Effectiveness of Bacille Calmette-Guerin Vaccination Policies in reducing infection and severity of COVID-19: A systematic review protocol

@#<p style="text-align: justify;"><strong>Introduction:</strong> The bacille Calmette-Guerin (BCG) vaccine is used for the prevention of tuberculosis (TB) worldwide. Evidence reports a much lower incidence of COVID-19 in TB-endemic areas implying a possible protective mechanism of BCG in countries with mandated BCG policies. The objective of the study is to synthesize and critically evaluate the effectiveness of national BCG vaccination policies in reducing infection and severity of COVID-19 in their native population.</p><p style="text-align: justify;"><strong>Methods:</strong> Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search using pre-identified keywords will be done in PubMed, Cochrane, HERDIN Plus, WPRIM, Web of Science and EBSCO databases. After the initial selection of studies based on eligibility criteria, methodological appraisal will be conducted using the Joanna Briggs Institute appraisal instruments and an adapted quality assessment checklist for ecologic studies. Relevant data will be extracted and synthesized including reporting descriptive and inferential statistics to interpret results.</p><p style="text-align: justify;"><strong>Results:</strong> The study will generate a systematic review synthesizing evidence regarding the effects of BCG in curtailing the spread of the COVID-19 pandemic.</p><p style="text-align: justify;"><strong>Discussion:</strong> The battle against the COVID-19 pandemic is far from over, and as such, further studies must be undertaken to verify the evidence behind initial strategies in battling it. This includes the use of BCG in decreasing COVID-19 incidence and mortality. The results of the review can ultimately guide health authorities and policy makers create evidence-based decisions regarding BCG vaccination policies and clinical trials related to COVID-19 control and prevention.</p><p style="text-align: justify;"><strong>Systematic Review Registration:</strong> PROSPERO, CRD42021244060</p>

Influenza vaccination among Malaysian healthcare workers: a survey of coverage and attitudes

Background: Healthcare workers (HCWs) are at increased risk of getting influenza than the general population, therefore putting patients at risk of nosocomial infection. Influenza vaccination coverage among HCWs is low despite the availability of a safe and effective vaccine. However, the reasons for such a poor uptake are not well reported in Malaysia. This study aimed at assessing the rate of influenza vaccination uptake, knowledge and attitude of healthcare workers regarding influenza, and employers’ policy on influenza vaccination. Methods: A cross-sectional questionnaire survey was conducted in three hospitals in the Klang Valley. Mann–Whitney test was used to assess possible differences in knowledge and attitude towards flu vaccination and the χ2 was used for categorical variables. Analyses were performed with SPSS 22.0. Results: A total of 690 questionnaires were distributed; 527 were returned (giving a response rate of 76.4%. The vaccine uptake was 51.4% with the majority (83.5%) of those believing they were vaccinated to protect themselves. Higher proportion of vaccinated HCWs (p <0.05) agreeing to the fact that influenza is a serious threat to their health, however, 10% were not sure of its safety. Eighty-three (15.7%) claimed their employers did not have a vaccination policy, while 43.3% were not sure if their employers have vaccination policy. Conclusion: This study has demonstrated more than half of the healthcare workers were vaccinated, with a significant proportion of the healthcare workers believed they were vaccinated to protect themselves, while most of those that were not vaccinated claimed they are worried about the safety of the vaccine. Most employers did not have a flu vaccination policy in place. Hence, the need for government to enforce such policy and make annual flu vaccination free and compulsory for all healthcare workers KEY WORDS:

Na política centrada no programa de vacinação contra o HPV no México: suas dilema ético / La política focalizada en el programa de vacunación contra el Virus del Papiloma Humano en México: aspectos éticos / The policy focused on the HPV vaccination program against Human Papilloma Virus in Mexico: ethics aspects

Se plantea un análisis ético de aspectos relacionados con la introducción de nuevas vacunas contra el Virus del Papiloma Humano en México, cuya política de distribución atiende a la equidad más que a la igualdad y tiene como ejes fundamentales abarcar a las personas más vulnerables y al costo más bajo posible, es decir, atiende a los principios de justicia distributiva. El esquema inicial de vacunación contra este virus en México se ha focalizado a la población femenina más marginada, la cual se concentra en las mujeres indígenas. Las estrategias de distribución de nuevas vacunas deberán tomar en consideración las características específicas en que se desenvuelven estos grupos y analizar las implicaciones éticas que tales medidas conllevan. Sin ello, una política de salud pública podría aumentar las desigualdades en materia de salud...

