METHODS: PubMed and Google Scholar were systematically reviewed for peer-reviewed papers up to January 2023.
RESULTS: A promising solution to the problem of emerging variants is a DNA vaccine platform since it can be easily modified. Besides expressing whole protein antigens, DNA vaccines can also be constructed to include specific nucleotide genes encoding highly conserved and immunogenic epitopes from the S protein as well as from other structural/non-structural proteins to develop effective vaccines against VOCs. DNA vaccines are associated with low transfection efficiencies which could be enhanced by chemical, genetic, and molecular adjuvants as well as delivery systems.
CONCLUSIONS: The DNA vaccine platform offers a promising solution to the design of effective vaccines. The challenge of limited immunogenicity in humans might be solved through the use of genetic modifications such as the addition of nuclear localization signal (NLS) peptide gene, strong promoters, MARs, introns, TLR agonists, CD40L, and the development of appropriate delivery systems utilizing nanoparticles to increase uptake by APCs in enhancing the induction of potent immune responses.
DESIGN: A cross-sectional survey was conducted on Malaysian adults with hearing loss to determine the impact of the COVID-19 crisis on hearing aid management, communication difficulties, psychosocial challenges, and access to audiological services.
STUDY SAMPLE: One hundred forty-six individuals aged 18 years old and above with hearing loss were recruited from hearing health care centers to participate in the survey.
RESULTS: Many of the participants (54.2%) reported significant difficulties communicating with people wearing face masks. For hearing aid management, repairing (36.3%) and fine-tuning devices (30.2%) were considered more challenging than obtaining a battery (21.3%). The COVID-19 pandemic had a serious psychosocial impact on a small portion of the individuals surveyed. Remote services were rarely offered by the audiologists, and most participants preferred in-person treatment. However, the majority perceived that creating awareness and training on telehealth was important.
CONCLUSIONS: Effective management for people with hearing loss needs to consider the challenges faced by them, as the world prepares to live with the coronavirus. Clinical protocols should consider providing a service that is helpful for the clients as well as safe and sustainable in future pandemics.