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Factors influencing COVID-19 vaccine hesitancy and acceptance among the Pakistani population

Chaudhary FA, Ahmad B, Khalid MD, Fazal A, Javaid MM, Butt DQ

Hum Vaccin Immunother, 2021 Oct 03;17(10):3365-3370.
PMID: 34236952 DOI: 10.1080/21645515.2021.1944743

This study examined the factors associated with acceptance of the COVID-19 vaccine compared to hesitance in the Pakistani population and specifically focusing on the perceived beliefs, knowledge, concerns, risk, and safety perception relating to the COVID-19 vaccine. A total of 423 subjects were recruited from the Pakistan Institute of Medical Sciences, Islamabad, Pakistan. A 27-item valid and reliable questionnaire was used to assess socio-demographic characteristics, acceptance, and hesitance toward COVID-19 vaccine, perceived beliefs, knowledge, perceived concerns, risk, and safety of COVID-19 vaccines and its source of information. Chi-square tests and logistic regression were used for analysis. About 53% of the participants were planning to get vaccinated and a significantly greater proportion of better educated, higher income, and healthier participants in the vaccine acceptance group (p

Matched MeSH terms: Vaccines*
The impact of geo-political socio-economic factors on vaccine dissemination trends: a case-study on COVID-19 vaccination strategies

Chauhan R, Varma G, Yafi E, Zuhairi MF

BMC Public Health, 2023 Nov 02;23(1):2142.
PMID: 37919737 DOI: 10.1186/s12889-023-17000-z

BACKGROUND: The world in recent years has seen a pandemic of global scale. To counter the widespread loss of life and severe repercussions, researchers developed vaccinations at a fast pace to immunize the population. While the vaccines were developed and tested through extensive human trials, historically vaccines have been known to evoke mixed sentiments among the generic demographics. In the proposed study, we aim to reveal the impact of political and socio-economic factors on SARS-Cov-2 vaccination trends observed in two hundred and seventeen countries spread across the six continents.
METHODS: The study had hypothesized that the citizens who have lower trust in their government would be less inclined towards vaccination programs. To test this hypothesis, vaccination trends of nations under authoritarian rule were compared against democratic nations. Further, the study was synthesized with Cov-2 vaccination data which was sourced from Our World Data repository, which was sampled among 217 countries spread across the 6 continents. The study was analyzed with exploratory data analysis and proposed with relevance and impacting factor that was considered for vaccine dissemination in comparison with the literacy rate of the nations. Another impacting factor the study focused on for the vaccination dissemination trends was the health expenses of different nations. The study has been synthesized on political and socio-economic factors where the features were ardently study in retrospect of varied socio- economic features which may include country wise literacy rate, overall GDP rate, further we substantiated the work to address the political factors which are discussed as the country status of democratic or having other status.
RESULTS: The comparison of trends showed that dissemination of SARS-Cov-2 vaccines had been comparable between the two-opposing types of governance. The major impact factor behind the wide acceptance of the SARS-Cov-2 vaccine was the expenditure done by a country on healthcare. These nations used a large number of vaccines to administer to their population and the trends showed positive growth. The overall percentage of vaccine utilized by countries in quantitative terms are Pfizer/BioNTech (17.55%), Sputnik V (7.08%), Sinovac (6.98%), Sinopharm/Beijing (10.04%), Oxford/AstraZeneca (19.56%), CanSino (2.85%), Moderna (12.05%), Covaxin (3.28%), JohnsonandJohnson (10.89%), Sputnik Light (3.07%), Novavax (3.49%). While the nations with the lowest healthcare expenses failed to keep up with the demand and depended on vaccines donated by other countries to protect their population.
CONCLUSIONS: The analysis revealed strong indicators that the nations which spend more on healthcare were the ones that had the best SARS-Cov-2 vaccination rollout. To further support decision-making in the future, countries should address the trust and sentiment of their citizens towards vaccination. For this, expenses need to be made to develop and promote vaccines and project them as positive health tools.

Matched MeSH terms: Vaccines*
On canine anti-rabies vaccination in Malaya

Kingsbury AN

Malayan Medical Journal, 1927;2:48-9.

