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While the efficacy of coronavirus disease 2019 (COVID-19) vaccines has been evaluated in numerous trials, comprehensive evidence on how protection by different vaccines has varied over time remains limited. We aimed to compare protective effects of different vaccines against different viral variants. To achieve this, we searched Medline, Cochrane Library and Embase for randomized controlled trials assessing the efficacy of COVID-19 vaccines. Forest plots using Mantel–Haenszel and random-effects models were generated showing risk ratios (RRs) and 95% CIs by vaccines and variants. We included 36 studies with 90 variant-specific primary outcomes. We found a RR of 0.26 (95% CI 0.21 to 0.31) against all variants overall, with the highest protective effects against the wild-type (RR 0.13; 95% CI 0.10 to 0.18), followed by Alpha (RR 0.26; 95% CI 0.18 to 0.36), Gamma (RR 0.34; 95% CI 0.21 to 0.55), Delta (RR 0.39; 95% CI 0.28 to 0.56) and Beta (RR 0.49; 95% CI 0.40 to 0.62) variants. Nucleic acid vaccines showed the highest protection levels against all variants (RR 0.11; 95% CI 0.08 to 0.15), followed by protein subunit, inactivated virus and viral vector. In conclusion, we found high but heterogenous levels of protection for most COVID-19 vaccines, with decreasing protective effects for vaccines based on traditional technologies as SARS-CoV-2 variants emerged over time. Novel nucleic acid-based vaccines offered substantially higher and more consistent protection. [ABSTRACT FROM AUTHOR]

Objectives Research on family caregiving for older adults has largely focused on primary caregivers. We identify caregiving task-sharing patterns among multiple caregivers, including family members and live-in hired workers. In addition, we investigate caregiver and care-recipient characteristics associated with these patterns. Methods We interviewed 278 primary family caregivers of home-dwelling older adults in Singapore about who provides what assistance across 3 domains: activities of daily living, health and social services use, and socioemotional and other needs. Latent class analysis was used to identify caregiving task-sharing patterns. Results Three patterns were identified: (a) "Shared-Diverse" (39%)—multiple caregivers assisting in all 3 domains, (b) "Shared-Domestic" (32%)—multiple caregivers assisting with activities of daily living and socioemotional and other needs, and (c) "Solo-Diverse" (29%)—a sole caregiver assisting in all 3 domains. "Solo-Diverse" caregivers were less likely to be employed and had higher depressive symptoms relative to "Shared-Diverse" primary family caregivers. Discussion The predominance of caregiving task-sharing patterns involving multiple caregivers calls for expansion of research, policies, and programs beyond primary caregivers. Greater attention should be given to how families and live-in hired workers share caregiving tasks for older adults, and how this varies across cultural settings, especially in familial Asian societies. The findings further highlight the vulnerabilities of solo caregivers, whose employment capacity and mental health may be adversely affected by their caregiving duties. Policy-makers should ensure that solo caregivers have access to support programs that address their financial and mental health needs. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 2022, many universities transitioned from virtual learning back to in-person teaching. Significant changes in working conditions, along with COVID-19-related anxiety during the pandemic, might impact the well-being of lecturers. OBJECTIVE: This study aims to assess the perceived stress, self-rated physical and occupational health of Vietnamese lecturers in 2022 compared to the pre-pandemic levels, and to identify their associating factors. METHOD: This is a cross-sectional study conducted in May–June 2022 through an online survey questionnaire. A sample of 425 university lecturers were included. Participants' stress levels were assessed using the Perceived Stress Scale. Participants were asked to compare their current physical and occupational health with before the pandemic. Explanatory variables included (1) COVID-19 exposure; and (2) perceptions of changes in working environment due to the pandemic. Multivariable ordinal least squared regression analyses were used to estimate the coefficient and 95% confidence intervals for the associations between COVID-19 exposure variables, work conditions, and each outcome. RESULTS: Our findings indicated that over 60% of participants experienced moderate stress, while nearly half reported worsened physical and occupational health during the pandemic. Gender, age, perceptions of workload, workplace safety, COVID-19 infection, and incentive programs were significant factors associated with higher stress levels and worse self-rated health. CONCLUSION: To ensure occupational safety and support lecturers as they return to in-person classes, it is crucial to provide appropriate psychological and health support services. [ABSTRACT FROM AUTHOR]

Objectives: In March 2020, a COVID‐19 outbreak in a major referral hospital in Hanoi, Vietnam led to 7664 patients and staff being sent into lockdown for 2 weeks, and more than 52,200 persons across 49 provinces being quarantined. We assessed SARS‐CoV‐2 transmission patterns during this to‐date largest hospital outbreak in Vietnam using social network analysis (SNA). Methods: We constructed a directed relational network and calculated network metrics for 'degree', 'betweenness', 'closeness' and 'eigenvector' centrality to understand individual‐level transmission patterns. We analysed network components and modularity to identify sub‐network structures with disproportionately big effects. Results: We detected 68 connections between 46 confirmed cases, of whom 27 (58.7%) were ancillary support staff, 7 (15.2%) caregivers, 6 (13%) patients and 2 (4.4%) nurses. Among the 10 most important cases selected by each SNA network metric, transmission dynamics clustered in 17 cases, of whom 12 (70.6%) cases were ancillary support staff. Ancillary support staff also constituted 71.1% of cases in the dominant sub‐network and 68.8% of cases in the three largest sub‐communities. Conclusions: We identified non‐clinical ancillary support staff, who are responsible for room service and food distribution in hospital wards in Vietnam, as a group with disproportionally big impacts on transmission dynamics during this outbreak. Our findings call for a holistic approach to nosocomial outbreak prevention and response that includes both clinical and non‐clinical hospital staff. Our work also shows the potential of SNA as a complementary outbreak investigation method to better understand infection patterns in hospitals and similar settings. [ABSTRACT FROM AUTHOR]

