It has been more than a year since March 2021, when the National Health Commission requested that the elderly over the age of 60 be included in the immunization programme.
According to the article "Shanghai's Response to the Current COVID-19 Opalon: Efforts to Save Lives" published in The Lancet on May 6, the likelihood of unvaccinated people, especially the elderly, progressing to severe cases or dying after infection is still high, according to the corresponding author, Academician Chen Saijuan and co-author Professor Zhang Wenhong.
This has been confirmed by the outbreak in Hong Kong. The Hong Kong Department of Health reported that as of May 4, 9,115 of the 1192765 COVID-19 cases during the fifth wave of the epidemic (crude case fatality ratio of 0.76%) were reported, compared with 2.70% for people over 60 years old.
Hong Kong, the fifth wave of the epidemic, has produced the highest mortality rate in the world.
About 19.30% of people over the age group in Hong Kong over the age of 60 are not vaccinated. In contrast, only 2% of New Zealand people over the age of 60 are not vaccinated, which is highly correlated with its crude case fatality rate as low as 0.07%.
In Shanghai, 62 percent of the 5.8 million people over the age of 60 were vaccinated, and only 38 percent were vaccinated with a booster.
As of May 4, of the 503 COVID-19 deaths in Shanghai, only 25 patients had received at least one dose of the COVID-19 vaccine. The vaccination rate for those who died was only 4.97%.
According to the National Health Commission, about 49 million people over the age of 60 in China have not been vaccinated.
The third vaccination rate of the elderly over 80 years old in Chinese mainland is about 20%, while the vaccination rate in Norway, Sweden and other countries exceeds 90%.
U.S. research says Omikeron may be just as dangerous as other CORONAVIRUS variants
According to Xinhua News Agency on May 7, a large sample study in the United States that has not yet been officially published shows that in essence, Omi kerong may be as serious as the previous version of the new coronavirus variant.
This overturns previous research assumptions that "Omilon is more contagious and less dangerous" and further highlights the importance of COVID-19 vaccination and booster vaccinations.
According to Reuters on May 5, the study is undergoing peer review at Nature Portfolio, a journal integration platform owned by Nature, with four researchers from Massachusetts General Hospital, the University of Minerva and Harvard Medical School.
The researchers studied the electronic medical records of more than 130,000 COVID-19 patients in Massachusetts and statewide COVID-19 vaccination data, not only looking at hospitalization and mortality data, but also taking into account demographics, patient vaccination status, and the "Charleson Comorbidity Index" and other distractions.
The researchers concluded that for two years, different variants of COVID-19, including Omiljung, had alternated into mainstream strains, but the risk of hospitalization and death at different times was "almost the same."
The research team believes that after The Omilon became the mainstream strain, the number of hospitalizations and deaths was lower than the level of the previous variants when they were endemic, not because the risk of Omiljung was low, but because the new crown vaccine played a role.
Dr. Arjun Vencatelsh of Yale University School of Medicine believes the study is unique and "quite compelling." Whereas previous studies have focused only on COVID-19 deaths and hospitalizations, this study considered patients' vaccination status, medical risk factors, and compared similar age groups.
Vynkats said the study further proves that it is vaccines that help people avoid the worst effects of Omiclon and not "mistakenly" think that vaccines and booster shots are not important.
Reuters reported that globally, a significant proportion of people in various countries are still reluctant to get the new crown vaccine. After the first discovery of the Omiljun strain in November 2021, some public health officials said the vast majority of Omiljun infected people had mild symptoms compared to those infected with other strains. This may make some skeptics of the COVID-19 vaccine feel even more unnecessary.
Zhang Wenhong et al.: What is China's next challenge?
On May 7, the "Huashan Infection" WeChat account forwarded an article published in The Lancet: "Shanghai's Response to the Current COVID-19 Oprick rong Epidemic: An Effort to Save Lives".
