COVID-19 vaccine hesitancy in KwaZulu-Natal, South Africa: A survey of unvaccinated adults

Background: Concerns and misconceptions surrounding coronavirus disease 2019 (COVID-19) vaccines may account for vaccine hesitancy and low uptake. Aim: To determine prevalence of COVID-19 vaccine hesitancy, vaccine-related misconceptions, and predictors of vaccine hesitancy among South Africans. Setting: Community setting in five districts in KwaZulu- Natal province. Methods: Between August 20, 2021, and September 27, 2021, we conducted a cross-sectional survey, interviewing 300 unvaccinated adults amid the national vaccination campaign. Predictors of hesitancy were identified through multivariable logistic regression analysis. Results: Participants had a median age of 29 years (IQR: 23­39), 86.7% were Black African, 63.2% were male, 53.3% resided in rural communities, and 59.3% (95% CI: 53.8% ­ 64.9%) were classified as vaccine hesitant. The primary reason for not vaccinating was a lack of trust in the vaccine (62.1%). Factors associated with reduced vaccine hesitancy included age (participants aged 35­49 years: OR: 0.28, 95% CI: 0.18­0.64, p = 0.003; participants over 50 years: OR: 0.18, 95% CI: 0.07­0.47, p = 0.0004), previous COVID-19 infection (OR: 0.31, 95% CI: 0.11­0.87, p = 0.03), and receiving vaccine information from healthcare workers (OR: 0.32, 95% CI: 0.10­1.0, p = 0.05). Unemployed (OR: 2.14, 95% CI: 1.1­4.2, p = 0.03) and self-employed individuals (OR: 2.98, 95% CI: 1.27­7.02, p = 0.01) were more likely to be vaccine hesitant. Conclusion: COVID-19 vaccine hesitancy rates are high in KwaZulu-Natal. Uptake could be enhanced by healthcare workers leading information campaigns with messages targeting younger individuals, the unemployed, and the self-employed. Contribution: This survey provides evidence to improve COVID-19 vaccination uptake in South Africa.

A COVID-19 perspective of Vogt–Koyanagi–Harada disease

Vogt–Koyanagi–Harada (VKH) disease, a bilateral granulomatous panuveitis associated with multisystem involvement, is a T-cell-mediated autoimmune disorder in which cytotoxic T-cell target melanocytes in genetically susceptible individuals. Recently, there has been an increase in literature on the new onset of uveitis and reactivation of previously diagnosed cases of uveitis following Covid-19 vaccinations. It has been postulated that Covid-19 vaccines can lead to an immunomodulatory change resulting in an autoimmune phenomenon in the recipients. VKH following COVID-19 infection was reported in four patients and a total of 46 patients developing VKH or VKH-like disease following COVID-19 vaccinations. There are reports of four patients who had been recovering or recovered from VKH after receiving the first dosage of the vaccine and developed worsening of ocular inflammation after receiving the second dose of the vaccine.

Conocimiento, actitudes y prácticas de mujeres gestantes respecto a la vacunación

Introducción: La vacunación durante el embarazo ha demostrado ser una medida segura y efectiva que protege a la mujer gestante y al feto contra enfermedades inmunoprevenibles. Objetivo: Determinar los conocimientos, actitudes y prácticas de mujeres gestantes respecto a la vacunación en el marco de la pandemia por el virus SARS-CoV-2. Materiales y Métodos: Estudio observacional de corte transversal realizado en Instituciones Prestadoras de Servicios de Salud Públicas de los 19 municipios de Casanare, Colombia, entre enero y marzo de 2022. Los datos se recolectaron mediante un instrumento de medición documentado que incluyó 22 ítems agrupados en cuatro secciones: datos sociodemográficos, conocimiento, actitudes y prácticas sobre vacunación. Resultados: La media de puntuación de conocimientos fue 5,9 (DE 1,9) de un máximo de 10. El 93,7% cree que la vacunación es realmente necesaria durante el embarazo. Los factores asociados al nivel adecuado de conocimiento incluyeron el grupo de edad entre 26-30 años (OR: 2,27; IC 95%: 1,21-4,25; p = 0,011), estar en el tercer trimestre de embarazo (OR: 2,37; IC 95%: 1,12-5,01; p = 0,024) y contar con un nivel educativo básico, medio o superior (OR: 10,45; IC 95%: 2,37-46,03; p = 0,002). Conclusión: Es esencial fortalecer las estrategias de información, educación y comunicación, para promover la vacunación segura durante el embarazo.

