One of the enduring side effects of the COVID-19 pandemic is an increase in vaccine hesitancy – not just for COVID-19 vaccines, but, in some cases, for childhood vaccines. Vaccine acceptance has become highly politicized in many countries and communities. Researcher Simon Nicholas Williams writes in The Conversation (Australia): In 2019, the World Health Organization (WHO) identified vaccine hesitancy as one of its top ten threats to global health. It appears this threat has only increased since the COVID pandemic…. In our research on attitudes to COVID-19 vaccines, my colleagues and I found that concerns over side-effects, distrust in government and a belief in conspiracy theories all increased hesitancy. And hesitancy around COVID-19 shots could also lead to hesitancy “spillover” for other vaccines…. In short, alongside efforts to catch kids up with vaccine doses missed during the pandemic, we also need to tackle misinformation. Otherwise, vaccine hesitancy will remain one of the greatest threats to global health for years to come.”
 
Addressing the issues around vaccine confidence in the US brought on by ant-vaccine presidential candidate Robert Kennedy, New York Times (US) opinion writer Jessica Grose argues that the push back on misinformation seems to be working in the US. “Many scientific experts have worked to promote accurate and up-to-date information about vaccines, including COVID-19 vaccines. In some cases, they’ve spent a lot of social capital in their efforts to debunk falsehoods. Many journalists have asked vaccine skeptics tough questions. Simply shaming those who don’t want to get their children vaccinated, for whatever reason, is not effective.” She quotes the authors of the newsletter Your Local Epidemiologist: “Answering people with valid questions needs to be scientists’ priority. We need to meet them where they are, answer their questions from a place of empathy not condescension, equip trusted messengers, and anticipate concerns so we can prevent information voids that will otherwise be filled with false rumors.”
 

If You Are in a Hurry

• Read The Guardian on new funding for trials of a promising TB vaccine.
• Read a profile of Ugandan vaccine champion Doreen Naiga on GAVI’s Vaccines Work Blog.
• Read Helio on plans to distribute a new malaria vaccine in a dozen countries.
• Read Nature on successes and lessons from digital contact tracing apps.
• Read an opinion in BMJ on health inequities and mpox.
• Read Health Policy Watch on why low- and middle-income countries will get little to no funding from the World Bank pandemic fund.
• Read outgoing US CDC director Rochelle Walensky on what’s needed from the CDC and public health in New York Times.

 

TB Vaccine Trial Funded

 
The Guardian (UK) reports, “The first new tuberculosis vaccine in 100 years may be within reach, after the announcement that more than $500m (£395m) has been pledged by philanthropic institutions for final trials involving 26,000 people in Africa and south-east Asia. The M72/AS01E vaccine, developed by the giant pharmaceutical company GlaxoSmithKline, was shown to be 50 percent effective in phase 2b trials in 2018, but the company pulled out rather than invest in the large-scale trials needed for a license, saying it did not see a market.” Bill Gates is quoted: “With TB cases and deaths on the rise, the need for new tools has never been more urgent. Greater investment in safe and effective TB vaccines, alongside a suite of new diagnostics and treatments, could transform TB care for millions of people, saving lives and lowering the burden of this devastating and costly disease.”
 

Ugandan Vaccine Champion

 
A post on GAVI’s Vaccines Work Blog profiles Ugandan vaccine champion and college student Doreen Naiga, who is part of “Africa CDC's team of young people – Bingwas– who are championing the continent's effort to vaccinate its population against COVID-19. Today the young woman has organised immunisation camps in her rural district of Ssembabule in central Uganda and helped to vaccinate more than 200 people against COVID-19…. ‘Doreen wants every Ugandan (and African) to vaccinate against COVID-19,’ said Noah Nantajja, a student from Ssembabule. ‘She's intentional and persuasive. When she's not in class, she is in student dormitories and communities talking about the importance of vaccination. I took my COVID-19 jab because of her. I'm sure many other people are getting vaccinated because of her work.’"
 

Vaccine Acceptance Studies

 
A study in Journal of Global Health Reports (UK) looks at vaccine acceptance among women in Liberia. “The survey found that only approximately one in three households in rural Liberia were fully COVID-19 vaccine accepting…. Having a household member who accepted the COVID-19 vaccine was associated with an 18.1 percentage point greater likelihood of an individual accepting the vaccine…. Social norms around vaccine acceptance within households are strongly associated with individual acceptance. Interventions that target hesitant households and individuals could have a significant impact on vaccine acceptance rates.”
 
A study in the journal Human Vaccines & Immunotherapeutics (UK) looks at COVID-19 vaccine uptake among adults in Malawi, finding, “Those up-to-date were more likely to know someone who had died from COVID-19, feel the vaccine is important and safe, and perceive pro-vaccination social norms. Despite prevalent concerns about vaccine side effects, 54 percent of unvaccinated respondents were willing to vaccinate. Access issues were reported by 28 percent of unvaccinated but willing respondents. Up-to-date COVID-19 vaccination status was associated with positive attitudes about the vaccine and with perceiving pro-vaccination social norms. Over half of unvaccinated respondents were willing to get vaccinated. Disseminating vaccine safety messages from trusted sources and ensuring local vaccine availability may ultimately increase vaccine uptake.”
 
