The newly developed coronavirus disease 2019 (COVID-19) vaccines are considered to be a powerful tool to contain the devastating pandemic. Healthcare workers (HCWs) are at the highest risk of exposure to COVID-19 and, therefore, they are the priority group for vaccination. The study aimed to examine the perceptions, attitudes, and acceptability of the COVID-19 vaccination among HCWs in India. A cross-sectional pilot survey was conducted using an online questionnaire between 13 and 25 January 2021. Among 264 respondents, 40.2% of HCWs would receive the vaccine against COVID-19 if available and 32.2% were willing to take the vaccine after observing adverse effects in others. Infected members in the immediate social network (OR:2.15; 95%CI:0.426-10.844), COVID-19 knowledge (OR:5.113; 95%CI:0.974-26.853), the safety of vaccines (OR:7.608; 95%CI:2.618-22.11), and those who did not receive a flu vaccine last year (OR:2.612; 95%CI:1.120-6.091) were found to have a statistically significant association with vaccine acceptance. The main reasons to delay/refuse vaccination included: ‘quick vaccine development and compromised quality’ (43.7%) and ‘lack of trusted information regarding COVID-19’ (41.3%). The finding showed a high rate of vaccine hesitancy among HCWs. Policymakers should take steps to increase public awareness and secure timely and affordable vaccines for the HCWs and general population with effective vaccine promotion campaigns.

The association of Vitamin D and children with asthma is known and there are several individual studies on Vitamin D polymorphisms. However, systematic reviews on all vitamin D associated gene polymorphisms have not been done in children with asthma. To investigate the association of Vitamin D associated gene polymorphisms and asthma in children (0–18 years) by systematic review and meta-analytic approach. Our search included 20 full text articles of which 15 were case control studies and 5 used family based linkage disequilibrium method. Total of 2491cases and 3682 controls were included in case control studies, with mean age of 9.58 years and 10.16 years respectively. Quantitative and qualitative analysis were done. Quantitative analysis revealed significant association with protective effect of Apa1 polymorphism in allele (OR 0.81 (0.71,0.91) and homozygous major form (OR 0.83 (0.70,0.98) and Taq 1 minor allele in homozygous form (OR 0.73 (0.58,0.92) in children with asthma. However, the minor allele of Apa1(OR 1.21 (1.07,1.37), Bsm 1 in heterozygous (OR 1.35 (1.07,1.71) and homozygous minor form (OR 1.95 (1.59,2.39), major allele of Fok1(OR1.34 (1.17,1.52) and Taq1 (OR 1.22 (1.08,1.38) were found to be increasing the odds of asthma. Ethnic variations were noted in subgroup analysis. Qualitative analysis of the polymorphisms of the Vitamin D associated metabolic genes also showed significant associations. Our review shows significant associations with VDR polymorphisms - Apa1, Bsm1, Fok 1, Taq 1, polymorphisms of Vitamin D metabolic genes – CYP27A1, CYP 2R1, CYP 24A1, GC and genes related to Vitamin D response element (VDRE) in children with asthma. Conducting large studies involving various ethnic regions will strengthen our knowledge on the association and aid in targeted interventions for control of asthma in children.

Vitamin D gene polymorphisms are known to be associated with asthma and allergic rhinitis in children. However, the genetic association of the same in South Indian children with above condition is still unknown. The present study was designed with the objective to analyze the association of polymorphisms of vitamin D receptor gene (VDR) (rs797532, rs154410, rs2258470, rs731236) and transport gene of vitamin D (rs7041) in children with asthma and allergic rhinitis in South India. Children (1-18years) presenting with symptoms suggestive of asthma and allergic rhinitis to hospital based outpatient department, in Vellore, South India were recruited as cases and children presenting with minor illness without respiratory complaints were enrolled as controls during January 2018 to September 2021. Polymorphisms were genotyped using tetra-arms PCR. Significant increase in levels of absolute eosinophil counts and serum IgE levels with decrease in vitamin D levels was seen among the cases. Significant association between levels of vitamin D and serum IgE was also observed. Analysis of polymorphisms showed that, in comparison to homozygous major allele the odds of having heterozygous (OR0.55 (0.3, 0.99) and homozygous minor form (OR0.52 (0.28, 0.97) of rs7975232, homozygous minor (OR 0.51 (0.34, 0.76)) and alternate allele (OR 0.7 (0.53, 0.93)) of rs154410 and homozygous minor form (OR 0.57 (0.37, 0.88) of rs731236 was significantly lesser among the cases. Genotypic model of rs154410 (p0.023) and allele form of rs7041 (p 0.041) were significantly associated with vitamin D levels however no association of gene blocks with cases was seen in haplotype analysis. There was an apparent gene pool difference noted in comparative analysis between Indian studies. The study is the first in south India to analyze levels of serum IgE, Vitamin D levels, association of VDR polymorphisms, and rs7041 in children with asthma.

Drug allergy is an immunologically mediated adverse reaction that can lead to substantial mortality and morbidity. However, there is no published literature on the incidence in India. Knowledge and management of drug allergies are imperative in day-to-day practice. Drugs elicit immune responses in several ways and are also capable of producing immunological reactions that may vary from Type I to Type 4 hypersensitivity reactions. There are risk factors that make certain people more vulnerable to such reactions. A systematic approach to a suspected drug allergy can help in better management of the same.