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(searched for: doi:10.1016/s0140-6736(20)32642-8)
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Mohammad S Razai, Tasnime Osama, Douglas G J McKechnie, Azeem Majeed
Published: 26 February 2021
by BMJ
BMJ, Volume 372; doi:10.1136/bmj.n513

The publisher has not yet granted permission to display this abstract.
History and Philosophy of the Life Sciences, Volume 43, pp 1-31; doi:10.1007/s40656-021-00384-9

Abstract:
As witnessed over the last year, immunity emerged as one of most highly debated topics in the current Covid-19 pandemic. Countries around the globe have been debating whether herd immunity or lockdown is the best response, as the race continues for the development and rollout of effective vaccines against coronavirus and as the economic costs of implementing strict containment measures are weighed against public health costs. What became evident all the more is that immunity is precisely what bridges between biological life and political life in the current climate, be it in terms of the contentious notion of herd immunity, the geopolitical struggle for vaccines, or the possible emergence of “Covid-elite”, i.e. holders of so-called “immunity passports”. Immunity, as such, is certainly not only a matter of science and biology alone, but is inherently political in the way that pandemics themselves are often highly politicised. Drawing on the work of Roberto Esposito and other literature from the field of biopolitics and immunology, this paper provides a critical examination of the concept of immunity in light of the recent events, highlighting the intersections between the politics of defence and the politics of sacrifice which animate governments’ immunitary responses to the Covid-19 pandemic. The paper ends with a discussion on the forms of solidarity and local initiatives that have been mobilised during the current pandemic and their potential for an affirmative form of biopolitics. Overall, the main aim of this paper is to provide a critical cultural and philosophical analysis of Covid-19 debates and responses and a nuanced account on the biopolitical effects of the current pandemic, highlighting the paradoxical nature of immunity which straddles at once negative practices of defence and sacrifice as well as affirmative forms of community and solidarity beyond state apparatuses.
, Alexander Adamson, William A MacLean, ,
Published: 1 February 2021
Abstract:
Objectives To inform critical public health messaging by determining how changes in Covid-19 vaccine hesitancy, attitudes to the priorities for administration, the emergence of new variants and availability of vaccines may affect the trajectory and achievement of herd immunity. Methods >9,000 respondents in an ongoing cross-sectional participatory longitudinal epidemiology study (LoC-19, n=18,581) completed a questionnaire within their personal electronic health record in the week reporting first effective Covid-19 vaccines, and then again after widespread publicity of the increased transmissibility of a new variant (November 13th and December 31st 2020 respectively). Questions covered willingness to receive Covid-19 vaccination and attitudes to prioritisation. Descriptive statistics, unadjusted and adjusted odds ratios (ORs) and natural language processing of free-text responses are reported, and how changes over the first 50 days of both vaccination roll-out and new-variant impact modelling of anticipated transmission rates and the likelihood and time to herd immunity. Findings Compared with the week reporting the first efficacious vaccine there was a 15% increase in acceptance of Covid-19 vaccination, attributable in one third to the impact of the new variant, with 75% of respondents “shielding” – staying at home and not leaving unless essential – regardless of health status or tier rules. 12.5% of respondents plan to change their behaviour two weeks after completing vaccination compared with 45% intending to do so only when cases have reduced to a low level. Despite the increase from 71% to 86% over this critical 50-day period, modelling of planned uptake of vaccination remains below that required for rapid effective herd immunity – now estimated to be 90 percent in the presence of a new variant escalating R0 to levels requiring further lockdowns. To inform the public messaging essential therefore to improve uptake, age and female gender were, respectively, strongly positively and negatively associated with wanting a vaccine. 22.7% disagreed with the prioritisation list, though 70.3% were against being able to expedite vaccination through payment. Teachers (988, 12.6%) and Black, Asian and Minority Ethnic (BAME) (837, 10.7%) groups were most cited by respondents for prioritisation. Interpretation In this sample, the growing impact of personal choice among the increasingly informed public highlights a decrease in Covid-19 vaccine hesitancy over time, with news of a new variant motivating increased willingness for vaccination but at levels below what may be required for effective herd immunity. We identify public preferences for next-in-line priorities, headed by teachers and BAME groups, consideration of which will help build trust and community engagement critical for maximising compliance with not only the vaccination programme but also all other public health measures.
Infectious Diseases and Therapy pp 1-8; doi:10.1007/s40121-020-00394-3

Abstract:
The authorization for emergency use of a vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been issued in diverse countries in December 2020, and additional vaccine candidates soon may be cleared for a similar emergency use. If it is reasonable to believe that in some Western countries most people may be vaccinated by the end of 2021, insufficient supplies, access inequities across countries, and deficiencies in enforcing the participatory engagement of communities will present important challenges for the achievement of sufficient vaccination coverage worldwide in less than 2-3 years. A possible strategy for bridging the gap until full vaccine deployment is based on the integration of improved non-pharmaceutical measures and recently authorized pharmaceutical interventions to reduce as much as possible hospitalizations and deaths in the coming months, when recurring infection peaks are expected.
Kiran Gaur, Raghubir S. Khedar, Kishore Mangal, Arvind K. Sharma, Rajinder K. Dhamija,
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, Volume 15, pp 343-350; doi:10.1016/j.dsx.2021.01.005

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