Missing the Point — How Primary Care Can Overcome Covid-19 Vaccine “Hesitancy”

Ratzan, Scott C.; Schneider, Eric C.; Hatch, Hilary; Cacchione, Joseph

doi:10.1056/nejmp2106137

Cited by 62 publications

(54 citation statements)

References 3 publications

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“…Health status included a history of chronic diseases, a history of psychological disorders, a family history of psychological disorders, depression symptoms measured by the Patient Health Questionaire-9 (PHQ-9), and anxiety symptoms measured by the Generalized Anxiety Disorder-7 (GAD-7). Total scores of the two scales were interpreted as the following: normal (0-4), mild (5)(6)(7)(8)(9), and moderate to severe (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) depression symptoms for the PHQ-9 [18], and normal (0-4), mild (5)(6)(7)(8)(9), and moderate to severe (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) anxiety symptoms for the GAD-7 [19].…”

Section: Willingness Of Covid-19 Vaccinationmentioning

confidence: 99%

Public Willingness and Determinants of COVID-19 Vaccination at the Initial Stage of Mass Vaccination in China

Liu

Sun

et al. 2021

Vaccines

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The present study assessed the willingness of the general population to receive COVID-19 vaccines and identified factors that influence vaccine hesitancy and resistance. A national online survey was conducted from 29 January 2021 to 26 April 2021 in China. Multinomial logistic regression analyses were conducted to identify factors that influence vaccine hesitancy and resistance. Of the 34,041 participants surveyed, 18,810 (55.3%) were willing to get vaccinated, 13,736 (40.3%) were hesitant, and 1495 (4.4%) were resistant. Rates of vaccine acceptance increased over time, with geographical discrepancies in vaccine hesitancy and resistance between provinces in China. Vaccine safety was the greatest concern expressed by most participants (24,461 [71.9%]), and the major reason for participants’ refusing vaccination (974 [65.2%]). Government agencies (23,131 [68.0%]) and social media (20,967 [61.6%]) were the main sources of COVID-19 vaccine information. Compared with vaccination acceptance, female, young and middle-aged, high income, and perceived low-risk of infection were associated with vaccine hesitancy. Histories of allergic reactions to other vaccines and depression symptoms were related to vaccine resistance. Common factors that influenced vaccine hesitancy and resistance were residing in cities and perceiving less protection with vaccines than with other protective measures. The results indicate that the rate of vaccine resistance is relatively low, but vaccine hesitancy is common. Individuals who are female, young and middle-aged, with a high income, and residing in cities are more likely to be hesitant for vaccination and should be the target populations for vaccination campaigns. Specific vaccine messaging from the government and social media could alleviate public concerns about vaccine safety and efficacy.

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Section: Willingness Of Covid-19 Vaccinationmentioning

confidence: 99%

Public Willingness and Determinants of COVID-19 Vaccination at the Initial Stage of Mass Vaccination in China

Liu

Sun

et al. 2021

Vaccines

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“…The copyright holder for this preprint (which this version posted July 14, 2021. ; https://doi.org/10.1101/2021.07. 13.449251 doi: bioRxiv preprint the etiologic agent of COVID-19, breakthrough infections in the immunocompromised [13][14][15][16][17][18][19] , infections in the young and elderly lacking a full repertoire of immunological responses 20 , vaccine reticence or hesitancy 21 , and the inequitable distribution of vaccines globally 22 indicate that therapeutic interventions will be required to limit severe disease and substantial mortality associated with pandemic SARS-CoV-2 infection. Currently, remdesivir, under emergency FDA authorization, is the only antiviral to show improvement of clinical outcomes, albeit with limited effectiveness and the limitation of intravenous administration 5 .…”

Section: Introductionmentioning

confidence: 99%

“…The emergence of multiple coronaviruses (CoVs) into the human population in recent years [10][11][12] highlights the need for the rapid development of broad-spectrum interventional strategies against genetically distinct CoVs. Despite the unprecedented rapid development of effective vaccines targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of COVID-19, breakthrough infections in the immunocompromised [13][14][15][16][17][18][19] , infections in the young and elderly lacking a full repertoire of immunological responses 20 , vaccine reticence or hesitancy 21 , and the inequitable distribution of vaccines globally 22 indicate that therapeutic interventions will be required to limit severe disease and substantial mortality associated with pandemic SARS-CoV-2 infection. Currently, remdesivir, under emergency FDA authorization, is the only antiviral to show improvement of clinical outcomes, albeit with limited effectiveness and the limitation of intravenous administration 5 .…”

