A series of epidemiological explorations has suggested a negative association between national bacillus Calmette–Guérin (BCG) vaccination policy and the prevalence and mortality of coronavirus ...disease 2019 (COVID-19). However, these comparisons are difficult to validate due to broad differences between countries such as socioeconomic status, demographic structure, rural vs. urban settings, time of arrival of the pandemic, number of diagnostic tests and criteria for testing, and national control strategies to limit the spread of COVID-19. We review evidence for a potential biological basis of BCG cross-protection from severe COVID-19, and refine the epidemiological analysis to mitigate effects of potentially confounding factors (e.g., stage of the COVID-19 epidemic, development, rurality, population density, and age structure). A strong correlation between the BCG index, an estimation of the degree of universal BCG vaccination deployment in a country, and COVID-19 mortality in different socially similar European countries was observed (r² = 0.88; P = 8 × 10−7), indicating that every 10% increase in the BCG index was associated with a 10.4% reduction in COVID-19 mortality. Results fail to confirm the null hypothesis of no association between BCG vaccination and COVID-19 mortality, and suggest that BCG could have a protective effect. Nevertheless, the analyses are restricted to coarse-scale signals and should be considered with caution. BCG vaccination clinical trials are required to corroborate the patterns detected here, and to establish causality between BCG vaccination and protection from severe COVID-19. Public health implications of a plausible BCG cross-protection from severe COVID-19 are discussed.
Fighting against the pandemic diseases with unique characters requires new sophisticated approaches like the artificial intelligence. This paper develops an artificial intelligence algorithm to ...produce multi-dimensional policies for controlling and minimizing the pandemic casualties under the limited pharmacological resources. In this respect, a comprehensive parametric model with a priority and age-specific vaccination policy and a variety of non-pharmacological policies are introduced. This parametric model is utilized for constructing an artificial intelligence algorithm by following the exact analogy of the model-based solution. Also, this parametric model is manipulated by the artificial intelligence algorithm to seek for the best multi-dimensional non-pharmacological policies that minimize the future pandemic casualties as desired. The role of the pharmacological and non-pharmacological policies on the uncertain future casualties are extensively addressed on the real data. It is shown that the developed artificial intelligence algorithm is able to produce efficient policies which satisfy the particular optimization targets such as focusing on minimization of the death casualties more than the infected casualties or considering the curfews on the people age over 65 rather than the other non-pharmacological policies. The paper finally analyses a variety of the mutant virus cases and the corresponding non-pharmacological policies aiming to reduce the morbidity and mortality rates.
China's hepatitis B virus (HBV) prevention policy has been evaluated through nationally representative serologic surveys conducted in 1992 and 2006. We report results of a 2014 serologic survey and ...reanalysis of the 1992 and 2006 surveys in the context of program policy. The 2014 survey used a 2-stage sample strategy in which townships were selected from 160 longstanding, nationally representative, county-level disease surveillance points, and persons 1-29 years of age were invited to participate. The 2014 sample size was 31,713; the response rate was 83.3%. Compared with the 1992 pre-recombinant vaccine survey, HBV surface antigen prevalence declined 46% by 2006 and by 52% by 2014. Among children <5 years of age, the decline was 97%. China's HBV prevention program, targeted toward interrupting perinatal transmission, has been highly successful and increasingly effective. However, this progress must be sustained for decades to come, and elimination of HBV transmission will require augmented strategies.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study aims to determine the Strengthening of Agile Government in implementing Covid-19 Vaccination Policies: Studies in 5 Provinces on the Island of Kalimantan. This research is a qualitative ...case study designed to analyze the findings with four characteristics of agile government: responsiveness, strategic adaptation, focus on results, and management anticipates future problems. This study shows that the best responsiveness in East Kalimantan Province, the responsiveness of handling the Covid-19 vaccine is considered very agile, the responsiveness level is 25.00%. In contrast, the province that is still under its responsiveness is West Kalimantan Province with its responsiveness. 14,00% rate. Furthermore, the highest strategy adaptation is the Province of South Kalimantan and Central Kalimantan, 22.00%, both of which have the same percentage value. At the same time, the lowest percentage is in North Kalimantan Province, which is 16.00%. In addition to Focus on Results, the highest percentage of achievement results in West Kalimantan Province, which is 31.00%. At the same time, Central Kalimantan, East Kalimantan, and North Kalimantan Provinces have a low achievement rate of 15.00%. Then in the Management of Overcoming Future Problems, the highest percentage is the Province of West Kalimantan, which is 26.00%, and the Provinces of East Kalimantan and Central Kalimantan, which have a low yield of 15.00%. The five provinces have different strategies for dealing with vaccination.
