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1.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 84(8-B):No Pagination Specified, 2023.
Article in English | APA PsycInfo | ID: covidwho-20237523

ABSTRACT

The COVID-19 pandemic has disrupted everyday life globally, with severe consequences in several countries and regions. A key concern related to the COVID-19 pandemic is the wide variation in mortality across nations and sub-national locations such as states and counties. Anecdotal evidence, as well as evidence from CDC, indicates that the risk of spread as well as the risk of mortality from the pandemic is higher for regions with a population characterized by disadvantaged economic (income) and racial (underserved communities) and demographic profiles (age). Multiple studies have indicated that the most crucial step toward reducing mortality is expanding critical care capacity through procuring personal protective equipment (PPE) and ventilators and training critical care frontline employees. It is projected that with exponential growth in the pandemic spread, many regions would fall short of critical care capacity, increasing mortality.Furthermore, the pandemic has imposed high levels of constraints on resource availability, even in developed nations. Under resource constraints in critical care delivery, mitigation strategies need to account for the variation in observed cases and the disparity in mortality across locations. In my dissertation, I make a concerted effort to contribute toward understanding the sources of variation in mortality and propose a framework that enables pandemic preparedness and mitigation strategies that encapsulate the spatial and temporal variation in risk of mortality from COVID-19. The mitigation strategies are divided into supply-side and demand-side moderators of mortality. Accordingly, I focus on two mitigation strategies: (i) ICU capacity as a supply-side moderator and (ii) Vaccination coverage as a demand-side moderator. The overarching objective of my dissertation is to understand the role of supply-side and demand-side moderators of mortality, independently and jointly, of the association between socio-economic, demographic (henceforth referred to as social), and clinical risk factors and COVID-19 mortality. Much of the epidemiological literature on COVID-19 has focused on reducing the spread. However, the ultimate goal is to reduce mortality. There is a necessity in both practice and academic literature to understand actionable policies that can reduce mortality in general and spatial variation of mortality in specific. This dissertation research primarily leverages empirical methodology combining matching procedures with fixed effect modeling of panel data to test the hypothesized relationships of interest. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

2.
Mod Rheumatol Case Rep ; 2022 Feb 02.
Article in English | MEDLINE | ID: covidwho-20240296

ABSTRACT

Coronavirus disease 2019 (COVID-19) vaccines have been widely used and have been shown to be effective in combating the pandemic. However, various side effects have been reported following vaccination. For instance, a condition called "shoulder injury related to vaccine administration" (SIRVA) is characterized by shoulder pain and limited range of motion after intramuscular injection of a vaccine into the deltoid muscle of the shoulder. Despite an increase in SIRVA cases, the exact incidence of the disease is unclear, and there are a few reports of SIRVA about the COVID-19 vaccine. Here, we report a rare case of an 83-year-old woman who was diagnosed with calcification in her left shoulder one year ago and developed calcific tendinitis after receiving an mRNA vaccine for COVID-19 (Pfizer-BioNTech). Radiographs showed calcification of the supraspinatus tendon, and magnetic resonance images showed continuous inflammatory findings from the subdeltoid bursa to the subacromial bursa. We treated the patient with celecoxib and acetaminophen, and she recovered after about two months. In order to prevent SIRVA, the presence of shoulder joint disease should be carefully asked during a pre-vaccination assessment. The puncture point should be chosen with the median point of the deltoid muscle or the anterior-posterior axillary line as landmarks, because the more cephalad the puncture position, the greater the chance of causing SIRVA.

