Pub Date : 2024-03-24DOI: 10.1016/j.hlpt.2024.100865
James Larkin , Shai Mulinari , Piotr Ozieranski , Kevin Lynch , Tom Fahey , Akihiko Ozaki , Frank Moriarty
Objective
Medical device industry payments to healthcare organisations (HCOs) can create conflicts of interest which can undermine patient care. One way of addressing this concern is by enhancing transparency of industry financial support to HCOs. MedTech Europe, a medical device trade body, operate a system of disclosure of education payments to European HCOs. This study aimed to characterise payments reported in this database and to evaluate the disclosure system.
Methods
An observational study of education-related payments to HCOs reported by the medical device industry in Europe was conducted. Data was manually extracted from transparentmedtech.eu. The primary outcome variable is the value of the payments, overall, and for each year, payment type, and country. The accessibility, availability and quality of the database was also analysed, using a proforma with 15 measures.
Results
Overall, 116 medical device companies reported education-related payments in 53 European and non-European countries, valuing over €425 million between 2017 and 2019, increasing in value between 2017 and 2019, from €93,798,419 to €175,414,302. Ten countries accounted for 94% of all payments and ten companies accounted for 80% of all payments. The accessibility, availability and quality of the database rated low for six measures, medium for six measures, and high for three measures.
Conclusion
There is a large amount of education-related payments from medical device companies to European HCOs, creating substantial potential for conflicts of interest. MedTech Europe's disclosure system has many shortcomings. A European-wide publicly mandated disclosure system for both the medical device and pharmaceutical industries should be introduced.
Public interest summary
The medical device industry pay healthcare organisations (e.g. hospitals) large amounts of money. Industry states that this money is to help pay for healthcare professionals’ education. However, these payments can have a negative impact on healthcare professionals’ decision-making. This study sought to examine a website run by MedTech Europe, a representative body for the medical device industry, which outlines details of some of these payments (www.transparentmedtech.eu). Our analysis found that between 2017 and 2019 the medical device industry made ‘education’ payments valuing €425 million to healthcare organisations in Europe. We also assessed how comprehensive and user-friendly the database was and found a range of issues. For example, the database is not downloadable and some other important types of payments, such as payments for consultancy, are not included. We concluded that a mandatory database for both the medical device and pharmaceutical industry run by the European Union, would significantly improve transparency.
{"title":"Payments to healthcare organisations reported by the medical device industry in Europe from 2017 to 2019: An observational study","authors":"James Larkin , Shai Mulinari , Piotr Ozieranski , Kevin Lynch , Tom Fahey , Akihiko Ozaki , Frank Moriarty","doi":"10.1016/j.hlpt.2024.100865","DOIUrl":"https://doi.org/10.1016/j.hlpt.2024.100865","url":null,"abstract":"<div><h3>Objective</h3><p>Medical device industry payments to healthcare organisations (HCOs) can create conflicts of interest which can undermine patient care. One way of addressing this concern is by enhancing transparency of industry financial support to HCOs. <em>MedTech Europe</em>, a medical device trade body, operate a system of disclosure of education payments to European HCOs. This study aimed to characterise payments reported in this database and to evaluate the disclosure system.</p></div><div><h3>Methods</h3><p>An observational study of education-related payments to HCOs reported by the medical device industry in Europe was conducted. Data was manually extracted from transparentmedtech.eu. The primary outcome variable is the value of the payments, overall, and for each year, payment type, and country. The accessibility, availability and quality of the database was also analysed, using a proforma with 15 measures.</p></div><div><h3>Results</h3><p>Overall, 116 medical device companies reported education-related payments in 53 European and non-European countries, valuing over €425 million between 2017 and 2019, increasing in value between 2017 and 2019, from €93,798,419 to €175,414,302. Ten countries accounted for 94% of all payments and ten companies accounted for 80% of all payments. The accessibility, availability and quality of the database rated low for six measures, medium for six measures, and high for three measures.</p></div><div><h3>Conclusion</h3><p>There is a large amount of education-related payments from medical device companies to European HCOs, creating substantial potential for conflicts of interest. <em>MedTech Europe's</em> disclosure system has many shortcomings. A European-wide publicly mandated disclosure system for both the medical device and pharmaceutical industries should be introduced.</p></div><div><h3>Public interest summary</h3><p>The medical device industry pay healthcare organisations (e.g. hospitals) large amounts of money. Industry states that this money is to help pay for healthcare professionals’ education. However, these payments can have a negative impact on healthcare professionals’ decision-making. This study sought to examine a website run by <em>MedTech Europe</em>, a representative body for the medical device industry, which outlines details of some of these payments (www.transparentmedtech.eu). Our analysis found that between 2017 and 2019 the medical device industry made ‘education’ payments valuing €425 million to healthcare organisations in Europe. We also assessed how comprehensive and user-friendly the database was and found a range of issues. For example, the database is not downloadable and some other important types of payments, such as payments for consultancy, are not included. We concluded that a mandatory database for both the medical device and pharmaceutical industry run by the European Union, would significantly improve transparency.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 2","pages":"Article 100865"},"PeriodicalIF":6.0,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000285/pdfft?md5=66282831ea8d60ac24853633e69387b9&pid=1-s2.0-S2211883724000285-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140546074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Objective</h3><p>This study focuses on the impact of social determinants of health (employment, housing, access to education, and food) on individuals affected by poverty during the COVID-19 pandemic in Tyrol, Austria.