Contributions of Small Grains Grown in Zimbabwe's Dryland Regions in Boosting Immunity and Combating COVID-19

The COVID-19 has had a significant impact on people's lives and livelihoods in Zimbabwe, particularly the elderly and those suffering from underlying conditions. Generally, COVID-19 has increased the use of immune-boosting foods and nutritional supplements as preventative and therapeutic interventions. Small grains, such as sorghum and millets, have long been mainstays of the Zimbabwean diets, both in rural and urban settings. There is, however, scarcity of data linking the nutritional content and phytochemistry of small grains grown in Zimbabwe's drylands to COVID-19 prevention and treatment. The current study investigates, critically synthesises, and identifies gaps in the role of sorghum and millets in boosting human immune systems, with a focus on COVID-19 prevention and treatment. The systematic literature review approach was adopted to gather information on how small grains can contribute to COVID-19 management. In Zimbabwe, sorghum and millets meal are used to prepare different foods, including porridges and most traditionally fermented foods, such as nonalcoholic beverages. Although there is no conclusive evidence that sorghum and millets boost immunity, presence of significant quantities of minerals, vitamins, and phytochemicals in sorghum and millets derived foods indicates their importance in improving immune system performance. Additionally, the high concentration of resistant starch in sorghum and millets has been linked to a delayed release of glucose into the circulation, resulting in reduced chances of underlying conditions, such as diabetes and hypertension. Furthermore, millets and sorghum are important sources of antioxidants, such as quercetin, curcumin, and ellagic and polyphenols, particularly flavonoids that have been identified as possible inhibitors of SARS-CoV-2 infection. With inconclusive evidence to support contributions of millets and sorghum in COVID-19 prevention and treatment, more randomised and controlled clinical trials are required to confirm their significance. The outcomes of such studies would significantly affect the possibilities of expanding nutritional interventions in the fight against COVID-19. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

Assessment of Anti-SARS-CoV-2 antibody levels among university students vaccinated with different COVID-19 primary and booster doses - fall 2021, Wisconsin.

BACKGROUND: University students commonly received COVID-19 vaccinations before returning to U.S. campuses in the Fall of 2021. Given likely immunologic variation among students based on differences in type of primary series and/or booster dose vaccine received, we conducted serologic investigations in September and December 2021 on a large university campus in Wisconsin to assess anti-SARS-CoV-2 antibody levels. METHODS: We collected blood samples, demographic information, and COVID-19 illness and vaccination history from a convenience sample of students. Sera were analyzed for both anti-spike (anti-S) and anti-nucleocapsid (anti-N) antibody levels using World Health Organization standardized binding antibody units per milliliter (BAU/mL). Levels were compared across categorical primary COVID-19 vaccine series received and binary COVID-19 mRNA booster status. The association between anti-S levels and time since most recent vaccination dose was estimated by mixed-effects linear regression. RESULTS: In total, 356 students participated, of whom 219 (61.5%) had received a primary vaccine series of Pfizer-BioNTech or Moderna mRNA vaccines and 85 (23.9%) had received vaccines from Sinovac or Sinopharm. Median anti-S levels were significantly higher for mRNA primary vaccine series recipients (2.90 and 2.86 log [BAU/mL], respectively), compared with those who received Sinopharm or Sinovac vaccines (1.63 and 1.95 log [BAU/mL], respectively). Sinopharm and Sinovac vaccine recipients were associated with a significantly faster anti-S decline over time, compared with mRNA vaccine recipients (P <.001). By December, 48/172 (27.9%) participants reported receiving an mRNA COVID-19 vaccine booster, which reduced the anti-S antibody discrepancies between primary series vaccine types. CONCLUSIONS: Our work supports the benefit of heterologous boosting against COVID-19. COVID-19 mRNA vaccine booster doses were associated with increases in anti-SARS-CoV-2 antibody levels; following an mRNA booster dose, students with both mRNA and non-mRNA primary series receipt were associated with comparable levels of anti-S IgG.

Vaccine Confidence and Uptake of the Omicron Bivalent Booster in Tennessee: Implications for Vulnerable Populations.

