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1.
International Migration Review ; 2022.
Article in English | Web of Science | ID: covidwho-2108528

ABSTRACT

Emerging evidence suggests that the COVID-19 pandemic has extracted a substantial toll on immigrant communities in the United States, due in part to increased potential risk of exposure for immigrants to COVID-19 in the workplace. In this article, we use federal guidance on which industries in the United States were designated essential during the COVID-19 pandemic, information about the ability to work remotely, and data from the 2019 American Community Survey to estimate the distribution of essential frontline workers by nativity and immigrant legal status. Central to our analysis is a proxy measure of working in the primary or secondary sector of the segmented labor market. Our results indicate that a larger proportion of foreign-born workers are essential frontline workers compared to native-born workers and that 70 percent of unauthorized immigrant workers are essential frontline workers. Disparities in essential frontline worker status are most pronounced for unauthorized immigrant workers and native-born workers in the secondary sector of the labor market. These results suggest that larger proportions of foreign-born workers, and especially unauthorized immigrant workers, face greater risk of potential exposure to COVID-19 in the workplace than native-born workers. Social determinants of health such as lack of access to health insurance and living in overcrowded housing indicate that unauthorized immigrant essential frontline workers may be more vulnerable to poor health outcomes related to COVID-19 than other groups of essential frontline workers. These findings help to provide a plausible explanation for why COVID-19 mortality rates for immigrants are higher than mortality rates for native-born residents.

2.
International Journal of Productivity and Performance Management ; 2022.
Article in English | Web of Science | ID: covidwho-2107750

ABSTRACT

Purpose The purpose of this study is to examine the effect of organizational readiness (OR) dimensions (organizational culture, climate and capability) on three types of innovations (INs) (service, process IN and entering new markets) in telecommunication companies. The study also tests the mediating role of employee engagement (EE) in the causal relationship between OR and IN. Design/methodology/approach In the theoretical framework, a deep and broad review of the literature was presented to determine the study variables and hypotheses that were tested in the field study. The study sample consisted of 306 respondents distributed to the headquarters of the three companies (Zain, Orange and Umniah) working in the Jordanian telecommunications sector. The number of questionnaires retrieved and valid for analysis was 255 (83%). Findings Results indicate a positive effect of organizational climate and organizational capacity on process IN and entering new markets. While organizational culture had no significant effect on the three types of IN EE did not have a mediating role in the relationship between OR and IN. Research limitations/implications The results of this study are related to the telecommunications sector as a highly competitive service sector and more able to work remotely with regard to customers, so its results cannot be generalized to other sectors such as the industry sector, which has suffered in recent years from the epidemic more than other sectors. Practical implications The study of OR as a concept, dimensions and effects provides great experience for leaders and managers facing the challenges of competition and threats posed by the Covid-19 pandemic. This study also helps researchers to study OR in new areas and in relation to other concepts. Social implications The OR covers a wide field that includes the individual, the group and the company. Therefore, readiness includes a social experience that can extend from the company to the community. Originality/value The study gains an important value by revealing that organizational culture as a dimension of readiness does not have a significant impact on IN. With the readiness to respond quickly to challenges, culture can be more inclined to the status quo and the prevailing routine than to IN and change.

3.
Healthcare (Basel) ; 10(11)2022 Nov 10.
Article in English | MEDLINE | ID: covidwho-2110004

ABSTRACT

Growing evidence is emerging on the higher risk of infection and adverse outcomes for the most disadvantaged groups of the population, and COVID-19 vaccination campaigns worldwide are struggling to ensure equitable access to immunization for all. From 21 June 2021 to 15 October 2021, the Local Health Unit ASL Roma 1 adopted a tailored immunization strategy to reach socially vulnerable groups of the population with the primary vaccination course. This strategy was developed with a step-by-step, participatory approach. Through engagement with internal and external stakeholders, target groups were identified, potential barriers analyzed, solutions discussed, and tailored interventions designed. Over nine thousand individuals from among irregular migrants, homeless people and hard-to-reach communities were contacted and vaccinated.