Background: Vaccination during pregnancy has proven to be a safe and effective measure that protects pregnant woman and the fetus against immuno-preventable diseases. Aim: To determine the knowledge, attitudes and practices of pregnant women regarding vaccination in the context of the SARS-CoV-2 pandemic. Methods: A cross-sectional observational study was conducted at public health care institutions in the 19 municipalities of Casanare, Colombia, from January to March 2022. Data were collected using a documented measurement instrument that included 22 items grouped into four sections: sociodemographic data, knowledge, attitudes and practices about vaccination. Results: The mean knowledge score was 5.9 (SD: 1.9) of a maximun of 10; 93.7% believed that vaccination was really necessary during pregnancy. Factors associated with adequate level of knowledge included age group 26-30 years (OR: 2.27; 95% CI: 1.21-4.25; p = 0.011), being in the third trimester of pregnancy (OR: 2.37; 95% CI: 1.12-5.01; p = 0.024) and having basic, intermediate or higher education (OR: 10.45; 95% CI: 2.37-46.03; p = 0.002). Conclusions: It is essential to strengthen information, education and communication strategies to promote safe vaccination during pregnancy.

Acute abducens nerve palsy with acute disseminated encephalomyelitis-like presentation following COVID-19 vaccination

We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated systemic symptoms. Post-vaccination demyelination typically known as acute disseminated encephalomyelitis (ADEM) associated with several vaccines is more common in children. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to the post-vaccine neuroinflammatory syndrome. Cranial nerve palsies and ADEM-like presentations may represent part of the neurologic spectrum following COVID-vaccination in adults, and ophthalmologists should be aware of these sequelae. Although cases of sixth nerve palsy following COVID vaccination are already reported, associated MRI changes have not been reported from India.

Knowledge, attitude, practice, and acceptability towards COVID-19 vaccination among medical professionals in Puducherry – A cross-sectional study

Background: Coronavirus disease 2019 (COVID-19) pandemic is still spreading worldwide and it has resulted in severe economic disruptions and unrivalled challenges to health-care system. Aims and Objectives: This study was planned to evaluate the knowledge, attitude, practice, and acceptability of COVID-19 vaccination among medical professionals. Materials and Methods: A questionnaire-based cross-sectional study was conducted on 276 medical professionals working in Puducherry using convenience sampling method. Data were collected using self-administered questionnaire. Descriptive statistics such as frequencies and percentages were computed. Statistical analysis was done using SPSS software 28.0 Version. Pearson’s Chi-square analysis and multinomial regression analysis were performed. Results: Among the 276 respondents, 71 (25.7%) were affected with COVID-19 infection, 274 (99.2%) got vaccinated. Two doses were taken by 90.6% and 24 (8.7%) had received one dose of vaccination during the study period. Adequate knowledge was seen (P = 0.029) among the doctors who received two doses of vaccination (P = 0.019). Positive attitude was observed among the professionals who were vaccinated with CoviShield (P ? 0.001) and received two doses of vaccination (P = 0.003). About 79% of participants experienced common side effects due to vaccination. About 83.3% of participants were willing to take Booster dose and their choice of vaccine was CoviShield 76.4%, Covaxin 21.7%, and only 12% endorsed Sputnik V. About 69.2% of them have accepted that after mass vaccination campaigns, COVID-19 infection has been reduced. Conclusion: The present study findings showed adequate knowledge, favorable attitude, good practice, and acceptability of COVID-19 vaccination. Public health officials should utilize this opportunity and engage the medical professionals in educational campaigns which could reduce the misconceptions and alleviate the fear about the vaccination among the general population.

