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Seasonal influenza epidemics accounted for significant morbidity and mortality loads worldwide despite the availability of a safe vaccine as an efficient tool against severity of the disease. However, the uptake of the latter was sub-optimal. This study aims to identify predictors and barriers related to seasonal influenza vaccine uptake in the Kingdom of Bahrain.

A cross-sectional study enrolled 502 individuals attending primary healthcare centers in Bahrain for ambulatory care between July and August 2022. The data were collected using an interviews-based questionnaire which included questions on demographic data, knowledge and attitudes and practices toward influenza vaccine. The authors identified the barriers as well as the determinants of the vaccine uptake and its recommendation to others.

The mean age of participants was 35.07 years (SD = 13.9). Most of the respondents were Bahraini (86.5%) and 53.4 % were females. The results revealed that 34.1% have previous information about the influenza vaccine and 36.9% versus 69.9% are willing to receive the vaccine or advice it to others, respectively. Determinants of vaccine uptake were identified.

This study confirmed a sub-optimal influenza vaccine acceptance in the general community of Bahrain despite a global access in primary care. Health professionals need to be more proactive in mobilizing the community and particularly females toward influenza vaccination.

Several types of vaccines were manufactured by different companies to control and stop the spread of COVID-19. This study aimed to identify the postvaccination side effects of the three different vaccines (Pfizer, AstraZeneca and Sinopharm) among the Iraqi population in Baghdad, Iraq.

A prospective cross-sectional study was conducted in Baghdad, Iraq from May 2021 to March 2022. An online-based questionnaire was used to collect the data through social media, i.e. WhatsApp, Messenger and Google Classroom. A total of 737 vaccinated participants using a snowball sampling methodology were used in this study.

Among the study population, 328 (44.50%) were males and 409 (55.50%) were females. The highest age group that participated was 18–30 years (79.10%) followed by 31–40 years (12.10%), 41–50 years (4.20%), 51–60 years (2.40%) and 60 = years (2.20%). However, 58.8% of the participants received Pfizer-BioNTech, 23.7% received the AstraZeneca-Oxford vaccine and 17.5% received Sinopharm. Out of the total participants, 56.60% showed postvaccination side-effects such as fever, headache, fatigue and dizziness, while 33% showed no side-effects and 10.40% were not sure. Pfizer-BioNTech and AstraZeneca-Oxford vaccines were the most vaccines prevalent of side-effects.

The majority of the side reactions associated with the AstraZeneca and Pfizer vaccines were manageable and self-limiting, including fever, fatigue, headache, joint pain and dizziness, compared to the Sinopharm vaccines, which reported lower postside effects.

This study aims to explore the effect of mental health in terms of depression, anxiety, stress, fear of COVID-19 and quality of life (QoL) on the reluctance to be vaccinated in a population of Palestinian adults living in occupied Palestinian territories and Israel.

The authors recruited 1,122 Palestinian adults who consented to participate in the study; 722 were females, and the mean age of the sample was 40.83 (SD 8.8). Depression, anxiety, and stress scale (DASS), World Health Organization QoL-BREF, FCov-19 and reluctance to the vaccine scale were administered; hierarchical regression analysis was applied to test vaccine reluctance as a dependent variable, and mental health, fear of COVID-19 and QoL as independent variables. This study hypothesized influence of such variables on the vaccine choice with differences due to the participants’ geographical locations.

Findings showed an effect of mental health, particularly depression, QoL and fear of COVID on vaccine reluctance, with depression and fear of COVID in the West Bank and Gaza, while in Israel, QoL played a role in vaccination choices.

The future needs to be comprehended more thoroughly to discover mutations and fluctuations over time in vaccine hesitancy and the increasing role of psychological distress, diminished QoL and fear of Covid-19. Online recruitment might not have allowed the study to include the most disadvantaged strips of the Palestinian population.

Human rights perspectives must be considered in public health and public mental health policies to ensure the QoL and well-being for the Palestinian population during and following the pandemic.

The crumbling of the Palestinian health-care system exacerbated the sense of dread among the population and made them less likely to vaccinate. The pandemic-like spread of Covid-19 prompts a plea for the global community to actively advocate for the urgent re-establishment of equity, autonomy and durability of the medical infrastructure in the occupied territories and equal entitlements for the Palestinians in Israel.

The results demonstrated the importance for public mental health to consider the multiple levels implied in the vaccine refusal in Palestine and Israel among the Palestinian population.