4.
Epidemiologia (Basel) ; 3(4): 518-532, 2022 Nov 10.
Article in English | MEDLINE | ID: covidwho-2109996

ABSTRACT

New York City (NYC) was deeply impacted by COVID-19 in spring 2020, with thousands of new cases daily. However, the pandemic's effects were not evenly distributed across the city, and the specific contributors have not yet been systematically considered. To help investigate that topic, this study analyzed the interaction of people with neighborhood businesses and other points of interest (POIs) in parts of three NYC neighborhoods in the spring of 2020 during the peak of the first COVID-19 wave through anonymized cellphone data and direct the observation of 1313 individuals leaving healthcare facilities. This study considered social vulnerability index (SVI) levels, population density, and POI visit behaviors from both cellphone data and firsthand observations of behavior around select NYC health facilities in different boroughs as various proxies. By considering equivalent businesses or groups of businesses by neighborhood, POI visits better aligned with COVID-19 infection levels than SVI. If tracking POI visit levels proves a reliable direct or relative proxy for disease transmission when checked against larger datasets, this method could be critical in both predictions of future outbreaks and the setting of customer density limits.

5.
Cancers (Basel) ; 14(22)2022 Nov 08.
Article in English | MEDLINE | ID: covidwho-2109947

ABSTRACT

IMPORTANCE: The COVID-19 pandemic has put a serious strain on health services, including cancer treatment. OBJECTIVE: This study aimed to investigate the changes in cancer treatment worldwide during the first phase of the SARS-CoV-2 outbreak. DATA SOURCES: Pubmed, Proquest, and Scopus databases were searched comprehensively for articles published between 1 January 2020 and 12 December 2021, in order to perform a systematic review and meta-analysis conducted following the PRISMA statement. STUDY SELECTION: Studies and articles that reported data on the number of or variation in cancer treatments between the pandemic and pre-pandemic periods, comprising oncological surgery, radiotherapy, and systemic therapies, were included. DATA EXTRACTION AND SYNTHESIS: Data were extracted from two pairs of independent reviewers. The weighted average of the percentage variation was calculated between the two periods to assess the change in the number of cancer treatments performed during the pandemic. Stratified analyses were performed by type of treatment, geographic area, time period, study setting, and type of cancer. RESULTS: Among the 47 articles retained, we found an overall reduction of -18.7% (95% CI, -24.1 to -13.3) in the total number of cancer treatments administered during the COVID-19 pandemic compared to the previous periods. Surgical treatment had a larger decrease compared to medical treatment (-33.9% versus -12.6%). For all three types of treatments, we identified a U-shaped temporal trend during the entire period January-October 2020. Significant decreases were also identified for different types of cancer, in particular for skin cancer (-34.7% [95% CI, -46.8 to -22.5]) and for all geographic areas, in particular, Asia (-42.1% [95% CI, -49.6 to -34.7]). CONCLUSIONS AND RELEVANCE: The interruption, delay, and modifications to cancer treatment due to the COVID-19 pandemic are expected to alter the quality of care and patient outcomes.

6.
Front Public Health ; 10: 1015090, 2022.
Article in English | MEDLINE | ID: covidwho-2109885

ABSTRACT

Italy was the first country in Europe to make vaccination against COVID-19 mandatory for healthcare professionals by imposing restrictions in cases of non-compliance. This study investigates the opinions of the Italian healthcare professionals' categories affected by the regulation. We performed a qualitative online survey: the questionnaire comprised both close- and open-ended questions. The final dataset included n = 4,677 valid responses. Responses to closed-ended questions were analyzed with descriptive statistics. The framework method was applied for analyzing the open-ended questions. The sample spanned all health professions subject to compulsory vaccination, with a prevalence of physicians (43.8%) and nurses (26.3%). The vaccine adhesion before the introduction of the obligation was substantial. 10.4% declared not to have adhered to the vaccination proposal. Thirty-five percent of HPs who opted not to get vaccinated said they experienced consequences related to their choice. The trust in the vaccine seems slightly cracked, demonstrating overall vaccine confidence among professionals. Nonetheless, our results show that whether (or not) professionals adhere to vaccination is not a reliable indicator of consent to how it was achieved. There are criticisms about the lawfulness of the obligation. The data show a great variety of participants interpreting their roles concerning public and individual ethics. The scientific evidence motivates ethics-related decisions-the epidemic of confusing and incorrect information affected professionals. The Law triggered an increased disaffection with the health system and conflicts between professionals. Dealing with the working climate should be a commitment to assume soon.


