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2. Health and Well-Being at the Transition to Adulthood Among Individuals With Disabilities: An Analysis of the Panel Study of Income Dynamics.

Author

Hotez, Emily Rose, Pan, Mengtong, Jackson, Nicholas, Rava, Julianna, Wisk, Lauren, Lei, Yvonne, Schickedanz, Adam, and Kuo, Alice

Subjects
Young Adult, Humans, Aged, Adult, Retrospective Studies, Attention Deficit Disorder with Hyperactivity, Learning Disabilities, Self Report, Learning
Abstract

PURPOSE: To describe positive mental health, or flourishing, and self-reported health trajectories among transition-aged young adults (TAYA) with developmental/learning and physical disabilities over a 12-year period, utilizing a population-based sample. METHODS: This study features a secondary analysis of national data from the Panel Study of Income Dynamics Transition to Adulthood Supplement. The analytic sample included all TAYA with (n = 487) and without (n = 810) disabilities, including developmental/learning disabilities (DD/LD), attention deficit hyperactivity disorder (ADHD), and speech, hearing, and vision impairments who participated in 2017 Transition to Adulthood Supplement data collection (n = 1,297; M age = 24.5, standard deviation = 2.40). We utilized linear mixed modeling to retrospectively describe flourishing and self-reported health trajectories across 12 years among TAYA with and without disabilities between ages 18 to 28, adjusting for demographic and developmental characteristics. RESULTS: Relative to TAYA without disabilities, TAYA with speech [0.10, 0.85] and vision impairments [0.10, 0.92], DD/LD [0.38, 1.11], and ADHD [0.27, 0.97] demonstrated lower flourishing. TAYA with speech [0.07, 0.36] and vision impairments [0.08, 0.38], DD/LD [0.15, 0.411], and ADHD [0.14, 0.93] reported lower health. Relative to TAYA with other disabilities, TAYA with ADHD [0.14, 0.93] and DD/LD [0.01, 0.29] reported lower flourishing and health, respectively. Interaction effects and descriptive analyses revealed distinct patterns of change for TAYA with ADHD. DISCUSSION: TAYA with disabilities report lower flourishing and health, relative to TAYA without disabilities. TAYA with specific disabilities differ in their flourishing and health trajectories. Findings can inform the development of interventions for TAYA with disabilities.

Published
2024

3. A trivalent protein-based pan-Betacoronavirus vaccine elicits cross-neutralizing antibodies against a panel of coronavirus pseudoviruses

Author

Thimmiraju, Syamala Rani, Adhikari, Rakesh, Redd, JeAnna R., Villar, Maria Jose, Lee, Jungsoon, Liu, Zhuyun, Chen, Yi-Lin, Sharma, Suman, Kaur, Amandeep, Uzcategui, Nestor L., Ronca, Shannon E., Chen, Wen-Hsiang, Kimata, Jason T., Zhan, Bin, Strych, Ulrich, Bottazzi, Maria Elena, Hotez, Peter J., and Pollet, Jeroen

Published
2024
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5. Virology—the path forward

Author

Rasmussen, Angela L, Gronvall, Gigi K, Lowen, Anice C, Goodrum, Felicia, Alwine, James, Andersen, Kristian G, Anthony, Simon J, Baines, Joel, Banerjee, Arinjay, Broadbent, Andrew J, Brooke, Christopher B, Campos, Samuel K, Caposio, Patrizia, Casadevall, Arturo, Chan, Gary C, Cliffe, Anna R, Collins-McMillen, Donna, Connell, Nancy, Damania, Blossom, Daugherty, Matthew D, Debbink, Kari, Dermody, Terence S, DiMaio, Daniel, Duprex, W Paul, Emerman, Michael, Galloway, Denise A, Garry, Robert F, Goldstein, Stephen A, Greninger, Alexander L, Hartman, Amy L, Hogue, Brenda G, Horner, Stacy M, Hotez, Peter J, Jung, Jae U, Kamil, Jeremy P, Karst, Stephanie M, Laimins, Lou, Lakdawala, Seema S, Landais, Igor, Letko, Michael, Lindenbach, Brett, Liu, Shan-Lu, Luftig, Micah, McFadden, Grant, Mehle, Andrew, Morrison, Juliet, Moscona, Anne, Mühlberger, Elke, Munger, Joshua, Münger, Karl, Murphy, Eain, Neufeldt, Christopher J, Nikolich, Janko Z, O'Connor, Christine M, Pekosz, Andrew, Permar, Sallie R, Pfeiffer, Julie K, Popescu, Saskia V, Purdy, John G, Racaniello, Vincent R, Rice, Charles M, Runstadler, Jonathan A, Sapp, Martin J, Scott, Rona S, Smith, Gregory A, Sorrell, Erin M, Speranza, Emily, Streblow, Daniel, Tibbetts, Scott A, Toth, Zsolt, Van Doorslaer, Koenraad, Weiss, Susan R, White, Elizabeth A, White, Timothy M, Wobus, Christiane E, Worobey, Michael, Yamaoka, Satoko, and Yurochko, Andrew

Subjects
Agricultural, Veterinary and Food Sciences, Biological Sciences, Biomedical and Clinical Sciences, Coronaviruses, Prevention, Emerging Infectious Diseases, Infectious Diseases, Good Health and Well Being, Humans, Containment of Biohazards, COVID-19, United States, Viruses, Virology, Biomedical Research, virology, SARS-CoV-2, oversight, biosafety, emergence, Agricultural and Veterinary Sciences, Medical and Health Sciences, Agricultural, veterinary and food sciences, Biological sciences, Biomedical and clinical sciences
Abstract

In the United States (US), biosafety and biosecurity oversight of research on viruses is being reappraised. Safety in virology research is paramount and oversight frameworks should be reviewed periodically. Changes should be made with care, however, to avoid impeding science that is essential for rapidly reducing and responding to pandemic threats as well as addressing more common challenges caused by infectious diseases. Decades of research uniquely positioned the US to be able to respond to the COVID-19 crisis with astounding speed, delivering life-saving vaccines within a year of identifying the virus. We should embolden and empower this strength, which is a vital part of protecting the health, economy, and security of US citizens. Herein, we offer our perspectives on priorities for revised rules governing virology research in the US.

Published
2024

6. A Mixed Methods Investigation of College Student Mental Health during the First Year of the COVID-19 Pandemic

Author

Emily Hotez, Candace M. Gragnani, Priyanka Fernandes, Kashia A. Rosenau, Karina Wang, Apsara Chopra, Katherine Chow, Ada Chung, Laila Khorasani, and Alice A. Kuo

Abstract

Objective: Researchers collaborated with undergraduate minority students to quantitatively and qualitatively investigate college students' mental health during the first year of the COVID-19 pandemic. Participants: Participants were two convenience samples of diverse college students surveyed in June (n = 128; M age = 21.7, SD = 1.7) and December (n = 242; M age = 20.3, SD = 1.7) of 2020. Methods: This study administered items from the California Health Interview Survey and open-ended qualitative items via Qualtrics. Results: Across both waves, students reported significant mental health challenges and psychological distress. Students surveyed in December were three to four times more likely to report depression and anxiety. Female and older students reported heightened odds of mental health challenges. Qualitative findings elaborated on contributing factors. Conclusion: During the pandemic, college students have experienced pronounced mental health challenges, potentially exacerbated by academic, professional, relational, and environmental stressors and uncertainty.

Published
2024
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7. Preliminary Pilot-Testing of Intimate Partner Violence Screening for Transgender and Gender Diverse (TGD) Individuals in Med-Peds and Family Medicine.

Author

Hotez, Emily, Yang, Bridgette, Chua, Kristine, Smith, Andrew, Lee, Cameron, Delgado, Daniela, and Weimer, Amy

Subjects
gender health, intimate partner violence (ipv), pilot project, screener, transgender health
Abstract

INTRODUCTION: Transgender and gender diverse (TGD) individuals, comprised of those whose gender identity does not correspond with the sex they were assigned at birth, represent approximately 1.4 million people in the U.S., with a higher prevalence among those 18-24 years old. TGD individuals experience high levels of intimate partner violence (IPV), which leads to disproportionately negative mental and physical health outcomes for this population. As a result, there is a resounding need to connect TGD populations to health-promoting services, supports and resources. Med-Peds and Family Medicine clinics may be particularly well-positioned to support these efforts due to physicians focus on transitional-aged youth and young adults under 30. METHODS: The current manuscript reports on processes and outcomes related to a quality improvement (QI) initiative that aimed to test the feasibility and acceptability of implementing IPV screening within both a Med-Peds and a Family Medicine specialty clinic serving TGD populations in Los Angeles, CA. This QI initiative included screeners that capture IPV in cisgender/non-TGD populations (Humiliation, Afraid, Rape, Kick [HARK]) as well as in TGD populations specifically (IPV-T). We utilized a mixed-methods approach to both quantify and qualify responses to existing IPV screening as well as informal feedback from clinic champions in each clinic. RESULTS: Quantitative and qualitative findings from this QI initiative, featuring both general and TGD-specific IPV screening measures with 140 TGD individuals, elucidated several important processes that can support effective IPV screening and referral to supports and services. These include the importance of interdisciplinary teams, the utility of an iterative approach to screener roll-out, and the essential role of solidifying a referral process in these efforts. This project additionally shed light on the potential utility and challenges of implementing both general and TGD-specific IPV screening measures. Our pilot test did not support the necessity of a TGD-specific IPV screener for identifying and responding to IPV in this population, yet additional data is critical to generate more conclusive recommendations. CONCLUSION: We recommend larger-scale data collection efforts to evaluate the utility of integrating general and TGD-specific screeners into clinic workflows to ensure optimal health promotion for the TGD population in Med-Peds and Family Medicine clinics.

