World is still struggling with widespread dissemination and many unanswered questions about Coronavirus disease-19(COVID-19). Global efforts introduced several candidate vaccines against causing COVID-19, mostly requires require 2 doses of injections and some with about 90-95% efficacy. All strategies against the spread of infection are placed on breaking the chain of virus transmission though protective public health measures and mass vaccination, as yet. The current situation emphasis on the global need for carefully designed policies to maximize vaccine access and uptake. The risk compensation theory states that a drop in perceived risk caused by access to prevention measures may lead to an increase in risky behaviors. The current pandemic has faced people to the sense of risk compensation and behavior change in response to a perceived risk level. Risk compensation phenomenon may significantly defeat the benefits of COVID-19 vaccination, especially if the vaccine is not very effective in real life or in high-risk populations. Acknowledging and be conscious of Peltzman risk compensation has crucial importance in counteracting and neutralizing the false complacency of community also lend more weight to public health efforts. The public health messages and practices should be clearly expressed, straightforward, reliable and applicable. It is important that as efforts made to encourage mass vaccination of population other NPIs needs to be re-established and implemented to ensuring strike the balance of learning to live with COVID-19 in parallel with daily activities and job tasks.

Background Francisella tularensis is the causative agent of tularemia in humans and a large number of animal species. Considering recent evidence of the circulation of this bacterium in different parts of Iran, especially in the western provinces, the aim of current study was to determine the tularemia seroprevalence in the human population living in Ilam Province. Methods In 2015, 360 serum samples were collected from five groups of people: ranchers ( n = 112), farmers ( n = 79), butchers and slaughterhouse workers ( n = 61), Nature Conservation Officers ( n = 34), and referents of medical diagnostic laboratories ( n = 74). These samples were tested for the presence of anti- F. tularensis IgG antibodies using the ELISA method. Results According to the ELISA manufacturer cutoffs, we found that 10 (2.78%) and 9 (2.5%) sera, respectively, were positive or borderline for F. tularensis IgG antibodies. The highest tularemia seroprevalence was observed among farmers (7.59%). Conclusions Our results strongly support the circulation of tularemia in Ilam Province. Because no human tularemia case has been reported so far in this province, we recommend specific education programs to increase knowledge of local health care professionals about this important zoonotic disease.

Background Q fever is a zoonotic disease of great public health importance in Iran. This disease is presented with high phase I antibody development in chronic and high phase II antibody in the acute form of illness. This study was conducted to evaluate the seroprevalence of Q fever among high-risk occupations in the Ilam province in Western Iran. Methods and findings In this cross-sectional study, 367 sera samples were collected from five groups comprised of animal husbandry workers, farmers, butchers, slaughterhouse workers, and park rangers. The collected sera were tested for IgG antibodies against Coxiella burnetii using ELISA. The seroprevalence of antibodies against C . burnetii in phase I and II was 24.38% and 26.37%, respectively (i.e., 32.42% overall). Low educational level, living in rural areas, keeping sheep/goats, ages older than 50 years, and a history of arthropod bites positively correlated with increased risk of Q fever infection. Animal husbandry workers (45.13%) were at higher risk of contracting Q fever compared with other occupations in the study (17.11%). Conclusions High seroprevalence of C . burnetii among high-risk occupations is a serious challenge in the Ilam province. In addition, the high seroprevalence of endemic Q fever in rural and nomadic areas and a higher concentration of occupations who are directly engaged with livestock demonstrate the critical need for preventive medicine education and training in regards to mitigating risk for disease contraction in susceptible groups.