SARS-CoV-2 mRNA vaccines induce persistent human germinal centre responses
Nature (June 28, 2021)
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA)-based vaccines are ~95% effective in preventing coronavirus disease 20191–5. The dynamics of antibody secreting plasmablasts (PBs) and germinal centre (GC) B cells induced by these vaccines in humans remain unclear. We examined antigen-specific B cell responses in peripheral blood (n=41) and draining lymph nodes (LNs) in 14 individuals who received two doses of BNT162b2, an mRNA-based vaccine encoding full-length SARS-CoV-2 spike (S) gene1 … Our studies demonstrate that SARS-CoV-2 mRNA-based vaccination of humans induces a persistent GC B cell response, enabling the generation of robust humoral immunity.
Safety and Immunogenicity Report from the Com-COV Study – a Single-Blind Randomised Non-Inferiority Trial Comparing Heterologous And Homologous Prime-Boost Schedules with An Adenoviral Vectored and mRNA COVID-19 Vaccine
The Lancet (June 25, 2021)
se of heterologous prime-boost COVID-19 vaccine schedules could facilitate mass COVID-19 immunisation, however we have previously reported that heterologous schedules incorporating an adenoviral-vectored vaccine (ChAd, Vaxzevria, Astrazeneca) and an mRNA vaccine (BNT, Comirnaty, Pfizer) at a 4-week interval are more reactogenic than homologous schedules. Here we report the immunogenicity of these schedules. … Despite the BNT/ChAd regimen not meeting non-inferiority criteria, the GMCs of both heterologous schedules were higher than that of a licensed vaccine schedule (ChAd/ChAd) with proven efficacy against COVID-19 disease and hospitalisation. These data support flexibility in the use of heterologous prime-boost vaccination using ChAd and BNT COVID-19 vaccines.
Community-level evidence for SARS-CoV-2 vaccine protection of unvaccinated individuals
Nature Medicine (June 10, 2021)
By analyzing vaccination records and test results collected during the rapid vaccine rollout in a large population from 177 geographically defined communities, we find that the rates of vaccination in each community are associated with a substantial later decline in infections among a cohort of individuals aged under 16 years, who are unvaccinated. On average, for each 20 percentage points of individuals who are vaccinated in a given population, the positive test fraction for the unvaccinated population decreased approximately twofold. These results provide observational evidence that vaccination not only protects individuals who have been vaccinated but also provides cross-protection to unvaccinated individuals in the community.
An effective rollout of vaccinations against COVID-19 offers the most promising prospect of bringing the pandemic to an end. We present the Our World in Data COVID-19 vaccination dataset, a global public dataset that tracks the scale and rate of the vaccine rollout across the world. This dataset is updated regularly and includes data on the total number of vaccinations administered, first and second doses administered, daily vaccination rates and population-adjusted coverage for all countries for which data are available (169 countries as of 7 April 2021). It will be maintained as the global vaccination campaign continues to progress. This resource aids policymakers and researchers in understanding the rate of current and potential vaccine rollout; the interactions with non-vaccination policy responses; the potential impact of vaccinations on pandemic outcomes such as transmission, morbidity and mortality; and global inequalities in vaccine access.
Prioritising COVID-19 vaccination in changing social and epidemiological landscapes: a mathematical modelling study
The Lancet (March 21, 2021)
During the COVID-19 pandemic, authorities must decide which groups to prioritise for vaccination in a shifting social–epidemiological landscape in which the success of large-scale non-pharmaceutical interventions requires broad social acceptance. We aimed to compare projected COVID-19 mortality under four different strategies for the prioritisation of SARS-CoV-2 vaccines
Vaccination and non-pharmaceutical interventions for COVID-19: a mathematical modelling study
The Lancet (March 18, 2021)
The dynamics of vaccination against SARS-CoV-2 are complicated by age-dependent factors, changing levels of infection, and the relaxation of non-pharmaceutical interventions (NPIs) as the perceived risk declines, necessitating the use of mathematical models. Our aims were to use epidemiological data from the UK together with estimates of vaccine efficacy to predict the possible long-term dynamics of SARS-CoV-2 under the planned vaccine rollout.
