Evidence and rationale for vaccinating children and adolescents against SARS-CoV-2: a comprehensive narrative review

Vaccines remain the most rigorous and cost-effective weapon of the public health care system against infectious diseases. The development of safe and effective vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged as an imperative response to the unprecedented morbidity and mortality of the Coronavirus Disease 2019 (COVID-19) pandemic and the subsequent immense pressure on health care systems, families and global society. Despite the typically mild disease course of SARS-CoV-2 in minors, the associated rare but potentially life-threatening complications, as well as the emergence of new highly transmissible variants, led promptly to the extension of COVID-19 vaccine clinical trials in children and adolescents. To date, various COVID-19 vaccine candidates have been successfully trialed in pediatric populations, followed by their incorporation into corresponding vaccination campaigns in both high- and low-income countries. However, the universal COVID-19 vaccination of children and adolescents remains a matter of debate, along with skepticism about their overall safety and benefits in this age group. In this narrative review, we attempt to summarize the multi-faceted burden of COVID-19 on minors, highlighting the favourable safety/effectiveness profile of COVID-19 vaccines in this age group, elucidating the raised concerns and presenting the current implemented vaccination strategies. [ FROM AUTHOR] Copyright of Signa Vitae is the property of Pharmamed Mado Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Parents' Readiness to Vaccinate Their Children Aged 5 to 17 Years Against Covid-19 and Its Associated Factors in Lira District, Uganda.

Background: Data on parents' readiness to vaccinate their children aged 5 to 17 years against COVID-19 is still scarce. This study assessed parents' readiness to vaccinate their children aged 5 to 17 years against COVID-19 and factors associated in Lira district, Uganda. Methods and Materials: A cross-sectional survey employing quantitative methods was conducted between October and November 2022 among 578 parents of children aged 5-17 years in 3 sub-counties in Lira district. An interviewer-administered questionnaire was used to collect data. Data was analyzed using descriptive statistics including means, percentages, frequencies, and odds ratios. Logistic regression was used to determine associations between the factors and the readiness of parents at a 95% level of significance. Results: Out of 634 participants, 578 responded to the questionnaire, giving a response rate of 91.2%. The majority of the parents (327, 56.8%) were female, had children aged between 12 and 15 years (266, 46.4%), and had completed primary education (351, 60.9%). Most of the parents were Christian (565, 98.4%), married (499, 86.6%), and had been vaccinated against COVID-19 (535, 92.6%). Results also indicated that 75.6% (ranging from 71.9% to 78.9%) of the parents were unwilling to vaccinate their children for the COVID-19 virus. The predictors of readiness were the age of the child (AOR: 2.02; 95% CI: 0.97-4.20; p=0.05) and lack of trust in the vaccine (AOR: 3.33; 95% CI: 1.95-5.71; p0.001). Conclusion: Our study shows that parents' readiness to vaccinate their children aged 5 to 17 years was only 24.6%, which is suboptimal. The predictors of hesitancy were the age of the child and a lack of trust in the vaccine. Based on our results, the Ugandan authorities should provide health education interventions targeting parents to combat mistrust with respect to COVID-19 and the COVID-19 vaccine and highlight the benefits of the vaccines.

The Becoming "literacy Chronotope": Mapping Translanguaging among Unaccompanied Minors as a Rhizome

In the present article, we draw on rhizomatic cartography and apply rhizomatic diagramming to palpate chronotopic diversity and dynamics in the "becoming"second language classroom. The context of the study is a hosting center for unaccompanied minors in Athens during the COVID-19 pandemic (June 2020 to March 2021). Through a chronotopic approach to literacy events, we examine a specific arts-and-crafts literacy event that includes four #Arabic-speaking minors and an intercultural mediator or "interpreter."Exploring "classroom"interaction moments rhizomatically, i.e., including interaction's socio-material aspects and dis-/continuities, we map the performed translanguaging space and problematize situated languaging and power relations among actors. We thus palpate intersections of striating and smoothing forces that shape this macroscopic "literacy chronotope"through an assemblage of microscopic chronotopes that we have come to call "transient sociolinguistic territoria."Our findings shed light on the diverse #Arabic (trans)languaging, making the language, cultural, and literacy brokering practices visible in the performed translanguaging space. Consequently, this study is expected to sensitize second language educators on the #Arabic sociolinguistic situation and the subtle nuances of translanguaging addressed in the literacy chronotope. © Common Ground Research Networks, Roula Kitsiou, Eleni Karantzola, All Rights Reserved.