Nursing students' perception of the covid- 19 disease and attitudes toward vaccination

Background: The COVID-19 is globally the most critical public health concern of our age. Raising awareness in fighting pandemics, society's perception of COVID-19 in acquiring herd immunity in society, attitudes toward vaccines, and the role of health-care professionals in vaccine acceptance is all important. Aim: This study aimed to determine nursing students' perceptions of the COVID-19 disease and attitudes toward the COVID-19 vaccine. Materials and methods: This cross-sectional study was conducted with 263 nursing students between December 2021 and April 2022. Data were collected using the COVID-19 Disease Perception Scale and the Attitudes toward the COVID-19 Vaccine Scale. Results: The nursing students had high levels of perceptions of COVID-19 and positive attitudes toward the COVID-19 vaccine. Based on the subscales, the nursing students had high scores in the dangerousness and infectious subscales regarding their perception of the disease. In addition, they had higher scores in the positive subscale than in the negative subscale concerning their attitudes toward the COVID-19 vaccine. Conclusion: Results of this study, planned training programs should be organized, curricula should be revised to help nursing students in order to be prepared for the future pandemics.

Serious adverse event following immunization and thromboembolic events associated with COVID19 vaccination: An analysis of nationwide causality assessment from India

Background: Vaccines against the COVID-19 pandemic were introduced in late 2020. The present study has been conducted to study the serious Adverse Events Following Immunization (AEFIs) reported for COVID-19 vaccines from India. Methods: Secondary data analysis of the causality assessment reports for the 1112 serious AEFIs published by the Ministry of Health & Family Welfare, Government of India, was conducted. For the current analysis, all the reports published till 29.03.2022 were included. The primary outcome variables analyzed were the consistent causal association and the thromboembolic events. Results: The majority of the serious AEFIs assessed were either coincidental (578, 52%) or vaccine product related (218, 19.6%). All the serious AEFIs were reported among the Covishield (992, 89.2%) and COVAXIN (120, 10.8%) vaccines. Among these, 401 (36.1%) were deaths, and 711 (63.9%) were hospitalized and recovered. On adjusted analysis, females, the younger age group and non-fatal AEFIs showed a statistically significant consistent causal association with COVID-19 vaccination. Thromboembolic events were reported among 209 (18.8%) of the analyzed participants, with a significant association with higher age and case fatality rate. Conclusion: Deaths reported under serious AEFIs were found to have a relatively lower consistent causal relationship with the COVID-19 vaccines than the recovered hospitalizations in India. No consistent causal association was found between the thromboembolic events and the type of COVID-19 vaccine administered in India

Lipschütz acute vulvar ulcer related to COVID-19 vaccination: First case report in South America / Úlcera vulvar aguda de Lipschütz relacionada con la vacunación por COVID-19: primer caso notificado en Sudamérica

Lipschütz ulcer is a non-sexually transmitted genital lesion of unknown etiology, which presents as a painful vulvar ulcer. Lipschütz ulcers have been described in most continents. This is the first case reported in Peru and South America. We present the case of a 33-year-old female patient with a Lipschütz ulcer after being vaccinated with the second dose of the AstraZeneca COVID-19 vaccine. She reported having had only one sexual partner in her lifetime. Laboratory results were negative for herpes simplex 2, Cytomegalovirus, Toxoplasma gondii, Epstein-Barr virus, and syphilis. The patient received symptomatic treatment. Ten days after the onset, the patient was significantly better during follow-up. This case report displays a potential adverse effect of the AstraZeneca COVID-19 vaccine as a Lipschütz ulcer triggered by the host humoral immune response. However, further research is needed to establish the causal relationship between these two.