About COVID-19 Epidemiology
CDC
When a new infectious disease is discovered, scientists called epidemiologists work with other scientists to find who has it, why they have it, and what CDC can do about it. From the beginning of the COVID-19 outbreak, scientists at CDC and around the world have been working to identify the source of the outbreak, monitor and track the disease, study the disease, and develop guidance for actions to slow the spread of the disease and lessen its impact.
Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study
The Lancet (September 1, 2021)
COVID-19 vaccines show excellent efficacy in clinical trials and effectiveness in real-world data, but some people still become infected with SARS-CoV-2 after vaccination. This study aimed to identify risk factors for post-vaccination SARS-CoV-2 infection and describe the characteristics of post-vaccination illness … Vaccination (compared with no vaccination) was associated with reduced odds of hospitalisation or having more than five symptoms in the first week of illness following the first or second dose, and long-duration (≥28 days) symptoms following the second dose. Almost all symptoms were reported less frequently in infected vaccinated individuals than in infected unvaccinated individuals, and vaccinated participants were more likely to be completely asymptomatic, especially if they were 60 years or older.
Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant
New England Journal of Medicine (August 12, 2021)
Only modest differences in vaccine effectiveness were noted with the delta variant as compared with the alpha variant after the receipt of two vaccine doses. Absolute differences in vaccine effectiveness were more marked after the receipt of the first dose. This finding would support efforts to maximize vaccine uptake with two doses among vulnerable populations
Mixed AstraZeneca-Pfizer shot boosts COVID antibody level – study
Reuters Health (July 26, 2021)
A mixed vaccination of first AstraZeneca (AZN.L) and then a Pfizer (PFE.N) COVID-19 shot boosted neutralizing antibody levels by six times compared with two AstraZeneca doses, a study from South Korea showed. The study involved 499 medical workers – 100 receiving mixed doses, 200 taking two doses of the Pfizer/BioNTech (22UAy.DE) shot and the remainder getting two AstraZeneca shots. All showed neutralizing antibodies, which prevent the virus from entering cells and replicating, and the result of the mixed schedule of vaccines showed similar amounts of neutralizing antibodies found from the group that received two Pfizer shots.
Prevention and Attenuation of Covid-19 with the BNT162b2 and mRNA-1273 Vaccines
New England Journal of Medicine (July 22, 2021)
We conducted a prospective cohort study involving 3975 health care personnel, first responders, and other essential and frontline workers. From December 14, 2020, to April 10, 2021, the participants completed weekly SARS-CoV-2 testing by providing mid-turbinate nasal swabs for qualitative and quantitative reverse-transcriptase–polymerase-chain-reaction (RT-PCR) analysis…Authorized mRNA vaccines were highly effective among working-age adults in preventing SARS-CoV-2 infection when administered in real-world conditions, and the vaccines attenuated the viral RNA load, risk of febrile symptoms, and duration of illness among those who had breakthrough infection despite vaccination.
SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness
The Lancet (June 14, 2021)
n summary, we show that the Delta VOC in Scotland was found mainly in younger, more affluent groups. Risk of COVID-19 hospital admission was approximately doubled in those with the Delta VOC when compared to the Alpha VOC, with risk of admission particularly increased in those with five or more relevant comorbidities. Both the Oxford–AstraZeneca and Pfizer–BioNTech COVID-19 vaccines were effective in reducing the risk of SARS-CoV-2 infection and COVID-19 hospitalisation in people with the Delta VOC, but these effects on infection appeared to be diminished when compared to those with the Alpha VOC.
Impact of vaccination on new SARS-CoV-2 infections in the United Kingdom
Nature Medicine (June 9, 2021)
Here, we used the Office for National Statistics COVID-19 Infection Survey—a large community-based survey of individuals living in randomly selected private households across the United Kingdom—to assess the effectiveness of the BNT162b2 (Pfizer–BioNTech) and ChAdOx1 nCoV-19 (Oxford–AstraZeneca; ChAdOx1) vaccines against any new SARS-CoV-2 PCR-positive tests … Overall, COVID-19 vaccination reduced the number of new SARS-CoV-2 infections, with the largest benefit received after two vaccinations and against symptomatic and high viral burden infections, and with no evidence of a difference between the BNT162b2 and ChAdOx1 vaccines.
