American Lessons: The COVID-19 Pandemic and the US Supreme Court

Ever since the outbreak of the COVID-19 Pandemic in America in March 2020, several US states imposed harsh measures to combat the pandemic. Such state measures have at times seriously violated human rights, such as freedom of religion or freedom of movement. This chapter attempts to look at how the US Supreme Court has responded to the pandemic and reviewed several state measures over the past couple of years through selected cases on freedom of religion and compulsory vaccinations. We particularly look at its views on the role of the judiciary during the crisis, the scrutiny applied on human rights violations, as well as whether changes in the Court's composition during the Trump Era have in fact influenced its judicial reasoning. Overall, has the COVID-19 pandemic had an impact on judicial review and the Court's role? If so, how?. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Experiences of adult epilepsy patients with COVID-19 infections and vaccinations

Objective: To assess the course of COVID-19 infections and the tolerability of the mRNA vaccines of Moderna and Pfizer/BioNTech and the viral vector vaccines from Astra Zeneca and Johnson & Johnson in adult patients with epilepsy (PWE). Method(s): From July 2020 to July 2021, we consecutively included adult outpatients with confirmed epilepsy. These PWE were interviewed about COVID-19 infections and vaccinations. Results of follow-up visits were added until the cut-off date (December 31, 2021). The data of COVID-19-infected without vaccinations or fully vaccinated PWE without COVID-19 infections were analyzed. Full vaccination was defined as a double vaccination with the Pfizer/BionTech, Moderna, or Astra Zeneca vaccines or a single Johnson & Johnson vaccination. Result(s): At cut-off, 612 of 1152 PWE fulfilled the inclusion criteria: 51 PWE had been infected without vaccination and 561 had full vaccination without infection. Among the infected PWE, 76.5% presented with symptoms;9.8% had a severe course (one death). The leading symptoms were influenza-like disorders (48.7% of infected PWE with symptoms), anosmia (28.2%), and ageusia (20.5%). Seizure increases or relapses after sustained seizure freedom occurred in 7.8%. Adverse events (AEs) were reported by 113 vaccinated PWE (20.1% of all vaccinated PWE). The leading AEs were fatigue, fever, and headache. The AE rate per vaccine was 14.0% for Pfizer/BionTech, 32.7% for Moderna, 25.8% for Astra Zeneca, and 46.2% for Johnson & Johnson. Of the AEs, 93.3% lasted <=1 week. Seizure increase or relapse occurred in 1.4% and was significantly less frequent than in the infected group (p= 0.0016). Conclusion(s): The course of COVID-19 infections and the tolerability of the vaccines were similar as in the general population, yet, seizure worsening occurred more often after the infection than after the vaccination.Copyright © 2023, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, part of Springer Nature.

Assessment the Psychological Mindsets and Effectiveness of COVID-19 Vaccines, Occurrence and Severity of Covid-19 Infection among Vaccinated People in Iraq