Subject(s)
COVID-19 , Vaccines , Humans , COVID-19 Vaccines , Cross-Sectional Studies , COVID-19/epidemiology , COVID-19/prevention & control , Italy/epidemiology
7.
Front Psychiatry ; 13: 1022881, 2022.
Article in English | MEDLINE | ID: covidwho-2109869

ABSTRACT

Background: Since February 2022, a new Omicron wave of COVID-19 emerged in Shanghai, China. Many healthcare workers came to Shanghai from hospitals of other parts of China as aid workers. Hospitals in areas with mild COVID-19 outbreaks will inevitably be understaffed, it is likely to cause job burnout of stay-behind healthcare workers. Stay-behind healthcare workers were those who had not been dispatched to support COVID-19 prevention and control in other regions. This study was designed to evaluate the burnout among stay-behind healthcare workers in the current COVID-19 Omicron wave in Taizhou, China. Methods: A population-based, anonymous, cross-sectional online survey was designed in the Wen-Juan Xing platform. The survey was sent to all stay-behind healthcare workers of the hospital (n = 1739) from April 29 to May 3, 2022. The Maslach Burnout Inventory-General Survey (MBI-GS) was used for the burnout survey. For univariate analysis, the χ2 test and one way ANOVA were used to assess differences in categorical variables and continuous variables, respectively. The effect of independent associated risk factors on each type of burnout was examined using the multinomial logistic regression model. Results: A total of 434 participants completed the survey invitation effectively. A total of 71.2% of stay-behind healthcare workers experienced burnout during COVID-19, including 54.8% experiencing mild to moderate burnout and 16.4% experiencing severe burnout. Night shift, depression, social support, positive coping and number of children appeared to be significantly related to mild to moderate burnout. Night shift, depression, social support, positive coping, number of children, professional title, and anxiety appeared to be significantly related to severe burnout. Conclusion: Job burnout among stay-behind healthcare workers was an important problem during the current Omicron wave of COVID-19. Night shift, depression, social support, positive coping, and number of children were associated with mild to moderate and severe burnout. Anxiety and professional title were associated with severe burnout.

8.
Front Psychol ; 13: 952783, 2022.
Article in English | MEDLINE | ID: covidwho-2109843

ABSTRACT

During the COVID-19 pandemic, healthcare workers have a high workload and have been exposed to various psychosocial stressors. This study aimed to evaluate health workers during the COVID-19 pandemic in the world. The method used in this research is qualitative with a literature review approach. The data sources in this study were taken from the Scopus database using the keywords "health workers," "burnout," AND "coronavirus" from the time range of 2020 to April 25, 2022. From the determination of the time range, 150 documents emerged. This study revealed that the Pearson correlation between total burnout scale scores on healthcare workers, professionals, exhaustion, mental, stress, personal, depression, symptoms, emergency, system, job, and impact indicated that overall burnout scores were associated with depression and anxiety. Stress symptoms had correlation values ranging from 0.84 to 0.73. Job burnout had a significant relationship with exhaustion at 0.89; depression r = 0.73), impacting a score of 0.66. At the same time, the fulfillment of professional and interpersonal disengagement showed a Pearson correlation between the total burnout scale scores on health workers, professionals, exhaustion, mental, stress, personal, depression, symptoms, emergency, system, job, and impact. Overall, the participants in health care workers worldwide experienced high levels of psychological distress. We also found that health workers dealing with COVID-19 pandemic patients were more likely to experience depression, stress, and burnout than health staff who were not personally involved in medical work. Furthermore, this study will be a follow-up study using the Work Ability Index (WAI) to measure work ability and work satisfaction.

9.
Front Med (Lausanne) ; 9: 1016008, 2022.
Article in English | MEDLINE | ID: covidwho-2109789
10.
J Korean Med Sci ; 37(43): e308, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2109725