3.
Disaster Med Public Health Prep ; 17: e398, 2023 05 18.
Article in English | MEDLINE | ID: covidwho-2322119

ABSTRACT

As of October 2021, Medical Reserve Corps (MRC) volunteers donated over 2 million h to coronavirus disease 2019 (COVID-19). The Health Belief Model (HBM) is used to understand the value a person places on preventative behavior against the risk of disease. A mixed method, unmatched, prospective case-control study was conducted regarding volunteers' experience during the pandemic, reasons why these highly trained persons volunteer, what barriers to vaccination they observed, and how they helped others overcome those barriers. The HBM can elucidate the cognitive process to vaccinate. Regression analysis found a person's attitude (which includes beliefs, peer pressure, preconceptions, unwillingness, and other indicators) is a barrier to vaccination. Service hours increased from 20 to 56 h among volunteers who saw attitude as a barrier to vaccination. Superstition and fear accounted for 99.8% of unvaccinated persons (P < 0.001). Fear was a barrier to protective health behavior. The public health system must do better to build trust as an ongoing endeavor, as even the increased service volunteers provided in response to the observed attitudes, was not enough to stem exponential transmission once the pandemic had begun. Policy-makers and the public health authority should take all necessary steps early in the pandemic to ensure the effectiveness of the vaccination program.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , COVID-19 Vaccines/therapeutic use , Case-Control Studies , COVID-19/epidemiology , COVID-19/prevention & control , Health Behavior , Fear , Vaccination
4.
Med Rev (Berl) ; 2(2): 169-196, 2022 Apr 26.
Article in English | MEDLINE | ID: covidwho-2316666

ABSTRACT

Currently, people all over the world have been affected by coronavirus disease 2019 (COVID-19). Fighting against COVID-19 is the top priority for all the countries and nations. The development of a safe and effective COVID-19 vaccine is considered the optimal way of ending the pandemic. Three hundred and 44 vaccines were in development, with 149 undergoing clinical research and 35 authorized for emergency use as to March 15 of 2022. Many studies have shown the effective role of COVID-19 vaccines in preventing SARS-CoV-2 infections as well as serious and fatal COVID-19 cases. However, tough challenges have arisen regarding COVID-19 vaccines, including long-term immunity, emerging COVID-19 variants, and vaccine inequalities. A systematic review was performed of recent COVID-19 vaccine studies, with a focus on vaccine type, efficacy and effectiveness, and protection against SARS-CoV-2 variants, breakthrough infections, safety, deployment and vaccine strategies used in the real-world. Ultimately, there is a need to establish a unified evaluation standard of vaccine effectiveness, monitor vaccine safety and effectiveness, along with the virological characteristics of SARS-CoV-2 variants; and determine the most useful booster schedule. These aspects must be coordinated to ensure timely responses to beneficial or detrimental situations. In the future, global efforts should be directed toward effective and immediate vaccine allocations, improving vaccine coverage, SARS-CoV-2 new variants tracking, and vaccine booster development.

5.
British Journal of Educational Technology ; 53(1):171-188, 2022.
Article in English | APA PsycInfo | ID: covidwho-2254293

ABSTRACT

The aims of nursing training include not only mastering skills but also fostering the competence to make decisions for problem solving. In prenatal education, cultivating nurses' knowledge and competence of vaccine administration is a crucial issue for protecting pregnant women and newborns from infection. Therefore, obstetric vaccination knowledge has become a basic and essential training program for nursing students. However, most of these training programs are given via the lecture-based teaching approach with skills practice, providing students with few opportunities to think deeply about the relevant issues owing to the lack of interaction and context. This could have a negative impact on their learning effectiveness and clinical judgment. To address this problem, a mobile chatbot-based learning approach is proposed in this study to enable students to learn and think deeply in the contexts of handling obstetric vaccine cases via interacting with the chatbot. In order to verify the effectiveness of the proposed approach, an experiment was implemented. Two classes of 36 students from a university in northern Taiwan were recruited as participants. One class was the experimental group learning with the proposed approach, while the other class was the control group learning with the conventional approach (ie, giving lectures to explain the instructional content and training cases). The results indicate that applying a mobile chatbot for learning can enhance nursing students' learning achievement and self-efficacy. In addition, based on the analysis of the interview results, students generally believed that learning through the mobile chatbot was able to promote their self-efficacy as well as their learning engagement and performance. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