Published
2023

9. Comparing the Writing Skills of Autistic and Nonautistic University Students: A Collaboration with Autistic University Students

Author

Gillespie-Lynch, Kristen, Hotez, Emily, Zajic, Matthew, Riccio, Ariana, DeNigris, Danielle, Kofner, Bella, Bublitz, Dennis, Gaggi, Naomi, and Luca, Kavi

Abstract

The writing skills of autistic university students have received very little empirical attention. Previous research has suggested that autistic people may struggle with writing, in part, due to challenges with Theory of Mind. However, other research indicates that Theory of Mind difficulties are far from universal in autism, varying across developmental and social contexts. Through a participatory research approach, autistic university students contributed to the current study examining the writing strengths and challenges of autistic (n = 25) and nonautistic (n = 25) university students. Autistic participants demonstrated more advanced writing skills, more perfectionistic attitudes about writing, and heightened nonverbal intelligence relative to nonautistic students. Autistic students did not exhibit reduced Theory of Mind skills. Although heightened nonverbal intelligence and being autistic were both initially predictive of writing quality, autism was no longer associated with writing quality after accounting for nonverbal intelligence. Findings suggest that autistic university students may often have enhanced cognitive and writing skills but may face challenges overcoming perfectionism. This research highlights the value of participatory collaborations with autistic students for identifying strengths that can help autistic students succeed in college. [For the corresponding grantee submission, see ED607171.]

Published
2020
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11. Building a Life Course Intervention Research Framework.

Author

Russ, Shirley, Hotez, Emily, Berghaus, Mary, Hoover, Clarissa, Verbiest, Sarah, Schor, Edward, and Halfon, Neal

Subjects
Adolescent, Humans, Life Change Events, Research Design
Abstract

OBJECTIVES: To report on first steps toward building a Life Course Intervention Research Framework (LCIRF) to guide researchers studying interventions to improve lifelong health. METHODS: The Life Course Intervention Research Network, a collaborative national network of >75 researchers, service providers, community representatives and thought leaders, participated in an iterative review process. Building on the revised Medical Research Council Guidance for Developing and Evaluating Complex Interventions, they identified 12 additional key models with features for inclusion in the LCIRF, then incorporated the 12 characteristics identified by the Life Course Intervention Research Network as actionable features of Life Course Interventions to produce the new LCIRF. RESULTS: The LCIRF sets out a detailed step-wise approach to intervention development: (1) conceptualization and planning, (2) design, (3) implementation, (4) evaluation, and (5) spreading and scaling of interventions. Each step is infused with life course intervention characteristics including a focus on (1) collaborative codesign (2) health optimization, (3) supporting emerging health development capabilities (4) strategic timing, (5) multilevel approaches, and (6) health equity. Key features include a detailed transdisciplinary knowledge synthesis to inform intervention development; formation of strong partnerships with family, community, and youth representatives in intervention codesign; a means of testing the impact of each intervention on biobehavioral processes underlying emerging health trajectories; and close attention to intervention context. CONCLUSIONS: This first iteration of the LCIRF has been largely expert driven. Next steps will involve widespread partner engagement in framework refinement and further development. Implementation will require changes to the way intervention studies are organized and funded.

Published
2022

12. What Makes an Intervention a Life Course Intervention?

Author

Russ, Shirley, Hotez, Emily, Berghaus, Mary, Verbiest, Sarah, Hoover, Clarissa, Schor, Edward, and Halfon, Neal

Subjects
Child, Ecosystem, Humans, Life Change Events
Abstract

OBJECTIVES: To develop an initial list of characteristics of life course interventions to inform the emerging discipline of life course intervention research. METHODS: The Life Course Intervention Research Network, a collaborative national network of >75 researchers, service providers, community representatives, and thought leaders, considered the principles, characteristics, and utility of life course interventions. After an in-person launch meeting in 2019, the steering committee collaboratively and iteratively developed a list of life course intervention characteristics, incorporating a modified Delphi review process. RESULTS: The Life Course Intervention Research Network identified 12 characteristics of life course interventions. These interventions (1) are aimed at optimizing health trajectories; (2) are developmentally focused, (3) longitudinally focused, and (4) strategically timed; and are (5) designed to address multiple levels of the ecosystem where children are born, live, learn, and grow and (6) vertically, horizontally, and longitudinally integrated to produce a seamless, forward-leaning, health optimizing system. Interventions are designed to (7) support emerging health development capabilities; are (8) collaboratively codesigned by transdisciplinary research teams, including stakeholders; and incorporate (9) family-centered, (10) strengths-based, and (11) antiracist approaches with (12) a focus on health equity. CONCLUSIONS: The intention for this list of characteristics of life course interventions is to provide a starting point for wider discussion and to guide research development. Incorporation of these characteristics into intervention designs may improve emerging health trajectories and move critical developmental processes and pathways back on track, even optimizing them to prevent or reduce adverse outcomes.

Published
2022

13. Incentives for COVID-19 vaccination

Author

Brewer, Noel T, Buttenheim, Alison M, Clinton, Chelsea V, Mello, Michelle M, Benjamin, Regina M, Callaghan, Timothy, Caplan, Arthur, Carpiano, Richard M, DiResta, Renee, Elharake, Jad A, Flowers, Lisa C, Galvani, Alison P, Hotez, Peter J, Lakshmanan, Rekha, Maldonado, Yvonne A, Omer, Saad B, Salmon, Daniel A, Schwartz, Jason L, Sharfstein, Joshua M, and Opel, Douglas J

Published
2022

14. The Autism Intervention Research Network on Physical Health (AIR-P) Research Agenda.

Author

Kuo, Alice A, Hotez, Emily, Rosenau, Kashia A, Gragnani, Candace, Fernandes, Priyanka, Haley, Madeline, Rudolph, Dawn, Croen, Lisa A, Massolo, Maria L, Holmes, Laura Graham, Shattuck, Paul, Shea, Lindsay, Wilson, Rujuta, Martinez-Agosto, Julian A, Brown, Heather M, Dwyer, Patrick SR, Gassner, Dena L, Kapp, Steven K, Ne'eman, Ari, Ryan, Jacalyn G, Waisman, TC, Williams, Zachary J, DiBari, Jessica N, Foney, Dana M, Ramos, Lauren R, and Kogan, Michael D

Subjects
Health Services and Systems, Public Health, Health Sciences, Pediatric, Mental Health, Behavioral and Social Science, Brain Disorders, Prevention, Autism, Clinical Research, Health Services, Intellectual and Developmental Disabilities (IDD), Generic health relevance, Good Health and Well Being, Autistic Disorder, Chronic Disease, Humans, Quality of Life, United States, AIR-P NATIONAL COORDINATING CENTER, AUTISTIC RESEARCHER REVIEW BOARD, Medical and Health Sciences, Psychology and Cognitive Sciences, Pediatrics, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

In the United States, autistic individuals experience disproportionate physical and mental health challenges relative to non-autistic individuals, including higher rates of co-occurring and chronic conditions and lower physical, social, and psychological health-related quality of life. The Autism Intervention Research Network on Physical Health (AIR-P) is an interdisciplinary, multicenter research network for scientific collaboration and infrastructure that aims to increase the life expectancy and quality of life for autistic individuals, with a focus on underserved or vulnerable populations. The current paper describes the development of the AIR-P Research Agenda. Development of the research agenda involved an iterative and collaborative process between the AIR-P Advisory Board, Steering Committee, and Autistic Researcher Review Board. The methodology consisted of 3 phases: (1) ideation and design, (2) literature review and synthesis; and (3) network engagement. Six core research priorities related to the health of autistic individuals were identified: (1) primary care services and quality, (2) community-based lifestyle interventions, (3) health systems and services, (4) gender, sexuality, and reproductive health, (5) neurology, and (6) genetics. Specific topics within each of these priorities were identified. Four cross-cutting research priorities were also identified: (1) neurodiversity-oriented care, (2) facilitating developmental transitions, (3) methodologically rigorous intervention studies, and (4) addressing health disparities. The AIR-P Research Agenda represents an important step forward for enacting large-scale health-promotion efforts for autistic individuals across the lifespan. This agenda will catalyze autism research in historically underrepresented topic areas while adopting a neurodiversity-oriented approach to health-promotion.

Published
2022

15. The Autism Intervention Research Network on Physical Health (AIR-P) Charter.

Author

Kuo, Alice A, Hotez, Emily, Rosenau, Kashia A, Gragnani, Candace, Fernandes, Priyanka, Haley, Madeline, Rudolph, Dawn, Croen, Lisa A, Massolo, Maria L, Graham Holmes, Laura, Shattuck, Paul, Shea, Lindsay, Wilson, Rujuta, Martinez-Agosto, Julian A, Brown, Heather M, Dwyer, Patrick SR, Gassner, Dena L, Kapp, Steven K, Ne'eman, Ari, Ryan, Jacalyn G, Waisman, TC, Williams, Zachary J, DiBari, Jessica N, Foney, Dana M, Ramos, Lauren R, and Kogan, Michael D

Subjects
Biomedical and Clinical Sciences, Health Sciences, Psychology, Autistic Disorder, Case-Control Studies, Humans, AIR-P NATIONAL COORDINATING CENTER, AIR-P STEERING COMMITTEE, AUTISTIC RESEARCHER REVIEW BOARD, Medical and Health Sciences, Psychology and Cognitive Sciences, Pediatrics, Biomedical and clinical sciences, Health sciences
Published
2022

16. Mindfulness and Wellbeing Among College Students During the COVID-19 Pandemic: A Qualitative Analysis of Emergent Themes and Concerns

Author

Rava, Julianna A and Hotez, Emily

Subjects
Health Services and Systems, Health Sciences, Social Determinants of Health, Complementary and Integrative Health, Infectious Diseases, Mental Health, Mind and Body, Coronaviruses Disparities and At-Risk Populations, Emerging Infectious Diseases, Prevention, Clinical Research, Pediatric, Coronaviruses, Behavioral and Social Science, Good Health and Well Being, med-peds, college, health, mindfulness, emerging adulthood, Medical and Health Sciences, Biomedical and clinical sciences, Health sciences
Abstract

Emerging adulthood (ages of 18-30 years) is a critical developmental period characterized by mental health challenges, particularly for college students who experience distinct mental health issues. Mindfulness-based approaches have been associated with mental health benefits. This study aimed to assess the mental health and wellbeing of college students with qualitative data obtained via their participation in a mindfulness exercise. We analyzed the sentiments and concerns of college students nearly a year into the coronavirus disease 2019 (COVID-19) pandemic. The results led to the development of four major themes: a source code of the COVID-19 pandemic, assessments of mindfulness and wellbeing, emergent concerns, and coping strategies. The findings from this paper can inform combined internal medicine and pediatrics (Med-Peds) providers' efforts to improve the mental and physical health outcomes among emerging adults.