La úlcera de Lipschütz es una lesión genital no transmitidas por vía sexual de etiología desconocida, se presenta como una úlcera vulvar muy dolorosa. Las úlceras de Lipschütz se han descrito en la mayoría de los continentes. Este es el primer caso que se reporta en Perú y Sudamérica. En este reporte de caso se presentauna paciente de 33 años con una úlcera de Lipschütz luego de haber sido vacunada con la segunda dosis de la vacuna AstraZeneca COVID-19. Refirió haber tenido una sola pareja sexual a lo largo de su vida. Los resultados de laboratorio fueron negativos para herpes simplex 2, Citomegalovirus, Toxoplasma gondii, virus de Epstein-Barr y sífilis. La paciente recibió tratamiento sintomático. Diez días después, durante el seguimiento, la paciente estaba significativamente mejor. Este reporte de caso expone un potencial efecto adverso de la vacuna AstraZeneca COVID-19, en forma de úlcera de Lipschütz, desencadenado por la respuesta inmune humoral del huésped. Sin embargo, es necesario realizar más investigación para establecer la relación causal entre ambos.

Granulomatous anterior uveitis following mRNA-based COVID-19 vaccination: A case report

A 23-year-old patient presented with complaints of redness, pain, photophobia, and blurred vision in the right eye 15 days after she received the third dose of BNT162b2 vaccination. Ocular examination revealed 2+ cellular reactions in the anterior chamber and mutton fat keratic precipitate with no vitritis or retinal alterations. Active uveitis findings regressed with corticosteroid and cycloplegic eye drops. We present a case of unilateral granulomatous anterior uveitis following the BNT162b2 vaccination, with no etiologic factor in uveitis work-up and no previous history of uveitis before vaccination. This report demonstrates a potential causal association of coronavirus disease 2019 (COVID-19) vaccine with granulomatous anterior uveitis.

Recommendation for Improvement in COVID-19 Vaccine Program in Malaysia: An Online Nationwide Qualitative Survey

@#Introduction: Maintaining high levels of vaccinations is important for public health success in any vaccination planning. Success requires a better understanding of the public’s perceptions of diseases and consequent decisions about vaccinations. This study aims to gather exploratory qualitative data on public opinion on the Malaysian Government’s COVID-19 immunization campaigns. Methods: Open-ended question on Google Form was advertised online between 2 to 17 December 2020. The questionnaire form was deactivated when saturation has been reached. The free text questions were analysed by qualitative thematic analysis by all authors on a Microsoft Excel spreadsheet. Results: Six hundred and sixty-one participants replied to the online questionnaire. Four themes emerged from the thematic analysis on suggestions for future National COVID-19 Immunisation Program. First, COVID-19 vaccine administration policy; secondly, knowledge dissemination and plan to address obstacles of public acceptances towards the vaccine proactively; thirdly, better implementation programs by the government and fourthly, using local research expertise for vaccine development and alternative medicines. Participants believe all this are essential in increasing their trust and uptake for the government’s future national COVID-19 Immunisation Program. Conclusion: This study highlights the suggestions made by the public for the Malaysian Government. These findings will help develop education and intervention strategies for new vaccine introduction to combat the COVID-19 pandemic in Malaysia.

Novel coronavirus infection and its vaccination-related ocular disease / 国际眼科杂志(Guoji Yanke Zazhi)

The continuous pandemic coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)is a serious threat to human life and health because of high infectious pathogenicity, and it also has posed a new challenge to the current medical model. Many literatures have shown that these changes range from the more common ocular surface diseases such as inflammation of the cornea, conjunctiva, and sclera, to the relatively rare paracentral acute middle maculopathy and acute macular neuroretinopathy. For patients with ocular symptoms as the first or accompanying symptoms of SARS-CoV-2 infection, how to identify the correlation between ocular manifestations and SARS-CoV-2 infection is undoubtedly a serious challenge for ophthalmologists. In this review, the ocular pathology caused by both SARS-CoV-2 infection and vaccination was discussed, covering pathological changes in the ocular surface, uvea, retina and macula, and cranial nerves.