The COVID-19 Omicron variant and its subvariants are now the dominant variants circulating in the US. Therefore, the original COVID-19 vaccine cannot offer full protection. Instead, vaccines that target the spike proteins of the Omicron variants are warranted. Hence, the FDA recommended the development of a bivalent booster. Unfortunately, despite the safety and immunogenicity of the Omicron bivalent boosters from Pfizer and Moderna, uptake in the US has been poor. At this time, only 15.8% of individuals in the US aged five and older have received the Omicron bivalent booster (OBB). The rate is 18% for those aged 18 and older. Poor vaccine confidence and booster uptake are often fueled by misinformation and vaccine fatigue. These result in more problems associated with vaccine hesitancy, which are particular prevalent in Southern states in the US. In Tennessee, the OBB vaccination rate for eligible recipients is only 5.88% at time of writing (16 February 2023). In this review, we discuss (1) the rationale for developing the OBBs; (2) the efficacy and safety of the bivalent boosters; (3) the adverse events associated with these boosters; (4) vaccine hesitancy associated with the OBBs uptake in Tennessee; (5) implications for vulnerable populations, disparities in uptake of OBBs in Tennessee, and strategies to improve vaccine confidence and OBB uptake. In support of public health, it is essential that we continue to provide education, awareness, and vaccine access to the vulnerable and medically underserved populations in Tennessee. Receiving the OBBs is the most effective method to date of protecting the public against severe COVID disease, hospitalization, and death.

Effectiveness of Booster Doses of Monovalent mRNA COVID-19 Vaccine Against Symptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children, Adolescents, and Adults During Omicron Subvariant BA.2/BA.2.12.1 and BA.4/BA.5 Predominant Periods.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) BA.2/BA.2.12.1 and BA.4/BA.5 subvariants have mutations associated with increased capacity to evade immunity when compared with prior variants. We evaluated mRNA monovalent booster dose effectiveness among persons ≥5 years old during BA.2/BA.2.12.1 and BA.4/BA.5 predominance. Methods: A test-negative, case-control analysis included data from 12 148 pharmacy SARS-CoV-2 testing sites nationwide for persons aged ≥5 years with ≥1 coronavirus disease-2019 (COVID-19)-like symptoms and a SARS-CoV-2 nucleic acid amplification test from April 2 to August 31, 2022. Relative vaccine effectiveness (rVE) was estimated comparing 3 doses of COVID-19 mRNA monovalent vaccine to 2 doses; for tests among persons ≥50 years, rVE estimates also compared 4 doses to 3 doses (≥4 months since third dose). Results: A total of 760 986 test-positive cases and 817 876 test-negative controls were included. Among individuals ≥12 years, rVE of 3 versus 2 doses ranged by age group from 45% to 74% at 1-month post vaccination and waned to 0% by 5-7 months post vaccination during the BA.4/BA.5 period.Adults aged ≥50 years (fourth dose eligible) who received 4 doses were less likely to have symptomatic SARS-CoV-2 infection compared with those with 3 doses; this rVE remained >0% through at least 3 months since last dose. For those aged ≥65 years, rVE of 4 versus 3 doses 1-month post vaccination was higher during BA.2/BA.2.12.1 (rVE = 49%; 95% confidence interval [CI], 43%-53%) than BA.4/BA.5 (rVE = 40%; 95% CI, 36%-44%). In 50- to 64-year-olds, rVE estimates were similar. Conclusions: Monovalent mRNA booster doses provided additional protection against symptomatic SARS-CoV-2 infection during BA.2/BA.2.12.1 and BA.4/BA.5 subvariant circulation, but protection waned over time.

COVID-19 preventives consumed in South Africa versus other Sub-Saharan African countries.

