关键词： Coronavirus   SARS-CoV-2   Germany   COVID-19   vaccination   cost-effectiveness   H00   H   I00   I   HOSPITALIZATION   VACCINATION   ADULTS  

摘要： ObjectivesTo assess the potential clinical impact and cost-effectiveness of coronavirus disease 2019 (COVID-19) mRNA vaccines updated for Autumn 2023 in adults aged >= 60 years and high-risk persons aged 30-59 years in Germany over a 1-year analytic time horizon (September 2023-August 2024).MethodsA compartmental Susceptible-Exposed-Infected-Recovered model was updated and adapted to the German market. Numbers of symptomatic infections, a number of COVID-19 related hospitalizations and deaths, costs, and quality-adjusted life-years (QALYs) gained were calculated using a decision tree model. The incremental cost-effectiveness ratio of an Autumn 2023 Moderna updated COVID-19 (mRNA-1273.815) vaccine was compared to no additional vaccination. Potential differences between the mRNA-1273.815 and the Autumn Pfizer-BioNTech updated COVID-19 (XBB.1.5 BNT162b2) vaccines, as well as societal return on investment for the mRNA-1273.815 vaccine relative to no vaccination, were also *** to no autumn vaccination, the mRNA-1273.815 campaign is predicted to prevent approximately 1,697,900 symptomatic infections, 85,400 hospitalizations, and 4,100 deaths. Compared to an XBB.1.5 BNT162b2 campaign, the mRNA-1273.815 campaign is also predicted to prevent approximately 90,100 symptomatic infections, 3,500 hospitalizations, and 160 deaths. Across both analyses we found the mRNA-1273.815 campaign to be *** mRNA-1273.815 vaccine can be considered cost-effective relative to the XBB.1.5 BNT162b2 vaccine and highly likely to provide more benefits and save costs compared to no vaccine in Germany, and to offer high societal return on investment.

关键词： COVID-19 vaccine   side effects   reinfection   safe   efficiency   Africa   MESSENGER-RNA VACCINES   REINFECTION   RISK  

摘要： Background In the absence of a specific treatment for COVID-19, preventive measures have been implemented to control this pandemic and vaccination is one of them. However, it is crucial to verify the safety and efficiency of every vaccine. The aim was to determinate the predictive factors of side effects and reinfection after COVID-19 vaccine. Methods A cross-sectional study was conducted in February 2022 among Tunisians infected with COVID-19 between March 2020 and February 2022, using an online self-administered questionnaire. We conducted univariate and multivariate analyses using binary stepwise logistic regression. Results A total of 1541 was selected from 1911 individuals. Comorbidities affected a quarter of the population (22.3%). Before the initial infection, 39.3% had received full vaccination, and 8.7% had received partial vaccination. By February 2022, the majority (82.9%) had received at least two vaccine doses. The reinfection rate was 30.6%. All vaccines prior to the first infection was identified as a protective factor against reinfection. Inactivated virus vaccinations were less likely to induce adverse effects. Conclusion ach vaccine has its own set of advantages and disadvantages: mRNA-based vaccines had a higher incidence of side effects but all vaccines provided better protection against reinfection.

关键词： Bivalent adenovirus type-5 vectored COVID-19 vaccine   inhalation   mucosal immunity   SigA   safety   INACTIVATED SARS-COV-2 VACCINE   MEMORY T-CELLS   OPEN-LABEL   MUCOSAL  

摘要： Vaccination strategies that can induce a broad spectrum immune response are important to enhance protection against SARS-CoV-2 variants. We conducted a randomized, double-blind and parallel controlled trial to evaluate the safety and immunogenicity of the bivalent (5x1010viral particles) and B.1.1.529 variant (5x1010viral particles) adenovirus type-5 (Ad5) vectored COVID-19 vaccines administrated via inhalation. 451 eligible subjects aged 18 years and older who had been vaccinated with three doses inactivated COVID-19 vaccines were randomly assigned to inhale one dose of either B.1.1.529 variant Ad5 vectored COVID-19 vaccine (Ad5-nCoVO-IH group, N=150), bivalent Ad5 vectored COVID-19 vaccine (Ad5-nCoV/O-IH group, N=151), or Ad5 vectored COVID-19 vaccine (5x1010viral particles; Ad5-nCoV-IH group, N=150). Adverse reactions reported by 37 (24.67%) participants in the Ad5-nCoVO-IH group, 28 (18.54%) in the Ad5-nCoV/O-IH group, and 26 (17.33%) in the Ad5-nCoV-IH group with mainly mild to moderate dry mouth, oropharyngeal pain, headache, myalgia, cough, fever and fatigue. No serious adverse events related to the vaccine were reported. Investigational vaccines were immunogenic, with significant difference in the GMTs of neutralizing antibodies against Omicron BA.1 between Ad5-nCoV/O-IH (43.70) and Ad5-nCoV-IH (29.25) at 28 days after vaccination (P=0.0238). The seroconversion rates of neutralizing antibodies against BA.1 in Ad5-nCoVO-IH, Ad5-nCoV/O-IH, and Ad5-nCoV-IH groups were 56.00%, 59.60% and 48.67% with no significant difference among the groups. Overall, the investigational vaccines were demonstrated to be safe and well tolerated in adults, and was highly effective in inducing mucosal immunities in addition to humoral and cellular immune responses defending against SARS-CoV-2 *** registration: *** identifier: ChiCTR2200063996.

