a single flu season between October 2022 and February 2023.

Investigators in the study created flu vaccine messaging – including a brief video, flyer and a scripted health provider question, “Would you be willing to accept the influenza vaccine?” – and assessed their effectiveness among nearly 800 patients in five cities: San Francisco, Houston, Philadelphia, Seattle and Durham, North Carolina.

The median age was 46, and more than half the participants in the trial were Black or Latino, 16 % lacked health insurance, nearly a third had no primary care and 9% were homeless or living in severely inadequate housing. These demographic characteristics are similar to patient populations often served by urban emergency departments.

“Overall, our study adds to the growing body of knowledge showing that a number of important public health interventions can and should be delivered to underserved populations in emergency departments,” said Rodriguez, whose previous research has found the effectiveness of delivering similar COVID-19 vaccine messaging to emergency department patients.

Source: University of California – San Francisco

Vaccine Acceptance is Sometimes Influenced in Unexpected Ways

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Using simulations, researchers at Vanderbilt University have uncovered new insights into vaccine hesitancy have shown that external factors such as vaccine mandates and availability have varied and sometimes contradictory influences on people’s willingness to get vaccinated. The research was published in the journal PLOS Global Public Health, and the simulations are available to be reviewed on GitHub.

Building on a new mathematical model that represents vaccine hesitancy as a belief that can influence whether parents vaccinate their children, Nicole Creanza, assistant professor of biological sciences, and postdoctoral scholar Kerri-Ann Anderson extended their work to include the effect of external factors that affect vaccine availability, such as vaccine mandates and vaccine inaccessibility.

“Instead of modelling vaccine mandates and inaccessibility as a physical driver or barrier to vaccination, respectively, we considered their effects from a cultural perspective,” Anderson said. “We model the effects of these external factors by considering how beliefs interact with them to shape vaccination behaviours. Our data shows that a vaccine mandate has a lesser consequence on a person’s motivation to vaccinate if they already had very positive feelings about vaccines.”

The findings also demonstrate that when large groups trust vaccines, they usually get vaccinated. But if there aren’t enough vaccines, even those who trust them might not get them. In addition, when vaccine mandates are in place, it can seem like everyone is getting vaccinated. But more people than researchers expected might still be unsure about vaccines and not get them.

“We hope that our research emphasises how important it is to not generalise populations based on a single characteristic or assume populations behave similarly or beliefs have similar influences across varying circumstances,” Anderson said.

“This research provides a better understanding of how public health policies could interact with cultural dynamics to bring about unexpected outcomes,” Creanza said. The research was funded by the John Templeton Foundation, and both researchers are members of the Evolutionary Studies Initiative.

Next, Creanza and Anderson aim to make a model to explore how people respond when a new vaccine (eg for COVID), is introduced. When a novel vaccine is initially introduced, people tend to exhibit more unpredictable behaviour, even those who have confidence in established vaccines, Creanza said.

Source: Vanderbilt University

After COVID, Trust in Vaccines has Plunged in Sub-Saharan Africa

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In a concerning trend, a study of 17 000 people has revealed that public confidence in vaccines has plunged across sub-Saharan Africa since the COVID pandemic. The study, published in Human Vaccines & Immunotherapeutics, covered eight countries including South Africa – which saw one of the biggest falls in trust.

The findings come as the World Health Organization and UNICEF have reported the largest sustained fall in uptake of routine childhood immunisations in three decades. Six million fewer children in Africa received routine shots for diseases including tetanus, polio, diphtheria and measles over the past two years, and rising outbreaks threaten to reverse decades of progress against preventable diseases. 

Previously, this was attributed to pdisruption of vaccination programs by the pandemic – however these new findings, which followed a study carried out by a team from London School of Hygiene & Tropical Medicine (LSHTM) and the Africa Centres for Disease Control and Prevention, suggest there could be other possible reasons too. 

“Our study paints a worrying picture of declining vaccine confidence trends across many sub-national regions in sub-Saharan Africa, notably in the Democratic Republic of Congo, where confidence losses are particularly large,” states lead author Dr Alex de Figueirido, a Research Fellow at LSHTM. 

The team’s results could be an early warning sign of wider scale loss in vaccine confidence, say the authors. Critically, regional losses in confidence – as seen in this study – could lead to clusters of non-vaccinated people which could have a negative impact on ‘herd immunity’ – the point at which a population is protected from a disease, either by enough people being vaccinated or by people having developed antibodies through having the disease.  