Matched MeSH terms: Rabies Vaccines
No more cholera inoculation

Chan JS

Family Practitioner, 1973;1(1):19.

Matched MeSH terms: Cholera Vaccines
Fulltext Commentary: Strategies to Address COVID-19 Vaccine Hesitancy and Mitigate Health Disparities in Minority Populations

Teo J

Front Public Health, 2021;9:723583.
PMID: 34395375 DOI: 10.3389/fpubh.2021.723583
Matched MeSH terms: Vaccines*
Fulltext Preferences and willingness of accepting COVID-19 vaccine booster: Results from a middle-income country

Chang CT, Lim XJ, Chew CC, Rajan P, Chan HK, Abu Hassan MR, et al.

Vaccine, 2022 Dec 12;40(52):7515-7519.
PMID: 36371369 DOI: 10.1016/j.vaccine.2022.10.057

The recent wave of COVID-19 cases has led to the potential need for booster doses. We surveyed 6,294 people and found that 87.6% reported willingness to take a booster dose, with vaccine efficacy rate being the most common reason cited to accept booster dose. Differences in acceptance rates were noted among those working in non-health related sectors, different ethnic groups as well as those who had taken viral vector vaccines.

Matched MeSH terms: Viral Vaccines*
Fulltext The COVID-19 vaccine patent: a right without rationale

Althabhawi NM, Kashef Al-Ghetaa AA

Med Humanit, 2023 Mar;49(1):128-133.
PMID: 35523578 DOI: 10.1136/medhum-2022-012386

Since the approval of COVID-19 vaccines, international efforts have intensified on vaccination schemes perceived as the only light at the end of the tunnel. Governments are working tirelessly to scale up the number of vaccinated people, just as vaccine manufacturers are stretching their facilities to meet the increasing demand for doses. The international community is trying to help the poorest countries in the world by improving vaccine supplies and removing obstacles. In this regard, India and South Africa have applied to World Trade Organisation to waive vaccine-related intellectual property rights. The proposal has sparked off academic debates as to its merit. This article addresses the waiver controversy. Following a critical review of both dimensions of the controversy, the article concentrates on the extent to which the waiver application contradicts the theoretical justification of the patent system. It concludes that the concerns raised over the conflict between the waiver proposal and the patent right philosophy are indefensible.

Matched MeSH terms: Vaccines*
Fulltext The development of DNA vaccines against SARS-CoV-2

Khalid K, Poh CL

Adv Med Sci, 2023 Sep;68(2):213-226.
PMID: 37364379 DOI: 10.1016/j.advms.2023.05.003

BACKGROUND: The COVID-19 pandemic exerted significant impacts on public health and global economy. Research efforts to develop vaccines at warp speed against SARS-CoV-2 led to novel mRNA, viral vectored, and inactivated vaccines being administered. The current COVID-19 vaccines incorporate the full S protein of the SARS-CoV-2 Wuhan strain but rapidly emerging variants of concern (VOCs) have led to significant reductions in protective efficacies. There is an urgent need to develop next-generation vaccines which could effectively prevent COVID-19.
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.

Matched MeSH terms: Vaccines, DNA*
Fulltext FDA approved vaccines for monkeypox: Current eminence

Chopra H, Dhawan M, Bibi S, Baig AA, Kushwah AS, Kaur M, et al.

Int J Surg, 2022 Sep;105:106896.
PMID: 36089263 DOI: 10.1016/j.ijsu.2022.106896
Matched MeSH terms: Vaccines*
Fulltext Emergence of mRNA vaccines in the management of cancer

Mohamad Razif MI, Nizar N, Zainal Abidin NH, Muhammad Ali SN, Wan Zarimi WNN, Khotib J, et al.