Safety, Immunogenicity, and Efficacy of the BNT162b2 Covid-19 Vaccine in Adolescents
New England Journal of Medicine (May 27, 2021)
In this ongoing multinational, placebo-controlled, observer-blinded trial, we randomly assigned participants in a 1:1 ratio to receive two injections, 21 days apart, of 30 μg of BNT162b2 or placebo. Noninferiority of the immune response to BNT162b2 in 12-to-15-year-old participants as compared with that in 16-to-25-year-old participants was an immunogenicity objective. Safety (reactogenicity and adverse events) and efficacy against confirmed coronavirus disease 2019 (Covid-19; onset, ≥7 days after dose 2) in the 12-to-15-year-old cohort were assessed.
The BNT162b2 vaccine in 12-to-15-year-old recipients had a favorable safety profile, produced a greater immune response than in young adults, and was highly effective against Covid-19.
Vaccines highly effective against B.1.617.2 variant after 2 doses
Public Health England (May 22, 2021)
New study by PHE shows for the first time that 2 doses of the COVID-19 vaccines are highly effective against the B.1.617.2 variant first identified in India.
A Real-World Look at COVID-19 Vaccines Versus New Variants
NIH (May 4, 2021)
New data from Israel offers an early look at how the Pfizer/BioNTech vaccine is holding up in the real world against coronavirus “variants of concern,” including the B.1.1.7 “U.K. variant” and the B.1.351 “South African variant.” And, while there is some evidence of breakthrough infections, the findings overall are encouraging.
Prior SARS-CoV-2 infection rescues B and T cell responses to variants after first vaccine dose
Science (April 30, 2021)
SARS-CoV-2 vaccine rollout has coincided with the spread of variants of concern. We investigated if single dose vaccination, with or without prior infection, confers cross protective immunity to variants. We analyzed T and B cell responses after first dose vaccination with the Pfizer/BioNTech mRNA vaccine BNT162b2 in healthcare workers (HCW) followed longitudinally, with or without prior Wuhan-Hu-1 SARS-CoV-2 infection. Single dose vaccination with BNT162b2 in the context of prior infection with a heterologous variant substantially enhances neutralizing antibody responses against variants.
Single Vaccination with BNT162b2 or ChAdOx1 in Older People Induces Equivalent Antibody Generation but Enhanced Cellular Responses after ChAdOx1
The Lancet (April 13, 2021)
Single doses of either the BNT162b2 or ChAdOx1vaccine in older people induce humoral immunity in most donors and are markedly enhanced by previous infection. Cellular responses are weaker but show relative enhancement after the ChAdOx1 platform.
Durability of immunity to SARS-CoV-2 and other respiratory viruses
Trends in Microbiology (April 7, 2021)
Even in non-pandemic times, respiratory viruses account for a vast global burden of disease. They remain a major cause of illness and death and pose a perpetual threat of breaking out into epidemics and pandemics. Many of these respiratory viruses infect repeatedly and appear to induce only narrow transient immunity, but the situation varies from one virus to another. In the absence of effective specific treatments, understanding the role of immunity in protection, disease and resolution is of paramount importance. These problems have been brought into sharp focus by the coronavirus COVID-19 pandemic. Here, we summarise what is now known about adaptive immunity to SARS-CoV-2 and draw comparisons with immunity to other respiratory viruses, focusing on the longevity of protective responses.
Dynamics of SARS-CoV-2 neutralising antibody responses and duration of immunity: a longitudinal study
The Lancet (March 23, 2021)
Neutralising antibody response dynamics in patients who have recovered from COVID-19 vary greatly, and prediction of immune longevity can only be accurately determined at the individual level. Our findings emphasise the importance of public health and social measures in the ongoing pandemic outbreak response, and might have implications for longevity of immunity after vaccination.
Early Evidence of the Effect of SARS-CoV-2 Vaccine at One Medical Center
New England Journal of Medicine (March 23, 2021)
Here, we report data from the University of Texas Southwestern Medical Center (UTSW), which initiated a program on December 15, 2020, to offer a vaccine against SARS-CoV-2 to its frontline employees in phase 1a of vaccination, as directed by the Texas Department of State Health Services. The effect of vaccination on the preservation of our workforce has been dramatic. We observed a greater than 90% decrease in the number of employees who are either in isolation or quarantine. Real-world experience with SARS-CoV-2 vaccination at UTSW has shown a marked reduction in the incidence of infections among employees. This decrease has preserved the workforce when it was most needed.