Published
2021

17. Promoting COVID-19 vaccine acceptance: recommendations from the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA

Author

Omer, Saad B, Benjamin, Regina M, Brewer, Noel T, Buttenheim, Alison M, Callaghan, Timothy, Caplan, Arthur, Carpiano, Richard M, Clinton, Chelsea, DiResta, Renee, Elharake, Jad A, Flowers, Lisa C, Galvani, Alison P, Lakshmanan, Rekha, Maldonado, Yvonne A, McFadden, SarahAnn M, Mello, Michelle M, Opel, Douglas J, Reiss, Dorit R, Salmon, Daniel A, Schwartz, Jason L, Sharfstein, Joshua M, and Hotez, Peter J

Subjects
Emerging Infectious Diseases, Vaccine Related, Immunization, Infectious Diseases, Prevention, Prevention of disease and conditions, and promotion of well-being, 3.4 Vaccines, Infection, Good Health and Well Being, Behavior Therapy, COVID-19, COVID-19 Vaccines, Communication, Humans, Immunization Programs, Politics, SARS-CoV-2, United States, Vaccination Refusal, Medical and Health Sciences, General & Internal Medicine
Abstract

Since the first case of COVID-19 was identified in the USA in January, 2020, over 46 million people in the country have tested positive for SARS-CoV-2 infection. Several COVID-19 vaccines have received emergency use authorisations from the US Food and Drug Administration, with the Pfizer-BioNTech vaccine receiving full approval on Aug 23, 2021. When paired with masking, physical distancing, and ventilation, COVID-19 vaccines are the best intervention to sustainably control the pandemic. However, surveys have consistently found that a sizeable minority of US residents do not plan to get a COVID-19 vaccine. The most severe consequence of an inadequate uptake of COVID-19 vaccines has been sustained community transmission (including of the delta [B.1.617.2] variant, a surge of which began in July, 2021). Exacerbating the direct impact of the virus, a low uptake of COVID-19 vaccines will prolong the social and economic repercussions of the pandemic on families and communities, especially low-income and minority ethnic groups, into 2022, or even longer. The scale and challenges of the COVID-19 vaccination campaign are unprecedented. Therefore, through a series of recommendations, we present a coordinated, evidence-based education, communication, and behavioural intervention strategy that is likely to improve the success of COVID-19 vaccine programmes across the USA.

Published
2021

18. Discrimination and Subsequent Mental Health, Substance Use, and Well-being in Young Adults

Author

Lei, Yvonne, Shah, Vivek, Biely, Christopher, Jackson, Nicholas, Dudovitz, Rebecca, Barnert, Elizabeth, Hotez, Emily, Guerrero, Alma, Bui, Anthony L, Sastry, Narayan, and Schickedanz, Adam

Subjects
Prevention, Behavioral and Social Science, Basic Behavioral and Social Science, Brain Disorders, Clinical Research, Mental Health, Aetiology, 2.3 Psychological, social and economic factors, Mental health, Good Health and Well Being, Adult, Age Factors, Ageism, Apathy, Binge Drinking, Cross-Sectional Studies, Female, Health Status, Humans, Interpersonal Relations, Logistic Models, Longitudinal Studies, Male, Mental Disorders, Prejudice, Prevalence, Psychological Distress, Racism, Self Report, Sex Factors, Sexism, Socioeconomic Factors, Substance-Related Disorders, Time Factors, United States, Young Adult, Medical and Health Sciences, Psychology and Cognitive Sciences, Pediatrics
Abstract

ObjectivesDiscrimination has been shown to have profound negative effects on mental and behavioral health and may influence these outcomes early in adulthood. We aimed to examine short-term, long-term, and cumulative associations between different types of interpersonal discrimination (eg, racism, sexism, ageism, and physical appearance discrimination) and mental health, substance use, and well-being for young adults in a longitudinal nationally representative US sample.MethodsWe used data from 6 waves of the Transition to Adulthood Supplement (2007-2017, 1834 participants) of the Panel Study of Income Dynamics. Outcome variables included self-reported health, drug use, binge drinking, mental illness diagnosis, Languishing and Flourishing score, and Kessler Psychological Distress Scale score. We used logistic regression with cluster-robust variance estimation to test cross-sectional and longitudinal associations between discrimination frequency (overall, cumulative, and by different reason) and outcomes, controlling for sociodemographics.ResultsIncreased discrimination frequency was associated with higher prevalence of languishing (relative risk [RR] 1.34 [95% CI 1.2-1.4]), psychological distress (RR 2.03 [95% CI 1.7-2.4]), mental illness diagnosis (RR 1.26 [95% CI 1.1-1.4]), drug use (RR 1.24 [95% CI 1.2-1.3]), and poor self-reported health (RR 1.26 [95% CI 1.1-1.4]) in the same wave. Associations persisted 2 to 6 years after exposure to discrimination. Similar associations were found with cumulative high-frequency discrimination and with each discrimination subcategory in cross-sectional and longitudinal analyses.ConclusionsIn this nationally representative longitudinal sample, current and past discrimination had pervasive adverse associations with mental health, substance use, and well-being in young adults.

Published
2021

20. Making it personal: science communication for the masses

Author

Sullivan, William J, Strathdee, Steffanie A, and Hotez, Peter J

Subjects
Veterinary Sciences, Agricultural, Veterinary and Food Sciences, Medical Microbiology, Biomedical and Clinical Sciences, Communication, Public Health, Science, narrative, science and society, science books, science communication, writing, Biological Sciences, Agricultural and Veterinary Sciences, Medical and Health Sciences, Mycology & Parasitology, Veterinary sciences, Medical microbiology
Abstract

To curtail the rising tide of antiscience threatening the health and progress of society, scientists are increasingly engaging with the public. Here, we describe our approach to write accessible books based on personal stories as a means to help spread scientific literacy to those who normally do not read science.

Published
2021

22. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015

Author

Roth, Gregory A, Johnson, Catherine, Abajobir, Amanuel, Abd-Allah, Foad, Abera, Semaw Ferede, Abyu, Gebre, Ahmed, Muktar, Aksut, Baran, Alam, Tahiya, Alam, Khurshid, Alla, François, Alvis-Guzman, Nelson, Amrock, Stephen, Ansari, Hossein, Ärnlöv, Johan, Asayesh, Hamid, Atey, Tesfay Mehari, Avila-Burgos, Leticia, Awasthi, Ashish, Banerjee, Amitava, Barac, Aleksandra, Bärnighausen, Till, Barregard, Lars, Bedi, Neeraj, Ketema, Ezra Belay, Bennett, Derrick, Berhe, Gebremedhin, Bhutta, Zulfiqar, Bitew, Shimelash, Carapetis, Jonathan, Carrero, Juan Jesus, Malta, Deborah Carvalho, Castañeda-Orjuela, Carlos Andres, Castillo-Rivas, Jacqueline, Catalá-López, Ferrán, Choi, Jee-Young, Christensen, Hanne, Cirillo, Massimo, Cooper, Leslie, Criqui, Michael, Cundiff, David, Damasceno, Albertino, Dandona, Lalit, Dandona, Rakhi, Davletov, Kairat, Dharmaratne, Samath, Dorairaj, Prabhakaran, Dubey, Manisha, Ehrenkranz, Rebecca, Zaki, Maysaa El Sayed, Faraon, Emerito Jose A, Esteghamati, Alireza, Farid, Talha, Farvid, Maryam, Feigin, Valery, Ding, Eric L, Fowkes, Gerry, Gebrehiwot, Tsegaye, Gillum, Richard, Gold, Audra, Gona, Philimon, Gupta, Rajeev, Habtewold, Tesfa Dejenie, Hafezi-Nejad, Nima, Hailu, Tesfaye, Hailu, Gessessew Bugssa, Hankey, Graeme, Hassen, Hamid Yimam, Abate, Kalkidan Hassen, Havmoeller, Rasmus, Hay, Simon I, Horino, Masako, Hotez, Peter J, Jacobsen, Kathryn, James, Spencer, Javanbakht, Mehdi, Jeemon, Panniyammakal, John, Denny, Jonas, Jost, Kalkonde, Yogeshwar, Karimkhani, Chante, Kasaeian, Amir, Khader, Yousef, Khan, Abdur, Khang, Young-Ho, Khera, Sahil, Khoja, Abdullah T, Khubchandani, Jagdish, Kim, Daniel, Kolte, Dhaval, Kosen, Soewarta, Krohn, Kristopher J, Kumar, G Anil, Kwan, Gene F, Lal, Dharmesh Kumar, Larsson, Anders, Linn, Shai, Lopez, Alan, Lotufo, Paulo A, and Razek, Hassan Magdy Abd El

