Background Migrants have been disproportionally affected by COVID-19 in Australia. Vaccination against COVID-19 is a key pillar of Australia's public health response, but little is known about the willingness to receive booster vaccinations among migrants. This study aimed to assess the factors associated with a willingness to receive a COVID-19 booster vaccine among migrants living in Australia born in the World Health Organization’s Eastern Mediterranean Region (EMRO). Methods A cross-sectional survey was conducted from September to November 2021 (n = 300). Participants were questioned on booster vaccine willingness, sociodemographic characteristics, COVID-19 vaccine information needs and sources, and perceptions of COVID-19 vaccines. Univariate and multivariate logistic regression were used to assess factors associated with booster willingness. Results Most respondents (87%) had received two doses of COVID-19 vaccine, of which 81% were willing to receive a booster dose. About half of the participants reported high or very high needs for receiving information about “COVID-19 vaccines’ safety monitoring in Australia”, “COVID-19 vaccines protection against illness”, “Safety of COVID-19 vaccines used in Australia”, and “The Australian COVID-19 vaccination program”. People who were willing to receive a boost dose had significantly higher self-estimated knowledge of COVID-19 vaccines, confidence in COVID-19 vaccines and trust in the Australian government’s vaccine recommendations, and perceived COVID-19 as a greater risk compared to those who were unsure/hesitant. Both groups reported similar perceptions of their personal risks from COVID-19 but diverged on their views of COVID-19 as a broader health problem. There were no statistically significant differences between the two groups in terms of channels used to find information about COVID-19 vaccines. Factors associated with willingness to receive a COVID-19 booster vaccine in the multivariate logistic regression were age (aOR 1.07 95% CI 1.02–1.12), and no exposure to concerning news about COVID-19 vaccines (aOR 3.71 95% CI 1.51–9.09). Conclusion Vaccine acceptance and reported booster willingness was high. The results suggest the news and information seen may impact willingness to receive booster doses, even among those who have already received doses of COVID-19 vaccine. Addressing vaccine concerns and transparent communication about uncertainty should be a priority in the current and in future pandemics.

Background Little is known about the transmission dynamics of the B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and young adolescents. We investigated an outbreak in an Australian high school, with limited public health mitigation measures in place, to understand the school activities associated with transmission, and the role of young adolescents in spreading SARS-CoV-2. Methods All 1,164 school attendees were monitored for SARS-CoV-2 infection through their mandated 14-day quarantine period. A cohort study design was used to investigate the effect of contact with the index case in different classes on the transmission of SARS-CoV-2, and the effect of vaccination among household contacts on becoming infected by SARS-CoV-2. Results There were 48 outbreak cases, including 14 students and one teacher who likely acquired their infection at the school. Attack rates among students in the index case’s classes ranged from 0% to 45%. The greatest risk of infection for students in the same grade attending a class with the index case were from the drama class (risk ratio, RR: 111.6; 95% confidence interval (95% CI): 14.88–837.19) and the personal development, health, and physical education class (RR: 7.45: 95% CI: 2.27–24.44). The overall household attack rate was 57%, and household contacts who were not fully vaccinated were 2.9 times more likely (95% CI: 1.07–7.87) to become cases than were effectively-vaccinated household contacts. Conclusion Children can play an important role in the transmission of the Delta variant of SARS-CoV-2 within schools and at home. Transmission in this outbreak was largely associated with active, practical lessons that had close contact between students. This study demonstrates that the absence of public health and social measures in a low-incidence context resulted in the rapid spread of coronavirus disease 2019 (COVID-19) within an educational setting. These findings reinforce the role of public health and social measures and vaccinations to reduce airborne transmission and to enable a safe face-to-face learning environment.