Background: The current coronavirus disease 2019 (COVID-19) pandemic has been of global concern as it has affected the health of many and the economies of nations. In order to strengthen the immune system against COVID-19, certain plant-source foods were consumed. Aim: This study was designed to identify and compare various special foods and drinks consumed to prevent COVID-19 during the lockdown in various sub-Saharan countries in comparison to South Africa (SA), as well as highlighting some current dietary recommendations. Setting: Online cross-sectional survey in six African countries, namely South Africa, Cameroon, Nigeria, Ghana, Ethiopia and Kenya. Methods: After sample size determination, an online questionnaire was designed and content validated. The survey link was pretested on 25 people and then circulated for 6 weeks during total lockdown. The proportion of responses for each question were reported using descriptive statistics. Results: Half of the 817 participants surveyed were not consuming anything special for COVID-19 prevention. South Africans mostly reported the consumption of supplements or conventional medicines (mainly vitamin C and zinc) while for other countries, a variety of natural foods and drinks were mentioned - some having already proved helpful in boosting immune systems. They included infusions of spices with or without honey, fruits and vegetables, medicinal drinks and local beverages. Conclusion: Programmes and campaigns designed to increase awareness of dietary measures for COVID-19 prevention have proved beneficial and should be promoted. Analytical evaluation of the nutritional and health benefits and antiviral potentials of the identified special foods would help in determining which foods to prioritise and promote in the fight against COVID-19. Contribution: This study shows the possibility of finding dietary solutions for managing the pandemic and 'preventive' potentials of certain plant substances.

Protection of hybrid immunity against SARS-CoV-2 reinfection and severe COVID-19 during periods of Omicron variant predominance in Mexico.

Background: With the widespread transmission of the Omicron SARS-CoV-2 variant, reinfections have become increasingly common. Here, we explored the role of immunity, primary infection severity, and variant predominance in the risk of reinfection and severe COVID-19 during Omicron predominance in Mexico. Methods: We analyzed reinfections in Mexico in individuals with a primary infection separated by at least 90 days from reinfection using a national surveillance registry of SARS-CoV-2 cases from March 3rd, 2020, to August 13th, 2022. Immunity-generating events included primary infection, partial or complete vaccination, and booster vaccines. Reinfections were matched by age and sex with controls with primary SARS-CoV-2 infection and negative RT-PCR or antigen test at least 90 days after primary infection to explore reinfection and severe disease risk factors. We also compared the protective efficacy of heterologous and homologous vaccine boosters against reinfection. Results: We detected 231,202 SARS-CoV-2 reinfections in Mexico, most occurring in unvaccinated individuals (41.55%). Over 207,623 reinfections occurred during periods of Omicron (89.8%), BA.1 (36.74%), and BA.5 (33.67%) subvariant predominance and a case-fatality rate of 0.22%. Vaccination protected against reinfection, without significant influence of the order of immunity-generating events and provided >90% protection against severe reinfections. Heterologous booster schedules were associated with ~11% and ~ 54% lower risk for reinfection and reinfection-associated severe COVID-19, respectively, modified by time-elapsed since the last immunity-generating event, when compared against complete primary schedules. Conclusion: SARS-CoV-2 reinfections increased during Omicron predominance. Hybrid immunity provides protection against reinfection and associated severe COVID-19, with potential benefit from heterologous booster schedules.

Persistence of immune responses after heterologous and homologous third COVID-19 vaccine dose schedules in the UK: eight-month analyses of the COV-BOOST trial.