Background: The World Health Organization had declared the release of COVID-19 vaccines in September 2020 and after. mRNA vaccine "Pfizer Biotech” and the adenoviral vector vaccine CoV-19 (AstraZeneca-Oxford) were granted emergency use. Researchers found that effectiveness of AstraZeneca and Pfizer vaccine is (70% and 95%) respectively. While the inactivated SARS-CoV-2 vaccine (Sinopharm) is safe, effective (effectiveness more than 50%) as WHO's declared. Sinopharm was the first vaccine that had been administered to Iraqi population. Only 2% of population had been vaccinated despite the efficacy and acceptability of it. Several studies conducted in different countries to assess the effectiveness of Covid-19 vaccines and its safety. Aim: This study done to assess the frequency of post vaccination infection with COVID-19 and accompanying signs and symptoms in different vaccine companies that are available in Iraq (Sinopharm, AstraZeneca-Oxford and Pfizer-BioNTech). Patients and methods: The study is a cross-sectional study conducted from 11th November 2021 to 15th March 2022 that included 500 Iraqi persons vaccinated with COVID-19 vaccine with either Pfizer, AstraZeneca or Sinopharm, Patients were chosen by Convenient sampling from different Iraqi governorate. All data management and analysis done by manual statistical methods. Results: From total 500 patients participated in the study with full doses vaccination (2 doses as recommended) there were (25%) person get covid-19 infection. Majority of infection occurred after 6 months of 2nd dose. Majority of postvaccination infections with Pfizer vaccine were with mild to moderate symptoms without need hospitalizations in comparison to (5.56%), (3.13%) hospitalizations rate and severe infection post AstraZeneca and Sinopharm vaccines respectively. Conclusion: Full vaccination of two doses of (Pfizer, AstraZeneca, Sinopharm) are highly effective in decrease the severity of COVID-19 infection signs and symptoms, decrease rate of hospitalizations. High efficacy of Pfizer vaccine than AstraZeneca and Sinopharm vaccines. © 2023,ournal for ReAttach Therapy and Developmental Diversities. All Rights Reserved.

Evaluation of Infancy Vaccine Applications within the Scope of Custodial Right

Vaccine hesitation, described by the WHO as "delay or refusal in the acceptance of vaccines notwithstanding the availability of vaccine services" and vaccine refusal, defined as the rejection of all vaccines, have been documented in more than 90% of the world's countries. In Turkey, some parents are increasingly rejecting vaccination of infants. These vaccines are essential to prevent the emergence of preventable diseases, especially in infants, and to prevent deaths caused by these diseases. The discussion of making vaccinations compulsory after the Covid-19 pandemic made it important to re-examine the necessity of infancy vaccinations. In its Halime Sare Aysal decision regarding infancy vaccination in 2015, the Constitutional Court found legal representatives of infants who refuse to consent to infancy vaccination practices to be a violation of rights. However, contrary to the Constitutional Court decision's reasoning, when the issue of whether to give consent that will make the medical intervention lawful is taken into consideration within the framework of the scope of limitation of the right of custody and "best interests of the child," mandatory vaccination debates will cease to be a typical constitutional law debate. In the first part of this study, the regulation of infancy vaccination practices in comparativelaw will be discussed. Furthermore, in the second part, the legislation regarding infancy vaccination practices in Turkey and the position of the national and supranational judiciary will be examined. In the last part, the refusal of the legal representative of the infant to consent to medical intervention will be analyzed in the context of limiting or removing the right of custody on the basis of the best interests of the child.

Improved Barnacle Mating Optimizer-Based Least Square Support Vector Machine to Predict COVID-19 Confirmed Cases with Total Vaccination

Every country must have an accurate and efficient forecasting model to avoid and manage the epidemic. This paper suggests an upgrade to one of the evolutionary algorithms inspired by nature, the Barnacle Mating Optimizer (BMO). First, the exploration phase of the original BMO is enhanced by enforcing and replacing the sperm cast equation through Levy flight. Then, the Least Square Support Vector Machine (LSSVM) is partnered with the improved BMO (IBMO). This hybrid approach, IBMO-LSSVM, has been deployed effectively for time-series forecasting to enhance the RBF kernel-based LSSVM model since vaccination started against COVID-19 in Malaysia. In comparison to other well-known algorithms, our outcomes are superior. In addition, the IBMO is assessed on 19 conventional benchmarks and the IEEE Congress of Evolutionary Computation Benchmark Test Functions (CECC06, 2019 Competition). In most cases, IBMO outputs are better than comparison algorithms. However, in other circumstances, the outcomes are comparable.

Implementation of the preventive vaccination program in the time of the COVID-19 pandemic - single center study.