Background: Trends in the public perception and awareness of COVID-19 over time are poorly understood. We conducted a longitudinal study to analyze characteristics and trends of online information during a major COVID-19 outbreak in Da Nang province, Vietnam in July-August 2020 to understand public awareness and perceptions during an epidemic. Methods: We collected online information on COVID-19 incidence and mortality from online platforms in Vietnam between 1 July and 15 September, 2020, and assessed their trends over time against the epidemic curve. We explored the associations between engagement, sentiment polarity, and other characteristics of online information with different outbreak phases using Poisson regression and multinomial logistic regression analysis. We assessed the frequency of keywords over time, and conducted a semantic analysis of keywords using word segmentation. Results: We found a close association between collected online information and the evolution of the COVID-19 situation in Vietnam. Online information generated higher engagements during compared to before the outbreak. There was a close relationship between sentiment polarity and posts' topics: the emotional tendencies about COVID-19 mortality were significantly more negative, and more neutral or positive about COVID-19 incidence. Online newspaper reported significantly more information in negative or positive sentiment than online forums or social media. Most topics of public concern followed closely the progression of the COVID-19 situation during the outbreak: development of the global pandemic and vaccination; the unfolding outbreak in Vietnam; and the subsiding of the outbreak after two months. Conclusion: This study shows how online information can reflect a public health threat in real time, and provides important insights about public awareness and perception during different outbreak phases. Our findings can help public health decision makers in Vietnam and other low and middle income countries with high internet penetration rates to design more effective communication strategies during critical phases of an epidemic. [ABSTRACT FROM AUTHOR]

Background One hundred days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Vietnam on 23 January, 270 cases were confirmed, with no deaths. We describe the control measures used by the government and their relationship with imported and domestically acquired case numbers, with the aim of identifying the measures associated with successful SARS-CoV-2 control. Methods Clinical and demographic data on the first 270 SARS-CoV-2 infected cases and the timing and nature of government control measures, including numbers of tests and quarantined individuals, were analyzed. Apple and Google mobility data provided proxies for population movement. Serial intervals were calculated from 33 infector-infectee pairs and used to estimate the proportion of presymptomatic transmission events and time-varying reproduction numbers. Results A national lockdown was implemented between 1 and 22 April. Around 200 000 people were quarantined and 266 122 reverse transcription polymerase chain reaction (RT-PCR) tests conducted. Population mobility decreased progressively before lockdown. In total, 60% (163/270) of cases were imported; 43% (89/208) of resolved infections remained asymptomatic for the duration of infection. The serial interval was 3.24 days, and 27.5% (95% confidence interval [CI], 15.7%-40.0%) of transmissions occurred presymptomatically. Limited transmission amounted to a maximum reproduction number of 1.15 (95% CI,.·37–2.·36). No community transmission has been detected since 15 April. Conclusions Vietnam has controlled SARS-CoV-2 spread through the early introduction of mass communication, meticulous contact tracing with strict quarantine, and international travel restrictions. The value of these interventions is supported by the high proportion of asymptomatic and imported cases, and evidence for substantial presymptomatic transmission. [ABSTRACT FROM AUTHOR]

To assess the role of in-flight transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we investigated a cluster of cases among passengers on a 10-hour commercial flight. Affected persons were passengers, crew, and their close contacts. We traced 217 passengers and crew to their final destinations and interviewed, tested, and quarantined them. Among the 16 persons in whom SARS-CoV-2 infection was detected, 12 (75%) were passengers seated in business class along with the only symptomatic person (attack rate 62%). Seating proximity was strongly associated with increased infection risk (risk ratio 7.3, 95% CI 1.2-46.2). We found no strong evidence supporting alternative transmission scenarios. In-flight transmission that probably originated from 1 symptomatic passenger caused a large cluster of cases during a long flight. Guidelines for preventing SARS-CoV-2 infection among air passengers should consider individual passengers' risk for infection, the number of passengers traveling, and flight duration. [ABSTRACT FROM AUTHOR]

• Slowing the spread of COVID-19 was initially achieved in Vietnam. • Vietnam's healthcare system put the precaution of COVID-19 to priority. • Intensive and expansive contact, overall isolation, and sterilization should be implemented as soon as possible. • Further measures are expected in light of different progressive scenarios of the disease. Vietnam was slowing the spread of COVID-19 to 200 cases by the end of March. From perspective of a relatively vulnerable healthcare systems, timely interventions were implemented to different stage of pandemic progress to limit the spread. The authors compiled literature on different public health measures in Vietnam in compared to the progression of COVID-19 from January to March 2020. Three stages of pandemic progression of COVID-19 were recorded in Vietnam. At 213 confirmed cases under treatment and isolation, a range of interventions were enforced including intensive and expansive contact, mass testing, isolation, and sterilization. Many were in place before any case were reported. Preparation were key for Vietnam's healthcare system in the ever-changing landscape of COVID-19 pandemic. [ABSTRACT FROM AUTHOR]