Background Bacillus Calmette-Guérin (BCG) vaccination offers protection against tuberculosis (TB), an infectious disease caused by the Mycobacterium tuberculosis bacterium. TB generally affects the ...lungs and can prove fatal. There is evidence that BCG vaccination has non-specific immune-boosting effects that protect against other pathogens including Candida albicans and Staphylococcus aureus. During the early months of the COVID-19 pandemic, the list of countries most affected bore a resemblance to the list of countries that do not have universal BCG vaccination policy. In this study, we explore the possible association between BCG vaccine policy and SARS CoV-2 attributable mortality. Methods We obtained cumulative counts of cases and deaths attributed to SARS CoV-2 from the WHO COVID-19 Dashboard, collated details of BCG vaccination policy from the BCG World Atlas and extracted data on BCG coverage for the past 30 years from WHO. We applied multivariate log-linear regression models to examine the association of deaths per 1 million population attributed to SARS CoV-2 and BCG vaccination policy and coverage. Results A significant association between the absence of universal BCG vaccination and the higher death rate was found even after controlling for other variables including median age, hospital beds and days since 100th case. The present study does not, however, find any significant association between BCG vaccination coverage and mortality attributed to SARS CoV-2 across the countries where the BCG immunization has been administered since or before 1990 and where BCG coverage falls within the range 35– 99% of the population. Conclusion These results support the prevailing view that the connection between BCG immunization and COVID-19 mortality is correlation rather than causation and is likely due to confounding factors within profoundly affected populations.
The Japanese government implemented a large-scale vaccination policy against the coronavirus disease 2019 (COVID-19) pandemic, primarily using messenger RNA vaccines in 2021. Its hallmark was ...prioritized vaccination for the elderly after healthcare workers in a short period of time. Vaccination for the elderly, vulnerable to infection and severe disease, was carried out rapidly in approximately 4 months since April 2021. We evaluated the impact of Japan's vaccination policy against COVID-19 during the pandemic, with a particular focus on how prioritized vaccination for the elderly affected the pandemic. We observed a remarkable decrease in the number of infections, cluster events in long-term care facilities, and severe disease among the elderly during the fifth wave (August 2021) despite rising incidence of infections in the overall population. In conclusion, we think that prioritized vaccination for the elderly was efficacious in preventing infections and severe COVID-19 among the elderly during the fifth wave in Japan.
The recent increase in whooping cough incidence (primarily caused by Bordetella pertussis) presents a challenge to both public health practitioners and scientists trying to understand the mechanisms ...behind its resurgence. Three main hypotheses have been proposed to explain the resurgence: 1) waning of protective immunity from vaccination or natural infection over time, 2) evolution of B. pertussis to escape protective immunity, and 3) low vaccine coverage. Recent studies have suggested a fourth mechanism: asymptomatic transmission from individuals vaccinated with the currently used acellular B. pertussis vaccines.
Using wavelet analyses of B. pertussis incidence in the United States (US) and United Kingdom (UK) and a phylodynamic analysis of 36 clinical B. pertussis isolates from the US, we find evidence in support of asymptomatic transmission of B. pertussis. Next, we examine the clinical, public health, and epidemiological consequences of asymptomatic B. pertussis transmission using a mathematical model.