INTRODUCTION: In addition to many diagnostic and therapeutic procedures, the COVID-19 pandemic also limited prophylaxis, including the implementation of the vaccination program among children. OBJECTIVE: The aim of the study was to assess the implementation of the vaccination program in the area covered by the care of patients of a selected Primary Health Care clinic in the city of Krakow in the field of selected vaccinations during the COVID-19 pandemic. MATERIAL AND METHODS: A retrospective study based on secondary data was conducted in a selected clinic (Kraków, Poland) that cares for 1,982 children aged 0-19 years. An analysis of the vaccination coverage in selected groups of children in 2019, 2020 and 2021 was carried out based on annual reports (MZ-54). Vaccination coverage against: diphtheria, tetanus, whooping cough, measles, mumps, rubella, influenza and pneumococcal infection was analyzed. The collected data were analyzed using descriptive statistics, Chi2 test and Fisher's exact test. RESULTS: In the general vaccination status of two-year-olds, no significant differences were observed in the period 2019-2021 (p=0.156). The percentage of fully vaccinated increased from 77.6% in 2019, to 81.5% in 2020 and to 85.2% in 2021. However, a high rate of vaccination refusals was observed in 2021 (4.1%) in this group. The percentage of 2-year-olds vaccinated against pneumococci (PCV) and 3-year-olds against diphtheria, tetanus, pertussis (DTP), and measles, mumps, rubella (MMR) in the years 2019-2021 was increasing. For DTP and MMR, this increase was significant (p<0.05). In the group of older children, in 2020 the percentage of 7- and 15-year-olds vaccinated decreased compared to 2019 and 2021, but the difference was insignificant (p>0.05). A significant difference in vaccination coverage was observed in the group of 19-year-olds, in which in 2020 the percentage of vaccinated was 58% (in 2019 - 74.6%, in 2021 - 81%). The largest number of children under the age of 5 were vaccinated against influenza in 2021, but it was only less than 2% of this group. CONCLUSIONS: Sanitary restrictions introduced during the COVID-19 pandemic did not significantly affect the vaccination status of children in selected age groups against the analyzed vaccine-preventable diseases. The exception is the group of 19-year-olds, whose vaccination coverage in 2020 was much lower than in 2019 and 2021. In addition, an increase in refusals of vaccination was observed, reaching 4.1% in 2021 in the group of the youngest patients.

Evaluation of a Community COVID-19 Vaccine Ambassador Train-the-Trainer Program.

Racially minoritized groups are more likely to experience COVID-19 vaccine hesitancy and have lower vaccination rates.  As part of a multi-phase community-engaged project, we developed a train-the-trainer program in response to a needs assessment. "Community vaccine ambassadors" were trained to address COVID-19 vaccine hesitancy. We evaluated the program's feasibility, acceptability, and impact on participant confidence for COVID-19 vaccination conversations. Of the 33 ambassadors trained, 78.8% completed the initial evaluation; nearly all reported gaining knowledge (96.8%) and reported a high confidence with discussing COVID-19 vaccines (93.5%). At two-week follow-up, all respondents reported having a COVID-19 vaccination conversation with someone in their social network, reaching an estimated 134 people. A program that trains community vaccine ambassadors to deliver accurate information about COVID-19 vaccines may be an effective strategy for addressing vaccine hesitancy in racially minoritized communities.

Combined Infection Control Interventions Protect Essential Food Workers from Occupational Exposures to SARS-CoV-2 in the Agricultural Environment.

