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The new coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus continues to spread rapidly worldwide, despite the increased prevention and treatment measures being taken. Vaccination is one of the most cost-effective and effective methods of preventing infectious diseases in the modern world, including one of the most effective methods of combating COVID-19. Over several centuries of history, vaccination has proven its effectiveness in saving people's lives, reducing the spread of infectious diseases among the population, as well as reducing mortality. The effectiveness of immunization against COVID-19 is an urgent problem at the moment, especially when it comes to vaccination. The aim of the work is to study the effect of vaccination on the incidence of a new coronavirus infection among residents of the Saratov Region. Material and methods. Methods of retrospective epidemiological analysis of trends in the epidemic process COVID-19 were used. The obtained materials were processed using methods of variational statistics (Excel program). The analysis was based on data from daily monitoring of laboratory diagnostic results (more than 1780 thousand PCR diagnostic studies were conducted during the epidemic), COVID-19 cases and deaths, taking into account the coverage of the population with preventive vaccinations. The statistical significance of the differences was assessed according to the Student's criterion. The differences were considered significant at t<=2. Results and discussion. As of June 30, 2021, more than 267 thousand people or 11% of the population of the Saratov region were fully vaccinated against COVID-19. There were no complications after the introduction of vaccines. In the structure of all medical immunobiological preparations that were immunized, the proportion of the vaccine "Gam-COVID-Vac" was 97.88%, "Epivaccorona" - 1.69% and "Covivac" - 0.43%. According to preliminary data, 361 of the vaccinated people were infected with SARS-CoV-2, of which: 255 (70.6%) had a mild course of the disease with manifestations of catarrhal syndrome, 84 (23.3%) had community-acquired pneumonia, 22 (6%) had no symptoms of the disease. No deaths have been registered among the vaccinated. The overall incidence of COVID-19 among vaccinated was 0.06%. The incidence rate of COVID-19 among the vaccinated population is 6.025+/-0.15 per 10 thousand people, which is significantly lower (t>2) than among the unvaccinated (103.8+/-0.63 per 10 thousand people), efficiency index - 17.23, epidemiological efficiency coefficient - 94.20% Conclusion. Insufficient coverage of the population of the Saratov Region with vaccination (as of June 30, 2021, 11% were fully vaccinated) does not allow to influence the reduction of the incidence of COVID-19. The high epidemiological effectiveness of COVID-19 vaccination of the adult population with domestic vaccines, including people over 65 years of age, has been revealed.Copyright © 2022 Geotar Media Publishing Group
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The coronavirus disease 2019 pandemic is an ongoing concern for medical care worldwide. Since its emergence, multiple COVID-19 vaccines have been designed, allowing for more effective control of the pandemic. COVID-19 vaccines, like any other form of medical intervention, may cause adverse and unforeseen side effects, varying in frequency and severity. Determining a correlation between the occurring symptoms and the vaccination is often a challenging task, requiring multiple data sources and reported cases. So far, there have been multiple reports of trigeminal neuralgia developing after COVID-19 vaccination. A 36-year-old woman was admitted to the Emergency Ward due to chronic pain attacks in the left side of her face. The pain appeared two months ago, on the day following the vaccination using the third dose of the Pfizer BioNTech COVID-19 vaccine. At the Neurology Department she was diagnosed with trigeminal neuralgia. Based on the lack of any obvious causes, relation to the vaccination, and other similar reports, we assumed that the trigeminal neuralgia was a complication of the vaccination. Hospital treatment consisted of oxcarbazepine, dexamethasone and pregabalin. Treatment was successful, with transient episodes of exacerbation. Six months after the onset of the disorder the patient remains without pain. We believe that the presented case supports the possibility of trigeminal neuralgia occurring in relation to the Pfizer BioNTech COVID-19 vaccine administration. Additional reports may further contribute to establishing a certain link. Copyright © 2023 Termedia.