ABSTRACT

BACKGROUND: To evaluate the effects of isolating coronavirus disease 2019 (COVID-19) patients in general wards, we compared the rates of COVID-19 infection in nurses and nursing assistants working in COVID-19 designated wards and in general wards of our hospital from 1 October 2021 to 21 April 2022. METHODS: This study was conducted in a 2,700-bed tertiary care hospital in Seoul, Korea. Designated wards comprised single, negative pressure rooms and a 100% outdoor air system. RESULTS: During the study period, a total of 2,698 nurses and nursing assistants were employed at our hospital, of whom 310 (11%) were working in the designated wards, and the remaining 2,388 (89%) in the general wards, and among whom 1,158 (43%) were diagnosed with COVID-19. The healthcare workers (HCWs) in the designated wards were less frequently diagnosed with COVID-19 than those in the general wards (31% vs. 45%, P < 0.001). During the period before patients with COVID-19 were isolated in general wards, and during the period after these cases were isolated in general ward, HCWs in designated wards were less frequently infected with the virus than those in general wards (7% vs. 11%, P = 0.039; and 23% vs. 33%, P < 0.001, respectively). CONCLUSION: HCWs in designated wards have a lower rate of contracting COVID-19 than those in general wards. A lack of exposure to undiagnosed cases and their caregivers, greater care with social distancing outside the hospital, higher rates of 3-dose vaccinations, and the use of isolation rooms with negative pressure may be associated with this finding.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Patients' Rooms , SARS-CoV-2 , Health Personnel , Hospitals
11.
Arch Public Health ; 80(1): 226, 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2108953

ABSTRACT

Secret shopper studies are particularly potent study designs that allow for the gathering of objective data for a variety of research hypotheses, including but not limited to, healthcare delivery, equity of healthcare, and potential barriers to care. Of particular interest during the COVID-19 pandemic, secret shopper study designs allow for the gathering of data over the phone. However, there is a dearth of literature available on appropriate methodological practices for these types of studies. To make these study designs more widely accessible, here we outline the case for using the secret shopper methodology and detail best practices for designing and implementing them.

12.
Arch Dis Child ; 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2108257

ABSTRACT

BACKGROUND: Despite the increased policy attention on ethnic health inequities since the COVID-19 pandemic, research on ethnicity and healthcare utilisation in children has largely been overlooked. OBJECTIVES: This scoping review aimed to describe and appraise the quantitative evidence on ethnic differences (unequal) and inequities (unequal, unfair and disproportionate to healthcare needs) in paediatric healthcare utilisation in the UK 2001-2021. METHODS: We searched Embase, Medline and grey literature sources and mapped the number of studies that found differences and inequities by ethnic group and healthcare utilisation outcome. We summarised the distribution of studies across various methodological parameters. RESULTS: The majority of the 61 included studies (n=54, 89%) identified ethnic differences or inequities in paediatric healthcare utilisation, though inequities were examined in fewer than half of studies (n=27, 44%). These studies mostly focused on primary and preventive care, and depending on whether ethnicity data were aggregated or disaggregated, findings were sometimes conflicting. Emergency and outpatient care were understudied, as were health conditions besides mental health and infectious disease. Studies used a range of ethnicity classification systems and lacked the use of theoretical frameworks. Children's ethnicity was often the explanatory factor of interest while parent/caregiver ethnicity was largely overlooked. DISCUSSION: While the current evidence base can assist policy makers to identify inequities in paediatric healthcare utilisation among certain ethnic groups, we outline recommendations to improve the validity, generalisability and comparability of research to better understand and thereby act on ethnic inequities in paediatric healthcare.

13.
Scand J Caring Sci ; 2022 Nov 09.
Article in English | MEDLINE | ID: covidwho-2108158

ABSTRACT

RATIONALE AND AIM: Nurses caring for critically ill patients need compassionate attention and support, especially during exceptional times. The aim of this study was to provide a trustworthy description of nurses' experiences and expectations for compassionate leadership and compassion at a central hospital in Finland. The study was conducted during the early stage of the coronavirus 2019 pandemic. ETHICAL ISSUES AND APPROVAL: The voluntary nature and anonymity of the survey were stressed in the cover letter, to make sure that participants did not perceive any undue influence caused by participating in the study. METHODS: The participants were 50 intensive care and emergency nurses of a central hospital. An online survey tool with open questions was used to collect data on the meaning of compassion and on nurses' experiences and expectations of compassion and compassionate leadership. Inductive content analysis was used to analyse the data. RESULTS: The nurses reported a great variety of positive experiences of compassion, although the emphasis in this study seemed to be on the absence of compassion, especially in regard to leadership. The nurses expected individual attention and genuine physical and psychological presence from their immediate supervisors. STUDY LIMITATIONS: One researcher analysed the data, which can cause some bias in the qualitative analysis. CONCLUSIONS: Immediate supervisors express compassion by being physically present and by fostering an open dialogue. Compassion received from leaders and colleagues may be reproduced in patient contacts, which can increase patients' confidence and psychological safety. Participatory and simulation-based learning methods, which involve shared reflection, are recommended for compassionate leadership skills.