The research involved face-to-face interviews with over 17 000 adults across eight sub-Saharan African countries: the Democratic Republic of Congo (DRC), Ivory Coast, Kenya, Niger, Nigeria, Senegal, South Africa and Uganda. The experts used sampling methods to get an accurate cross section of the population and to gain a picture of vaccine confidence at both national and regional levels. 

Interviewees’ age, sex, religion, employment status and highest education level were recorded to help the researchers to analyse whether social background affected confidence in vaccines. The interviews were carried out in 2020 and again in 2022, after the pandemic. 

Respondents were asked to say how strongly they agreed with statements such as ‘Vaccines are important for all ages’, ‘Vaccines are important for children’ and ‘Vaccines are safe’. They were also asked specifically about COVID vaccines, rating their agreement that COVID vaccines would be important, safe and effective – both before they had been developed (in 2020) and then after they had been developed and rolled out, in 2022. 

Findings showed a fall in people’s view that vaccines are important for children across all eight countries between 2020 and 2022, particularly in DRC (20% decline), followed by Uganda (14%) and Nigeria (10.5%). In Nigeria and DRC, public confidence in vaccine safety and effectiveness also declined, and fewer people agreed that ‘vaccines are important for all ages’ in Ivory Coast, Kenya, Nigeria, South African and Uganda.  

When it came to COVID vaccines, people thought they were less important in 2022 than they had in 2020 in seven out of the eight countries, with the biggest loss of trust in DRC, South Africa and Uganda. People in DRC, Kenya, Niger, Senegal and Nigeria thought that the COVID vaccine was less effective in 2022 than they had expected it to be in 2020. However, trust in the safety of the COVID vaccine stayed consistent over the two years.  

In 2022, the over-60s were more likely than younger adults to agree that vaccines are generally safe, effective and important for children, but no other links were found between vaccine confidence and sex, education, employment status or religious affiliation.  

“Early warning signals of confidence losses – such as those detected in this study – can provide time to respond, in the case of other epidemics, pandemics or other emerging crises,” adds co-author, Professor of Anthropology, Risk and Decision Science Heidi Larson, who is the Founding Director of the Vaccine Confidence Project at LSHTM. 

“Confidence monitoring at sub-national resolutions can also provide clearer signals to the regions and groups facing confidence losses and can better prepare policymakers and stakeholders for potential losses in vaccine uptake.” 

A thorough investigation is now needed to find out whether loss of confidence in COVID vaccines will trigger mistrust of other immunisation programmes, say the study authors.  

“Considering global decreases in routine immunisation rates over the past two years, vaccine confidence losses could prove to be highly disruptive at this time when there are concerted efforts to address losses in routine immunization rates post pandemic. We need to understand the impact of the COVID pandemic on confidence in routine immunisation programmes, not just in Africa, but across the world,” says Dr Defigueirido. 

“Understanding the role of the COVID pandemic and associated policies on wider vaccine confidence can inform post-COVID vaccination strategies and help rebuild immunisation system resilience.”

Source: EurekAlert!

Increase in Global Willingness to Accept COVID Vaccines

Vaccine injection
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Global COVID vaccine acceptance increased from 75.2% in 2021 to 79.1% in 2022, according to a new survey of 23 countries accounting for more than 60% of the world’s population, published today in Nature Medicine. It was not all good news, though: vaccine hesitancy increased in eight countries including South Africa, and nearly one in eight vaccinated respondents were hesitant about receiving a booster dose.

This third annual study reveals a wide variability between countries and suggests a need to tailor communication strategies to effectively address vaccine hesitancy.

“The pandemic is not over, and authorities must urgently address vaccine hesitancy and resistance as part of their COVID prevention and mitigation strategy,” says CUNY Graduate School of Public Health and Health Policy (CUNY SPH) Senior Scholar Jeffrey V. Lazarus. “But to do so effectively, policymakers need solid data on vaccine hesitancy trends and drivers.”

To provide these data, an international collaboration led by Lazarus and CUNY SPH Dean Ayman El-Mohandes performed a series of surveys starting in 2020 in 23 countries which were impacted significantly by the pandemic, including the United States as well as South Africa and Brazil.