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AIM: The objective is to explore the general perception, knowledge, and attitude of people in Saudi Arabia toward the COVID-19 vaccination. METHOD(S): An observational and cross-sectional study was conducted with 332 Saudi adult population attending primary health centers in King Abdul-Aziz Medical City, Riyadh, Saudi Arabia, between May and July2021 using a self-administered questionnaire. All adults, equal, or older than 18 years old of both genders during the period of the study were included and the only exclusion criteria are the age and patient with psychiatric disorder. We use convenience-sampling technique, due to the difficulty to generate sampling frame. Data are going to be entered and analyzed using Statistics Package for the Social Science version 21 software in August 2021. RESULT(S): Majority of participants (93.4%) had good knowledge about COVID-19 vaccines, regarding attitude more than 50% have positive attitude toward vaccination. Despite this high level on acceptance 48.5% of the participant in this study disclosed that they are not aware of vaccine side effects. With regard to perception, 66.9% of our study subjects believed that vaccination is necessary to eradicate COVID-19 pandemic. Furthermore, 72.4% thought that everyone should be vaccinated, starting with general public 74.5%, then health worker 57.9%. CONCLUSION(S): Almost most of Saudi population aware about the COVID-19 vaccines. Most Saudi people knew about it through media. A long-term side effect of getting vaccines is the main obstacles toward vaccine acceptance.Copyright © 2023, Scientific Foundation SPIROSKI. All rights reserved.
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The COVID-19 pandemic has been going on for more than two years. Vaccination is believed to be one of the most efficient ways to achieve herd immunity and end pandemic. However, the contents about COVID-19 vaccines on social media have impacts on personal attitude towards vaccination. The present study aims to examine the current scenario and the echo chamber effect of COVID-19 vaccine videos on YouTube. A total of 1,646 videos with comments and replies were identified. An approach combining topic modeling, sentiment analysis, and social network analysis was employed to explore users' attitude towards COVID-19 vaccines and whether the echo chamber effect existed. The results indicate that, even if the misleading and anti-vaccination videos were removed by the platform, "anti-vaccination"contents still widely appear in the comments. Moreover, the community of "anti-vaccination"users was more homogeneous compared with that of "pro-vaccination"users. The findings of this study advanced theories of echo chamber effect and the network perspective to examine echo chambers. We propose that should be paid more attention ideology echo chamber, compared with exposure echo chamber. © 2022 IEEE.
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Objective To investigate Pfizer-BioNTech 162b2 mRNA COVID-19 vaccine (BNT162b2) immunization-related myocarditis and describe the risk factors for consequent hospitalization in the pediatric intensive care unit (PICU) in children between 12−18 years. Methods Children and adolescents 12 years of age and older who presented with discomfort after BNT162b2 immunization (BNTI) and visited pediatric emergency room (PER) at Chang Gung Memorial Hospital from September 22, 2021 to March 21, 2022, were included for analysis. Results 681 children presented with discomfort after BNTI and visited our PER. The mean age was 15.1 ± 1.7 years. Three hundred and ninety-four (57.9%) and 287 (42.1%) events were after 1st and 2nd dose, respectively. 58.4% (n = 398) were male. The most common complaints were chest pain (46.7%) and chest tightness (27.0%). The median (interquartile range [IQR]) interval of discomfort after BNTI was 3.0 (1.0−12.0) days. BNTI-related pericarditis, myocarditis and myopericarditis were diagnosed in 15 (2.2%), 12 (1.8%) and 2 (0.3%) patients, respectively. Eleven (1.6%) needed hospitalization in PICU. The median (IQR) hospital stay was 4.0 (3.0−6.0) days. There was no mortality. More patients were diagnosed myocarditis (p = 0.004) after 2nd dose BNTI. PICU admission occurred more commonly after 2nd dose BNTI (p = 0.007). Risk factors associated with hospitalization in PICU were abnormal EKG findings (p = 0.047) and abnormal serum troponin levels (p = 0.003) at PER. Conclusions Myocarditis in children aged 12−18 years occurred more commonly following 2nd dose BNTI. Most cases were of mild or intermediate severity without death. Factors predicting BNTI-related myocarditis and consequent hospitalization in PICU were abnormal EKG findings and abnormal serum troponin levels at PER in this study.
