PUBH6012 Applied Research Project in Public
This assessment advanced skills in reporting the justification, methods, results, and conclusions of a research project. Key understanding contained includes how to justify a research project using literature, how to implement a research proposal to collect and analysis data, how to report the results of the analysis of data, how to contextualize one’s own research in the context of the wider body of literature, and how to draw conclusions about future research and recommendations based on research. This prepares students for the conduct and reporting of research, which is an important skill set for public health practitioners.
Part 1: Due Sunday end of Module 1 Week 1 Based on the feedback from your Capstone A Research Proposal, revise your research plan and GANTT chart.
Submit these to your Capstone A facilitator by Sunday end of Module 1 Week 1. You may not proceed with your data collection until this has been approved by your supervising facilitator.
The final assignment for this subject will be the write-up of the findings of your research into a final report. This will be comprised of the following parts:
a. Summary of your report (as you would find in a published research article)
a. Introduction to and justification of the topic area, drawing upon your literature review (from Capstone A), and including the knowledge gap your project addresses
b. Your research question
3) Research design and methods
a. Summarise your research design/methods (from Capstone A) – what type of project did you do?
b. How did you collect the data (ie search strategy and process/ policy consultation process)? If a policy consultation, explain how any organizations/individuals that you consulted with were approached
c. How did you analyse the data (ie thematic analysis, systematic review process, consultation synthesis)?
d. Briefly explain the ethical issues that should be considered
a. Report the results of your findings, e.g. key themes if a qualitative study, results in table
format if a quantitative study
b. Clearly explain key figures, tables and graphs
5) Discussion: Interpretation and contextualisation of yourresults
a. Place your results in the context of your literature review
b. Contextualise the results within the academic literature
c. Describe any limitations of your study
a. Conclusions from this study
b. Recommendations for future research or policy change based on feasible solutions
7) Supplementary material
a. Reference List
b. Any appendices
This research report format has been based on the standard format for a journal article, and thus may be submitted to a journal in the future if the student is interested.
In December 2019, a continuous bout of pneumonia associated with a new COVID was reported in Wuhan, Hubei Area, China (Sallam, 2021). Contaminations quickly spread throughout China and other countries around the world (Broockman, et al., 2021). The disease caused by the new was dubbed "Covid infection 2019" by the WHO on February 12, 2020 (Lee, 2021). Even while the majority of Corona virus cases are asymptomatic or accompanied by mild, influenza-like signs, select populations, particularly the elderly and persons with concealed illnesses, might develop severe lung harm and severe respiratory miserable condition (Sallam, 2021). For assignment help As the number of Corona virus cases continues to climb and medications are constrained to symptomatic treatment, there is an undeniable need for a preventative approach, such as a vaccination, capable of preventing or decreasing the severity of COVID-19 (Broockman, et al., 2021).In less than a year before the World Health Organization (WHO) declared Coronavirus to be a pandemic, ten distinct vaccines have been approved for use in various countries throughout the world (Edwards, et al., 2021). Nonetheless, there is widespread opposition to Coronavirus vaccines in the United Kingdom, Australia, and a number of other countries (Roope, et al., 2020).Even with vaccinations that are very successful at preventing and stopping corona virus epidemics, large levels of immunisation coverage in communities will be necessary (Lee, 2021). According to the World Health Organization, countries should take a proactive approach to vaccination hesitancy hotspots based on social and behavioural data (Roope, et al., 2020).
With more than ten vaccines manufactured by various nations in a single year, it is critical to do global research on their action, efficiency, effectiveness, safety, side effects, and so on (Vanderslott, et al., 2021). While many countries in the Global North are likely to achieve universal vaccination by late 2021, middle and low-income countries may not have essential antibody availability until 2024 (Lee, 2021). Vaccine aversion by even a small percentage of the population can jeopardise the plan's success (Sallam, 2021). As a result, this research is being performed to focus on the efficiency and safety of these vaccinations, as well as to explore their adverse effects in order to reduce the uneasiness associated with Covid-19 immunizations (Vanderslott, et al., 2021).According to current research, COVID-19 vaccination intentions differ significantly among nations (Lee, 2021). Vaccine hesitancy, or being doubtful about obtaining a vaccine, generally accounts for a larger proportion of people who will not get vaccinated than vaccine resistance, or those who refuse to vaccines (Sallam, 2021). Vaccine reluctance to a COVID-19 vaccination was reported at 9% in Australia, with vaccine resistance at 5%, although this information came from a non-representative online poll (Edwards, et al., 2021). According to national representative polls conducted in the United Kingdom, 25–27 percent of respondents were apprehensive (Edwards, et al., 2021). Hence, considering the information, it is deemed important to conduct a systematic review to understand the factors more intricately.