Essential food workers experience elevated risks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to prolonged occupational exposures in food production and processing areas, shared transportation (car or bus), and employer-provided shared housing. Our goal was to quantify the daily cumulative risk of SARS-CoV-2 infection for healthy susceptible produce workers and to evaluate the relative reduction in risk attributable to food industry interventions and vaccination. We simulated daily SARS-CoV-2 exposures of indoor and outdoor produce workers through six linked quantitative microbial risk assessment (QMRA) model scenarios. For each scenario, the infectious viral dose emitted by a symptomatic worker was calculated across aerosol, droplet, and fomite-mediated transmission pathways. Standard industry interventions (2-m physical distancing, handwashing, surface disinfection, universal masking, ventilation) were simulated to assess relative risk reductions from baseline risk (no interventions, 1-m distance). Implementation of industry interventions reduced an indoor worker's relative infection risk by 98.0% (0.020; 95% uncertainty interval [UI], 0.005 to 0.104) from baseline risk (1.00; 95% UI, 0.995 to 1.00) and an outdoor worker's relative infection risk by 94.5% (0.027; 95% UI, 0.013 to 0.055) from baseline risk (0.487; 95% UI, 0.257 to 0.825). Integrating these interventions with two-dose mRNA vaccinations (86 to 99% efficacy), representing a worker's protective immunity to infection, reduced the relative infection risk from baseline for indoor workers by 99.9% (0.001; 95% UI, 0.0002 to 0.005) and outdoor workers by 99.6% (0.002; 95% UI, 0.0003 to 0.005). Consistent implementation of combined industry interventions, paired with vaccination, effectively mitigates the elevated risks from occupationally acquired SARS-CoV-2 infection faced by produce workers. IMPORTANCE This is the first study to estimate the daily risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across a variety of indoor and outdoor environmental settings relevant to food workers (e.g., shared transportation [car or bus], enclosed produce processing facility and accompanying breakroom, outdoor produce harvesting field, shared housing facility) through a linked quantitative microbial risk assessment framework. Our model has demonstrated that the elevated daily SARS-CoV-2 infection risk experienced by indoor and outdoor produce workers can be reduced below 1% when vaccinations (optimal vaccine efficacy, 86 to 99%) are implemented with recommended infection control strategies (e.g., handwashing, surface disinfection, universal masking, physical distancing, and increased ventilation). Our novel findings provide scenario-specific infection risk estimates that can be utilized by food industry managers to target high-risk scenarios with effective infection mitigation strategies, which was informed through more realistic and context-driven modeling estimates of the infection risk faced by essential food workers daily. Bundled interventions, particularly if they include vaccination, yield significant reductions (>99%) in daily SARS-CoV-2 infection risk for essential food workers in enclosed and open-air environments.

Perceived impact of the COVID-19 pandemic among people with spinal cord injury: A descriptive study.

Objective: To describe the self-reported impact of the COVID-19 pandemic on the lives of persons with spinal cord injury (SCI). Design: Cross sectional study. Participants: There were a total of 382 adult participants with traumatic SCI of at least one-year duration, all of whom were identified through a state-based surveillance registry in the Southeastern United States. The majority of participants were male (68.4%) and 72% were ambulatory. The average age at the time of the study was 57.7. Main Outcome Measures: Participants completed a self-report assessment (SRA) online or by mail on the impact of COVID-19 on quality-of-life, ability to get daily necessities, and access to healthcare. Results: Over half of the participants (58.9%) reported a negative impact of the pandemic in at least one of five life areas, with community participation being the primary area affected (51.4%). A small portion of individuals had trouble obtaining necessities, with approximately 12% reporting difficulties getting enough or quality food and 8.2% reporting difficulty getting prescription medications. However, 25% reported delaying healthcare procedures because of fear of catching COVID-19. Among those requiring personal assistance, 32% reported a decrease in quality of care and 51.9% relied more on family to assist with their care. Conclusions: The COVID-19 pandemic had multiple negative impacts. Of particular importance were reduced access to healthcare and declines in quality and stability of attendant care, with greater reliance on family. Fear of contracting COVID-19 when accessing routine medical procedures needs to be addressed in future outbreaks.

Heterologous vaccination with inactivated vaccine and mRNA vaccine augments antibodies against both spike and nucleocapsid proteins of SARS-CoV-2: a local study in Macao.