Subjects
Prevention, Cardiovascular, Burden of Illness, Heart Disease, Aging, Aetiology, 2.4 Surveillance and distribution, Good Health and Well Being, Adult, Aged, Cardiovascular Diseases, Cause of Death, Female, Global Health, Humans, Life Expectancy, Male, Middle Aged, Morbidity, Prevalence, Prospective Studies, Retrospective Studies, Risk Assessment, Risk Factors, Sex Distribution, Survival Rate, Young Adult, cause of death, epidemiology, global health, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology
Abstract

BackgroundThe burden of cardiovascular diseases (CVDs) remains unclear in many regions of the world.ObjectivesThe GBD (Global Burden of Disease) 2015 study integrated data on disease incidence, prevalence, and mortality to produce consistent, up-to-date estimates for cardiovascular burden.MethodsCVD mortality was estimated from vital registration and verbal autopsy data. CVD prevalence was estimated using modeling software and data from health surveys, prospective cohorts, health system administrative data, and registries. Years lived with disability (YLD) were estimated by multiplying prevalence by disability weights. Years of life lost (YLL) were estimated by multiplying age-specific CVD deaths by a reference life expectancy. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility.ResultsIn 2015, there were an estimated 422.7 million cases of CVD (95% uncertainty interval: 415.53 to 427.87 million cases) and 17.92 million CVD deaths (95% uncertainty interval: 17.59 to 18.28 million CVD deaths). Declines in the age-standardized CVD death rate occurred between 1990 and 2015 in all high-income and some middle-income countries. Ischemic heart disease was the leading cause of CVD health lost globally, as well as in each world region, followed by stroke. As SDI increased beyond 0.25, the highest CVD mortality shifted from women to men. CVD mortality decreased sharply for both sexes in countries with an SDI >0.75.ConclusionsCVDs remain a major cause of health loss for all regions of the world. Sociodemographic change over the past 25 years has been associated with dramatic declines in CVD in regions with very high SDI, but only a gradual decrease or no change in most regions. Future updates of the GBD study can be used to guide policymakers who are focused on reducing the overall burden of noncommunicable disease and achieving specific global health targets for CVD.

Published
2017

26. Pediatric Tropical Diseases and the World's Children Living in Extreme Poverty

Author

Hotez, Peter J.

Abstract

Enormous strides have been made in reducing the number of global under-five child deaths through expanded development and use of vaccines under the auspices of the GAVI Alliance. However such successes have left behind a significant burden of child morbidity and mortality in developing countries from six major tropical diseases, i.e., dengue, malaria, schistosomiasis, soil-transmitted helminth infections, trachoma, and visceral leishmaniasis. Approximately 1.7 billion infections occur from these six diseases that result in disability-adjusted life years that exceed HIV/AIDs and result in 700,000 to 1.2 million deaths annually. International efforts are in place to reduce the disease burden of several tropical diseases through packages of essential medicines administered through mass treatments and insecticide-treated bednets. Except for malaria in 34 countries, and trachoma, there is a dearth of coordinated efforts to eliminate these childhood diseases in the world's poorest areas. An emerging body of evidence has also identified a previously hidden burden of tropical diseases among poor people living in wealthy countries including the United States. Several tropical [diseases] are now affecting populations in Texas and other southern states of the US. Ironically, efforts to control or eliminate these diseases in the southern US have lagged behind international efforts in developing countries.

Published
2013

31. Identification of vaccine targets in pathogens and design of a vaccine using computational approaches

Author

Rawal, Kamal, Sinha, Robin, Abbasi, Bilal Ahmed, Chaudhary, Amit, Nath, Swarsat Kaushik, Kumari, Priya, Preeti, P., Saraf, Devansh, Singh, Shachee, Mishra, Kartik, Gupta, Pranjay, Mishra, Astha, Sharma, Trapti, Gupta, Srijanee, Singh, Prashant, Sood, Shriya, Subramani, Preeti, Dubey, Aman Kumar, Strych, Ulrich, Hotez, Peter J., and Bottazzi, Maria Elena

Published
2021
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33. Kv1.3 channel‐blocking immunomodulatory peptides from parasitic worms: implications for autoimmune diseases

Author

Chhabra, Sandeep, Chang, Shih Chieh, Nguyen, Hai M, Huq, Redwan, Tanner, Mark R, Londono, Luz M, Estrada, Rosendo, Dhawan, Vikas, Chauhan, Satendra, Upadhyay, Saneev K, Gindin, Mariel, Hotez, Peter J, Valenzuela, Jesus G, Mohanty, Biswaranjan, Swarbrick, James D, Wulff, Heike, Iadonato, Shawn P, Gutman, George A, Beeton, Christine, Pennington, Michael W, Norton, Raymond S, and Chandy, K George

Subjects
Biomedical and Clinical Sciences, Immunology, Rare Diseases, Digestive Diseases, Autoimmune Disease, Clinical Research, 5.1 Pharmaceuticals, 2.1 Biological and endogenous factors, Amino Acid Sequence, Animals, Autoimmune Diseases, Cell Proliferation, Cells, Cultured, Cnidarian Venoms, Cytokines, Electrophysiology, Female, Fibroblasts, Helminths, Humans, Hypersensitivity, Delayed, Immunologic Memory, Kv1.3 Potassium Channel, Magnetic Resonance Spectroscopy, Male, Mice, Models, Molecular, Molecular Sequence Data, Peptide Fragments, Phylogeny, Potassium Channel Blockers, Protein Conformation, Rats, Rats, Inbred Lew, Receptors, CCR7, Sequence Homology, Amino Acid, Structure-Activity Relationship, T-Lymphocytes, ShK, probiotic worm therapy, T lymphocytes, ion channel modulator, hookworm, Biochemistry and Cell Biology, Physiology, Medical Physiology, Biochemistry & Molecular Biology, Biochemistry and cell biology, Medical physiology
Abstract

The voltage-gated potassium (Kv) 1.3 channel is widely regarded as a therapeutic target for immunomodulation in autoimmune diseases. ShK-186, a selective inhibitor of Kv1.3 channels, ameliorates autoimmune diseases in rodent models, and human phase 1 trials of this agent in healthy volunteers have been completed. In this study, we identified and characterized a large family of Stichodactyla helianthus toxin (ShK)-related peptides in parasitic worms. Based on phylogenetic analysis, 2 worm peptides were selected for study: AcK1, a 51-residue peptide expressed in the anterior secretory glands of the dog-infecting hookworm Ancylostoma caninum and the human-infecting hookworm Ancylostoma ceylanicum, and BmK1, the C-terminal domain of a metalloprotease from the filarial worm Brugia malayi. These peptides in solution adopt helical structures closely resembling that of ShK. At doses in the nanomolar-micromolar range, they block native Kv1.3 in human T cells and cloned Kv1.3 stably expressed in L929 mouse fibroblasts. They preferentially suppress the proliferation of rat CCR7(-) effector memory T cells without affecting naive and central memory subsets and inhibit the delayed-type hypersensitivity (DTH) response caused by skin-homing effector memory T cells in rats. Further, they suppress IFNγ production by human T lymphocytes. ShK-related peptides in parasitic worms may contribute to the potential beneficial effects of probiotic parasitic worm therapy in human autoimmune diseases.

Published
2014

35. Elimination and Eradication of Neglected Tropical Diseases with Mass Drug Administrations: A Survey of Experts

Author

Keenan, Jeremy, Porco, Travis, Lietman, Thomas, Keenan, JD, Hotez, PJ, Amza, A, Stoller, NE, Gaynor, BD, Porco, TC, and Lietman, TM

Abstract

Background:Lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths, and trachoma are the five most prevalent neglected tropical diseases in the world, and each is frequently treated with mass drug administrations. We performed a s

Published
2013

36. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.

Author

Lozano, Rafael, Naghavi, Mohsen, Foreman, Kyle, Lim, Stephen, Shibuya, Kenji, Aboyans, Victor, Abraham, Jerry, Adair, Timothy, Aggarwal, Rakesh, Ahn, Stephanie, Alvarado, Miriam, Anderson, H, Anderson, Laurie, Andrews, Kathryn, Atkinson, Charles, Baddour, Larry, Barker-Collo, Suzanne, Bartels, David, Bell, Michelle, Benjamin, Emelia, Bennett, Derrick, Bhalla, Kavi, Bikbov, Boris, Bin Abdulhak, Aref, Birbeck, Gretchen, Blyth, Fiona, Bolliger, Ian, Boufous, Soufiane, Bucello, Chiara, Burch, Michael, Burney, Peter, Carapetis, Jonathan, Chen, Honglei, Chou, David, Chugh, Sumeet, Coffeng, Luc, Colan, Steven, Colquhoun, Samantha, Colson, K, Condon, John, Connor, Myles, Cooper, Leslie, Corriere, Matthew, Cortinovis, Monica, de Vaccaro, Karen, Couser, William, Cowie, Benjamin, Criqui, Michael, Cross, Marita, Dabhadkar, Kaustubh, Dahodwala, Nabila, De Leo, Diego, Degenhardt, Louisa, Delossantos, Allyne, Denenberg, Julie, Des Jarlais, Don, Dharmaratne, Samath, Dorsey, E, Driscoll, Tim, Duber, Herbert, Ebel, Beth, Erwin, Patricia, Espindola, Patricia, Ezzati, Majid, Feigin, Valery, Flaxman, Abraham, Forouzanfar, Mohammad, Fowkes, Francis, Franklin, Richard, Fransen, Marlene, Freeman, Michael, Gabriel, Sherine, Gakidou, Emmanuela, Gaspari, Flavio, Gillum, Richard, Gonzalez-Medina, Diego, Halasa, Yara, Haring, Diana, Harrison, James, Havmoeller, Rasmus, Hay, Roderick, Hoen, Bruno, Hotez, Peter, Hoy, Damian, Jacobsen, Kathryn, James, Spencer, Jasrasaria, Rashmi, Jayaraman, Sudha, Johns, Nicole, Karthikeyan, Ganesan, Kassebaum, Nicholas, Keren, Andre, Khoo, Jon-Paul, Knowlton, Lisa, Kobusingye, Olive, Koranteng, Adofo, Krishnamurthi, Rita, Lipnick, Michael, Lipshultz, Steven, and Ohno, Summer

Subjects
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Cause of Death, Child, Child, Preschool, Female, Global Health, Humans, Infant, Infant, Newborn, Male, Middle Aged, Mortality, Sex Factors, Young Adult
Abstract

BACKGROUND: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. FINDINGS: In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimers disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. INTERPRETATION: Population growth, increased average age of the worlds population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. FUNDING: Bill & Melinda Gates Foundation.

