Monthly Archives: August 2020

Cognitive Bias and Public Health Policy During the COVID-19 Pandemic

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JAMA
July 21, 2020, Vol 324, No. 3, Pages 209-310
https://jamanetwork.com/journals/jama/currentissue

 

Cognitive Bias and Public Health Policy During the COVID-19 Pandemic
Scott D. Halpern, MD, PhD; Robert D. Truog, MD; Franklin G. Miller, PhD
free access
JAMA. 2020;324(4):337-338. doi:10.1001/jama.2020.11623
This Viewpoint reviews common cognitive biases that led health centers and the public to favor patient- over population health–oriented policy responses to the initial COVID-19 pandemic, and proposes messaging to better articulate the rationale for more effective population health responses.

The COVID-19 Pandemic and Rapid Implementation of Adolescent and Young Adult Telemedicine: Challenges and Opportunities for Innovation

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Journal of Adolescent Health
August 2020 Volume 67, Issue 2, p145-308
https://www.jahonline.org/issue/S1054-139X(20)X0007-3

 

Original Articles
The COVID-19 Pandemic and Rapid Implementation of Adolescent and Young Adult Telemedicine: Challenges and Opportunities for Innovation
Angela Barney, Sara Buckelew, Veronika Mesheriakova, Marissa Raymond-Flesch
p164–171
Published online: May 14, 2020

Tailored Messages Addressing Human Papillomavirus Vaccination Concerns Improves Behavioral Intent Among Mothers: A Randomized Controlled Trial

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Journal of Adolescent Health
August 2020 Volume 67, Issue 2, p145-308
https://www.jahonline.org/issue/S1054-139X(20)X0007-3

 

Tailored Messages Addressing Human Papillomavirus Vaccination Concerns Improves Behavioral Intent Among Mothers: A Randomized Controlled Trial
Catherine A. Panozzo, Katharine J. Head, Melanie L. Kornides, Kristen A. Feemster, Gregory D. Zimet
p253–261
Published online: March 18, 2020

The truth is out there, somewhere

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The Lancet
Aug 01, 2020 Volume 396 Number 10247 p291-360, e12
https://www.thelancet.com/journals/lancet/issue/current

 

Editorial
The truth is out there, somewhere
The Lancet
The tidal wave of information on the internet concerning the COVID-19 pandemic has resulted in difficulties in discerning truth from fiction. This so-called infodemic, defined by WHO as an “overabundance of information—some accurate and some not—that makes it harder for people to find trustworthy sources and reliable guidance when needed”, has become a major threat to public health. Infection rates will rise if people are confused about restrictions and patients may be harmed if they use unproven treatments or bogus remedies.
An urgent call for action to gauge, map, and develop a means of combating this problem was explored at a WHO-organised conference held across April, June, and July. The meeting, which focused on so-called infodemiology—the science behind managing infodemics—brought together experts from a range of disciplines, including epidemiology, public health, applied mathematics, and data science…

Why vaccine rumours stick—and getting them unstuck

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The Lancet
Aug 01, 2020 Volume 396 Number 10247 p291-360, e12
https://www.thelancet.com/journals/lancet/issue/current

 

Perspectives
Book
Why vaccine rumours stick—and getting them unstuck
Bruce Gellin
…Heidi Larson’s compelling new book Stuck: How Vaccine Rumors Start—and Why They Don’t Go Away looks at the dynamics of the evolving debate through the lens of an anthropologist who has been studying vaccine confidence for decades. Largely written before COVID-19 surfaced, this book is timely as the world has its eyes longingly set on a COVID-19 vaccine.
As Larson notes, ”the quality of life that most of us enjoy today is dependent on vaccines. In many ways it is one of the biggest worldwide social experiments in collectivism and cooperation in modern times. The challenge is that it depends on a social contract whose fabric is eroding in a broader context of anti-globalization, nationalism, and populism. Vaccines can, as they have in the past, serve as a form of soft diplomacy to keep at least a fundamental level of global cooperation alive and well.”
…Larson’s book draws from a vast array of findings from her Vaccine Confidence Project that has established an information surveillance system for early detection of public concerns around vaccines. From this large body of work, Larson explores several important themes in Stuck: rumour, dignity, distrust, risk, emotional contagion, choice, the power of beliefs over facts, and the power of stories over data. Her analysis of these issues covers a broad range of events, settings, and countries, including Ebola virus vaccine trials in west Africa, routine MMR vaccination in the Somali community in Minnesota, USA, human papillomavirus vaccination in Japan and Columbia, dengue vaccine introduction in the Philippines, and the ramifications of a CIA-inspired sham hepatitis vaccination campaign in Pakistan as part of the hunt for Osama bin Laden.
…But Larson asks that we do more because it isn’t only about getting the facts right. As she frames the core problem: “we don’t have a misinformation problem, we have a relationship problem”. The misinformation can be deleted, but the underlying distrust that has caused it and allowed it to stick remains. Rather than countering and dismissing rumours, Larson encourages the health community and other stakeholders to listen to these rumours and recognise what people are saying. These analyses can reveal deeper issues such as the feeling of being disenfranchised and not being heard. It is from these insights, she argues, “lie the cues to building new and more trusting relationships”…

