Center News
BU’s Nahid Bhadelia Joins White House COVID Response Team
CEID Faculty Dr. David Hamer To Serve As Interim Director
Dear CEID Community,
We write to congratulate our Founding Director, Dr. Nahid Bhadelia, who has joined the White House COVID-19 Response Team as senior policy advisor for global COVID-19 response. We also want to share that Dr. Bhadelia will be on sabbatical for the duration of this full-time position.
During this interim period, CEID will continue its critical work under the leadership of Dr. David Hamer, who will serve as CEID’s Interim Director. Dr. Hamer has been faculty at CEID since its inception and he brings decades of global public health and infectious diseases experience. He will continue to work with our team to move forward the projects currently under way and to expand our partnerships.
Last month, we celebrated the one year anniversary of the founding of CEID and we are immensely grateful for your support of our work and mission over the past year. As the pandemic continues and we are faced with new challenges, our mission of building resilience against pandemics through equity remains at the core of what we do as a center. We look forward to your continued support as we enter this new chapter.
Sincerely,
The CEID Team
Working with healthcare workers to improve vaccination uptake in Uganda
Over the last two years, more than ten billion doses of COVID-19 vaccines have been administered worldwide. However, global vaccine inequity has led to disproportionate vaccine distribution, with Africa, for example, receiving less than 6% of the worldwide share of vaccines. We believe that advocacy to bridge this disparity is urgently needed. Gaining ground on controlling the pandemic currently hinges on getting as many COVID-19 vaccines as possible to those susceptible, in order to reduce the death toll and avoid overwhelming essential services. Additionally, investment is needed to ensure doses are delivered to the last mile and address vaccine hesitancy. We present the current challenges to vaccine uptake in Uganda and suggest strategies for improvement.
Uganda has received 32 million vaccines, including AstraZeneca, Moderna, J&J, BioNTech, Sinovac, and Sinopharm. Until November 2021, the Ministry of Health prioritized the vaccination of essential workers (health care, teachers, security), people with comorbidities, and people over 50 years old. In preparation to open the economy, this scope was expanded to include all adults over 18. Then, with the surge in cases due to the omicron variant, boosters were recommended for individuals who had been fully vaccinated for a minimum of six months. The Government of Uganda has considered legislation against refusal to get vaccinated, although vaccination among healthcare workers was already high before this .
As of January 2022, 46% of all priority individuals in Uganda have been vaccinated, with healthcare workers accounting for the biggest share of those who have received at least one dose of the COVID-19 vaccine yet, 65% of all COVID-19 hospital admissions have been for the unvaccinated elderly .
So, how can we leverage the success achieved with healthcare workers for other groups (elderly and those with comorbidities) where coverage has lagged ? The rapid advances in science related to vaccine development and safety and access and government directives present a challenge. Until recently, myths relating to vaccine safety in pregnant women and lactating mothers–despite the data– were prevalent . Encouragingly, health workers are a trusted source of information for peers and community members, including for COVID-19 vaccines, and we believe that they are well positioned to provide accurate information about COVID vaccines during antenatal and postnatal visits.
Healthcare workers administer vaccines often in their workplace. However, most doses are currently in use in large scale community outreach efforts known as accelerated mass vaccination campaigns. These campaigns aim to reach large numbers of people within the community and aim to use up vaccine doses quickly, particularly vaccine doses with short expiry. Consequently, patients with comorbidities may attend their appointments at facilities which do not have vaccines and this is a missed opportunity for direct intervention from healthcare workers.
With the challenge of vaccines with a short shelf life, mass campaigns remain a relevant approach. However, health facilities can leverage existing staff and resources for routine childhood immunizations and ensure adequate local stocks of COVID-19 vaccines. Health workers must systematically screen vulnerable groups for vaccination status, must have the knowledge and skills to create demand for vaccines, and must link patients to locations where vaccines are administered. These approaches are not only targeted to maximize the benefits of vaccines for the most vulnerable, but they are also more sustainable and less costly than large scale community outreach. The robust vaccine distribution networks and vaccines with a long shelf life are essential for the success of this approach.
Additionally, the elderly may face challenges due to frailty, inadequate resources for transportation or to avoid crowds. Community health workers may be needed to ensure that elderly patients are counseled and mobilized for vaccination or linked to the nearest vaccination location points once vaccines are available.
The lifting of travel restrictions and the reopening of schools in Uganda presents an opportunity to collaborate with health workers to promote vaccine uptake among our most vulnerable populations. This intervention should be layered on other public health measures such as screening and testing, mask use, hand hygiene, and physical distancing to strengthen resilience to future waves.
We believe Uganda’s experience may be mirrored in other countries in the region and these experiences would have broader lessons for how COVID-19 vaccines are distributed on a global scale.
Dr. Rodgers R. Ayebare
CEID Scholar
Infectious Diseases Scientist, Infectious Diseases Institute, Makerere University, Kampala, Uganda
Dr. Mohammed Lamorde
Head of Global Health Security, Infectious Diseases Institute, Makerere University, Kampala, Uganda
Boston University’s Center for Emerging Infectious Diseases Policy & Research (CEID) Announces $25K Pilot Grant Awardees
An integral component of CEID’s mission is to share knowledge and training opportunities that improve societal resilience against emerging and epidemic infectious diseases threats worldwide. As part of that goal, in Fall 2021, we released an inaugural call for proposals for pilot grants in the amount of $25,000.