</p></div><div><h3>Methods</h3><p>A qualitative research design was employed to explore the individual experiences of the pandemic, poverty, job loss, and precariousness. Biographical narrative and episodic problem-based interviews were used in combination. A total of 151 participants were recruited using various non-random sampling methods. The data were analyzed through inductive qualitative content analysis to identify relevant thematic complexes resulting from the reconstructions.</p></div><div><h3>Results</h3><p>The main driver of challenges faced by individuals living in poverty is their precarious financial situation. Poverty negatively affects physical and mental health, the quality of food, housing conditions, medication expenses, access to healthcare, to relevant digital resources, and health literacy. Informal social support plays a crucial role for people in poverty, but it diminishes over time, leading to social exclusion. The COVID-19 pandemic has exacerbated poverty-related challenges and intensified social disconnection and marginalization. Addressing poverty requires comprehensive interventions at both the individual and structural levels.</p></div><div><h3>Conclusions</h3><p>The COVID-19 pandemic has highlighted the critical role of social determinants of health, including poverty, distress, employment, social participation, and digital exclusion. These factors pose immediate risks to individuals' health and can contribute to negative long-term health issues. State and institutional support are crucial in preventing and combating poverty, social disparities, health inequalities, and negative health outcomes.</p></div><div><h3>Public interest abstract</h3><p>This study highlights the negative impact of poverty on an individual's biopsychosocial health, which has been exacerbated by the COVID-19 pandemic. Financial distress, uncertainty, and employment disruptions caused by the pandemic had a negative impact on social participation and quality of life, thereby decreasing overall well-being. Individuals affected by poverty experience adverse health outcomes such as distress, exhaustion, and hopelessness. The pandemic has further reduced the availability of public-funded professional support, leaving individuals with limited resources for essentials such as food, heating, rent, and social participation. Therefore, increased public funding for health and social services and accessible low-threshold financial aid are essential for improving well-being of those affected. Furthermore, poverty is a complex issue that necessitates public support to combat and prevent its effects in the sense of social justice and health equity. To address negative health outcomes and provide targeted support, we must tackle the soci
{"title":"COVID-19 and health inequalities: The impact of social determinants of health on individuals affected by poverty","authors":"Lukas Kerschbaumer , Leigh Crossett , Marina Holaus , Ursula Costa","doi":"10.1016/j.hlpt.2023.100803","DOIUrl":"10.1016/j.hlpt.2023.100803","url":null,"abstract":"<div><h3>Objective</h3><p>This study focuses on the impact of social determinants of health (employment, housing, access to education, and food) on individuals affected by poverty during the COVID-19 pandemic in Tyrol, Austria.</p></div><div><h3>Methods</h3><p>A qualitative research design was employed to explore the individual experiences of the pandemic, poverty, job loss, and precariousness. Biographical narrative and episodic problem-based interviews were used in combination. A total of 151 participants were recruited using various non-random sampling methods. The data were analyzed through inductive qualitative content analysis to identify relevant thematic complexes resulting from the reconstructions.</p></div><div><h3>Results</h3><p>The main driver of challenges faced by individuals living in poverty is their precarious financial situation. Poverty negatively affects physical and mental health, the quality of food, housing conditions, medication expenses, access to healthcare, to relevant digital resources, and health literacy. Informal social support plays a crucial role for people in poverty, but it diminishes over time, leading to social exclusion. The COVID-19 pandemic has exacerbated poverty-related challenges and intensified social disconnection and marginalization. Addressing poverty requires comprehensive interventions at both the individual and structural levels.</p></div><div><h3>Conclusions</h3><p>The COVID-19 pandemic has highlighted the critical role of social determinants of health, including poverty, distress, employment, social participation, and digital exclusion. These factors pose immediate risks to individuals' health and can contribute to negative long-term health issues. State and institutional support are crucial in preventing and combating poverty, social disparities, health inequalities, and negative health outcomes.</p></div><div><h3>Public interest abstract</h3><p>This study highlights the negative impact of poverty on an individual's biopsychosocial health, which has been exacerbated by the COVID-19 pandemic. Financial distress, uncertainty, and employment disruptions caused by the pandemic had a negative impact on social participation and quality of life, thereby decreasing overall well-being. Individuals affected by poverty experience adverse health outcomes such as distress, exhaustion, and hopelessness. The pandemic has further reduced the availability of public-funded professional support, leaving individuals with limited resources for essentials such as food, heating, rent, and social participation. Therefore, increased public funding for health and social services and accessible low-threshold financial aid are essential for improving well-being of those affected. Furthermore, poverty is a complex issue that necessitates public support to combat and prevent its effects in the sense of social justice and health equity. To address negative health outcomes and provide targeted support, we must tackle the soci","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100803"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000795/pdfft?md5=bfc690f7a060bb3b2e6723d9470b79c0&pid=1-s2.0-S2211883723000795-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135348591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.hlpt.2023.100791
Michelle Falkenbach , Charley E. Willison , Phillip M. Singer
Objectives
We conduct a rapid review of the post-COVID-19 vaccination efforts undertaken by Denmark, the United States, and Canada. The main areas of focus are threefold: 1) To analyze the timeline of the rollout and access/barriers to vaccinations considering the changing dynamics of COVID-19 and the launch of new generation booster-vaccines across the case countries. 2) To examine sociopolitical factors related to this juxtaposition between lower booster acceptance, despite higher rates of initial vaccine series, in each of the three cases. 3) To determine how each country is moving forward with their ongoing COVID-19 strategies for long-term mitigation planning.