6.
J Orthop ; 2022 Nov 12.
Article in English | MEDLINE | ID: covidwho-2243521

ABSTRACT

Introduction: Shoulder Injuries Related to Vaccine Administration (SIRVA), describes those cases of shoulder severe post-inoculation complications, including pain and prolonged disability. Most of the reported cases have been secondary to influenza vaccination. This study retrospectively describes a series of 18 patients following SARS-CoV-2 inoculation and compares the findings with those previously reported for other vaccines. Materials and methods: Inclusion criteria was onset of symptoms within 48 hours after injection, symptoms duration of at least seven days, and restricted range of motion in absence of symptoms prior to vaccination. Average age was 59.4 years old (38-76), and 72.2% were women. Results: In many cases (58%) the initial diagnosis was not clear, which lead to incorrect treatment. The most common pathological finding was subacromial-subdeltoid bursitis (66.6%). All patients who received depot corticosteroids followed by a gentle rehabilitation program showed strong clinical improvement but did not completely resolve the symptoms at 7.2 months average final follow-up. Surgical intervention was necessary in one of the patients due to the persistence of symptoms despite conservative treatment. Conclusions: Shoulder injury related to vaccine administration is rare, but when present, its torpid evolution makes it difficult to treat. We have found in our case series a similar pattern to that already described for other vaccines. A high index of suspicion helps to pick up the condition promptly and early treatment can bring satisfactory outcome.

7.
Vaccines (Basel) ; 11(2)2023 Jan 28.
Article in English | MEDLINE | ID: covidwho-2217105

ABSTRACT

The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried reports in the Vaccine Adverse Event Reporting System (VAERS) database from 2017 to 2022 and identified cases involving anaphylaxis with an onset within one day of vaccine administration. The primary outcome was the combined prevalence of death or disability for each setting while the secondary outcome was the prevalence of hospitalization. Adjusted (age, sex, prior history of allergy, vaccine type) odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated using logistic regression analysis. A total of 2041 cases of anaphylaxis comprised the primary study cohort with representation in the sample from all 50 US states and the District of Columbia. The mean age was 43.3 ± 17.5 years, and most cases involved women (79.9%). Cases of anaphylaxis were reported after receiving a coronavirus vaccine (85.2%), influenza vaccine (5.9%), tetanus vaccine (2.2%), zoster vaccine (1.6%), measles vaccine (0.7%), and other vaccine (4.5%). Outcomes associated with reports of vaccine anaphylaxis included 35 cases of death and disability and 219 hospitalizations. Compared with all other settings, the aOR of death and disability when anaphylaxis occurred was 1.92 (95% CI, 0.86-4.54) in a medical provider's office, 0.85 (95% CI, 0.26-2.43) in a pharmacy and 1.01 (95% CI, 0.15-3.94) in a public health clinic. Compared with all other settings, the aOR of hospitalization when anaphylaxis occurred was 1.02 (95% CI, 0.71-1.47) in a medical provider's office, 1.06 (95% CI, 0.72-1.54) in a pharmacy, and 1.12 (95% CI, 0.61-1.93) in a public health clinic. An analysis of a national database across six years revealed no significant differences in the odds of death/disability and odds of hospitalization associated with post-vaccination anaphylaxis in the medical office, pharmacy, and public health clinic compared with all other settings. This study expands our understanding of the safety of immunization services and reinforces that all settings must be prepared to respond to such an emergency.

8.
Int J Environ Res Public Health ; 19(20)2022 Oct 11.
Article in English | MEDLINE | ID: covidwho-2071414

ABSTRACT

Since the onset of the COVID-19 pandemic in New York State (NYS), local health departments (LHDs) have worked to mitigate the highly infectious disease. As lead public health experts in their communities, LHDs are responsible for providing communicable disease control, emergency response, and establishing immunization programs, including leading large-scale vaccine distribution efforts. The aim of this qualitative study was to understand the processes used by LHDs in NYS to administer COVID-19 vaccines, as well as identify successes and challenges, and highlight lessons learned to improve future mass vaccination campaigns. Data were collected in two phases: (1) extant data collection of public communications; and (2) discussion groups with public health leaders across the state. Notable themes from both phases include: partnerships, programmatic elements, communication, role of LHD, State-LHD coordination, and human and physical resources. Analysis of both public and internal communications from LHDs across NYS revealed several core challenges LHDs faced during COVID-19 vaccine rollout and identified innovative solutions that LHDs used to facilitate vaccine access, administration, and uptake in their communities. Findings from this multi-phase qualitative analysis support the need to bolster the capacity and training of the local public health workforce to ensure preparedness for future public health emergencies.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , COVID-19 Vaccines/therapeutic use , Pandemics/prevention & control , New York , COVID-19/epidemiology , COVID-19/prevention & control , Immunization Programs , Public Health , Local Government
9.
Explor Res Clin Soc Pharm ; 8: 100183, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2042103

