Key Points Question Is indirect exposure to live attenuated poliovirus in the oral polio vaccine (OPV) associated with diminished symptomatic infection with SARS-CoV-2? Findings In this cohort study of 4190 women in Iran, none of those indirectly exposed to OPV developed COVID-19 during the 9 months of the study, while 0.74% of age-matched women who had no exposure to OPV did develop COVID-19. Meaning These findings suggest that indirect exposure to live attenuated poliovirus may be associated with decreased symptomatic COVID-19 infection for at least 6 months.

Background Several live attenuated vaccines were shown to provide temporary protection against a variety of infectious diseases through stimulation of the host innate immune system. Objective To test the hypothesis that countries using oral polio vaccine (OPV) have a lower cumulative number of cases diagnosed with COVID-19 per 100,000 population (CP100K) compared with those using only inactivated polio vaccine (IPV). Methods In an ecological study, the CP100K was compared between countries using OPV vs IPV. We used a random-effect meta-analysis technique to estimate the pooled mean for CP100K. We also used negative binomial regression with CP100K as the dependent variable and the human development index (HDI) and the type of vaccine used as independent variables. Results The pooled estimated mean CP100K was 4970 (95% CI 4030 to 5900) cases per 100,000 population for countries using IPV, significantly (p<0.001) higher than that for countries using OPV—1580 (1190 to 1960). Countries with higher HDI prefer to use IPV; those with lower HDI commonly use OPV. Both HDI and the type of vaccine were independent predictors of CP100K. Use of OPV compared to IPV could independently decrease the CP100K by an average of 30% at the mean HDI of 0.72. Conclusions Countries using OPV have a lower incidence of COVID-19 compared to those using IPV. This might suggest that OPV may either prevent SARS-CoV-2 infection at individual level or slow down the transmission at the community level.

Considering that 46.7% of participants did not perform BSE, and that almost all of those who did perform BSE did it incorrectly-and taking into account that a lack of knowledge on how to perform BSE was the main reason why most non-performers did not examine themselves-establishing educational programmes to teach women at risk may help in the early diagnosis of breast cancer.

BackgroundMother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) is an important global health issue. We hypothesized that the live attenuated poliovirus existing in oral polio vaccine (OPV) may protect uninfected neonates born to HIV-positive mothers through the stimulation of innate immune system.ObjectiveTo test the hypothesis that countries using OPV have a lower MTCT rate (due to postnatal protection provided by the vaccine) compared with those using only inactivated polio vaccine (IPV).MethodsIn an ecological study, the incidence of HIV/AIDS in children aged &lt;1 year (IncHIV1), considered a surrogate index for MTCT rate, was compared between countries using OPV vs. IPV. The aggregated population data were retrieved for 204 countries from the Global Burden of Disease (GBD 2019) Collaborative Network website, “Our World in Data” website, the World Bank website, and the WHO Global Polio Eradication Initiative (GPEI). We used a negative binomial regression model with IncHIV1 as the dependent variable and the prevalence of HIV/AIDS in women aged 15–49 years (PrevHIV), antiretroviral therapy (ART) coverage, human development index (HDI), and the type of vaccine used in each country as independent variables. Multivariate imputation by chained equations was used to treat missing values. Analyses were performed for both the original dataset (with missing values) and the five imputed datasets.ResultsIncHIV1 and PrevHIV were available for all 204 countries; vaccine type, 194 countries; HDI, 182 countries; and ART coverage, 133 countries. One-hundred and twenty-nine countries in the original dataset had complete data for all the above-mentioned variables; the imputed datasets had complete data for all 204 countries. The results obtained from the analysis of the original dataset had no overall difference with the pooled results obtained from the analysis of the five imputed datasets. Countries with higher HDI mainly use IPV; those with lower HDI commonly use OPV. PrevHIV, HDI, and the type of vaccine were independent predictors of IncHIV1. Use of OPV compared to IPV, was independently associated with an average decrease of 17% in IncHIV1 at the median HDI of 0.75. The protection provided by OPV increased in countries with lower HDI.ConclusionsUse of OPV compared with IPV, was independently associated with lower MTCT rate.

Summary Background The type of health insurance may affect the likelihood of mortality of insured people. We conducted this study to determine if accessing free quality health care services could decrease the premature mortality of people in a developing country. Methods In a multicenter cross sectional study, “years‐life‐lost” (YLL) due to premature death was evaluated in 202 671 insured people residing in six large regions in Iran. The participants had access to free quality health care services. The number of insured people that died in the six regions during March 20, 2014, to March 20, 2015, as well as their sex, age, and cause of the death, were collected, and the YLL was calculated based on assumptions made in Global Burden of Disease Study 2010 (GBD2010). Results The crude mortality rate was 2.3 per 1000, significantly lower than the overall rate of 4.6 per 1000 people in general population of Iran. The average YLL was 47 years per 1000 persons, significantly lower than that in general population of Iran and many industrialized countries. The most common causes of death (and YLL) were cardiovascular diseases and malignancies. Conclusion Having access to free quality health care services is associated with a significant decrease in premature death.