Recognizing and treating psychological trauma in abused children during COVID-19

The COVID-19 pandemic and related restrictive measures have had a significant impact on the mental health of the entire population, especially children and adolescents. It seems appropriate to make a distinction between stressful events, which most families have experienced, and real traumatic experiences, which only the most vulnerable individuals have been victims of. In fact, the most recent data (WHO, 2020) show a significant increase in the rates of intra-family violence against women and minors around the world, during the period of the lockdown. The aim of this paper is to illustrate the spectrum of symptoms that the experience of a complex trauma determines on children and adolescents, and at the same time to indicate the possible strategies to facilitate the early detection of distress indicators and implement the necessary interventions in emergency contexts in an integrated and multilevel perspective. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Italian) La pandemia da COVID-19 e le relative misure restrittive hanno avuto un impatto signifi cativo sulla salute mentale di tutta la popolazione, soprattutto di bambini e di adolescenti. Appare opportuno operare una distinzione tra eventi stressanti, di cui hanno fatto esperienza la maggior parte delle famiglie, e vere e proprie esperienze traumatiche, di cui sono state vittime soltanto i soggetti piu vulnerabili. I dati piu recenti (WHO, 2020), infatti, evidenziano un incremento signifi cativo dei tassi di violenza intrafamiliare nei confronti di donne e minori in tutto il mondo, durante il periodo del lockdown. L'obiettivo di questo articolo e illustrare i quadri sintomatologici che l'esperienza di un trauma complesso determina su bambini e adolescenti, indicando allo stesso tempo, le possibili strategie per facilitare la rilevazione precoce degli indicatori di disagio e avviare gli interventi necessari in contesti emergenziali in un'ottica integrata e multilivello. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Facing amyotrophic lateral sclerosis under lockdown: The experiences of minors

Purpose: The purpose of this study is to assess the effect of social isolation of minors with a parent or grandparent suffering from amyotrophic lateral sclerosis (ALS) and to determine whether the psychological support offered by an Italian no-profit association helped them to manage stress. Methodology: This study followed a qualitative research design. The participants responded to in-depth interviews that were processed with inductive thematic analysis. Findings: Five themes emerged: feedback on the psychological intervention;learning and changes after the intervention;discourses on illness and death in the family;experiences and difficulties during the lockdown and suggestions for other peers who might face the same situation. Social Implications: Psychological support is necessary for these minors, and it helped them to manage both the stress of living with ALS and the limitations of social relationships during the pandemic. It showed the importance of authentic and honest communication about illness and death that allowed minors to manage anxiety and fear. Positive reinterpretation of these experiences by transforming them into opportunities was also revealed. Originality: Studies on families with ALS patients are numerous, but studies on children of these patients are still rare, and no study has investigated the impact of the COVID-19 pandemic on these children. This research investigated a topic that has not been covered previously and it also provided the opportunity to know how these children, preadolescents and adolescents living in an already complex environment, have experienced lockdown and restrictions. The study also enriched the literature on this important issue. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

THE LEGAL REGIME OF THE COVID-19 VACCINE TODAY: FROM GENERAL IMPOSITION TO THE RESOLUTION OF CONFLICTS BETWEEN PARENTS

The present paper analyses the evolution in the legal treatment of vaccination in the Spanish legal system and the complexity of the subject in the current coordinates. © 2022 Ibero-American Law Institute. All rights reserved.

Free access to emergency oral contraceptives (EOCs) in the European union: A regulatory vacuum to be filled.