Digital tools against COVID-19: taxonomy, ethical challenges, and navigation aid

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Lancet Digital Health
Aug 2020 Volume 2 Number 8e380-e440
https://www.thelancet.com/journals/landig/issue/current

 

Health Policy
Digital tools against COVID-19: taxonomy, ethical challenges, and navigation aid
Urs Gasser, Marcello Ienca, James Scheibner, Joanna Sleigh, Effy Vayena
Summary
Data collection and processing via digital public health technologies are being promoted worldwide by governments and private companies as strategic remedies for mitigating the COVID-19 pandemic and loosening lockdown measures. However, the ethical and legal boundaries of deploying digital tools for disease surveillance and control purposes are unclear, and a rapidly evolving debate has emerged globally around the promises and risks of mobilising digital tools for public health. To help scientists and policy makers to navigate technological and ethical uncertainty, we present a typology of the primary digital public health applications that are in use. These include proximity and contact tracing, symptom monitoring, quarantine control, and flow modelling. For each, we discuss context-specific risks, cross-sectional issues, and ethical concerns. Finally, recognising the need for practical guidance, we propose a navigation aid for policy makers and other decision makers for the ethical development and use of digital public health tools.

Applications of digital technology in COVID-19 pandemic planning and response

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Lancet Digital Health
Aug 2020 Volume 2 Number 8e380-e440
https://www.thelancet.com/journals/landig/issue/current

 

Viewpoint
Applications of digital technology in COVID-19 pandemic planning and response
Sera Whitelaw, Mamas A Mamas, Eric Topol, Harriette G C Van Spall
Summary
With high transmissibility and no effective vaccine or therapy, COVID-19 is now a global pandemic. Government-coordinated efforts across the globe have focused on containment and mitigation, with varying degrees of success. Countries that have maintained low COVID-19 per-capita mortality rates appear to share strategies that include early surveillance, testing, contact tracing, and strict quarantine. The scale of coordination and data management required for effective implementation of these strategies has—in most successful countries—relied on adopting digital technology and integrating it into policy and health care. This Viewpoint provides a framework for the application of digital technologies in pandemic management and response, highlighting ways in which successful countries have adopted these technologies for pandemic planning, surveillance, testing, contact tracing, quarantine, and health care.

Achieving coordinated national immunity and cholera elimination in Haiti through vaccination: a modelling study

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Lancet Global Health
Aug 2020 Volume 8 Number 8 e973-e1100
http://www.thelancet.com/journals/langlo/issue/current

 

Articles
Achieving coordinated national immunity and cholera elimination in Haiti through vaccination: a modelling study
Elizabeth C Lee, et al
Summary
Background
Cholera was introduced into Haiti in 2010. Since then, more than 820 000 cases and nearly 10 000 deaths have been reported. Oral cholera vaccine (OCV) is safe and effective, but has not been seen as a primary tool for cholera elimination due to a limited period of protection and constrained supplies. Regionally, epidemic cholera is contained to the island of Hispaniola, and the lowest numbers of cases since the epidemic began were reported in 2019. Hence, Haiti may represent a unique opportunity to eliminate cholera with OCV.
Methods
In this modelling study, we assessed the probability of elimination, time to elimination, and percentage of cases averted with OCV campaign scenarios in Haiti through simulations from four modelling teams. For a 10-year period from January 19, 2019, to Jan 13, 2029, we compared a no vaccination scenario with five OCV campaign scenarios that differed in geographical scope, coverage, and rollout duration. Teams used weekly department-level reports of suspected cholera cases from the Haiti Ministry of Public Health and Population to calibrate the models and used common vaccine-related assumptions, but other model features were determined independently.
Findings
Among campaigns with the same vaccination coverage (70% fully vaccinated), the median probability of elimination after 5 years was 0–18% for no vaccination, 0–33% for 2-year campaigns focused in the two departments with the highest historical incidence, 0–72% for three-department campaigns, and 35–100% for nationwide campaigns. Two-department campaigns averted a median of 12–58% of infections, three-department campaigns averted 29–80% of infections, and national campaigns averted 58–95% of infections. Extending the national campaign to a 5-year rollout (compared to a 2-year rollout), reduced the probability of elimination to 0–95% and the proportion of cases averted to 37–86%.
Interpretation
Models suggest that the probability of achieving zero transmission of Vibrio cholerae in Haiti with current methods of control is low, and that bolder action is needed to promote elimination of cholera from the region. Large-scale cholera vaccination campaigns in Haiti would offer the opportunity to synchronise nationwide immunity, providing near-term population protection while improvements to water and sanitation promote long-term cholera elimination.
Funding
Bill & Melinda Gates Foundation, Global Good Fund, Institute for Disease Modeling, Swiss National Science Foundation, and US National Institutes of Health.

