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Arepalli S, Kopplin L, Tsui E, Brill D, Sobrin L, Papaliodis G, Darwish D, Raiji V, Janardhana P, Emami-Naeini P, Nore L, Parker M, Thomas AS. THE HETEROGENEOUS PRESENTATIONS OF DE NOVO AND RECURRENT OCULAR INFLAMMATION AFTER COVID-19 VACCINATION : A Multicenter Report and a Review of the Literature. Retina 2025; 45:1175-1183. [PMID: 39841907 DOI: 10.1097/iae.0000000000004413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2025]
Abstract
PURPOSE To describe the patterns of ocular inflammation after coronavirus disease 2019 vaccination, assess underlying commonalities, and understand outcomes. METHODS Retrospective, multicenter cohort study, conducted between 2020 and 2021. Patients with no previous uveitis history ( de novo ) or a known uveitis history (recurrent) who developed ocular inflammation within 42 days of coronavirus disease 2019 vaccination were identified. Characteristics of the uveitis, treatment approaches, and clinical outcomes were assessed. RESULTS Fifty-five eyes of 39 patients with ocular inflammation temporally related to vaccination were identified. Twenty-two patients (36 eyes) were de novo , while 17 (19 eyes) were recurrent. Anterior uveitis was most common. HLA-B27 positivity was found in 6 (27.2%) de novo patients, and 5 (29.4%) recurrent patients. Most patients required only observation, topical, or systemic corticosteroids. Among vaccinated patients, 12.3% of new uveitis referrals during the study period were related to coronavirus disease 2019 vaccination. Among patients with a history of quiescent uveitis, only 0.85% experienced a flare after vaccination. CONCLUSION Most inflammation thought to be secondary to coronavirus disease 2019 vaccination achieved quiescence with observation or steroids, and the overall incidence is low. Anterior uveitis was the most common. HLA-B27 positivity occurred at a higher rate than reported in the baseline population.
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Affiliation(s)
- Sruthi Arepalli
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - Laura Kopplin
- Department of Ophthalmology, University of Wisconsin, Madison, Wisconsin
| | - Edmund Tsui
- Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, California
| | | | - Lucia Sobrin
- Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
| | | | - Dana Darwish
- Department of Ophthalmology, Cook County Hospital, Illinois
| | - Veena Raiji
- Illinois Retina Associates, Chicago, Illinois
- Department of Ophthalmology, Rush University Medical Center, Illinois
| | - Priya Janardhana
- Department of Ophthalmology, University of Massachusetts, Worcester, Massachusetts
| | - Parisa Emami-Naeini
- Department of Ophthalmology, University of California, Davis, California; and
| | - Lish Nore
- Tennessee Retina, Nashville, Tennessee
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Tran AD, Suwanbamrung C, Stanikzai MH, Chutipattana N, Shohaimin S, Khammaneechan P, Luan LM, Dien TP, Nam TT, Tung PT, Le CN. Parental predictors of childhood vaccination adherence in border areas of Southern Vietnam: a first look at minority communities. J Pediatr (Rio J) 2025:S0021-7557(25)00085-3. [PMID: 40383143 DOI: 10.1016/j.jped.2025.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Revised: 03/23/2025] [Accepted: 04/03/2025] [Indexed: 05/20/2025] Open
Abstract
OBJECTIVES Suboptimal timeliness and coverage of childhood vaccination programs undermined their effectiveness in achieving population-level immunity. This issue is particularly concerning among minority populations, where disparities in vaccination adherence persist. To address this gap, the study assessed the extent of parental adherence to age-appropriate childhood vaccination and its predictors among the minority children under five years of age. METHODS This cross-sectional study was conducted in three districts of Dong Thap Province, Vietnam, and neighboring Cambodia. A total of 449 ethnic minority parents with children under five years old participated. Data were gathered through face-to-face household interviews using a structured questionnaire, complemented by direct observation of the children's vaccination cards to verify adherence. Binary logistic regression was used to identify predictors of vaccination adherence. RESULTS The adherence rate to childhood vaccination among children in the minority population was 18.9 %. Parental adherence was significantly higher for children under one year of age (aOR = 2.54, 95 % CI: 1.29-5.03) and for firstborn children (aOR = 3.48, 95 % CI: 1.36-9.92). Within the Health Belief Model framework, greater perceived barriers were associated with lower adherence (aOR = 0.32, 95 % CI: 0.21-0.49), while higher parental self-efficacy was linked to increased adherence (aOR = 1.84, 95 % CI: 1.11-3.11). CONCLUSION This study revealed a low parental adherence rate (18.9 %) to childhood vaccination. A child's age, birth order, perceived barriers, and parental self-efficacy influenced adherence. These findings emphasize the need to incorporate these factors into targeted policies and interventions for improving immunization rates in minority populations and comparable settings.
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Affiliation(s)
- An Dai Tran
- Walailak University, School of Public Health, Public Health Research Program, Nakhon Si Thammarat, Thailand; Dong Thap Provincial Center for Disease Control, Dong Thap, Vietnam
| | - Charuai Suwanbamrung
- Walailak University, School of Public Health, Public Health Research Program, Nakhon Si Thammarat, Thailand; Walailak University, Excellent Center for Public Health Research (EC for PHR), Nakhon Si Thammarat, Thailand
| | - Muhammad Haroon Stanikzai
- Walailak University, School of Public Health, Public Health Research Program, Nakhon Si Thammarat, Thailand; Kandahar University, Faculty of Medicine, Department of Public Health, Kandahar, Afghanistan
| | - Nirachon Chutipattana
- Walailak University, School of Public Health, Public Health Research Program, Nakhon Si Thammarat, Thailand; Walailak University, Excellent Center for Public Health Research (EC for PHR), Nakhon Si Thammarat, Thailand
| | - Shamarina Shohaimin
- Universiti Putra Malaysia, Faculty of Science, Department of Biology, Selangor, Malaysia
| | - Patthanasak Khammaneechan
- Walailak University, School of Public Health, Public Health Research Program, Nakhon Si Thammarat, Thailand; Walailak University, Excellent Center for Public Health Research (EC for PHR), Nakhon Si Thammarat, Thailand
| | | | | | - Truong Thanh Nam
- Can Tho University of Medicine and Pharmacy, Faculty of Public Health, Can Tho City, Vietnam
| | - Phan Thanh Tung
- Dong Thap Provincial Center for Disease Control, Dong Thap, Vietnam
| | - Cua Ngoc Le
- Walailak University, School of Public Health, Public Health Research Program, Nakhon Si Thammarat, Thailand; Walailak University, Excellent Center for Public Health Research (EC for PHR), Nakhon Si Thammarat, Thailand.
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Bekele Y, Erbas B, Batra M. Is Iron Supplementation Associated with Infant Mortality in Sub-Saharan Africa and Does Birth Weight Modify These Associations? Nutrients 2025; 17:1696. [PMID: 40431434 PMCID: PMC12114251 DOI: 10.3390/nu17101696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2025] [Revised: 05/10/2025] [Accepted: 05/15/2025] [Indexed: 05/29/2025] Open
Abstract
Background: Iron supplementation during pregnancy is associated with several health benefits, including a reduced risk of maternal anaemia and improved neonatal outcomes such as lower rates of low birth weight, infection, and anaemia in infancy. However, its impact on neonatal and post-neonatal mortality remains unclear in resource-limited settings, where adherence to maternal iron supplementation is low. This study examined the association between maternal iron supplementation and neonatal and post-neonatal mortality and explored whether low birth weight (LBW) modifies those associations. Methods: This cross-sectional study utilised Demographic and Health Survey data collected between 2015 and 2023 from 26 sub-Saharan countries, including 287,642 neonates and 279,819 post-neonates. The primary outcomes were neonatal deaths (within 28 days) and post-neonatal deaths (between 29 days and 12 months). These outcomes and the exposure variables of iron supplementation and its duration were based on maternal recall. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were estimated using generalised linear mixed models, with stratification by LBW. Results: There was no significant association between maternal iron supplementation and neonatal mortality (aOR = 1.07; 95% CI: 0.86, 1.34). However, the interaction between LBW and iron supplementation was statistically significant (p = 0.04). Among the LBW infants, the absence of iron supplementation increased the odds of neonatal mortality by 68% (aOR = 1.68; 95% CI: 1.14, 2.47), while supplementation for ≥90 days reduced the odds by 45% (aOR = 0.55; 95% CI: 0.35, 0.84). For post-neonatal mortality, lack of iron supplementation increased the odds by 25% (aOR = 1.25; 95% CI: 1.01, 1.56), whereas supplementation for ≥90 days reduced the odds by 27% (aOR = 0.73; 95% CI: 0.57, 0.93). Conclusions: Maternal iron supplementation was associated with lower post-neonatal mortality and improved neonatal survival among LBW infants. These findings suggest that iron intake may support infant survival, particularly in vulnerable populations.