BACKGROUND: COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of seven COVID-19 vaccines used as a third booster dose in June 2021. Monovalent messenger RNA (mRNA) COVID-19 vaccines were subsequently widely used for the third and fourth-dose vaccination campaigns in high-income countries. Real-world vaccine effectiveness against symptomatic infections following third doses declined during the Omicron wave. This report compares the immunogenicity and kinetics of responses to third doses of vaccines from day (D) 28 to D242 following third doses in seven study arms. METHODS: The trial initially included ten experimental vaccine arms (seven full-dose, three half-dose) delivered at three groups of six sites. Participants in each site group were randomised to three or four experimental vaccines, or MenACWY control. The trial was stratified such that half of participants had previously received two primary doses of ChAdOx1 nCov-19 (Oxford-AstraZeneca; hereafter referred to as ChAd) and half had received two doses of BNT162b2 (Pfizer-BioNtech, hereafter referred to as BNT). The D242 follow-up was done in seven arms (five full-dose, two half-dose). The BNT vaccine was used as the reference as it was the most commonly deployed third-dose vaccine in clinical practice in high-income countries. The primary analysis was conducted using all randomised and baseline seronegative participants who were SARS-CoV-2 naïve during the study and who had not received a further COVID-19 vaccine for any reason since third dose randomisation. RESULTS: Among the 817 participants included in this report, the median age was 72 years (IQR: 55-78) with 50.7% being female. The decay rates of anti-spike IgG between vaccines are different among both populations who received initial doses of ChAd/ChAd and BNT/BNT. In the population that previously received ChAd/ChAd, mRNA vaccines had the highest titre at D242 following their vaccine dose although Ad26. COV2. S (Janssen; hereafter referred to as Ad26) showed slower decay. For people who received BNT/BNT as their initial doses, a slower decay was also seen in the Ad26 and ChAd arms. The anti-spike IgG became significantly higher in the Ad26 arm compared to the BNT arm as early as 3 months following vaccination. Similar decay rates were seen between BNT and half-BNT; the geometric mean ratios ranged from 0.76 to 0.94 at different time points. The difference in decay rates between vaccines was similar for wild-type live virus-neutralising antibodies and that seen for anti-spike IgG. For cellular responses, the persistence was similar between study arms. CONCLUSIONS: Heterologous third doses with viral vector vaccines following two doses of mRNA achieve more durable humoral responses compared with three doses of mRNA vaccines. Lower doses of mRNA vaccines could be considered for future booster campaigns.

How Well the Constructs of Health Belief Model Predict Vaccination Intention: A Systematic Review on COVID-19 Primary Series and Booster Vaccines.

This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity's effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention.

Heterogeneity in Vaccinal Immunity to SARS-CoV-2 Can Be Addressed by a Personalized Booster Strategy.

SARS-CoV-2 vaccinations were initially shown to substantially reduce risk of severe disease and death. However, pharmacokinetic (PK) waning and rapid viral evolution degrade neutralizing antibody (nAb) binding titers, causing loss of vaccinal protection. Additionally, there is inter-individual heterogeneity in the strength and durability of the vaccinal nAb response. Here, we propose a personalized booster strategy as a potential solution to this problem. Our model-based approach incorporates inter-individual heterogeneity in nAb response to primary SARS-CoV-2 vaccination into a pharmacokinetic/pharmacodynamic (PK/PD) model to project population-level heterogeneity in vaccinal protection. We further examine the impact of evolutionary immune evasion on vaccinal protection over time based on variant fold reduction in nAb potency. Our findings suggest viral evolution will decrease the effectiveness of vaccinal protection against severe disease, especially for individuals with a less durable immune response. More frequent boosting may restore vaccinal protection for individuals with a weaker immune response. Our analysis shows that the ECLIA RBD binding assay strongly predicts neutralization of sequence-matched pseudoviruses. This may be a useful tool for rapidly assessing individual immune protection. Our work suggests vaccinal protection against severe disease is not assured and identifies a potential path forward for reducing risk to immunologically vulnerable individuals.

Impact of Vaccination, Prior Infection and Therapy on Omicron Infection and Mortality.

BACKGROUND: Understanding the immunity against omicron infection and severe outcomes conferred by Covid-19 vaccination, prior SARS-CoV-2 infection, and monoclonal antibody therapy will inform intervention strategies. METHODS: We considered 295,691 patients who were tested for SARS-CoV-2 at Cleveland Clinic between October 1, 2021 and January 31, 2022. We used logistic regression to investigate the association of vaccination and prior infection with the risk of SARS-CoV-2 infection and used Cox regression to investigate the association of vaccination, prior infection and monoclonal antibody therapy with the risks of intensive care unit (ICU) stay and death. RESULTS: Vaccination and prior infection were less effective against omicron than delta infection but provided strong protection against ICU admission and death. Boosting greatly increased vaccine effectiveness against omicron infection and severe outcomes, though the effectiveness waned rapidly over time. Monoclonal antibody therapy considerably reduced the risks of ICU admission and death. Finally, the relatively low mortality of the omicron variant was due to both the reduced lethality of this variant and the increased population immunity acquired from booster vaccination and previous infection. CONCLUSIONS: Booster vaccination and prior SARS-CoV-2 infection provide strong protection against ICU admission and death from omicron infection. Monoclonal antibody therapy is also beneficial.

