ABSTRACT
How and why is implicit and explicit human rights language used by World Trade Organization (WTO) negotiators in debates about intellectual property, know-how, and technology needed to manufacture COVID-19 vaccines, and how do these findings compare with negotiators' human rights framing in 2001? Sampling 26 WTO members and two groups of members, this study uses document analysis and six key informant interviews with WTO negotiators, a representative of the WTO Secretariat, and a nonstate actor. In WTO debates about COVID-19 medicines, negotiators scarcely used human rights frames (e.g., "human rights" or "right to health"). Supporters used both human rights frames and implicit language (e.g., "equity," "affordability," and "solidarity") to garner support for the TRIPS waiver proposal, while opponents and WTO members with undetermined positions on the waiver used only implicit language to advocate for alternative proposals. WTO negotiators use human rights frames to appeal to previously agreed language about state obligations;for coherence between their domestic values and policy on one hand, and their global policy positions on the other;and to catalyze public support for the waiver proposal beyond the WTO. This mixed-methods design yields a rich contextual understanding of the modern role of human rights language in trade negotiations relevant for public health.
ABSTRACT
Background: India is one of the most severely affected countries due to the COVID-19 pandemic. A higher risk of severe illness and complications from COVID-19 had been observed in pregnant women as compared to nonpregnant women. The government of India on July 2, 2021, provided approval for the vaccination of pregnant women against COVID-19. A little data regarding the safety or harm during pregnancy of vaccination were available that time. Lack of safety data, fear, mistrust, underestimation of efficacy of vaccine, and chaos due to pandemic makes indecisive surrounding for pregnant women and this causes hesitancy with decision making about the COVID-19 vaccination. Aims and Objectives: This study aims to analyze the willingness and hesitancy of pregnant women to get vaccinated against COVID-19. Materials and Methods: This prospective study was conducted in a tertiary care institute in Northern India. Five hundred antenatal women who were eligible for COVID-19 vaccination were included in this study. Informed consent has been taken and data were analyzed after filling face to face questionnaire regarding vaccine acceptance or hesitancy. Results: The present study revealed low acceptance of COVID-19 vaccination in pregnancy. Prime reasons for the same are no allowance by the family and the possibility of vaccine harming the baby. Conclusion: Specific efforts should be directed toward high-risk populations including pregnant women and those who are planning for pregnancy. This will promote vaccination rates by increasing people's trust in immunization and the health-care system.
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In this work we analyze the effectiveness of vaccination strategies for the COVID-19 epidemic in the Brazilian state of Minas Gerais. Firstly we study the effectiveness of general vaccination in the decreasing of the number of infected individuals using a traditional non structured SEIR model. Secondly we consider an age-structured SEIR model with three age classes (youngster, adult and elderly) and we analyze the current strategy in the Brazilian state of Minas Gerais, of focusing the vaccination on the elderly group. We conclude by showing this strategy to be mistaken and that a vaccination focusing on the age group of the adults would be much more efficient in decreasing the total number of infected individuals.
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To prevent and control COVID-19, COVID-19 vaccines are being developed, tested, and approved at an unprecedented rate. As of September 24, 2021, 22 types of COVID-19 vaccines have been approved for conditional marketing or emergency use by at least one country worldwide. Vaccine efficacy/effectiveness is a crucial concern for vaccination. This article provides an overview of efficacy of phase III clinical trials, vaccination, effectiveness of real-world studies as well as challenges of COVID-19 vaccine.
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Throughout the COVID-19 pandemic, international access to COVID-19 vaccines and other health technologies has remained highly asymmetric. This inequity has had a particularly deleterious impact on low- and middle-income countries, engaging concerns about the human rights to health and to the equal enjoyment of the benefits of scientific progress enshrined under articles 12 and 15 of the International Covenant on Economic, Social and Cultural Rights. In response, the relationship between intellectual property rights and public health has reemerged as a subject of global interest. In October 2020, a wholesale waiver of the copyright, patent, industrial design, and undisclosed information sections of the Agreement on Trade-Related Aspects of Intellectual Property (TRIPS Agreement) was proposed by India and South Africa as a legal mechanism to increase access to affordable COVID-19 medical products. Here, we identify and evaluate the TRIPS waiver positions of World Trade Organization (WTO) members and other key stakeholders throughout the waiver's 20-month period of negotiation at the WTO. In doing so, we find that most stakeholders declined to explicitly contextualize the TRIPS waiver within the human right to health and that historical stakeholder divisions on the relationship between intellectual property and access to medicines appear largely unchanged since the early 2000s HIV/AIDS crisis. Given the WTO's consensus-based decision-making process, this illuminates key challenges faced by policy makers seeking to leverage the international trading system to improve equitable access to health technologies.
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Objective: We aimed to evaluate the long-term graft functions of kidney transplant recepients (KTR) who have been cured of the COVID-19 and to investigate the role of inactivated COVID-19 vaccine in the clinical course of the disease. Materials and Methods: KTR who had COVID-19 pneumonia between March 2020 and September 2021 were included in the study.. The clinical course of the disease was evaluated in vaccinated patients and compared with those who were not vaccinated. The laboratory information of the patients at the time of admission to the hospital, 6 months and 12 months after the disease was recorded. Results: Of the 83 patients included, 67.5% were male. COVID-19 disease developed in 20 patients after vaccination. Vaccine;it decreased the development of acute kidney injury (AKI) 5.9 fold and hospitalization in the intensive care unit (ICU) 1.4 times fold (p < 0.05). In the follow-up, 10 patients died at the first admission to the hospital and no late death was recorded in the first year. Dialysis treatment was started in 5 patients due to graft loss. Conclusion: In kidney transplant patients, graft dysfunction may develop after COVID-19 infection. However, the inactivated COVID-19 vaccine;it can reduce the risks of hospitalization, AKI, and ICU admission.