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Affiliation(s)
- Yibeltal Bekele
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia; (Y.B.); (B.E.)
- School of Public Health, Bahir Dar University, Bahir Dar 79, Ethiopia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia; (Y.B.); (B.E.)
| | - Mehak Batra
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia; (Y.B.); (B.E.)
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Norton AE, Risma K, Ben-Shoshan M. Serum Sickness-Like Reactions in Children-Is Lifelong Avoidance Indicated? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2025; 13:969-977. [PMID: 39978544 DOI: 10.1016/j.jaip.2025.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2024] [Revised: 01/17/2025] [Accepted: 01/20/2025] [Indexed: 02/22/2025]
Abstract
Serum sickness-like reactions (SSLRs) consist of urticaria or urticarial-like rashes with joint pain and variable features of fever, angioedema, and gastrointestinal distress. Allergists typically evaluate patients in the clinic for an implicated medication, such as an antibiotic or vaccine. Although SSLR may be mistaken for classical serum sickness or anaphylaxis owing to overlapping clinical features, there is minimal evidence for type I or type III hypersensitivity reactions. Despite recent studies showing antibiotic allergy is rarely verified, patients rarely undergo allergy evaluation. A difficulty is that there is no agreement about challenge procedures- multiple-day dosing protocols lead to a risk for hives and joint pain that does not occur with single-day challenges. In addition, tolerance of either challenge protocol does not fully prevent rashes and repeat episodes of SSLR in all nonallergic children who used the culprit or an unrelated antibiotic again. Owing to the distressing symptoms, lack of abortive therapies, and uncertainty with challenge, many health care professionals and families may prefer to bypass allergy evaluation and continue lifelong avoidance. However, medication allergy labels may be associated with poor health outcomes. Well-designed prospective studies are needed to provide better insight into the diagnosis, effective treatments, and true recurrence rates.
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Affiliation(s)
- Allison E Norton
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn; Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tenn.
| | - Kimberly Risma
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
| | - Moshe Ben-Shoshan
- Division of Pediatric Allergy Clinical Immunology and Dermatology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
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Weets CM, Wilson R, Swadley H, Katz R. Strengthening health security through routine vaccination policy: A comprehensive analysis of childhood vaccination laws across 194 countries. Vaccine 2025; 54:127121. [PMID: 40239299 DOI: 10.1016/j.vaccine.2025.127121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2025] [Revised: 04/05/2025] [Accepted: 04/07/2025] [Indexed: 04/18/2025]
Abstract
BACKGROUND Vaccine preventable diseases (VPD) present a resurgent threat to global health security and jeopardize decades of advancements in public health and economic development. Since 1974, childhood vaccinations are estimated to have prevented 154 million deaths from VPD, yet recent declines in routine vaccination rates highlight the global population's growing vulnerability to these diseases. When paired with appropriate access to healthcare and trusted information, evidence informed enforceable policies have demonstrably improved childhood vaccination rates in countries that have recently implemented more stringent laws on routine vaccination. Here we comprehensively map and describe the current legal environment for childhood vaccination. METHODS We conducted a comprehensive analysis of the childhood vaccination-related policies in 194 countries. Policies were systematically identified, collated, and categorized into a publicly available tool. RESULTS A total of 106 countries have legally-enforceable policies requiring vaccination for at least one disease. We found that vaccines against diphtheria, measles, and tetanus were the most universally mandated, while vaccines against COVID-19 and Japanese Encephalitis were mandated by the fewest countries. In 91 countries, childhood vaccination requirements are enforced through either legal sanctions, such as monetary fines or incarceration, through exclusion from congregate settings, or through some combination of the two. CONCLUSION Analyses of the efficacy of childhood vaccination laws are predicated upon a comprehensive mapping of the current legal landscape related to routine immunization. Public health officials and researchers with an interest in increasing routine childhood vaccination rates in their country must know what characteristics of policy have been effective across various contexts. Our mapping of legally-enforceable childhood vaccination policies is foundational for assessing current vulnerabilities to vaccine-preventable diseases and future policy analyses.
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Affiliation(s)
- Ciara M Weets
- Georgetown University Center for Global Health Science and Security, 3900 Reservoir Road NW, Washington, DC 20057, United States of America.
| | - Rory Wilson
- Georgetown University Center for Global Health Science and Security, 3900 Reservoir Road NW, Washington, DC 20057, United States of America
| | - Heather Swadley
- Georgetown University Center for Global Health Science and Security, 3900 Reservoir Road NW, Washington, DC 20057, United States of America
| | - Rebecca Katz
- Georgetown University Center for Global Health Science and Security, 3900 Reservoir Road NW, Washington, DC 20057, United States of America
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Miranda-Soberón U, Pino-Arana I, Pastor-Ramírez N, Figueroa-Cabezudo E, Zevallos-Parra C, Valencia-Borja G. Vaccination Coverage and Adherence to Scheduling in Children Aged 0 to 18 Months: Effects of COVID-19 and Age. Vaccines (Basel) 2025; 13:387. [PMID: 40333246 PMCID: PMC12031324 DOI: 10.3390/vaccines13040387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2025] [Revised: 03/29/2025] [Accepted: 03/29/2025] [Indexed: 05/09/2025] Open
Abstract
Vaccination in Peru began 50 years ago as part of the Expanded Program on Immunization (EPI), which has proven effective in saving the lives of millions of children. This research aimed to determine the coverage and adherence to the vaccination schedule in children up to 18 months of age during the period 2018-2022, including the COVID-19 pandemic lockdown, in order to assess its influence. MATERIALS AND METHODS This was a secondary source study based on the Demographic and Family Health Survey (ENDES) of Peru, including a sample of 82,702 male and female children whose caregivers presented vaccination cards. Coverage and adherence indicators were calculated, and differences were evaluated between the pre-confinement, absolute confinement, and relative confinement periods using a chi-square test. RESULTS For almost all vaccines, coverage decreased from 2018 to 2022 (from 82.46% to 80.16% on average, p < 0.001). Coverage also decreased as the scheduled age increased (0-2 months: median 93%, 7-18 months: median 63%; p < 0.001). Average adherence rates also declined over time (2018: 65.82% to 2022: 61.77%). The most affected vaccine was the yellow fever vaccine. Coverage did not reach protective population levels, while adherence has averaged 85.06% since 2018. CONCLUSIONS COVID-19 negatively influenced compliance with the vaccination schedule and adherence.
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Affiliation(s)
| | - Isabel Pino-Arana
- Nursing Faculty, National University “San Luis Gonzaga”, Ica 11004, Peru; (I.P.-A.); (N.P.-R.); (E.F.-C.)
| | - Norma Pastor-Ramírez
- Nursing Faculty, National University “San Luis Gonzaga”, Ica 11004, Peru; (I.P.-A.); (N.P.-R.); (E.F.-C.)
| | - Elena Figueroa-Cabezudo
- Nursing Faculty, National University “San Luis Gonzaga”, Ica 11004, Peru; (I.P.-A.); (N.P.-R.); (E.F.-C.)
| | - Cyntia Zevallos-Parra
- Seedbed CLIMA, Human Medicine Faculty, National University “San Luis Gonzaga”, Ica 11004, Peru; (C.Z.-P.); (G.V.-B.)
| | - Gabriela Valencia-Borja
- Seedbed CLIMA, Human Medicine Faculty, National University “San Luis Gonzaga”, Ica 11004, Peru; (C.Z.-P.); (G.V.-B.)