A study in JAIDS (US) looks at vaccine hesitancy and uptake among persons living with HIV in Washington, DC, finding, “Among 1,029 participants (66 percent men, 74 percent Black, median age 54), 13 percent were vaccine hesitant and 9 percent refused. Females were 2.6 to 3.5 times, non-Hispanic Blacks were 2.2 times, Hispanics, and those of other race/ethnicities were 3.5 to 8.8 times and younger PWH were significantly more likely to express hesitancy or refusal than males, non-Hispanic Whites and older PWH, respectively. The most reported reasons for vaccine hesitancy were side effect concerns (76 percent), plans to use other precautions/masks (73 percent), and speed of vaccine development (70 percent). Vaccine hesitancy and refusal declined over time (33 percent in October 2020 vs. 4 percent in December 2021, p<0.0001).”
 

Dozen Countries to Get Malaria Vaccine Doses

 
Healio (US) reports, “A total of 18 million doses of the world’s first malaria vaccine will be allocated to 12 countries in Africa, WHO announced Wednesday. The 12 countries — Benin, Burkina Faso, Burundi, Cameroon, the Democratic Republic of the Congo, Ghana, Kenya, Liberia, Malawi, Niger, Sierra Leone and Uganda — are expected to start receiving vaccine doses during the last quarter of 2023 and to begin rolling them out in early 2024, according to WHO…. ‘This vaccine has the potential to be very impactful in the fight against malaria, and when broadly deployed alongside other interventions, it can prevent tens of thousands of future deaths every year,’ Thabani Maphosa, Gavi’s managing director of country programs, said in a press release.”
 

Measles Deaths in Sudan Displacement Camps

 
CNN (US) reports, “At least 13 children have died in recent weeks during a suspected measles outbreak at internal displacement camps in Sudan’s White Nile state, amid conflict between the country’s two warring factions, according to an international medical NGO Sunday…. From June 6 to 27, the NGO treated 223 children with suspected measles in White Nile camps, it said, with 72 – including the 13 who died – admitted to two clinics it supports. ‘We are receiving sick children with suspected measles every day, most with complications,’ MSF Sudan tweeted.”
 

COVID-19 and Diabetes

 
BBC (UK) reports, A new study in JAMA Network Open journal has collated available data from different countries, including the UK, on more than 38,000 young people diagnosed during the pandemic. The authors describe the increase in cases of diabetes as ‘substantial’. More work is needed to understand why the rise is happening, they say. Some of the rise could be attributed to catch-up - from backlogs and delays when health services were shut - but does not explain all of the newly diagnosed cases, say scientists.” Read the JAMA study.
 

Digital Contact Tracing Lessons for the Next Pandemic

 
A Nature (UK) comment looks at the success and lessons learned from digital contact tracing efforts during the COVID-19 pandemic. “Digital contact tracing received much media attention, and much criticism, in that first year. Many worried that the technology provided a way for governments and technology companies to have even more control over people’s lives than they already do. Others dismissed the apps as a failure, after public-health authorities hit problems in deploying them. Three years on, the data tell a different story. The United Kingdom successfully integrated a digital contact-tracing app with other public-health programmes and interventions, and collected data to assess the app’s effectiveness. Several analyses now show that, even with the challenges of introducing a new technology during an emergency, and despite relatively low uptake, the app saved thousands of lives. It has also become clearer that many of the problems encountered elsewhere were not to do with the technology itself, but with integrating a twenty-first-century technology into what are largely twentieth-century public-health infrastructures.”
 

New Coronaviruses Found in UK Bats

 
Nature (UK) reports a survey of UK bat species “turned up new coronaviruses, and some from the same group as SARS-CoV-2. Laboratory studies with safe versions of these viruses suggest that some share key adaptations with SARS-CoV-2 — but are unlikely to spread in humans without further evolution.”
 

EU Vaccine Deal

 
Reuters (UK) reports, “The European Commission has secured deals with Pfizer (PFE.N) and several European drugmakers to reserve capacity to make up to 325 million vaccines per year in case of a future global health emergency, it said on Friday…. The deal ensures that companies are ready to respond to a crisis by keeping their facilities up to date and monitoring their supply chains, ‘including stockpiling where necessary’, the Commission said in a statement. If a new public health emergency was to be declared, companies would ‘rapidly start production’, it said. But vaccine equity activists said the EU risked a repeat of what the World Health Organization dubbed ‘vaccine apartheid’ during COVID-19.”
 