20th Anniversary Update of the Ottawa Decision Support Framework Part 1: A Systematic Review of the Decisional Needs of People Making Health or Social Decisions

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Medical Decision Making (MDM)
Volume 40 Issue 5, July 2020
http://mdm.sagepub.com/content/current

 

Reviews
20th Anniversary Update of the Ottawa Decision Support Framework Part 1: A Systematic Review of the Decisional Needs of People Making Health or Social Decisions
Lauren Hoefel, Annette M. O’Connor, Krystina B. Lewis, Laura Boland, Lindsey Sikora, Jiale Hu, Dawn Stacey
First Published July 13, 2020; pp. 555–581
Abstract
Background. The Ottawa Decision Support Framework (ODSF) has been used for 20 years to assess and address people’s decisional needs. The evidence regarding ODSF decisional needs has not been synthesized.
Objectives. To synthesize evidence from ODSF-based decisional needs studies, identify new decisional needs, and validate current ODSF decisional needs.
Methods. A mixed-studies systematic review. Nine electronic databases were searched. Inclusion criteria: studies of people’s decisional needs when making health or social decisions for themselves, a child, or a mentally incapable person, as reported by themselves, families, or practitioners. Two independent authors screened eligibility, extracted data, and quality appraised studies using the Mixed Methods Appraisal Tool. Data were analyzed using narrative synthesis.
Results. Of 4532 citations, 45 studies from 7 countries were eligible. People’s needs for 101 unique decisions (85 health, 16 social) were reported by 2857 patient decision makers (n = 36 studies), 92 parent decision makers (n = 6), 81 family members (n = 5), and 523 practitioners (n = 21). Current ODSF decisional needs were reported in 2 to 40 studies. For 6 decisional needs, there were 11 new (manifestations): 1) information (overload, inadequacy regarding others’ experiences with options), 2) difficult decisional roles (practitioner, family involvement, or deliberations), 3) unrealistic expectations (difficulty believing outcome probabilities apply to them), 4) personal needs (religion/spirituality), 5) difficult decision timing (unpredictable), and 6) unreceptive decisional stage (difficulty accepting condition/need for treatment, powerful emotions limiting information processing, lacking motivation to consider delayed/unpredictable decisions). Limitations. Possible publication bias (only peer-reviewed journals included). Possible missed needs (non-ODSF studies, patient decision aid development studies, 3 ODSF needs added in 2006).
Conclusion. We validated current decisional needs, identified 11 new manifestations of 6 decisional needs, and recommended ODSF revisions.

ENCODE

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Nature
Volume 583 Issue 7818, 30 July 2020
http://www.nature.com/nature/current_issue.html

 

ENCODE
This week marks the publication of results from phase three of the Encyclopedia of DNA Elements (ENCODE) project. Nine articles in this issue of Nature, along with papers published online and in several other journals, examine the most comprehensive catalogue yet of the candidate functional elements in the human and mouse genomes. In an overview paper, the ENCODE Project Consortium offers a summary of the new elements in the encyclopedia, which have been compiled with data sets from some 6,000 experiments. Much of the work published in this issue examines DNA regions called candidate cis-regulatory elements (cCREs), which may regulate gene transcription. Three papers — from Joseph Ecker, Bing Ren, Barbara Wold and their colleagues — look at cCREs during embryonic development in the mouse. Two papers from Wouter Meuleman, Jeff Vierstra, John Stamatoyannopoulos and colleagues map cCREs and transcription factor footprints in hundreds of human cell and tissue types. Michael Snyder and colleagues map chromatin loops in 24 human cell types; Eric Mendenhall and co-workers map the genome-wide binding of almost one-quarter of all chromatin-associated proteins active in a human liver cell line; and Brenton Graveley and colleagues integrate multiple assays to produce a comprehensive analysis of RNA-binding proteins and their functional elements. Finally, in a Perspective article, the project team puts the multiple phases of ENCODE in context

Electronic health records and polygenic risk scores for predicting disease risk

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Nature Reviews Genetics
Volume 21 Issue 8, August 2020
https://www.nature.com/nrg/volumes/21/issues/8

 

Review Article | 31 March 2020
Electronic health records and polygenic risk scores for predicting disease risk
Electronic health records (EHRs) linked to biobanks provide new opportunities for developing and applying polygenic risk scores in the clinic. The authors review the opportunities and challenges that arise when using EHR data for the systematic evaluation of patient disease susceptibilities.
Ruowang Li, Yong Chen[…] & Jason H. Moore

A call to arms: helping family, friends and communities navigate the COVID-19 infodemic

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Nature Reviews Immunology
Volume 20 Issue 8, August 2020
https://www.nature.com/nri/volumes/20/issues/8

 

Comment | 02 July 2020
A call to arms: helping family, friends and communities navigate the COVID-19 infodemic
In this Comment, Heidi Larson discusses the COVID-19 ‘infodemic’ and suggests the ways in which scientists can help to mitigate the spread of misinformation.
Heidi J. Larson

