Future pandemics and vaccination: Public opinion and attitudes across three European countries

BackgroundUnderstanding public opinion and attitudes regarding vaccination is crucial for successful outbreak management and effective communication at the European level.MethodsWe explored national differences by conducting focus group discussions in The Netherlands, Poland and Sweden. Discussions were structured using concepts from behavioural models.ResultsThematic analysis revealed that participants would base their vaccination decision on trade-offs between perceived benefits and barriers of the vaccine also taking into account the seriousness of the new outbreak. Except for those having chronic diseases, participants expected a low infection risk, resulting in a low willingness to get vaccinated. Information about the health status of cases was considered important since this might change perceived susceptibility. Participants displayed concerns about vaccine safety due to the limited available time to produce and test vaccines in the acute situation of a new pandemic. Swedish participants mentioned their tendency of doing the right thing and following the rules, as well as to get vaccinated because of solidarity with other citizens and social influences. This appeared much less prominent for the Dutch and Polish participants. However, Swedish participants indicated that their negative experiences during the Influenza A/H1N1 2009 pandemic decreases their acceptance of future vaccinations. Polish participants lacked trust in their national (public) health system and government, and were therefore sceptical about the availability and quality of vaccines in Poland.ConclusionsAlthough participants overall expressed similar considerations, important differences between countries stand out, such as previous vaccination experiences, the degree of adherence to social norms, and the degree of trust in health authorities.     

The impact of COVID-19 on cancer patients,their carers and oncology health professionals: A qualitative study

ObjectiveCancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs) when COVID-19 first emerged.MethodsIn this qualitative study, participants (cancer patients currently receiving treatment, family carers and HPs) completed a semi-structured interview exploring their experiences of COVID-19 and the impact it had on cancer care. Participants also completed the Hospital Anxiety and Depression Scale (patients) and the Depression, Anxiety and Stress Scale (carers and HPs) to assess emotional morbidity. Thematic analysis was undertaken on qualitative data.Results32 patients, 16 carers and 29 HPs participated. Qualitative analysis yielded three shared themes: fear and death anxiety, isolation, and uncertainty. For HPs, uncertainty incorporated the potential for moral distress and work-stress. Patients and carers scoring high on anxiety/depression measures were more likely to have advanced disease, expressed greater death anxiety, talked about taking more extreme precautionary measures, and felt more impacted by isolation.ConclusionCancer and COVID-19 can have compounding psychological impacts on all those receiving or giving care.Practice ImplicationsScreening for distress in patients, and burnout in HPs, is recommended. Increased compassionate access and provision of creative alternatives to face-to-face support are warrented.     

Enhanced growth of seed viruses for H5N1 influenza vaccines

Seed viruses used to produce inactivated H5N1 influenza vaccines are recombinant viruses with modified avirulent-type hemagglutinin (HA) and intact neuraminidase (NA) genes, both derived from an H5N1 isolate, and all remaining genes from the PR8 strain, which grows well in eggs. However, some reassortants grow suboptimally in eggs, imposing obstacles to timely, cost-efficient vaccine production. Here, we demonstrate that our PR8 strain supports better in ovo growth than the PR8 strain used for the WHO-recommended seed virus, NIBRG-14. Moreover, inclusion of an alternative NA protein further enhanced viral growth in eggs. These findings suggest that our H5N1 vaccine candidates would increase the availability of H5N1 vaccine doses at the onset of a new pandemic.     

Self-reported mental health symptoms,quality of life and coping strategies in French health sciences students during the early stage of the COVID-19 pandemic: An online survey

IntroductionHealth sciences students usually report high rates of mental health problems. The COVID-19 pandemic context may have serious psychological impacts in this at-risk population. We aimed to assess the self-reported mental health status, health-related quality of life and coping strategies of health sciences students during the early stage of the pandemic.MethodAn online 128-item questionnaire sent to 17,673 health sciences students from the Claude Bernard University Lyon 1 in April 2020 assessed: a) sociodemographic characteristics, b) conditions of lockdown, c) depressive (Beck Depression Inventory- Short Form, BDI-SF), anxiety (State-Trait Anxiety Inventory-A, STAI-A) and traumatic symptoms (Impact of Event Scale -Revised, IES-R), d) health-related quality of life (SF12) and e) coping strategies (Brief Coping Orientation to Problems Experienced, Brief COPE).ResultsThe participation rate was 9.9% (n = 1,765). A total of 19.5% of participants reported an IES-R > 33, 11.6% depressive symptoms, 58.1% anxiety symptoms, and 4.4% suicidal ideation. Their mental health-related quality of life was significantly poorer than for physical health. Female gender, COVID-like symptoms, social isolation due to the lockdown, pandemic-related financial restraint and exams-related stress were significantly associated with poorer self-reported mental health conditions. Volunteering in the healthcare system was significantly associated with lower mental health scores. Coping strategies were mostly oriented toward avoidance and positive appraisal.ConclusionFrench health sciences students exhibited high levels of self-reported mental health problems and a poor mental health-related quality of life during the early stage of the COVID-19 pandemic. Specific risk factors related to the pandemic partly explain the observed prevalence.     