Methods
We followed a Most Similar Systems Design (MSSD) framework to select our cases. We analyze country responses amongst high-income, OECD countries, who shared Western or liberal Democracy, with a formal framework of rule of law, presence of a legal authority and the independence of the judiciary, but differ in their rollout and uptake of the vaccine booster.
Results
Despite variation in booster uptake, all three countries’ COVID-19 mitigation responses became more similar over time, and each country experienced lower than expected booster uptake.
Conclusions
Decline in booster doses across each country was related to broad declines in concern about the virus in each location. However, cases with higher uptake of the initial series and use of NPIs, in Denmark and Canada, continue to fare better in morbidity and mortality from COVID-19, despite dwindling booster uptake.
Public Interest Summary
This study looks at how three high income western democracies (Denmark, the United States and Canada) handled the COVID-19 pandemic and booster vaccinations. We briefly look at the initial outbreak of the pandemic, contextualize the initial (pre-booster) vaccination uptake and then assess the booster vaccine uptake. We find that although the countries differ in their approach during the initial stages of COVID-19 and vaccination policy, they all share similarly low booster vaccine uptake. Yet, even with a similarly low booster uptake, each of the countries continue to exhibit differences in morbidity, mortality and disparities associated with COVID-19. The implications of this research are clear – providing access to vaccinations, boosters, testing, and treatment are essential in combating inequalities in COVID-19 outcomes. Overlaying these implications is the importance of a continuously updated national strategy for future pandemics is important.
{"title":"Denmark, the United States and Canada: Before, during and post vaccination rollout","authors":"Michelle Falkenbach , Charley E. Willison , Phillip M. Singer","doi":"10.1016/j.hlpt.2023.100791","DOIUrl":"10.1016/j.hlpt.2023.100791","url":null,"abstract":"<div><h3>Objectives</h3><p>We conduct a rapid review of the post-COVID-19 vaccination efforts undertaken by Denmark, the United States, and Canada. The main areas of focus are threefold: 1) To analyze the timeline of the rollout and access/barriers to vaccinations considering the changing dynamics of COVID-19 and the launch of new generation booster-vaccines across the case countries. 2) To examine sociopolitical factors related to this juxtaposition between lower booster acceptance, despite higher rates of initial vaccine series, in each of the three cases. 3) To determine how each country is moving forward with their ongoing COVID-19 strategies for long-term mitigation planning.</p></div><div><h3>Methods</h3><p>We followed a Most Similar Systems Design (MSSD) framework to select our cases. We analyze country responses amongst high-income, OECD countries, who shared Western or liberal Democracy, with a formal framework of rule of law, presence of a legal authority and the independence of the judiciary, but differ in their rollout and uptake of the vaccine booster.</p></div><div><h3>Results</h3><p>Despite variation in booster uptake, all three countries’ COVID-19 mitigation responses became more similar over time, and each country experienced lower than expected booster uptake.</p></div><div><h3>Conclusions</h3><p>Decline in booster doses across each country was related to broad declines in concern about the virus in each location. However, cases with higher uptake of the initial series and use of NPIs, in Denmark and Canada, continue to fare better in morbidity and mortality from COVID-19, despite dwindling booster uptake.</p></div><div><h3>Public Interest Summary</h3><p>This study looks at how three high income western democracies (Denmark, the United States and Canada) handled the COVID-19 pandemic and booster vaccinations. We briefly look at the initial outbreak of the pandemic, contextualize the initial (pre-booster) vaccination uptake and then assess the booster vaccine uptake. We find that although the countries differ in their approach during the initial stages of COVID-19 and vaccination policy, they all share similarly low booster vaccine uptake. Yet, even with a similarly low booster uptake, each of the countries continue to exhibit differences in morbidity, mortality and disparities associated with COVID-19. The implications of this research are clear – providing access to vaccinations, boosters, testing, and treatment are essential in combating inequalities in COVID-19 outcomes. Overlaying these implications is the importance of a continuously updated national strategy for future pandemics is important.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100791"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000679/pdfft?md5=e57e03445fce488f5e13a1638ebd9777&pid=1-s2.0-S2211883723000679-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42698774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.hlpt.2023.100800
Hanna Tiirinki , Markus Sovala , Vesa Jormanainen , Sirkka Goebeler , Kimmo Parhiala , Liina-Kaisa Tynkkynen , Ilmo Keskimäki
Objectives
To analyze how the vaccines and various measures to control the pandemic affected epidemiological, health and socioeconomic outcomes of COVID-19 in Finland. The focus of the analysis is on the endemic phase of the COVID-19 pandemic.
