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Title: A case for cross-border governance? a comparative trend assessment of COVID-19 transmission, vaccination, and outcomes among 35 nations in Europe across 18 months
Authors: Cuschieri, Sarah
Cuschieri, Andrea
Farrugia, Elysia
Diacono, Emily
Balzan, Elaine
Grupetta, Miguel
Vella, Alessia
Cutajar, Catriona
Formosa, Martina
Barbara, Matthias
Mintoff, Franziska
Shaw, Conor
Fleri-Soler, Samuel
Borg, Norbert
Pace, Gillian
Vella, Lauren
Pisani, Robert
Attard Mallia, Tamara
Gouder, Mattea
Attard, Rosie
Grixti, Nicole
Scicluna, Mark
Borda, Timothy
Bartolo, Katya
Chircop, Ruben
Degabrielle-Ferrante, Etienne
Mallia, Mariah
Attard, Miguel
Frendo, Naomi
Gatt, Gianluca
Damato, Greta
Riolo, Nicole
Muscat-Baron, Lorna
Galea, Matteo
Grech, Elizabeth
Keywords: COVID-19 (Disease) -- Transmission -- Europe
COVID-19 (Disease) -- Vaccination -- Europe
COVID-19 (Disease) -- Mortality -- Europe
COVID-19 (Disease) -- Prevention -- Europe
COVID-19 Pandemic, 2020- -- Europe
Issue Date: 2022
Publisher: Cambridge University Press
Citation: Cuschieri, S., Cuschieri, A., Farrugia, E., Diacono, E., Balzan, E., Grupetta, M.,...Grech, E. (2022). A case for cross-border governance? A comparative trend assessment of COVID-19 transmission, vaccination, and outcomes among 35 nations in Europe across 18 months. Disaster Medicine and Public Health Preparedness, 1-49, doi: 10.1017/dmp.2022.108.
Abstract: Objective: Coronavirus disease 2019 (COVID-19) spread globally, including across Europe, resulting in different morbidity and mortality outcomes. The aim of this study was to explore the progression of the COVID-19 pandemic over 18mo in relation to the effect of COVID-19 vaccination at a population level across 35 nations in Europe, while evaluating the data for cross-border epidemiological trends to identify any pertinent lessons that can be implemented in the future.
Methods: Epidemiological data were obtained from European Centre for Disease Prevention and Control and Our World in Data databases while Ministry of Health websites of each respective country and local newspapers were used for COVID-19-related vaccination strategies. Case, mortality, and vaccination incidence comparative analyses were made across neighboring countries.
Results: Similar morbidity and mortality outcomes were evident across neighboring countries over 18 mo, with a bidirectional relationship evident between cumulative fully vaccinated population and case fatality rates.
Conclusion: Countries’ COVID-19 outcome is related on national mitigative measures, vaccination rollouts, and neighboring countries’ actions and COVID-19 situations. Mass population vaccination appeared to be effective in reducing COVID-19 case severity and mortality rates. Vaccination equity and pan-European commitment for cross-border governance appear to be the way forward to ensure populations’ return to “normality.”
Appears in Collections:Scholarly Works - FacM&SAna

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