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Fernandez E, Jaggers J, Norton AE, Stone C, Phillips E. Adverse Events Following Vaccines: From Detection to Research Translation. Annu Rev Public Health 2025; 46:1-19. [PMID: 39656965 DOI: 10.1146/annurev-publhealth-071723-102841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2024]
Abstract
Vaccines are lifesaving interventions that reduce the morbidity and mortality of disease. Fortunately, serious adverse events with vaccination are uncommon, but they must promptly be recognized and evaluated to assess and clarify the safety of future administration, a process that the public must understand in order to feel safe in receiving vaccines. In this article, we provide a review of vaccine development, discuss the process by which safety is ensured, and describe key adverse events associated with their administration. We review in detail existing mechanisms for reporting these events and assessing them following recovery, as well as communication related to vaccine safety. We also describe barriers to vaccination, such as nocebo effects and antivaccination groups, and use lessons learned from the successful development of COVID-19 vaccines during the recent pandemic to define future opportunities and directions for vaccine safety.
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Affiliation(s)
- Edward Fernandez
- Department of Medicine, Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
| | - Jordon Jaggers
- Department of Medicine, Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
| | - Allison E Norton
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine; Department of Pediatrics; Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - Cosby Stone
- Department of Medicine, Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
| | - Elizabeth Phillips
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
- Department of Medicine, Center for Drug Safety and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;
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Abu Hammour K, Al Manaseer Q, Abdel-Jalil M, El-dahiyat F, Abu Hammour W, Abu Hammour AM, Al-Ashwal FY, Abu-Farha R. Knowledge, attitude, and perception regarding the respiratory syncytial virus vaccine among healthcare professionals. J Pharm Policy Pract 2025; 18:2482669. [PMID: 40165942 PMCID: PMC11956094 DOI: 10.1080/20523211.2025.2482669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2025] [Accepted: 03/16/2025] [Indexed: 04/02/2025] Open
Abstract
Background Respiratory syncytial virus (RSV) is a significant respiratory pathogen. Despite vaccine availability, uptake remains low, and healthcare professionals play a key role in promoting immunisation. This study aims to evaluate healthcare providers' knowledge, perceptions and practices regarding the RSV vaccine. Methods A validated survey was distributed to healthcare professionals. The study questionnaire contained sections to assess sociodemographic characteristics, knowledge of RSV and its vaccines, healthcare professionals' perception towards RSV and its vaccines, and their perception towards the potential barriers against RSV vaccination. The last section assesses physicians' previous practice in dealing with RSV infection. Results Over half of the participants (56.6%) had no prior awareness of RSV, though many recognised its potential severity, particularly in vulnerable populations like children and older adults (52.6%). Awareness of FDA-approved RSV vaccines was limited, with only 28.1% of respondents familiar with vaccines intended for older adults. Views on vaccination recommendations for older age groups were divided; 23.7% supported vaccination for those 75 and older, while 31.1% advocated for vaccination in those aged 60-74 at higher risk. Perceived barriers to RSV vaccination were prominent. Most respondents (85.1%) cited concerns about vaccine safety as a key obstacle, and 81.1% identified out-of-pocket costs as a significant barrier. Testing for RSV was infrequent (24.6%), mainly due to a lack of effective treatment. Most participants (96.9%) called for greater awareness and education about RSV vaccines, and 91.2% supported recommending the vaccine if it was available and free. Conclusion This study reveals significant gaps in healthcare professionals' knowledge and practices regarding RSV and its vaccines, with substantial barriers to vaccine adoption. Targeted education, improved diagnostics, and addressing vaccine barriers are essential strategies for improving the healthcare response to RSV.
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Affiliation(s)
- Khawla Abu Hammour
- Department of Clinical Pharmacy and Biopharmaceutics, Faculty of Pharmacy, University of Jordan, Amman, Jordan
| | - Qusai Al Manaseer
- Department of Orthopedic, Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Mariam Abdel-Jalil
- Department of Clinical Pharmacy and Biopharmaceutics, Faculty of Pharmacy, University of Jordan, Amman, Jordan
| | | | - Walid Abu Hammour
- School of Medicine, University of Jordan, Amman, Jordan
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Science, Dubai, UAE
| | | | - Fahmi Y. Al-Ashwal
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana'a, Yemen
- Department of Clinical Pharmacy, College of Pharmacy, Al-Ayen Iraqi University, Thi-Qar, Iraq
| | - Rana Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Robitaille J, Esser K, King C, Leask J, Wiley K, Vigod S, Rodin G, Bolotin S, Shapiro GK. The Relationship Between Postpartum Depression and Timely Child Vaccination: A Systematic Review. Vaccines (Basel) 2025; 13:222. [PMID: 40266081 PMCID: PMC11946840 DOI: 10.3390/vaccines13030222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 01/24/2025] [Accepted: 02/10/2025] [Indexed: 04/24/2025] Open
Abstract
Background/Objective: Vaccines administered during early childhood rely on caregivers being aware, willing, and able to vaccinate their child. Postpartum depression (PPD) could adversely affect a parent's ability to undertake such preventive care. This systematic review sought to examine the relationship between PPD and timely vaccination in children. Methods: We systematically searched eight databases (MEDLINE ALL, Embase, PsycINFO, CINAHL, LILACS, Web of Science, Sociological Abstracts, and Scopus) from database inception to September 2023. We also reviewed reference lists of included studies. We included primary studies that examined the association between PPD and child vaccination status between birth and 24 months. Two researchers independently extracted data and assessed study quality. Results: In total, 5504 records were screened for eligibility. Of the 50 articles included in full-text assessment, 12 met the eligibility criteria. Most studies (83%) were conducted in high-income countries, with a minority (17%) from lower-middle income countries (LMICs). The sample size of studies varied from <500 (33%) to >450,000 participants (17%). Overall, six studies (50%) found a relationship between maternal PPD and child vaccinations not completed on time, and six (50%) found no relationship. In most studies that were assessed to be of high-quality and found a relationship, the magnitude of the absolute risk was small. Conclusions: We detected significant heterogeneity among the included studies. Further high-quality research using standardized definitions is needed to determine whether parents with PPD may require tailored strategies and supports that consider their symptoms and specific barriers to vaccination.
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Affiliation(s)
- Julien Robitaille
- Centre for Vaccine Preventable Disease, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Kayla Esser
- Centre for Vaccine Preventable Disease, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Catherine King
- School of Public Health, Sydney Infectious Diseases Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Julie Leask
- School of Public Health, Sydney Infectious Diseases Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Kerrie Wiley
- School of Public Health, Sydney Infectious Diseases Institute, University of Sydney, Camperdown, NSW 2050, Australia
| | - Simone Vigod
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON M5G 1N8, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Gary Rodin
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada
| | - Shelly Bolotin
- Centre for Vaccine Preventable Disease, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Gilla K. Shapiro
- Centre for Vaccine Preventable Disease, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada
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Din MU, Liu X, Jiang H, Ahmad S, Xiangdong L, Wang X. Advancing vaccine development in genomic era: a paradigm shift in vaccine discovery. PROGRESS IN BIOMEDICAL ENGINEERING (BRISTOL, ENGLAND) 2025; 7:022004. [PMID: 39908664 DOI: 10.1088/2516-1091/adb2c8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Accepted: 02/05/2025] [Indexed: 02/07/2025]
Abstract
The issue of antibiotic resistance is increasing with time because of the quick rise of microbial strains. Overuse of antibiotics has led to multidrug-resistant, pan-drug-resistant, and extensively drug-resistant bacterial strains, which have worsened the situation. Different techniques have been considered and applied to combat this issue, such as developing new antibiotics, practicing antibiotic stewardship, improving hygiene levels, and controlling antibiotic overuse. Vaccine development made a substantial contribution to overcoming this issue, although it has been underestimated. In the recent era, reverse vaccinology has contributed to developing different kinds of vaccines against pathogens, revolutionizing the vaccine development process. Reverse vaccinology helps to prioritize better vaccine candidates by using various tools to filter the pathogen's complete genome. In this review, we will shed light on computational vaccine designing, immunoinformatic tools, genomic and proteomic data, and the challenges and success stories of computational vaccine designing.