ABSTRACT

Background: Shoulder injury related to vaccine administration (SIRVA) has been recognised as the compensable term for any shoulder injury that may result from an improper vaccination technique since 2017, however, its incidence and impact remain poorly understood. Objectives: To examine knowledge of SIRVA through reported cases, determine SIRVA incidence related to COVID-19 vaccinations, and investigate recovery rates. Methods: Six pharmacovigilance agencies in the United States of America (USA), Canada, United Kingdom, European Union, Australia, and New Zealand were systematically search to identify all reported cases of SIRVA between January 2017 to July 2021. Primary outcome measures were SIRVA case reports. Secondary outcome measures included recovery status as well as vaccine received, age, and sex. SIRVA-related outcome measures were retrieved between July 18th and July 22nd 2021, with UK data received via personal correspondence. Results: Retrospective analysis yielded 505 SIRVA cases since 2017, with 330 (65%) of cases reported from January to July 2021. Sub-analysis, using COVID-19 data of 189 SIRVA cases from 891,906,986 vaccinations, estimated incidence to be 2 per 10 million. 32 cases (7%) had recovered from symptoms at the time of reporting, with 311 (62%) reported as 'not recovered', and 162 cases (32%) 'unknown'. Females represented 75% of reported cases. Conclusion: SIRVA case report numbers and incidence from COVID-19 data, compared with prior evidence, raises questions around health practitioner knowledge and reporting accuracy of SIRVA. Recovery rates are poorly understood. A global consensus definition of SIRVA and more transparent and routine reporting is required. The disproportionate representation of females is of concern with no known reasons for this disparity. Further research is needed on SIRVA knowledge in healthcare practitioners, reporting rates, incidence, management, and long-term outcomes for those impacted. Pharmacist vaccinators should be aware of their role in preventing SIRVA and be active in its detection.

10.
Lessons from COVID-19: Impact on Healthcare Systems and Technology ; : 171-211, 2022.
Article in English | Scopus | ID: covidwho-2027802

ABSTRACT

Blockchain is a decentralized digital ledger, structured as a chain of blocks, containing chronologically related transactions regulated by a system of cryptographic algorithms and rules. COVID-19 has highlighted the critical issues related to the management of a pandemic situation, reaffirming the crucial role of the supply chain: First in the identification of outbreaks of contagion and then to the supplying and the distribution of personal protective equipment (PPE), to finish with the problematic campaign of administering anti COVID-19 vaccines. All these criticalities can be managed effectively by adopting innovative technologies such as the blockchain. In this chapter, the basic blockchain concepts will be analyzed, and the use of this technology in addressing the COVID-19 emergency will be discussed. Finally, a blockchain-based model for vaccine supply chain will be studied. © 2022 Elsevier Inc. All rights reserved.