We find that: 1) the timing of changes in age-specific attack rates observed in the US and UK are consistent with asymptomatic transmission; 2) the phylodynamic analysis of the US sequences indicates more genetic diversity in the overall bacterial population than would be suggested by the observed number of infections, a pattern expected with asymptomatic transmission; 3) asymptomatic infections can bias assessments of vaccine efficacy based on observations of B. pertussis-free weeks; 4) asymptomatic transmission can account for the observed increase in B. pertussis incidence; and 5) vaccinating individuals in close contact with infants too young to receive the vaccine ("cocooning" unvaccinated children) may be ineffective.
Although a clear role for the previously suggested mechanisms still exists, asymptomatic transmission is the most parsimonious explanation for many of the observations surrounding the resurgence of B. pertussis in the US and UK. These results have important implications for B. pertussis vaccination policy and present a complicated scenario for achieving herd immunity and B. pertussis eradication.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
About a year into the pandemic, COVID-19 accumulates more than two million deaths worldwide. Despite non-pharmaceutical interventions such as social distance, mask-wearing, and restrictive lockdown, ...the daily confirmed cases remain growing. Vaccine developments from Pfizer, Moderna, and Gamaleya Institute reach more than 90% efficacy and sustain the vaccination campaigns in multiple countries. However, natural and vaccine-induced immunity responses remain poorly understood. There are great expectations, but the new SARS-CoV-2 variants demand to inquire if the vaccines will be highly protective or induce permanent immunity. Further, in the first quarter of 2021, vaccine supply is scarce. Consequently, some countries that are applying the Pfizer vaccine will delay its second required dose. Likewise, logistic supply, economic and political implications impose a set of grand challenges to develop vaccination policies. Therefore, health decision-makers require tools to evaluate hypothetical scenarios and evaluate admissible responses.
Following some of the WHO-SAGE recommendations, we formulate an optimal control problem with mixed constraints to describe vaccination schedules. Our solution identifies vaccination policies that minimize the burden of COVID-19 quantified by the number of disability-adjusted years of life lost. These optimal policies ensure the vaccination coverage of a prescribed population fraction in a given time horizon and preserve hospitalization occupancy below a risk level. We explore “via simulation” plausible scenarios regarding efficacy, coverage, vaccine-induced, and natural immunity.
Our simulations suggest that response regarding vaccine-induced immunity and reinfection periods would play a dominant role in mitigating COVID-19.
•We address WHO-SAGE vaccination modeling questions using an optimal control approach.•COVID-19 optimal vaccination policies minimize DALY.•Coverage-time horizon and the limited hospital beds are modeled as constraints.•We consider scenarios with different vaccine-induced immunity and efficacies.•Natural immunity and high vaccine efficacy are related to mitigation of the outbreak.
Paratuberculosis or Johne’s disease (JD) prevalence in Australia is low at the cow-level with varying herd-level prevalence. Control strategies incorporating vaccination are limited, suggesting ...opportunities for changes in regulatory oversight. In order to study this further, we examined the economic benefits of participation in JD control programmes in Australia with and without vaccination as well as knowledge, attitudes, and practices (KAP) relating to JD.
We used an online questionnaire to gather information describing demographics and KAP from 71 Australian dairy farms. Data from fully completed questionnaires from 32 farms in Victoria, Australia combined with cost and revenue data averaged from several years of the Dairy Farm Monitor Project were used to then simulate a larger robust dataset. These production data informed the simulation model to establish farm profitability. A partial farm budget was then developed to estimate the benefits of engaging in JD control activities. Respondents who stated they participated in JD control programmes gained an additional $43.80/cow/year net income (profit) compared to non-participants. Respondents also using a JD vaccine gained an additional $35.84/cow/year over non-users; this represents $10.56/cow/year over and above the average producer in the industry. However, we also noted that there clearly exists a barrier between farmers stated intentions to participate and actual participation in JD control activities.
These significant differences in net income realized by farms using different approaches to JD control (in this case, adoption of vaccination) offer a starting point from which to explore questions of how much farmers would be willing to pay for control activities, why they are willing to pay, and the likelihood of participating. Communication of the benefits of participation needs to improve to bridge this gap between farmers stated intentions and their actions.
Simulation modelling suggests increased profitability from participation in JD control programs and vaccination in Australia. The JD regulatory policies of other countries may benefit from the Australian experience with JD control.
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