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Affiliation(s)
- Miraj Ud Din
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Xiaohui Liu
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Hui Jiang
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Sajjad Ahmad
- Department of Health and Biological Sciences, Abasyn University, Peshawar 25000, Pakistan
| | - Lai Xiangdong
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
| | - Xuemei Wang
- State Key Laboratory of Digital Medical Engineering, Southeast University, Nanjing 210096, People's Republic of China
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Bin Abdulrahman K, Bin Abdulrahman A. Scrutinizing the COVID-19 vaccine safety debate. Hum Vaccin Immunother 2024; 20:2401646. [PMID: 39693192 DOI: 10.1080/21645515.2024.2401646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/23/2024] [Accepted: 09/03/2024] [Indexed: 12/20/2024] Open
Abstract
The controversy surrounding the safety of coronavirus disease-19 vaccinations is part of a larger historical backdrop of ongoing discussions regarding vaccine safety that have spanned several decades. The historical disputes around measles, mumps, rubella, and influenza highlight the recurring pattern in which public doubt is fueled by false information and personal stories. A 2024 multinational study in the journal Vaccine presented preexisting safety indicators for myocarditis, pericarditis, Guillain - Barré syndrome, and cerebral venous sinus thrombosis. The study had a notably large sample size and contributed to the ongoing discussion of vaccine safety. Examining this research clarifies the subtle distinctions between demonstrating causality and simple association, emphasizing the importance of thorough scientific investigation and open communication. The following recommendations should be prioritized to tackle vaccine hesitancy and ensure that politicians, healthcare practitioners, and public health officials make informed decisions. Vaccine safety data should be openly and readily provided to the public, particularly regarding potential hazards and advantages. Establishing post-marketing surveillance systems to monitor and examine adverse effects linked to vaccinations helps strengthen public confidence in the safety monitoring process and officials' dedication to addressing safety concerns with thoroughness.
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Affiliation(s)
- Khalid Bin Abdulrahman
- Department of Medical Education, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
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12
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Vigezzi GP, Maggioni E, Bert F, de Vito C, Siliquini R, Odone A. Who is (not) vaccinated? A proposal for a comprehensive immunization information system. Hum Vaccin Immunother 2024; 20:2386739. [PMID: 39103249 DOI: 10.1080/21645515.2024.2386739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 07/27/2024] [Indexed: 08/07/2024] Open
Abstract
The role of immunization in public health is crucial, offering widespread protection against infectious diseases and underpinning societal well-being. However, achieving optimal vaccination coverage is impeded by vaccine hesitancy, a significant challenge that necessitates comprehensive strategies to understand and mitigate its effects. We propose the integration of Population Health Management principles with Immunization Information Systems (IISs) to address vaccine hesitancy more effectively. Our approach leverages systematic health determinants analysis to identify at-risk populations and tailor interventions, thereby promoting vaccination coverage and public health responses. We call for the development of an enhanced version of the Italian National Vaccination Registry, which aims to facilitate real-time tracking of individuals' vaccination status while improving data accuracy and interoperability among healthcare systems. This registry is designed to overcome current barriers by ensuring robust data protection, addressing cultural and organizational challenges, and integrating behavioral insights to foster informed public health campaigns. Our proposal aligns with the Italian National Vaccination Prevention Plan 2023-2025 and emphasizes proactive, evidence-based strategies to increase vaccination uptake and contrast the spread of vaccine-preventable diseases. The ultimate goal is to establish a data-driven, ethically sound framework that enhances public health outcomes and addresses the complexities of vaccine hesitancy within the Italian context and beyond.
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Affiliation(s)
- Giacomo Pietro Vigezzi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Elena Maggioni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Fabrizio Bert
- Department of Public Health and Pediatrics Sciences, University of Torino, Torino, Italy
| | - Corrado de Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Roberta Siliquini
- Department of Public Health and Pediatrics Sciences, University of Torino, Torino, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Medical Direction, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
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13
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Kalia M, Sharma M, Rohilla R, Rana K. Trend of immunization & gap in vaccine doses as observed in National Family Health Survey rounds in India. Indian J Med Res 2024; 160:303-311. [PMID: 39632635 PMCID: PMC11619027 DOI: 10.25259/ijmr_1770_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 08/06/2024] [Indexed: 12/07/2024] Open
Abstract
Background & objectives Immunization is an efficient and cost-effective way of lowering the infectious disease related morbidity and mortality in the community. The current study reviewed the trend of immunization, gaps in doses of vaccine given at the same time and gaps between the doses of same vaccine from National Family Health Survey (NFHS 1-5) rounds. Methods The current study extracted data from all five NFHS rounds conducted from 1992-93 to 2019-21. The study analyzed the State-wise and demography-wise distribution of trends of immunization from NFHS-1 to NFHS-5. State wise distribution of change in vaccination coverage between NFHS-4 and 5 was analyzed. The study also assessed the State-wise trends of fully vaccinated and unvaccinated children from NFHS 1-5. Results The northeastern States had maximum gap between the vaccination given at birth i.e., 47.3 per cent between BCG and Hepatitis B, and 32.8 per cent between BCG and birth dose of OPV in Manipur in NFHS -5. A gradual rise in the percentage of male (40.2%) and female (41.9%) childrens' vaccination was found across the NFHS rounds with reduction in gap between the male and female vaccination from NFHS-1 (2.6%) to NFHS-5 (0.9%). The percentage of vaccination decreased proportionately with birth order. The vaccination coverage has increased in both urban and rural population, but the rise was higher in rural (45.9%) areas than urban (24.8%). An increase in percentage of fully vaccinated children by 41.2 per cent and decrease in percentage of non-vaccinated children by 26.4 per cent was observed from NFHS-1 to NFHS-5. Interpretation & conclusions Our analysis clearly suggests that immunization coverage has improved over a period of time but the variability in vaccine coverage across States and gap in vaccine doses needs attention of the policy makers to cover this for achieving our national immunization goals.
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Affiliation(s)
- Meenu Kalia
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Megha Sharma
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Ravi Rohilla
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Kirtan Rana
- Department of Community Medicine, Gian Sagar Medical College & Hospital, Patiala, Punjab, India
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Weyers S, Götz S. [Early childhood intervention and children's health development : Exemplary findings and methodological challenges in the use of the school entry examination]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:1384-1393. [PMID: 39370495 PMCID: PMC11615017 DOI: 10.1007/s00103-024-03955-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 09/09/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND Early childhood intervention is intended to systematically network and customise support services, particularly for socio-economically disadvantaged families. The programmes are universal or selective, but the evidence on their effectiveness is limited. AIMS The aims of this study were to exemplary analyse whether participants in early childhood intervention services had better development than non-participants using the school entry examination (SEE) as well as to discuss to what extent the SEE can be used to assess the impact of early childhood intervention services. METHODS We analysed three typical offers of early childhood intervention services (family education; Zukunft für Kinder (ZfK); Kita-U) in relation to full vaccination coverage and age-appropriate development at U9. Data from 4579 Düsseldorf first graders were included. Propensity score matching was used to calculate percentage differences (average treatment effect on the treated; ATT) in terms of immunisation coverage and development between comparable intervention and control groups. RESULTS All programmes are associated with a slightly increased probability of full vaccination protection (ATT 2.1 for family education; 2.5 for ZfK; 5.3 for Kita-U). Family education is also associated with a slightly higher probability of age-appropriate development (ATT 1.6), while the probability of age-appropriate development is lower for participants in ZfK (-10.1) and Kita‑U (-4.5). DISCUSSION The evaluation of early childhood intervention, especially selective services, is a methodological challenge due to confounding and suitable comparison groups. However, the SEE could be a framework for impact analyses under specific conditions.