Published
2012

37. Vaccine Science Diplomacy and "The Phenomenon of Man".

Author

Hotez, Peter

Subjects
VACCINE development, INTERPROFESSIONAL relations, HEALTH policy, NEGOTIATION, COVID-19 vaccines, BIOETHICS, INTERNATIONAL relations, ETHICS, PRACTICAL politics, POVERTY
Abstract

The central tenets of international scientific collaborations leading to the development, testing, and the equitable distribution vaccines to combat poliomyelitis, smallpox, COVID-19, and other devasting infections, first accelerated in the mid-twentieth century. The genesis of vaccine science diplomacy also coincides with the publication of Le Phénomène Humain (The Phenomenon of Man) shortly after the death of its author, the French Jesuit priest and scientist, Dr. Teilhard de Jardin. Several tenets of Teilhard's posthumous essay, including our collective consciousness, and the "conjugated faces" of science and religion, are relevant to a modern vaccine diplomacy framework, even if Teilhard may not have specifically addressed vaccines in his writings. This could also include the potential for arriving at an "omega point" through international scientific collaboration and joint vaccine development, while simultaneously avoiding the destructive forces of anti-vaccine or anti-science activism. Collaborations between the Vatican, Catholic research universities and institutions; and leaders of the Catholic-majority nations in Africa, Asia, and Latin America in an integrated framework might accelerate these activities as they apply to both pandemic threats and neglected diseases of poverty. [ABSTRACT FROM AUTHOR]

Published
2024
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44. Longitudinal Change in the Use of Services in Autism Spectrum Disorder: Understanding the Role of Child Characteristics, Family Demographics, and Parent Cognitions

Author

Siller, Michael, Reyes, Nuri, Hotez, Emily, Hutman, T, and Sigman, Marian

Abstract

The aim of this study was to identify child characteristics, family demographics, and parent cognitions that may affect access to early intervention, special education, and related services. The sample included 70 families of young children with autism spectrum disorders. All parents were enrolled in a short education program, providing them with basic information and resources on advocating for a young child with autism spectrum disorders (Parent Advocacy Coaching). Longitudinal change in children's intervention program in the community was evaluated over a period of about 27 months, starting 12 months prior to enrollment in Parent Advocacy Coaching. Results revealed large individual differences in the intensity of children's individual and school-based services. Despite this variability, only two child characteristics (age, gender) emerged as independent predictors. In contrast, the intensity of children's intervention programs was independently predicted by a broad range of demographic characteristics, including parental education, child ethnicity and race, and family composition. Finally, even after child characteristics and family demographics were statistically controlled, results revealed associations between specific parental cognitions (parenting efficacy, understanding of child development) and the subsequent rate of change in the intensity of children's intervention programs. Implications for improving educational programs that aim to enhance parent advocacy are discussed.

Published
2014
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46. Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities

Author

Lai, Meng-Chuan, Amestoy, Anouck, Bishop, Somer, Brown, Heather M, Giwa Onaiwu, Morénike, Halladay, Alycia, Harrop, Clare, Hotez, Emily, Huerta, Marisela, Kelly, Amy, Miller, Dylan, Nordahl, Christine Wu, Ratto, Allison B, Saulnier, Celine, Siper, Paige M, Sohl, Kristin, Zwaigenbaum, Lonnie, and Goldman, Sylvie

Abstract

Emerging evidence suggests that the higher prevalence of autism in individuals who are assigned male than assigned female at birth results from both biological factors and identification biases. Autistic individuals who are assigned female at birth (AFAB) and those who are gender diverse experience health disparities and clinical inequity, including late or missed diagnosis and inadequate support. In this Viewpoint, an international panel of clinicians, scientists, and community members with lived experiences of autism reviewed the challenges in identifying autism in individuals who are AFAB and proposed clinical and research directions to promote the health, development, and wellbeing of autistic AFAB individuals. The recognition challenges stem from the interplay between cognitive differences and nuanced or different presentations of autism in some AFAB individuals; expectancy, gender-related, and autism-related biases held by clinicians; and social determinants. We recommend that professional development for clinicians be supported by health-care systems, professional societies, and governing bodies to improve equitable access to assessment and earlier identification of autism in AFAB individuals. Autistic AFAB individuals should receive tailored support in education, identity development, health care, and social and professional sense of belonging.

Published
2023
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47. Global Vaccine Access Demands Combating Both Inequity And Hesitancy

Author

Hotez, Peter J.

Abstract

The world’s population suffered from lack of access to COVID-19 vaccines. Although inequities in vaccine availability for low- and middle-income countries are widely cited as a component of this lack of access, there is a related but less discussed component: vaccine refusal or hesitancy. Regarding the first component (global vaccine inequities), there are multiple dimensions to this topic and its causes, but for low- and middle-income countries, the most glaring one resulted from upstream science policies that prioritized speed and innovation at the expense of technologies that could be produced by low- and middle-income country vaccine producers. Regarding the second component (vaccine refusal or hesitancy), as COVID-19 waves swept across the United States in 2021, thousands of unvaccinated Americans perished from refusing COVID-19 immunizations. These deaths occurred because of an expanding antiscience ecosystem that now extends into low- and middle-income countries and could block the uptake of new vaccines or routine childhood immunizations. Future vaccine policies must address both elements of global access and their political identities. This recommendation reflects the author’s experiences as a vaccine scientist who both develops affordable COVID-19 and neglected disease vaccines and lives on the front lines combating vaccine refusal.

Published
2023
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48. Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Author