This study aims to focus on building a conceptual closed-loop vaccine supply chain (CLVSC) to decrease vaccine wastage and counterfeit/fake vaccines.

Through a focused literature review, the framework for the CLVSC is described, and the system dynamics (SD) research methodology is used to build a causal loop diagram (CLD) of the proposed model.

In the battle against COVID-19, waste management systems have become overwhelmed, which has created negative environmental and extremely hazardous societal impacts. A key contributing factor is unused vaccine doses, shown as a source for counterfeit/fake vaccines. The findings identify a CLVSC design and transshipment operations to decrease vaccine wastage and the potential for vaccine theft.

This study contributes to establishing a pandemic-specific VSC structure. The proposed model informs the current COVID-19 pandemic as well as potential future pandemics.

A large part of the negative impact of counterfeit/fake vaccines is on human well-being, and this can be avoided with proper CLVSC.

This study develops a novel overarching SD CLD by integrating the epidemic model of disease transmission, VSC and closed-loop structure. This study enhances the policymakers’ understanding of the importance of vaccine waste collection, proper handling and threats to the public, which are born through illicit activities that rely on stolen vaccine doses.

This paper focuses on multi-objective order allocation with product substitution for the vaccine supply chain under uncertainty.

The weighted-sum minimization approach is used to find a compromised solution between three objectives of minimizing inefficiently vaccinated people, postponed vaccinations, and purchasing costs. A mixed-integer formulation with substitution quantities is proposed, subject to capacity and demand constraints. The substitution ratios between vaccines are assumed to be exogenous. Besides, uncertainty in supplier reliability is formulated using optimistic, most likely, and pessimistic scenarios in the proposed optimization model.

Covid-19 vaccine supply chain process is studied for one government and three vaccine suppliers as an illustrative example. The results provide essential insights for the governments to have proper vaccine allocation and support governments to manage the Covid-19 pandemic.

This paper considers the minimization of postponement in vaccination plans and inefficient vaccination and purchasing costs for order allocation among different vaccine types. To the best of the authors’ knowledge, there is no study in the literature on order allocation of vaccine types with substitution. The analytical hierarchy process structure of the Covid-19 pandemic also contributes to the literature.

The purpose of this paper is to develop a framework to evaluate and assess the performance of the COVID-19 vaccine distribution process that is sensitive to the unique supply-side and demand-side constraints exhibited in the US vaccine rollout.

A queuing framework that operates under two distinct regimes is formulated to analyze service rates that represent system capacity to vaccinate (under the first regime) and hesitancy-induced throughput (under the second regime). These supply- and hesitancy-constrained regimes form the focus of the present paper, as the former reflects the inherent ability of the nation in its various jurisdictions to mobilize, whereas the latter reflects a critical area for public policy to protect the population’s overall health and safety.

The two-regime framework analysis provides insights into the capacity to vaccinate and hesitancy-constrained demand, which is found to vary across the country primarily by politics and region. The framework also allows analysis of the end-to-end supply chain, where it is found that the ability to vaccinate was likely constrained by last-mile administration issues, rather than the capacity of the manufacturing and transportation steps of the supply chain.

This study presents a new framework to consider end-to-end supply chains as dynamic systems that exhibit different regimes because of unique supply- and demand-side characteristics and estimate rollout capacity and underlying determinants at the national, state and county levels.

This study provides a systematic literature review and categorization of the costs reported in the literature for the introduction of new vaccines, focusing on sub-Saharan Africa within LMICs, where vaccines are highly needed, financial resources are scarce and data are lacking and scattered.

A systematic literature search of PubMed and Web of Science databases was conducted according to the PRISMA requirements. Searches also included the relevant grey literature. In total, 39 studies were selected and nine cost categories were investigated to build a comprehensive framework.

The paper considers nine cost categories that cover the whole life of the vaccine, from its initial study to its full implementation, including for each of them the relevant subcategories. The systematic review, besides providing specific quantitative data and allowing to assess their variability within each category, points out that delivery, program preparation, administration and procurement costs are the most frequently estimated categories, while the cost of the good sold, costs borne by households and costs associated to AEFI are usually overlooked. Data reported on R&D costs and investment in the production plant differ significantly among the selected contributions.

The literature contributions on cost estimation tend to focus on a precise vaccine, a specific geographic area, or to adopt a narrow approach that captures only a subset of the costs. This article presents a rich and inclusive set of the economic quantitative data on immunization costs in limited-resource countries.