Information-Seeking Behavior for COVID-19 Boosters in China: A Cross-Sectional Survey.

As China launches its second COVID-19 booster campaign and races to bring new vaccine technologies to protect against severe COVID-19 infections, there is limited research on how Chinese residents search for vaccine-related information. This study examined the factors influencing Chinese residents' information-seeking behaviors regarding COVID-19 boosters with a sample of 616 respondents with a mean age of 31.53 from a research panel. Structural equation modeling was used to report factors that influenced respondents' seeking intent. The results indicated that seeking-related subjective norms (ß = -0.55, p < 0.001), negative affect (ß = 0.08, p < 0.05), positive affect (ß = 0.18, p < 0.001), and perceived knowledge insufficiency (ß = 0.10, p < 0.001) are strong predictors of one's seeking intent. We also discovered that there was an inverse relationship between risk perception and positive affect (ß = -0.55, p < 0.001) and between negative and positive affect (ß = -0.19, p < 0.01), while all measurements were either directly or indirectly related to information-seeking intent. A few more indirect but important relationships were also included in our discussion. In conclusion, the present study helps understand what motivates Chinese residents to seek COVID-19 booster information when limited information is available.

The Association Between Pre-Booster Vaccination Antibody Levels and the Risk of SARS-CoV-2 Infection.

The correlation between Anti-SARS-CoV-2 antibody levels and infection was reported. Here, we estimated the role of pre-fourth-dose levels using data from 1,098 health-care-workers. The risk of infection was reduced by 46% (95% CI: 29-59%) with a 10-fold increase in pre-booster levels. Pre-booster antibody levels could be used to optimally time boosters.

Neutralizing antibodies induced by homologous and heterologous boosters in CoronaVac vaccinees in Chile.

OBJECTIVES: To determine the impact of a booster dose on the humoral response in individuals inoculated with a complete schedule of any SARS-CoV-2 vaccine, we evaluated the neutralizing antibody (NAb) titers of homologous or heterologous booster doses over a 90-days period in CoronaVac vaccinees from three centers in Santiago, Chile. METHODS: Individuals previously inoculated with two doses of CoronaVac (N = 523) were recruited in the context of the REFUERZO clinical trial (NCT04992182) and received either placebo (N=129), or a booster dose of CoronaVac (N=134), BNT162b2 (N=133) or ChAdOx1 (N=127). Pseudovirus neutralizing antibody titers (pVNT) were determined at baseline (day 0) as well as days 14, 30, 60 and 90 post booster administration. RESULTS: Inoculating a booster dose increases the pVNTs titers at days 14 and 30 in all groups, (13.5 and 12.0 fold increase for the CoronaVac group; 247.0 and 212.3 fold increase for the BTN162b2 group; and 89.1 and 128.1 fold increased for ChAdOx1 at each time point, respectively) with a decline observed at days 60 and 90. However, while pVNTs remained significantly higher for the BTN162b2 and ChAdOx1 groups at days 60 and 90, neutralizing antibody titers reached baseline levels in the CoronaVac group at 90 days post-inoculation. CONCLUSIONS: A single heterologous booster (BTN162b2 or ChAdOx1) in individuals who completed the CoronaVac primary series resulted in an important increase in NAb titers remaining significantly higher at least for 90 days. These data may directly impact middle- and low-income countries currently using CoronaVac as the main vaccination strategy.

Prospect of herbal medication as prevention against COVID variants.

Personal immunity frolicked an essential role in combating COVID-19 impacts on human health individually and collectively in community. Literature represented the fact about food or nutritional supplements are certified to protect against diseases; this was the reason behind public trust on certain plants and other commercial products to boost up immunity against coronavirus disease. Present study was conducted to observe the attitude of common public towards natural herbs in treating various diseases and to assess the possible potential of herbal medication in prevention of negative impacts of different variants of COVID-19 on human health at herbal clinic named "Pakistan Matab". Results concluded that most of the patients (About 80%) avoided COVID-19 testing even on experiencing major symptoms and they preferred herbal medication. Patients who died by COVID-19 were also experiencing different diseases like liver and Kideny malfunctioning; old age was another significant factor in this case. About 90% of patients were COVID symptomatic and 10% were carrying other diseases during observational study period at herbal clinic. Study represented that patients who visited clinic, have a faith on herbal medication with about 60% of patients in favor of vaccine and allopathic medication in combination with herbal treatment. Study investigated that vaccine was only for one type of variant and use of herbal medicines could be better option to boost up immunity against various COVID variants.