Methods
The paper provides an overview of Finland's healthcare system, trends in COVID-19 morbidity, mortality and vaccination coverage data, political considerations, interventions to control the pandemic, as well as the economic impact of the pandemic in the endemic phase. Data were collected from various sources, including previous studies, government reports, national statistics and registers and general media.
Results
In Finland, the total number of COVID-19 infections increased significantly during 2022, but the number of serious forms of the disease decreased. The implementation of the vaccination strategy caused a diversity of opinions among authorities and experts. The governing of the pandemic was fully decentralized. Overall, there is a good vaccination coverage of the population. In the endemic phase society returned to live without restrictions.
Conclusions
It seems clear that vaccines played an important role in controlling the pandemic. Overall mortality increased substantially in 2022 causing life expectancy to fall. Moreover, different “excess death” indicators show an increase in 2021 and 2022, but the timing and magnitude of the effect varies. It is relatively safe to conclude that at least part of increase can be attributed to the pandemic, but a more exact conclusion calls for a comprehensive study. Similarly, understanding long covid and designing required intervention calls for more research.
{"title":"COVID-19 endemic phase in Finland: An analysis of health policies and vaccination strategy","authors":"Hanna Tiirinki , Markus Sovala , Vesa Jormanainen , Sirkka Goebeler , Kimmo Parhiala , Liina-Kaisa Tynkkynen , Ilmo Keskimäki","doi":"10.1016/j.hlpt.2023.100800","DOIUrl":"10.1016/j.hlpt.2023.100800","url":null,"abstract":"<div><h3>Objectives</h3><p>To analyze how the vaccines and various measures to control the pandemic affected epidemiological, health and socioeconomic outcomes of COVID-19 in Finland. The focus of the analysis is on the endemic phase of the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>The paper provides an overview of Finland's healthcare system, trends in COVID-19 morbidity, mortality and vaccination coverage data, political considerations, interventions to control the pandemic, as well as the economic impact of the pandemic in the endemic phase. Data were collected from various sources, including previous studies, government reports, national statistics and registers and general media.</p></div><div><h3>Results</h3><p>In Finland, the total number of COVID-19 infections increased significantly during 2022, but the number of serious forms of the disease decreased. The implementation of the vaccination strategy caused a diversity of opinions among authorities and experts. The governing of the pandemic was fully decentralized. Overall, there is a good vaccination coverage of the population. In the endemic phase society returned to live without restrictions.</p></div><div><h3>Conclusions</h3><p>It seems clear that vaccines played an important role in controlling the pandemic. Overall mortality increased substantially in 2022 causing life expectancy to fall. Moreover, different “excess death” indicators show an increase in 2021 and 2022, but the timing and magnitude of the effect varies. It is relatively safe to conclude that at least part of increase can be attributed to the pandemic, but a more exact conclusion calls for a comprehensive study. Similarly, understanding long covid and designing required intervention calls for more research.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100800"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221188372300076X/pdfft?md5=233dee9e6053979ffaff1e716715703e&pid=1-s2.0-S221188372300076X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49234525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.hlpt.2023.100786
Hao Yang , Hao Tan , Jintao Zhang , Mengying Yang
Objective
This paper aims to examine China's vaccine policy within the context of broader policy interventions and evaluate their impact on both health and non-health outcomes.
Method
We first utilize the categorizing Policy & Technology Interventions (CPTI) framework to assess the intensities of different policy responses during various stages of the COVID-19 pandemic. We adopt a process inspired by the Delphi method to evaluate the timelines and intensities of the policy measures comprehensively. Subsequently, we probe the results generated from this process to identify distinctive patterns in China's pandemic policy changes, particularly in relation to the country's reopening process. To explain this distinctive pattern, we employ the governmentality perspective, drawing on Foucault's theories, which focus on the power dynamics between techniques and governance.
Results
The policy interventions in China during the COVID-19 pandemic significantly differ from those in the other countries in the four policy areas. Despite the massive vaccination efforts, vaccines did not play a decisive role in China's reopening in late 2022. Our analysis reveals that the vaccines are only used in China as part of a broader social governing system in conjunction with zero-COVID policy, such as lockdowns, travel restrictions, and mass tracking.
Conclusions
China's approach to COVID vaccines and the policies governing their use are distinctive, shaped by a governmentality perspective that prioritizes the strengthening of governance.