Kinyoki, D, Osgood-Zimmerman, A, Bhattacharjee, N, Schaeffer, L, Lazzar-Atwood, A, Lu, D, Ewald, S, Donkers, K, Letourneau, I, Collison, M, Schipp, M, Abajobir, A, Abbasi, S, Abbasi, N, Abbasifard, M, Abbasi-Kangevari, M, Abbastabar, H, Abd-Allah, F, Abdelalim, A, Abd-Elsalam, S, Abdoli, A, Abdollahpour, I, Abedi, A, Abolhassani, H, Abraham, B, Abreu, L, Abrigo, M, Abualhasan, A, Abu-Gharbieh, E, Abushouk, A, Accrombessi, M, Adabi, M, Adebayo, O, Adegbosin, A, Adekanmbi, V, Adetokunboh, O, Adeyinka, D, Adham, D, Advani, S, Agasthi, P, Aghaali, M, Ahmad, S, Ahmad, T, Ahmadi, K, Ahmadi, S, Ahmed, M, Aichour, M, Aji, B, Akinyemi, O, Aklilu, A, Akunna, C, Al-Aly, Z, Alanzi, T, Alcalde-Rabanal, J, Alemu, B, Alemu, A, Alhassan, R, Alif, S, Alipour, V, Alizade, H, Aljunid, S, Almasi-Hashiani, A, Al-Mekhlafi, H, Al-Raddadi, R, Alvis-Guzman, N, Amini, S, Amiri, F, Amugsi, D, Anber, N, Ancuceanu, R, Andrei, T, Anegago, M, Anjomshoa, M, Ansari, F, Ansari-Moghaddam, A, Anteneh, Z, Antriyandarti, E, Anvari, D, Anwer, R, Aqeel, M, Arabloo, J, Arab-Zozani, M, Aremu, O, Areri, H, Artaman, A, Arzani, A, Asaad, M, Asadi-Aliabadi, M, Asadi-Pooya, A, Asemahagn, M, Asghari Jafarabadi, M, Ashebir, M, Ataro, Z, Athari, S, Atout, M, Ausloos, M, Awoke, N, Ayala Quintanilla, B, Ayano, G, Ayanore, M, Aynalem, Y, Ayza, M, Azadmehr, A, B, D, Babalola, T, Badawi, A, Badiye, A, Bahrami, M, Bairwa, M, Bakkannavar, S, Banik, P, Baraki, A, Barboza, M, Basaleem, H, Basu, S, Bayati, M, Baye, B, Bazmandegan, G, Bedi, N, Bekuma, T, Bell, M, Bensenor, I, Berhe, K, Berhe, A, Berhie, K, Bhandari, D, Bhardwaj, N, Bhardwaj, P, Bhattacharyya, K, Bhattarai, S, Bhutta, Z, Bijani, A, Bikbov, B, Biondi, A, Birhanu, M, Biswas, R, Bockarie, M, Bohlouli, S, Bohluli, M, Boloor, A, Borzouei, S, Bragazzi, N, Braithwaite, D, Brunoni, A, Burugina Nagaraja, S, Butt, Z, Caetano dos Santos, F, Camera, L, Car, J, Cardenas, R, Carvalho, F, Castaldelli-Maia, J, Castaneda-Orjuela, C, Castro, F, Cevik, M, Chanie, W, Charan, J, Chatterjee, S, Chattu, V, Chaturvedi, S, Chen, S, Chin, K, Chowdhury, M, Cook, A, Costa, V, Cromwell, E, Dachew, B, Dagne, H, Dagnew, B, Dahiru, T, Dahlawi, S, Dai, H, Dandona, L, Dandona, R, Daneshpajouhnejad, P, Daoud, F, Das, J, Das Gupta, R, Dash, A, Davila-Cervantes, C, Davletov, K, Deeba, F, De Neve, J, Denova-Gutierrez, E, Deribe, K, Desalew, A, Dessie, G, Dey, S, Dhimal, M, Dhungana, G, Dianatinasab, M, Diaz, D, Dipeolu, I, Djalalinia, S, Do, H, Dorostkar, F, Doshmangir, L, Duko, B, Duraes, A, Earl, L, Edinur, H, Efendi, F, Elayedath, R, Elema, T, Elhabashy, H, El-Jaafary, S, El Sayed, I, El Sayed Zaki, M, Elsharkawy, A, El-Sherbiny, Y, El Tantawi, M, Endalew, D, Eshrati, B, Eskandari, K, Eskandarieh, S, Fadhil, I, Faraon, E, Fareed, M, Faris, P, Farwati, M, Farzadfar, F, Fasanmi, A, Fattahi, N, Fauk, N, Feigin, V, Feleke, B, Fereshtehnejad, S, Fernandes, E, Ferrara, P, Foigt, N, Fomenkov, A, Foroutan, M, Francis, J, Franklin, R, Freitas, M, Fukumoto, T, Gad, M, Gaidhane, A, Gayesa, R, Geberemariyam, B, Gebregiorgis, B, Gebremariam, H, Gebremariam, T, Gebremeskel, L, Gebremeskel, G, Gebreslassie, A, Geramo, Y, Gesesew, H, Gessner, B, Getacher, L, Ghadiri, K, Ghaffarifar, F, Ghafourifard, M, Ghajarzadeh, M, Ghamari, F, Ghashghaee, A, Ghith, N, Gilani, S, Gill, T, Godinho, M, Gona, P, Grada, A, Gubari, M, Gudi, N, Guido, D, Guled, R, Guo, Y, Gupta, R, Haj-Mirzaian, A, Hamadeh, R, Handiso, D, Hanif, A, Hargono, A, Hasaballah, A, Hasan, M, Hasan, S, Hashemian, M, Hashi, A, Hassan, S, Hassan, A, Hassanipour, S, Hassankhani, H, Hayat, K, Hegazy, M, Heidari-Soureshjani, R, Henry, N, Herteliu, C, Heydarpour, F, Heydarpour, S, Hidru, H, Hoang, C, Holla, R, Hon, J, Hong, S, Hoogar, P, Hosseini, S, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Hotez, P, Househ, M, Huda, T, Huluko, D, Hussain, S, Hwang, B, Ilesanmi, O, Ilic, I, Ilic, M, Inbaraj, L, Iqbal, U, Islam, M, Islam, S, Iwu, C, Jadidi-Niaragh, F, Jahani, M, Jain, V, Jakovljevic, M, Jalali, A, Jalilian, F, Janodia, M, Javaheri, T, Jha, R, John, O, Johnson, K, Jonas, J, Jonnagaddala, J, Joseph, N, Joshi, A, Joukar, F, Jozwiak, J, Kabir, A, Kabir, Z, Kahlon, T, Kalankesh, L, Kalhor, R, Kamath, A, Kamiab, Z, Kanchan, T, Kapil, U, Kapoor, N, Karami Matin, B, Karimi, S, Kasa, A, Kasahun, G, Kassa, Z, Kassa, G, Kassahun, G, Kayode, G, Kazemi Karyani, A, Keflie, T, Keiyoro, P, Kelkay, B, Keramati, M, Ketema, D, Khalid, N, Khammarnia, M, Khan, M, Khan, J, Khatab, K, Khater, A, Khater, M, Khoja, A, Khubchandani, J, Kianipour, N, Kim, Y, Kimokoti, R, Kisa, S, Kisa, A, Kolola, T, Koolivand, A, Kosen, S, Koul, P, Koyanagi, A, Krishan, K, Krishnamoorthy, V, Kuate Defo, B, Kugbey, N, Kulkarni, V, Kumar, G, Kumar, N, Kumar, P, Kumar, M, Kurmi, O, Kusuma, D, Lacey, B, Lad, D, Lal, D, Lami, F, Landires, I, Larsson, A, Lasrado, S, Laurens, M, La Vecchia, C, Laxmaiah, A, Lee, P, Lee, S, Legrand, K, Lewycka, S, Li, B, Li, S, Liu, X, Lopez, J, Machado, D, Madhava Kunjathur, S, Magdy Abd El Razek, H, Magdy Abd El Razek, M, Mahadeshwara Prasad, D, Mahasha, P, Maheri, M, Mahotra, N, Majeed, A, Maled, V, Maleki, S, Malekzadeh, R, Malta, D, Mamun, A, Mansour-Ghanaei, F, Mansouri, B, Mansournia, M, Manzar, M, Marrugo Arnedo, C, Martins-Melo, F, Masaka, A, Maulik, P, Mayala, B, Mehari, M, Mehndiratta, M, Mehrabi Nasab, E, Mehri, F, Mehta, K, Meitei, W, Mekonnen, T, Meles, G, Melku, M, Mendoza, W, Menezes, R, Mengesha, M, Mengesha, E, Meretoja, T, Mersha, A, Metekiya, W, Miazgowski, T, Michalek, I, Mini, G, Mir, S, Mirica, A, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Mirzaei-Alavijeh, M, Misra, S, Moazen, B, Moghadaszadeh, M, Mohammad, Y, Mohammad, D, Mohammad Gholi Mezerji, N, Mohammadi, S, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, H, Mohammed, S, Mohammed, A, Mohammed, J, Mohseni Bandpei, M, Mokdad, A, Molassiotis, A, Monasta, L, Moradi, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Mosapour, A, Mouodi, S, Mousavi, S, Mousavi