Several coronavirus disease 2019 (COVID-19) vaccines are currently in human trials. In June 2020, we surveyed 13,426 people in 19 countries to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Of these, 71.5% of participants reported that they would be very or somewhat likely to take a COVID-19 vaccine, and 61.4% reported that they would accept their employer's recommendation to do so. Differences in acceptance rates ranged from almost 90% (in China) to less than 55% (in Russia). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer's advice to do so. The COVID-19 pandemic is expected to continue to impose enormous burdens of morbidity and mortality while severely disrupting societies and economies worldwide. Governments must be ready to ensure large-scale, equitable access and distribution of a COVID-19 vaccine if and when a safe and effective one becomes available. This will require sufficient health system capacity, as well as strategies to enhance trust in and acceptance of the vaccine and those who deliver it. In 2015, the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunization defined vaccine hesitancy as a ' delay in acceptance or refusal of vaccination despite availability of vaccination services' 1 , which can vary in form and intensity based on when and where it occurs and what vaccine is involved, as has been confirmed in multiple studies 2,3. Concern about vaccine hesitancy is growing worldwide 4 ; in fact, WHO identified it as one of the top ten global health threats in 2019 (https://www.who. int/news-room/spotlight/ten-threats-to-global-health-in-2019). In many countries, vaccine hesitancy and misinformation present substantial obstacles to achieving coverage and community immunity 5,6. Governments, public health officials and advocacy groups must be prepared to address hesitancy and build vaccine literacy so that the public will accept immunization when appropriate. Anti-vaccination activists are already campaigning in multiple countries against the need for a vaccine, with some denying the existence of COVID-19 altogether 7. Misinformation spread through multiple channels could have a considerable effect on the acceptance of a COVID-19 vaccine 8. The accelerated pace of vaccine development has further heightened public anxieties and could compromise acceptance 9. Governments and societies must gauge current levels of willingness to receive a potentially safe and effective COVID-19 vaccine and identify correlates of vaccine hesitancy and/or acceptance. We present findings from a survey of the likelihood of vaccine acceptance from a sample of 13,426 respondents in 19 countries.

China reported to the World Health Organization (WHO) cases of pneumonia in Wuhan, Hubei Province, China, caused by a novel coronavirus, currently designated 2019-nCoV. Mounting cases and deaths pose major public health and governance challenges. China's imposition of an unprecedented cordon sanitaire (a guarded area preventing anyone from leaving) in Hubei Province has also sparked controversy concerning its implementation and effectiveness.Cases have now spread to at least 4 continents. As of January 28, there are more than 4500 confirmed cases (98% in China) and more than 100 deaths. 1 In this Viewpoint, we describe the current status of 2019-nCoV, assess the response, and offer proposals for strategies to bring the outbreak under control. Current StatusChina rapidly isolated the novel coronavirus on January 7 and shared viral genome data with the international community 3 days later. Since that time, China has reported increasing numbers of cases and deaths, partly attributable to wider diagnostic testing as awareness of the outbreak grows. Health officials have identified evidence of transmission along a chain of 4 "generations" (a person who originally contracted the virus from a nonhuman source infected someone else, who infected another individual, who then infected another individual), suggesting sustained human-to-human transmission. Current estimates are that 2019-nCoV has an incubation period of 2 to 14 days, with potential asymptomatic transmission. 1,2 Multiple countries have confirmed travel-associated cases

Public health ethics, like the field of public health it addresses, traditionally has focused more on practice and particular cases than on theory, with the result that some concepts, methods, and boundaries remain largely undefined. This paper attempts to provide a rough conceptual map of the terrain of public health ethics. We begin by briefly defining public health and identifying general features of the field that are particularly relevant for a discussion of public health ethics.Public health is primarily concerned with the health of the entire population, rather than the health of individuals. Its features include an emphasis on the promotion of health and the prevention of disease and disability; the collection and use of epidemiological data, population surveillance, and other forms of empirical quantitative assessment; a recognition of the multidimensional nature of the determinants of health; and a focus on the complex interactions of many factors—biological, behavioral, social, and environmental—in developing effective interventions.

The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security—its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including WHO reform, it will be important to distil lessons learned from the Ebola outbreak. The Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. Their contributions describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed. Their common goal is a more sustainable and resilient society for human health and wellbeing.

No abstract

No abstract

No abstract

Bridging the gap between gene discovery and our ability to use genetic information to benefit health requires population-based knowledge about the contribution of common gene variants and gene-environment interactions to the risk of disease. The risks and benefits associated with population-based research involving genetics, especially lower-penetrance gene variants, can differ in nature from those associated with family-based research. In response to the urgent need for appropriate guidelines, the Centers for Disease Control and Prevention formed a multidisciplinary group to develop an informed consent approach for integrating genetic variation into population-based research. The group used expert opinion and federal regulations, the National Bioethics Advisory Commission's report on research involving human biological materials, existing consent forms, and literature on informed consent to create suggested language for informed consent documents and a supplemental brochure. This language reflects the premise that the probability and magnitude of harm, as well as possible personal benefits, are directly related to the meaning of the results for the health of the participant and that appropriate disclosures and processes for obtaining consent should be based on an assessment at the outset of the likelihood that the results will generate information that could lead directly to an evidence-based intervention. This informed consent approach is proposed to promote discussion about how best to enable potential participants to make informed decisions about population-based research involving genetics and to suggest issues for consideration by research sponsors, institutional review boards, and investigators.