{"title":"China's pivot from zero-COVID strategy and the role of vaccines","authors":"Hao Yang , Hao Tan , Jintao Zhang , Mengying Yang","doi":"10.1016/j.hlpt.2023.100786","DOIUrl":"10.1016/j.hlpt.2023.100786","url":null,"abstract":"<div><h3>Objective</h3><p>This paper aims to examine China's vaccine policy within the context of broader policy interventions and evaluate their impact on both health and non-health outcomes.</p></div><div><h3>Method</h3><p>We first utilize the categorizing Policy & Technology Interventions (CPTI) framework to assess the intensities of different policy responses during various stages of the COVID-19 pandemic. We adopt a process inspired by the Delphi method to evaluate the timelines and intensities of the policy measures comprehensively. Subsequently, we probe the results generated from this process to identify distinctive patterns in China's pandemic policy changes, particularly in relation to the country's reopening process. To explain this distinctive pattern, we employ the governmentality perspective, drawing on Foucault's theories, which focus on the power dynamics between techniques and governance.</p></div><div><h3>Results</h3><p>The policy interventions in China during the COVID-19 pandemic significantly differ from those in the other countries in the four policy areas. Despite the massive vaccination efforts, vaccines did not play a decisive role in China's reopening in late 2022. Our analysis reveals that the vaccines are only used in China as part of a broader social governing system in conjunction with zero-COVID policy, such as lockdowns, travel restrictions, and mass tracking.</p></div><div><h3>Conclusions</h3><p>China's approach to COVID vaccines and the policies governing their use are distinctive, shaped by a governmentality perspective that prioritizes the strengthening of governance.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100786"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221188372300062X/pdfft?md5=176192d74989c98b18f33a0bd49d4174&pid=1-s2.0-S221188372300062X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42286923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.hlpt.2023.100820
Aregawi G. Gebremariam , Dereje Abegaz , Halefom Y. Nigus , Thomas Lemma Argaw , Mulusew Gerbaba , Mesfin G. Genie , Francesco Paolucci
Objective
This study examines the factors influencing vaccination rollout and its effectiveness in reducing infectious disease outbreaks in African countries. It aims to understand why some countries performed better in vaccination coverage than others and explores the impact of COVID-19 vaccinations in conjunction with the stringency index in Africa.
Methods
Two data sources were utilized. Firstly, a scoping review of relevant studies and gray literature was conducted using the Arksey H & O'Malley L methodological framework. Additionally, data from the Oxford COVID-19 Government Response Tracker (OxCGRT dataset) were analysed to explore the effect of COVID-19 vaccines in Africa. Regression discontinuity in time was employed to assess the effects of COVID-19 vaccination on new COVID-19 cases, deaths, and reproduction rate.
Results
The study found that the number of vaccinated individuals increased from March 2021, while the stringency index steadily declined since January 2021. Despite higher vaccination coverage, new COVID-19 cases and deaths peaked in late 2021 and early 2022, indicating the continued need for non-pharmaceutical interventions. After considering country fixed effects and other covariates, the number of new cases and deaths were negatively associated with the stringency index and vaccine introduction.
Conclusion
COVID-19 vaccination was shown to be crucial in reducing new cases and deaths in Africa. However, vaccination progress in the region remains low and is influenced by factors at both structural and micro levels. Further research is required to disentangle the effects of non-pharmaceutical interventions and other measures from vaccination campaigns in the context of Africa while accounting for other contributing factors.
Lay summary
This study aimed to understand why some African countries did better than others in their COVID-19 vaccination efforts and how these vaccinations affected the spread of the virus. Researchers reviewed existing studies and government data along with the Oxford COVID-19 Government Response Tracker. While vaccinations increased from March 2021 and strict measures eased from January 2021, new cases and deaths remained high in late 2021 and early 2022, indicating the need for additional measures. Stricter government actions and higher vaccination rates were linked to fewer cases and deaths. In Africa, COVID-19 vaccinations are crucial, but progress is slow due to various factors at both macro and individual levels. Further research is required to understand the interplay between vaccinations, other measures, and controlling the virus.