This article raises an ethical analysis of issues related to the introduction of new vaccines against Human Papillomavirus in Mexico, whose distribution policy attend to equity more than equality, and has as fundamental axes to cover the most vulnerable people and the lowest cost possible, i.e. serving the principles of distributive justice. The initial scheme of vaccination against this virus in Mexico has been focused on the most marginalized female population, which focuses on indigenous women. Distribution strategies for new vaccines must take into account the specific characteristics that develop these groups and analyze the ethical implications that such measures will involve; without this public health policy could increase health inequalities...

O propósito foi fazer uma análise ética das questões relacionadas com a introdução de novas vacinas contra o Papilomavírus Humano, no México, cuja política de distribuição serve apenas para a equidade mais do que para a igualdade e tem como eixos fundamentais abrangir os mais vulneráveis e os menores custos possíveis, isto é, servindo aos princípios de justiça distributiva. O regime inicial da vacinação contra esse vírus no México tem sido focado na população feminina mais marginalizada, que incide sobre as mulheres indígenas. As estratégias de distribuição de novas vacinas devem tomar em consideração as características específicas que desses grupos e analisar as implicações éticas que tais medidas implicam, sem isso a política de saúde pública poderia aumentar as desigualdades na saúde...

The Policy of Full Subsidy for Six Voluntary Vaccinations and Community Education in Horokanai Town ; Effects on Vaccine Coverage / 日本プライマリ・ケア連合学会誌

 In Horokanai town, Hokkaido, the policy of full subsidies for voluntary vaccinations against influenza, haemophilus influenzae type b (Hib), varicella, mumps, pneumococcal for children and human papillomavirus (HPV) was introduced between 2008 and 2010. A campaign for community education about vaccination was initiated.<br> Vaccination coverage improved after the subsidy as follows : influenza vaccination increased from 57.4% to 60.1%, Hib from 2.9% to 52.2%, varicella from 0% to 30.0%, mumps from 2.8% to 38.2%, pneumococcal for children from 1.3% to 50.6%, and HPV from 0% to 81.3%.

Primary Humoral Immune Responses to Formalin Inactivated Hemorrhagic Fever with Renal Syndrome Vaccine (Hantavax(R)): Consideration of Active Immunization in South Korea

The efficacy of a formalin-inactivated hemorrhagic fever with renal syndrome (HFRS) vaccine and the effectiveness of a related vaccination program have not been previously evaluated. We measured the primary immune responses to Hantavax by plaque reduction neutralizing antibody test (PRNT), hemagglutination inhibition test (HAI), ELISA and high density particle agglutination test (HDPA) in order to confirm a possible biological efficacy through independent substantiation of experimental results and to compare the results with previous studies. Following two doses of primary vaccination, the seroconversion rate of PRNT and HAI antibody was 33.3% (10/30)[95% C.I. 17.3-52.5%] and 26.7% (8/30) [95% C.I. 12.3-45.9%], respectively. The correlation between PRNT and HAI antibody showed a statistical significance (r=0.58, p 0.01). The seroconversion rate of HDPA and ELISA were both 76.7% (23/30) [95% C.I. 57.7-90.1%], which correlated well with each other(r=0.58, p 0.01). In our study, Hantavax elicited low neutralizing antibody responses, at least in the volunteers samples that we tested. The vaccination program, including the vaccine itself, that has been adopted by the national immunization program to protect against HFRS in Korea should be re-evaluated and re-formulated to produce a higher protective immune response rate.