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      Efficacy, Safety, and Public Attitude toward COVID-19 Vaccines: A Systematic Review

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          Abstract

          Background:

          This paper reviews some of the literature on the safety and efficacy of different COVID-19 vaccines, the attitudes, and perceptions of people towards the vaccines, and the factor underlying such perceptions and behavior.

          Methods:

          Two major databases (PubMed and Epistemonikos) were checked using search expansion mechanisms and several search strings. After the title, abstract, and full-text analysis, 19 studies were selected for review.

          Results:

          The seven different vaccines studied all have supporting data on their efficacy in the reduction of COVID-19 cases, prevention of hospitalization after infection, and reduction in the mortality rate of COVID-19 patients. There was high hesitancy about the COVID-19 vaccine and the perceived efficacy and safety of the vaccines are less than recorded in clinical data. Distrust of the vaccines, their manufacturers and different institutions and governments, personal beliefs and feelings, age, gender, education, and socioeconomic status were identified factors affecting behaviors towards the COVID-19 vaccines.

          Conclusion:

          Several articles support the efficacy of COVID-19 vaccines, but general awareness and conception about them vary, including hesitancy, distrust, and some acceptance. Many factors affected the perception and attitude of people toward these vaccines. More clinical data on the efficacy and safety of COVID-19 vaccines should be generated to help boost confidence among users.

          Résumé

          Contexte:

          Cet article passe en revue une partie de la littérature sur l’innocuité et l’efficacité de différents vaccins COVID-19, les attitudes et les perceptions des personnes à l’égard des vaccins, ainsi que les facteurs sous-jacents et le facteur sous-jacent à ces perceptions et comportements.

          Méthode:

          Deux bases de données majeures (PubMed et Epistemonikos) ont été vérifiées à l’aide de mécanismes d’expansion de la recherche et de plusieurs chaînes de recherche. Après l’analyse du titre, du résumé et du texte intégral, 19 études ont été sélectionnées pour examen.

          Résultat:

          Les 7 vaccins différents étudiés ont tous des données à l’appui sur leur efficacité dans la réduction des cas de COVID-19, la prévention des hospitalisations après infection et la réduction du taux de mortalité des patients COVID-19. Il y avait une grande hésitation à propos du vaccin COVID-19 et l’efficacité et l’innocuité perçues des vaccins sont inférieures à celles enregistrées dans les données cliniques. La méfiance à l’égard des vaccins, de leurs fabricants et des différentes institutions et gouvernements, les croyances et sentiments personnels, l’âge, le sexe, l’éducation et le statut socio-économique ont été identifiés comme des facteurs affectant les comportements à l’égard des vaccins COVID-19.

          Conclusion:

          Plusieurs articles soutiennent l’efficacité des vaccins COVID-19, mais la sensibilisation et la conception générales à leur sujet varient, y compris l’hésitation, la méfiance et une certaine acceptation. De nombreux facteurs ont affecté la perception et l’attitude des gens envers ces vaccins. Plus de données cliniques sur l’efficacité et l’innocuité des vaccins COVID-19 devraient être générées pour aider à renforcer la confiance des utilisateurs.

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          Most cited references35

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          Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine

          Abstract Background Vaccines are needed to prevent coronavirus disease 2019 (Covid-19) and to protect persons who are at high risk for complications. The mRNA-1273 vaccine is a lipid nanoparticle–encapsulated mRNA-based vaccine that encodes the prefusion stabilized full-length spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19. Methods This phase 3 randomized, observer-blinded, placebo-controlled trial was conducted at 99 centers across the United States. Persons at high risk for SARS-CoV-2 infection or its complications were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo 28 days apart. The primary end point was prevention of Covid-19 illness with onset at least 14 days after the second injection in participants who had not previously been infected with SARS-CoV-2. Results 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. Conclusions The mRNA-1273 vaccine showed 94.1% efficacy at preventing Covid-19 illness, including severe disease. Aside from transient local and systemic reactions, no safety concerns were identified. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427.)
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            Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

            Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; p interaction =0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. Funding UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D’Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca.
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              [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China].

              (2020)
              Objective: An outbreak of 2019 novel coronavirus diseases (COVID-19) in Wuhan, China has spread quickly nationwide. Here, we report results of a descriptive, exploratory analysis of all cases diagnosed as of February 11, 2020. Methods: All COVID-19 cases reported through February 11, 2020 were extracted from China's Infectious Disease Information System. Analyses included: 1) summary of patient characteristics; 2) examination of age distributions and sex ratios; 3) calculation of case fatality and mortality rates; 4) geo-temporal analysis of viral spread; 5) epidemiological curve construction; and 6) subgroup analysis. Results: A total of 72 314 patient records-44 672 (61.8%) confirmed cases, 16 186 (22.4%) suspected cases, 10567 (14.6%) clinical diagnosed cases (Hubei only), and 889 asymptomatic cases (1.2%)-contributed data for the analysis. Among confirmed cases, most were aged 30-79 years (86.6%), diagnosed in Hubei (74.7%), and considered mild (80.9%). A total of 1 023 deaths occurred among confirmed cases for an overall case-fatality rate of 2.3%. The COVID-19 spread outward from Hubei sometime after December 2019 and by February 11, 2020, 1 386 counties across all 31 provinces were affected. The epidemic curve of onset of symptoms peaked in January 23-26, then began to decline leading up to February 11. A total of 1 716 health workers have become infected and 5 have died (0.3%). Conclusions: The COVID-19 epidemic has spread very quickly. It only took 30 days to expand from Hubei to the rest of Mainland China. With many people returning from a long holiday, China needs to prepare for the possible rebound of the epidemic.
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                Author and article information

                Journal
                Ann Afr Med
                Ann Afr Med
                AAM
                Ann Afr Med
                Annals of African Medicine
                Wolters Kluwer - Medknow (India )
                1596-3519
                0975-5764
                Oct-Dec 2023
                08 November 2023
                : 22
                : 4
                : 405-414
                Affiliations
                [1 ]Department of Nursing, Turks and Caicos Islands Community College, Grand Turk, Turks and Caicos Islands
                [2 ]Department of Research and Statistics, Institute of Nursing Research, Oshogbo, Nigeria
                [3 ]Windsor University School of Medicine, Brighton's Estate, Cayon. St. Kitts and Nevis, Leeds, United Kingdom
                [4 ]Freelance Financial Consultant, Basseterre, St. Kitts and Nevis, Leeds, United Kingdom
                [5 ]Adult Critical Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
                [6 ]Medical, Surgical, and Neuro Intensive Care Units, Scripps Hospital, San Diego, California, United States of America
                Author notes
                Address for correspondence: Mr. Blessing Osagumwendia Josiah, Department of Nursing, Turks and Caicos Islands Community College, Grand Turk, Turks and Caicos Islands. Department of Research and Statistics, Institute of Nursing Research, Oshogbo, Nigeria. E-mail: josiahblessing141@ 123456gmail.com
                Article
                AAM-22-405
                10.4103/aam.aam_13_23
                10775944
                19773da8-e685-493c-a7e2-19e0a13eb8b1
                Copyright: © 2023 Annals of African Medicine

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 30 January 2023
                : 28 April 2023
                : 02 May 2023
                Categories
                A Systematic Review

                attitude,covid-19,covid-19 vaccines,efficacy,safety,vaccins covid-19,efficacité,innocuité

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