Health Inequities and Mpox

 
An opinion in BMJ (UK) argues, “Mpox has been downgraded as a public health emergency, but vulnerable communities continue to bear the brunt of its impact…. Several reports from the US and globally have found that many patients who have died of mpox during this outbreak also had advanced HIV. The COVID-19 pandemic disrupted HIV/AIDS care globally, creating a particularly challenging set of conditions just before the mpox outbreak emerged. Furthermore, access to mpox vaccines and antivirals has been severely limited in low- and middle-income countries, despite these countries bearing the brunt of the disease before this outbreak…. Who continues to be harmed? We’re still seeing ongoing low levels of transmission in people experiencing advanced HIV, homelessness, substance abuse disorder, and psychiatric disease, making it clear from our clinical experience that the most vulnerable people (often from ethnic minorities) are continuing to bear the brunt of the mpox outbreak.”
 

Long COVID Updates

 
Nature (UK) provides an overview of recent research findings on long COVID noting, “researchers now have enough data to provide some preliminary answers to urgent questions about the condition such as the timescale for possible improvement, factors that raise the risk of developing long COVID, and what can be done to prevent it.”
 
CIDRAP (US) reports, “New studies on SARS-CoV-2's neurologic effects describe how even mild infections can lead to neuropsychiatric conditions by altering brain structure and function and review possible mechanisms for viral passage through the blood-brain barrier. Even mild COVID-19 infections can alter brain structures and functions, leading to neuropsychiatric conditions such as anxiety, depression, fatigue, and sleepiness and undermining well-being, health, and the ability to work, according to studies presented last week at the ninth Brazilian Institute of Neuroscience and Neurotechnology (BRAINN) congress in Sao Paulo.”
 
AP (US) reports, “Nearly 36 million people in Europe may have had long-lasting health problems from coronavirus infections they got during the first three years of the COVID-19 pandemic, the World Health Organization’s regional director said…. ‘Unless we develop comprehensive diagnostics and treatment for long COVID, we will never truly recover from the pandemic,’ Kluge said, reiterating that older adults, people with underlying medical conditions and others with weakened immune systems should continue getting vaccinated.”
 

Advice from the Departing US CDC Director

 
Outgoing CDC director Rochelle Walensky writes in a New York Times (US) opinion piece, “I ‌believe that scientific expertise ‌should not take a back seat to partisan will. That said, public health and scientific recommendations inevitably intersect with social values and policy. Acknowledging this intersection is not to suggest that elected leaders‌ — regardless of party ‌ — should disregard science or undermine ‌‌its integrity. We in public health must recognize that recommendations do not occur within a vacuum; rather, they affect other sectors of American life ‌ — education, the economy‌ and national security, to name a few. The job of public health is to strike an appropriate balance between protecting the health of all those who live in the U‌nited States while minimizing the disruption to the normal functioning of society. ‌The goal is to offer science-driven recommendations that balance protection and practicality in the context of one’s individual risk tolerance and value set.”
 

Who Gets New COVID-19 Vaccines?

 
Nature (UK) reports, “Now that the COVID-19 global emergency is over and infections have dwindled, officials have been rethinking who should receive the jab and when. Some countries have already restricted access to current boosters so they are available only to people at high risk of severe disease or death, and several nations have hinted that updated boosters rolled out in the coming months will be reserved for vulnerable individuals. Health officials note that many people are still protected against severe disease by either previous infection, vaccination or both. That protection, combined with pandemic fatigue and a relatively low level of hospitalizations and infections ‘has put us in a different era, and we need different approaches’, says Annelies Wilder-Smith, a vaccinologist at [WHO].”
 

Gap in Pandemic Financing

 
Health Policy Watch (Switzerland) reports, “Later this month, the Pandemic Fund Governing Board is due to meet in Washington D.C. to make the first round of decisions on disbursement of some $300-350 million in initial funding for pandemic preparedness. However, due to a woeful shortfall in funds so far raised for the fund, hosted by the World Bank, most of the requests submitted by some 129 low- and middle-income countries will likely be denied.... All of these requests are competing for the relatively minuscule $300-350 million that the Fund currently has to disperse – meaning that most countries will likely not receive any funding at all – or very minimal funding at best.”
 

Blood Type and COVID-19

 
CIDRAP (US) reports, “People with type A blood are likely more susceptible to COVID-19 infections, because the spike protein of the virus shows an affinity for blood group A cells, according to a new study in Blood. This is the strongest evidence to date to support the idea that blood types influence who is more likely to contract COVID-19. Moreover, the study shows the spike protein's affinity for type A cells may be amplified by the Omicron strain of the virus…. ‘Among a group of several thousand people, some studies suggest that those with blood group A may be 20 percent more likely to be infected after exposure to SARS-CoV-2 compared with those who have blood group O. But people with blood group O can still contract the virus and may transmit it to others,’ said Sean R. Stowell, MD, PhD, of Harvard Medical School, in a press release.”