Real-World Evidence Confirms High Effectiveness of Pfizer-BioNTech COVID-19 Vaccine
Pfizer (March 11, 2021)
The Israel Ministry of Health (MoH), Pfizer Inc. (NYSE: PFE) and BioNTech SE (Nasdaq: BNTX) announced real-world evidence demonstrating dramatically lower incidence rates of COVID-19 disease in individuals fully vaccinated with the Pfizer-BioNTech COVID-19 Vaccine (BNT162b2), underscoring the observed substantial public health impact of Israel’s nationwide immunization program. These new data build upon and confirm previously released data from the MoH demonstrating the vaccine’s effectiveness in preventing symptomatic SARS-CoV-2 infections, COVID-19 cases, hospitalizations, severe and critical hospitalizations, and deaths.
Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine
New England Journal of Medicine (February 4, 2021)
The trial enrolled 30,420 volunteers who were randomly assigned in a 1:1 ratio to receive either vaccine or placebo (15,210 participants in each group). More than 96% of participants received both injections, and 2.2% had evidence (serologic, virologic, or both) of SARS-CoV-2 infection at baseline. Symptomatic Covid-19 illness was confirmed in 185 participants in the placebo group (56.5 per 1000 person-years; 95% confidence interval [CI], 48.7 to 65.3) and in 11 participants in the mRNA-1273 group (3.3 per 1000 person-years; 95% CI, 1.7 to 6.0); vaccine efficacy was 94.1% (95% CI, 89.3 to 96.8%; P<0.001). Efficacy was similar across key secondary analyses, including assessment 14 days after the first dose, analyses that included participants who had evidence of SARS-CoV-2 infection at baseline, and analyses in participants 65 years of age or older. Severe Covid-19 occurred in 30 participants, with one fatality; all 30 were in the placebo group. Moderate, transient reactogenicity after vaccination occurred more frequently in the mRNA-1273 group. Serious adverse events were rare, and the incidence was similar in the two groups.
Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine
New England Journal of Medicine (December 31, 2020)
A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups.
Understanding the Spectrum of Vaccine Efficacy Measures
BMJ
Phase III covid-19 vaccine efficacy trials have returned encouraging results, exceeding the 50% efficacy threshold specified by the World Health Organization (WHO) and the Food and Drug Administration (FDA). Multiple vaccines are now available for use. These phase III trials address the central question of a vaccine’s effect on a meaningful clinical outcome. In nearly all of the trials, the primary aim is to measure efficacy against laboratory confirmed symptomatic disease, including mild symptoms. But this is not the only endpoint that policy makers and individuals care about when making decisions. In fact, we can think about it as one measure of vaccine efficacy that lies alongside others on a spectrum.
Anxiety-Related Adverse Event Clusters After Janssen COVID-19 Vaccination
CDC (May 7, 2021)
Five mass vaccination sites reported 64 anxiety-related events, including 17 events of syncope (fainting) after receipt of Janssen COVID-19 vaccine. The reporting rates of syncope to VAERS after Janssen COVID-19 and influenza vaccines (2019–20) were 8.2 and 0.05 per 100,000 doses, respectively. Vaccine providers should be aware of anxiety-related events after vaccination and observe all COVID-19 vaccine recipients for any adverse reactions for at least 15 minutes after vaccine administration.
Diagnosis and Management of Cerebral Venous Sinus Thrombosis with Vaccine-Induced Thrombotic Thrombocytopenia
American Heart Association/American Stroke Association Stroke Council Leadership (April 29, 2021)
While awaiting further information on the causal nature of the relationships of vaccines to CVST with thrombocytopenia, clinicians should be aware of the symptoms to facilitate recognition of potential cases of CVST in patients receiving these vaccinations. The goal of this report is to heighten awareness of the apparent association between adenovirus SARS-CoV2 vaccinations and CVST with vaccine-induced immune thrombotic thrombocytopenia (VITT) and suggest approaches to management.