Of the 23 000 respondents (1000 per country surveyed), 79.1% were willing to accept vaccination, up 5.2% from June 2021. The willingness of parents to vaccinate their children also increased slightly, from 67.6% in 2021 to 69.5% in 2022. However, eight countries saw an increase in hesitancy (from 1.0% in the UK to 21.1% in South Africa). Worryingly, almost one in eight (12.1%) vaccinated respondents were hesitant about booster doses, and booster hesitancy was higher among the 18–29 age groups.

“We must remain vigilant in tracking this data, containing COVID variants and addressing hesitancy, which may challenge future routine COVID immunisation programs,” says Dean El-Mohandes, the study’s senior author.

The survey also provides new information on COVID treatments received. Globally, ivermectin was used as frequently as other approved medications, despite the fact that it is not recommended by the WHO or other agencies to prevent or treat COVID  

Also of note, almost 40% of respondents reported paying less attention to new COVID information than before, and there was less support for vaccine mandates. 

In some countries, vaccine hesitancy was associated with being female (for example in China, Poland, Russia), having no university degree (in France, Poland, South Africa, Sweden, or the US), or lower income (in Canada, Germany, Turkey or the UK). Also, the profile of people paying less attention to the pandemic varied between countries.

“Our results show that public health strategies to enhance booster coverage will need to be more sophisticated and adaptable for each setting and target population,” says Lazarus, also head of the Health Systems Research Group at ISGlobal. “Strategies to enhance vaccine acceptance should include messages that emphasise compassion over fear and use trusted messengers, particularly healthcare workers.”

The data provided by these surveys may offer insight to policymakers and public health officials in addressing COVID vaccine hesitancy. The study follows on the heels of a global consensus statement on ending COVID as a public health threat that Lazarus, El-Mohandes and 364 co-authors from 112 countries published in Nature in November.

Source: CUNY SPH

Vaccine Acceptance is Increasing Around the World

Image of a syring for vaccination
Photo by Mika Baumeister on Unsplash

COVID vaccine acceptance across much of the world increased by 3.7% between 2020 and 2021, according to a new study published in Nature Communications.

In a June 2021 survey of over 23 000 individuals across 23 countries, the researchers found that 75.2% of respondents reported vaccine acceptance, up from 71.5% one year earlier.  

The study was carried out during a year of substantial but very unequal global COVID vaccine availability and acceptance, which required new assessments of the drivers of vaccine hesitancy and the characteristics of people not vaccinated.

Vaccine hesitancy was most consistently associated with concerns about vaccine safety and efficacy and mistrust in vaccine development. Other factors associated with vaccine hesitancy varied by country and included personal experience with COVID (eg, sickness or loss of a family member) and demographic characteristics (eg, gender, education, and income).

The authors also found that vaccine hesitancy was not associated with a country’s current COVID case burden and mortality. In June 2021, vaccine hesitancy was reported most frequently in Russia (48.4%), Nigeria (43%), and Poland (40.7%), and least often in China (2.4%), the UK (18.8%), and Canada (20.8%).

“In order to improve global vaccination rates, some countries may at present require people to present proof of vaccination to attend work, school, or indoor activities and events,” said CUNY SPH Senior Scholar Jeffrey Lazarus. “Our results found strong support among participants for requirements targeting international travellers, while support was weakest among participants for requirements for schoolchildren.”

Those who were vaccine-hesitant were also less likely to express support for vaccine mandates. “Importantly, however, recommendations by a doctor, or to a lesser extent by an employer, might have an impact on a respondent’s views on vaccination in some countries,” said CUNY SPH Dean Ayman El-Mohandes.

Although some countries are currently disengaging from evidence-based COVID control measures, the disease has by no means been controlled or ended as a public health threat. The authors note that for ongoing COVID vaccination campaigns to succeed in improving coverage going forward, substantial challenges remain. These include targeting those reporting lower vaccine confidence with evidence-based information campaigns and greatly expanding vaccine access in low- and middle-income countries.

The Role of Social Networks

The researchers also held a meeting to explore vaccine messaging. According to data presented from a European survey carried out by the Vaccine Confidence Project, the population group most exposed to social networks, ie people under 24, with secondary or university studies and living in urban areas, are the most reluctant to be vaccinated. Additionally, messages that call for vaccination as a “moral obligation” are strongly rejected compared to those that call for “protection,” which are more commonly well received.

As with previous studies, humour was shown to be one of the most effective ways to convey anti-vaccine messages. Therefore, participants in the meeting agreed on the need to disseminate the benefits of vaccines using this same tool, but without making fun of those who have mistaken beliefs about vaccines. In the face of misinformation, it is important to improve information on vaccination using simple language and channels that reach the population, such as social networks, the participants concluded.

