Flattening the Curve of COVID-19 Vaccine Rejection—A Global Overview

Current levels of public acceptability of immunisation put at serious risk the effectiveness of any future anti-SARS-CoV-2 vaccination programs. High levels of COVID-19 vaccine hesitancy are reported even from countries severely affected by the pandemic. A survey on a representative sample of adult Polish citizens (n=1066) was conducted, showing that 28% of adults in Poland would not vaccinate against SARS-CoV-2 if the vaccine became available. A majority (51%) of the reluctant respondents indicated that their minds would not be changed if given information regarding vaccine safety or efficacy, or if threatened with heavy fines. Significantly fewer respondents (37%) supported COVID-19 vaccinations specifically than supported childhood vaccinations in Poland in general (78% in 2018). Subsequently, a systematic search of nationally representative and methodologically sound surveys identified a total of 20. The vaccine hesitancy for the hypothetical, yet anticipated COVID-19 vaccine varied from very low (2–6% China) to very high (43%, Czechia, and 44%, Turkey). A legislative action, as well as the creation of sound and coherent common international public policies, should precede the availability of effective and safe COVID-19 vaccine. Note: Funding: This research was funded by the joint grant from the Warsaw University and the Medical University of Warsaw Federation Conflict of Interest: We declare no competing interests. Keywords: vaccine, vaccine hesitancy, anti-vaxers, COVID-19, SARS-CoV-

Analysis and evaluation of environmental tobacco smoke exposure as a risk factor for chronic cough

Exposure to environmental tobacco smoke (ETS) and active tobacco smoking has been shown to increase symptoms of bronchial asthma such as bronchoconstriction but effects on other respiratory symptoms remain poorly assessed. Current levels of exposure to tobacco smoke may also be responsible for the development of chronic cough in both children and adults. The present study analyses the effects of tobacco smoke exposure as potential causes of chronic cough. A panel of PubMed-based searches was performed relating the symptom of cough to various forms of tobacco smoke exposure. It was found that especially prenatal and postnatal exposures to ETS have an important influence on children's respiratory health including the symptom of cough. These effects may be prevented if children and pregnant women are protected from exposure to ETS. Whereas the total number of studies adressing the relationship between cough and ETS exposure is relatively small, the present study demonstrated that there is a critical amout of data pointing to a causative role of environmental ETS exposure for the respiratory symptom of cough. Since research efforts have only targeted this effect to a minor extent, future epidemiological and experimental studies are needed to further unravel the relation between ETS and cough

Problems of providing medical care to children of Ukraine as a result of russian aggression

Background. The russian aggression in Ukraine has caused numerous casualties among civilians, including children. Military actions lead directly or indirectly to increased morbidity in adults and children and to chronic stress, especially in children. The purpose of this research was to analyze the problems of providing medical assistance to the children of Ukraine who are suffering from the russian invasion. Materials and methods. We have used the official statistical and own data for 2022–2023. Results. Currently, more than 7.5 million Ukrainian children are suffering from the war, not only due to physical injuries but also violations of their mental and psycho-emotional state. A special problem for Ukrainian paediatricians at the beginning of 2023 was an increase in the incidence of acute respiratory diseases, COVID-19 and stress disorders in children due to a shortage of medical personnel and infrastructure. Also, in conditions of limited access to medical care and medicines, it is necessary to pay attention to chronic diseases, in particular, asthma and other allergic diseases. Paediatricians from the departments of the Bogomolets National Medical University provided voluntary assistance to children in frontline regions. Conclusions. In the new conditions of warfare, where civilians and life support infrastructure have become the target of armed attacks, children have become the most vulnerable group. The issues of restoration of full medical care for children, including emergency and urgent care, provision with doctors of certain paediatric specialties, full supply of medicines and medical devices, and restoration of destroyed medical infrastructure remain extremely relevant to the health system in the frontline and liberated areas

Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments

Current data indicate that the “bronchiolitis” diagnosis comprises more than one condition. Clinically, pathophysiologically, and even genetically three main clusters of patients can be identified among children suffering from severe bronchiolitis (or first wheezing episode): (a) respiratory syncytial virus (RSV)-induced bronchiolitis, characterized by young age of the patient, mechanical obstruction of the airways due to mucus and cell debris, and increased risk of recurrent wheezing. For this illness, an effective prophylactic RSV-specific monoclonal antibody is available; (b) rhinovirus-induced wheezing, associated with atopic predisposition of the patient and high risk of subsequent asthma development, which may, however, be reversed with systemic corticosteroids in those with severe illness; and (c) wheeze due to other viruses, characteristically likely to be less frequent and severe. Clinically, it is important to distinguish between these partially overlapping patient groups as they are likely to respond to different treatments. It appears that the first episode of severe bronchiolitis in under 2-year-old children is a critical event and an important opportunity for designing secondary prevention strategies for asthma. As data have shown bronchiolitis cannot simply be diagnosed using a certain cutoff age, but instead, as we suggest, using the viral etiology as the differentiating factor.</p