Acute Allergic Reactions to mRNA COVID-19 Vaccines
JAMA (March 8, 2021)
Anaphylaxis to the mRNA COVID-19 vaccines is currently estimated to occur in 2.5 to 11.1 cases per million doses, largely in individuals with a history of allergy.1 Allergic concerns contribute to vaccine hesitancy; we investigated acute allergic reaction incidence after more than 60 000 mRNA COVID-19 vaccine administrations.
Thrombocytopenia following Pfizer and Moderna SARS‐CoV‐2 vaccination
American Journal of Hematology (February 19, 2021)
Cases of apparent secondary immune thrombocytopenia (ITP) after SARS‐CoV‐2 vaccination with both the Pfizer and Moderna versions have been reported and reached public attention. Public alarm was heightened following the death of the first identified patient from an intracranial hemorrhage, which was reported on the Internet, then in USA Today and then in The New York Times. We have collected a series of cases of very low platelet counts occurring within 2 weeks of vaccination in order to enhance our understanding of the possible relationship, if any, between SARS‐CoV‐2 vaccination and development of ITP with implications for surveillance and management.
Reports of Anaphylaxis After Receipt of mRNA COVID-19 Vaccines in the US—December 14, 2020-January 18, 2021
JAMA (February 12, 2021)
During December 14, 2020 through January 18, 2021, a total of 9 943 247 doses of the Pfizer-BioNTech vaccine and 7 581 429 doses of the Moderna vaccine were reported administered in the US (CDC unpublished data, February 2021). CDC identified 66 case reports received by VAERS that met Brighton Collaboration case definition criteria for anaphylaxis (levels 1, 2 or 3): 47 following Pfizer-BioNTech vaccine, for a reporting rate of 4.7 cases/million doses administered, and 19 following Moderna vaccine, for a reporting rate of 2.5 cases/million doses administered. Cases occurred after receipt of doses from multiple vaccine lots.
Anaphylaxis after COVID-19 vaccination
CDC
Anaphylaxis after COVID-19 vaccination is rare. If this occurs, vaccination providers can effectively and immediately treat the reaction. CDC and FDA scientists have evaluated reports from people who experienced a type of severe allergic reaction—anaphylaxis—after getting a COVID-19 vaccine. Anaphylaxis after COVID-19 vaccination is rare and occurred in approximately 2 to 5 people per million vaccinated in the United States based on events reported to VAERS. This kind of allergic reaction almost always occurs within 30 minutes after vaccination. Fortunately, vaccination providers have medicines available to effectively and immediately treat patients who experience anaphylaxis following vaccination.
Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19–Associated Hospitalization in Infants Aged <6 Months — 17 States, July 2021–January 2022
CDC (February 18, 2022)
Completion of a 2-dose mRNA COVID-19 vaccination series during pregnancy might help prevent COVID-19 hospitalization among infants aged <6 months. Effectiveness of maternal completion of a 2-dose primary mRNA COVID-19 vaccination series during pregnancy against COVID-19 hospitalization among infants aged <6 months was 61% (95% CI = 31% to 78%). Effectiveness of completion of the primary COVID-19 vaccine series early and later in pregnancy was 32% (95% CI = –43% to 68%) and 80% (95% CI = 55% to 91%), respectively.
Association of Psychiatric Disorders With Mortality Among Patients With COVID-19
JAMA Psychiatry (January 27, 2021)
In this cohort study of adults with SARS-CoV-2–positive test results in a large New York medical system, adults with a schizophrenia spectrum disorder diagnosis were associated with an increased risk for mortality, but those with mood and anxiety disorders were not associated with a risk of mortality. These results suggest that schizophrenia spectrum disorders may be a risk factor for mortality in patients with COVID-19.
Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons
New England Journal of Medicine (April 21, 2021)
From December 14, 2020, to February 28, 2021, we used data from the “v-safe after vaccination health checker” surveillance system, the v-safe pregnancy registry, and the Vaccine Adverse Event Reporting System (VAERS) to characterize the initial safety of mRNA Covid-19 vaccines in pregnant persons.
Preliminary findings did not show obvious safety signals among pregnant persons who received mRNA Covid-19 vaccines. However, more longitudinal follow-up, including follow-up of large numbers of women vaccinated earlier in pregnancy, is necessary to inform maternal, pregnancy, and infant outcomes.