Source: CUNY Graduate School of Public Health and Health Policy

Up in Smoke: The Tobacco Wars and Lessons for Vaccination Efforts

Tobacco companies waged a massive disinformation campaign to keep people consuming their products. There are parallels with today’s antivaxx movement. Even before the 1964 US Surgeon General’s report on tobacco, the tobacco industry was deflecting health concerns by featuring doctors in their advertising and actively courting the medical industry. This advert is from 1930.

In a perspective piece published in the New England Journal of Medicine, authors find a parallel between the tactics used in the ‘tobacco wars’ and vaccination efforts. In a seeming repeat of history, anti-vaccination groups are using the same tactics the tobacco industry used to defend their products and undermine trust in science, but the successful anti-tobacco campaign holds important lessons for turning the tide against misinformation and normalising vaccination.

In late 2020 when the first COVID vaccines became available, the authors note that surveys indicated that about a third of US adults were keen to be vaccinated, 15% expressed strong resistance to vaccination (a proportion that has stayed fairly constant), and the remainder didn’t harbour strong ideological resistance. Now, about 27% of US adults now remain unvaccinated – and reaching this remainder is an important public health challenge.

The authors believe that the ‘tobacco wars’ can provide perspective. The tobacco industry fuelled preventable deaths by glamourising smoking, with almost 50% of US adults smoking cigarettes in the 1960s.

The current rate of about 12.5% is the result of decades of public health efforts to make tobacco use less socially acceptable. The first US Surgeon General’s report on smoking and health in 1964 was attacked by the tobacco industry. It was only until C. Everett Koop’s overwhelming report in 1986 that cemented tobacco use as a major preventable cause of cancer and death and highlighted the dangers of second-hand smoking.

Koop and others were vilified by the tobacco industry, which mounted a sustained campaign that cast doubts on the science, publicised misinformation, emphasised tobacco’s economic importance, and warned against restricting individual freedom. Industry leaders directly lied about knowing that nicotine was addictive and the lethal dangers of tobacco use. Indeed, from the 1920s to 1950s, in response to growing health concerns, the tobacco industry had actively courted doctors and influenced medical journals, widely reporting positive findings of studies that were deeply flawed. This may have only played into the hands of antivaxxers, creating a historical example of distrust in the medical system.

A 1940s advert showing how ‘doctors’ (probably actors) enjoyed Camel brand cigarettes. With the 1950 publication of studies showing the connection between cancer and tobacco, the public began to be suspicious and such campaigns featuring doctors ended by 1954.

While the focus of the debate was initially on smoking as an individual choice, two 1981 studies on nonsmoking wives of smokers vs nonsmokers revealed the dangers of secondhand smoke and shifted the discourse.

The US Congress has never enacted a federal smoking ban, but did grant the FDA limited authority to regulate tobacco in 2009, enabling restrictions on youth sales.

However, the broad-based effort from all levels of society that were important, discouraging smoking in public settings. This was supplemented by messaging from celebrities, taxation, and even a 1998 legal battle against the tobacco industry.

Efforts undertaken by the antivaccination movement, which is hardly new but is thriving during the COVID pandemic, bear many similarities to strategies used during the tobacco wars. Although not driven by a single industry but a collection of celebrities and social media groups, it sows mistrust in science and promotes conspiracy theories. Misinformation tactics are used that are strikingly similar to the tobacco industry’s, and this time Dr Antony Fauci is vilified instead of Koop.

There are big differences between tobacco control and vaccination; such as taking a long time for smoking interventions to reduce chronic diseases, whereas vaccinations usually reduce hospitalisations and severe illness within days or weeks.

The authors believe that success against antivaccination movement can draw on the tobacco wars’ lessons, illustrating COVID’s harm and the power of vaccines. Getting vaccinated and boosted should be the accepted social norm during a pandemic, they stress.

Drawing on similar efforts for anti-tobacco campaigns, vaccination campaigns using real patients in ICU who express regret over not being vaccinated. Unvaccinated people often assume they can be cared for if they get sick, so messages could also be included from healthcare works talking about the strain of the pandemic.

“There is an opportunity to mount a serious effort to provide accurate vaccination information using the same media channels on which people currently consume misinformation,” they wrote.