Staining effect of herbal immune boosters used during Covid-19 pandemic on teeth shade: In-vitro study

Objective: Assessment of staining effect of herbal immune boosters used during COVID-19 pandemic on teeth shade. Material and method: 70 extracted premolars (N=10) were assigned to different solutions which were formulated to mimic the impact of herbal immune boosters on teeth. A baseline reading was performed using in-vitro VITA Easy shade Advance 4.0 and one day later, seven days later, and fourteen days later. The data was entered into SPSS software version 26. Results: A statistically significant difference was noticed in orange, lemon, and curcuma. Conclusion: The consumption of some herbal products has an impact on teeth's shade. Moreover, some materials such as, orange, lemon, and curcuma had the ability to change the teeth shade faster and stronger effect on teeth shade.

Herbal Medicines as Potential Immune Boosters against Coronavirus Diseases

Coronavirus disease COVID-19 is causing havoc globally, infecting millions of people and has led to the deaths of people in thousands. COVID-19 attacks persons with low immune sys-tems, especially neonates and geriatrics. Hence, boosting immunity may be one of the best options during this pandemic. There is a need to explore the possible herbal drugs to boost the immunity of people as a result of the rising cases of deaths due to COVID-19. However, the rationale for the use of herbal drugs is that each herb has the possibility of treating many health conditions. A single herb could have antiviral, antibacterial, and anti-inflammatory properties. Herbs may be one possible source of a true cure for COVID-19. Herbal drugs are from renewable sources and pose less danger of possible adverse effects compared to synthetic drugs. Because COVID-19 has no true cure pres-ently, man should resort to herbal drugs given by nature. Herbal drugs are highly potent and effica-cious;hence, the early men treated their ailments with herbs. However, their use has been limited by poor pharmaceutical design into dosage forms that would be acceptable to people. Herbal drugs could be formulated as teas, decoctions, infusions, and, more recently, tablets, capsules, microparti-cles, nanoparticles, and phytosomes, amongst others. Different herbal plants with possible immune booster effects will be discussed in this work, and how they can be formulated into stable and acceptable dosage forms will be explored. Copyright © 2023 Bentham Science Publishers.

Healthcare workers' perspectives on the COVID-19 vaccine and boosters for themselves, their patients, and their communities: a mixed methods study.

Aim: To examine experiences and attitudes of a diverse sample of clinical and non-clinical healthcare workers regarding COVID-19 vaccines and boosters for themselves, their patients, and their communities. Subject and methods: We conducted a sequential exploratory mixed methods study; 52 healthcare workers participated in qualitative interviews between April 22 and September 7, 2021, and 209 healthcare workers completed surveys between February 17 and March 23, 2022. Interviews and survey questions asked about personal attitudes toward COVID-19 vaccination and boosters and experiences discussing vaccination with patients. Results: Participants were predominantly White (56% and 73%, respectively) and female (79% and 81%, respectively). Factors motivating healthcare workers to take the vaccine were the belief that vaccination would protect themselves, their families, patients, and communities. Healthcare workers were accepting of and had high receipt of the booster, though some had diminished belief in its effectiveness after becoming infected with SARS-CoV-2 after initial vaccination. Race related mistrust, misinformation related to vaccine safety, and concerns about vaccine effects during pregnancy were the most common barriers that providers encountered among their patients and communities. Conclusions: Healthcare workers' primary motivation to receive COVID-19 vaccines was the desire to protect themselves and others. Healthcare workers' perception was that concerns about safety and misinformation were more important barriers for their patients than themselves. Race-related medical mistrust amplified concerns about vaccine safety and hindered communication efforts.

Immune System and Epidemics: The Role of African Indigenous Bioactive Substances.