The mRNA vaccines (RVs) can reduce the severity and mortality of severe acute respiratory syndrome coronavirus (SARS-CoV-2). However, almost only the inactivated vaccines (IVs) but no RVs had been used in mainland China until most recently, and the relaxing of its anti-pandemic strategies in December 2022 increased concerns about new outbreaks. In comparison, many of the citizens in Macao Special Administrative Region of China received three doses of IV (3IV) or RV (3RV), or 2 doses of IV plus one booster of RV (2IV+1RV). By the end of 2022, we recruited 147 participants with various vaccinations in Macao and detected antibodies (Abs) against the spike (S) protein and nucleocapsid (N) protein of the virus as well as neutralizing antibodies (NAb) in their serum. We observed that the level of anti-S Ab or NAb was similarly high with both 3RV and 2IV+1RV but lower with 3IV. In contrast, the level of anti-N Ab was the highest with 3IV like that in convalescents, intermediate with 2IV+1RV, and the lowest with 3RV. Whereas no significant differences in the basal levels of cytokines related to T-cell activation were observed among the various vaccination groups before and after the boosters. No vaccinees reported severe adverse events. Since Macao took one of the most stringent non-pharmaceutical interventions in the world, this study possesses much higher confidence in the vaccination results than many other studies from highly infected regions. Our findings suggest that the heterologous vaccination 2IV+1RV outperforms the homologous vaccinations 3IV and 3RV as it induces not only anti-S Ab (to the level as with 3RV) but also anti-N antibodies (via the IV). It combines the advantages of both RV (to block the viral entry) and IV (to also intervene the subsequent pathological processes such as intracellular viral replication and interference with the signal transduction and hence the biological functions of host cells).

National calendar of preventive vaccinations: present and future

In the context of a pandemic of a new coronavirus infection, vaccine prophylaxis within the framework of the National Calendar of Preventive Vaccinations (NCPV) is an absolute priority in the fight against infectious diseases. The lecture presents the structure and features of the NCPV, the main directions of its improvement, information on the priority infections for vaccination. The strategy of immunization throughout life, which guarantees the creation of maximum protection against infections and preservation of the optimal level of health of people without age restrictions, is considered. Information is provided on approaches to vaccination of various patient populations against new coronavirus, pertussis, pneumococcal, and rotavirus infections. The presented lecture materials can be useful both to medical students and doctors of various specialties (infectious disease specialists, pediatricians, epidemiologists, bacteriologists).Copyright © 2022 by the authors.

A Hybrid Method for Analyzing the Situation Based on Cumulative Fully Vaccinated and Confirmed Cases of Covid-19 in Malaysia

SARS-CoV-2 is an infection that affects several organs and has a wide range of symptoms in addition to producing severe acute respiratory syndrome. Millions of individuals were infected when it first started because of how quickly it travelled from its starting location to nearby countries. Anticipating positive Covid-19 incidences is required in order to better understand future risk and take the proper preventative and precautionary measures. As a result, it is critical to create mathematical models that are durable and have as few prediction errors as possible. This study suggests a unique hybrid strategy for examining the status of Covid-19 confirmed patients in conjunction with complete vaccination. First, the selective opposition technique is initially included into the Grey Wolf Optimizer (GWO) in this study to improve the exploration and exploitation capacity for the given challenge. Second, to execute the prediction task with the optimized hyper-parameter values, the Least Squares Support Vector Machines (LSSVM) method is integrated with Selective Opposition based GWO as an objective function. The data source includes daily occurrences of confirmed cases in Malaysia from February 24, 2021 to July 27, 2022. Based on the experimental results, this paper shows that SOGWO-LSSVM outperforms a few other hybrid techniques with ideally adjusted parameters. © 2022 IEEE.

