key: cord-0784041-0fglfoqj authors: Tatar, Moosa; Wilson, Fernando A title: The largest vaccination campaign in history: A golden opportunity for bundling public health interventions date: 2021-05-22 journal: Journal of global health DOI: 10.7189/jogh.11.03076 sha: 4e38644d1be471279fdcdb492b00476c39c3f90e doc_id: 784041 cord_uid: 0fglfoqj nan The COVID-19 campaign has the potential to make great strides toward advancing population health and decreasing global disparities in health outcomes. For example, tuberculosis (TB) is a preventable disease and often curable; however, it is a leading cause of death worldwide. Further, undiagnosed and untreated TB often leads to permanent and debilitating conditions such as loss of lung function [4] . Hundreds of millions of individuals, especially in developing (ie, low-and middle-income) countries have latent TB infection, and, of these, ten million people develop active TB that infects an average of ten other people each year [5] . Unfortunately, the COVID-19 pandemic has substantially disrupted efforts to monitor and mitigate TB and other infectious diseases and public health resources were re-allocated away from many of these efforts to combat COVID-19 [6] . Similar to TB infection, there is a long-term public health challenge in addressing rates of chronic HepC infection. Globally, there are more than 70 million individuals infected with HepC, and, within the United States, between 2 and 3.5 million people have chronic HepC infection, and the majority of them are not aware of their disease. Consequently, undiagnosed HepC often results in permanent and severe liver impairment and premature death, and thus early screening for HepC is critical. Studies suggest undertaking targeted HepC screening for at-risk people [7] , and the CDC and the US Preventive Services Task Force (USPSTF) promote universal HepC screening for all adults aged 18 and older in the United States [8, 9] . Because HepC is often spread via injectable illicit drug use, it is possible that we may experience increasing rates of HepC due to evidence of increasing drug use since the beginning of the COVID-19 pandemic [10] . The COVID-19 vaccination campaign creates a unique opportunity for screening and early diagnosis for these and other long-standing public health threats such as HIV or diabetes. Tuberculosis, HepC, and HIV are co-epidemics and, therefore, pairing COVID-19 vaccinations with the opportunity to provide additional screening and diagnoses will have an enhanced, cost-effective impact on population health, particularly in low to middle-income countries which are resource constrained. These screenings also require additional time and resources including, for example, counseling time and associated costs. A rapid antigen or oral fluid antibody test for HIV involves either a finger prick or an oral fluid sample, and they can provide results in 20 to 30 minutes. A TB blood test or a HepC Virus antibody test requires a blood sample, and public health or medical professionals would need to follow-up with individuals concerning their test results. Other screenings which are more involved or require patient fasting or a follow-up visit such as the tuberculin skin test or A1C test for blood glucose levels can be offered to individuals when scheduling their COVID-19 vaccinations. In addition to public health screenings, COVID-19 vaccination sites are ideal in distributing educational materials to inform patients on the above infectious and chronic diseases and can help them identify symptoms or refer them to additional health resources. These materials can be bundled as a Preventive Health Toolkit, increasing patient awareness of symptoms and available resources relating to infectious, sexually transmitted, and chronic diseases as well as mental health status (eg, anxiety, depression), domestic violence, and other public health concerns. The Toolkit could be in the form of a brochure or CD, or even in the form of health supplies such as birth control. Patient contact information can also be solicited and used to follow-up after testing and distribute targeted educational materials and resources via mail or email. This is a unique and valuable opportunity to advance public health across a range of initiatives and to improve public trust in the health care system and fight against health science misinformation, not only regarding COVID-19, but with TB, HepC, HIV and other infectious and chronic diseases. Successful global mitigation of the COVID-19 virus in conjunction with tackling other infectious and chronic diseases, along with increasing public awareness and information on individual and public health challenges, has the potential to make great strides toward advancing population health and decreasing global disparities in health outcomes. However, in addition to funding and resources, these interventions will require logistical planning (ie, storage requirements) and have other challenges (eg, surveillance, safety, credibility, etc.) to increase their reach and effectiveness. Also, coordinating these interventions needs global commitment and efforts (possibly by Global Health Initiatives, WHO, UNESCO, COVAX, and World Bank). World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report -51 Johns Hopkins CSSE Coronavirus Pandemic (COVID-19). 2021. Our World in Data Mortality hazard and survival after tuberculosis treatment Government and Global Tuberculosis Efforts. Global Health Policy Web site COVID-19 and TB control in immigrant communities Cost-effectiveness of universal and targeted hepatitis C virus screening in the United States Preventive Services Task Force (USPSTF). A and B Recommendations Testing Recommendations for Hepatitis C Virus Infection Mental health, substance use, and suicidal ideation during the COVID-19 pandemic-United States The authors have no financial disclosures to report.Authorship contributions: All authors read, edited, and approved the manuscript. As the corresponding author, I confirm all authors had full access to all aspects of the research and writing process, and take final responsibility for the paper. The authors completed the ICMJE Unified Competing Interest form (available upon request from the corresponding author), and declare no conflicts of interest.