Background: Vaccination is a cornerstone of public health measurements to mitigate the burden of COVID-19 infection. For health equity, information needs to be accessible to all members of society to allow for informed decision-making about COVID-19 vaccines. We sought to investigate barriers that migrants living in Australia faced in accessing official information about COVID-19 vaccines and identify potential solutions. Methods: This study used a descriptive qualitative study design. Seventeen adults living in Australia and born in the World Health Organization’s Eastern Mediterranean Region participated in a semi-structured interview conducted via telephone. Participants were recruited using advertising through social media platforms. The interviews were conducted between December 2021 and February 2022. All interviews were audio-recorded and transcribed verbatim. Data were analysed using inductive thematic analysis. Results: Barriers to accessing official information about COVID-19 vaccines were related to unmet language needs, methods of dissemination, and mistrust in official sources of information. To overcome barriers, participants suggested improving the quality and timeliness of language support, using diverse modes of dissemination, working with members of migrant communities, providing opportunities for two-way communication, communicating uncertainty, and building a broader foundation of trust. Conclusion: Information about COVID-19 vaccines during different stages of the vaccination program should be provided in migrants’ languages at the same time that it is available in English using a variety of methods for dissemination. The acceptability of official information can be improved by communicating uncertainty, acknowledging people’s concerns about the safety and effectiveness of COVID-19 vaccines and providing opportunities for two-way communication. People’s trust in official sources of health information can be improved by working with migrant communities and recognising migrants’ contributions to society. The findings of this study may improve managing the response to COVID-19 and other health emergencies in Australia and in other similar societies.

Background: The emergence of a new pathogen requires a rapid assessment of its transmissibility, to inform appropriate public health interventions. Methods: The peer-reviewed literature published between 1 January and 30 April 2020 on COVID-19 in PubMed was searched. Estimates of the incubation period, serial interval and reproduction number for COVID-19 were obtained and compared. Results: A total of 86 studies met the inclusion criteria. Of these, 33 estimated the mean incubation period (4–7 days) and 15 included estimates of the serial interval (mean 4–8 days; median length 4–5 days). Fifty-two studies estimated the reproduction number. Although reproduction number estimates ranged from 0.3 to 14.8, in 33 studies (63%), they fell between 2 and 3. Discussion: Studies calculating the incubation period and effective reproduction number were published from the beginning of the pandemic until the end of the study period (30 April 2020); however, most of the studies calculating the serial interval were published in April 2020. The calculated incubation period was similar over the study period and in different settings, whereas estimates of the serial interval and effective reproduction number were setting-specific. Estimates of the serial interval were shorter at the end of the study period as increasing evidence of pre-symptomatic transmission was documented and as jurisdictions enacted outbreak control measures. Estimates of the effective reproduction number varied with the setting and the underlying model assumptions. Early analysis of epidemic parameters provides vital information to inform the outbreak response.

Background An outbreak of gastroenteritis was investigated following complaints of illness after eating donuts from a food premises in the Australian Capital Territory (ACT). Methods Food poisoning complainants and contacts were surveyed using a standard gastroenteritis questionnaire including menu items from the food premises. Descriptive analyses were performed on data collected for all responses. A case-control study was conducted for a group of 140 people at a catered function. Food safety inspections were conducted with food and environmental samples tested at the ACT Government Analytical Laboratory. Stool specimens were collected from cases who were ill at the time of interview. Neither active case finding, nor viral testing of food or environmental samples, could be conducted. Results Three hundred and one people were surveyed, and 215 individuals (71.4%) reported vomiting and/or diarrhoea following consumption of a donut purchased from the business over a five-day period. All ill respondents reported eating a donut. The medians of incubation period and illness duration were 34 hours (interquartile range, IQR: 29–42 hours) and 48 hours (IQR: 29–72 hours) respectively. Diarrhoea, vomiting and abdominal pain were the most commonly reported symptoms. Eight out of 11 specimens collected from ill individuals were positive for norovirus. For the case-control study, data from 59 attendees were collected, with an attack rate of 46% (27/59). Eating any kind of filled donut was associated with a person becoming ill (odds ratio: 10.4; 95% confidence interval: 1.18–478.13). No single flavour was identified as the likely source of infection. Elevated levels of coliforms were present in two samples of donut filling obtained during the food safety inspection. Conclusion Donuts are a novel vehicle for norovirus infection. This implicated pathogen, plus evidence collected at the food premises suggestive of faecal contamination, indicates the source of this outbreak was likely an ill food handler. The findings of this outbreak highlight the importance of excluding food handlers from work while ill. While this was one of the largest foodborne outbreaks investigated in the ACT, the true extent of illness remains unknown. Active case finding should be pursued to determine the magnitude of outbreaks.