BACKGROUND: According to the World Health Organization (WHO), any woman in childbearing age who have decided not to take permanently an oral contraceptive but who are sexually active has the right to access emergency contraception (EC). Despite this, in many European countries there are no specific laws governing the criteria for access to emergency oral contraceptives (EOCs) for girls under 18, especially about the need for third party consent. This normative vacuum is dangerous as it risks creating confusion and entrusting the management of the fundamental right of self-determination to the discretion of others. Moreover, in European Union (EU) countries, there is an inequality in terms of access to contraceptive supplies, reimbursement criteria and the availability of information online. OBJECTIVE: Our article compares the criteria for access to EOCs (Ulipristal Acetate-UPA and Levonorgestrel-LNG) in the various EU countries to highlight possible disparities and consequent inequalities. METHODS: Government and ministerial websites, European agencies websites, and Contraceptive Use by Method 2019 (WHO) have been consulted. RESULTS: There are some differences between the various European countries that could configure inequality in EU countries. CONCLUSIONS: It would be appropriate a definitive levelling of the legislation of the European Union on emergency contraception associated with massive information and awareness campaigns.

Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain.

BACKGROUND: In recent decades, the increase in population movements has turned the focus to imported diseases. The COVID-19 pandemic has negatively impacted the access to health care systems, especially in highly vulnerable populations. We address the effects of the pandemic on the health screening of migrant unaccompanied minors (UM) in Spain. METHOD: Retrospective cross-sectional study including UM screened for imported diseases with a unified protocol at a pediatric reference unit for tropical and infectious diseases in Madrid, Spain. We compared the pre-pandemic (2018-2019) and post-pandemic periods (2020-2021). RESULTS: A total of 192 minors were screened during the study period, with a drop in UM's referral to our center in the post-pandemic years (140 in 2018-2019 vs. 52 in 2020-2021). Out of 192, 161 (83.9%) were diagnosed with at least one medical condition. The mean age was 16.8 years (SD 0.8) and 96.9% were males. Most cases were referred for a health exam; only 38% of children were symptomatic. Eosinophilia was present in 20.8%. The most common diagnosis were latent tuberculosis infection (LTBI) (72.9%), schistosomiasis (15.1%), toxocariasis (4.9%) and strongyloidiasis (4.9%). The prevalence of LTBI did not vary significantly (69.3% vs. 82.7%, p = 0.087). A total of 38% of the patients diagnosed with LTBI never started treatment or were lost to follow-up, as were two out of three patients with active pulmonary tuberculosis. CONCLUSIONS: In this series, the number of UM referred for health screening has dropped dramatically after the COVID pandemic, and two years after the beginning of the pandemic, access to care is still limited. Lost to follow-up rates are extremely high despite institutionalization. Specific resources, including multidisciplinary teams and accessible units are needed to improve diagnoses and linkage to care in this vulnerable population.

Qualitative descriptive study during the COVID-19 pandemic on the needs of informal caregivers of Chinese minors who underwent craniopharyngioma surgery.

PURPOSE: To determine the needs of informal caregivers during the long-term health management of minors who have undergone craniopharyngioma surgery. Design and methodology This is a qualitative and descriptive research study. Purposive sampling was used to select participants, and semi-structured interviews were conducted to explore the needs of 21 informal caregivers for postoperative minors. Due to the COVID-19 pandemic, the respondents were provided with the options of online video call or offline one-on-one interviews. Following this, a content analysis method was conducted. RESULTS: Four themes and 14 sub-themes were extracted from the results of the study, including needs for relieving psychological stress (including psychological pressure on both minors and on caregivers); requirement for on-campus assistance (physical activity, eliminating verbal violence in schools, special education needs for child, healthcare services provided by school hospitals); demands for medical help (acquiring medical knowledge, need for medication management, convenience and reliable access to medical services, need for technological development, expectations of multidisciplinary cooperation, the necessity of health review reminders); and the desire for financial aid (charity platform assistance, inclination of government policy). CONCLUSIONS: In China, informal caregivers of young patients with onset craniopharyngioma require both the multidisciplinary cooperation of medical institutions and the multi-departmental cooperation of society. Information and medical technology advancements may benefit families with young patients. Improving community hospitals' medical services and encouraging the practical use of online medical treatment and prescriptions are both necessary in the context of COVID-19. PRACTICE IMPLICATIONS: By identifying the needs of informal caregivers, medical professionals are able to develop care plans and interventions aimed at reducing the burden of care for minors who have undergone craniopharyngioma surgery.