Allergic reactions of COVID-19 vaccine based on mRNA-LNP and its pharmacokinetics in vivo / 药学学报

Vaccination has been proved to be the most effective strategy to prevent the Corona Virus Disease 2019 (COVID-19). The mRNA vaccine based on nano drug delivery system (NDDS) - lipid nanoparticles (LNP) has been widely used because of its high effectiveness and safety. Although there have been reports of severe allergic reactions caused by mRNA-LNP vaccines, the mechanism and components of anaphylaxis have not been completely clarified yet. This review focuses on two mRNA-LNP vaccines, BNT162b2 and mRNA-1273. After summarizing the structural characteristics, potential allergens, possible allergic reaction mechanism, and pharmacokinetics of mRNA and LNP in vivo, this article then reviews the evaluation methods for patients with allergic history, as well as the regulations of different countries and regions on people who should not be vaccinated, in order to promote more safe injection of vaccines. LNP has become a recognized highly customizable nucleic acid delivery vector, which not only shows its value in mRNA vaccines, but also has great potential in treating rare diseases, cancers and other broad fields in the future. At the moment when mRNA-LNP vaccines open a new era of nano medicine, it is expected to provide some inspiration for safety research in the process of research, development and evaluation of more nano delivery drugs, and promote more nano drugs successfully to market.

Anaiysis on the strategy of promoting COVID-19 vaccination for the elderly in China / 上海预防医学

ObjectiveCOVID-19 vaccination is critical for pandemic control， especially in the elderly. Compared with developed countries， the rate of full vaccination and booster vaccination for the elderly in China is low， making it urgent to accelerate the process of vaccination for the elderly in China. MethodsThis study summarizes the policy experiences of the United Kingdom， the United States， Singapore， and South Korea by sorting relevant literature and government websites， analyzes the current performance and reasons for COVID-19 vaccination among the elderly in China， and explores strategic suggestions for improving COVID-19 vaccination in the elderly in terms of vaccination priority groups， service provision， and vaccination intention. ResultsIt is important to vaccination rate for the elderly in China by focusing on the priority vaccination population， establishing a permanent mechanism based on the family doctor system， and increasing the willingness to vaccinate. ConclusionContinued reinforcement of COVID-19 vaccination for the elderly is needed， and the existing vaccination model is overwhelming. We should establish a permanent mechanism based on the family doctor system to transfer from a mobilization model to a regular vaccination model.

Factors Related to Low COVID-19 Vaccination Rate in Pregnant and Postpartum Women with and without COVID-19 / Fatores relacionados à baixa taxa de vacinação contra COVID-19 em gestantes e puérperas com e sem COVID-19

Abstract Objective This study focused on pregnant and postpartum women during the COVID-19 pandemic, aiming to determine the attitudes and behaviors of vaccinated and unvaccinated groups, and the vaccination behaviors in the groups with and without the disease. The reasons for refusing the vaccine were also questioned. Methods This cross-sectional study was performed from September 2021 to October 2021. The study data were collected using a face-to-face questionnaire. The participants were pregnant women who applied to the hospital for routine antenatal care and were hospitalized, and women in the postpartum period. Additionally, pregnant and postpartum patients who were diagnosed with COVID-19 at the time of admission and were hospitalized and admitted to the intensive care unit due to this disease were also included in the study. Results A total of 1,146 pregnant and postpartum women who completed the questionnaire were included in our study. Only 43 (3.8%) of the participants were vaccinated; 154 (13.4%) of the participants had comorbidities. The number of COVID-19-positive patients was 153. The lack of sufficient information about the safety of the COVID-19 vaccine is the most common reason for the refusal. Conclusion Vaccine refusal can significantly delay or hinder herd immunity, resulting in higher morbidity and mortality. Considering the adverse effects of COVID-19 on pregnancy, it is essential to understand pregnant and postpartum women's perceptions toward vaccination to end the pandemic.