The corresponding authors of this article are Academician Chen Saijuan of the State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, and National Major Scientific and Technological Infrastructure of Translational Medicine (Shanghai), Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Professor Zhang Xinxin of the Clinical Virus Research Laboratory of the Department of Infectious Diseases of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, and Professor Zhang Wenhong of the Department of Infectious Diseases of Huashan Hospital Affiliated to Fudan University.
According to the Shanghai Municipal Health Commission, as of May 4, 2022, there are 601942 cases of new coronavirus infection in Shanghai, of which 547056 cases are asymptomatic infections, with a cumulative death of 503 cases.
Unvaccinated people, especially the elderly, remain more likely to progress to severe cases or death after infection. This has been confirmed by the outbreak in Hong Kong. The Hong Kong Department of Health reported that as of May 4, 9,115 of the 1192765 COVID-19 cases during the fifth wave of the epidemic (crude case fatality ratio of 0.76%) were reported, while the crude case fatality rate of people over 60 years old (about 19.30% of people in this age group were unvaccinated) was 2.70%.
In contrast, only 2% of New Zealand's population over the age of 60 is not vaccinated, which is highly correlated with its crude case fatality rate of as low as 0.07%.
With a population of 25 million, Shanghai has an overall vaccination coverage rate of more than 90 percent; however, vaccination coverage for the elderly remains low — 62 percent of the 5.8 million people over the age of 60 are vaccinated, while only 38 percent are vaccinated.
As of 4 May, of the 503 COVID-19 deaths, only 25 patients had received at least one dose of covid-19 vaccine. The vaccination rate for those who died was only 4.97%. It can be seen that the new crown vaccine can reduce the risk of disease for the public, especially the risk of severe illness and death.
According to the National Health Commission, about 49 million people over the age of 60 in China have not been vaccinated, and a significant number of them suffer from underlying diseases.
The next challenge for China will be how to strengthen communication between health workers and the public so that people can overcome the "vaccine hesitancy" of vaccines – when vaccines are successfully developed and freely vaccinated, people show delays or refuse vaccinations.
Understanding the reasons for "vaccine hesitation", and potential ways to reduce hesitation in the future, will hopefully lead to a higher proportion of individuals being vaccinated and help end the current COVID-19 pandemic.
What are the reasons for the widespread "hesitation" to get the COVID-19 vaccine?
As of 6 May 2022, Oxford University Our World in Data reported a cumulative global coverage of 11.64 billion doses of COVID-19 vaccine, with a vaccination rate of 65.4%.
As of May 5, 2022, China has reported a cumulative total of more than 3.34 billion doses of COVID-19 vaccines, covering 91.22% and 88.74% of the country's total population, respectively.
At present, the vaccination rate in China's cities and suburbs is higher than in rural areas. The percentage of older people who completed full vaccinations, including receiving booster vaccines, was higher than that of young people. In addition, the number of vaccinations in the upper middle- and high-income populations is much higher than that of the middle- and low-income populations [1].
For the efficacy of the COVID-19 vaccine, the U.S. Centers for Disease Control and Prevention reports that the vaccine is 93.5 percent effective against symptomatic infections compared to the Delta variant, compared with the Omicron variant, 67 percent effective against symptomatic infections, and 94 percent effective against complete vaccination (three doses of mRNA-based vaccine) in hospitalization [2].
A recent article published in the journal Human Vaccines and Immunotherapy titled "COVID-19 Vaccine Hesitation: Reluctance and Consideration for Improved Vaccine Acceptance" found that the main reasons for COVID-19 vaccination hesitation are as follows:
Demographic differences
The older a person is, the more likely they are to be vaccinated against COVID-19.
In addition, a higher level of education can reduce hesitation about vaccines. A survey of medical students found that 23 percent of them were reluctant to vaccinate immediately after approval by the U.S. Food and Drug Administration (FDA) due to concerns about vaccine safety and side effects, but 53 percent of respondents trusted public health experts and said they were willing to participate in a COVID-19 vaccine trial [3].
Safety and efficacy of COVID-19 vaccines
By far one of the most common reasons for hesitation about vaccination is the safety of vaccines.