Optimizing safety surveillance for COVID-19 vaccines

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Nature Reviews Immunology
Volume 20 Issue 8, August 2020
https://www.nature.com/nri/volumes/20/issues/8

 

Comment | 17 June 2020
Optimizing safety surveillance for COVID-19 vaccines
Rebecca Chandler from the Uppsala Monitoring Centre discusses how the COVID-19 pandemic could be the catalyst that propels vaccine safety surveillance into the twenty-first century.
Rebecca E. Chandler

The non-specific and sex-differential effects of vaccines

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Nature Reviews Immunology
Volume 20 Issue 8, August 2020
https://www.nature.com/nri/volumes/20/issues/8

 

Viewpoint | 27 May 2020
The non-specific and sex-differential effects of vaccines
In this Viewpoint article, members of the Optimmunize consortium discuss the evidence for non-specific and sex-differential effects of vaccines and how this information might inform vaccine design and policy, including in relation to the COVID-19 pandemic.
Peter Aaby, Christine Stabell Benn[…] & Frank Shann

Boosting delivery of rare disease therapies: the IRDiRC Orphan Drug Development Guidebook

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Nature Reviews Drug Discovery
Volume 19 Issue 8, August 2020
https://www.nature.com/nrd/volumes/19/issues/8

 

Comment | 20 April 2020
Boosting delivery of rare disease therapies: the IRDiRC Orphan Drug Development Guidebook
The International Rare Diseases Research Consortium (IRDiRC) has created a Guidebook to facilitate drug development for rare diseases by organizing available tools into a standardized framework.
Anneliene Hechtelt Jonker, Virginie Hivert[…] & Diego Ardigo

Developing a low-cost and accessible COVID-19 vaccine for global health

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PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 1 Aug 2020)

 

Viewpoints
Developing a low-cost and accessible COVID-19 vaccine for global health
Peter J. Hotez, Maria Elena Bottazzi
| published 29 Jul 2020 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0008548
Overview
There is an urgent need to advance safe and affordable COVID-19 vaccines for low- and middle-income countries of Asia, Africa, and Latin America. Such vaccines rely on proven technologies such as recombinant protein–based vaccines to facilitate its transfer for emerging market vaccine manufacturers. Our group is developing a two-pronged approach to advance recombinant protein–based vaccines to prevent COVID-19 caused by SARS-CoV-2 and other coronavirus infections. One vaccine is based on a yeast-derived (Pichia pastoris) recombinant protein comprised of the receptor-binding domain (RBD) of the SARS-CoV formulated on alum and referred to as the CoV RBD219-N1 Vaccine. Potentially, this vaccine could be used as a heterologous vaccine against COVID-19. A second vaccine specific for COVID-19 is also being advanced using the corresponding RBD of SARS-CoV-2. The first antigen has already undergone current Good Manufacturing Practices (cGMP) manufacture and is therefore “shovel ready” for advancing into clinical trials, following vialing and required Good Laboratory Practice (GLP) toxicology testing. Evidence for its potential efficacy to cross-protect against SARS-CoV-2 includes cross-neutralization and binding studies using polyclonal and monoclonal antibodies. Evidence in support of its safety profile include our internal assessments in a mouse challenge model using a lethal mouse-adapted SARS strain, which shows that SARS-CoV RBD219-N1 (when adsorbed to aluminum hydroxide) does not elicit eosinophilic lung pathology. Together, these findings suggest that recombinant protein–based vaccines based on the RBD warrant further development to prevent SARS, COVID-19, or other coronaviruses of pandemic potential.

Determinants of pregnant women’s knowledge about influenza and the influenza vaccine: A large, single-centre cohort study

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PLoS One
http://www.plosone.org/

 

Research Article
Determinants of pregnant women’s knowledge about influenza and the influenza vaccine: A large, single-centre cohort study
Stéphanie Bartolo, Ophélie Mancel, Emilie Deliege, Sophie Carpentier, Rodrigue Dessein, Karine Faure, Damien Subtil
| published 31 Jul 2020 PLOS ONE
https://doi.org/10.1371/journal.pone.0236793

Trait reactance and trust in doctors as predictors of vaccination behavior, vaccine attitudes, and use of complementary and alternative medicine in parents of young children

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PLoS One
http://www.plosone.org/

 

Trait reactance and trust in doctors as predictors of vaccination behavior, vaccine attitudes, and use of complementary and alternative medicine in parents of young children
Anna Soveri, Linda C. Karlsson, Otto Mäki, Jan Antfolk, Otto Waris, Hasse Karlsson, Linnea Karlsson, Mikael Lindfelt, Stephan Lewandowsky
Research Article | published 27 Jul 2020 PLOS ONE
https://doi.org/10.1371/journal.pone.0236527

Eco-evolutionary control of pathogens

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PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/

 

Eco-evolutionary control of pathogens
Michael Lässig and Ville Mustonen
PNAS first published July 31, 2020. https://doi.org/10.1073/pnas.1920263117
Significance
Vaccinations and therapies targeting evolving pathogens aim to curb the pathogen and to steer it toward a controlled evolutionary state. Control is leveraged against the pathogen’s intrinsic evolutionary forces, which in turn, can drive an escape from control. Here, we analyze a simple model of control, in which a host produces antibodies that bind the pathogen. We show that the leverages of host (or external intervention) and pathogen are often highly imbalanced: an error threshold separates parameter regions of efficient control from regions of compromised control, where the pathogen retains the upper hand. Because control efficiency can be predicted from few measurable fitness parameters, our results establish a proof of principle how control theory can guide interventions against evolving pathogens.