关键词： SARS-CoV-2   spike   antibodyomics   antibody repertoire   epitope mapping   lineage tracking   POTENT NEUTRALIZING ANTIBODIES   SARS-COV-2 INFECTION   BINDING  

摘要： Neutralizing antibodies are a key component in protective humoral immunity against SARS-CoV-2. Currently, available technologies cannot track epitope-specific antibodies in global antibody repertoires. Thus, the comprehensive repertoire of spike-specific neutralizing antibodies elicited by SARS-CoV-2 infection is not fully understood. We therefore combined high-throughput immunoglobulin heavy chain (IgH) repertoire sequencing, and structural and bioinformatics analysis to establish an antibodyomics pipeline, which enables tracking spike-specific antibody lineages that target certain neutralizing epitopes. We mapped the neutralizing epitopes on the spike and determined the epitope-preferential antibody lineages. This analysis also revealed numerous overlaps between immunodominant neutralizing antibody-binding sites and mutation hotspots on spikes as observed so far in SARS-CoV-2 variants. By clustering 2677 spike-specific antibodies with 360 million IgH sequences that we sequenced, a total of 329 shared spike-specific antibody clonotypes were identified from 33 COVID-19 convalescents and 24 SARS-CoV-2-naive individuals. Epitope mapping showed that the shared antibody responses target not only neutralizing epitopes on RBD and NTD but also non-neutralizing epitopes on S2. The immunodominance of neutralizing antibody response is determined by the occurrence of specific precursors in human naive B-cell repertoires. We identified that only 28 out of the 329 shared spike-specific antibody clonotypes persisted for at least 12 months. Among them, long-lived IGHV3-53 antibodies are likely to evolve cross-reactivity to Omicron variants through accumulating somatic hypermutations. Altogether, we created a comprehensive atlas of spike-targeting antibody lineages in COVID-19 convalescents and antibody precursors in human naive B cell repertoires, providing a valuable reference for future vaccine design and evaluation.

关键词： Technostress   leadership styles   transformational leadership   transactional leadership   laissez-faire leadership   PLS-SEM   Covid-19   public sector   Cambodia   TRANSFORMATIONAL LEADERSHIP   DARK SIDE   TECHNOLOGY   BEHAVIOR   SECTOR   PERFORMANCE   EXHAUSTION   MEDIATION   TURNOVER   STRESS  

摘要： This study examines the impact of different leadership styles on technostress within public organizations in Cambodia amidst the challenges of the COVID-19 pandemic. Utilizing Partial Least Squares Structural Equation Modeling (PLS-SEM), data were collected from 351 employees working in various public organizations across Cambodia. The study specifically investigates the relationships between three leadership styles-transformational, transactional, and laissez-faire-and the level of technostress experienced by employees. The findings reveal a statistically significant and positive relationship between transformational leadership and a reduction in technostress, suggesting that transformational leadership qualities such as inspiration, motivation, and individualized consideration effectively mitigate the adverse effects of technostress. Conversely, transactional and laissez-faire leadership styles are positively associated with increased levels of technostress, indicating that these styles may exacerbate the stress employees experience in response to technological changes and challenges. The study contributes to the existing literature by providing empirical evidence on the impact of leadership styles on technostress in a unique cultural and organizational context. It offers valuable insights for policymakers, organizational leaders, and practitioners in understanding the role of leadership in managing technostress, especially during times of crisis and rapid technological change. The study also highlights the importance of leadership development programs in public sector organizations that emphasize leadership styles that help reduce technostress. The findings emphasize the need for a balanced approach to leadership that considers both the demands of technological adaptation and the well-being of employees.