After a peer reviewed selection process of this year's slate of exceptional proposals, we are pleased to announce the two projects awarded these inaugural grants! These projects demonstrate strength in research and a commitment to furthering CEID’s mission, with a respective focus on our core pillars of trust and innovation. Congratulations to all the researchers!
Social Media Analysis of Misinformation and Vaccine Hesitancy in Three Middle-Income Countries
Dr. Traci Hong, Dr. Derry Wijaya, Dr. Veronika J. Wirtz
Misinformation fuels vaccine hesitancy across the world, but the mechanism by which misinformation inhibits vaccine uptake is largely under-studied, specifically in middle-income countries. The slow rollout of the COVID-19 vaccine in middle-income countries presents fertile ground for misinformation to proliferate. Moreover, social media usage in middle-income countries is projected to grow whereas usage has plateaued in high-income countries. Political leaders as well as religious personalities play a critical role in health decision making and dissemination of health information. Anecdotal evidence suggests that when some religious personalities espouse views contrary to science, it can have significant consequences to the wellbeing of large segments of the population, but this has not been empirically demonstrated. These conditions present a unique opportunity to study the impact of social media misinformation from key influencers on vaccine hesitancy in middle-income countries.
This research project will develop a big data methodology to measure Twitter-based COVID-19 vaccine hesitancy and related political- and religious-based COVID-19 vaccine misinformation for three middle-income countries: Brazil, Indonesia and Nigeria. The researchers will also identify shared misinformation themes across the three foci countries, and use mediation analysis to test the hypothesis that vaccine hesitancy mediates the relationship between misinformation and vaccine uptake and other behaviors related to COVID-19. This research builds on CEID’s core pillar of trust.
Modeling Antimicrobial Resistance (AMR) Outbreaks in Wastewater
Dr. Muhammad Zaman, Dr. David Hamer
Wastewater (comprising industrial, hospital and agricultural wastewater or run-offs and domestic wastewater or sewage) systems are major reservoirs of multi-drug resistant bacterial populations that put the lives of vulnerable communities at risk. This is particularly of concern in low and middle income countries, and in urban informal settlements, where wastewater systems represent a leading driver of antimicrobial resistance (AMR). The dynamics of AMR emergence in wastewater environments is currently not fully understood. Existing studies have only surveyed the presence of antibiotic resistant organisms, genes and antibiotic residue in wastewater environments; the evolution and causative drivers of antibiotic resistant infectious disease outbreaks remain unknown. This has been a challenge due to both the lack of quantitative studies and the fact that experimental studies that mimic the wastewater environment can be difficult with standard laboratory culture techniques.
The goal of this project is to develop a novel, integrated mathematical modeling and experimental approach that will serve as a rigorous, data-driven, robust and scalable method allowing for the simultaneous study of several bacterial and environmental factors. The researchers will focus on several informal urban settlements in Pakistan, Bangladesh and South Africa for data collection and optimization of our model. This work will lead to a model to be used as a surveillance tool which can not only shed light on the evolution of antibiotic resistance, but also inform specific interventions, including surveillance, regulations, wastewater treatment plans and targeted antibiotic stewardship programs. Furthermore, the researchers believe that the outcome of this work in the form of an experimentally- and field-validated mathematical model is readily customizable and scalable, and can therefore be adapted to study context-specific wastewater systems in varying geographies and socioeconomic environments. Closing this gap through quantitative modeling and analysis is critical to fundamentally understanding the drivers of AMR and creating effective interventions to prevent outbreaks of multi-drug resistant pathogens. This research builds on CEID’s core pillar of innovation.
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New Partnership with CONNECTED DMV to build global resilience against emerging infectious disease threats
We are excited to announce a partnership between CEID and CONNECTED DMV. We will be cooperating with CONNECTED DMV in their Pandemic Prevention and Biodefense Initiative and serve as a key partner in the Global Pandemic Prevention and Biodefense Center and AHEAD100 initiative.
CONNECTED DMV’s Global Pandemic Prevention & Biodefense Center aims to harness all of the rich talent and critical health research, biotech, defense, and government assets that the world has to offer to deliver a full-scale response. The flagship lead initiative of the Center is AHEAD100, an ambitious, medical countermeasures program aims to develop and stockpile monoclonal antibodies (mAbs) for the world's top 100 pathogens across 25 pathogen families most likely to cause pandemics. The availability of this stockpile fills the critical time gap between outbreaks and activated vaccines during which a pandemic can be wholly avoided. Learn more about CONNECTED DMV and the Global Pandemic Prevention & Biodefense Center at www.pandemicprevention.org.
Dr. Bhadelia will serve on the Steering Committee of the Pandemic Prevention and Biodefense Initiative in the DMV, and CEID faculty will provide expertise and strategic guidance for the new venture through this cooperation. We look forward to joining forces with CONNECTED DMV in helping build global resilience against emerging infectious disease threats.
Dr. Bhadelia joins Science Council convened by the Federation of American Scientists and Congressman Bill Foster
CEID Founding Director Dr. Nahid Bhadelia joins a new Science Council convened by the Federation of American Scientists and Congressman Bill Foster (D, IL-11) to help inform evidence-based policy measures. The group of science and technology experts will work collaboratively to provide evidence-based information in many diverse scientific focus areas, including "infectious diseases, artificial intelligence, synthetic biology, and social epidemiology." The Council will also help foster relationships between policymakers and the scientific community.
To learn more, view the press release about the new Science Council.