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Affiliation(s)
- Simone Weyers
- Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
| | - Simon Götz
- Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland
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15
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Dumitra GG, Alexiu SA, Sănduţu D, Berbecel C, Curelea M, Barbu CV, Deleanu A, Grom A, Lup M, Budiu I, Vesa M, Surugiu R, Lăcătuş A, Turcu-Stiolica A. Segmenting attitudes toward vaccination - behavioral insights into influenza vaccination refusal in Romania. Germs 2024; 14:362-374. [PMID: 40271094 PMCID: PMC12013666 DOI: 10.18683/germs.2024.1446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2024] [Revised: 12/31/2024] [Accepted: 12/31/2024] [Indexed: 04/25/2025]
Abstract
Introduction Vaccine hesitancy remains a significant public health challenge, particularly in rural populations where geographic and socioeconomic barriers exacerbate the issue. This study aimed to examine the factors influencing vaccine hesitancy, focusing on influenza vaccinations in rural and urban communities in Romania. Methods The study was conducted between October 4 and October 30, 2024, across 16 family medicine practices, including seven in rural and nine in urban areas from Romania. A 13-item vaccine hesitancy questionnaire, assessing factors such as fear of adverse effects, distrust in vaccines, and perceived necessity included 272 responses. Latent Class Analysis (LCA) was used to identify distinct subgroups of hesitancy, while Chi-square and odds ratio analyses assessed geographic differences. We performed logistic regression for the most observed root attitudes on influenza vaccination refusal. Results Rural residents were significantly more likely to refuse influenza vaccination compared to urban residents. The LCA revealed three distinct latent classes, characterized by varying levels of agreement with key hesitancy items. Class 1 demonstrated low hesitancy, Class 2 exhibited high hesitancy driven by beliefs in natural immunity and perceived lack of necessity, and Class 3 showed intermediate hesitancy, influenced by distrust in vaccines and past negative experiences. Among the key significant triggers underlying vaccine refusal were fear of adverse effects, parental status, chronic diseases, and previous vaccination experiences, while factors such as age and gender showed limited impact. Conclusions Vaccine hesitancy persists as a complex, multidimensional issue, with rural populations disproportionately affected. Targeted, context-specific interventions addressing key drivers such as distorted risk perception, fear of adverse effects and distrust in vaccines are critical for improving vaccination rates These findings underscore the importance of tailored public health strategies to promote equitable vaccine uptake.
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Affiliation(s)
- Gheorghe Gindrovel Dumitra
- MD, PhD, Family Medicine Department, University of Medicine and Pharmacy of Craiova, 2-4 Petru Rares Street, 200349, Craiova and Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Sandra Adalgiza Alexiu
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Dorica Sănduţu
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Cosmina Berbecel
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Monica Curelea
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Cristina Vasilica Barbu
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Anca Deleanu
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Adrian Grom
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Maria Lup
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Ioana Budiu
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Mădălina Vesa
- MD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest, Romania
| | - Roxana Surugiu
- MD, PhD, Department of Biochemistry, University of Medicine, and Pharmacy of Craiova, 2 Petru Rares Street, 200349, Craiova, Romania
| | - Anca Lăcătuş
- MD, PhD, Immunization Working Group, Romanian National Society of Family Medicine, 65, Popa Nan Street, Bucharest and Faculty of Medicine, Transylvania University of Brasov, 500036 Brasov, Romania
| | - Adina Turcu-Stiolica
- MD, PhD, Pharmacoeconomics Department, University of Medicine and Pharmacy of Craiova, 2-4 Petru Rares Street, Craiova 200349, Romania
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Krieger N, Moallef S, Chen JT, Balasubramanian R, Cowger TL, Hamad R, McGregor AJ, Hanage WP, Tabb LP, Bassett MT. Politicians, power, and the people's health: US elections and state health outcomes, 2012-2024. HEALTH AFFAIRS SCHOLAR 2024; 2:qxae163. [PMID: 39664487 PMCID: PMC11631342 DOI: 10.1093/haschl/qxae163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 10/21/2024] [Accepted: 11/26/2024] [Indexed: 12/13/2024]
Abstract
Our descriptive study examined current associations (2022-2024) between US state-level health outcomes and 4 US state-level political metrics: 2 rarely used in public health research (political ideology of elected representatives based on voting records; trifectas, where 1 party controls the executive and legislative branches) and 2 more commonly used (state policies enacted; voter political lean). The 8 health outcomes spanned the life course: infant mortality, premature mortality (death at age <65), health insurance (adults aged 35-64), vaccination for children and persons aged ≥65 (flu; COVID-19 booster), maternity care deserts, and food insecurity. For the first 3 outcomes, we also examined trends in associations (2012-2024). For all political metrics, higher state-level political conservatism was associated with worse health outcomes, especially for the metrics for political ideology and state trifectas. For example, in 2016, the premature mortality rate in states with Republican vs Democratic trifectas was higher by 55.4 deaths per 100 000 person-years (95% CI: 7.7, 103.1), and the slope of the rate of increase to 2021 was also higher, by 27.0 deaths per 100 000 person-years (95% CI: 24.4, 29.7). These results suggest elections, political ideology, and concentrations of political power matter for population health.
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Affiliation(s)
- Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Soroush Moallef
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
- FXB Center for Health and Human Rights, Harvard University, Boston, MA 02115, United States
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Ruchita Balasubramanian
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Tori L Cowger
- FXB Center for Health and Human Rights, Harvard University, Boston, MA 02115, United States
| | - Rita Hamad
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Alecia J McGregor
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - William P Hanage
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Loni Philip Tabb
- Department of Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, United States
| | - Mary T Bassett
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
- FXB Center for Health and Human Rights, Harvard University, Boston, MA 02115, United States
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Rerolle F, Dey AK, Benmarhnia T, Arnold BF. Spatial targeting and integration across vaccination, vitamin A and deworming programs throughout India 2019-21. Int J Epidemiol 2024; 53:dyae160. [PMID: 39657980 PMCID: PMC11631194 DOI: 10.1093/ije/dyae160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 11/08/2024] [Indexed: 12/12/2024] Open
Abstract
BACKGROUND Currently, most large-scale public health programs, such as immunization or anti-parasitic deworming, work in relative isolation. Integrating efforts across programs could potentially improve their efficiency, but identifying populations that could benefit from multiple programs has been an operational challenge. METHODS We analyzed a nationally representative survey conducted in India between 2019 and 2021 to assess and map coverage of seven vaccines [Bacillus Calmette-Guérin (BCG), hepatitis B, polio, diphtheria-tetanus-pertussis (DTP), haemophilus influenza type b (Hib), rotavirus and measles-containing vaccine (MCV)], plus Vitamin A supplementation and anti-parasitic deworming treatment among 86 761 children aged 1-3 years old. RESULTS National coverage varied widely by program, from 42% (rotavirus) to 95% (BCG). There was high correlation between district-level coverage estimates (r ≥ 0.7) and extensive spatial overlap in low-coverage populations. In simulated implementation strategies, we show that an integrated strategy that targets full immunization coverage for four core vaccines (BCG, polio, DTP, MCV) would achieve similar coverage to an optimal (but unrealistic) implementation strategy and far better coverage than multiple efforts focused on individual vaccines. Targeting the most under-vaccinated districts within states based on spatial clustering or coverage thresholds led to further improvements in full coverage per child targeted. Integration of anti-parasitic deworming or rotavirus vaccination into a core vaccine delivery mission could nearly double their coverage (from ∼45% to ∼85%). CONCLUSIONS Integrated delivery and geographic targeting across core vaccines could accelerate India's progress toward full immunization coverage. An integrated platform could greatly expand coverage of non-core vaccines and other child health interventions.
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Affiliation(s)
- Francois Rerolle
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Climate, Atmospheric Sciences, and Physical Oceanography, Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Arnab K Dey
- Climate, Atmospheric Sciences, and Physical Oceanography, Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Tarik Benmarhnia
- Climate, Atmospheric Sciences, and Physical Oceanography, Scripps Institution of Oceanography, University of California, San Diego, CA, USA
| | - Benjamin F Arnold
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA
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18
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Iileka E, Geldenhuys M, Nyasulu JCY. The effects of the SARS-CoV-2 pandemic on the delivery of maternal and child health services in South Africa. Infect Dis Now 2024; 54:104978. [PMID: 39307277 DOI: 10.1016/j.idnow.2024.104978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Accepted: 09/18/2024] [Indexed: 10/08/2024]
Abstract
OBJECTIVE The COVID-19 pandemic severely interrupted the functioning of healthcare systems, negatively affecting the global provision of maternal and child health (MCH) services. This study aims to specify the effects of COVID-19 on these services in the Gauteng province (South Africa) and to put forward context-specific recommendations aimed at augmenting them and ensuring ongoing uninterrupted coverage, even and especially during pandemics. METHODS In this quantitative study, a retrospective review of District Health Information System data routinely collected between February 2019 and March 2021 was conducted, comparing performance of the relevant indicators across the two-year span. The data were analyzed using Stata 16 statistical software (StataCorp). The two sample t-test with equal variance and the Mann-Whitney test were applied to evaluate the equality of the indicators. RESULTS Routine MCH services were negatively impacted, with marked declines in all relevant indicators from the onset of the pandemic. There was a statistically significant decline in cervical cancer coverage and maternal postnatal visits within six days of delivery. While declines in the other critical indicators were likewise observed, they were not statistically significant. CONCLUSION The South African response to the pandemic had negative repercussions on all MCH services in the Gauteng province. The lessons to be drawn from the pandemic experience should help to strengthen health system capacities, boost service provision, and mitigate future damage to the healthcare system.