基于多重PCR的副溶血弧菌大流行菌群及其毒力基因检测方法的建立与评价

目的 基于多重聚合酶链反应（PCR）建立一种快速方便的检测副溶血弧菌大流行菌群及其毒力基因的方法。方法 结合副溶血弧菌大流行菌群的群特异鉴定方法GS-PCR,与副溶血弧菌致病相关的耐热直接溶血素基因（tdh）和耐热直接溶血素相关溶血素基因（trh）序列设计引物,建立并优化多重PCR检测方法。用已知的大流行菌株和非大流行临床分离株,对其进行特异性、灵敏度等性能的评价。并对224株食品分离株和3株临床分离株副溶血弧菌进行了再鉴定。结果 副溶血弧菌大流行菌群有群特异PCR标识基因和tdh扩增条带。而其他细菌扩增结果呈阴性。检测灵敏度可达到105 CFU/ml。对实验室保存的224株食品分离株和3株临床分离株进行再鉴定表明,其中5株为副溶血弧菌大流行菌群,其中3株为tdh阳性、trh阴性,2株tdh、trh均阴性。结论 本研究所建立的多重PCR方法特异性好、灵敏度高。为副溶血弧菌大流行菌群及其毒力基因的快速大规模检测提供良好的技术支持。     

Coronavirus: la emergencia geriátrica de 2020. Documento conjunto de la Sección de Cardiología Geriátrica de la Sociedad Española de Cardiología y la Sociedad Española de Geriatría y Gerontología

SARS-CoV-2 infection, also known as COVID-19 (coronavirus infectious disease-19), was first identified in December 2019. In Spain, the first case of this infection was diagnosed on 31 January, 2020 and, by 15 April 2020, has caused 18 579 deaths, especially in the elderly. Due to the rapidly evolving situation regarding this disease, the data reported in this article may be subject to modifications. The older population are particularly susceptible to COVID-19 infection and to developing severe disease. The higher morbidity and mortality rates in older people have been associated with comorbidity, especially cardiovascular disease, and frailty, which weakens the immune response. Due to both the number of affected countries and the number of cases, the current situation constitutes an ongoing pandemic and a major health emergency. Because Spain has one of the largest older populations in the world, COVID-19 has emerged as a geriatric emergency. This document has been prepared jointly between the Section on Geriatric Cardiology of the Spanish Society of Cardiology and the Spanish Society of Geriatrics and Gerontology.     

Technology transfer of an oil-in-water vaccine-adjuvant for strengthening pandemic influenza preparedness in Indonesia

With the current enzootic circulation of highly pathogenic avian influenza viruses, the ability to increase global pandemic influenza vaccine production capacity is of paramount importance. This has been highlighted by, and is one of the main pillars of, the WHO Global Action Plan for Influenza Vaccines (GAP). Such capacity expansion is especially relevant in developing countries. The Vaccine Formulation Laboratory at University of Lausanne is engaged in the technology transfer of an antigen-sparing oil-in-water adjuvant in order to empower developing countries vaccine manufacturers to increase pandemic influenza vaccine capacity. In a one-year project funded by United States Department of Health and Human Services, the Vaccine Formulation Laboratory transferred the process know-how and associated equipment for the pilot-scale manufacturing of an oil-in-water adjuvant to Bio Farma, Indonesia's state-owned vaccine manufacturer, for subsequent formulation with H5N1 pandemic influenza vaccines. This paper describes the experience acquired and lessons learnt from this technology transfer project.     

Adverse event analysis in fatal cases of influenza A (H1N1) – A lesson from Poland

During pandemic of influenza A (H1N1) in 2009 the relationship between mortality and medical errors, especially delayed antiviral treatment initiation, was highlighted in many studies. Our study was based on 5 fatal cases of pandemic influenza A (H1N1) hospitalized in Poland between November 2009 and February 2011. The material included data from medical documentation as well as testimonies from medical personnel and patients' families recorded during on-going lawsuits alleging medical malpractice. The risk factors of adverse events were: lack of typical symptoms, lack of detailed medical history, clinical masking of a “trivial” illness, doctors' ignorance and insufficient knowledge, several physicians treating the same patient during hospitalization. Recommendations for improving management of pandemic infectious disease include: an effective, quick and detailed system of information about the epidemiological threat, clear indication of units with diagnostic and medical possibilities, rational health policy and national system of closed claims and adverse event analysis.