This paper aims to provide rigor and clarity to the current coronavirus disease 2019 (COVID-19) policy debate in Vietnam. It is intended to serve a three-fold purpose. First, it critically examines the framing of policy objectives and the utilization of policy instruments for controlling COVID-19 in Vietnam. Second, it goes beyond policy design to consider the coordination and implementation of COVID-19 policies in Vietnam. Third, it discusses policy measures needed for post-COVID sustainable and inclusive growth, especially the sharing of the public costs of COVID-19 policies.

The paper employs a positivist research framework that emphasizes the causal relationships between the variables under study. The method of analysis is mixed, combining both qualitative and quantitative techniques. In particular, a simple, theoretical model is constructed to evaluate the welfare effects of alternative vaccine strategies. No primary data were collected.

The Vietnamese government’s dual goals of containing the pandemic and maintaining economic growth, while being reasonable, need clarification and updating. It is argued that in the longer term, there is no trade-off between saving lives and protecting the economy. The downward revision of the projected growth rate and commitment to a coherent and transparent vaccination strategy is the best way to move forward in Vietnam. The choice of vaccine rollout order involves a consideration of ethics. It is suggested that it is appropriate to vaccinate elderly people and people with underlying medical conditions first. Complementary policy measures to stimulate aggregate demand and supply need to be expanded but also more targeted. Effective coordination and implementation of COVID-19 policies remain a serious challenge for Vietnam. Finally, inclusive growth and sustainable development should take account of human capital development and distributive justice.

The paper proposes a number of policy measures which have social impact. These include the government's formal commitment to a vaccine first strategy and a relief package of essential goods to poor and disadvantaged households.

The paper contributes positively to the current COVID-19 policy formulation by providing rigor and clarity to the framing of policy objectives and the utilization of policy instruments. While vaccination has been adopted as a national policy instrument, its design and implementation can be much improved. The paper recommends an appropriate vaccine strategy for Vietnam. It also draws attention to other dimensions of successful policies, namely, communication, coordination, implementation and distributive justice.

The COVID-19 pandemic has forced countries to consider how to reach vulnerable communities with extended outreach services to improve vaccination uptake. The authors created an optimization model to align with decision-makers' objective to maximize immunization coverage within constrained budgets and deploy resources considering empirical data and endogenous demand.

A mixed integer program (MIP) determines the location of outreach sites and the resource deployment across health centers and outreach sites. The authors validated the model and evaluated the approach in consultation with UNICEF using a case study from The Gambia.

Results in The Gambia showed that by opening new outreach sites and optimizing resource allocation and scheduling, the Ministry of Health could increase immunization coverage from 91.0 to 97.1% under the same budget. Case study solutions informed managerial insights to drive gains in vaccine coverage even without the application of sophisticated tools.

The research extended resource constrained LMIC vaccine distribution modeling literature in two ways: first, endogenous calculation of demand as a function of distance to health facility location enabled the effective design of the vaccine network around convenience to the community and second, the model's resource bundle concept more accurately and flexibly represented complex requirements and costs for specific resources, which facilitated buy-in from stakeholders responsible for managing health budgets. The paper also demonstrated how to leverage empirical research and spatial analysis of publicly available demographic and geographic data to effectively represent important contextual factors.

Each individual needs to be vaccinated to control the spread of the COVID-19 pandemic in the shortest possible time. However, the vaccine distribution with an already strained supply chain in low- and middle-income countries (LMICs) will not be effective enough to vaccinate all the population in stipulated time. The purpose of this paper is to show that there is a need to revolutionize the vaccine supply chain (VSC) by overcoming the challenges of sustainable vaccine distribution.

An integrated lean, agile and green (LAG) framework is proposed to overcome the challenges of the sustainable vaccine supply chain (SVSC). A hybrid best worst method (BWM)–Measurement of Alternatives and Ranking According to COmpromise Solution (MARCOS) methodology is designed to analyze the challenges and solutions.

The analysis shows that vaccine wastage is the most critical challenge for SVSC, and the coordination among stakeholders is the most significant solution followed by effective management support.

The result of the analysis can help the health care organizations (HCOs) to manage the VSC. The effective vaccination in stipulated time will help control the further spread of the virus, which will result in the normalcy of business and availability of livelihood for millions of people.

To the best of the author's knowledge, this is the first study to explore sustainability in VSC by considering the environmental and social impact of vaccination. The LAG-based framework is also a new approach in VSC to find the solution for existing challenges.