ABSTRACT
ObjectiveTo determine the attributes of COVID-19 vaccines that influence vaccine acceptance using a DCE through a systematic review. MethodsA systematic search was carried out for articles published up to November 2021 in the PubMed, Psycinfo, Embase, Web of Science, and Global Index Medicus databases. The electronic search algorithm consisted of the terms (Covid-19) AND (Vaccine) AND (discrete choice experiment). FindingsA total of 39 records were retrieved of which 18 duplicates were identified and removed. Of the remaining 21 records, 10 were excluded because they did not use a DCE approach. 11 studies were included in the meta-analyses with a total of 42 795 participants from three WHO regions. We examined 13 attributes of COVID-19 vaccine that influenced acceptance; cost, vaccine efficacy, number of doses, risk of side effects, proof of vaccination, vaccination setting, duration of immunity, doctors recommendation, proportion of acquaintances vaccinated, region of vaccine manufacture, background knowledge of herd immunity, life attenuated or mRNA, speed of vaccination development. The four attributes reported to influence COVID-19 vaccine preferences most worldwide were; high vaccine efficacy, low risk of side effects, long duration of immunity and low number of doses of the vaccine. ConclusionThe most preferred COVID-19 vaccine attributes should be taken into account by vaccine manufacturers and public health policy makers for better introduction and acceptance of COVID-19 vaccine to the world.
ABSTRACT
ObjectiveWe aimed to compare the safety and efficacy of a doxycycline-based regimen against the national standard guidelines (Hydroxychloroquine plus Azithromycin) for the treatment of mild symptomatic COVID-19. MethodsWe conducted an open-label, randomized, non-inferiority trial, in Cameroon comparing Doxycycline 100mg, twice daily for 7 days versus Hydroxychloroquine, 400 mg daily for 5 days and Azithromycin 500mg at day 1 and 250mg from day 2 through 5, in mild COVID-19 patients. Clinical improvement, biological parameters and adverse events were assessed. The primary outcome was the proportion of clinical cure at day 3, 10 and 30. Non-inferiority was determined by the clinical cure rate between protocols with a 20 percentage points margin. Results194 participants underwent randomization and were treated with Doxycycline (n=97) or Hydroxychloroquine-Azithromycin (n=97). At day 3, 74/92 (80.4%) participants on Doxycycline versus 77/95 (81.1%) on Hydroxychloroquine-Azithromycin -based protocols were asymptomatic (p=0.91). At day 10, 88/92 (95.7%) participants on Doxycycline versus 93/95 (97.9%) on Hydroxychloroquine-Azithromycin were asymptomatic (p=0.44). At day 30 all participants were asymptomatic. SARS-CoV2 PCR was negative at Day 10 in 60/92 (65.2%) participants allocated to Doxycycline and 63/95 (66.3%) participants allocated to Hydroxychloroquine-Azithromycin. None of the participants were admitted for worsening of the disease after treatment initiation. ConclusionDoxycycline 100 mg twice daily for 7 days is as effective and safe as Hydroxychloroquine-Azithromycin, for preventing clinical worsening of mild symptomatic or asymptomatic COVID-19, and achieving virological suppression. Strengths and Limitations[tpltrtarr] This study is one of the first randomized trial, assessing the efficacy and tolerance of Doxycycline to treat COVID-19 [tpltrtarr]It is one of the first to evaluate disease progression and need to hospitalization in mild or asymptomatic COVID-19 [tpltrtarr]Patients will not receive identical treatments [tpltrtarr]Doxycycline has advantages in terms of availability, safety and cost compared to Hydroxychloroquine and Azytromycin [tpltrtarr]Though this study has encounter 7 lost to follow-up, this does not have a major influence on our results [tpltrtarr]These data will assist clinicians in their daily practice, and provide a new tool for the fight against COVID-19