Interdependence and the cost of uncoordinated responses to COVID-19

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PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/

 

Interdependence and the cost of uncoordinated responses to COVID-19
David Holtz, Michael Zhao, Seth G. Benzell, Cathy Y. Cao, Mohammad Amin Rahimian, Jeremy Yang, Jennifer Allen, Avinash Collis, Alex Moehring, Tara Sowrirajan, Dipayan Ghosh, Yunhao Zhang, Paramveer S. Dhillon, Christos Nicolaides, Dean Eckles, and Sinan Aral
PNAS first published July 30, 2020. https://doi.org/10.1073/pnas.2009522117
Significance
As local governments relax shelter-in-place orders worldwide, policy makers lack evidence on how policies in one region affect mobility and social distancing in other regions and the consequences of uncoordinated regional policies adopted in the presence of such spillovers. Our analysis suggests the contact patterns of people in one region are significantly influenced by the policies and behaviors of people in other, sometimes distant, regions. When just one-third of a state’s social and geographic peer states adopt shelter-in-place policies, it creates a reduction in mobility equal to the state’s own policy decisions, highlighting the need for national coordination. The paper gives governors a roadmap for coordination in the absence of national leadership and applies globally to other regions lacking coordination.

Social distancing responses to COVID-19 emergency declarations strongly differentiated by income

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PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/

 

Social distancing responses to COVID-19 emergency declarations strongly differentiated by income
Joakim A. Weill, Matthieu Stigler, Olivier Deschenes, and Michael R. Springborn
PNAS first published July 29, 2020. https://doi.org/10.1073/pnas.2009412117

Noninvasive wearable electroactive pharmaceutical monitoring for personalized therapeutics

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PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/

 

Noninvasive wearable electroactive pharmaceutical monitoring for personalized therapeutics
Shuyu Lin, Wenzhuo Yu, Bo Wang, Yichao Zhao, Ke En, Jialun Zhu, Xuanbing Cheng, Crystal Zhou, Haisong Lin, Zhaoqing Wang, Hannaneh Hojaiji, Christopher Yeung, Carlos Milla, Ronald W. Davis, and Sam Emaminejad
PNAS first published July 27, 2020. https://doi.org/10.1073/pnas.2009979117
Significance
To achieve the mission of personalized medicine, centering on delivering the right drug to the right patient at the right dose, therapeutic drug monitoring solutions are necessary. By devising a surface engineering strategy, we created a voltammetric sensing interface, featuring an “undistorted potential window,” within which the target electroactive drug’s voltammetric response is dominant and interference is eliminated, rendering reliable target quantification in noninvasively retrievable biofluids (sweat and saliva). Leveraging this sensing interface, a fully integrated, wearable solution was constructed to seamlessly render drug readouts with minute-level temporal resolution. To inform its clinical utility, the solution was utilized to demonstrate noninvasive pharmacokinetic monitoring of a pharmaceutical (here, acetaminophen, a widely used analgesic and antipyretic) in a wearable format.

Law, Ethics, and Politics in the Face of a Global Pandemic

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Public Health Ethics
IN PROGRESS

 

Volume 13, Issue 1, April 2020
http://phe.oxfordjournals.org/content/current
Editorial
Law, Ethics, and Politics in the Face of a Global Pandemic
Angus Dawson, Marcel Verweij
Public Health Ethics, Volume 13, Issue 1, April 2020, Pages 1–3, https://doi.org/10.1093/phe/phaa023
Extract
We are in the midst of a global pandemic caused by the novel SARS-CoV-2 virus. Millions of people have been infected, hundreds of thousands have died and health care systems have been stretched to breaking point. Unprecedented work is going on around the world to discover effective treatments and vaccines. In their absence, we are reliant upon traditional public health measures that aim to both prevent transmission (through the use of isolation, quarantine, physical distancing, restrictions on movement, shutting of borders, etc.) and detect infected individuals and those possibly exposed to infection (through testing and contact tracing, etc.). The implementation of such actions, particularly physical distancing, has caused massive disruption to social life and economic activity,…

The Factors That Promote Vaccine Hesitancy, Rejection, or Delay in Parents

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Qualitative Health Research
Volume 30 Issue 11, September 2020
http://qhr.sagepub.com/content/current

 