They also consider vaccine mandates which make being vaccinated a social norm such as wearing a seatbelt, and other regulations at the community and business level may be more effective.

They note that personal physicians play a key role, being the best way to transmit health information. But many people at risk of remaining unvaccinated have had negative experiences with health care, compounded by doctors spreading misinformation.

The authors note that the dangers of tobacco use were known to public health practitioners for years, but it took a well-funded concerted effort that emphasised the impact on others to achieve a change in behaviour. This is something that needs to be repeated for vaccinations.

“Freedom of choice remains; people can still smoke cigarettes and decline vaccinations. But the roadmap drawn by tobacco-control efforts shows that the public mindset can be tilted toward public health and social good. With vaccination, this work shouldn’t take decades; it needs to begin immediately.”

Source: New England Journal of Medicine

Quebec to Impose Health Tax on The Unvaccinated

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The Canadian province of Quebec will impose a health tax on residents not vaccinated against COVID. The province is experiencing a surge in cases, and its 12 028 deaths as of Tuesday are the highest in Canada.

The province’s Premier Francois Legault announced on Tuesday that it would be the first in the nation to financially penalise the unvaccinated.

Around 12.8% of Quebec residents are unvaccinated, yet make up nearly half of all hospital cases.

At a news conference, the premier said that people who have not had a first vaccine dose will have to pay a “contribution”, which will be “significant”.

“I think right now it’s a question of fairness for the 90% of the population who made some sacrifices,” Mr Legault said. “I think we owe them this kind of measure.”

The province also announced last week that proof of vaccination would be required to shop in government cannabis and liquor stores.

Death rates are similar to January 2021, before widespread vaccinations had begun in the province. Unvaccinated patients make up 45% of COVID ICU cases.

Hospitals in Montreal, the province’s largest city, are nearing 100% capacity and have already started limiting non-Covid related care. Quebec’s positivity rate stands at 20%.

Though such approaches are rare, some unvaccinated individuals in other parts of the world face penalties from their governments.

Greece is set to require those over 60 to pay a €100 (R1750) fine for each month that they remain unvaccinated. Austria is considering an even stiffer €7200 (R126 000) fine for unvaccinated individuals. Unvaccinated COVID patients in Singapore will also have to pay their own medical bills: with ICU stays, this has been estimated at a median of S$25 000 (R287 500).

Source: BBC News

Should Unvaccinated-by-choice COVID Patients Get Less Priority?

Credit: ATS

A new opinion piece provides an exhaustive examination of the ethics of using hospital resources on unvaccinated-by-choice COVID patients with pneumonia, versus patients with other serious but slower illnesses.

In his article published online in the Annals of the American Thoracic Society, William F. Parker, MD, PhD, looked at cases in which hospitals delayed time-sensitive and medically necessary procedures for vaccinated adults when they were overwhelmed with unvaccinated patients who had severe, life-threatening COVID pneumonia and suggested an ethical framework for triaging these patients.

“These vaccinated patients are directly harmed when hospitals use all their resources to care for the many unvaccinated patients with COVID,” he wrote.  “For example, delaying breast cancer surgery by just four weeks increases the relative risk of death from the disease by 8%.”

Dr Parker argues for a contingency care standard prioritising emergency life-support, regardless of vaccination status, in order to save the most lives.  “Simply rejecting the use of vaccination in prioritisation of medical resources without analysis ignores the very real tradeoffs at play during a pandemic.  The pain and suffering of the vaccinated from deferred medical care require a deeper defense of caring for the unvaccinated.”

Eliminating double standards
He stated: “Even though the vast majority of patients who develop life-threatening COVID pneumonia are unvaccinated, hospitals still have ethical obligations to expand capacity and focus operations on caring for them—even if it means making vaccinated patients wait for important but less urgent care like cancer and heart surgeries.”

“If tertiary care centers turn inward and stop taking transfers of COVID patients from overwhelmed community hospitals, this will result in de facto triage in favor of lower benefit care and cause systematic harm to both the vaccinated and unvaccinated in vulnerable communities,” he adds.  “Hospitals must justify their nonprofit status by accepting transfers and prioritizing life-saving care during a pandemic surge.”

He cited the example of a surge in Los Angeles, when the public health department had to issue an order forcing elite hospitals to stop doing financially lucrative elective procedures and accept patient transfers from community hospitals with ICUs overwhelmed by COVID.