11.
Vaccines (Basel) ; 10(8)2022 Aug 19.
Article in English | MEDLINE | ID: covidwho-1997859

ABSTRACT

In response to the increased demand for healthcare services during the COVID-19 pandemic, the Public Readiness and Emergency Preparedness (PREP) Act amendments and guidance authorized pharmacy technicians, who are not otherwise authorized in their state, to administer the Advisory Committee on Immunization Practices (ACIP)-recommended immunizations and COVID-19 vaccines under pharmacist order. Subsequently, many pharmacies nationwide have expanded technician duties to include immunization administration. The primary objective of this study was to evaluate and compare the attitudes and experiences associated with technician-administered immunizations among community pharmacists and technicians. The cross-sectional study evaluated the primary endpoint through the completion of anonymous surveys containing peer-reviewed questionnaires. Pharmacy technicians and their supervising pharmacists were selected to complete the survey at a grocery chain's pharmacies located in five states across the Northeast if they completed the immunization program and administered at least one immunization. Surveys were drafted using Microsoft Forms and results were analyzed using Microsoft Excel. Chi-squared tests were utilized for comparing categorical variables between groups. A total of 268 survey responses were obtained; 171 responses came from pharmacists and 97 responses came from immunization-certified technicians. Most pharmacists and pharmacy technicians responded that technicians could safely administer vaccines (87.1% and 96.9%, respectively) and competently process and bill vaccine services (90.6% and 99.0%, respectively). In addition, both participant populations responded that technician-administered vaccines improved the workflow of vaccine services (76.6% and 82.5%, respectively) without increasing the likelihood of vaccine errors (56.1% and 78.3%, respectively). When compared with technicians, fewer pharmacists were confident in a technician's ability to competently prepare vaccines (63.7% vs. 91.8%; p < 0.001). A statistically significant association was observed between responses regarding an efficient process for immunizing patients and the likelihood of technician vaccination errors (χ2 = 14.36; p < 0.01). Pharmacists and pharmacy technicians responded that technicians competently administer immunizations and should participate in more patient-care duties. Multiple states are enacting legislation to include technician vaccine administration as a permanent component of their scope of practice.

12.
Intern Med ; 61(15): 2295-2300, 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1968928

ABSTRACT

Objective Vaccination technique is a crucial skill for medical trainees to learn, especially in the current coronavirus disease 2019 pandemic. To this end, validated assessment tools are essential in teaching appropriate techniques. However, valid instruments for assessing vaccine administration skills have not yet been developed. We therefore explored the development and validation of an assessment tool for vaccination techniques based on expert consensus. Methods We implemented a modified Delphi process to develop a vaccination technique assessment tool. We then conducted a validation study to establish the reliability and validity of the tool. Results Two rounds of the modified Delphi process were performed to generate a 19-item, vaccination performance assessment checklist. In the validation study, the linear weighted kappa value for inter-rater reliability of the overall checklist score was 0.725. Spearman's correlation coefficient between the mean checklist score and the global rating was 0.98 (p<0.01). Conclusions This is a pioneering study examining the development and validation of an assessment tool for vaccine administration techniques. The tool will be widely used in vaccination-related education.


Subject(s)
COVID-19 , Checklist , COVID-19/prevention & control , Checklist/methods , Clinical Competence , Humans , Reproducibility of Results , Vaccination
13.
Comput Ind Eng ; 167: 108031, 2022 May.
Article in English | MEDLINE | ID: covidwho-1814246

ABSTRACT

This paper addresses a framework for the operational allocation and administration of COVID-19 vaccines in Thailand, based on both COVID-19 transmission dynamics and other vital operational restrictions that might affect the effectiveness of vaccination strategies in the early stage of vaccine rollout. In this framework, the SIQRV model is first developed and later combined with the COVID-19 Vaccine Allocation Problem (CVAP) to determine the optimal allocation/administration strategies that minimize total weighted strain on the whole healthcare system. According to Thailand's second pandemic wave data (17th January 2021, to 15th February 2021), we find that the epicenter-based strategy is surprisingly the worst allocation strategy, due largely to the negligence of provincial demographics, vaccine efficacy, and overall transmission dynamics that lead to higher number of infectious individuals. We also find that early vaccination seems to significantly contribute to the reduction in the number of infectious individuals, whose effects tend to increase with more vaccine supply. With these insights, healthcare policy-makers should therefore focus not only on the procurement of COVID-19 vaccines at strategic levels but also on the allocation and administration of such vaccines at operational levels for the best of their limited vaccine supply.