Vaccination strategies in structured populations under partial immunity and reinfection

Optimal protocols of vaccine administration to minimize the effects of infectious diseases depend on a number of variables that admit different degrees of control. Examples include the characteristics of the disease and how it impacts on different groups of individuals as a function of sex, age or socioeconomic status, its transmission mode, or the demographic structure of the affected population. Here we introduce a compartmental model of infection propagation with vaccination and reinfection and analyze the effect that variations on the rates of these two processes have on the progression of the disease and on the number of fatalities. The population is split into two groups to highlight the overall effects on disease caused by different relationships between vaccine administration and various demographic structures. As a practical example, we study COVID-19 dynamics in various countries using real demographic data. The model can be easily applied to any other disease transmitted through direct interaction between infected and susceptible individuals, and any demographic structure, through a suitable estimation of parameter values. Two main conclusions stand out. First, the higher the fraction of reinfected individuals, the higher the likelihood that the disease becomes quasi-endemic. Second, optimal vaccine roll-out depends on demographic structure and disease fatality, so there is no unique vaccination protocol, valid for all countries, that minimizes the effects of a specific disease. Simulations of the general model can be carried out at this interactive webpage Atienza (2021 S2iyrd model simulator). © 2023 The Author(s). Published by IOP Publishing Ltd.

Willingness to COVID-19 vaccination: Empirical evidence from EU.

The unforgettable COVID-19 shock is most likely to be reversed by a viable vaccination strategy. In this paper, we investigate willingness to be vaccinated (WTV) against the COVID-19. Current trends suggest that only around 73% of EU inhabitants (15 and +) were immunized, with more than 104 million people still warranted to be immunized. Vaccine reluctance is a key impediment to conducting immunization programs in the setting of a pandemic. We provide first of its kind empirical evidence on the citizens (N = 11,932) of the EU-27 by employing the recent data from the European Commission. Based on the survey responses, controlling for the correlations in the error terms, we utilize a simulated multivariate probit regression model. Our results show that amongst all the statistically significant drivers of the WTV, the positive perception (vaccination works and has no side effects); R&D information (clarity on how vaccination is developed, tested, authorized) has the largest impact on the WTV. We find that the group of variables on social feedback (Positive perception; social adoption and pressure), and on trustworthy sources of information (R&D info; medical advice) are to be considered for WTV policy. The counteracting policy gaps that act against WTV include vaccination governance dissatisfaction, perception of long-term side effects, growing mistrust in information sources, uncertainty between safety and efficacy, education level, and risky age group. Strategies based on the outcomes of this study are needed to address public acceptance and willingness to vaccinate during a pandemic. This research is novel and offers authorities in-depth insights into the challenges and solutions regarding the COVID-19 pandemic and thus to its end via stimulation of the WTV.

The long-term antibody response after SARS-CoV-2 prime-boost vaccination in healthy individuals. The positive influence of extended between-dose intervals and heterologous schedule.

Introduction: Anti-COVID vaccination in Argentina was carried out using different protocols and variations in periods between administrations, as well as combinations of different vaccine platforms. Considering the relevance of the antibody response in viral infections, we analyzed anti-S antibodies in healthy people at different points of time following the Sputnik immunization procedure. Methods: We attended the vaccination centers in the city of Rosario, which had shorter versus longer intervals between both doses. A total of (1021) adults with no COVID-compatible symptoms (throughout the study period) were grouped according to the gap between both vaccine doses: 21 (Group A, n=528), 30 (Group B, n=147), and 70 days (Group C, n=82), as well as an additional group of individuals with heterologous vaccination (Sputnik/Moderna, separated by a 107-day interval, group D, n=264). Results and conclusions: While there were no between-group differences in baseline levels of specific antibodies, data collected several weeks after administering the second dose showed that group D had the highest amounts of specific antibodies, followed by values recorded in Groups C, B, and A. The same pattern of group differences was seen when measuring anti-S antibodies at 21 or 180 days after the first and second doses, respectively. Delayed between-dose intervals coexisted with higher antibody titers. This happened even more when using a prime-boost heterologous schedule.