The research aims to highlight and shed critical focus on the vaccine efficacy and safety while also identifying any side effects such that nervousness from their administrations can be reduced to a considerable amount.
The research aims to address the following objectives:
- To outline the efficacy of the vaccines manufactured for COVID-19
- To highlight the safety that is associated with the vaccines manufactured for COVID-19
- To identify any perceived side effects experienced by the administration of vaccines manufactured for COVID-19
The research aims to answer the following questions:
- What is the difference between the efficacy and safety of different COVID-19 vaccines in Australia, the United Kingdom and its neighbouring countries?
- What are the side effects of the each of the vaccines manufactured for COVID-19?
The research aims to conduct following explorations and tests to achieve:
- Decision on effectiveness of which vaccine in regards to its action of protection against being infected by COVID-19
- A clear understanding of safety and efficacy of each vaccine manufactured, thereby reducing fright spread and anxiety among people to administer vaccines
- A clear understanding of the side effects that are observed in each vaccine and to outline the severity in people with pre-existing health conditions
- A detailed action of the vaccines in countries such as Australia, the United Kingdom, and its neighbouring countries
When doing any type of investigation, it is critical to discover a reasonable technique that can enable showing up at the exploration location. An efficient technique will be used in the flow extent of investigation. Because the goal of this investigation is to determine the efficacy and security of Covid-19 antibodies, as well as their incidental effects in Australia, the United Kingdom, and neighbouring European countries, a few articles must be investigated, and an orderly audit of various articles will be intended in the research.
For the current research, 9 databases were searched for the retrieval of appropriate research studies in regards to the topic. Databases like Libraryof Torrens University Australia, PubMed, and open data sets like Scopus, ProQuest, Elsevier, BMJ, Global Public wellbeing, Mendeley, and Google researcher were searched. The publication date of the articles selected for the study were restricted to year 2020 and 2021 as the incident of COVID-19 is recent. For the retrieval of articles in a relevant manner and to gain an appropriate understanding of the research objectives, no restriction on the study design being adopted by authors in studies were done. However, language restrictions were put in place in order to understand the meaning of the content of the articles in an appropriate manner and not being lost in translation.
For the selection of the appropriate articles, it is necessary to outline the inclusion and exclusion criteria of the journals selected for the current systematic review. The following are the criteria for exclusion in the current study. The remaining articles have been selected for the study.
- Articles for which the authors have not adopted research methods concerning the topic and their eligibility for critique
- Articles for which only the abstract is available in the databases searched
- Articles which do not highlight the perceived efficacy of the vaccines and their perceived side effects
- Articles which are not published in English Language
- Articles which are not published by their authors since the year 2020 and 2021
The PRISMA protocol flow diagram depicts the flow of data during the various stages of a systematic review. It describes the number of records recognised, included, and rejected, as well as the reasons for rejections. The flow diagram is depicted below:
Data were descriptively synthesised to map various parts of the literature as indicated in our central questions. The studies were classified based on the instrument, audience, and research design, with RCT data being studied in greater depth. Because conversation boards are not included in the initial classification method, results are reported for all included research as well as studies that evaluated tools other than discussion boards. Data analysis must be carried out in accordance with the 'Systematic Review,' utilising the PRISMA protocol checklist and flowchart. The PRISMA declaration provides a starting point for organising a systematic review. It includes a checklist of topics to keep in mind for the report analysis.The PRISMA Statement includes a 27-item plan or agenda that is downloaded in Word format for participants to re-use, as well as a four-stage stream diagram in their investigation. The purpose of the PRISMA Statement is to support makers with the declaration of methodical audits and meta-examinations; nevertheless, PRISMA may also be employed as a rationale for discovering precise orderly surveys of various forms of investigations, specifically assessments of medicine mediations. Nonetheless, the PRISMA plan is not a quality evaluation tool for quantifying the concept of systematic audits. PRISMA's general concepts and focuses are typically applicable to any intentional audit, not only those whose goal is to summarise the benefits and drawbacks of clinical consideration mediation. Regardless, a few alterations to the agenda's focuses or the flow diagram will be critical expressly in particular circumstances.As a result, the PRISMA Protocol will be used to conduct an ordered survey for this exploration endeavour. The rationale for employing this mindset is to determine whether the examination disclosures are reliable throughout the targeted countries.
In the current research study, no participants have been undertaken as it is a secondary research. Hence, in regards, ethical considerations for the articles for analysis have already been taken by their respective authors.
