Reasons underlying the intention to vaccinate children aged 5-11 against COVID-19: A cross-sectional study of parents in Israel, November 2021 (preprint)

BackgroundVaccination is a key tool to mitigate the impact of the COVID-19 pandemic. In Israel, COVID-19 vaccines became available to adults in December 2020 and to 5-11-year-old children in November 2021. Ahead of the vaccine roll-out in children, we aimed to determine whether parents intended to vaccinate their children and describe reasons for their intentions. MethodsWe recruited parents on social media and collected information on parental socio-demographic characteristics, COVID-19 vaccine history, intention to vaccinate their children against COVID-19, and reasons for parental decisions, using an anonymous online survey. We identified associations between parental characteristics and intention to vaccinate children using a logistic regression model and described reasons for intentions to vaccinate or not using proportions together with 95% confidence intervals (CI). Results1837 parents participated. Parental non-vaccination and having experienced major vaccination side effects were strongly associated with non-intention to vaccinate their children (OR 0.09 and 0.18 respectively, p<0.001). Compared with others, parents who were younger, lived in the socio-economically deprived periphery, and belonged to the Arab population had lower intentions to vaccinate their children. Commonly stated reasons for non-intention to vaccinate included vaccine safety and efficacy (53%, 95%CI 50-56) and the belief that COVID-19 was a mild disease (73%, 95%CI 73-79). The most frequently mentioned motives for intending to vaccine children was returning to normal social and educational life (89%, 95%CI 87-91). ConclusionParental socio-demographic background and their own vaccination experience was associated with intention to vaccinate their children aged 5-11. Intention to vaccinate was mainly for social and economic reasons rather than health, whereas non-intention to vaccinate mainly stemmed from health concerns. Understanding rationales for COVID-19 vaccine rejection or acceptance, as well as parental demographic data, can pave the way for intentional educational campaigns to encourage not only vaccination against COVID-19, but also regular childhood vaccine programming. HighlightsO_LIParental intention to vaccinate 5-11 children is much lower than vaccine coverage in parental age groups C_LIO_LIBeing unvaccinated and having experienced side effects following vaccination were the greatest negative predictors in parents of intention to vaccinate their children C_LIO_LIParents were more likely to accept a COVID-19 vaccine for their children to allow them to return to daily social life and to ensure economic security in the family C_LIO_LIParents were more likely to reject a COVID-19 vaccination for health reasons such as safety concerns or due the belief that COVID-19 was a mild disease in children C_LI

Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness (preprint)

Objective: Studies have demonstrated a potential link between low vitamin D levels and both an increased risk of infection with SARS-CoV-2 and poorer clinical outcomes but have not established temporality. This retrospective study examined if, and to what degree, a relationship exists between pre-infection serum vitamin D levels and disease severity and mortality of SARS-CoV-19. Design and patients: The records of individuals admitted between April 7th, 2020 and February 4th, 2021 to the Galilee Medical Center (GMC) in Nahariya, Israel with positive polymerase chain reaction (PCR) tests for SARS-CoV-2 were searched for vitamin D (VitD) levels measured 14 to 730 days prior to the positive PCR test. Measurements: Patients admitted to GMC with COVID-19 were categorized according to disease severity and VitD level. Association between pre-infection VitD levels and COVID-19 severity was ascertained utilizing a multivariate regression analysis. Results: Of 1176 patients admitted, 253 had VitD levels prior to COVID-19 infection. Compared with mildly or moderately diseased patients, those with severe or critical COVID-19 disease were more likely to have pre-infection vitamin D deficiency of less than 20 ng/mL (OR=14.30, 95%, 4.01-50.9; p < .001); be older (OR=1.039 for each year, 95% CI for OR, 1.017-1.061; p< .01), and have diabetes (OR=2.031, 95% CI for OR, 1.04-3.36; p= 0.038). Vitamin D deficiency was associated with higher rates of mortality (p<0.001) and comorbidities including COPD (p=0.006), diabetes (p=0.026), and hypertension (p =0.016). Conclusions: Among hospitalized COVID-19 patients, pre-infection deficiency of vitamin D was associated with increased disease severity and mortality.

Revealing Global Government Health Website Accessibility Errors During COVID-19 and the Necessity of Digital Equity (preprint)

Background: Many government websites and mobile content are inaccessible for people with vision, hearing, and cognitive disabilities. The COVID-19 pandemic highlighted these disparities when health authority website information, critical in providing resources for curbing the spread of the virus, remained inaccessible for disabled populations. Methods: The Web Content Accessibility Guidelines (WCAG) provide comparatively universally accepted guidelines for website accessibility. We utilized these parameters to examine the number of countries with or without accessible health authority websites. Findings:The resulting data indicate a dearth of countries with websites accessible for persons with disabilities. Fewer than 5% of all countries had health authority websites fully accessible according to the WCAG. Interpretation: Methods of information dissemination must take into consideration individuals with disabilities, particularly in times of global health crises. Government health websites can be considered the most trustworthy sources of preventative healthcare information and therefore must be accessible to all, regardless of ability. Nations should seek to improve website compliance with the WCAG.Funding Statement: The authors report no funding sources. Declaration of Interests: The authors have no other competing interests to declare.

A lesson from COVID-19 on inaccessibility of web-based information for disabled populations worldwide (preprint)

Many government websites and mobile content are inaccessible for people with vision, hearing, and cognitive disabilities. The COVID-19 pandemic highlighted these disparities when health authority website information, critical in providing resources for curbing the spread of the virus, remained inaccessible for disabled populations. The Web Content Accessibility Guidelines provide comparatively universally accepted guidelines for website accessibility. We utilized these parameters to examine the number of countries with or without accessible health authority websites. The resulting data indicate a dearth of countries with websites accessible for persons with disabilities. Methods of information dissemination must take into consideration individuals with disabilities, particularly in times of global health crises.