Background: The emergence of a new pathogen requires a rapid assessment of its transmissibility, to inform appropriate public health interventions. Methods: The peer-reviewed literature published between 1 January and 30 April 2020 on COVID-19 in PubMed was searched. Estimates of the incubation period, serial interval and reproduction number for COVID-19 were obtained and compared. Results: A total of 86 studies met the inclusion criteria. Of these, 33 estimated the mean incubation period (4–7 days) and 15 included estimates of the serial interval (mean 4–8 days; median length 4–5 days). Fifty-two studies estimated the reproduction number. Although reproduction number estimates ranged from 0.3 to 14.8, in 33 studies (63%), they fell between 2 and 3. Discussion: Studies calculating the incubation period and effective reproduction number were published from the beginning of the pandemic until the end of the study period (30 April 2020); however, most of the studies calculating the serial interval were published in April 2020. The calculated incubation period was similar over the study period and in different settings, whereas estimates of the serial interval and effective reproduction number were setting-specific. Estimates of the serial interval were shorter at the end of the study period as increasing evidence of pre-symptomatic transmission was documented and as jurisdictions enacted outbreak control measures. Estimates of the effective reproduction number varied with the setting and the underlying model assumptions. Early analysis of epidemic parameters provides vital information to inform the outbreak response.

Background Migrants have been disproportionally affected by COVID-19 in Australia. Vaccination against COVID-19 is a key pillar of Australia's public health response, but little is known about the willingness to receive booster vaccinations among migrants. This study aimed to assess the factors associated with a willingness to receive a COVID-19 booster vaccine among migrants living in Australia born in the World Health Organization’s Eastern Mediterranean Region (EMRO). Methods A cross-sectional survey was conducted from September to November 2021 (n = 300). Participants were questioned on booster vaccine willingness, sociodemographic characteristics, COVID-19 vaccine information needs and sources, and perceptions of COVID-19 vaccines. Univariate and multivariate logistic regression were used to assess factors associated with booster willingness. Results Most respondents (87%) had received two doses of COVID-19 vaccine, of which 81% were willing to receive a booster dose. About half of the participants reported high or very high needs for receiving information about “COVID-19 vaccines’ safety monitoring in Australia”, “COVID-19 vaccines protection against illness”, “Safety of COVID-19 vaccines used in Australia”, and “The Australian COVID-19 vaccination program”. People who were willing to receive a boost dose had significantly higher self-estimated knowledge of COVID-19 vaccines, confidence in COVID-19 vaccines and trust in the Australian government’s vaccine recommendations, and perceived COVID-19 as a greater risk compared to those who were unsure/hesitant. Both groups reported similar perceptions of their personal risks from COVID-19 but diverged on their views of COVID-19 as a broader health problem. There were no statistically significant differences between the two groups in terms of channels used to find information about COVID-19 vaccines. Factors associated with willingness to receive a COVID-19 booster vaccine in the multivariate logistic regression were age (OR:1.07, 95%CI:1.02–1.12), and no exposure to concerning news about COVID-19 vaccines (OR:3.71, 95%CI:1.51–9.08). Conclusion Vaccine acceptance and reported booster willingness was high. The results suggest the news and information seen may impact willingness to receive booster doses, even among those who have already received doses of COVID-19 vaccine. Addressing vaccine concerns and transparent communication about uncertainty should be a priority in the current and in future pandemics.