{"title":"Vaccine uptake and effectiveness: Why some African countries performed better than the others?","authors":"Aregawi G. Gebremariam , Dereje Abegaz , Halefom Y. Nigus , Thomas Lemma Argaw , Mulusew Gerbaba , Mesfin G. Genie , Francesco Paolucci","doi":"10.1016/j.hlpt.2023.100820","DOIUrl":"10.1016/j.hlpt.2023.100820","url":null,"abstract":"<div><h3>Objective</h3><p>This study examines the factors influencing vaccination rollout and its effectiveness in reducing infectious disease outbreaks in African countries. It aims to understand why some countries performed better in vaccination coverage than others and explores the impact of COVID-19 vaccinations in conjunction with the stringency index in Africa.</p></div><div><h3>Methods</h3><p>Two data sources were utilized. Firstly, a scoping review of relevant studies and gray literature was conducted using the Arksey H & O'Malley L methodological framework. Additionally, data from the Oxford COVID-19 Government Response Tracker (OxCGRT dataset) were analysed to explore the effect of COVID-19 vaccines in Africa. Regression discontinuity in time was employed to assess the effects of COVID-19 vaccination on new COVID-19 cases, deaths, and reproduction rate.</p></div><div><h3>Results</h3><p>The study found that the number of vaccinated individuals increased from March 2021, while the stringency index steadily declined since January 2021. Despite higher vaccination coverage, new COVID-19 cases and deaths peaked in late 2021 and early 2022, indicating the continued need for non-pharmaceutical interventions. After considering country fixed effects and other covariates, the number of new cases and deaths were negatively associated with the stringency index and vaccine introduction.</p></div><div><h3>Conclusion</h3><p>COVID-19 vaccination was shown to be crucial in reducing new cases and deaths in Africa. However, vaccination progress in the region remains low and is influenced by factors at both structural and micro levels. Further research is required to disentangle the effects of non-pharmaceutical interventions and other measures from vaccination campaigns in the context of Africa while accounting for other contributing factors.</p></div><div><h3>Lay summary</h3><p>This study aimed to understand why some African countries did better than others in their COVID-19 vaccination efforts and how these vaccinations affected the spread of the virus. Researchers reviewed existing studies and government data along with the Oxford COVID-19 Government Response Tracker. While vaccinations increased from March 2021 and strict measures eased from January 2021, new cases and deaths remained high in late 2021 and early 2022, indicating the need for additional measures. Stricter government actions and higher vaccination rates were linked to fewer cases and deaths. In Africa, COVID-19 vaccinations are crucial, but progress is slow due to various factors at both macro and individual levels. Further research is required to understand the interplay between vaccinations, other measures, and controlling the virus.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100820"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000965/pdfft?md5=6857a4cb753d8a8b637fbf7f6a9cb6ca&pid=1-s2.0-S2211883723000965-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136059874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.hlpt.2023.100801
Mehdi Ammi , Zachary W. Desson , Maeva Z. Doumbia
Background
As a federal country where health prerogatives are primarily at the subnational level (provinces), Canada has implemented non-pharmaceutical interventions (NPIs) of differing stringency and attained varied COVID-19 vaccination coverage across the different vaccination campaigns. NPIs and vaccination may have thus interacted in different ways.
Methods
A mixed-methods design combining a regression analysis and a comparative case study. The regression analysis focuses on COVID-19 outcomes such as COVID-19 cases, deaths, hospitalizations, and admissions in intensive care units. The case study centers on three provinces and explores outcomes beyond COVID-19, such as spillover on the healthcare system and the economy.
Results
While more stringent NPIs are associated with lower COVID outcomes, their interaction with vaccination coverage depends on the vaccination campaign. Increasing the vaccination coverage with more stringent NPIs was not associated with a decrease in COVID cases growth rate during the primary campaign (two-doses), however it was associated with a decrease in COVID hospitalizations during the booster campaign. For non-COVID outcomes, having less stringent restrictions and lower initial vaccination coverage did not help prevent longer wait times for healthcare nor higher initial unemployment.
Conclusion
The differing interaction between NPIs and vaccination coverage suggests that the interaction was more effective when the vaccine uptake was primarily from high-risk populations. Confirming this finding would require further detailed microdata analysis.
{"title":"Non-pharmaceutical interventions and vaccination during COVID-19 in Canada: Implications for COVID and non-COVID outcomes","authors":"Mehdi Ammi , Zachary W. Desson , Maeva Z. Doumbia","doi":"10.1016/j.hlpt.2023.100801","DOIUrl":"10.1016/j.hlpt.2023.100801","url":null,"abstract":"<div><h3>Background</h3><p>As a federal country where health prerogatives are primarily at the subnational level (provinces), Canada has implemented non-pharmaceutical interventions (NPIs) of differing stringency and attained varied COVID-19 vaccination coverage across the different vaccination campaigns. NPIs and vaccination may have thus interacted in different ways.</p></div><div><h3>Methods</h3><p>A mixed-methods design combining a regression analysis and a comparative case study. The regression analysis focuses on COVID-19 outcomes such as COVID-19 cases, deaths, hospitalizations, and admissions in intensive care units. The case study centers on three provinces and explores outcomes beyond COVID-19, such as spillover on the healthcare system and the economy.</p></div><div><h3>Results</h3><p>While more stringent NPIs are associated with lower COVID outcomes, their interaction with vaccination coverage depends on the vaccination campaign. Increasing the vaccination coverage with more stringent NPIs was not associated with a decrease in COVID cases growth rate during the primary campaign (two-doses), however it was associated with a decrease in COVID hospitalizations during the booster campaign. For non-COVID outcomes, having less stringent restrictions and lower initial vaccination coverage did not help prevent longer wait times for healthcare nor higher initial unemployment.</p></div><div><h3>Conclusion</h3><p>The differing interaction between NPIs and vaccination coverage suggests that the interaction was more effective when the vaccine uptake was primarily from high-risk populations. Confirming this finding would require further detailed microdata analysis.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100801"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000771/pdfft?md5=632a501c6062c435f2af6e2dd0e9acde&pid=1-s2.0-S2211883723000771-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135200207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.hlpt.2023.100815
Ingunn Skjesol , Gøril Ursin , Jonathan Tritter
Objectives
To analyze the relationship between the stringency of policies that focus on containment, mitigation and elimination and practices to change behavior implemented during the COVID-19 pandemic and apparent impacts in the Norwegian population and society. In particular, to consider how the escalation and de-escalation of policy stringency relates to both health and non-health societal factors.