According to Badiani et al. (2020), Pfizer vaccine showed a significant amount of effectiveness against the COVID 19. It has been seen that the results of the study highlighted a significant rise the effectiveness in the percentage from 90 to 95 per cent. Among 43538 participants 170 people affected with COVID 19. Among all these cases, 162 are from the control group and 8 are from the vaccinated group. Hence, it can be highlighted that the study effectively provided the idea of the effectiveness of the vaccine in terms of the immunization process against the COVID 19. The results have been seen after the phase III trial. This study also highlighted that the impact of the vaccine can be long lasting and the priority group that is over the age of 65 the vaccine showed effectiveness almost 94 per cent. Hence, this can be stated that the Pfizer vaccine is very much effective against the disease of COVID 19. Moreover, the vaccine has not shown any kind of negative health concerns for the participants that is there is no safety issues involved for the vaccine. In this consideration, it should be stated that the study effectively provided a proper idea regarding Pfizer vaccine for the COVID 19 immunization.
As per the views of Nasreen et al. (2021), Pfizer-BioNTechComirnaty, ModernaSpikevax and AstraZeneca Vaxzevria are the most prominent vaccines in Ontario, Canada. The authors conducted the test-negative design study and found out the effectiveness of the vaccine products against the alpha, beta, gamma and delta strains of the COVID 19 virus and the SARS-CoV-2 variants of concern are more transmissible and pose increased threats regarding the disease severity. Based on this study, the vaccine products are more effective if the two doses of the vaccines are provided to the patients and the effectiveness of the vaccine products are similar mostly. It has been seen that the vaccine showed effectiveness against alpha strain from 89 to 92 per cent, against beta strain by 87 per cent, against gamma strain it is 88 per cent and delta strain it showed 87 to 95 per cent of effectiveness. Hence, in scenario of Canada the impact of the vaccines are mostly similar and the rate of the effectiveness of the vaccines are higher in case of double dose completion compared to the single dose and also the impacts are more prominent among the elderly people over the age of 60. Hence, it is clear that the vaccination if completed then the immunisation of all the vaccines are mostly similar and the chances of the SARS-CoV-2 variants of concern are reduced by these vaccination process. On the other hand, the impacts of the vaccines are mostly positive for the disease reduction.
Based on the views of Boytchev (2021), it has been seen that the AstraZeneca vaccine is mostly used in the European context and the impact of the vaccine can be seen positively in most of the cases. It can be stated that the impact of the vaccine is mostly found against the younger population and the elderly population have not effectively immunized with this vaccination process. In case German newspaper reports it has been seen that the AstraZeneca vaccine can be effective for the elderly people only up to 8 per cent which is a concerning factor for the vaccination of the elderly people of the country as the contamination and the impacts of the COVID 19 disease is very high. Thus, it should be stated that the factor of the vaccination through AstraZeneca should be changed and other effective vaccines should be considered for the change in the situation and increase the effectiveness of the vaccination of the same.
According to Heath et al. (2021), the effectiveness of the NVX-CoV2373 vaccine against the COVID 29 is considerably high. It has been seen that the study conducted by the authors considered 15187 participants in the randomised group and 14039 participants were from the placebo group and the results highlighted that the from the vaccinated group 10 people and from the placebo group 96 people showed onset of the symptoms after the double dose for 7 days. No cases of hospitalisation and deaths were seen among the participants and on the other hand, the study showed that the vaccine 86.3 per cent efficacy against the alpha strain and 96.4 per cent against the non alpha strains with the confidence interval of 95 per cent. Hence, as per the data it can be stated that the vaccine is more effective for the later strains came into action of the COVID 19 than the alpha strain. However, the efficacy of the vaccine is very much prominent for the improvement in the situation considering the decrease in the impact of the disease.
Mahase(2020), highlighted that the Moderna showed a higher efficacy in case of the US and UK population as the rate of the efficacy is found to be 94.1 per cent. However, in several situations in UK it has been seen that the impact of the vaccine is 87 per cent and that can be marked as the true efficacy for the vaccine. Moreover, the vaccine showed several safety and security related impacts on the patients. The vaccine is still less effective for the elderly population over the age of 65 and it can be a concerning aspect for the considered country and the population of the country. It should be stated that the effectiveness of the vaccine can be considered for the improvement of the situation of the COVID 19 situation. However, the consideration of the safety of the elderly people needed to be considered and proper recombination of the vaccine to improve4 the safety should be implemented.