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Intro: VLA2001 is a highly-purified, inactivated whole-virus SARS-CoV-2 vaccine based on a dual-adjuvant system of Alum and CpG1018 for induction of a robust immune response. The vaccine was designed using a well-established technology platform and has received full marketing authorization in Europe. In a pivotal Phase 3 trial, VLA2001 demonstrated superior neutralizing antibody geometric mean titers (GMT) to the comparator, AstraZeneca's AZD1222, as well as non-inferior seroconversion rates two weeks after priming. The extension of the Phase 3 trial evaluated safety and immunogenicity of homologous and heterologous booster vaccinations of VLA2001. Method(s): This is a randomized observer-blind controlled, pivotal trial conducted in the UK in participants aged >=18 years who were randomly assigned 2:1 to receive two doses of VLA2001 or AZD1222, 28 days apart. A booster with VLA2001 was administered to eligible participants at 7 to 8 months after priming. The primary safety outcome was the frequency and severity of any adverse event following the booster vaccination. The primary immunogenicity outcomes were the GMT and fold increase of neutralizing antibodies against SARS-CoV-2 two weeks after the booster vaccination. The study is registered under NCT04864561. Finding(s): A booster dose of VLA2001 is well-tolerated in both AZD1222 and VLA2001 primed participants. High neutralizing antibody titers and fold- increases were generated two weeks following a booster of VLA2001. Cross- neutralizing serological responses against Delta and the Omicron BA.4/BA.5 variants of concern are elicited following a homologous or heterologous booster dose in VLA2001 or AZD1222 primed participants, respectively. Additionally, VLA2001 induced broad T-cell responses with antigen-specific IFN-gamma producing T-cells against the Spike, the Nucleocapsid and the Membrane protein. Conclusion(s): Homologous and heterologous booster doses of VLA2001 demonstrated a favorable tolerability profile irrespective of priming and induced broadly reactive neutralizing antibodies against the ancestral virus and variants of concern, including the currently circulating BA.4/BA.5.Copyright © 2023
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Americans' concerns about the risks of vaccination are rising in recent years. In the original piece that explicated the psychometric paradigm, vaccinations were rated as less dreaded and less unknown. However, in 2016, vaccinations were more dreaded and more unknown in the public eye. A national survey (N = 1025) conducted in August 2021 reflects this trend in risk perception of the COVID-19 vaccines. Individuals who report different risk perceptions based on the unknown and dread characteristics associated with the COVID-19 vaccines also report different behavioral intent toward the vaccines. Overall, these findings show unknown risk to have a more salient impact on participants' risk perception that influence their vaccine-related decisions. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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Pivetti et al. (2021a;2021b) examined links between COVID-related conspiracy beliefs and acceptance of vaccinations in Italy and Finland in 2020. They found that moral purity negatively predicted confidence in science, whereas political orientation predicted COVID-related conspiracy beliefs. Confidence in science, general conspiracy beliefs, and COVID-related conspiracy beliefs were found to negatively predict support for governmental restrictions and attitudes towards vaccines, and positively predict perceptions of informational contamination. Finally, attitudes towards vaccines in general strongly predicted attitudes towards the COVID-19 vaccine. The current research seeks to replicate these findings conceptually on a predominately Muslim sample (N = 570, M age = 26.69, 69.8% females) in Turkey in 2021, when the COVID vaccines were widely available. Measures of religiosity and left, center, and right political orientations were added to the original instrument. Hypothesized serial mediational models were tested using structural equation modelling. Results revealed that left and center political orientations positively predicted COVID-related conspiracy beliefs and confidence in science. Religiosity was negatively related to confidence in science. Confidence in science and COVID-related conspiracy beliefs predicted general attitudes toward vaccines. Conspiracy beliefs predicted COVID-related conspiracy beliefs, which in turn negatively predicted support for government restrictions and positively predicted distrust in mainstream media. Attitudes towards vaccines were strongly and positively related to attitudes toward COVID-19 vaccines. [This paper was added to the Special Issue on "Conspiracy Theories about Infectious Diseases” in a post-hoc manner. Online publishing allows the addition of new papers to a published special issue, thereby permitting a special issue to grow.] © The Author(s) 2023.
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Objective: To assess whether the coronavirus disease 2019 (COVID-19) mRNA vaccine affects sperm morphokinetics using a computer-assisted semen analyzer and other semen parameters using a sperm chromatin structure assay. Method(s): Healthy male volunteers in two Japanese clinics between May 2021 and December 2021 were prospectively analyzed. Participants donated sperm twice, two days apart, in the following phases: before vaccination, 2 weeks after the first vaccine dose, and 2, 4, and 12 weeks after the second dose. Basic sperm parameters, sperm motility characteristics, and the percentage of DNA-damaged sperm were compared among the different phases. Result(s): Ninety-six semen samples from ten volunteers, who were vaccinated with the BNT162b2 mRNA vaccine, were evaluated. There were no significant differences between any phases in basic semen findings and parameters of the sperm chromatin structure assays. Regarding sperm motion characteristics, the average linear velocity, beat-cross frequency, and sperm motility index significantly decreased after the second vaccine dose (P=0.018, P=0.003, and P=0.027, respectively), with no significant differences between any two phases by post-hoc pairwise comparisons. Conclusion(s): After COVID-19 mRNA vaccination, while sperm motion characteristics might fluctuate, no apparent deterioration of basic sperm parameters or sperm DNA integrity was observed. Given the adverse effects of COVID-19 on sperm, our findings suggest that there might be no reason to refrain from vaccination for healthy individuals.Copyright © 2023 Asian Pacific Journal of Reproduction Produced by Wolters Kluwer- Medknow.