A Case Study on the Impact of Digital Relationships on Unaccompanied Minors during the COVID-19 Lockdown

The exploratory study investigates how unaccompanied minors (UAMs) in Italy dealt with social isolation at the time of the outbreak of the COVID-19 pandemic. Have they suffered from the effects of the lockdown? How did their relationships change? What feelings characterised their experience? What factors helped them? Did ICT help them, or did it increase their social and economic marginalisation? Very little research has investigated the issues of UAMs, socialisation, technologies, and pandemics together. The data were collected through a purpose-built questionnaire that obtained an excellent Cronbach Alpha index (0.91) for internal consistency, which was administered to the migrant students of a school in North-East Italy. The answers indicated that they perceived the change in their social relations;but they coped with it, thanks to their internal resources, such as resilience and self-efficacy, and external ones, including digital devices and social support from family and teachers. Their friendship networks are regrettably fragile, and the youths do not rely much on them. On the other hand, the results show the crucial role of adults for the UAMs' well-being: everyone, from the developers of policies to teachers, should take this aspect into account. Providing teenagers with appropriate communication technologies, ensuring the support of caregivers and teachers, and organising activities that strengthen peer networks are the actions of paramount importance, to ensure their welfare. ©Authors.

Effector memory T cell subset CD45RA−CCR7−CD27−CD28− EM3 increases in direct proportion to the disease severity of COVID‐19

COVID‐19, which emerged in December 2019 and continues to wreak havoc, has led to the death of many people around the world. In this study, we aimed to uncover the variables underlying the exacerbation of the disease by considering the changes in T cell subsets in adults and juveniles with different disease severity of COVID‐19. Peripheral blood samples of 193 patients (128 adults and 65 juveniles) diagnosed with COVID‐19 were evaluated in a flow cytometer, and a broad T cell profile was revealed by examining T cell subsets in terms of exhaustion and senescence. We found remarkable differences in the effector memory (EM;CD45RA−CCR7−) cell subsets of severe pneumonia cases. The frequencies of EM2 CD4+ T, EM3 CD4+ T, EM3 CD8+ T, EM2 DN T and EM3 DN T cells were found to increase in severe pneumonia cases. Consistently, these cells were found in juveniles and uncomplicated adults in similar or lower proportions to healthy controls. The findings of our study provide a view of the T cell profile that may underlie differences in the course of COVID‐19 cases in juveniles and adults and may provide new insights into the development of effective treatment strategies.

Minors' Experiences Accessing Confidential Contraception in Texas.

PURPOSE: Texas is one of 24 states that restricts minors' ability to obtain contraception without parental consent, unless they access confidential services at federally funded Title X clinics. This study explores Texas minors' reasons for and experiences seeking confidential contraception. METHODS: Between September 2020 and June 2021, we conducted in-depth phone interviews with 28 minors aged 15-17 years. Participants were recruited via the text line and Instagram account of an organization that helps young people navigate Texas' parental consent laws. Interview transcripts were coded and analyzed using inductive and deductive codes in our thematic analysis. RESULTS: Participants wanted to be proactive about preventing pregnancy by using more effective contraceptive methods but faced resistance from adults when they initiated conversations about sex and contraception or tried to obtain consent. In the absence of adult support, they turned to online and social media resources for information about types of contraception but encountered challenges finding accurate information about where to obtain methods in Texas without a parent. Only 10 participants were able to attend an appointment for contraception. Parents' increased monitoring of minors' activities during the COVID-19 pandemic, combined with transportation and appointment-scheduling barriers, made it difficult for minors to attend in-person visits, particularly if clinics were farther away. DISCUSSION: Minors in Texas faced a range of barriers to finding accurate information and obtaining confidential contraceptive services, which were exacerbated by the COVID-19 pandemic. Expanding options for accessible confidential contraception, along with repealing parental consent laws, would better support minors' reproductive autonomy.