Management of asthma in childhood: study protocol of a systematic evidence update by the Paediatric Asthma in Real Life (PeARL) Think Tank

IntroductionClinical recommendations for childhood asthma are often based on data extrapolated from studies conducted in adults, despite significant differences in mechanisms and response to treatments. The Paediatric Asthma in Real Life (PeARL) Think Tank aspires to develop recommendations based on the best available evidence from studies in children. An overview of systematic reviews (SRs) on paediatric asthma maintenance management and an SR of treatments for acute asthma attacks in children, requiring an emergency presentation with/without hospital admission will be conducted.Methods and analysisStandard methodology recommended by Cochrane will be followed. Maintenance pharmacotherapy of childhood asthma will be evaluated in an overview of SRs published after 2005 and including clinical trials or real-life studies. For evaluating pharmacotherapy of acute asthma attacks leading to an emergency presentation with/without hospital admission, we opted to conduct de novo synthesis in the absence of adequate up-to-date published SRs. For the SR of acute asthma pharmacotherapy, we will consider eligible SRs, clinical trials or real-life studies without time restrictions. Our evidence updates will be based on broad searches of Pubmed/Medline and the Cochrane Library. We will use A MeaSurement Tool to Assess systematic Reviews, V.2, Cochrane risk of bias 2 and REal Life EVidence AssessmeNt Tool to evaluate the methodological quality of SRs, controlled clinical trials and real-life studies, respectively. Next, we will further assess interventions for acute severe asthma attacks with positive clinical results in meta-analyses. We will include both controlled clinical trials and observational studies and will assess their quality using the previously mentioned tools. We will employ random effect models for conducting meta-analyses, and Grading of Recommendations Assessment, Development and Evaluation methodology to assess certainty in the body of evidence.Ethics and disseminationEthics approval is not required for SRs. Our findings will be published in peer reviewed journals and will inform clinical recommendations being developed by the PeARL Think Tank.PROSPERO registration numbers CRD42020132990, CRD42020171624.</p

Cosmetics for neonates and infants: haptens in products’ composition

Abstract Cosmetics and skin care products for neonates and infants are considered as ‘‘hypoallergenic’’, “tested” or ‘‘safe’’. Nevertheless, the prevalence of haptens in these products is a matter of concern, since allergic contact dermatitis in children is gaining an importance. We aimed to assess the prevalence of haptens in cosmetics designed for children younger than 1 year. To identify haptens, the components of the cosmetics listed on packaging were compared with substances from European baseline series, Cosmetics series and Fragrance series. Survey comprised 212 cosmetics among which 186 (87.7%) contained at least one hapten from reference lists. Altogether there were 41 different haptens found in cosmetics. Number of sensitizers per product ranged between 1–12 and, each product contained 2.51 haptens on average. The most abundant sensitizers were cocamidopropyl betaine, tocopherol, propylene glycol, fragrances, lanolin. Majority of products for children were labeled as hypoallergenic/dermatologically tested/safe for children etc. from which 85% contained haptens. This survey highlights the extent of presence of haptens in cosmetics for children under the first year of age

A Cross-Sectional Study of Smoking Behaviors and Attitudes of Parents in Pediatric Primary Care Settings

Environmental tobacco smoke (ETS) exposure is considered an important public health issue in pediatric population. In this study, we aimed to investigate parents&rsquo; knowledge on side effects of passive smoking and counseling for parental smoking among pediatricians and family practitioners. Participants were biological parents of pediatric patients up to the age of 18 years old who attended Pediatric Hospital of Medical University of Warsaw. The questionnaire included 28 questions and queries on environmental tobacco smoke in children&rsquo;s environment. Medical students identified potential subjects and handed out previously created questionnaires. In total, 506 parents of children aged 0&ndash;18 years old were interviewed; 41% (207/506) of parents were smokers, 23% (114/506) were asked about ETS exposure by their pediatricians and 41% (205/506) by family physicians during routine visits. Only a minority of the respondents confirmed having &ldquo;no smoking&rdquo; policy in their car 31% (157/506) or in their households 24% (121/506). All parents believed that passive smoking could cause at least one harmful effect: most common were more frequent respiratory infections (43%), asthma (40%), and low birth weight (37%). Among smoking parents, 38% (78/207) has tried to quit smoking for their child&rsquo;s health sake; 63% (131/207) of smokers have never been asked to quit smoking by their doctor. Parents&rsquo; understanding of passive smoking among children differs from current medical knowledge. Rates of screening and counseling for parental smoking in pediatric and family practices are still unsatisfactory