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Coronavirus disease 2019 (COVID-19), a highly contagious infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a devastating effect on world demographics and emerged as a significant global health emergency since the influenza pandemic of 1918. It emphasized the significance of international cooperation in battling SARS-CoV-2 efficiently ever since the discovery and publication of the virus's genome in January 2020. The world took significant steps to combat the disease, ranging from increasing personal protective equipment production and emphasizing the importance of social distancing/masking to the Emergency Use Authorization of remdesivir/therapeutic antibodies. Despite significant advances in clinical research that have led to a better understanding of SARS-CoV-2 and COVID-19 management, limiting the virus's and its variants' spread, has become a growing concern as SARS-CoV-2 continues to cause chaos around the world, with many countries experiencing a second or third wave of outbreaks attributed primarily due to the emergence of mutant virus variants. Considering the potential threat of this global outbreak, scientist and medics have rushed to identify possible treatment regimens and effective therapeutic drugs and vaccinations. As a matter of fact, several COVID-19 vaccines candidate have been researched, created, tested, and reviewed at a breakneck pace. Finding patents, examining relevant patents for current research activities and assessing them plays a key part for the best possible research and development before establishing and executing a trading strategy, especially with recent technology advancements. Therefore, to support current research and development we have evaluated patents relevant to various COVID-19 vaccine technology platforms. The aim of the present research work is to map the existing work through an analysis of patent literature in the field of Coronaviruses, particularly COVID-19 vaccines which will subsequently help the organization launch campaigns, as well as academics and research-driven institutions with the aid of patent literature information for a range of initiatives to combat this circulating demon.
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Vaccination has been proved to be the most effective strategy to prevent the Corona Virus Disease 2019 (COVID-19). The mRNA vaccine based on nano drug delivery system (NDDS) - lipid nanoparticles (LNP) has been widely used because of its high effectiveness and safety. Although there have been reports of severe allergic reactions caused by mRNA-LNP vaccines, the mechanism and components of anaphylaxis have not been completely clarified yet. This review focuses on two mRNA-LNP vaccines, BNT162b2 and mRNA-1273. After summarizing the structural characteristics, potential allergens, possible allergic reaction mechanism, and pharmacokinetics of mRNA and LNP in vivo, this article then reviews the evaluation methods for patients with allergic history, as well as the regulations of different countries and regions on people who should not be vaccinated, in order to promote more safe injection of vaccines. LNP has become a recognized highly customizable nucleic acid delivery vector, which not only shows its value in mRNA vaccines, but also has great potential in treating rare diseases, cancers and other broad fields in the future. At the moment when mRNA-LNP vaccines open a new era of nano medicine, it is expected to provide some inspiration for safety research in the process of research, development and evaluation of more nano delivery drugs, and promote more nano drugs successfully to market.Copyright © 2023, Chinese Pharmaceutical Association. All rights reserved.
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We analyze the impact of COVID-19 vaccine announcements by leading vaccine companies on the financial and commodity markets from January to December 2020. We show that the vaccine announcements had varied and economically significant impacts on asset prices. The announcements moved interest rates, stock markets in the U.S. and numerous other countries as well as commodities used in transportation and some agricultural commodities. We show that the stock and commodity markets that experienced larger declines at the beginning of the pandemic receive a larger boost from good vaccine news. We also find that the vaccine news affects stock returns through changes in the expectations of the corporate cash flows and the expected equity risk premium. © 2023 The Eastern Finance Association.