A NEW ERA FOR THE RIGHTS OF THE CHILD: THE NEW “ROME STRATEGY” (2022-2027) The Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse: “The Lanzarote Convention” as an instrument of protection

The significant increase in the existence and exploitation of self-generated sexual images and videos by boys and girls, is the focus of the new monitoring Report presented by the Council of Europe´s Lanzarote Committee in Rome. In 2017, exploitation of boy and girls self-generated sexual material was already perceived as a potentially serious risk. Later, in 2019-2020, a large increase in the existence of sexual material generated by minors was observed. The pandemic situation derived from Covid-19 exacerbated this reality. The Report examines 43 European States Parties to The Lanzarote Convention, with special mention to the fact of preventing this particular form of sexual exploitation of boys and girls, investigat-ing and prosecuting it, improving the identification and protection of victims and and likewise, an improvement of the framework law in this matter with the consequent guidelines to the respective governments. © GKA Ediciones, authors.

A Pilot COVID-19 Surveillance Program at the Zendrini Center in Milan (Italy) for Unaccompanied Foreign Minors.

During the COVID-19 pandemic, not only crowded refugee camps and immigration detention centers, but also receptions were places in which outbreaks occurred. To date there has been no report of the application of a COVID-19 surveillance system in reception centers for unaccompanied foreign minors only, who most of all deserve the utmost attention. Aware of this critical issue, we implemented a pilot COVID-19 surveillance program at the Zendrini center in Milan. It was started in September 2021 and was carried out for 4 months. Nasopharyngeal antigenic swabs were adopted. One day a week, two forensic physicians performed the first antigenic swab to minors who had just entered the center, or a monitoring swab after 15 days to those who were still hosted at the center. Operators were also swabbed for surveillance. A total of 80 subjects were enrolled and divided into 68 (72.5%) unaccompanied foreign minors and 22 (27.5%) operators. A total of 178 antigenic nasopharyngeal swabs were performed and tested negative. Regarding the monitoring activities, it was found that the minimum number of swabs per subject was 1 and the maximum number was 7, with an average value of 2.2 per individual. Having been able to confirm the absence of SARS-CoV-2 within the community represented a way to protect individual and collective health that could not have been pursued otherwise. Only inclusive approaches can allow communities and societies to respond more effectively to this crisis, and reduce the risk of future ones, intended as both upcoming COVID-19 waves and new infectious diseases.

Covid-19 and the Rohingya Refugees in Bangladesh: Socioeconomic and Health Impacts on Women and Adolescents

COVID-19 has exacerbated the existing crisis that the vulnerable refugee population faces. More than a million Rohingya refugees live in Bangladesh. COVID-19 has affected both males and females. It is critical to understand how this population group is coping during this trying period. They are constituted by 52% women and 55% adolescents. The socioeconomic and physiological repercussions of the pandemic on the Rohingya people are contextualised in this study. The socioeconomic and health impacts of COVID-19 on Rohingya women and adolescents in Bangladesh are investigated. Because of the restrictions imposed, over 63% of Rohingya adolescent females suffered from food scarcity. The vast majority of respondents (87%) stated that they had reduced their meal frequency, resulting in a protein deficiency. Since their arrival in Bangladesh, they have had limited access to medical and educational facilities. The pandemic has further exacerbated the situation. Girls are more vulnerable to sexual and gender-based abuse, early marriage, school dropout, and pregnancy. This research aims to add to existing knowledge on refugees, Rohingya, women, and adolescents.

Caregiving solutions in Mexican households during COVID-19 lockdown.

The COVID-19 quarantine in Mexico has meant that household members spend more time inside the home, increasing the demand for direct and indirect care by minors, the elderly, chronically ill and disabled. This forced a reconfiguration of the provision of these services by household members. The aim of the document is twofold: first, to describe socioeconomic and demographic aspects of Mexican households around care activities during the quarantine and second, to estimate the determinants of the provision of care in the quarantine. The information was obtained from the Survey of Care and COVID-19 in Mexican Homes during Quarantine (SCCMHQ). The propensity score-matching technique is used as a quasi-experimental procedure to estimate the causal effects of a treatment variable (presence of minors, elderly, chronically ill, disability, or domestic service in the home) in Mexican households. The Probit model shows that age and economic dependency are determinants of caregiving for treatment groups with minors, disability and chronic disease. In addition, sex, home income, and current employment situation are significant for treatment groups with a disability, paid domestic work, and minors, respectively. A positive "net" effect of the treatment variables in the probability of care provision was also observed. Particularly, the existence of minors at home was highly effective to promote direct and indirect care. The confinement solution is characterized by a balance between genders, except in the case of households with disabilities. This shows that a cultural and functional change is possible in the distribution of care responsibilities, which can be consolidated through public policies.

