Acceptability of a Fentanyl Vaccine to Prevent Opioid Overdose and Need for Personalized Decision-Making.

BACKGROUND: The opioid epidemic worsened during the coronavirus disease 2019 (COVID-19) pandemic. Synthetic opioids (primarily fentanyl) comprise the most common drugs involved in overdose (OD) death. A vaccine that blocks fentanyl from reaching the brain to prevent OD is under development, and insight is needed into its acceptability. METHODS: Using a semi-structured interview guide, persons with opioid use disorder (OUD), family, professionals, and the public were interviewed about attitudes and concerns regarding a fentanyl vaccine. Reactions to fictional clinical vignettes of persons at risk of OUD because of pain and/or substance use histories were collected, analyzed, and quantified for favorability. Interviews were transcribed, coded, and analyzed thematically. RESULTS: Among N = 64 participants, (70.3% female, average age 32.4 years), attitudes were favorable toward a fentanyl vaccine, with preference for lifelong durability (76% of n = 55 asked). Perceived benefits centered on the potential for a life-saving intervention, suffering averted, healthcare dollars saved, and the utility of a passive harm reduction strategy. Concerns centered on uncertainty regarding vaccine safety, questions about efficacy, worry about implications for future pain management, stigma, and need for supportive counseling and guidance to personalize decision making. Reactions to vignettes revealed complex attitudes toward fentanyl vaccination when considering recipient age, health history, and future risks for addiction and pain. CONCLUSIONS: Positive responses to a fentanyl vaccine were found along with appreciation for the complexity of a vaccine strategy to prevent OD in the setting of pain and uncertain durability. Further research is needed to elucidate operational, ethical, and communications strategies to advance the model.

The Association of Vaping With Social/Emotional Health and Attitudes Toward COVID-19 Mitigation Measures in Adolescent and Young Adult Cohorts During the COVID-19 Pandemic

Background: Vaping is a major health risk behavior which often occurs socially. Limited social activity during the COVID-19 pandemic contributed to worsening social and emotional health. We investigated associations among youth vaping, and reports of worsening mental health, loneliness, and relationships with friends and romantic partners (ie, social health), as well as perceived attitudes toward COVID-19 mitigation measures. Methods: From October 2020 to May 2021, a clinical convenience sample of adolescents and young adults (AYA) reported on their past-year substance use, including vaping, their mental health, COVID-19 related exposures and impacts, and their attitudes toward non-pharmaceutical COVID-19 mitigation interventions, via a confidential electronic survey. Multivariate logistic regressions were used to estimate associations among vaping and social/emotional health. Results: Of 474 AYA (mean age = 19.3 (SD = 1.6) years;68.6% female), 36.9% reported vaping in the prior 12 months. AYA who self-reported vaping were more likely than non-vaping AYA to report worsening: anxiety/worry (81.1%;P = .036), mood (78.9%;P = .028), eating (64.6%;P = .015), sleep (54.3%;P = .019), family discord (56.6%;P = .034), and substance use (54.9%;P < .001). Participants who vaped also reported easy access to nicotine (63.4%;P < .001) and cannabis products (74.9%;P < .001). No difference in perceived change in social wellbeing was seen between the groups. In adjusted models, vaping was associated with symptoms of depression (AOR = 1.86;95% CI = 1.06-3.29), less social distancing (AOR = 1.82;95% CI = 1.11-2.98), lower perceived importance of proper mask wearing (AOR = 3.22;95% CI = 1.50-6.93), and less regular use of masks (AOR = 2.98;95% CI = 1.29-6.84). Conclusions: We found evidence that vaping was associated with symptoms of depression and lower compliance with non-pharmaceutical COVID-19 mitigation efforts among AYA during the COVID-19 pandemic.

Pediatric Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccines: Perceptions and Attitudes From the Food and Drug Administration Public Commentary.

Authorization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines for children has ushered in a new phase of the immunization campaign to address the pandemic but has been received with mixed responses from parents, children, and opinion leaders. Herein we consider perceptions and attitudes towards pediatric SARS-CoV-2 vaccines from a Food and Drug Administration (FDA) public commentary reflecting more than 63 000 comments.

SARS-CoV-2 mRNA Vaccine Attitudes as Expressed in U.S. FDA Public Commentary: Need for a Public-Private Partnership in a Learning Immunization System.

As part of the U.S. Food and Drug Administration COVID-19 vaccine review process, public commentary was solicited offering an opportunity to reflect on vaccine attitudes that may impact the uptake of coronavirus vaccines. We identified themes in the commentary that highlighted the safety, efficacy, ethics, and trustworthiness and transparency regarding the novel mRNA COVID-19 vaccines. A "Learning Immunization System" model is proposed to optimize public, private, and academic partnerships relating to vaccine development and implementation.