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Therapy with neutralizing monoclonal antibodies (mAbs) is particularly relevant during COVID-19 outbreaks in patients at high risk of severe disease, including kidney transplant recipients (KTRs). Objective: to evaluate the efficacy and safety of neutralizing mAbs in KTRs with mild to moderate COVID-19. Materials and methods. The retrospective study included 99 KTRs who received inpatient treatment for COVID-19 between September 1 and December 31, 2021. Patients were 52.0 +/- 11.5 years old (M, 47.5%). Bamlanivimab/etesevimab combination drug at a dose of 700/1400 mg was used as mAbs. To evaluate the efficacy of mAbs therapy, two groups of patients were identified. Group 1 consisted of 33 KTRs who received mAbs as one of the therapy components, while group 2 consisted of 66 patients who received no mAbs. Discharge from the hospital or death was considered as the endpoint of follow-up. Results. In group 1, after the use of mAb, progression of pulmonary process was observed less frequently than in the control group with CT1-2 transformation to CT3-4 (9.1% vs. 30.3%, respectively, p < 0.01). Group 1 KTRs differed significantly from group 2 - lower need for ICU and ventilator care (6.1% vs. 27.3% and 3% vs. 19.8%, respectively). The groups were comparable by sex, age, body mass index, Charlson Comorbidity Index (CCI) and time after kidney transplant (KTx) at the onset of the disease and by.aseline blood biochemistry parameter values at the time of hospitalization. Only C-reactive protein (CRP) and fibrinogen values were higher in the non-mAbs patients who were hospitalized later in the course of the disease (7.7 +/- 3.2 days versus 4.6 +/- 1.6 days in group 1, p < 0.001). The frequency of prescription of other therapies did not differ between the compared groups. Use of mAbs significantly reduced mortality from 19.7% in KTRs in group 2 to 3% in group 1 without adverse effect on graft function. Conclusion. The use of mAbs therapy in the early stages of COVID-19 in KTRs is safe, it prevents severe COVID-19, and reduces the incidence of adverse outcomes.
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Background Patients with autoimmune rheumatic diseases (ARD) are at a potentially higher risk for COVID-19 infection complications. Given their inherent altered immune system and the use of immunomodulatory medications, vaccine immunogenicity could be unpredictable with a suboptimal or even an exaggerated immunological response. The aim of this study is to provide real-time data on the emerging evidence of COVID-19 vaccines' efficacy and safety in patients with ARDs. Methods We performed a literature search of the PubMed, EMBASE, and OVID databases up to 11-13 April 2022 on the efficacy and safety of both types of the mRNA-vaccines and the AstraZeneca COVID-19 vaccines in patients with ARD. The risk of bias in the retrieved studies was evaluated using the Quality in Prognostic Studies tool. Also, current clinical practice guidelines from multiple international professional societies were reviewed Results We identified 60 prognostic studies, 69 case reports and case series, and eight international clinical practice guidelines. Our results demonstrated that most patients with ARDs were able to mount humoral and/or cellular responses after two doses of COVID-19 vaccine although this response was suboptimal in patients receiving certain disease-modifying medications including rituximab, methotrexate, mycophenolate mofetil, daily glucocorticoids >10 mg, abatacept, as well as in older individuals, and those with comorbid interstitial lung diseases. Safety reports on COVID-19 vaccines in patients with ARDs were largely reassuring with mostly self-limiting adverse events and very minimal post-vaccination disease flares. Conclusion Both types of the mRNA-vaccines and the AstraZeneca COVID-19 vaccines are highly effective and safe in patients with ARD. However, due to their suboptimal response in some patients, alternative mitigation strategies such as booster vaccines and shielding practices should also be followed. Management of immunomodulatory treatment regimens during the peri vaccination period should be individualized through shared decision making with patients and their attending rheumatologists.
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Vaccine uptake and coverage in susceptible populations are needed through effective vaccination campaigns to address the COVID-19 pandemic in South Asian countries. We aimed to measure the pooled proportion of COVID-19 vaccine hesitancy in this regard. Research articles published between January 1, 2020, to December 31, 2021, were searched through Medline, PubMed, Cochrane, Google Scholar, and the WHO COVID-19 database. The Joanna Briggs Institute (2014) tool for prevalence studies was used to assess data quality. We performed a meta-regression test and a sensitive analysis among the studies and used the DerSimonian and Laird random-effects model to measure the pooled effect estimates. Subgroup analyses were performed concerning vaccine hesitancy, countries, study population, study level, and the time since the first outbreak of the pandemic. A total of 43 studies out of 598 published articles across the eight countries in South Asia were included. The pooled proportion of COVID-19 vaccine hesitancy was 26.5% (95% CI [22, 31], I2 = 99.59%). Vaccine hesitancy was higher in Afghanistan (37%), Pakistan (33%), and Bangladesh (28.9%);among the general population (29%);at community levels (27.9%);and the duration of time of 1–12 months since the first outbreak in each country (27.5%). Vaccine hesitancy exists in South Asia with different rates among countries, population sub-groups, communities, study-levels, duration of time since the first outbreak, and study population. Therefore, enhancing public awareness of vaccination and vaccine hesitancy is required to prevent future pandemics. © 2023,Journal of Population and Social Studies. All Rights Reserved.
