ObjectivesEven though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample.MethodsA structured questionnaire prepared after consultation with experts in the field and guided by the “Report of the SAGE working group on vaccine hesitancy” was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine.ResultsAlthough 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines.ConclusionsCOVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs.

Background Vaccine hesitancy and vaccine inequity are two major hurdles towards achieving population immunity to COVID-19. Although several studies have been published on vaccine hesitancy among numerous populations, there is inadequate information on any potential correlation between vaccine acceptance and lack of access to vaccines. Our cross-sectional study in a low-income country aimed to fill this gap. Methods We conducted a nation-wide cross-sectional survey among the general population in Yemen, a low-income conflict country. Participants from all the provinces in Yemen were included in the study. We evaluated factors influencing agreement to accept a COVID-19 vaccine and any potential correlation between vaccine hesitancy and lack of access to vaccines. Results Overall, 50.1% of the 5329 respondents agreed to accept a COVID-19 vaccine. Only 39.9% of the participants agreed to having access to a COVID-19 vaccine, with females indicating lower access than males. Potential determinants of vaccine acceptance included being male, updating self on the development of vaccines against COVID-19, opinion about severity of COVID-19, anxiety about contracting COVID-19, concerns about the safety of COVID-19 vaccines and lack of access to vaccines. Conclusions our results indicate that the immediate threat in Yemen towards achieving population immunity is the severe shortage and lack of access to vaccines, rather than vaccine hesitancy.

ObjectivesPreventing severe disease and acquiring population immunity to COVID-19 requires global immunization coverage through mass vaccination. While high-income countries are battling vaccine hesitancy, low-income and fragile nations are facing the double dilemma of vaccine hesitancy and lack of access to vaccines. There is inadequate information on any correlation between vaccine hesitancy and access to vaccines. Our study in a low-income nation aimed to fill this gap.MethodsIn the backdrop of a severe shortage of COVID-19 vaccines in Yemen, a low-income fragile nation, we conducted a nation-wide cross-sectional survey among its healthcare workers (HCWs), between 6 July and 10 August 2021. We evaluated factors influencing agreement to accept a COVID-19 vaccine and any potential correlation between vaccine acceptance and lack of access to vaccines.ResultsOverall, 61.7% (n = 975) of the 1,581 HCWs agreed to accept a COVID-19 vaccine. Only 45.4% of the participants agreed to have access to a COVID-19 vaccine, with no sex dependent variations. Although several determinants of vaccine acceptance were identified, including, having a systemic disease, following the updates about COVID-19 vaccines, complying with preventive guidelines, having greater anxiety about contracting COVID-19, previous infection with COVID-19, believing COVID-19 to be a severe disease, and lower concern about the side effects of COVID-19, the strongest was access to vaccines (OR: 3.18; 95% CI: 2.5–4.03; p-value: 0.001).ConclusionThe immediate and more dangerous threat in Yemen toward achieving population immunity is the severe shortage and lack of access to vaccines, rather than vaccine hesitancy, meaning, improving access to vaccines could lead to greater acceptance.

Purpose: This study sought to investigate the acceptance rate and associated factors of COVID-19 vaccines among dentists and dental students in seven countries. Material and Methods: A structured questionnaire prepared and guided by the report of the SAGE Working Group on Vaccine Hesitancy was distributed among groups of dentists and dental students in seven countries across four continents. Results: A total of 1527 subjects (850 dentists and 677 dental students) participated in this survey. Although 72.5% of the respondents reported their intention to accept COVID-19 vaccines (dentists: 74.4%, dental students: 70.2%), there was a significant difference in agreement between dentists/dental students across countries; generally, respondents in upper-middle-, and high-income countries (UM-HICs) showed significantly higher acceptance rates compared to those in low- and lower-middle income countries (L-LMICs). Potential predictors of higher vaccine acceptance included being a dentist, being free of comorbidity, being well-informed about COVID-19 vaccines, having better knowledge about COVID-19 complications, having anxiety about COVID-19 infection, having no concerns about the side effects of the produced vaccines and being a resident of an UM-HIC. Conclusion: The results of our survey indicate a relatively good acceptance rate of COVID-19 among the surveyed dentists and dental students. However, dentists and dental students in L-LMICs showed significantly lower vaccine acceptance rates and trust in COVID-19 vaccines compared to their counterparts in UM-HICs. Our results provide important information to policymakers, highlighting the need for implementation of country-specific vaccine promotion strategies, with special focus on L-LMICs.

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This study aimed at assessing the safety of a mixed extract of Trigonella Foenum-graecum seeds and Withania Somnifera root (TFWS), which effectively relieves male menopausal symptoms. To this end, male and female Sprague-Dawley rats were divided into the following groups and repeatedly administered TFWS orally for 90 days: control, low-dose (500 mg/kg/day), intermediate-dose (1,000 mg/kg/day), and high-dose (2,000 mg/kg/day) groups. The animals were monitored for general symptoms; their body weights and electrolyte levels were measured; urinalysis, blood chemistry, biochemistry tests, and histopathological tests were performed to assess the toxicity of TFWS. The no-observed-adverse-effect level of TFWS was 2,000 mg/kg/day for all male and female rats. While in the TFWS-administered and control groups, most parameters were within the normal range; some rats in the high-dose group showed changes not induced by the test substance but which may be specific to an individual animal or may occur naturally. Thus, based on our findings, we consider that TFWS may be a safe, non-toxic substance for alleviating male menopausal symptoms.

The administration of vitamin A (10000 IU/kg b.w), vitamin A, C and E (10000 IU/kg, 100 mg/kg 100 mg/kg b.w), penicillin (50000 IU/kg b.w), penicillin + vitamin A, penicillin + vitamin A, C and E, streptomycin (50 mg/kg b.w), streptomycin + vitamin A, streptomycin + vitamins A, C and E for 30 days caused a significant increase in the levels of AST, ALT and ALP, and also caused a significant decrease in the levels of total protein and albumin in penicillin and streptomycin treated groups. However, co-administration of penicillin and streptomycin with vitamin A alone or in combination with vitamins C and E ameliorated the harmful effects of penicillin and streptomycin in most of the tested parameters. Vitamin A, either alone or in combination with vitamin C and E, has a protective effect on the histological changes of liver tissues induced either by penicillin or streptomycin administration. The result of the present work reveals for the first time that vitamin A alone or in combination with vitamin C and E plays an important role as cytoprotective compounds on hepatic damage in guinea pigs. Hence, further studies on the possible uses of vitamins as protective compounds during treatment with antibiotics are needed.

In our present research, we investigated the hepatoprotective and hepatocurative effects nabk honey in penicillin-induced hepatotoxicity. Biochemical analysis of serum was done for all groups. Hepatotoxicity was confirmed by comparing the serum levels of AST, ALT, ALP, total protein and albumin in penicillintreated group with that of normal salinetreated groups. Nabk honey considerably ameliorated the toxic effects of penicillin on livers. Nabk honey showed the ability to avert the elevated serum AST, ALT and ALP levels, and augmented the total protein and albumin, along with improved histopathological changes in livers. On comparing between hepatoprotective and hepatocurative effects, hepatoprotective effect of nabk honey showed a considerably significant [P < 0.01] improvement in biochemical parameters and morphological changes of livers in penicillin-induced hepatotoxicity. Accordingly, hepatoprotective effect of nabk honey was more effective than hepatocurative effect of nabk honey.