As per the views of Chavda, Vora and Vihol (2021), COVAX 19 is one of the most prominent vaccine against the COVID 19 situation and this vaccine is focused on the spike protein of the virus and nullifies the impacts of the vaccine on the human body effectively. Moreover, it can effectively blocks the ACE2 receptor of the humans and it will reduce the effectiveness of the COVID 19 virus on the body. Thus, it should be stated that the impact of the vaccine is very much prominent as this can impact of the receptor activity and inhibits the growth of the COVID 19 virus. In this consideration the practical studies on the vaccine through experiments required to be considered for the better view on the vaccine.
Baden et al. (2021), conducted a study on 30420 participants among them half of the participants were selected randomly and the people of this group are provided with the mRNA-1273 SARS-CoV-2 Vaccine and the other half of the participants were provided with the placebo treatment. The placebo group showed 185 participants with infection and the confidence interval was 95 per cent. On the other hand, the participants from the random group showed 11 infection cases. Thus, the efficacy rate of the vaccine is 94.1 per cent. Moreover, the affected people with the infection were found to be over the age of 65. Thus, it is evident that the vaccine is effective against the virus and it can effectively reduce the impact of the CIVID 19 cases though the elderly people are more vulnerable to the COVID 19. Hence, it should be stated that the importance of the improvement of the quality of the vaccine for the improvement of the outcome of the elderly people. It should be stated that the impact of the vaccination is prominent and effective for the participants and it should be considered for the further processes of the immunisation.
Based on all the above studies, it should be stated that more or less all the vaccines highlighted prominent impacts and efficacies against the virus and the disease reduction was prominent. However, the Moderna and AstraZeneca vaccine showed some safety issues for the elderly people and that should be improved for the further effectiveness and proper efficacy identification. However, the vaccines are comparably very much effective for the people of the world and the countries should try to improve the quality of the vaccines. Moreover, it should be stated that the improvement of the situation should be considered for future of the disease.
The impacts and the efficacies of the vaccines can be seen through the studies. However, the impact of the safety and the security of the disease reduction should be considered and the recommendations should be provided which are missing and the practical studies should be considered for the future context.
There are not many literary sources which can give an account of the efficacies of vaccines prepared by many countries. Although a number of pharmaceutical companies are coming up with vaccines and vaccination has already started rigorously, the research on vaccine development is still and scientists all over the world have been at their best to bring out the best version of the vaccines to fight with the evolving strains of the virus. Multiple vaccine candidates are in the phase 1, 2 and 3 of the trial, while many other had been finishing the preclinical trials. Some of the vaccines developed are the Messenger RNA based vaccines, which is a novel technology and had been used in vaccine preparation of other diseases before the pandemic. Results from phase 1 and phase 2 of the trial have showed the safety of the vaccines.Many of the vaccines had been showing some promising effects like recombinant vaccine AZD1222 conducted by the University of Oxford and Astrazeneca. The imperial college of USA has developed the mRNA 1273 vaccine by the Moderna. Other vaccines which has already been approved by WHO are Covaxin developed by Bharat Biotech and Covishield developed by the Serum Institute of India.
While searching for papers to find out the effectiveness of the vaccines, one of the papers have claimed the effectiveness of the Pfizer- Biotech and Astrazeneca vaccines. A paper by Bernalet al., (2021) have conducted a case control study in England, where 156930 adults have been chosen for the administration of vaccine Pfizer-BioNTech BNT162b2 and Oxford-AstraZeneca ChAdOx1-S vaccines. It has been found that a single dose of BNT162b2 vaccine has been 6-=70 % effective in preventing the symptoms of Covid-19. Those who were vaccinated and still had the symptoms were had 45 % lesser chance of getting admitted in the hospital along with 50 % lower risks of death. However, One paper has referred to the side effects shown by the Astrazeneca vaccines. Similar types of results have been shown by a study conducted by Solomon et al., (2021), where it has been stated that just like the other vaccines, the Oxford–AstraZeneca COVID-19 vaccine have certain side effects which showed its peak within the first 24 hours after the administration of the vaccination and lasted for about 1-3 days. The severe symptoms were not very common, but were the main reason for the avoidance of the vaccines by the recipients or they did not wanted to pursue for the second dose. Most of the symptoms identified were headache, tiredness and dizziness. Another paper by