Expert Rev Vaccines, 2023;22(1):629-642.
PMID: 37401128 DOI: 10.1080/14760584.2023.2232450

INTRODUCTION: mRNA vaccines have been developed as a promising cancer management. It is noted that specification of the antigen sequence of the target antigen is necessary for the design and manufacture of an mRNA vaccine.
AREAS COVERED: The steps involved in preparing the mRNA-based cancer vaccines are isolation of the mRNA cancer from the target protein using the nucleic acid RNA-based vaccine, sequence construction to prepare the DNA template, in vitro transcription for protein translation from DNA into mRNA strand, 5' cap addition and poly(A) tailing to stabilize and protect the mRNA from degradation and purification process to remove contaminants produced during preparation.
EXPERT OPINION: Lipid nanoparticles, lipid/protamine/mRNA nanoparticles, and cell-penetrating peptides have been used to formulate mRNA vaccine and to ensure vaccine stability and delivery to the target site. Delivery of the vaccine to the target site will trigger adaptive and innate immune responses. Two predominant factors of the development of mRNA-based cancer vaccines are intrinsic influence and external influence. In addition, research relating to the dosage, route of administration, and cancer antigen types have been observed to positively impact the development of mRNA vaccine.

Matched MeSH terms: Vaccines*; Cancer Vaccines*
Fulltext Social expectations and government incentives in Malaysia's COVID-19 vaccine uptake

Abdul Aziz NI, Flanders S, Nungsari M

PLoS One, 2022;17(9):e0275010.
PMID: 36156604 DOI: 10.1371/journal.pone.0275010

High vaccination rates are integral to reducing infection and severity rates of COVID-19 infections within a community. We examine the role of social expectations in COVID-19 vaccination take-ups and its interaction with potential government actions in Malaysia. We find that individuals' expectations of others in their social groups towards vaccination predicts those individuals' vaccination registrations. Using a vignette experiment, we examine the extent of normative expectations in normalizing pro-vaccination behavior beyond an individual's reference group. We find that unless moderated by a high level of public trust, individuals prefer punitive policies as a way to increase vaccination rates in their communities.

Matched MeSH terms: Influenza Vaccines*; AIDS Vaccines*; SAIDS Vaccines*; Respiratory Syncytial Virus Vaccines*; Papillomavirus Vaccines*
Approaches towards the development of a vaccine against tuberculosis: recombinant BCG and DNA vaccine

Mohd Nor N, Musa M

Tuberculosis (Edinb), 2004;84(1-2):102-9.
PMID: 14670351 DOI: 10.1016/j.tube.2003.08.011

The last few years have witnessed intense research on vaccine development against tuberculosis. This has been driven by the upsurge of tuberculosis cases globally, especially those caused by multi-drug-resistant Mycobacterium tuberculosis strains. Various vaccine strategies are currently being developed which can be broadly divided into the so-called living and non-living vaccines. Examples are attenuated members of the M. tuberculosis complex, recombinant mycobacteria, subunit proteins and DNA vaccines. Given current developments, we anticipate that recombinant BCG and DNA vaccines are the most promising. Multiple epitopes of M. tuberculosis may need to be cloned in a vaccine construct for the desired efficacy to be achieved. The technique of assembly polymerase chain reaction could facilitate such a cloning procedure.

Matched MeSH terms: Vaccines, Synthetic; Vaccines, DNA; Tuberculosis Vaccines*
[Rabies control in Malaya: compulsory vaccination combined with legal provisions for enforced use of control measures]

WELLS CW

Bol Oficina Sanit Panam, 1954 Oct;37(4):395-406.
PMID: 13230218
Matched MeSH terms: Rabies Vaccines*; Vaccines*
DNA vaccines

Subramaniam G

JUMMEC, 1998;3:18-21.

Matched MeSH terms: Vaccines
Application of Reverse Vaccinology and Immunoinformatic Strategies for the Identification of Vaccine Candidates Against Shigella flexneri

Leow CY, Chuah C, Abdul Majeed AB, Mohd Nor N, Leow CH

Methods Mol Biol, 2022;2414:17-35.
PMID: 34784029 DOI: 10.1007/978-1-0716-1900-1_2

