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2 Global Vaccine Uptake During the COVID-19 Pandemic and the State of Vaccine Confidence
Pages 5-22

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From page 5...
... He discussed early warnings related to the COVID-19 pandemic, trends and factors contributing to vaccine hesitancy, and approaches for promoting acceptance of forthcoming COVID-19 vaccines. IMPACT OF THE COVID-19 PANDEMIC ON IMMUNIZATION SERVICES AND ACCESS Presented by Ann Lindstrand, World Health Organization Lindstrand described how the COVID-19 pandemic has disrupted immunization services and interrupted essential health services worldwide (see Box 2-1)
From page 6...
... counterparts submitting responses directly or with facilitation through WHO country offices.2 Survey data indicate that routine immunization, provided both via outreach and at fixed health facilities, are some of the most negatively affected 1  More information about the pulse survey on the continuity of essential health services during the COVID-19 pandemic is available at https://www.who.int/publications/i/item/WHO2019-nCoV-EHS_continuity-survey-2020.1 (accessed November 4, 2020)
From page 7...
... In 60 percent of 103 responding countries, routine immunization services provided at fixed health facilities have reported disruptions. All of the 25 essential health services included in the survey had countries reporting both partial and complete disruptions during the COVID-19 pandemic, with disruption rates ranging from 19 to 77 percent of responding countries.
From page 8...
... AMRO and the WHO Regional Office for the Western Pacific indicated the highest levels of lack of availability of health care workers because of employees being diverted for pandemic response. Immunization Demand Disruptions Lindstrand described a substantial decrease in reported demand of vaccination services, with 73 percent of the 62 responding nations indicating disruption in demand.
From page 9...
... reported efforts involving awareness building, community engagement, and social mobilization. Tactics to increase awareness include mass media (e.g., television, radio, newspaper)
From page 10...
... Lindstrand said the lack of PPE has made it especially difficult for parents and health care workers to participate in effective immunization services. Not only has the COVID-19 pandemic been affecting routine immunizations, it has also been causing disruptions in other ongoing health services around the world, said Lindstrand.
From page 11...
... Although countries were initially advised to temporarily suspend mass vaccination campaigns, WHO has backed away from this advice if the vaccine campaigns can be implemented safely. The guidance encourages maintaining ongoing routine immunization delivery with protection measures against COVID-19 in place.
From page 12...
... Omer, Yale Institute for Global Health Omer presented three warnings he issued at the outset of the COVID19 pandemic in the United States, and then he explored the state of global vaccine hesitancy. He presented data that showed how attempting to correct misinformation can backfire, and he introduced an approach to addressing vaccine hesitancy based on the Moral Foundations Theory.
From page 13...
... Preprints can be a useful tool when sharing nascent information in a rapidly evolving data landscape. However, Omer contended, when information has not gone through the critique and quality control measures involved in peer review, it can exacerbate the issue of premature data release muddling public understanding.
From page 14...
... . 9  More information about the Moral Foundations Theory is available at https://moral foundations.org (accessed November 8, 2020)
From page 15...
... . The Moral Foundations Theory identifies six "moral taste buds" that the authors of the theory call moral foundations (Haidt, 2012)
From page 16...
... Omer suggested approaching vaccine hesitancy by framing vaccination as a routine act and non-vaccination as an active decision, rather than the converse; the limitations to this approach could potentially be addressed with a focus on values.
From page 17...
... Omer closed by presenting an overview of the current evidence about effective strategies to address vaccine hesitancy (see Box 2-2)
From page 18...
... SOURCE: Omer presentation, August 17, 2020. DISCUSSION Addressing Vaccine Hesitancy Related to Development Speed Zahn asked Omer and Lindstrand about approaches to address fears and vaccine hesitancy that are specifically related to the speed at which the COVID-19 vaccines are being developed, tested, and approved.
From page 19...
... Lindstrand noted the lack of good instruments and procedures for reporting and follow-up; she was hopeful that the rapid development and implementation of the COVID19 vaccine would help to fast-track the implementation of data-collection systems as well. Accelerated Vaccination Schedules Zahn asked about evidence related to accelerated or catch-up vaccination schedules in which multiple vaccines may be administered simultaneously.
From page 20...
... Lindstrand noted that the Access to COVID-19 Tools Accelerator is a global collaborative effort to accelerate the development and production of COVID-19 diagnostics, therapeutics, and vaccines, and ensure equitable access to these products.14 One of the pillars of this effort is the logistics systems for delivering vaccines. The delivery and readiness work stream within the accelerator is a joint effort among UNICEF, WHO, and Gavi, she added.
From page 21...
... Remarking that "the ordinary often hampers the exceptional," Omer noted that the bottlenecks in COVID-19 testing in the United States were not due to polymerase chain reaction technology, equipment, or primers.17 Instead, the bottlenecks were caused by lengthy turnaround times, limited availability of tests, and delays in scaling up. To implement a mass vaccination campaign in early 2021, the United States should have started preparing in March 2020, he warned, which underscores the need to set up a national adult vaccination program for COVID-19 with great speed.


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