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Objective: Although there are many vaccine developments, vaccine side-effect studies globally, limited literature information on COVID-19 vaccine hesitancy/refusal. In our study, we aimed to investigate the factors for COVID-19 vaccine refusal of healthcare professionals (HCPs). Methods: An online questionnaire was administered to HCPs employed who were not vaccinated with the COVID-19 vaccine during the study period at two pandemic hospitals. Results: A total of 74 who were not vaccinated with COVID-19 vaccine HCPs participated in the survey. A large majority of respondents were female (n=49,66.2%) and nurses (n=35,47.3%), and the average age of HCPs was 32.2 .. 7.8.55.4% of HCPs were not vaccinated against COVID-19, and 44.6% of HCPs were one dose COVID-19 vaccinated. 50% of HCPs were confused about the COVID-19 vaccine. 63.5% of HCPs were not vaccinated as they were waiting for a different form of the current vaccine. 58.1% of HCPs believe that the vaccine doesn't effective as vaccinated people became infected. Conclusion: Measures should be taken to increase the COVID-19 immunization rates of HCPs. The level of knowledge of HCPs about COVID-19 vaccines should be increased. If possible, the opportunity to be vaccinated with different forms of COVID-19 vaccines should be given.
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Vaccination is effective in preventing the increase of disease, especially emerging infectious diseases (EIDs), and it is particularly important for people in close contact with infected sources and susceptible populations who are at increased risk of getting infectious diseases due to behavior, occupation or health. Despite targeted vaccination guidelines, inadequate vaccination of the key populations fails to receive widespread attention, resulting in a high-risk transition of disease from key populations to general populations. Strengthening the vaccination of the susceptible groups can effectively block the spread of pathogens to general populations, and reduce the consumption of medical resources in universal vaccination, which has significant economic value. In this review, we describe the prevalence of EIDs, analyze the experience and lessons of infectious disease vaccination in key populations through several cases, and further explore the causes for the decline in vaccination rates of key populations. According to the trends of EIDs, a plan to strengthen the vaccination of key populations is proposed to effectively prevent the transition of EIDs from key populations to general populations.
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Background: COVID-19 severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was declared Pandemic by the World Health Organization on January 30, 2020. Vaccination represents the best possibility to resolve this pandemic. The current global challenge is the immunization against the SARS-CoV-2. However, the adverse events following immunization (AEFI) of the corona vaccine remains unclear. Aim and Objectives: This observational study aims to represent an accountable data of the AEFI between Covaxin and Covishield in North Indian population. Materials and Methods: The hospital-based prospective and observational study was employed from January 2021 to December 2021 for detecting and monitoring of AEFI in adults. All population vaccinated either covishield or covaxin with both doses were enrolled in the study as targeted population. Post-vaccination vaccinated population were telephonic follow-up with prior consent. Results: A total of 1015 vaccinated individuals were included in this study for assessment of AEFI. After statistical analysis of AEFI between both vaccination at 24 h P = 0.13, 3-7 days 0.4 and complete AEFI P = 0.06 observed. There is no association that was found significant P < 0.05 with the incidence of AEFI. Conclusion: The short-term outcome has not attribute any serious AEFI. This study demonstrated that both vaccines were well-tolerated and safe in generalized population.
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Background: The private health sector has a significant role in the delivery of health services in India. However, given fast changing COVID-19 pandemic, it is critical to understand the role of the private health sector in delivery of services going forward. The supply of COVID-19 vaccines is firmly regulated by the Government of India and the private sector received unrestricted access to vaccine supply directly from manufacturers from June 2021 onwards. Materials and Methods: PATH carried out a rapid assessment of private health facilities in the state of Maharashtra to understand the challenges faced by private facilities in providing COVID-19 vaccination. Results: During the assessment it was found that 100% of the private health facilities have a robust cold chain system which is essential for safe storage of COVID-19 vaccines and delivery of immunization services. The in-charges of the health facilities reported difficulty in estimating requirement of COVID-19 vaccines doses, as 67% of the beneficiaries in Mumbai and Nashik were direct walk-ins. During the assessment 93.3% of the facilities were observed to have adequate availability of COVID-19 vaccines doses, based on the beneficiary registration data for the day. Ministry of Health, Government of India, recommends a trained 5-member vaccination team for providing services at each vaccination site. Conclusion: The key challenges faced by private health facilities during delivery of COVID-19 immunization were associated with differential vaccine pricing, time taken to receive supply of vaccines, difficulties in accurately estimating vaccine demand, multiple record keeping at the facility level and declining vaccine demand.
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Yellow fever transmission in Africa included outbreaks and cases in countries with a history of YF mass vaccination campaigns (Cameroon, Central African Republic, Ghana), escalating the concern raised by the re-emergence of outbreaks in West Africa in 2020. In 2021, those outbreaks affected populations that had not been reached by immunization services, including people living in areas with compromised security and people missed in large-scale campaigns. The resurgence of intense viral transmission highlights the importance of achieving and maintaining equitable, high vaccination coverage of all at-risk populations. COVID-19 continued to impact YF control in 2021. The type of effect changed as countries prioritized vaccination against COVID-19, which led to postponement or de-prioritization of YF vaccination in some countries and affected vaccine acceptance. Despite the challenges, priority countries made good progress in implementing the Eliminate Yellow fever Epidemics (EYE) strategy in 2021, with >48 million people reached through reactive, catch-up and preventive YF vaccination campaigns in Africa.