Cetoacidosis diabética posterior a vacuna contra SARS-CoV-2: reporte de un caso / Diabetic ketoacidosis following SRS-CoV-2 vaccination: a one case report

Las emergencias hiperglicémicas como la cetoacidosis diabética (CAD) y el síndrome hiperglicémico hiperosmolar (SHH) se han descrito en el contexto de infección por SARS-CoV-2, como también secundarias a las múltiples vacunas desarrolladas contra el virus. La fisiopatología que explicaría esta asociación aún no está clara, pero existen diversas teorías que incluyen la destrucción directa de los islotes pancreáticos por el virus o secundario a mecanismos inmuno-inflamatorios. Presentamos el caso de un paciente que debutó con CAD al tercer día de la primera dosis de CoronaVac, y que posteriormente presentó hiperglicemia sin cumplir criterios de CAD luego de la segunda y tercera dosis de CoronaVac y Pfizer respectivamente. La temporalidad, como la falta de gatillante y la evolución del cuadro, apuntan a la vacuna como el principal precipitante. Por lo anterior, es importante mantener una vigilancia estricta de los efectos adversos de las vacunas y educar sobre los síntomas sugerentes de una crisis hiperglicémica para pesquisarla a tiempo y actuar oportunamente.

Hyperglycemic emergencies such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) have been reported in SARS-CoV-2 infections and after vaccination. The pathophysiology behind this association is still unclear, several theories have been described that include the direct destruction of the pancreatic islets by the virus, and some immuno-inflammatory mechanisms. We present the case of a patient who develope DKA the third day after the first dose of CoronaVac vaccine, and then hypergycemia after the second and third dose of CoronaVac and Pfizer repectively. The temporal relation, lack of a trigger and evolution of the disease, point the vaccine as the main precipitant. The strict surveillance of vaccines adverse effects and education of symptoms suggestive of hyperglicemic emergency are critical to prevent and treat promptly this kind of situations.

COVID-19 vaccination of patients with chronic immune-mediated inflammatory disease

Abstract Objective This study aimed to analyze the safety and efficacy of COVID-19 vaccines among patients with chronic immune-mediated inflammatory disease (IMID) in China. Methods Participants who were diagnosed with a chronic IMID were eligible for inclusion in this study. Age- and sex-matched healthy vaccinated individuals were set as the control group. All participants received two doses of the inactivated CoronaVac vaccine or three doses of the recombinant protein subunit vaccine ZF2001. Adverse events, IMID activity after vaccination, and the rate of COVID-19 in the two groups were compared. Results There were 158 patients in the IMID group, with an average age of 40 ± 14 years old, and 98 female subjects. In the IMID group, 123 patients received the inactivated CoronaVac vaccine, and 35 patients received the recombinant protein subunit vaccine ZF2001. There were 153 individuals in the control group, including 122 who received the CoronaVac vaccine and 31 who received the recombinant protein subunit vaccine ZF2001. The frequency of vaccine-related adverse events in the IMID group was less than that in the control group, all of which were mild local effects, and no serious events occurred. Of note, no disease flares occurred in the IMID group. No participants in either group subsequently got COVID-19, so the incidence rate was 0% in both groups. Conclusion COVID-19 vaccination was found to be safe for IMID subjects, any adverse events were mild, and vaccination did not increase the risk of disease activity. Meanwhile, vaccination could effectively reduce the incidence of COVID-19 in IMID patients. In the future, studies with a larger sample size and a longer duration are needed.

Clinical-epidemiological characteristics and survival of cases of severe acute respiratory syndrome (SARS) due to COVID-19, according to the COVID-19 vaccination schedule in Brazil, 2021-2022: a prospective study / Características clinico-epidemiológicas y sobrevida de casos de síndrome respiratoria aguda grave (SRAG) por COVID-19, según esquema vacunal contra COVID-19 en Brasil, 2021-2022: estudo prospectivo / Características clínico-epidemiológicas e sobrevida de casos de síndrome respiratória aguda grave (SRAG) por covid-19, segundo esquema vacinal contra covid-19 no Brasil, 2021-2022: estudo prospectivo

