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Tourism was one of the fastest-growing sectors of the global economy before the COVID-19 pandemic, accounting for around 10% of global GDP. This has created a number of challenges including environmental degradation, especially in small island countries where the carbon footprint of tourism constitute a substantial share of carbon dioxide (CO2) emissions. This study investigates the impact of tourism on CO2 emissions in a relatively homogenous panel of 15 Caribbean countries over the period 1960–2019. The results show that international tourist arrivals have a statistically and economically significant effect on CO2 emissions, after controlling for other economic, institutional and social factors. Managing tourism sustainably requires a comprehensive set of policies and reforms aimed at reducing its environmental impact, and curbing excessive dependency on fossil fuel-based energy consumption. © 2022 International Monetary Fund.
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Introduciton: Multiple Sclerosis (MS) is an autoimmune disease with B-cell dysregulation playing an essential role in pathogenesis. As B-cells are also responsible for antibody production, their disfunction could also affect the humoral immune response against SARS-CoV-2 vaccines. Aim(s): To compare the immune response after messenger RNA (mRNA) BNT162b2 (Pfizer/BioNTech) and inactivated Coronavac vaccines in newly diagnosed treatment-naive MS (tnMS) patients and healthy controls (HC). Method(s): A single-center cross-sectional study evaluating antibody response against SARS-CoV-2 vaccines (inactivated vs mRNA) in HC and newly diagnosed and treatment-naive MS patients. Serum samples were collected at least two weeks after the second dose of the vaccine. The cutoff level of seropositivity is >= 50 antibody unit (AU)/ml. Result(s): 46 participants had two doses of inactivated Coronavac (35 HC and 11 tnMS), and 103 (57 HC and 46 tnMS) had two doses of mRNA. There was no significant difference in antibody response between HC and tnMS in the inactivated vaccine group. In the mRNA group, the antibody titers were significantly higher in HC (p=0.009), though no difference in the seropositivity rates was observed. Conclusion(s): Although MS is an autoimmune inflammatory disease, it does not affect immunity against the SARS-CoV-2 vaccine in treatment-naive patients.
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Introduction: Disease-modifying therapy (DMT) may decrease the immune response to COVID-19 vaccines, and the antibody response against SARS- CoV-2 is still not fully explored in people with multiple sclerosis(pwMS). Aim(s): To evaluate the immune response after messenger RNA (mRNA) BNT162b2 (Pfizer/BioNTech) and inactivated Coronavac vaccines in pwMS treated with a DMT compared to healthy controls(HC). Method(s): Patients who came to our MS unit for treatment or routine control were included in the study. Serum samples were collected at least two weeks after the second dose of the vaccine. The cutoff level or seropositivity is >= 50 antibody units (AU)/ml. The antibody titers were compared between HC and each treatment group. Result(s): 815 pwMS treated with DMT, 90 untreated MS patients and 92 healthy controls were enrolled in this single-center crosssectional study. In total, 500 (50.2%) participants received two doses of inactivated Coronavac, and 497(49.8%) received two doses of BNT162b2. In HC group, only one patient who had mRNA vaccine was seronegative. All patients on cladribine (n =14, 100%)and azathioprine (n=5) treatment have seropositive results in both vaccine types. Among treatment groups, fingolimod and ocrelizumab were associated with lower antibody titers (p<0.005). Only in fingolimod group, seropositivity rate was higher for mRNA vaccine compared to inactivated vaccine. The SARS CoV-2 antibody titer was significantly associated with mRNA vaccine [beta= 0.739 (0.067) 95%CI= 0.607;-0.870 p<0.001], EDSS [beta= -0.061 (0.024) 95%CI= -0.108;-0.013 p<0.012], time between second vaccine dose and sample collection dates [beta=-0.002 (0.001) 95%CI= -0.003;-0.001 p<0.001] and relapsing MS type [beta= -0.395 (0.136) 95%CI= -0.662;-0.127 p<0.004] Conclusion(s): Fingolimod and ocrelizumab therapy are associated with decreased immunity after SARS CoV2 vaccines. mRNA type of vaccine is the preferable choice in pwMS.
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Introduction/Objectives: Immunity after two doses of inactivated and messenger RNA(mRNA) SARS-CoV 2 vaccines in Multiple Sclerosis (MS) is influenced by the Disease-Modifying Therapy (DMT) and vaccine type used. Being lower in fingolimod, ocrelizumab, and inactivated vaccine groups. A booster dose could change this discrepancy. Aim(s): To compare the immunogenicity of a booster dose of mRNA BNT162b2 (Pfizer/BioNTech) versus inactivated vaccine, performed after completing two doses of inactivated Coronavac in people with MS (pwMS). Method(s): pwMS and Healthy Controls (HC) who received a booster dose of SARS-CoV 2 mRNA or inactivated vaccine after completing two doses of inactivated Coronovac were enrolled in this single-center cross-sectional study. Serum samples were collected at least two weeks after the third dose of the vaccine. The antibody titers were compared between HC, MS, and each treatment group. Result(s): Each of 339 pwMS and 52 HC received three doses of SARS-CoV-2 vaccines. 283 (72,3%) participants received a booster dose of mRNA, and 108 (27,7%) participants received a booster dose of inactivated Coronavac. In all comparisons, patients treated with ocrelizumab had the lowest antibody titer (p<0.005). In the fingolimod group, booster mRNA caused a higher antibody titer than the inactivated vaccine. In total, pwMS had a lower antibody titer than HC regardless of the vaccine type. In regression analyses having a booster mRNA [beta= -0.671 (0.133) 95%CI= -0.933 - -0.409, p<0.001] and lower disease duration [beta-0.019 (0.010)95%CI= -0.038 - 0.000, p=0.44] were two markers which significantly associated with higher antibody titer in pwMS. Conclusion(s): The study shows that a third dose vaccine is an effective strategy to boost antibody response in the MS population, and the mRNA SARS CoV-2 vaccine's booster is preferable to inactivated ones.
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While the world's attention is on dealing with the COVID-19 pandemic, climate change remains a greater existential threat to vulnerable countries that are highly dependent on a weather-sensitive sector like tourism. Using a multidimensional index, this study investigates the long-term impact of climate change vulnerability on international tourism in a panel of 15 Caribbean countries over the period 1995-2017. Empirical results show that climate vulnerability already has a statistically and economically significant negative effect on international tourism revenues across the region. As extreme weather events are becoming more frequent and severe over time, our findings indicate that the Caribbean countries need to invest more in adaptation and mitigation in order to reduce vulnerabilities. © 2021 Walter de Gruyter GmbH, Berlin/Boston 2021.