Khaneghah, A, Mulu, G, Munir, M, Muriithi, M, Murthy, G, 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S., Keiyoro P. N., Kelkay B., Keramati M., Ketema D. B., Khalid N., Khammarnia M., Khan M. N., Khan M., Khan J., Khatab K., Khater A. M., Khater M. M., Khoja A. T., Khubchandani J., Kianipour N., Kim Y. -E., Kim Y. J., Kimokoti R. W., Kisa S., Kisa A., Kolola T., Koolivand A., Kosen S., Koul P. A., Koyanagi A., Krishan K., Krishnamoorthy V., Kuate Defo B., Kugbey N., Kulkarni V., Kumar G. A., Kumar N., Kumar P., Kumar M., Kurmi O. P., Kusuma D., Lacey B., Lad D. P., Lal D. K., Lami F. H., Landires I., Larsson A. O., Lasrado S., Laurens M. B., La Vecchia C., Laxmaiah A., Lee P. H., Lee S. W. H., LeGrand K. E., Lewycka S., Li B., Li S., Liu X., Lopez J. C. F., Machado D. B., Madhava Kunjathur S., Magdy Abd El Razek H., Magdy Abd El Razek M., Mahadeshwara Prasad D. R., Mahasha P. W., Maheri M., Mahotra N. B., Majeed A., Maled V., Maleki S., Malekzadeh R., Malta D. C., Mamun A. A., Mansour-Ghanaei F., Mansouri B., Mansournia M. A., Manzar M. D. D., Marrugo Arnedo C. A., Martins-Melo F. R., Masaka A., Maulik P. K., Mayala B. K., Mehari M., Mehndiratta M. M., Mehrabi Nasab E., Mehri F., Mehta K. M., Meitei W. B., Mekonnen T., Meles G. G., Melku M., Mendoza W., Menezes R. G., Mengesha M. B., Mengesha E. W., Meretoja T. J., Mersha A. M., Metekiya W. M., Miazgowski T., Michalek I. M., Mini G. K., Mir S. A., Mirica A., Mirrakhimov E. M., Mirzaei H., Mirzaei M., Mirzaei-Alavijeh M., Misra S., Moazen B., Moghadaszadeh M., Mohammad Y., Mohammad D. K., Mohammad Gholi Mezerji N., Mohammadi S. M., Mohammadian-Hafshejani A., Mohammadpourhodki R., Mohammed H. M., Mohammed S., Mohammed A. S., Mohammed J. A., Mohseni Bandpei M. A., Mokdad A. H., Molassiotis A., Monasta L., Moradi M., Moradi-Lakeh M., Moradzadeh R., Moraga P., Mosapour A., Mouodi S., Mousavi S. M., Mousavi Khaneghah A., Mulu G. B. B., Munir M., Muriithi M. K., Murthy G. V. S., Mustafa G., Nabhan A. F., Naderi M., Nagarajan A. J., Nagaraju S. P., Naghavi M., Naik G., Naimzada M. D., Nangia V., Nansseu J. R., Naqvi A. A., Nascimento B. R., Nayak S., Nayak V. C., Nazari J., Ndejjo R., Negoi I., Negoi R. I., Netsere H. B., Nguefack-Tsague G., Ngunjiri J. W., Nguyen C. T., Nguyen D. N., Nguyen H. L. T., Nigatu Y. T., Nikbakhsh R., Nikpoor A. R., Nnaji C. A., Nong V. M., Noubiap J. J., Nunez-Samudio V., Nwatah V. E., Nyanhanda T., Oancea B., Ogbo F. A., Oghenetega O. B., Oh I. -H., Okello D. M., Oladnabi M., Olagunju A. T., Olusanya J. O., Olusanya B. O., Bali A. O., Omer M. O., Omonisi A. E. E., Onwujekwe O. E., Ortiz A., Ortiz-Panozo E., Otstavnov N., Otstavnov S. S., Owolabi M. O., Mahesh P. A., Padubidri J. R., Pakhare A. P., Pakshir K., Pana A., Panda-Jonas S., Pandey A., Pandi-Perumal S. R., Pangaribuan H. U., Pasupula D. K., Patel S. K., Patel U. K., Pathak A., Patton G. C., Toroudi H. P., Pereira J., Pescarini J. M., Pham H. Q., Pickering B. V., Pirouzpanah S., Pirsaheb M., Pokhrel K. N., Postma M. J., Pottoo F. H., Pourchamani H., Pourjafar H., Poustchi H., Prada S. I., Pribadi D. R. A., Syed Z. Q., Rabiee N., Rafiee A., Rahim F., Rahman M. H. U., Rahman M. A., Rahmani A. M., Rai R. K., Rajesh A., Ram P., Ramezanzadeh K., Ranabhat C. L., Rao S. J., Rao S., Rastogi P., Rathi P., Rawal L., Rawasia W. F., Rawassizadeh R., Regassa L. D., Reiner R. C., Reshmi B., Rezaei N., Rezahosseini O., Rezapour A., Riahi S. M., Ribeiro D., Ribeiro A. I., Rickard J., Roba H. S., Roever L., Ronfani L., Rostamian M., Rumisha S. F., Rwegerera G. M., Sabour S., Sadeghi E., Saeedi Moghaddam S., Sagar R., Sahebkar A., Sahraian M. A., Sajadi S. M., Salam N., Salem M. R., Kafil H. S., Santos I. S., Santric-Milicevic M. M., Saraswathy S. Y. I., Sarrafzadegan N., Sartorius B., Sarveazad A., Sathian B., Sathish T., Saxena D., Sbarra A. N., Schwebel D. C., Senbeta A. M., Sengupta D., Senthilkumaran S., Sepanlou S. G., Seylani A., Sha F., Shafaat O., Shahabi S., Shahbaz M., Shahid I., Shaikh M. A., Shaka M. F., Shalash A. S., Shamali M., Shams-Beyranvand M., Shamsi M. B., Shamsizadeh M., Shannawaz M., Sharafi K., Sharifi A., Sheikh A., Sheikhtaheri A., Shetty R. S., Shetty B. S. K., Shetty A., Shiferaw W. S., Shigematsu M., Il Shin J., Shiri R., Shirkoohi R., Shivarov V., Siabani S., Malleshappa S. K. S., Siddiqi T. J., Sidemo N. B., Singh B. B., Singh S., Sintayehu Y., Skryabin V. Y., Skryabina A. A., Sobhiyeh M. R., Soheili A., Soltani S., Sorrie M. B., Spurlock E. E., Sreeramareddy C. T., Sudaryanto A., Sufiyan M. B., Sultan I., Tabares-Seisdedos R., Tabuchi T., Taddele B. W., Tadesse E. G., Taherkhani A., Tamir Z., Tamiru A. T., Tareque M. I., Tbakhi A., Teame H., Tefera Y. G., Tehrani-Banihashemi A., Tekalegn Y., Tekle M. G., Teklehaimanot B. F., Temsah M. -H., Tesema G. A., Thankappan K. R., Thomas N., Tiki T., Tilahune A. B., Titova M. V., Tovani-Palone M. R., Tran K. B., Tran B. X., Tripathi R., Tripathy J. P., Truong P. N., Uddin R., Ullah A., Umeokonkwo C. D., Uneke C. J., Unnikrishnan B., Upadhyay E., Usman M. S., Vacante M., Vakilian A., Tahbaz S. V., Valdez P. R., Vasseghian Y., Verma M., Violante F. S., Vo B., Wado Y. D., Waheed Y., Wang Y., Wang Y. -P., Wangdi K., Weldesamuel G. T., Werdecker A., Wiangkham T., Wickramasinghe N. D., Wiysonge C. S., Wonde T. E., Wu A. -M., Wu C., Xie Y., Yadollahpour A., Jabbari S. H. Y., Yamada T., Yang M., Yaya S., Yazdi-Feyzabadi V., Yeheyis T. Y., Yeshaneh A., Yeshaw Y., Yeshitila Y. G., Yilma M. T., Yip P., Young M. F., Yousefi Z., Yousefinezhadi T., Yousof H. -A. S. A., Yousuf A. Y., Yu C., Yu Y., Zafar S., Zaidi S. S., Zaidi Z., Zakzuk J., Bin Zaman S., Zamani M., Zamanian M., Zandifar A., Zangeneh A., Zastrozhin M. S., Zastrozhina A., Zewdie D. T., Zewdie K. A., Zhang Y., Zhu C., Ziapour A., Kassebaum N. J., and Hay S. I.