ABSTRACT Objective To analyze the clinical and sociodemographic characteristics and survival of individuals with severe acute respiratory syndrome due to COVID-19 according to the COVID-19 vaccination schedule, Brazil, 2021-2022. Methods This was a cohort study based on data from the Influenza Epidemiological Surveillance Information System; the Kaplan-Meier and Survival Tree methods were used to analyze survival. Results Among the 559,866 hospitalized cases, a higher proportion of vaccinated individuals was found among female (15.0%), elderly people aged ≥ 80 (34.5%), people from the Southeast region (15.7%), those who did not undergo respiratory support (21.2%) and those who did progress to death (15.2%); the survival curve showed that risk of death for unvaccinated individuals was higher in all age groups (p-value < 0.001); elderly people aged ≥ 80, who did not undergo mechanical ventilation and who had a booster dose had lower risk when compared to their peers who had two doses or were unvaccinated (hazard ratio = 0.64; 95%CI 0.62;0.67). Conclusion Lowest risk of death was found in vaccinated individuals, especially those who had two doses or a booster dose as well.

RESUMEN Objetivo Analizar las características clínicas, sociodemográficas y supervivencia de individuos con síndrome respiratoria aguda grave por COVID-19, según el esquema de vacunación contra COVID-19, Brasil, 2021-2022. Métodos Estudio de cohorte con datos del Sistema de Informação de Vigilância Epidemiológica de la Gripe; se utilizó el método de Kaplan-Meier y el árbol de supervivencia para analizar la supervivencia. Resultados Entre los 559.866 casos hospitalizados, se observó una mayor proporción de vacunados entre el sexo femenino (15,0%), ancianos ≥ 80 (34,5%), región Sudeste (15,7%), quienes no recibieron soporte ventilatorio (21,2%) y no fallecidos (15,2%); la curva de supervivencia mostró que los no inmunizados presentaron un mayor riesgo de óbito en todos los grupos de edad (p-valor < 0,001); los ancianos ≥ 80, que no recibieron ventilación mecánica, con dosis de refuerzo, tienen un menor riesgo en comparación con sus pares con dos dosis o no vacunados (HR = 0,64; IC95% 0,62;0,67). Conclusión El menor riesgo de óbito se observó en individuos vacunados, especialmente aquellos con dos dosis o refuerzo.

RESUMO Objetivo Analisar as características clínicas e sociodemográficas e a sobrevida de indivíduos com síndrome respiratória aguda grave por covid-19, segundo esquema vacinal contra covid-19, Brasil, 2021-2022. Métodos Estudo de coorte, com dados do Sistema de Informação de Vigilância Epidemiológica da Gripe; métodos de Kaplan-Meier e árvore de sobrevivência foram utilizados para analisar a sobrevida. Resultados Dos 559.866 casos internados, observou-se maior proporção de vacinados entre sexo feminino (15,0%), idosos ≥ 80 anos (34,5%), na região Sudeste (15,7%), entre os que não receberam suporte ventilatório (21,2%) e os não evoluídos a óbito (15,2%); na curva de sobrevida, não imunizados apresentaram maior risco de óbito, independentemente da faixa etária (p-valor < 0,001); idosos que não realizaram ventilação mecânica, com dose de reforço, apresentaram menor risco, comparados a seus pares com duas doses ou não imunizados (hazard ratio = 0,64; IC95% 0,62;0,67). Conclusão Observou-se menor risco de ocorrência de óbito nos indivíduos vacinados, especialmente com duas doses ou reforço.

Assessment of COVID-19 vaccine hesitancy among people living with HIV/AIDS: a single-centered study