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Affiliation(s)
- Ellen Iileka
- Division Health Systems and Public Health, Department of Global Health, Faculty of Clinical Medicine, Stellenbosch University, Cape Town, South Africa.
| | - Maryke Geldenhuys
- Division Health Systems and Public Health, Department of Global Health, Faculty of Clinical Medicine, Stellenbosch University, Cape Town, South Africa
| | - Juliet Charity Yauka Nyasulu
- Division Health Systems and Public Health, Department of Global Health, Faculty of Clinical Medicine, Stellenbosch University, Cape Town, South Africa; Health Systems Strengthening, AFRIQUIP, Johannesburg, South Africa
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19
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Best NC, Thomas CS, Mosley-Williams F, Chang A, Nielsen T. Back to school: Routine vaccines for children and adolescents. Nurse Pract 2024; 49:29-35. [PMID: 39186123 DOI: 10.1097/01.npr.0000000000000224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
ABSTRACT Preparing for the new school year is an exciting and busy time. An important task for parents and caregivers during the back-to-school season is to ensure that their child or adolescent is up to date with their vaccines. NPs play a vital role in guiding parents and caregivers through the vaccination process, thereby ensuring that school-aged children and adolescents' health requirements are met. This article provides NPs with resources to assist in making decisions about child and adolescent immunizations. It also explores effective communication strategies to convey the benefits of vaccination to parents and caregivers, equipping NPs with the necessary knowledge and tools to navigate vaccination complexities and advocate for the health and safety of school-aged children and adolescents.
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Lv SR, Wang MK, Yu XL, Li XY, Yang JS. Impact of COVID-19 pandemic on routine childhood vaccinations. World J Virol 2024; 13:90271. [PMID: 38984085 PMCID: PMC11229842 DOI: 10.5501/wjv.v13.i2.90271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/25/2024] [Accepted: 03/01/2024] [Indexed: 06/24/2024] Open
Abstract
Routine pediatric vaccination is one of the most effective public health inter-ventions for the control of a number of fatal diseases. However, during the coronavirus disease 2019 pandemic, routine pediatric vaccination rates were severely affected by disruptions of health services and vaccine confidence issues. Governments and the United Nations have taken measures to re-establish routine pediatric vaccination, while additional efforts are needed to catch up and develop plans to ensure routine vaccination services for the future pandemics.
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Affiliation(s)
- Shi-Rong Lv
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Ming-Ke Wang
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Xue-Lu Yu
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Xin-Yue Li
- Department of Disease Control and Prevention, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
| | - Ji-Shun Yang
- Medical Care Center, Naval Medical Center of PLA, Naval Medical University, Shanghai 200052, China
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May S, Roach M, Maravic M, Mitrovich R, Wilson R, Prood N, Eiden AL. Understanding the factors that shape vaccination ecosystem resilience: a qualitative assessment of international expert experiences and perspectives. BMJ PUBLIC HEALTH 2024; 2:e000381. [PMID: 40018100 PMCID: PMC11812773 DOI: 10.1136/bmjph-2023-000381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/26/2024] [Indexed: 03/01/2025]
Abstract
Introduction 'Shocks' or external stressors to vaccination programmes can lead to decreased vaccination coverage rates. The capacity of vaccination ecosystems to effectively respond and adapt to shocks demonstrates programme resilience. This study sought to describe components that contribute to resilience in national immunisation programmes. Methods Mixed-methods study comprising in-depth interviews and surveys with n=30 vaccination programme experts in eight countries (Brazil, Costa Rica, Greece, Japan, Nigeria, Philippines, Spain and the USA). We elicited data on country-specific shocks, associated effects and factors that facilitated or impeded programme resilience. Interviews and open-ended survey responses were analysed qualitatively, with closed-ended survey questions analysed using descriptive statistics. Results Experts described immediate effects of shocks including decreased vaccine uptake and negative perceptions of vaccination from the public and media. Late emerging impacts included increased vaccine hesitancy and vaccine-preventable disease (VPD) rates. Stakeholder education, immunisation information systems (IIS) and programme financing were key factors to strengthening programme resilience. Appropriately trained frontline healthcare personnel can counter vaccine misinformation that otherwise erodes trust and contributes to hesitancy. The COVID-19 pandemic also exposed structural weaknesses in programme resilience, with experts highlighting the need for robust IIS and workforce support to mitigate burnout and strengthen resilience when a shock occurs. Conclusions Our findings provide preliminary insights into factors that experts believe to be associated with vaccination programme resilience. Anticipating, adapting and responding to shocks is central to strengthening systems, ensuring ecosystem resilience and protecting against current and future VPD threats.
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Tayu B, Melaku N, Tefera K, Gebretsadik A. Incomplete immunization and associated factors among children 12-23 months in Aletawondo district, Sidama zone, South Ethiopia: Across-sectional study. J Child Health Care 2024; 28:362-376. [PMID: 36282108 DOI: 10.1177/13674935221133463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Immunization is one of the most cost-effective and commonly used public health strategies for preventing child mortality. The goal of this study was to determine the prevalence of incomplete immunization and associated variables in children aged 12-23 months in the Aleta Wondo district of Southern Ethiopia. The researchers utilized a community-based cross-sectional study approach. A modified World Health Organization-Expanded Program on Immunization cluster sampling method was used to choose 634 mothers/caregivers of children aged 12-23 months. Data were collected by trained data collectors between March and April 2019. Descriptive statistics and logistic regression were done. In this study, 138 (21.8%) of children were not completed their immunization. Mothers who were literate [AOR = 2.1; (95% CI: 1.1, 4.2)]. Home birth [AOR = 2.9; (95% CI: 1.7, 5.3)], walking time from home to vaccination site [AOR = 1.95; (95% CI: 1.1,3.3)], inconvenience times for vaccination service [AOR = 2.4; (95% CI: 1.3,4.5)], postponing vaccination session schedule [AOR = 2.4; (95% CI:1.1,5.4)], households not visited by health extension workers [AOR = 4.1; (95% CI: 2.2,7.4)], poorer knowledge about child immunization [AOR = 4; (95% CI:2.2,7.5)] were factors associated with incomplete immunization. Incomplete immunization was higher compared to the national target. It is necessary to strengthen the program by enhancing the number of outreach sites considering the size of the target group.
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Affiliation(s)
- Binyam Tayu
- Aleta Wondo Primary Hospital, Hawassa, Ethiopia
| | - Nebiyu Melaku
- Maternal and Child Health Core Process, Southern Nation Nationalities and People Regional Health Bureau, Hawassa, Ethiopia
| | - Kebede Tefera
- School of Public Health, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Achamyelesh Gebretsadik
- School of Public Health, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
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23
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Lanza-León P, Cantarero-Prieto D, Pascual-Sáez M. Exploring trends and determinants of basic childhood vaccination coverage: Empirical evidence over 41 years. PLoS One 2024; 19:e0300404. [PMID: 38512892 PMCID: PMC10956826 DOI: 10.1371/journal.pone.0300404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children's Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.