Reciprocity and proportionality
The principle of reciprocity supports a possible tiebreaker role for vaccination status when two patients have equivalent survival benefit from a scarce health care resource. However, a universal exclusion of the unvaccinated from life support during a pandemic surge fails the test of proportionality for reciprocity, according to Dr Parker.

Reciprocity is rewarding one positive action with another. One example of this principle is giving vaccinated people access to sporting or entertainment events that are off limits to the unvaccinated (even if negative for COVID). Proportionality is the principle that ‘payback’ should be proportional to the magnitude of the act.  For example, living kidney donors get moved way up the waitlist- the equivalent of four years of waiting time on dialysis.  This satisfies the proportionality principle.

Dr Parker points out that while the increased relative risk of death of 8% from deferring breast cancer surgery is awful, the absolute increase in risk is only one per 100, and perhaps only one per 200 for a two-week deferral.
“After the surge is over, the hospital can catch up on deferred elective surgeries,” he wrote. “The harm from a coronary artery bypass or cancer surgery delayed two weeks is real, but tiny in comparison to certain death from denying life support for respiratory failure.”

He concluded that: “There is a defensible role for vaccination status in triage as a limited tiebreaker, not as a categorical exclusion, but only in the context of a well-defined and transparent triage algorithm.  Despite the enormous financial pressure to do otherwise, elite academic centres are obligated to prioritise life support for emergency conditions to save as many lives as possible during COVID surges.”    

Source: EurekAlert!

South Africa Faces Vaccine Glut as Uptake Slows

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South Africa has asked Johnson & Johnson and Pfizer to delay delivery of COVID vaccines as it has too much stock now, health ministry officials said, as vaccine hesitancy continues to slow the immunisation campaign.

About 35% of South Africans are fully vaccinated, still only half the government’s target of 70% by year end. In the past 15 days, an average of 106 000 doses a day have been administered. At the beginning of the year, the programme had been beset by a lack of doses for a wide range of reasons, from AstraZeneca’s ineffectiveness against the Beta variant to overseas production delays. 

Deputy director-general of the Health Department, Nicholas Crisp, told Reuters that South Africa had 16.8 million doses in stock and said that deliveries had been deferred.

A spokesman for the Health Ministry said: “We have 158 days’ stock in the country at current use. We have deferred some deliveries.”

Stavros Nicolaou, chief executive of Aspen Pharmacare, which is packaging 25 million doses a month of J&J vaccines in South Africa, said most of the vaccines bound for South Africa would now be diverted to the rest of Africa, and deliveries would likely be deferred until the first quarter of next year.

A Pfizer spokesperson said: “We remain adaptable to individual country’s vaccine requirements whilst continuing to meet our quarterly commitments as per the South Africa supply agreement.”

The government has been trying to boost the rate of daily administered doses, such as with R100 ‘Vooma vouchers’ for registering to vaccinate, but even these have failed to sufficiently stoke uptake.

“There is a fair amount of apathy and hesitancy,” said Wits University’s Professor Shabir Madhi.

On Twitter, he further suggested using the excess stock for booster shots, which would “provide all single dose JJ adult recipients a JJ or Pfizer boost, and  those > 65 or immunosuppressive conditions an additional Pfizer dose if received 2 doses > 5 months ago.” 

Source: U.S. News

Vaccine Hesitancy Among Caregivers of Childhood Cancer Survivors

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In a study published in Pediatric Blood & Cancerresearchers reported that caregivers of childhood cancer survivors expressed high rates of vaccine hesitancy, especially if they lacked confidence in governmental COVID response.

The researchers conducted a survey of 130 caregivers of childhood cancer survivors, 21% of caregivers expressed hesitancy to vaccinate themselves and 29% expressed hesitancy to vaccinate their children who had survived cancer.  

Caregivers who expressed confidence in the US government’s response to COVID were six times more likely to express willingness to self-vaccinate and were three times more likely to express willingness to vaccinate their children.  

Caregivers who reported that they were hesitant to vaccinate cited concerns about the speed of COVID vaccine development and a lack of safety and efficacy data in children, particularly children with cancer.

“Results suggest that COVID vaccination outreach to hesitant caregivers might be more effective when delivered by non-governmental organisations, including paediatric oncology care teams,” said senior author Kyle Walsh, PhD, of the Duke Cancer Institute. “Such providers are well-positioned to discuss potential risks and benefits of vaccination and to update families as longer-term outcomes data emerge from vaccine trials and registries.”

Source: Wiley