Vaccine Knowledge of Saudi Parents and Adherence to Immunization Schedule in Saudi Arabia

Objectives: Immunization is one of the best measures to limit the transition of infectious disease and disease severity. Despite that, vaccination programs are frequently affected by a delay in giving vaccines on time or ignorance and avoidance due to various reasons. Our study aimed to estimate the percentage of vaccination delay in our society and assess the level of parents' awareness about vaccine importance;finally, we will shed light on the effect of the coronavirus pandemic on the immunization schedule. Methods: This cross-sectional study was conducted in Dawadmi, Saudi Arabia, from May 2022 to August 2022. Data were collected from parents using a structured questionnaire. Vaccinations were considered delayed if they occurred more than 30 days after the designated time. Parents residing outside Dawadmi or older than 65 years were excluded. Results: Among 393 respondents, the majority were mothers, aged between 30-50 years. Overall, 88% adhered to the immunization schedule. Major reasons for delay were forgetting the vaccination date, unavailability of vaccines, and being busy at work. In comparison to the delayed group, parents who adhered to the immunization schedule were aware about its importance. Conclusions: The majority of parents adhered to the immunization schedule. The most common reason was forgetting the vaccine date. Other reasons were the lack of vaccines in Primary Health Care. The commonly delayed vaccines were the 4 and 9-months vaccines. The pandemic affected adherence to vaccination schedules.

Acute Retinal Pigment Epitheliitis following Vaccination.

We present a rare case of acute retinal pigment epitheliitis (ARPE) following vaccination. An 18-year-old Japanese man visited our hospital with a 5-day history of a central scotoma in the right eye. He had received the second dose of coronavirus disease 2019 vaccination (BNT162b2 mRNA, Pfizer-BioNTech) 1 month prior, following which he developed a low-grade fever of 37.3-37.5°C for 2 days accompanied by joint pain. Although he had received influenza vaccination 5 days prior to this presentation, no systemic symptoms other than injection site pain were observed. Blood test results were unremarkable. Ophthalmological examination revealed a decimal best-corrected visual acuity (BCVA) of 0.8 and 1.2 in the right and left eyes, respectively. Intraocular pressure was 15 mm Hg in both eyes. Intraocular inflammation was not observed. Fundus examination revealed a localized lesion of pigment stippling associated with yellowish hypopigmentation in the fovea. Fluorescein angiography revealed slight transmission hyperfluorescence without leakage. Optical coherence tomography (OCT) revealed disruption of the external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ). We diagnosed the patient with ARPE in the right eye. The patient was followed up without treatment. Five weeks after onset, the central scotoma in the right eye disappeared, and patient's BCVA in the right eye improved to 1.5. OCT showed improvement in ELM and EZ continuity in the right eye, but IZ remained disruptive. Although the exact pathophysiology of the association between ARPE and these vaccinations is unclear, ARPE may develop after the vaccination.

Conspiracy beliefs and attitudes toward COVID-19 vaccinations

During the coronavirus pandemic, this study aimed to investigate the impact of conspiracy beliefs on Finnish attitudes toward vaccinations in general and COVID-19 vaccinations in particular. This study was a conceptual replication in Finland of a study by Pivetti et al. (2021). Some 529 Finnish participants responded to a self-report questionnaire during the partial lockdown in Finland in spring 2020. The hypothesized relationships between variables of interest were integrated in a serial multiple mediation model via structural equation modelling. Results showed that endorsing general conspiracy beliefs directly predicted (1) general attitudes toward vaccines and (2) COVID-19 conspiracy beliefs, and indirectly predicted (3) attitudes toward COVID-19 vaccines via the serial mediation of COVID-19 conspiracy beliefs and general attitudes toward vaccines. As for the antecedents of beliefs in conspiracy theories, political orientation and moral purity predicted beliefs in COVID-19 conspiracy theories. Trust in science was inversely related to general conspiracy beliefs. As for the consequences of conspiracy beliefs, COVID-19 conspiracy beliefs directly predicted support for governmental restrictions (negatively) and the perception of informational contamination (positively).

Effect of the COVID-19 Pandemic on Paediatric Check-Ups and Vaccinations in Germany.