COVID-19 vaccine response in pregnant and lactating women: a cohort study
American Journal of Obstetrics and Gynecology (March 25, 2021)
COVID-19 mRNA vaccines generated robust humoral immunity in pregnant and lactating women, with immunogenicity and reactogenicity similar to that observed in non-pregnant women. Vaccine-induced immune responses were significantly greater than the response to natural infection. Immune transfer to neonates occurred via placenta and breastmilk.
Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors
The Lancet (April 1, 2021)
The data we present here provide, for the first time, a reassuring safety signal regarding the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors. Considering the high mortality due to COVID-19 in patients with cancer who are being treated, our data support current guidelines and call for vaccination of patients being treated with immune checkpoint inhibitors, especially during pandemic surges.
Immunogenicity of a Single Dose of SARS-CoV-2 Messenger RNA Vaccine in Solid Organ Transplant Recipients
JAMA (March 15, 2021)
Immunocompromised individuals have been excluded from studies of SARS-CoV-2 messenger RNA (mRNA) vaccines. In such patients, the immune response to vaccination may be blunted. To better understand the immunogenicity of mRNA vaccines in immunocompromised individuals, we quantified the humoral response to the first dose in solid organ transplant recipients.
Lottery-Based Incentive in Ohio and COVID-19 Vaccination Rates
JAMA (July 2, 2021)
Widespread vaccine administration is necessary to curb the COVID-19 pandemic. To overcome COVID-19 vaccine hesitancy, states have introduced various strategies to increase vaccine uptake. On May 12, 2021, the state of Ohio announced a lottery system to pay randomly selected vaccine recipients up to $1 million. After initial reports that vaccine uptake had subsequently increased in Ohio, other states adopted similar vaccine payment lotteries. However, the announcement of the Ohio vaccine lottery closely coincided with the US Food and Drug Administration expanding Emergency Use Authorization of the BNT162b2 (Pfizer-BioNTech) messenger RNA vaccine to adolescents aged 12 to 15 years on May 10, 2021.3 We assessed changes in COVID-19 vaccination rates before and after the Ohio vaccine lottery announcement compared with national rates to control for the expansion of vaccine indications to adolescents … The study did not find evidence that a lottery-based incentive in Ohio was associated with increased rates of adult COVID-19 vaccinations. In contrast, the analyses suggest that the rate of decline in vaccinations slowed to a greater extent in the US than in Ohio after the May 12 lottery announcement. The slower decline in vaccination rates among adults in the US may suggest that expansion of vaccine eligibility to adolescents also was associated with an increase in adult vaccinations. These results contrast with prior reports of increased vaccination uptake in Ohio, which did not account for the contemporaneous expansion in vaccine eligibility to adolescents.
Incentives for Immunity — Strategies for Increasing Covid-19 Vaccine Uptake
New England Journal of Medicine (May 26, 2021)
Given flagging vaccination rates and the societal imperative to end the pandemic, financial incentives hold appeal, especially if an incentive-based program were focused on groups with persistently low vaccination rates. Some people who are reluctant to be vaccinated might opt to get the vaccine “because of the incentive,” thereby overcoming inertia or resistance from their peer group.Even if incentives can produce a short-term bump in vaccination, however, multiple strategies will be necessary to increase population immunity.
We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor’s appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.
A Rapid Systematic Review of Public Responses to Health Messages Encouraging Vaccination against Infectious Diseases in a Pandemic or Epidemic
Vaccines (January 20, 2021)
Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available. A rapid systematic review was performed by searching PsycINFO, MEDLINE, healthevidence.org, OSF Preprints and PsyArXiv Preprints in May 2020 for studies including at least one health message promoting vaccine uptake of airborne-, droplet- and fomite-spread viruses … Evidence from moderate to high quality studies for improving vaccine uptake included providing information about virus risks and vaccination safety, as well as addressing vaccine misunderstandings, offering vaccination reminders, including vaccination clinic details, and delivering mixed media campaigns across hospitals or communities. Behavioural influences (beliefs and intentions) were improved when: shorter, risk-reducing or relative risk framing messages were used; the benefits of vaccination to society were emphasised; and beliefs about capability and concerns among target populations (e.g., vaccine safety) were addressed. Clear, credible, messages in a language target groups can understand were associated with higher acceptability.