Badiani et al., (2020) have explored on the efficacy of the Pfizer vaccines on reducing the symptoms of Covid-19. Similar type of results have been shown in the study by Tenforde (2021), where a study has been conducted to find out the effectiveness of Pfizer-BioNTech and Moderna Vaccines. It was found that there was significant effectiveness of the vaccines was detected after the first dose. Effectiveness was shown after the second dose of the vaccine has been completed. However, the adults had been recommended to abide by the hand hygiene protocols and wearing of masks for at least 14 days after the second dose has been administered. However, this study has also admitted that a total vaccination course might not prevent an individual from contracting the disease but can prevent Covid-19 associated hospitalization and death. Vaccinations can also have impact on the post Covid situation in an individual. Similar types of results can be found in the study conducted by
Mahase,(2020), where only one case was found in the vaccination group and for in the placebo group. This study also mentioned about the adverse effects related to the vaccines like short term mild to moderate pain in the site of the injection, hand pain, headache and fatigue. The adverse events were low and similar in the vaccine and the placebo groups respectively. Apart from Pfizer, AstraZeneca, Moderna, another vaccine that is available in UK is Novavax(Sacks, 2021). ChAdOx1 nCoV-19 has been referred to be having a pretty safety profile which has been important for the Covid -19 symptoms. One of the most important thing is that it is well tolerable for the elderly people (Sacks, 2021). The Australian government had also approved the Spikevax or the Moderna vaccines for people above the age of 12(Sacks, 2021). A study by Mahase, (2020), analyzed severe Covid cases. It was found that most of the severe cases were found in the placebo group than that of the vaccine group. One death had occurred in the study, that also in the placebo group. However, considering lesser side effects, this vaccines have been rolledout. Another vaccine that has been accepted are vaccine developed by the John & Johnson, which is likely to be the third COV 2 vaccines. Rosenblum et al., (2021),on the other hand have stated about the adverse effects related to Janssen vaccine. On July 202, a warning was issued by FDA about the number of GBS cases after the vaccine administration. The GBS is a rare neurological disorder which is characterized by the sudden onset of fatigue and weakness. GBS can be lethal and can cause permanent paralysis as well as death. Another adverse report noted for the Janssen vaccine was blood clotting, due to which the vaccination trialwas discontinued in a study (Rosenblum et al., 2021).
Covax-19 is a recombinant protein based Covid-19 vaccine that has been developed by a South Australian based biotech company Vaxine. Only one paper found in the systematic review contained information about the effectiveness of Covax-19. There are almost no papers that can validate its efficacy, as it is based on the interim data that has been collected from a Phase III SpikoGen trial which has recruited about 17000 volunteers(Kim, Marks & Clemens, 2021). The interim data has shown that the vaccine has surpassed 60 % of the efficacy of the virus. However, a rigorous trial for this vaccine is still needed considering its partial efficacy(Kim, Marks & Clemens, 2021). It should be mentioned that the primary goal for the implementation of Covid-19 vaccine is to protect against the disease and mortality. Since the production of the vaccine are still at its early stage, it is very difficult to predict or point out the methodological constraints. Secondly, many persons have dropped out from the real RCTs after the administration of the first dose probably due to vaccination hesitancy that, is unjustified speculations about the effects of vaccinations, which can differ from half-truths and unsubstantiated guesses to deliberate misinformation on the basis of the conspiracy theories(Sharma et al., 2021).A very close attention is given to the attendance of the study visits, the cold chain requirement as well as the administration of the study products. All these parameter are difficult to control incase of general population (Solomon et al., 2021). Hence, such randomized controlled trials can overestimate the extent of protection provided by the vaccines in comparison to the real world. Additionally, it is also necessary to say that after the administration of the vaccines, the recipients should be informed of all the side effects, the ways to treat them and when and whom to seek help in case any such adverse effects are seen(Solomon et al., 2021). Thus, from these limited number of papers, it can be said that among the many vaccines that are still under trial, only the vaccines produced by Astrazenaca, Moderna and Pfizer had been showing a promising effects with minimum side effects.
In conclusion, it can be stated that although vaccines are the ultimate tool to save the mankind from the paws of this pandemic, the vaccines needs to be carefully wielded and should definitely be used along with other safety protocols. For example, even after the second dosage of the vaccination has been completed, it is necessary to wear masks in public places, wear gloves, use sanitizers and avoid unnecessary crowding, considering the fact that the virus is continuously evolving and the question lies whether misinformation, politics, vaccine hesitation, division and deception be able to make community vaccination possible and lower the burden of Covid-19. Although, many countries and organization are still carrying out researches on vaccination, there are 3-4 main vaccines that has been approved by the World Health Organization and FDA, considering the minimum side effects. This scoping review has explore the differences in the efficacy of the vaccines developed in countries like US, UK and Australia.Among the vaccines, the vaccines developed by the University of Oxford and Astrazeneca and the one developed by the Pfizer had shown good effects. More research trials are required to understand the mode of action of these vaccines and how they can be improved.