Introduction: as the coronavirus disease 2019 (COVID-19) vaccines are distributed and administered globally, hesitancy towards the vaccine hinders the immunisation of a significant number of vulnerable populations, such as people living with HIV/AIDS. Hence, this study aims to assess COVID-19 vaccine hesitancy among people living with HIV/AIDS (PLHIV) attending clinicaloutpatient follow-up at State Specialist Hospital Maiduguri (SSHM), Borno State, Nigeria. Methods: a hospital-based cross-sectional study design was conducted to assess COVID-19 vaccine hesitancy among 344 PLHIV receiving antiretroviral therapy (ART) at the United States President´s Emergency Plan for AIDS (PEPFAR) clinic in SSHM from 4 th January to 25th February 2022. Data were collected using a structured and pretested interviewer-administered questionnaire. The results were presented using frequencies and percentages. The factors that are associated with COVID-19 vaccine hesitancy were identified using the Chi-square statistical test. Results: among the 344 respondents of the study, only 88 (26.6%) received the COVID-19 vaccine. Out of the 256 respondents that did not receive the vaccine, only 10.5% (27/256) are willing to be vaccinated, while the majority; 57.8% (148/256) are not willing to be vaccinated and 31.7% (81/256) of the respondents are uncertain, thus resulting in a hesitation rate of 89.45%. There was no statistically significant association between COVID-19 vaccine hesitancy and the study´s independent variables; where p-value is greater than 0.05. Conclusion: hesitancy towards COVID-19 vaccine is high among PLHIV and there is no any statistically significant association between COVID-19 vaccine hesitancy and the independent variables of the study where p-value is greater than 0.05. Hence, it is necessary to develop targeted strategies to boost vaccine uptake among this vulnerable population.

Perception and willingness to the uptake of COVID-19 vaccine among household-heads in a rural community of South-Western Nigeria

Background:The COVID-19 pandemic and its vaccine have been met with varying perceptions that may have both negative and positive effects on the willingness to uptake the COVID-19 vaccine. The study is set to determine the perception and willingness of the household heads to the uptake of COVID-19 vaccine in a rural community in Southwestern, Nigeria.Materials and Methods:A cross-sectional study was carried out among 409 household heads selected through a multistage sampling technique. The instrument of data collection was a semi-structured interviewer-administered questionnaireusing the Health Belief model constructs. Data were analyzed with IBM SPSS version 21.0 and Pearson's Chi-square test was used to determine the association between perception and willingness to uptake vaccine. P<0.05 was taken as significant at 95% confidence interval.Results:The majority of the unvaccinated respondents in the study were not willing to take the COVID-19 vaccine (60.1%). There was a poor perception of the susceptibility/severity of unvaccinated respondents to COVID-19 infection and a poor perception of the benefit/barrier to the uptake of the COVID-19vaccine. Perception of susceptibility and severity of COVID-19 infection were statistically related to the willingness to uptake the COVID-19vaccine.Conclusion:There should be an increase in awareness campaigns to change the perception of people positively to COVID-19 infection and uptake of the COVID-19vaccine.

A survey of public perception, knowledge and factors influencing COVID-19 vaccine acceptability in five communities in Ghana

Objective: The present study assessed the public's perception and Knowledge about COVID-19 and factors that could affect vaccine acceptability in Ghana. Design: We carried out a cross-sectional population-based study. A structured questionnaire was used to capture data on socio-demographic information, knowledge, and the public's perception of COVID-19 infection, as well as COVID-19 vaccine acceptability from consented participants. Factors affecting vaccine acceptability in Ghana were explored. Robust ordinary least square linear regression analysis was adopted to assess factors associated with vaccine acceptability. Setting: Five communities (Labone, Lartebiorkoshie, Old Fadama, Chorkor, and Ashiyie) in Accra in the Greater Accra district were selected. Participants: WHO modified cluster-sampling method was applied to select households of 997 participants in the five communities. Results: Most respondents were males (57.6%), and the median age of participants was 30 years. The study participants demonstrated a good knowledge of COVID-19 and had high perceptions of the COVID-19 pandemic. The results revealed that the highest educational level, marital status, self-rated Knowledge of COVID-19, Knowledge of COVID-19 definition, Knowledge of COVID-19 symptoms, and perception of the COVID-19 pandemic were significantly associated with vaccine acceptability. Self-reported impact of COVID-19 lockdown/movement restrictions on agriculture and job as a source of livelihood was associated with vaccine acceptability. Conclusion: Higher subjective and objective knowledge of COVID-19 increases vaccine acceptability scores significantly thus, education on COVID-19 and the vaccination against SARS-CoV-2 infection must be intensified to improve vaccine acceptability in Ghana, especially among those with lower educational backgrounds