Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean.

Despite the speedy development of vaccines for COVID-19, their rollout has posed a major public health challenge, as vaccine hesitancy (VH) and refusal are high. Addressing vaccine hesitancy is a multifactorial and context-dependent challenge. This perspective focuses on VH in the world region of Latin America and the Caribbean (LAC) and includes people suffering from severe mental illness, therefore covering populations and subpopulations often neglected in scientific literature. We present an overview of VH in LAC countries, discussing its global and historical context. Vaccine uptake has shown to widely vary across different subregions of LAC. Current data points to a possible correlation between societal polarization and vaccination, especially in countries going through political crises such as Brazil, Colombia, and Venezuela. Poor accessibility remains an additional important factor decreasing vaccination rollout in LAC countries and even further, in the whole Global South. Regarding patients with severe mental illness in LAC, and worldwide, it is paramount to include them in priority groups for immunization and monitor their vaccination coverage through public health indicators.

Influence of different breast expression techniques on human colostrum macronutrient concentrations.

OBJECTIVE: To evaluate the effects of breast expression methods on macronutrient and caloric concentrations in human colostrum. STUDY DESIGN: A cross-sectional study in which colostrum samples were collected simultaneously from each breast using different milk expression methods, including manual expression or electric pumping, assigned by simple randomization. Macronutrients were measured by infrared spectroscopy, and their concentrations were compared by the Wilcoxon test. RESULTS: Ninety-six samples from each breast of selected donors were evaluated. There were no differences in carbohydrate (6.1 vs. 6.1 g/dL; p: 0.218) and protein (2.1 vs. 2.1 g/dL; p: 0.772) concentrations between the samples collected by manual expression and electric pumping. However, in those collected by manual expression, lipid concentrations (2.6 vs. 2.2 g/dL; p < 0.001) and caloric content (60 vs. 57 Kcal/dL; p = 0.001) were higher. CONCLUSIONS: Colostrum collected by hand expression had a higher lipid concentration and caloric content than that collected by an electric pump.