Covid-19: Medical Decisions, Mandates, and High-Risk Minors.

Kensey Dishman was unvaccinated when she contracted Covid-19 at thirteen years old. She also had asthma and is now dead. Her divorced parents disagreed about whether Kensey should be vaccinated, and her father suggested that it was Kensey's own choice to refuse vaccination. This situation is as complicated as it is tragic, and it raises a number of legal and ethical issues regarding medical decision-making for minors, parental rights, vaccination mandates, and individual freedom versus government interests in protecting minors as well as public health. This commentary explores these issues and highlights potential sources of liability for those involved in Kensey's treatment decisions given her high-risk for complications from Covid-19.

Facing Amyotrophic Lateral Sclerosis Under Lockdown: The Experiences of Minors

Purpose: The purpose of this study is to assess the effect of social isolation of minors with a parent or grandparent suffering from amyotrophic lateral sclerosis (ALS) and to determine whether the psychological support offered by an Italian no-profit association helped them to manage stress.Methodology: This study followed a qualitative research design. The participants responded to in-depth interviews that were processed with inductive thematic analysis.Findings: Five themes emerged: feedback on the psychological intervention;learning and changes after the intervention;discourses on illness and death in the family;experiences and difficulties during the lockdown and suggestions for other peers who might face the same situation.Social Implications: Psychological support is necessary for these minors, and it helped them to manage both the stress of living with ALS and the limitations of social relationships during the pandemic. It showed the importance of authentic and honest communication about illness and death that allowed minors to manage anxiety and fear. Positive reinterpretation of these experiences by transforming them into opportunities was also revealed.Originality: Studies on families with ALS patients are numerous, but studies on children of these patients are still rare, and no study has investigated the impact of the COVID-19 pandemic on these children. This research investigated a topic that has not been covered previously and it also provided the opportunity to know how these children, preadolescents and adolescents living in an already complex environment, have experienced lockdown and restrictions. The study also enriched the literature on this important issue.

Unaccompanied foreign minors in Italy: Recent developments

The migration of unaccompanied minors in our country has evolved over time, becoming particularly evident in the years of the so-called European refugee crisis. Over the last few years, considerable changes have been observed, due on the one hand to measures to contain migration flows from the Central Mediterranean and on the other hand to the new national hospitality strategy specifically addressed to them. Moreover, recently a new obstacle in the path of these young people has been represented by the Covid-19 pandemic and the related measures of mobility restriction adopted in our country. This contribution will describe the historical evolution of this phenomenon in Italy, underlining the inter-weaving of motivations that lead these adolescents to undertake their migratory path. Furthermore, on the basis of official statistical sources, this contribution will analyse the most recent changes in the presence and characteristics of this particularly vulnerable group of migrants. © 2022, Fondazione Centro Studi Emigrazione. All rights reserved.

I minori stranieri non accompagnati in Italia: gli sviluppi recenti

The migration of unaccompanied minors in our country has evolved over time, becoming particularly evident in the years of the so-called European refugee crisis. Over the last few years, considerable changes have been observed, due on the one hand to measures to contain migration flows from the Central Mediterranean and on the other hand to the new national hospitality strategy specifically addressed to them. Moreover, recently a new obstacle in the path of these young people has been represented by the Covid-19 pandemic and the related measures of mobility restriction adopted in our country. This contribution will describe the historical evolution of this phenomenon in Italy, underlining the inter-weaving of motivations that lead these adolescents to undertake their migratory path. Furthermore, on the basis of official statistical sources, this contribution will analyse the most recent changes in the presence and characteristics of this particularly vulnerable group of migrants. © 2022, Fondazione Centro Studi Emigrazione. All rights reserved.