14.
SAGE Open Med Case Rep ; 10: 2050313X221089494, 2022.
Article in English | MEDLINE | ID: covidwho-1794294

ABSTRACT

Shoulder pain is a common symptom after intramuscular vaccination. However, only a few cases of shoulder joint injury have been reported after coronavirus disease 2019 vaccination. A 52-year-old woman experienced clinically significant pain in the left shoulder joint after receiving the first dose of a coronavirus disease 2019 vaccine. She neglected the shoulder pain, hoping that it would spontaneously improve without medical attention. However, the pain continued with obvious limitations in shoulder movement and function. After 8 months, she presented to the outpatient clinic with a frozen left shoulder. Such rare consequences of vaccinations, known as shoulder injury related to vaccine administration, can be prevented by using an appropriate needle gauge and length according to the patient's sex and weight with the correct injection site away from shoulder structures.

15.
Aims Mathematics ; 7(5):9288-9310, 2022.
Article in English | Web of Science | ID: covidwho-1760885

ABSTRACT

An immunogenic and safe vaccine against COVID-19 for use in the healthy population will become available in the near future. In this paper, we aim to determine the optimal vaccine administration strategy in refugee camps considering maximum daily administration and limited total vaccine supply. For this purpose, extended SEAIRD compartmental models are established to describe the epidemic dynamics with both single-dose and double-dose vaccine administration. Taking the vaccination rates in different susceptible compartments as control variables, the optimal vaccine administration problems are then solved under the framework of nonlinear constrained optimal control problems. To the best of our knowledge, this is the first paper that addresses an optimal vaccine administration strategy considering practical constraints on limited medical care resources. Numerical simulations show that both the single-dose and double-dose strategies can successfully control COVID-19. By comparison, the double-dose vaccination strategy can achieve a better reduction in infection and death, while the single-dose vaccination strategy can postpone the infection peak more efficiently. Further studies of the influence of parameters indicate that increasing the number of medical care personnel and total vaccine supply can greatly contribute to the fight against COVID-19. The results of this study are instructive for potential forthcoming vaccine administration. Moreover, the work in this paper provides a general framework for developing epidemic control strategies in the presence of limited medical resources.

16.
Vaccine ; 40(9): 1246-1252, 2022 02 23.
Article in English | MEDLINE | ID: covidwho-1665512

ABSTRACT

BACKGROUND: Between May 2005 and March 2007, three vaccines were recommended by the Advisory Committee on Immunization Practices for routine use in adolescents in the United States: quadrivalent meningococcal conjugate vaccine (MenACWY), tetanus, diphtheria and acellular pertussis vaccine (Tdap), and human papillomavirus vaccine (HPV). Understanding historical adolescent vaccination patterns may inform future vaccination coverage efforts for these and emerging adolescent vaccines, including COVID-19 vaccines. METHODS: This was a descriptive, retrospective cohort study. All vaccines administered to adolescents aged 11 through 18 years in the Vaccine Safety Datalink population between January 1, 2007 and December 31, 2016 were examined. Vaccination coverage was assessed by study year for ≥1 dose Tdap or Td, ≥1 dose Tdap, ≥1 dose MenACWY, ≥1 dose HPV, and ≥3 dose HPV. The proportion of vaccine visits with concurrent vaccination (≥2 vaccines administered at the same visit) was calculated by sex and study year. The most common vaccine combinations administered in the study population were described by sex for two time periods: 2007-2010 and 2011-2016. RESULTS: The number of 11-18-year-olds in the study population averaged 522,565 males and 503,112 females per study year. Between January 2007 and December 2016 there were 4,884,553 vaccine visits in this population (45% among males). The overall proportion of concurrent vaccine visits among males was 43% (33-61% by study year). Among females, 39% of all vaccine visits included concurrent vaccination (32-48% by study year). Vaccine coverage for Tdap, MenACWY, and 1- and 3-dose HPV increased across the study period. A wide variety of vaccine combinations were administered among both sexes and in both time periods. CONCLUSIONS: The high vaccine uptake and multitude of vaccine combinations administered concurrently in the adolescent population of the Vaccine Safety Datalink provide historical patterns with which to compare future adolescent vaccination campaigns.