Reverse vaccinology (RV) was first introduced by Rappuoli for the development of an effective vaccine against serogroup B Neisseria meningitidis (MenB). With the advances in next generation sequencing technologies, the amount of genomic data has risen exponentially. Since then, the RV approach has widely been used to discover potential vaccine protein targets by screening whole genome sequences of pathogens using a combination of sophisticated computational algorithms and bioinformatic tools. In contrast to conventional vaccine development strategies, RV offers a novel method to facilitate rapid vaccine design and reduces reliance on the traditional, relatively tedious, and labor-intensive approach based on Pasteur"s principles of isolating, inactivating, and injecting the causative agent of an infectious disease. Advances in biocomputational techniques have remarkably increased the significance for the rapid identification of the proteins that are secreted or expressed on the surface of pathogens. Immunogenic proteins which are able to induce the immune response in the hosts can be predicted based on the immune epitopes present within the protein sequence. To date, RV has successfully been applied to develop vaccines against a variety of infectious pathogens. In this chapter, we apply a pipeline of bioinformatic programs for identification of Shigella flexneri potential vaccine candidates as an illustration immunoinformatic tools available for RV.

Matched MeSH terms: Bacterial Vaccines
Fulltext Development of Peptide Vaccines in Dengue

Reginald K, Chan Y, Plebanski M, Poh CL

Curr Pharm Des, 2018;24(11):1157-1173.
PMID: 28914200 DOI: 10.2174/1381612823666170913163904

Dengue is one of the most important arboviral infections worldwide, infecting up to 390 million people and causing 25,000 deaths annually. Although a licensed dengue vaccine is available, it is not efficacious against dengue serotypes that infect people living in South East Asia, where dengue is an endemic disease. Hence, there is an urgent need to develop an efficient dengue vaccine for this region. Data from different clinical trials indicate that a successful dengue vaccine must elicit both neutralizing antibodies and cell mediated immunity. This can be achieved by designing a multi-epitope peptide vaccine comprising B, CD8+ and CD4+ T cell epitopes. As recognition of T cell epitopes are restricted by human leukocyte antigens (HLA), T cell epitopes which are able to recognize several major HLAs will be preferentially included in the vaccine design. While peptide vaccines are safe, biocompatible and cost-effective, it is poorly immunogenic. Strategies to improve its immunogenicity by the use of long peptides, adjuvants and nanoparticle delivery mechanisms are discussed.

Matched MeSH terms: Vaccines, Subunit/immunology*; Dengue Vaccines/immunology*
Fulltext Live virus vaccines based on a yellow fever vaccine backbone: standardized template with key considerations for a risk/benefit assessment

Monath TP, Seligman SJ, Robertson JS, Guy B, Hayes EB, Condit RC, et al.

Vaccine, 2015 Jan 01;33(1):62-72.
PMID: 25446819 DOI: 10.1016/j.vaccine.2014.10.004

The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to evaluate the safety of live, recombinant viral vaccines incorporating genes from heterologous viruses inserted into the backbone of another virus (so-called "chimeric virus vaccines"). Many viral vector vaccines are in advanced clinical trials. The first such vaccine to be approved for marketing (to date in Australia, Thailand, Malaysia, and the Philippines) is a vaccine against the flavivirus, Japanese encephalitis (JE), which employs a licensed vaccine (yellow fever 17D) as a vector. In this vaccine, two envelope proteins (prM-E) of YF 17D virus were exchanged for the corresponding genes of JE virus, with additional attenuating mutations incorporated into the JE gene inserts. Similar vaccines have been constructed by inserting prM-E genes of dengue and West Nile into YF 17D virus and are in late stage clinical studies. The dengue vaccine is, however, more complex in that it requires a mixture of four live vectors each expressing one of the four dengue serotypes. This vaccine has been evaluated in multiple clinical trials. No significant safety concerns have been found. The Phase 3 trials met their endpoints in terms of overall reduction of confirmed dengue fever, and, most importantly a significant reduction in severe dengue and hospitalization due to dengue. However, based on results that have been published so far, efficacy in preventing serotype 2 infection is less than that for the other three serotypes. In the development of these chimeric vaccines, an important series of comparative studies of safety and efficacy were made using the parental YF 17D vaccine virus as a benchmark. In this paper, we use a standardized template describing the key characteristics of the novel flavivirus vaccine vectors, in comparison to the parental YF 17D vaccine. The template facilitates scientific discourse among key stakeholders by increasing the transparency and comparability of information. The Brighton Collaboration V3SWG template may also be useful as a guide to the evaluation of other recombinant viral vector vaccines.