Special Issue: International Health
Research Articles
The Factors That Promote Vaccine Hesitancy, Rejection, or Delay in Parents
Umair Majid, Mobeen Ahmad
First Published June 29, 2020; pp. 1762–1776
Preview
Vaccines are some of the most cost-effective public health interventions for reducing disease burden and mortality. However, in recent years, health systems have faced a growing challenge with increasing number of parents who choose not to vaccinate their children. This decision has important implications for the health of communities worldwide, and despite a considerable amount of research that reinforces vaccine effectiveness and safety, there is uncertainty surrounding the factors that may encourage vaccine hesitancy in parents. In this interpretive review of 34 qualitative studies, we examine the factors that bolster vaccine hesitancy, rejection, and delay, and identify the overlaps and relationships between these factors. We depict our findings using the metaphor of a gear train where each gear represents one of seven factors: previous experiences; “natural” and “organic” living; perceptions of other parents; experiences interacting with health care providers; information sources, challenges, and preferences; distrust in health system players; and mandatory vaccine policies.

Perinatal COVID-19 in Latin America

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Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)
https://www.paho.org/journal/en

 

Latest articles
Perinatal COVID-19 in Latin America
Sola et al. 31 Jul 2020
Objective.
To evaluate and report the clinical characteristics and outcomes of SARS-CoV-2 infection in pregnant women and newborns in Latin America.
Methods.
Descriptive study based on the prospective report of the units of the Ibero-American Society of Neonatology Network.
Results.
Of 86 pregnant women with COVID-19 confirmed by RT-PCR in seven countries (6 from Latin America, and Equatorial Guinea) 68% (59) were asymptomatic. Of 32% of symptomatic women, 89% (24) had mild symptoms and 3.5% (3) had severe respiratory symptoms. No women died. The cesarean section rate was 38%; gestational age was < 37 weeks in 6% of cases. RT-PCR was performed on all newborns between 16 and 36 hours of age; 6 (7%) were positive. All of them presented mild and transient respiratory distress; none died. Two newborns with negative RT-PCR died from other causes. Breastfeeding was authorized in only 24% of mothers; in 13% milk was expressed and 63% of newborns were fed with formula. In 76% of cases the motherchild pair was separated, and in 95% of cases the mother could not be accompanied at delivery or during the postpartum period.
Conclusions.
The lack of maternal accompaniment, the low rate of breastfeeding and the frequent separation of the mother-child dyad are of concern. The health care team must reflect on the need to defend humanized and family-centered care during this pandemic.

Cautious optimism

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Science
31 July 2020 Vol 369, Issue 6503
http://www.sciencemag.org/current.dtl

 

Editorial
Cautious optimism
By H. Holden Thorp
Science31 Jul 2020 : 483
Summary
The first half of 2020 has seen extraordinary accomplishments in science. The international scientific community has described the genomic sequence of the virus that causes coronavirus disease 2019 (COVID-19) and structures of its important proteins, elucidated principal aspects of the immune response, identified neutralizing antibodies that can serve as therapeutics, and developed promising vaccines. There is much more to learn about COVID-19 and its cause, but the achievements so far are remarkable. So why doesn’t this progress feel like the triumph that it is?

Using influenza surveillance networks to estimate state-specific prevalence of SARS-CoV-2 in the United States

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Science Translational Medicine
29 July 2020 Vol 12, Issue 554
https://stm.sciencemag.org/

 

Report
Using influenza surveillance networks to estimate state-specific prevalence of SARS-CoV-2 in the United States
By Justin D. Silverman, Nathaniel Hupert, Alex D. Washburne
Science Translational Medicine29 Jul 2020 Open Access
Analysis of influenza-like illness surveillance data estimates that most SARS-CoV-2 infections in the United States went undetected in March 2020.

 

Scientific considerations for global drug development

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Science Translational Medicine
29 July 2020 Vol 12, Issue 554
https://stm.sciencemag.org/

Perspective
Scientific considerations for global drug development
By Jennifer L. Wilson, Kit Wun Kathy Cheung, Lawrence Lin, Elizabeth A. E. Green, Analia I. Porrás, Ling Zou, David Mukanga, Paul A. Akpa, Delese Mimi Darko, Rae Yuan, Sheng Ding, Wiltshire C. N. Johnson, Howard A. Lee, Emer Cooke, Carl C. Peck, Steven E. Kern, Dan Hartman, Yoshikazu Hayashi, Peter W. Marks, Russ B. Altman, Murray M. Lumpkin, Kathleen M. Giacomini, Terrence F. Blaschke
Science Translational Medicine29 Jul 2020 Restricted Access
Abstract
Requiring regional or in-country confirmatory clinical trials before approval of drugs already approved elsewhere delays access to medicines in low- and middle-income countries and raises drug costs. Here, we discuss the scientific and technological advances that may reduce the need for in-country or in-region clinical trials for drugs approved in other countries and limitations of these advances that could necessitate in-region clinical studies.