With over 6 million coronavirus pandemic deaths, the African continent reported the lowest death rate despite having a high disease burden. The African community's resilience to the pandemic has been attributed to climate and weather conditions, herd immunity, repeated exposure to infectious organisms that help stimulate the immune system, and a disproportionately large youth population. In addition, functional foods, herbal remedies, and dietary supplements contain micronutrients and bioactive compounds that can help boost the immune system. This review identified significant traditional fermented foods and herbal remedies available within the African continent with the potential to boost the immune system in epidemics and pandemics. Methodology: Databases, such as PubMed, the Web of Science, and Scopus, were searched using relevant search terms to identify traditional African fermented foods and medicinal plants with immune-boosting or antiviral capabilities. Cereal-based fermented foods, meat-, and fish-based fermented foods, and dairy-based fermented foods containing antioxidants, immunomodulatory effects, probiotics, vitamins, and peptides were identified and discussed. In addition, nine herbal remedies and spices belonging to eight plant families have antioxidant, immunomodulatory, anti-inflammatory, neuroprotective, hepatoprotective, cardioprotective, and antiviral properties. Peptides, flavonoids, alkaloids, sterols, ascorbic acid, minerals, vitamins, and saponins are some of the bioactive compounds in the remedies. Bioactive compounds in food and plants significantly support the immune system and help increase resistance against infectious diseases. The variety of food and medicinal plants found on the African continent could play an essential role in providing community resilience against infectious diseases during epidemics and pandemics. The African continent should investigate nutritional, herbal, and environmental factors that support healthy living and longevity.

Parental hesitancy towards vaccinating their children with a booster dose against COVID-19: Real-world evidence from Taizhou, China.

INTRODUCTION: Parental vaccine-hesitancy can lead to delays or refusal to vaccinate children despite the availability of vaccines. This is a population-based, cross-sectional study investigating whether parents in China are hesitant to vaccinate their children with a COVID-19 vaccine booster. METHODS: Parents in Taizhou, China, responded to a self-reported online questionnaire on their hesitancy to vaccinate their children with a COVID-19 vaccine booster. Of the 1252 parents who were invited to answer the structured questionnaire, 514 (41.1%) samples had valid data for data analysis. RESULTS: A total of 41.8% of participants were hesitant to give their children a COVID-19 vaccine booster. After adjusting for confounders, parental gender (female vs. male parent, OR=0.56 95% CI: 0.32-0.87), parental opinion (yes vs. no, OR=0.17, 95% CI: 0.09-0.30), parental attitudes (yes vs. no, OR=0.28, 95% CI: 0.16-0.50), the presence of people around them who are generally hesitant to receive COVID-19 booster vaccines for children (yes vs. no, OR=0.14, 95%CI: 0.08-0.23), the individual hesitancy of people around them to administer booster COVID-19 vaccines to children (yes vs. no, OR=0.02, 95%CI: 0.02-0.22), and parents' hesitancy to receive a booster vaccine for their children showed significant correlation. The disparity of factors related to booster vaccine-hesitancy for children between fathers and mothers was also found. CONCLUSIONS: We found that a moderate proportion of parents reported that they were hesitant to give their children a COVID-19 vaccine booster. The results suggest that an in-depth, dynamic assessment and further health education planning are necessary to reduce Chinese parents' hesitancy to vaccinate their children.

Comparing immunogenicity and efficacy of two different mRNA-based COVID-19 vaccines as a fourth dose; six-month follow-up, Israel, 27 December 2021 to 24 July 2022.

We assess the immunogenicity and efficacy of Spikevax and Comirnaty as fourth dose COVID-19 vaccines. Six months post-fourth-dose, IgG levels were higher than pre-fourth dose at 1.58-fold (95% CI: 1.27-1.97) in Spikevax and 1.16-fold (95% CI: 0.98-1.37) in Comirnaty vaccinees. Nearly 60% (159/274) of vaccinees contracted SARS-CoV-2. Infection hazard ratios (HRs) for Spikevax (0.82; 95% CI: 0.62-1.09) and Comirnaty (0.86; 95% CI: 0.65-1.13) vaccinees were similar, as were substantial-disease HRs, i.e. 0.28 (95% CI: 0.13-0.62) and 0.51 (95% CI: 0.27-0.96), respectively.