Effects of vaccination on mitigating COVID-19 outbreaks: a conceptual modeling approach.

This paper is devoted to investigating the impact of vaccination on mitigating COVID-19 outbreaks. In this work, we propose a compartmental epidemic ordinary differential equation model, which extends the previous so-called SEIRD model [1,2,3,4] by incorporating the birth and death of the population, disease-induced mortality and waning immunity, and adding a vaccinated compartment to account for vaccination. Firstly, we perform a mathematical analysis for this model in a special case where the disease transmission is homogeneous and vaccination program is periodic in time. In particular, we define the basic reproduction number $ \mathcal{R}_0 $ for this system and establish a threshold type of result on the global dynamics in terms of $ \mathcal{R}_0 $. Secondly, we fit our model into multiple COVID-19 waves in four locations including Hong Kong, Singapore, Japan, and South Korea and then forecast the trend of COVID-19 by the end of 2022. Finally, we study the effects of vaccination again the ongoing pandemic by numerically computing the basic reproduction number $ \mathcal{R}_0 $ under different vaccination programs. Our findings indicate that the fourth dose among the high-risk group is likely needed by the end of the year.

Professional stakeholders' perceptions of barriers to behavioral health care following pediatric traumatic brain injury.

OBJECTIVE: To examine professional stakeholders' perspectives of barriers to behavioral health care (BHC) follow-up and telepsychology after pediatric traumatic brain injury (TBI). METHODS: Twenty-nine professionals participated in a focus group (FG) or key informant interview (KII) between January and March 2020. Professionals answered questions about facilitators and barriers to BHC follow-up and telepsychology. Given widespread telepsychology implementation since COVID-19, a follow-up survey assessing telehealth perceptions since the pandemic was sent out in December 2020. Nineteen professionals completed the survey. RESULTS: Professionals identified individual (e.g., family factors, insurance coverage/finances, transportation/distance, availability, planning follow-up care) and system-level (e.g., lack of access to BHC providers) barriers to BHC post-injury. Possible solutions, like collaborative follow-up care, were also identified. Generally, clinical professionals have favorable impressions of telepsychology and utilized services as a delivery modality for clinical care. Though telepsychology could reduce barriers to care, professionals also expressed concerns (e.g., technology issues, security/safety) and challenges (e.g., funding, accessibility, training/licensure for clinicians) with implementing telepsychology. CONCLUSION: Barriers identified highlight the need for context-specific solutions to increase BHC access, with telepsychology generally recognized as a beneficial modality for BHC. Future work should continue to focus on understanding barriers to BHC and potential solutions after pediatric TBI.

Vaccine Hesitancy: Drivers and How the Allergy Community Can Help.

Vaccine hesitancy-defined by the World Health Organization (WHO) as a "delay in acceptance or refusal of vaccines despite availability of vaccination services"-is not a recent phenomenon. Historical records indicate that vaccine hesitancy existed by the 18th century in Europe and even resulted in violent riots. The drivers of vaccine hesitancy have evolved over the last 200 years but not, perhaps, as much as one might expect. More problematic are the means by which concerns over vaccine hesitancy are communicated by a new landscape of digital communication, generating what has been described as an "infodemic" in which an overabundance of information-both factual and misinformation-contributes to hesitancy. In this review, we discuss the background and current drivers of vaccine hesitancy and the evidence base for strategies to combat this. We highlight the important role the allergy/immunology community could have in working to mitigate vaccine hesitancy, particularly with respect to the current coronavirus disease 2019 (COVID-19) pandemic.

Impact of COVID-19 on adolescent and emerging adult brain tumor survivors and their parents.

BACKGROUND: The COVID-19 pandemic has prompted unprecedented challenges, contributing to greater difficulties among families of children with special health care needs, such as pediatric brain tumor survivors. We examined the impact of the pandemic on psychosocial functioning of adolescent and emerging adult survivors and their parents. We hypothesized that COVID-19 disruptions and survivor social connectedness would be associated with survivor-reported posttraumatic stress and family outcomes, including family functioning, parenting, and parent mental health. PROCEDURE: Fifty-five families (44 survivors, 48 parents) were recruited via phone and email to participate in the study. Survivors were ages 13-25 (M = 19.62, SD = 3.47) and at least 5 years post diagnosis. Parents completed the COVID-19 Exposure and Family Impact Survey (CEFIS), and survivors completed the Environmental influences on Child Health Outcomes (ECHO) COVID-19 child self-report form, which assessed pandemic impacts on their psychosocial functioning. RESULTS: Parents reported a mean of 7.52 (SD = 2.83) disruptions to their families' lives. The pandemic negatively affected survivors' life satisfaction (Mdiff  = 0.46, t(44) = 3.96, p < .001), with 92% reporting reduced social connectedness (n = 39). Total disruptions due to COVID-19 and survivor social connectedness predicted survivor-reported posttraumatic stress, above and beyond survivors' pre-pandemic psychosocial risk. Most parents reported positive changes in their parenting (n = 31, 67.4%) and family cohesion (n = 30, 66.7%). However, they also reported worsened mood (n = 28, 62.3%) and increased anxiety (n = 31, 71.1%). CONCLUSIONS: Parents and survivors reported positive and negative impacts of COVID-19, which had downstream consequences on survivor psychosocial functioning. Follow-up care should consider potential adverse effects on social connectedness and stress symptoms.

Deterministic and stochastic models for the epidemic dynamics of COVID-19 in Wuhan, China.