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Affiliation(s)
- Paloma Lanza-León
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
| | - David Cantarero-Prieto
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
| | - Marta Pascual-Sáez
- Departamento de Economía, Universidad de Cantabria, Santander, Spain
- Health Economics Research Group, Valdecilla Biomedical Research Institute—IDIVAL Santander, Spain
- Santander Financial Institute—SANFI, Santander, Spain
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24
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TORUN C, SARMIS A, OGUZ A. Is ChatGPT an Accurate and Reliable Source of Information for Patients with Vaccine and Statin Hesitancy? Medeni Med J 2024; 39:1-7. [PMID: 38511678 PMCID: PMC10961658 DOI: 10.4274/mmj.galenos.2024.03154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/09/2024] [Indexed: 03/22/2024] Open
Abstract
Objective Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence (AI) language model that is trained to respond to questions across a wide range of topics. Our aim is to elucidate whether it would be beneficial for patients who are hesitant about vaccines and statins to use ChatGPT. Methods This cross-sectional and observational study was conducted from March 2 to March 30, 2023, using OpenAI ChatGPT-3.5. ChatGPT provided responses to 7 questions related to vaccine and statin hesitancy. The same questions were also directed at physicians. Both the answers from ChatGPT and the physicians were assessed for accuracy, clarity, and conciseness by experts in cardiology, internal medicine, and microbiology, who possessed a minimum of 30 years of professional experience. Responses were rated on a scale of 0-4, and the ChatGPT's average score was compared with that of physicians using the Mann-Whitney U test. Results The mean scores of ChatGPT (3.78±0.36) and physicians (3.65±0.57) were similar (Mann-Whitney U test p=0.33). The mean scores of ChatGPT were 3.85±0.34 for vaccination and 3.68±0.35 for statin use. The mean scores of physicians were 3.73±0.51 for vaccination and 3.58±0.61 for statin use. There was no statistically significant difference between the mean scores of ChatGPT and physicians for both vaccine and statin use (p=0.403 for vaccination, p=0.678 for statin). ChatGPT did not consider sources of conspiratorial information on vaccines and statins. Conclusions This study suggests that ChatGPT can be a valuable source of information for guiding patients with vaccine and statin hesitancy.
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Affiliation(s)
- Cundullah TORUN
- Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Internal Medicine, Istanbul, Turkey
| | - Abdurrahman SARMIS
- Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Microbiology, Istanbul, Turkey
| | - Aytekin OGUZ
- Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Internal Medicine, Istanbul, Turkey
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25
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Montero DA, Vidal RM, Velasco J, Carreño LJ, Torres JP, Benachi O. MA, Tovar-Rosero YY, Oñate AA, O'Ryan M. Two centuries of vaccination: historical and conceptual approach and future perspectives. Front Public Health 2024; 11:1326154. [PMID: 38264254 PMCID: PMC10803505 DOI: 10.3389/fpubh.2023.1326154] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Over the past two centuries, vaccines have been critical for the prevention of infectious diseases and are considered milestones in the medical and public health history. The World Health Organization estimates that vaccination currently prevents approximately 3.5-5 million deaths annually, attributed to diseases such as diphtheria, tetanus, pertussis, influenza, and measles. Vaccination has been instrumental in eradicating important pathogens, including the smallpox virus and wild poliovirus types 2 and 3. This narrative review offers a detailed journey through the history and advancements in vaccinology, tailored for healthcare workers. It traces pivotal milestones, beginning with the variolation practices in the early 17th century, the development of the first smallpox vaccine, and the continuous evolution and innovation in vaccine development up to the present day. We also briefly review immunological principles underlying vaccination, as well as the main vaccine types, with a special mention of the recently introduced mRNA vaccine technology. Additionally, we discuss the broad benefits of vaccines, including their role in reducing morbidity and mortality, and in fostering socioeconomic development in communities. Finally, we address the issue of vaccine hesitancy and discuss effective strategies to promote vaccine acceptance. Research, collaboration, and the widespread acceptance and use of vaccines are imperative for the continued success of vaccination programs in controlling and ultimately eradicating infectious diseases.
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Affiliation(s)
- David A. Montero
- Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Centro Integrativo de Biología y Química Aplicada, Universidad Bernardo O'Higgins, Santiago, Chile
| | - Roberto M. Vidal
- Programa de Microbiología y Micología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Instituto Milenio de Inmunología e Inmunoterapia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juliana Velasco
- Unidad de Paciente Crítico, Clínica Hospital del Profesor, Santiago, Chile
- Programa de Formación de Especialista en Medicina de Urgencia, Universidad Andrés Bello, Santiago, Chile
| | - Leandro J. Carreño
- Instituto Milenio de Inmunología e Inmunoterapia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juan P. Torres
- Departamento de Pediatría y Cirugía Pediátrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Manuel A. Benachi O.
- Área de Biotecnología, Tecnoacademia Neiva, Servicio Nacional de Aprendizaje, Regional Huila, Neiva, Colombia
| | - Yenifer-Yadira Tovar-Rosero
- Departamento de Biología, Facultad de Ciencias Naturales, Exactas y de la Educación, Universidad del Cauca, Popayán, Colombia
| | - Angel A. Oñate
- Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Miguel O'Ryan
- Programa de Microbiología y Micología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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26
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Abdelmagid N, Southgate RJ, Alhaffar M, Ahmed M, Bani H, Mounier-Jack S, Dahab M, Checchi F, Sabahelzain MM, Nor B, Rao B, Singh NS. The Governance of Childhood Vaccination Services in Crisis Settings: A Scoping Review. Vaccines (Basel) 2023; 11:1853. [PMID: 38140257 PMCID: PMC10747651 DOI: 10.3390/vaccines11121853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
The persistence of inadequate vaccination in crisis-affected settings raises concerns about decision making regarding vaccine selection, timing, location, and recipients. This review aims to describe the key features of childhood vaccination intervention design and planning in crisis-affected settings and investigate how the governance of childhood vaccination is defined, understood, and practised. We performed a scoping review of 193 peer-reviewed articles and grey literature on vaccination governance and service design and planning. We focused on 41 crises between 2010 and 2021. Following screening and data extraction, our analysis involved descriptive statistics and applying the governance analysis framework to code text excerpts, employing deductive and inductive approaches. Most documents related to active outbreaks in conflict-affected settings and to the mass delivery of polio, cholera, and measles vaccines. Information on vaccination modalities, target populations, vaccine sources, and funding was limited. We found various interpretations of governance, often implying hierarchical authority and regulation. Analysis of governance arrangements suggests a multi-actor yet fragmented governance structure, with inequitable actor participation, ineffective actor collaboration, and a lack of a shared strategic vision due to competing priorities and accountabilities. Better documentation of vaccination efforts during emergencies, including vaccination decision making, governance, and planning, is needed. We recommend empirical research within decision-making spaces.
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Affiliation(s)
- Nada Abdelmagid
- Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | | | - Mervat Alhaffar
- Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Syria Research Group (SYRG), Co-Hosted by the London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK and Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Matab Ahmed
- School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
| | - Hind Bani
- School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Maysoon Dahab
- Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Francesco Checchi
- Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Majdi M. Sabahelzain
- School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Barni Nor
- Department of Women’s and Children’s Health, Uppsala University, 751 23 Uppsala, Sweden
| | - Bhargavi Rao
- Department of Global Health and Development, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Neha S. Singh
- Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
- Department of Global Health and Development, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
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Zhang X, Yue Q, Li M, Wu C, Zhou L, Cai Y, Xu J. SARS-CoV-2 vaccination may improve anxious, insomnia and depressive symptoms among Chinese population aged 18-75 years during the COVID-19 pandemic. Sci Rep 2023; 13:22029. [PMID: 38087031 PMCID: PMC10716261 DOI: 10.1038/s41598-023-48977-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
Previous studies have reported significant decreases in the incidence of mental health problems following SARS-CoV-2 vaccination. However, less relevant studies are published in China. We conducted a cross-sectional study involving Chinese adults aged 18-75 years with no known psychiatric diseases. The study used data from mental health of SARS-CoV-2 vaccinated and unvaccinated participants from May 2020 to July 2021.Three standardized scales, namely, the Generalized Anxiety Disorder-7 (GAD-7) for anxious symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and Athens Insomnia Score-8 (AIS-8) for insomnia symptoms, as well as basic demographic questions were used. The hierarchical regression method was used for multivariate logistic regression analysis to explore the effects of SARS-CoV-2 vaccination on anxious, insomnia, and depressive symptoms. The results confirmed first that vaccinated participants experienced significantly lower anxious, insomnia, and depressive symptoms scores (P < 0.001) compared with unvaccinated participants. Second that vaccinated participants had a lower prevalence of anxious, insomnia, and depressive symptoms (P < 0.001). Third, after adjusting for potential confounders, we still observed a good correlation between vaccination and a reduced risk of anxious, insomnia, and depressive symptoms. The current study showed that SARS-CoV-2 vaccination may be helpful in improving anxious, insomnia, and depressive symptoms.