Matched MeSH terms: Vaccines, Attenuated/adverse effects; Vaccines, Attenuated/genetics; Vaccines, Synthetic/adverse effects; Vaccines, Synthetic/genetics; Viral Vaccines/adverse effects*; Viral Vaccines/genetics*
Fulltext Advances & challenges in leptospiral vaccine development

Bashiru G, Bahaman AR

Indian J Med Res, 2018 Jan;147(1):15-22.
PMID: 29749356 DOI: 10.4103/ijmr.IJMR_1022_16

Considerable progress has been made in the field of leptospiral vaccines development since its first use as a killed vaccine in guinea pigs. Despite the fact that the immunity conferred is restricted to serovars with closely related lipopolysaccharide antigen, certain vaccines have remained useful, especially in endemic regions, for the protection of high-risk individuals. Other conventional vaccines such as the live-attenuated vaccine and lipopolysaccharide (LPS) vaccine have not gained popularity due to the reactive response that follows their administration and the lack of understanding of the pathogenesis of leptospirosis. With the recent breakthrough and availability of complete genome sequences of Leptospira, development of novel vaccine including recombinant protein vaccine using reverse vaccinology approaches has yielded encouraging results. However, factors hindering the development of effective leptospiral vaccines include variation in serovar distribution from region to region, establishment of renal carrier status following vaccination and determination of the dose and endpoint titres acceptable as definitive indicators of protective immunity. In this review, advancements and progress made in LPS-based vaccines, killed- and live-attenuated vaccines, recombinant peptide vaccines and DNA vaccines against leptospirosis are highlighted.

Matched MeSH terms: Vaccines, Attenuated; Vaccines, Inactivated; Vaccines, DNA; Vaccines, Subunit
Fulltext Development of virus-like particles-based vaccines against coronaviruses

Yong CY, Liew WPP, Ong HK, Poh CL

Biotechnol Prog, 2022 Nov;38(6):e3292.
PMID: 35932092 DOI: 10.1002/btpr.3292

Severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are the most impactful coronaviruses in human history, especially the latter, which brings revolutionary changes to human vaccinology. Due to its high infectivity, the virus spreads rapidly throughout the world and was declared a pandemic in March 2020. A vaccine would normally take more than 10 years to be developed. As such, there is no vaccine available for SARS-CoV and MERS-CoV. Currently, 10 vaccines have been approved for emergency use by World Health Organization (WHO) against SARS-CoV-2. Virus-like particle (VLP)s are nanoparticles resembling the native virus but devoid of the viral genome. Due to their self-adjuvanting properties, VLPs have been explored extensively for vaccine development. However, none of the approved vaccines against SARS-CoV-2 was based on VLP and only 4% of the vaccine candidates in clinical trials were based on VLPs. In the current review, we focused on discussing the major advances in the development of VLP-based vaccine candidates against the SARS-CoV, MERS-CoV, and SARS-CoV-2, including those in clinical and pre-clinical studies, to give a comprehensive overview of the VLP-based vaccines against the coronaviruses.

Matched MeSH terms: Viral Vaccines*; Vaccines, Virus-Like Particle*
Immunogenicity and safety of low dose virosomal adjuvanted influenza vaccine administered intradermally compared to intramuscular full dose administration

Künzi V, Klap JM, Seiberling MK, Herzog C, Hartmann K, Kürsteiner O, et al.

Vaccine, 2009 Jun 2;27(27):3561-7.
PMID: 19464535 DOI: 10.1016/j.vaccine.2009.03.062

Despite the established benefit of intramuscular (i.m.) influenza vaccination, new adjuvants and delivery methods for comparable or improved immunogenicity are being explored. Intradermal (i.d.) antigen administration is hypothesized to initiate an efficient immune response at reduced antigen doses similar to that observed after i.m. full dose vaccination.

Matched MeSH terms: Influenza Vaccines/administration & dosage; Influenza Vaccines/adverse effects; Influenza Vaccines/immunology*; Vaccines, Virosome/administration & dosage; Vaccines, Virosome/adverse effects; Vaccines, Virosome/immunology*

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