Methods
Observational analysis of publicly available statistics, government documents and media sources.
Results
The stringency of policies relating to social containment, mitigation and elimination and practices to change behaviour were linked to infection rates and pressures on the health system until the endemic phase of COVID-19. In the endemic phase all restrictions were removed despite high levels of infection justified on the basis of the success of the vaccination programme.
Conclusions
In the Norwegian context containment policies were highly effective in limiting both infections and deaths from COVID-19 and more so than reliance on vaccinations alone despite high levels of public participation. In part this is due to the significant trust in the state apparent in Norway that leads to compliance with even highly restrictive policies. Therefore compliance may be more important than the level of stringency in explaining the consequence of public policies on pandemic outcomes.
{"title":"Learning to live with COVID-19 in Norway: Moving from a pandemic to an endemic state","authors":"Ingunn Skjesol , Gøril Ursin , Jonathan Tritter","doi":"10.1016/j.hlpt.2023.100815","DOIUrl":"10.1016/j.hlpt.2023.100815","url":null,"abstract":"<div><h3>Objectives</h3><p>To analyze the relationship between the stringency of policies that focus on containment, mitigation and elimination and practices to change behavior implemented during the COVID-19 pandemic and apparent impacts in the Norwegian population and society. In particular, to consider how the escalation and de-escalation of policy stringency relates to both health and non-health societal factors.</p></div><div><h3>Methods</h3><p>Observational analysis of publicly available statistics, government documents and media sources.</p></div><div><h3>Results</h3><p>The stringency of policies relating to social containment, mitigation and elimination and practices to change behaviour were linked to infection rates and pressures on the health system until the endemic phase of COVID-19. In the endemic phase all restrictions were removed despite high levels of infection justified on the basis of the success of the vaccination programme.</p></div><div><h3>Conclusions</h3><p>In the Norwegian context containment policies were highly effective in limiting both infections and deaths from COVID-19 and more so than reliance on vaccinations alone despite high levels of public participation. In part this is due to the significant trust in the state apparent in Norway that leads to compliance with even highly restrictive policies. Therefore compliance may be more important than the level of stringency in explaining the consequence of public policies on pandemic outcomes.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100815"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000916/pdfft?md5=f29a69c237bc2c035d52ae2ce19fe3a4&pid=1-s2.0-S2211883723000916-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135607313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.hlpt.2023.100812
Amandine Gagneux-Brunon , Elisabeth Botelho-Nevers , Pierre Verger , Fatima Gauna , Odile Launay , Jeremy K. Ward
Introduction
High COVID-19 vaccine coverage was obtained in France after theCOVID-19 vaccination campaign, in part due to the implementation of a COVID-19 vaccination pass, a kind of vaccine mandate. Vaccine mandates could lead to reactance and may affect confidence in vaccines. We aimed to evaluate the impact of the COVID-19 vaccination campaign on self-perceived vaccine confidence in France.
Methods
Between the 25th of April and the 9th of May 2022, we conducted a cross-sectional online survey among a representative sample of the French population aged 18 and over. The primary outcome was the perceived change in vaccine confidence after the COVID-19 vaccination campaign. We performed a multinomial regression analysis to identify factors associated with perceived decrease and increase in vaccine confidence in reference to no change.
Results
Among the 1,928 respondents, decrease in vaccine confidence was reported by 579 (30 %) and increase in vaccine confidence by 259 (13.4%). Among the 1,711 vaccinated individuals, 693 (40.5%), 404 (23.6%) respectively reported that they felt strongly and a little coerced into getting vaccinated against COVID-19. Younger age, feeling coerced to get vaccinated, low confidence in health authorities, fears about vaccine side effects, and not considering vaccination as a collective responsibility were associated with perceived decrease in vaccine confidence in multivariable analysis. Men were more prone than women to report a gain in vaccine confidence.
Conclusion
Vaccination campaign that included coercive measures to raise high COVID-19 vaccine coverage could have led to reactance and with an impact on vaccine confidence in general.