14.
Disasters ; 2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-2107969

ABSTRACT

Frontline healthcare workers (HCWs) looking after COVID-19 patients are at high risk of developing mental health problems. Both preventive and interventional initiatives are essential, therefore, to maintain and improve the mental health of HCWs and ultimately to enhance the quality of care that they provide. This qualitative content analysis study, conducted in Iran between September 2020 and February 2021, involved the gathering of data on the issue through face-to-face interviews with 22 HCWs working directly with COVID-19 patients. Data analysis led to the generation of 163 codes, 45 categories (16 risk factors and 29 consequences), and 9 themes. Overall, the results suggest that caring for a patient with COVID-19 is associated with positive and negative psychological impacts. Measures such as increasing sensitivity to crisis situations, self-adjustment skills training, and identifying signs of job burnout owing to moral conflicts can reduce or eliminate the risk of negative psychological consequences among HCWs.

15.
Soc Work ; 2022 Nov 09.
Article in English | MEDLINE | ID: covidwho-2107587

ABSTRACT

Though COVID-19 has had sweeping implications, many immigrant groups in the United States have been disproportionately affected. The purpose of the present study is to explore the impact of COVID-19 on immigrant communities and how local immigrant-serving organizations (ISOs) have responded during the pandemic. The authors conducted in-depth qualitative interviews with executive directors and program coordinators of 31 ISOs and health clinics in Kentucky, North Carolina, and South Carolina. Findings highlight the needs of immigrants and refugees during the pandemic, including economic burden, lack of information, and limited access to testing and treatment for COVID-19. The authors find that ISOs have responded to these needs by providing basic supports, partnering with other local organizations to channel needed resources to immigrant communities, and collaborating with state-level entities to improve outreach, testing, and treatment. The authors also identify mechanisms that enabled the organizations to make nimble accommodations during the pandemic as well as the burden and compromises that these organizations have experienced. The authors argue that ISOs represent an important aspect of safety nets available for immigrants and provide insights into how other organizations can prepare for public health crises like COVID-19 in the future.

16.
Schizophr Bull Open ; 3(1): sgac061, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-2107584

ABSTRACT

The COVID-19 pandemic mainly affected the most vulnerable individuals. Among those, patients with schizophrenia especially suffered from unexpected changes in their routines, barriers to treatment, and distress-related events. We conducted a narrative review using all available sources of information to describe the challenges faced by schizophrenia patients and their families in Brazil, including the strategies that have been adopted to tackle them. In addition, we analyzed public data on antipsychotic prescriptions and hospitalizations. It was found that digital prescriptions with extended expiration dates implemented during the pandemic in Brazil allowed patients to maintain their access to antipsychotics. Hospitalizations among patients with schizophrenia, schizotypal, and schizoaffective disorders decreased at the beginning of the pandemic. Nevertheless, in the following months, the admissions returned to a trend similar to the prepandemic period. The systematization of online resources will be one of the main legacies to mental health care, including schizophrenia. We believe one of the main limitations of the policies adopted was the decision to not prioritize COVID-19 vaccination in patients with severe psychiatric disorders, despite preliminary evidence of a higher risk of complications in this group. The coronavirus pandemic is still ongoing and a longer time will be required to have a better perspective of its effects, but we expect this record of challenges and insights about the lessons learned during the pandemic can help healthcare professionals to face similar situations in the future.