The COVID-19 vaccine is the fastest ever developed vaccine, but with it comes the hasty development and trials of the vaccine, which has led many to be skeptical about the safety of the vaccine. In addition, many COVID-19 vaccines have been developed using novel mRNA techniques, raising concerns about vaccine safety.
As the time spent on COVID-19 vaccines in clinical trials increases, the testing of COVID-19 vaccines increases, and the side effects decrease, the more likely it is that individuals will be vaccinated. In addition, the efficacy and duration of THE NEW CROWN vaccine immunization also have a certain impact on the hesitation to receive the NEW CROWN vaccine.
Distrust of government and health officials
Many in Europe and the United States are skeptical of information provided by governments and health organizations about COVID-19 and new vaccines. Distrust of vaccine development and the rate of misinformation can lead to increased public hesitation about vaccines.
The above paper mentions that the distrust of medical institutions by black Americans can be traced back to the Tuskegee syphilis experiment, which is a proper noun that makes many blacks smell and has become one of the synonyms of racism. Since 1932, the U.S. Department of Public Health (PHS) has used 400 black African-American men as experimental objects to secretly study the harm of syphilis to the human body, concealing the parties for up to 40 years, making a large number of victims and their relatives pay the price of health and even life. The U.S. government ordered a thorough investigation and compensation after the East Window incident in the 1970s, and finally issued a belated apology in 1997.
But the root of this mistrust is not just a single incident, but also based on centuries of racist exploitation by medical researchers and doctors. Misinformation and information disputes between superior officials have also reportedly led to higher distrust of the health care system among black Americans [4].
The above article examines the situation in the United States. According to eight points of health reports, in China, the factors that the elderly are reluctant to vaccinate against the new crown vaccine are mainly:
Have an underlying medical condition and are concerned about the risk of vaccination.
Due to the effective prevention and control of the epidemic in China, the risk of infection is not high, and there is a lack of perception of the threat of the new crown.
When indexing the "acute onset of chronic diseases", all localities stipulate that "blood pressure below 160/100 mmllg should be vaccinated". Whether it is unstable blood pressure "in the onset period" or long-term hypertension, as long as the blood pressure is found to be higher than 160/100mmHg after the on-site physical examination, it will be suspended.
Between the coupled responses affecting the population and vaccines with higher actual safety, there is a trust problem similar to the "Tacitus Trap".
How to reduce hesitation about COVID-19 vaccination?
According to the above-mentioned US study, the hesitation shown by the COVID-19 vaccine is not a new concept, and the reasons are diverse and need to be minimized by appropriate measures.
Health care professionals need to provide consistent and accurate information to individuals about the needs and safety of COVID-19 vaccines.
Governments and health care officials must provide transparent, stable and reliable information, especially on the severity of the pandemic.
When it comes to the safety of vaccines, it is most important to educate individuals about the functions and benefits of vaccines. To this end, governments and health-care officials need to be consistent in promoting and promoting vaccines.
With higher levels of hesitation in rural and low-income areas, local leaders, including religious leaders, should advocate for vaccination. [5]
Resources:
[1] Mathieu E，Ritchie H，Ortiz-Ospina E，et al. A global database of COVID-19 vaccinations[J]. Nature Human Behav，2021，5（7）：947-53.
[2] Shader RI. COVID-19 Vaccine Effectiveness[J]. Clinical Therapeutics，2021，43（6）：1132-1133.
[3] Lucia VC，Kelekar A，Afonso NM. COVID-19 vaccine hesitancy among medical students[J]. Journal of Public Health，2021，43（3）：445-49.
[4] Ni o MD，Hearne BN，Cai T.Trajectories of COVID-19 vaccine intentions among U.S. adults：the role of race and ethnicity[J]. SSM Popul Health，2021，15：100824.
[5] Tian Qing, "Puzzle: Why Do We Hesitate about COVID-19 Vaccines?" , Frontline of Respiratory Infections in Health, May 7, 2022
[6] Yu Huanhuan Yan Shengnan, "Why are these elderly people who should be protected the most delayed in getting the new crown vaccine?" Eight O'Clock Kenwen, April 26, 2022
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