Paediatric check-ups and vaccinations are provided and free of charge in Germany. Despite being hitherto generally well-received and adhered to, it is possible that the lockdown implemented due to the COVID-19 pandemic resulted in delays or even cancellations of critical paediatric visits with healthcare providers. This study attempts to quantify the rate and time to follow-up for check-ups in Germany using the retrospective IQVIATM Disease Analyzer database. Additionally, timely administration of 4 vaccines (Hexavalent, pneumococcal, MMR-V, Rotavirus) was analysed to examine the impact of pandemic restrictions on vaccine uptake. The timeframes which were compared to determine the effects of COVID-19 were June 2018-December 2019 and March 2020-September 2021. The follow-up rates for paediatric check-ups were consistently lower in the COVID-19 phase, but generally ~90%. Follow-up rates for the vaccinations were distinctly higher during COVID-19. The time between events was almost unchanged for check-ups during the pandemic. For check-ups, age at initial event differed by less than a week between the phases. For vaccinations, the age differences were slightly higher, but exceeded one week in only two cases. The results show that the COVID-19 pandemic had little effect on paediatric check-ups and vaccinations in Germany.

The Effects of Expressing Empathy/Autonomy Support Using a COVID-19 Vaccination Chatbot: Experimental Study in a Sample of Belgian Adults.

BACKGROUND: Chatbots are increasingly used to support COVID-19 vaccination programs. Their persuasiveness may depend on the conversation-related context. OBJECTIVE: This study aims to investigate the moderating role of the conversation quality and chatbot expertise cues in the effects of expressing empathy/autonomy support using COVID-19 vaccination chatbots. METHODS: This experiment with 196 Dutch-speaking adults living in Belgium, who engaged in a conversation with a chatbot providing vaccination information, used a 2 (empathy/autonomy support expression: present vs absent) × 2 (chatbot expertise cues: expert endorser vs layperson endorser) between-subject design. Chatbot conversation quality was assessed through actual conversation logs. Perceived user autonomy (PUA), chatbot patronage intention (CPI), and vaccination intention shift (VIS) were measured after the conversation, coded from 1 to 5 (PUA, CPI) and from -5 to 5 (VIS). RESULTS: There was a negative interaction effect of chatbot empathy/autonomy support expression and conversation fallback (CF; the percentage of chatbot answers "I do not understand" in a conversation) on PUA (PROCESS macro, model 1, B=-3.358, SE 1.235, t186=2.718, P=.007). Specifically, empathy/autonomy support expression had a more negative effect on PUA when the CF was higher (conditional effect of empathy/autonomy support expression at the CF level of +1SD: B=-.405, SE 0.158, t186=2.564, P=.011; conditional effects nonsignificant for the mean level: B=-0.103, SE 0.113, t186=0.914, P=.36; conditional effects nonsignificant for the -1SD level: B=0.031, SE=0.123, t186=0.252, P=.80). Moreover, an indirect effect of empathy/autonomy support expression on CPI via PUA was more negative when CF was higher (PROCESS macro, model 7, 5000 bootstrap samples, moderated mediation index=-3.676, BootSE 1.614, 95% CI -6.697 to -0.102; conditional indirect effect at the CF level of +1SD: B=-0.443, BootSE 0.202, 95% CI -0.809 to -0.005; conditional indirect effects nonsignificant for the mean level: B=-0.113, BootSE 0.124, 95% CI -0.346 to 0.137; conditional indirect effects nonsignificant for the -1SD level: B=0.034, BootSE 0.132, 95% CI -0.224 to 0.305). Indirect effects of empathy/autonomy support expression on VIS via PUA were marginally more negative when CF was higher. No effects of chatbot expertise cues were found. CONCLUSIONS: The findings suggest that expressing empathy/autonomy support using a chatbot may harm its evaluation and persuasiveness when the chatbot fails to answer its users' questions. The paper adds to the literature on vaccination chatbots by exploring the conditional effects of chatbot empathy/autonomy support expression. The results will guide policy makers and chatbot developers dealing with vaccination promotion in designing the way chatbots express their empathy and support for user autonomy.