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The World Health Organization has issued a report on 228 cases of acute hepatitis of unknown cause in children between 1 month and 16 years, 10% of them required liver transplantation and 4 died (3 in Indonesia), another 50 cases are under investigation. The adenovirus type 41 is one of the causative agents of acute gastroenteritis in children, characterized by diarrhea, vomiting and fever, often accompanied by respiratory symptoms. Cases of hepatitis in immunocompromised children have been documented;however, there is no available evidence to indicate that adenovirus type 41 can cause hepatitis in healthy children. Although adenovirus is currently hypothesized as the underlying cause, it does not fully explain the severity of the clinical picture. Given this new situation, we have more questions than answers, the reported cases had no apparent risk factors, most had not received the COVID-19 vaccine. Several hypotheses are being evaluated and it seems that the infectious cause is more solid. The possible role of previous SARS-CoV-2 infection in children reported with acute hepatitis is analyzed.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.
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The year 2019 ended with the official report of an unknown pneumonia outbreak in Wuhan, Hubei Province, China. Subsequently, this novel pneumonia was named COVID-19, which mainly attacks the respiratory system, causing severe damage. Although vaccination has relieved the stress of combating pandemics around the world after one year, there are still unknowns and challenges that come with hope. In this regard, stem cell therapy has been proposed as an effective approach to treating COVID-19. Mesenchymal stem cells (MSCs) can potentially be used as a hopeful tool in the cell-based therapy due to their ability to regenerate and regulate immune response. Although research and clinical results have shown encouraging achievement in patients who were treated with MSCs, drawbacks and challenges still exist in the face of new opportunities. This review aims to introduce the challenges of the COVID-19 vaccine and the possible clinical use of MSC-based therapy. Through analysis of COVID-19 and MSC-based therapy, the author aims to find the possibilities and feasibility of using MSCs to treat acute respiratory diseases, such as COVID. As a result, the author finds that MSC treatment is very practical, and it shows significant potential to treat COVID-19. © 2023 SPIE.
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It is crucial to understand COVID-19 vaccine uptake and attitudes among young adult cannabis users given the lowest vaccination rates among young adults and negative association between cannabis use and willingness to get vaccinated. 18–21-year-old and 26–33-year-old cohorts of cannabis users, recruited in California, were surveyed about the COVID-19 vaccine uptake/attitudes between March-August 2021. Cannabis use/demographic differences were investigated by vaccination status. Vaccine attitudes data were categorized and presented descriptively. 44.4% of the older and 71.8% of the younger cohorts were vaccinated. Non-Hispanic Black/African American race/ethnicity, lack of health insurance, and medicinal orientation towards cannabis use were negatively associated with vaccine receipt within the older cohort. For both cohorts, top reasons for vaccine hesitancy and rejection were concerns about speed of development, potential side effects, natural immunity, and lack of trust of vaccines. Our results highlight greater vaccine hesitance/rejection and need for targeted interventions among mid-20's-early-30's cannabis users.
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This paper investigates the distribution problem of the COVID-19 vaccine at the provincial level in Turkey and the management of medical waste, considering the cold chain requirements and the perishable nature of vaccines. In this context, a novel multi-period multi-objective mixed-integer linear programming model is initially presented over a 12-month planning horizon for solving the deterministic distribution problem. The model includes newly structured constraints due to the feature of COVID-19 vaccines, which must be administered in two doses at specified intervals. Then, the presented model is tested for the province of Izmir with deterministic data, and the results show that the demand can be satisfied and community immunity can be achieved in the specified planning horizon. Moreover, for the first time, a robust model is created using polyhedral uncertainty sets to manage uncertainties related to supply and demand quantities, storage capacity, and deterioration rate, and it has been analyzed under different uncertainty levels. Accordingly, as the level of uncertainty increases, the percentage of meeting the demand gradually decreases. It is observed that the biggest effect here is the uncertainty in supply, and in the worst case, approximately 30% of the demand cannot be met.