Stigma in African genomics research: Gendered blame, polygamy, ancestry and disease causal beliefs impact on the risk of harm

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Social Science & Medicine
Volume 258 August 2020
https://www.sciencedirect.com/journal/social-science-and-medicine/vol/258/suppl/C

 

Discussion Open access
Stigma in African genomics research: Gendered blame, polygamy, ancestry and disease causal beliefs impact on the risk of harm
Jantina de Vries, Guida Landouré, Ambroise Wonkam
Article 113091
Highlights
:: Gendered blame, polygamy and supernatural causal beliefs relate to stigma.
:: African genomics research intersects with pre-existing stigma and may cause harm.
:: Genomics can reveal sensitive information about group ancestry.
: Genomics researchers need to be culturally competent to minimize risk of harm.
Abstract
A recurring concern in genomics research is the possibility that it could lead to stigma for participants, their families and the population groups they belong to. Little evidence exists to explain how and when this ought to be a concern in genomics research in Africa whilst there is growing international evidence drawing into question the direct link between stigma and genetics. In this paper, we interrogate practical instances from African genomics research where stigma was identified as a concern in an attempt to nuance and refine accounts of when stigma should be considered as an ethical issue. The paper describes examples involving gendered blame, polygamy, beliefs in supernatural disease causation and sensitive information about group lineage. We propose that the concern may not be about stigma so much as broader research-related harm, including for instance reputational harm to population groups. Furthermore, we propose to shift the analytical gaze from establishing causal relationships to exploring the intersection of genomics with pre-existing stigma. Finally, we emphasize the importance of ensuring genomics researchers are culturally competent, meaning able to recognise when cultural factors impact on the possibility that genomics research could cause harm.

Logistical challenges for potential SARS-CoV-2 vaccine and a call to research institutions, developers and manufacturers

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Vaccine
Volume 38, Issue 34 Pages 5389-5562 (22 July 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/34

 

Discussion Full text access
Logistical challenges for potential SARS-CoV-2 vaccine and a call to research institutions, developers and manufacturers
Umit H. Kartoglu, Kelly L. Moore, John S. Lloyd

Use of seasonal influenza and pneumococcal polysaccharide vaccines in older adults to reduce COVID-19 mortality

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Vaccine
Volume 38, Issue 34 Pages 5389-5562 (22 July 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/34

 

Discussion Full text access
Use of seasonal influenza and pneumococcal polysaccharide vaccines in older adults to reduce COVID-19 mortality
Deus Thindwa, Maria Garcia Quesada, Yang Liu, Julia Bennett, … Stefan Flasche
Pages 5398-5401

Landscape analysis of pharmacovigilance and related practices among 34 vaccine manufacturers’ from emerging countries

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Vaccine
Volume 38, Issue 34 Pages 5389-5562 (22 July 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/34

 

Research article Open access
Landscape analysis of pharmacovigilance and related practices among 34 vaccine manufacturers’ from emerging countries
Katharina Hartmann, Sonia Pagliusi, Alexander Precioso
Pages 5490-5497

Pneumococcal Vaccination for Children in Asian Countries: A Systematic Review of Economic Evaluation Studies

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Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 1 Aug 2020)

 

Open Access Review
Pneumococcal Vaccination for Children in Asian Countries: A Systematic Review of Economic Evaluation Studies
by Neily Zakiyah , Widya N. Insani , Auliya A. Suwantika , Jurjen van der Schans and Maarten J. Postma
Vaccines 2020, 8(3), 426; https://doi.org/10.3390/vaccines8030426 (registering DOI) – 30 Jul 2020
Background: Evidence on costs and health benefits of pneumococcal conjugate vaccine (PCV) for children in Asian countries is limited but growing. As a region with a considerably high burden of pneumococcal disease, it is prominent to have a comprehensive overview on the cost-effectiveness […]

Media/Policy Watch

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Media/Policy Watch
This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.
We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

 

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 1 Aug 2020
Ideas
When a Vaccine Arrives, People Will Ignore the Anti-Vaxxers
Even if some Americans opt out, the country will still reach herd immunity against COVID-19.
July 31, 2020

 

BBC
http://www.bbc.co.uk/
Accessed 1 Aug 2020
[No new, unique, relevant content]

 

The Economist
http://www.economist.com/
Accessed 1 Aug 2020
[No new, unique, relevant content]

 

Financial Times
http://www.ft.com/home/uk
Accessed 1 Aug 2020
Global Insight
A coronavirus vaccine could split America
In the battle between public science and anti-vaxxer sentiment, science is heavily outgunned
Edward Luce July 30 2020

Pfizer chief says Trump price threats distract from vaccine progress
July 28, 2020

 

Forbes
http://www.forbes.com/
Accessed 1 Aug 2020
Aug 1, 2020
Trust Is The Vaccine Infrastructure We Need
The promise of a vaccine is the failsafe for millions of Americans nostalgic for normalcy but will communities trust us enough to take it?
By Lisa Fitzpatrick Contributor