关键词： COVID-19   vaccine hesitancy   medical staff   social networks   China  

摘要： COVID-19 vaccine hesitancy remains problematic among healthcare workers. Social network influences may shape vaccine decision-making, but few studies have examined this in this critical workforce. We assessed the relationship between friends' COVID-19 vaccination attitudes and personal hesitancy among Chinese healthcare personnel. In December 2022-January 2023, a cross-sectional online survey was conducted at a tertiary hospital in China using WeChat. Of the 1832 healthcare personnel who were invited to answer the structured questionnaire, 613 (33.5%) samples had valid data for data analysis. Logistic regression examined the association between friends' hesitancy and participants' own hesitancy, adjusting for confounders. Of 613 healthcare workers included, 266 (43.4%) were hesitant. Those with hesitant friends had 6.34 times higher adjusted odds of hesitating themselves versus those without hesitant friends (95% CI 2.97-13.52). Strong associations persisted across subgroups. Chinese healthcare workers' COVID-19 vaccination hesitancy was highly influenced by perceived friends' attitudes. Fostering pro-vaccine social norms through trusted peer networks could help promote vaccine acceptance in this critical workforce.

关键词： Rural   community health workers   COVID-19   pandemic preparedness   community based pandemic response   COST-EFFECTIVENESS   CARE   CHALLENGES   ACCESS   DENGUE   IMPACT   ASHAS  

摘要： BackgroundRural community health workers [CHWs] play a critical role in improving health outcomes during non-pandemic times, but evidence on their effectiveness during the COVID-19 pandemic is limited. There is a need to focus on rural CHWs and rural health systems as they have limited material and human resources rendering them more vulnerable than urban health systems to severe disruptions during *** systematic review aims to describe and appraise the current evidence on the effectiveness of rural CHWs in improving access to health services and health outcomes during the COVID-19 pandemic in low-and middle-income countries [LMICs].MethodsWe searched electronic databases for articles published from 2020 to 2023 describing rural CHW interventions during the COVID-19 pandemic in LMICs. We extracted data on study characteristics, interventions, outcome measures, and main results. We conducted a narrative synthesis of key *** studies from 10 countries met our inclusion criteria. Most of the studies were from Asia [10 of 15 studies]. Study designs varied and included descriptive and analytical studies. The evidence suggested that rural CHW interventions led to increased household access to health services and may be effective in improving COVID-19 and non-COVID-19 health outcomes. Overall, however, the quality of evidence was poor due to methodological limitations; 14 of 15 studies had a high risk of *** CHWs may have improved access to health services and health outcomes during the COVID-19 pandemic in LMICs but more rigorous studies are needed during future pandemics to evaluate their effectiveness in improving health outcomes in different settings and to assess appropriate support required to ensure their impact at scale.

关键词： Dynamic clearance   full liberalization   new coronavirus infection   vaccination policy   the elderly  

摘要： On 7 December 2022, the State Council of China released 'Measures to Further Optimize the Implementation of the Prevention and Control of the New Coronavirus Epidemic'. The previous three-year dynamic zero epidemic prevention policy was then replaced with a full liberalization policy. On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a 'public health emergency of international concern.' However, given the ongoing prevalence of coronavirus, emerging mutations, and the liberalization of restrictions, there are increased risks of vulnerable people contracting new variants. Low vaccination coverage among older people with compromised immune systems, puts them at further risk. The policy shift will increase pressure on already stretched health infrastructure and medical resources. This short article adds to the current debate arguing that the Chinese government should take commensurate preventive measures, including strengthening medical facilities and equipment and targeting ongoing vaccination in older people.

关键词： Risk compensation   COVID-19   vaccination   protective behaviour   France   HPV VACCINATION   BEHAVIOR   INTERVENTIONS   PERCEPTIONS   REDUCTION   SPILLOVER   EFFICACY   HELMETS   HIV  

摘要： Vaccination has played a key role in reducing the health burden of COVID-19, however, concern has been raised worldwide regarding risk compensation, a process whereby feelings of security arising from being vaccinated may lead people to reduce their engagement in other protective *** investigated whether vaccination led to risk compensation and whether this changed over time by conducting a repeated cross-sectional study at seven intervals over the initial months (February to September 2021) of the vaccine rollout in France. Participants (N = 14,003) completed an online survey measuring vaccination status, vaccination intention and engagement in four preventive behaviours: mask wearing, avoidance of physical contact, hand hygiene, and avoiding social gatherings. Risk compensation was measured indirectly by comparing levels of engagement in protective behaviours according to vaccination status, with those unvaccinated but intending to vaccinate serving as a *** compensation did not occur systematically and was mostly observed towards the end of the vaccine rollout for two of the four protective behaviours: avoiding social gatherings (in July and September for fully-vaccinated participants (Adjusted Odds Ratio (AOR) = .72, p = .045; AOR = .54, p = .022, respectively) and wearing a mask (those vaccinated with one dose, in September: AOR = .48, p = .029)). Our findings suggest that whilst unlikely to impede the overall effectiveness of public health campaigns, risk compensation nonetheless merits attention when designing informed, targeted public health messages and policy.