Epidemiological evaluation of mass testing in a small municipality in the Netherlands during the SARS-CoV-2 epidemic.

During 6 weeks in February-March 2021, the Dutch municipal health service Utrecht studied the epidemiological effects on test incidence and the detection of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with mass testing (MT). During MT, inhabitants of Bunschoten could repeatedly test regardless of symptoms and as often as desired at the close-by test facilities in the municipality. Data from the regular COVID-19 registration was used for analysis. In Bunschoten, MT caused a significant increase in test incidence and an immediate increase in the number of detected active infections, in contrast to a stabilisation in the rest of the province of Utrecht. Age distribution of test incidence shifted to the older population in Bunschoten during MT. During MT, there was a 6.8 percentage point increase in detected asymptomatic cases, a 0.4 percentage point increase in pre-symptomatic cases and a decrease of 0.5 days between onset of symptoms and test date. This study has shown that MT increases test incidence and helps to obtain a more complete view of the presence of SARS-CoV-2 in a community, which can be useful in specific situations with a defined target group or goal. However, the question remains open whether the use of MT is proportionate to the overall gain.

A systematic literature review to clarify the concept of vaccine hesitancy.

Vaccine hesitancy (VH) is considered a top-10 global health threat. The concept of VH has been described and applied inconsistently. This systematic review aims to clarify VH by analysing how it is operationalized. We searched PubMed, Embase and PsycINFO databases on 14 January 2022. We selected 422 studies containing operationalizations of VH for inclusion. One limitation is that studies of lower quality were not excluded. Our qualitative analysis reveals that VH is conceptualized as involving (1) cognitions or affect, (2) behaviour and (3) decision making. A wide variety of methods have been used to measure VH. Our findings indicate the varied and confusing use of the term VH, leading to an impracticable concept. We propose that VH should be defined as a state of indecisiveness regarding a vaccination decision.