Subject(s)
Vaccination , Vaccines , Adolescent , COVID-19 , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage , Diphtheria-Tetanus-acellular Pertussis Vaccines/adverse effects , Female , Humans , Immunization Schedule , Male , Meningococcal Vaccines/administration & dosage , Meningococcal Vaccines/adverse effects , Papillomavirus Vaccines/administration & dosage , Papillomavirus Vaccines/adverse effects , Retrospective Studies , SARS-CoV-2 , United States , Vaccination/trends , Vaccines/administration & dosage , Vaccines/adverse effects
17.
Engineering News ; 41(36), 2021.
Article in English | Africa Wide Information | ID: covidwho-1661263
18.
Vaccine ; 39(37): 5326-5330, 2021 08 31.
Article in English | MEDLINE | ID: covidwho-1294289

ABSTRACT

BACKGROUND: Recent phase-3 clinical trials have demonstrated very encouraging results for mRNA based vaccines against COVID-19. Current FDA and manufacturer guidelines mandate intramuscular administration of these vaccines, as other administration routes may not provide the same levels of effectiveness and safety. Observing the vast amount of published media images of persons receiving their vaccines, the authors noted in many cases the injection technique involved skin bunching, raising concerns of inadequate deltoid muscle penetration and consequent lowered vaccine efficacy. Our study hypothesis was that skin bunching will increase the skin-to-muscle distance over 20 mm, the maximal distance allowing the required 5 mm muscle penetration with a 25 mm needle. MATERIALS AND METHODS: 60 adult volunteers from our hospital staff were recruited, and using ultrasound, the skin-to-muscle distance measured in three positions: flat, skin bunching and muscle bunching. The skin-to-muscle distance difference and correlation with gender and BMI were calculated. RESULTS: Skin bunching significantly increased the skin-to-muscle distance in all subjects. In 6 (10%) subjects, this increase exceeded the 20 mm limit. Having a skin-to-deltoid distance of 20 mm or more strongly correlated with a BMI of 30 or more. CONCLUSIONS: Skin bunching will prevent adequate intramuscular injection of vaccines in a small percentage of persons, but as hundreds of millions are expected to receive mRNA vaccines in the coming months, the multiplied result can have significant personal and societal consequences for millions of people globally, especially in obese populations, and therefore this practice should be strictly discouraged.


Subject(s)
COVID-19 Vaccines , COVID-19 , Vaccines, Synthetic , Adult , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Deltoid Muscle , Humans , Injections, Intramuscular , RNA, Messenger , SARS-CoV-2 , Vaccines, Synthetic/administration & dosage , Vaccines, Synthetic/adverse effects
19.
Vaccines (Basel) ; 9(6)2021 Jun 18.
Article in English | MEDLINE | ID: covidwho-1273527

ABSTRACT

Even though vaccination programs have now started in earnest across the globe and in Qatar, vaccine hesitancy remains a barrier to effectively tackling the pandemic. Many factors influence willingness to take vaccines including safety, efficacy, and side effects. Given their proximity to research and education, university students and employees represent an interesting cohort in which to investigate vaccine hesitancy. The aim of this study was to assess the attitudes of Qatar University employees and students towards the COVID-19 vaccine. In total, 231 employees and 231 students participated in an online cross-sectional study in February 2021. Of the sample, 62.6% were willing to take a vaccine against COVID-19. Participants with or taking postgraduate degrees were more willing to take the vaccine compared to participants with or taking a diploma or bachelor's degree (p < 0.001). Males had a higher rate of vaccine acceptance (p < 0.001). In the group that regarded flu vaccination as important, 13% were unwilling to take COVID-19 vaccine. There were no associations between willingness to vaccinate and vaccine/virus knowledge and social media use. Participants showed a high level of concern regarding vaccine side effects in themselves or their children. Two-thirds agreed or strongly agreed that they would take the vaccine if it was mandatory for international travel. Our participants were neutral to the origin of vaccine development. These findings, which represent data collected after the start of the national vaccination program, show that vaccine hesitancy persists in the Qatari population and that some groups, such as undergraduate students, could benefit from specific, targeted public health campaigns.

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