Section: Introductionmentioning

confidence: 99%

Water-soluble tocopherol derivatives inhibit SARS-CoV-2 RNA-dependent RNA polymerase

Pacl

Tipper

Sevalkar

et al. 2021

Preprint

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The recent emergence of a novel coronavirus, SARS-CoV-2, has led to the global pandemic of the severe disease COVID-19 in humans. While efforts to quickly identify effective antiviral therapies have focused largely on repurposing existing drugs, the current standard of care, remdesivir, remains the only authorized antiviral intervention of COVID-19 and provides only modest clinical benefits. Here we show that water-soluble derivatives of α-tocopherol have potent antiviral activity and synergize with remdesivir as inhibitors of the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp). Through an artificial-intelligence-driven in silico screen and in vitro viral inhibition assay, we identified D-α-tocopherol polyethylene glycol succinate (TPGS) as an effective antiviral against SARS-CoV-2 and β-coronaviruses more broadly that also displays strong synergy with remdesivir. We subsequently determined that TPGS and other water-soluble derivatives of α-tocopherol inhibit the transcriptional activity of purified SARS-CoV-2 RdRp and identified affinity binding sites for these compounds within a conserved, hydrophobic interface between SARS-CoV-2 nonstructural protein 7 and nonstructural protein 8 that is functionally implicated in the assembly of the SARS-CoV-2 RdRp. In summary, we conclude that solubilizing modifications to α-tocopherol allow it to interact with the SARS-CoV-2 RdRp, making it an effective antiviral molecule alone and even more so in combination with remdesivir. These findings are significant given that many tocopherol derivatives, including TPGS, are considered safe for humans, orally bioavailable, and dramatically enhance the activity of the only approved antiviral for SARS-CoV-2 infection.

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“…Potential candidates include vaccination centers, hospitals, retail pharmacies or doctors’ offices. The integration of general practitioners into a country’s vaccination campaign has been especially discussed in the literature, for instance, in terms of overcoming vaccine “hesitancy” in the population [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Efficiency in COVID-19 Vaccination Campaigns—A Comparison across Germany’s Federal States

et al. 2021

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Vaccination programs are considered a central pillar of the efforts to stop COVID-19. However, vaccine doses are scarce and several organizational and logistical obstacles, such as the timing of and reserves for second shots and delivery failures, apparently slow down vaccination roll-outs in several countries. Moreover, it is an open question as to where vaccines are administered as efficiently as possible (vaccination centers, hospitals, doctor’s offices, pharmacists, etc.). The first aim of our study was to systematically evaluate the efficiency of a country’s vaccination campaign. The second aim was to analyze how the integration of doctors’ offices into a campaign that formerly relied only on vaccination centers affected the speed of that campaign. Using data on vaccine deliveries and vaccinations given in Germany, we find considerable differences across federal states in terms of efficiency, defined as the ability to administer the most vaccinations out of a given number of available doses. Back-of-the-envelope calculations for January to May 2021 show that vaccinations would have been 3.4–6.9% higher if all federal states had adopted a similar ratio between vaccinations given and vaccines stored, as the most efficient states did. This corresponds to 1.7–3.3% of Germany’s total population. In terms of our second research goal, we find evidence that the integration of doctors’ offices into the vaccination campaign significantly increased the ratio of vaccinations administered out of a given stock of vaccine doses. On average, there appears to be a structural break in this ratio after doctors’ offices were integrated into the vaccination campaign on 5 April 2021. On average, an additional 11.6 out of 100 available doses were administered each week compared to the period prior to that date. We conclude that there are considerable regional differences in the efficiency of the vaccination roll-out. Systematic efficiency analyses are one step to detecting inefficiencies and to identify best practices that can be adopted to eventually speed up the vaccination roll-out in a country.

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Missing the Point — How Primary Care Can Overcome Covid-19 Vaccine “Hesitancy”

Cited by 62 publications

References 3 publications

Public Willingness and Determinants of COVID-19 Vaccination at the Initial Stage of Mass Vaccination in China

Public Willingness and Determinants of COVID-19 Vaccination at the Initial Stage of Mass Vaccination in China

Water-soluble tocopherol derivatives inhibit SARS-CoV-2 RNA-dependent RNA polymerase

Efficiency in COVID-19 Vaccination Campaigns—A Comparison across Germany’s Federal States

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