17.
Schizophr Bull Open ; 3(1): sgac036, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-2107581

ABSTRACT

The Coronavirus Disease 2019 (COVID-19) pandemic is a syndemic of viral infection and mental health adversity. The pandemic has exacerbated inequalities of access to care in vulnerable populations within the Canadian mental healthcare system. Primary care services are first-line health services in Canada, and are necessary to access specialized services. However, as a result of the limited availability of primary health services, and subsequently, specialized providers (eg, psychiatrists), the demand for these services outweigh the supply. Hitherto, timely access to appropriate services has been cited as a common challenge in Canada as a result of limitations as it relates to resources and in-person activities and support services. While there has been an increase in virtual care opportunities, concerns have been raised with respect to the digital divide. Moreover, while individuals with serious mental illness (SMI) and psychosis are at an increased risk for hospitalization and death from COVID-19, testing and vaccination services have not been prioritized for this population. Taken together, increased funding for mental health service delivery should be emphasized especially for individuals with SMI. There should also be a focus on increased collaboration among individuals with lived experience and health care providers to ensure future policies are developed specifically for this population. Addressing the social determinants of health and prioritizing a continuum of care across various stakeholders may lead to strong integration of care both during and after the pandemic.

18.
Journal of Public Policy ; : 1-26, 2022.
Article in English | Web of Science | ID: covidwho-2106254

ABSTRACT

How has public healthcare spending prepared countries for tackling the COVID-19 pandemic? Arguably, spending is the primary policy tool of governments for providing effective health. We argue that the effectiveness of spending for reducing COVID deaths is conditional on the existence of healthcare equity and lower political corruption because the health sector is particularly susceptible to political spending. Our results, obtained using ordinary least squares and two-stage least squares estimations, suggest that higher spending targeted at reducing inequitable access to health has reduced COVID deaths. Consistent with the findings of others, our results indirectly suggest that health spending is necessary, but not sufficient unless accompanied by good governance and equitable access. Equitable health systems ease the effects of COVID presumably because they allow states to reach and treat people more effectively. Spending aimed at increasing health system capacity by increasing access thus seems a sound strategy for fighting the spread of disease, ultimately benefiting us all.

19.
The Journal of Emergency Medicine ; 2022.
Article in English | ScienceDirect | ID: covidwho-2105332

ABSTRACT

Background Since the development of the first Food and Drug Administration approved vaccine for the prevention of serious disease and death associated with the SARS-CoV-2 virus, healthcare workers have been expected to comply with mandatory immunization requirements or face potential termination of employment and censure by state medical board. Although most accepted this mandate, there have been several who have felt this was an unnecessary intrusion and violation of their right to choose their own healthcare mitigation strategies and/or an infringement on their autonomy and other civil liberties. Others have argued that being a healthcare professional places your duties above your own self-interests, so-called fiduciary duties. As a result of these duties there is an expected obligation to do the best action to achieve the “most good” for society. A so-called utilitarian argument. Discussion We explore arguments both for and against these mandatory vaccine requirements and conclude utilizing duty and consequence-based moral reasoning to weigh the merits of each. Conclusion While arguments for and against vaccine mandates are compelling, it is the opinion of the Ethics Committee of AAEM that vaccine mandates for healthcare workers are ethically just and appropriate, and the benefit to society far outweighs the minor inconvenience to individuals’ personal liberties.

20.
International Journal of Production Economics ; : 108716, 2022.
Article in English | ScienceDirect | ID: covidwho-2105100

ABSTRACT

The vaccine distribution system, being a bio-pharmaceutical cold chain, is a complicated and sensitive system that must be effectively managed and maintained due to its direct impact on public health. However, vaccine supply chains continue to be affected by concerns, including vaccine expiry, inclusion of counterfeit vaccines, and vaccine record fraud. The blockchain technology integrated with the Internet of Things (IoT) can create a solution for global vaccine distributions with improved trust, transparency, traceability, and data management, which will help monitor the cold chain, tackle counterfeit drugs, surveillance, and waste management. Several theoretical models for vaccine management with blockchain have recently been published, and a few pilot studies for COVID-19 vaccine management using blockchain have been started in India. Still, full-scale adoption of blockchain technology in vaccine distribution and management has yet to be achieved due to underlying barriers. This study explores the adoption barriers utilizing Technology-Organization-Environment (TOE) framework with the help of extant literature and inputs from administrators, academics, immunization, and blockchain experts and then analyzed using the Delphi and fuzzy Decision-Making Trial and Evaluation Laboratory (DEMATEL) techniques. The finding shows that the requirement of change in organization structure and policies is the most prominent barrier, and the barrier related to requirement of large-scale IoT infrastructure and lack of technical expertise are the most impactful barriers. The theoretical contribution of this study lies in the identification and analysis of barriers that should be addressed to achieve blockchain technology adoption in the vaccine supply chain.

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