Abstract

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.

Published
2021

49. A Triple Threat to Humanity: Climate Change, Pandemics, and Anti-Science.

Author

MANN, MICHAEL E. and HOTEZ, PETER J.

Subjects
COVID-19 pandemic, BUSINESS enterprises, CLIMATOLOGY, ANTI-vaccination movement, ENVIRONMENTAL sciences, ZIKA Virus Epidemic, 2015-2016, URBANIZATION
Abstract

The article "A Triple Threat to Humanity: Climate Change, Pandemics, and Anti-Science" discusses the existential threat posed by the warming of the planet, pandemic threats, and anti-science disinformation. The authors, Michael E. Mann and Peter J. Hotez, highlight the urgent need to address these interconnected challenges to safeguard human civilization. They emphasize the detrimental impacts of climate change, the increasing frequency of pandemics, and the coordinated campaign of disinformation against mainstream science. The article calls for immediate action to combat these threats before it is too late. [Extracted from the article]

Published
2025

50. A multinational Delphi consensus to end the COVID-19 public health threat

Author

Lazarus, J. V., Romero, D., Kopka, C. J., Karim, S. A., Abu-Raddad, L. J., Almeida, G., Baptista-Leite, R., Barocas, J. A., Barreto, M. L., Bar-Yam, Y., Bassat, Q., Batista, C., Bazilian, M., Chiou, S. -T., del Rio, C., Dore, G. J., Gao, G. F., Gostin, L. O., Hellard, M., Jimenez, J. L., Kang, G., Lee, N., Maticic, M., Mckee, M., Nsanzimana, S., Oliu-Barton, M., Pradelski, B., Pyzik, O., Rabin, K., Raina, S., Rashid, S. F., Rathe, M., Saenz, R., Singh, S., Trock-Hempler, M., Villapol, S., Yap, P., Binagwaho, A., Kamarulzaman, A., El-Mohandes, A., Barreto, M., Abdulla, S., Addleman, S., Aghayeva, G., Agius, R., Ahmed, M., Ramy, M. A., Aide, P., Aleman, S., Alfred, J. -P., Ali, S., Aliaga, J., Aloudat, T., Alqahtani, S. A., Al-Salman, J., Amuasi, J. H., Agrawal, A., Anwar, W., Araujo-Jorge, T., Artaza, O., Asadi, L., Awuku, Y., Baker, M., Barberia, L., Bascolo, E., Belcher, P., Bell, L., Benzaken, A., Bergholtz, E., Bhadelia, N., Bhan, A., Bilodeau, S., Bitran, R., Bluyssen, P., Bosman, A., Bozza, F. A., Brinkmann, M. M., Brown, A., Mellado, B., Bukusi, E., Bullen, C., Buonanno, G., Burgess, R., Butler, M., Byakika-Kibwika, P., Cabieses, B., Carlsson, G., Cascini, Fidelia, Chabala, C., Chakroun, M., Cheng, K. K., Chetty, A., Chumachenko, D., Consalves, G., Conway Morris, A., Cordie, A., Corrah, T., Crabtree-Ramirez, B., Dashdorj, N., Davidovitch, N., de Souza, L. E., Dhariwal, A. C., Druica, E., Ergonul, O., Erondu, N. A., Essar, M. Y., Ewing, A., Fanjul, G., Feierstein, D., Feigl-Ding, E., Figueroa, R., Figueroa, J. P., Fisher, D., Flores, W., Forero-Pena, D. A., Frumkin, H., Gamkrelidze, A., Gandhi, M., Garcia, P., Garcia-Basteiro, A. L., Garcia-Sastre, A., Garg, S., Gbeasor-Komlanvi, F. A., Gershenson, C., Gilada, I., Giovanella, L., Gonzalez, M., Green, M. S., Greenhalgh, T., Griffin, P., Griffin, S., Grinsztejn, B., Anand, T., Guerra, G., Guinto, R., Gujski, M., Guner, R., Hamdy, A., Hancean, M. -G., Haniffa, A., Hartigan-Go, K. Y., Hassan, H. K., Hay, S. I., Heino, M. T. J., Hel, Z., Hotez, P., Hu, J., Hukic, M., Ijsselmuiden, C., Iroko, D., Iskarous, M., Izugbara, C., Jacobs, C., Jadad, A. R., Jehan, F., Jordan, A., Jroundi, I., Kain, K., Kamberi, F., Karamov, E., Karan, A., Katz, R., Katzourakis, A., Kazembe, A., Khamis, F., Khamzayev, K., Khanyola, J., Khunti, K., Kiguli-Malwadde, E., Kim, W. J., Kirenga, B. J., Klimovsky, D., Kmush, B. L., Knaul, F., Kogevinas, M., Kristensen, F., Kumar, D., Kumar, R., Kvalsvig, A., Lacerda, M. V., Lal, A., Lawton, T., Lemery, J., Leonardi, A. J., Li, Y., Lottvall, J., Lounis, M., Maceira, D., Macintyre, C. R., Madani, A., Magiorkinis, G., Malekzadeh, R., Choisy, M., Marcelin, J. R., Marks, G. B., Marr, L., Marrazzo, J., Martina, A., Martin-Moreno, J. M., Mateos, C., Mayxay, M., Mazarati, J. B., Mboup, S., Mcdonald, J., Mcmillan, F., Mechili, E., Medici, A., Davis, S. L. M., Meier, P., Memish, Z. A., Menon, J., Menon, P., Mesiano-Crookston, J., Michie, S., Mikolasevic, I., Milicevic, O., Mishra, A. K., Mohamed, R., Mokdad, A. H., Monroy-Valle, M., Morawska, L., Moschos, S. A., Motawea, K., Mousavi, S. H., Mumtaz, G., Munene, P. K., Munoz Almagro, C., Muriuki, J., Muyingo, S., Naniche, D., Naylor, C. D., Ndembi, N., Nemec, J., Nesteruk, I., Ngaruiya, C., Nguyen, H., Nikolova, D., Nitzan, D., Norheim, O., Noushad, M., Ntoumi, F., Nyborg, G. A., Ochodo, E., Odabasi, Z., Okwen, M. P., Olivia, K., Ong, D. S. Y., Opara, I., Orozco, M., Oshitani, H., Pagel, C., Pai, M., Palsdottir, B., Papatheodoridis, G., Paraskevis, D., Leigh, J. P., Pecoul, B., Peichl, A., Perez-Then, E., Duc, P. P., Philippe, C., Pineda Rojas, A., Pladsen, C., Pozniak, A., Quiroga, R., Qureshi, H., Rampal, S., Ranney, M., Rathe, L., Ratzan, S., Raventos, H., Rees, H., Reis, R., Ricciardi, Walter, Rizk, N., Robalo, M., Robertson, E., Robinson, L., Rokx, C., Ros, T., Rottingen, J. -A., Rubin, M., Ruxrungtam, K., Sadirova, S., Saha, S., Salgado, N., Sanchez, L., Sangaramoorthy, T., Santamaria-Ulloa, C., Santos, R., Sawaf, B., Schneider, M. F., Schooley, R. T., Sener, A., Sepulveda, J., Shah, J., Shibani, M., Shoib, S., Sikazwe, I., Simaitis, A., Gill, A. S., Skhvitaridze, N., Sokolovic, M., Solomon, R., Solorzano, X., Springer, S. A., Srol, J., Staines, A., Stelfox, H. T., Strathdee, S., Sulaiman, L. H., Sutton, B., Svanaes, D., Swed, S., Sypsa, V., Sorensen, K., Tajudeen, R., Tan, A., Tang, J., Tanner, M., Sethi, T., Temmerman, M., Than, K. K., Tinto, H., Tometissi, S. P., Torres, I., Tshering, K. P., Tsiodras, S., Tsofa, B., Vahlne, A., Vargas, J. R., Bernal, I. D. V., Ventura, D., Vilasanjuan, R., Vipond, J., Wamala-Andersson, S., Wargocki, P., West, R., Weyand, A., White, T. M., Wolff, G., Yao, M., Yates, C. A., Yeboah, G., Yee-Sin, L., Yi, S., Teo, Y. -Y., Yong, P., Zamora-Mesia, V., Ovrehus, A., Cascini F. (ORCID:0000-0001-6499-0734), Ricciardi W. (ORCID:0000-0002-5655-688X), Lazarus, J. V., Romero, D., Kopka, C. J., Karim, S. A., Abu-Raddad, L. J., Almeida, G., Baptista-Leite, R., Barocas, J. A., Barreto, M. L., Bar-Yam, Y., Bassat, Q., Batista, C., Bazilian, M., Chiou, S. -T., del Rio, C., Dore, G. J., Gao, G. F., Gostin, L. O., Hellard, M., Jimenez, J. L., Kang, G., Lee, N., Maticic, M., Mckee, M., Nsanzimana, S., Oliu-Barton, M., Pradelski, B., Pyzik, O., Rabin, K., Raina, S., Rashid, S. F., Rathe, M., Saenz, R., Singh, S., Trock-Hempler, M., Villapol, S., Yap, P., Binagwaho, A., Kamarulzaman, A., El-Mohandes, A., Barreto, M., Abdulla, S., Addleman, S., Aghayeva, G., Agius, R., Ahmed, M., Ramy, M. A., Aide, P., Aleman, S., Alfred, J. -P., Ali, S., Aliaga, J., Aloudat, T., Alqahtani, S. A., Al-Salman, J., Amuasi, J. H., Agrawal, A., Anwar, W., Araujo-Jorge, T., Artaza, O., Asadi, L., Awuku, Y., Baker, M., Barberia, L., Bascolo, E., Belcher, P., Bell, L., Benzaken, A., Bergholtz, E., Bhadelia, N., Bhan, A., Bilodeau, S., Bitran, R., Bluyssen, P., Bosman, A., Bozza, F. A., Brinkmann, M. M., Brown, A., Mellado, B., Bukusi, E., Bullen, C., Buonanno, G., Burgess, R., Butler, M., Byakika-Kibwika, P., Cabieses, B., Carlsson, G., Cascini, Fidelia, Chabala, C., Chakroun, M., Cheng, K. K., Chetty, A., Chumachenko, D., Consalves, G., Conway Morris, A., Cordie, A., Corrah, T., Crabtree-Ramirez, B., Dashdorj, N., Davidovitch, N., de Souza, L. E., Dhariwal, A. C., Druica, E., Ergonul, O., Erondu, N. A., Essar, M. Y., Ewing, A., Fanjul, G., Feierstein, D., Feigl-Ding, E., Figueroa, R., Figueroa, J. P., Fisher, D., Flores, W., Forero-Pena, D. A., Frumkin, H., Gamkrelidze, A., Gandhi, M., Garcia, P., Garcia-Basteiro, A. L., Garcia-Sastre, A., Garg, S., Gbeasor-Komlanvi, F. A., Gershenson, C., Gilada, I., Giovanella, L., Gonzalez, M., Green, M. S., Greenhalgh, T., Griffin, P., Griffin, S., Grinsztejn, B., Anand, T., Guerra, G., Guinto, R., Gujski, M., Guner, R., Hamdy, A., Hancean, M. -G., Haniffa, A., Hartigan-Go, K. Y., Hassan, H. K., Hay, S. I., Heino, M. T. J., Hel, Z., Hotez, P., Hu, J., Hukic, M., Ijsselmuiden, C., Iroko, D., Iskarous, M., Izugbara, C., Jacobs, C., Jadad, A. R., Jehan, F., Jordan, A., Jroundi, I., Kain, K., Kamberi, F., Karamov, E., Karan, A., Katz, R., Katzourakis, A., Kazembe, A., Khamis, F., Khamzayev, K., Khanyola, J., Khunti, K., Kiguli-Malwadde, E., Kim, W. J., Kirenga, B. J., Klimovsky, D., Kmush, B. L., Knaul, F., Kogevinas, M., Kristensen, F., Kumar, D., Kumar, R., Kvalsvig, A., Lacerda, M. V., Lal, A., Lawton, T., Lemery, J., Leonardi, A. J., Li, Y., Lottvall, J., Lounis, M., Maceira, D., Macintyre, C. R., Madani, A., Magiorkinis, G., Malekzadeh, R., Choisy, M., Marcelin, J. R., Marks, G. B., Marr, L., Marrazzo, J., Martina, A., Martin-Moreno, J. M., Mateos, C., Mayxay, M., Mazarati, J. B., Mboup, S., Mcdonald, J., Mcmillan, F., Mechili, E., Medici, A., Davis, S. L. M., Meier, P., Memish, Z. A., Menon, J., Menon, P., Mesiano-Crookston, J., Michie, S., Mikolasevic, I., Milicevic, O., Mishra, A. K., Mohamed, R., Mokdad, A. H., Monroy-Valle, M., Morawska, L., Moschos, S. A., Motawea, K., Mousavi, S. H., Mumtaz, G., Munene, P. K., Munoz Almagro, C., Muriuki, J., Muyingo, S., Naniche, D., Naylor, C. D., Ndembi, N., Nemec, J., Nesteruk, I., Ngaruiya, C., Nguyen, H., Nikolova, D., Nitzan, D., Norheim, O., Noushad, M., Ntoumi, F., Nyborg, G. A., Ochodo, E., Odabasi, Z., Okwen, M. P., Olivia, K., Ong, D. S. Y., Opara, I., Orozco, M., Oshitani, H., Pagel, C., Pai, M., Palsdottir, B., Papatheodoridis, G., Paraskevis, D., Leigh, J. P., Pecoul, B., Peichl, A., Perez-Then, E., Duc, P. P., Philippe, C., Pineda Rojas, A., Pladsen, C., Pozniak, A., Quiroga, R., Qureshi, H., Rampal, S., Ranney, M., Rathe, L., Ratzan, S., Raventos, H., Rees, H., Reis, R., Ricciardi, Walter, Rizk, N., Robalo, M., Robertson, E., Robinson, L., Rokx, C., Ros, T., Rottingen, J. -A., Rubin, M., Ruxrungtam, K., Sadirova, S., Saha, S., Salgado, N., Sanchez, L., Sangaramoorthy, T., Santamaria-Ulloa, C., Santos, R., Sawaf, B., Schneider, M. F., Schooley, R. T., Sener, A., Sepulveda, J., Shah, J., Shibani, M., Shoib, S., Sikazwe, I., Simaitis, A., Gill, A. S., Skhvitaridze, N., Sokolovic, M., Solomon, R., Solorzano, X., Springer, S. A., Srol, J., Staines, A., Stelfox, H. T., Strathdee, S., Sulaiman, L. H., Sutton, B., Svanaes, D., Swed, S., Sypsa, V., Sorensen, K., Tajudeen, R., Tan, A., Tang, J., Tanner, M., Sethi, T., Temmerman, M., Than, K. K., Tinto, H., Tometissi, S. P., Torres, I., Tshering, K. P., Tsiodras, S., Tsofa, B., Vahlne, A., Vargas, J. R., Bernal, I. D. V., Ventura, D., Vilasanjuan, R., Vipond, J., Wamala-Andersson, S., Wargocki, P., West, R., Weyand, A., White, T. M., Wolff, G., Yao, M., Yates, C. A., Yeboah, G., Yee-Sin, L., Yi, S., Teo, Y. -Y., Yong, P., Zamora-Mesia, V., Ovrehus, A., Cascini F. (ORCID:0000-0001-6499-0734), and Ricciardi W. (ORCID:0000-0002-5655-688X)

Abstract

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.

Published
2022

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