Jul 31, 2020
Scientists Sequence DNA From Civil War Era Smallpox Vaccines
DNA sequenced from 150-year-old smallpox vaccination kits sheds some light on the evolutionary history of the viral strains used in smallpox vaccines.
By Kiona N. Smith Contributor

Jul 31, 2020
CDC Director: White House Stripped Agency Of Covid-19 Data With No Warning
The CDC director says he wasn’t told hospitals must now report directly toTrump administration until the decision was made.
By Jemima McEvoy Contributor

Jul 30, 2020
FDA Chief: We’ll Consider Emergency Use Authorization For Covid-19 Vaccines
The head of the U. S Food and Drug Administration said he would consider an “emergency use authorization” to expedite getting a vaccine against the Coronavirus strain Covid-19 to Americans.
By Bruce Japsen Senior Contributor

 

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 1 Aug 2020
Essay July 27, 2020
The Tragedy of Vaccine Nationalism
Global cooperation on vaccine allocation would be the most efficient way to disrupt the spread of the virus
Thomas J. Bollyky and Chad P. Bown

 

Foreign Policy
http://foreignpolicy.com/
Accessed 1 Aug 2020 |
Document of The Week: Global Plan for Sharing Vaccines [COVAX]
An alliance of international health organizations are competing with the United States and other rich countries in an effort to secure vaccines for the world’s neediest.
Colum Lynch

 

The Guardian
http://www.guardiannews.com/
[No new, unique, relevant content]

 

New Yorker
http://www.newyorker.com/
Accessed 1 Aug 2020
[No new, unique, relevant content]

 

New York Times
http://www.nytimes.com/
Accessed 1 Aug 2020
Asia Pacific
Indian Billionaires Bet Big on Head Start in Coronavirus Vaccine Race
The world’s largest vaccine producer, the Serum Institute, announced a plan to make hundreds of millions of doses of an unproven inoculation. It’s a gamble with a huge upside. And huge risks.
By Jeffrey Gettleman
PRINT EDITION August 2, 2020

Europe
Russia Preparing Mass Vaccination Against Coronavirus for October
Russia’s health minister is preparing a mass vaccination campaign against the novel coronavirus for October, local news agencies reported on Saturday, after a vaccine completed clinical trials.
By Reuters Aug. 1

Europe
Sanofi, Glaxo Advance Talks to Supply Up to 300 Million COVID-19 Vaccine Doses to Europe: Companies
Sanofi SA and GlaxoSmithKline Plc on Friday said they are in advanced discussions with the European Commission to supply up to 300 million doses of the drugmakers’s experimental COVID-19 vaccine.
By Reuters July 31

Asia Pacific
Impact of Coronavirus Will Be Felt for Decades to Come, WHO Says
The global coronavirus outbreak is the sort of disaster whose effects will last far into the future, World Health Organization Director General Tedros Adhanom Ghebreyesus said on Friday.
By Reuters July 31

U.S.
Trump Planning for U.S. Rollout of Coronavirus Vaccine Falling Short, Officials Warn
As scientists and pharmaceutical companies work at breakneck speed to develop a vaccine for the novel coronavirus, public health officials and senior U.S. lawmakers are sounding alarms about the Trump administration’s lack of planning for its nationwide distribution.
By Reuters July 31

Europe
Large U.S. COVID-19 Vaccine Trials Will Exclude Pregnant Women for Now
The first two COVID-19 vaccines to enter large-scale U.S. trials will not be tested in pregnant women this year, raising questions about how this vulnerable population will be protected from the coronavirus, researchers told Reuters.
By Reuters July 31

Europe
Pfizer, BioNTech to Supply 120 Million Doses of Coronavirus Vaccine to Japan
Pfizer Inc and BioNTech SE have agreed to supply Japan with 120 million doses of their experimental coronavirus vaccine in the first half of 2021, the companies said on Friday.
By Reuters July 31

 

Washington Post
https://www.washingtonpost.com/
Accessed 1 Aug 2020
[No new, unique, relevant content]

Think Tanks et al

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Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 1 Aug 2020
[No new relevant content]

Center for Global Development [to 1 Aug 2020]
http://www.cgdev.org/page/press-center
Accessed 1 Aug 2020
[No new relevant content]

Chatham House [to 1 Aug 2020]
https://www.chathamhouse.org/
[No new relevant content]

 

CSIS
https://www.csis.org/
Accessed 1 Aug 2020
Report
Covid-19 Reshapes the Future
July 28, 2020 | By Samuel Brannen

Commentary
Digital in the Time of the Coronavirus: Data Science and Technology as a Force for Inclusion
July 28, 2020 | By Aleem Walji

Commentary
Co-Chairs’ Statement: Vaccine Confidence, Social Media Misinformation, and National Security within the Covid-19 Crisis
July 27, 2020 | By Katherine E. Bliss, J. Stephen Morrison

 

Council on Foreign Relations
http://www.cfr.org/
Accessed 1 Aug 2020
[No new relevant content]

 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 1 Aug 2020
[No new relevant content]