In this paper, deterministic and stochastic models are proposed to study the transmission dynamics of the Coronavirus Disease 2019 (COVID-19) in Wuhan, China. The deterministic model is formulated by a system of ordinary differential equations (ODEs) that is built upon the classical SEIR framework. The stochastic model is formulated by a continuous-time Markov chain (CTMC) that is derived based on the ODE model with constant parameters. The nonlinear CTMC model is approximated by a multitype branching process to obtain an analytical estimate for the probability of a disease outbreak. The local and global dynamics of the disease are analyzed by using the deterministic model with constant parameters, and the result indicates that the basic reproduction number $ \mathcal{R}_0 $ serves as a sharp disease threshold: the disease dies out if $ \mathcal{R}_0\le 1 $ and persists if $ \mathcal{R}_0 > 1 $. In contrast to the deterministic dynamics, the stochastic dynamics indicate that the disease may not persist when $ \mathcal{R}_0 > 1 $. Parameter estimation and validation are performed to fit our ODE model to the public reported data. Our result indicates that both the exposed and infected classes play an important role in shaping the epidemic dynamics of COVID-19 in Wuhan, China. In addition, numerical simulations indicate that a second wave of the ongoing pandemic is likely to occur if the prevention and control strategies are not implemented properly.

Strengthening Vaccine Confidence and Acceptance in the Pediatric Provider Office.

Although vaccine acceptance and uptake are overall high among children in the United States, vaccine delays or refusals are a growing concern. Vaccine hesitancy is a challenge for the pediatric provider, given the diverse factors associated with hesitancy and the limited evidence on effective strategies for addressing vaccine hesitancy in the provider office. In this article, we review available evidence and approaches for vaccine communication, including the importance of using a whole-team approach, building trust, starting the conversation early, using a presumptive approach for vaccine recommendations, motivational interviewing with parents who have concerns for vaccines, and additional techniques for responding to parent questions. We also review organizational strategies to help create a culture of immunization in the practice, including evidence-based approaches for increasing vaccine uptake and efficiency. Although these communication approaches and organizational strategies are intended to reassure parents who are vaccine hesitant that all routine, universally recommended vaccines are safe and effective, they likely will take on increased significance as the development, implementation, and evaluation of coronavirus disease 2019 vaccines continue to unfold. [Pediatr Ann. 2020;49(12):e523-e531.].

Telepsychotherapy With Children and Families: Lessons Gleaned From Two Decades of Translational Research.

The novel coronavirus, COVID-19, has led to sweeping changes in psychological practice and the concomitant rapid uptake of telepsychotherapy. Although telepsychotherapy is new to many clinical psychologists, there is considerable research on telepsychotherapy treatments. Nearly 2 decades of clinical research on telepsychotherapy treatments with children with neurological conditions has the potential to inform emerging clinical practice in the age of COVID-19. Toward that end, we synthesized findings from 14 clinical trials of telepsychotherapy problem-solving and parent-training interventions involving more than 800 children and families with diverse diagnoses, including traumatic brain injury, epilepsy, brain tumors, congenital heart disease, and perinatal stroke. We summarize efficacy across studies and clinical populations and report feasibility and acceptability data from the perspectives of parents, children, and psychotherapists. We describe adaptation for international contexts and strategies for troubleshooting technological challenges and working with families of varying socioeconomic strata. The extensive research literature reviewed and synthesized provides considerable support for the utility of telepsychotherapy with children with neurological conditions and their families and underscores its high level of acceptability with both diverse clinical populations and providers. During this period of heightened vulnerability and stress and reduced access to usual supports and services, telepsychotherapy approaches such as online family problem-solving treatment and online parenting skills training may allow psychologists to deliver traditional evidence-based treatments virtually while preserving fidelity and efficacy.

El nuevo coronavirus, COVID-19, ha conducido a cambios radicales en la psicología. práctica y el rápido consumo concomitante de telepsicoterapia. A pesar de que la telepsicoterapia es nueva para muchos psicólogos clínicos, existe una investigación considerable sobre tratamientos de telepsicoterapia. Casi dos décadas de investigación clínica sobre los tratamientos de telepsicoterapia con niños con afecciones neurológicas tienen la potencial para informar la práctica clínica emergente en la edad de COVID-19. Hacia ese fin, sintetizamos los resultados de 14 ensayos clínicos de resolución de problemas de telepsicoterapia e intervenciones de capacitación para padres que involucran a más de 800 niños y familias con diagnósticos diversos que incluyen lesión cerebral traumática, epilepsia, tumores cerebrales, enfermedad cardíaca congénita y accidente cerebrovascular perinatal. Resumimos la eficacia entre los estudios y poblaciones clínicas e reportamos datos de viabilidad y aceptabilidad desde las perspectivas de padres, hijos y psicoterapeutas. Describimos adaptacion para contextos internacionales y estrategias para resolver problemas tecnológicos y trabajar con familias de estratos socioeconómicos variables. La extensa literatura de investigación revisada y sintetizado proporciona un apoyo considerable para la utilidad de la telepsicoterapia con niños con afecciones neurológicas y sus familias y subraya su alto nivel de aceptabilidad con diversas poblaciones clínicas y proveedores. Durante este período de mayor vulnerabilidad y estrés y menor acceso a los apoyos habituales y servicios, enfoques de telepsicoterapia como tratamiento em línea para resolución de problemas familiares y la capacitación en habilidades para padres en línea pueden permitir que los psicólogos brinden tratamientos tradicionales basados en evidencia virtualmente mientras se preserva la fidelidad y la eficacia.