{"title":"Change in self-perceived vaccine confidence in France after the COVID-19 vaccination campaign: A cross-sectional survey in the French general population","authors":"Amandine Gagneux-Brunon , Elisabeth Botelho-Nevers , Pierre Verger , Fatima Gauna , Odile Launay , Jeremy K. Ward","doi":"10.1016/j.hlpt.2023.100812","DOIUrl":"10.1016/j.hlpt.2023.100812","url":null,"abstract":"<div><h3>Introduction</h3><p>High COVID-19 vaccine coverage was obtained in France after theCOVID-19 vaccination campaign, in part due to the implementation of a COVID-19 vaccination pass, a kind of vaccine mandate. Vaccine mandates could lead to reactance and may affect confidence in vaccines. We aimed to evaluate the impact of the COVID-19 vaccination campaign on self-perceived vaccine confidence in France.</p></div><div><h3>Methods</h3><p>Between the 25th of April and the 9th of May 2022, we conducted a cross-sectional online survey among a representative sample of the French population aged 18 and over. The primary outcome was the perceived change in vaccine confidence after the COVID-19 vaccination campaign. We performed a multinomial regression analysis to identify factors associated with perceived decrease and increase in vaccine confidence in reference to no change.</p></div><div><h3>Results</h3><p>Among the 1,928 respondents, decrease in vaccine confidence was reported by 579 (30 %) and increase in vaccine confidence by 259 (13.4%). Among the 1,711 vaccinated individuals, 693 (40.5%), 404 (23.6%) respectively reported that they felt strongly and a little coerced into getting vaccinated against COVID-19. Younger age, feeling coerced to get vaccinated, low confidence in health authorities, fears about vaccine side effects, and not considering vaccination as a collective responsibility were associated with perceived decrease in vaccine confidence in multivariable analysis. Men were more prone than women to report a gain in vaccine confidence.</p></div><div><h3>Conclusion</h3><p>Vaccination campaign that included coercive measures to raise high COVID-19 vaccine coverage could have led to reactance and with an impact on vaccine confidence in general.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100812"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883723000886/pdfft?md5=44853f25041fe0f42751f5fcce8a8b81&pid=1-s2.0-S2211883723000886-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1016/j.hlpt.2024.100849
Marcello Antonini , Mesfin G. Genie , Arthur E. Attema , Katie Attwell , Zsolt J. Balogh , Daiga Behmane , Chiara Berardi , Shuli Brammli-Greenberg , Andrew Greenland , Terje P. Hagen , Madeleine Hinwood , Carole James , Adrian Kellner , Brian Kelly , Liubovė Murauskienė , Neil McGregor , Alessia Melegaro , Naomi Moy , Ana Rita Sequeira , Renu Singh , Francesco Paolucci
Objective
Despite widespread perceptions that SARS-CoV-2 (COVID-19) is no longer a significant threat, the virus continues to loom, and new variants may require renewed efforts to control its spread. Understanding how individual preferences and attitudes influence vaccination behaviour and policy compliance in light of the endemic phase is crucial in preparation for this scenario.
Method
This paper presents descriptive data from a global stated choice survey conducted in 22 countries across 6 different continents between July 2022 and August 2023, and reports the methodological work developed to address the need for comparable data.
Results
This study included 50,242 respondents. Findings indicated significant heterogeneity across countries in terms of vaccination status and willingness to accept boosters. Vaccine hesitancy and refusal were driven by lower trust in public health bodies, younger age, and lower educational levels. Refusers and hesitant people reported lower willingness to take risks compared to those fully vaccinated (p<0.05). Lower mental health levels were found for the hesitant cohort (p<0.05).
Conclusions
Insights from this database can help public health authorities to gain a new understanding of the vaccine hesitancy phenomenon, support them in managing the transition from the pandemic to the endemic phase, and favour a new stream of research to maximise behavioural response to vaccination programs in preparation of future pandemics.
{"title":"Public preferences for vaccination campaigns in the COVID-19 endemic phase: insights from the VaxPref database","authors":"Marcello Antonini , Mesfin G. Genie , Arthur E. Attema , Katie Attwell , Zsolt J. Balogh , Daiga Behmane , Chiara Berardi , Shuli Brammli-Greenberg , Andrew Greenland , Terje P. Hagen , Madeleine Hinwood , Carole James , Adrian Kellner , Brian Kelly , Liubovė Murauskienė , Neil McGregor , Alessia Melegaro , Naomi Moy , Ana Rita Sequeira , Renu Singh , Francesco Paolucci","doi":"10.1016/j.hlpt.2024.100849","DOIUrl":"10.1016/j.hlpt.2024.100849","url":null,"abstract":"<div><h3>Objective</h3><p>Despite widespread perceptions that SARS-CoV-2 (COVID-19) is no longer a significant threat, the virus continues to loom, and new variants may require renewed efforts to control its spread. Understanding how individual preferences and attitudes influence vaccination behaviour and policy compliance in light of the endemic phase is crucial in preparation for this scenario.</p></div><div><h3>Method</h3><p>This paper presents descriptive data from a global stated choice survey conducted in 22 countries across 6 different continents between July 2022 and August 2023, and reports the methodological work developed to address the need for comparable data.</p></div><div><h3>Results</h3><p>This study included 50,242 respondents. Findings indicated significant heterogeneity across countries in terms of vaccination status and willingness to accept boosters. Vaccine hesitancy and refusal were driven by lower trust in public health bodies, younger age, and lower educational levels. Refusers and hesitant people reported lower willingness to take risks compared to those fully vaccinated (<em>p</em><0.05). Lower mental health levels were found for the hesitant cohort (<em>p</em><0.05).</p></div><div><h3>Conclusions</h3><p>Insights from this database can help public health authorities to gain a new understanding of the vaccine hesitancy phenomenon, support them in managing the transition from the pandemic to the endemic phase, and favour a new stream of research to maximise behavioural response to vaccination programs in preparation of future pandemics.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"13 1","pages":"Article 100849"},"PeriodicalIF":6.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2211883724000121/pdfft?md5=d967c5b8e8fa95ed709179851ee893c3&pid=1-s2.0-S2211883724000121-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139815892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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