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Affiliation(s)
- Xiaobo Zhang
- Department of Neurology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), 818 Renmin Road, Changde, 415000, Hunan, China
| | - Qiang Yue
- Department of Neurology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), 818 Renmin Road, Changde, 415000, Hunan, China
| | - Mingxia Li
- Department of NeurosurgeryChangde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), 818 Renmin Road, Changde, 415000, Hunan, China
| | - Chaoping Wu
- Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Lu Zhou
- The Outpatient DepartmentChangde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), 818 Renmin Road, Changde, 415000, Hunan, China
| | - Yang Cai
- Department of Infectious Diseases, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), 818 Renmin Road, Changde, 415000, Hunan, China.
| | - Jian Xu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, China.
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28
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Thirunavukkarasu A, Falji A Alanazi M, Al-Hazmi AH, Farhan ALruwaili B, Alsaidan AA, M Alruwaili TA, M Algaed MA, Kaseb Alsharari A, Alenazi RH, Alshalan AM, Alshalan SM. Maternal Perception, Hesitancy, and Satisfaction Toward Childhood Immunization in Primary Health Centers, Hafr Al-Batin: A Multicenter Cross-Sectional Study from Eastern Saudi Arabia. Risk Manag Healthc Policy 2023; 16:2357-2368. [PMID: 38024494 PMCID: PMC10640816 DOI: 10.2147/rmhp.s406933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Background Consumer perception of and satisfaction with vaccination services is a critical and commonly used indicator for evaluating the quality of services provided by concerned authorities. The present survey assessed maternal perceptions, hesitancy, satisfaction, and factors associated with childhood immunization services provided at the primary health centers (PHCs) of eastern Saudi Arabia. Methods The current analytical cross-sectional study included mothers of childhood vaccine beneficiaries attending PHCs in Hafr Al-Batin. We collected data related to mothers' perceptions, hesitancy, and satisfaction using a validated Arabic version of the data collection tool. Factors associated with low and high satisfaction with the immunization services were evaluated using logistic regression analysis. We performed Spearman correlation test to identify the correlation between the perception and satisfaction scores. Results Of the 675 participants, 87.4% were satisfied with the immunization services provided at the PHCs. The participants' satisfaction was significantly associated with the immunized child's age group (adjusted odds ratio [AOR] = 1.89, 95% CI = 1.39-2.89, p = 0.037) and occupation status (AOR = 1.42, 95% CI = 1.17-1.74, p = 0.024). Vaccine hesitancy was significantly associated with the mother's age group (AOR = 1.89, 95% CI of AR = 1.35-3.39, P = 0.003) and number of children (AOR = 1.42, 95% CI of AR = 1.17-1.74, P = 0.024), Additionally, we found a significant positive correlation (Spearman's rho = 0.207, p < 0.001) between perception and satisfaction scores. Conclusion We recommend targeted health education programs for mothers to improve their perceptions and the importance of all recommended childhood vaccines. Additionally, we suggest continuing maternal satisfaction assessments to enhance and maintain the quality of vaccination services.
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Affiliation(s)
| | | | - Ahmad Homoud Al-Hazmi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Bashayer Farhan ALruwaili
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Aseel Awad Alsaidan
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | | | | | | | | | - Amal Muteb Alshalan
- Department of Medicine, King Abdulaziz Specialist Hospital, Sakaka, Saudi Arabia
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29
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Wiley K, Christou-Ergos M, Degeling C, McDougall R, Robinson P, Attwell K, Helps C, Drislane S, Carter SM. Childhood vaccine refusal and what to do about it: a systematic review of the ethical literature. BMC Med Ethics 2023; 24:96. [PMID: 37940949 PMCID: PMC10633934 DOI: 10.1186/s12910-023-00978-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 10/31/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Parental refusal of routine childhood vaccination remains an ethically contested area. This systematic review sought to explore and characterise the normative arguments made about parental refusal of routine vaccination, with the aim of providing researchers, practitioners, and policymakers with a synthesis of current normative literature. METHODS Nine databases covering health and ethics research were searched, and 121 publications identified for the period Jan 1998 to Mar 2022. For articles, source journals were categorised according to Australian Standard Field of Research codes, and normative content was analysed using a framework analytical approach. RESULTS Most of the articles were published in biomedical journals (34%), bioethics journals (21%), and journals that carry both classifications (20%). Two central questions dominated the literature: (1) Whether vaccine refusal is justifiable (which we labelled 'refusal arguments'); and (2) Whether strategies for dealing with those who reject vaccines are justifiable ('response arguments'). Refusal arguments relied on principlism, religious frameworks, the rights and obligations of parents, the rights of children, the medico-legal best interests of the child standard, and the potential to cause harm to others. Response arguments were broadly divided into arguments about policy, arguments about how individual physicians should practice regarding vaccine rejectors, and both legal precedents and ethical arguments for vaccinating children against a parent's will. Policy arguments considered the normative significance of coercion, non-medical or conscientious objections, and possible reciprocal social efforts to offset vaccine refusal. Individual physician practice arguments covered nudging and coercive practices, patient dismissal, and the ethical and professional obligations of physicians. Most of the legal precedents discussed were from the American setting, with some from the United Kingdom. CONCLUSIONS This review provides a comprehensive picture of the scope and substance of normative arguments about vaccine refusal and responses to vaccine refusal. It can serve as a platform for future research to extend the current normative literature, better understand the role of cultural context in normative judgements about vaccination, and more comprehensively translate the nuance of ethical arguments into practice and policy.
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Affiliation(s)
- Kerrie Wiley
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, Sydney, 2006, Australia.
| | - Maria Christou-Ergos
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, Sydney, 2006, Australia
| | - Chris Degeling
- Australian Centre for Health Engagement, Evidence and Values, The University of Wollongong, Wollongong, 2522, Australia
| | - Rosalind McDougall
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, 3010, Australia
| | - Penelope Robinson
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, Sydney, 2006, Australia
| | - Katie Attwell
- School of Social Sciences, Asian Studies & Politics, International Relations, University of Western Australia, Perth, 6009, Australia
| | - Catherine Helps
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, Sydney, 2006, Australia
| | - Shevaun Drislane
- School of Social Sciences, Asian Studies & Politics, International Relations, University of Western Australia, Perth, 6009, Australia
| | - Stacy M Carter
- Australian Centre for Health Engagement, Evidence and Values, The University of Wollongong, Wollongong, 2522, Australia
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30
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Ji WY, Liu DL, Yu R, Miao L, Yuan QL, Suo LD, Yu JP. Vaccination coverage survey of children aged 1-3 years in Beijing, China, 2005-2021. Vaccine 2023; 41:6444-6452. [PMID: 37709591 DOI: 10.1016/j.vaccine.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND The routine immunization program for children is a primary strategy and a core part of vaccination. Achieving and maintaining high level of vaccination coverage are important to reduce morbidity and mortality caused by vaccine-preventable diseases. In Beijing, annual coverage surveys have been conducted since 2005. It is necessary and possible to assess the level and trend of routine vaccination coverage of children in Beijing as well as the disruption of coronavirus disease 2019 (COVID-19) pandemic and provide the reference for the further improve the vaccination coverage. METHODS The data of 61,521 children aged 1-3 years in the vaccination coverage surveys during 2005-2021 were analyzed by Beijing Center for Disease Control and Prevention. Descriptive epidemiological method was used to analyze the data and the difference of vaccination coverage within the time period. RESULTS More than 99 % of participants had immunization cards and electronic immunization records. The concordance rate of both records were also over 99 %. During 2011-2019, the rates of on-time and in-time vaccination of each routine vaccine reached 96 % or more and increased significantly (all P values <0.05), compared with that of 2005-2010. All rates of the investigated vaccine, except for Bacillus Calmette-Guérin vaccine (BCG) and the first dose of hepatitis B vaccine (HepB), decreased in 2020-2021 significantly (all P values <0.05). For the causes of failing to vaccinate on time, delayed vaccination accounted for 47.82 %. The top two vaccines to be missed were the first dose of hepatitis A vaccine and the 4th dose of diphtheria-tetanus-acellular pertussis vaccine, accounting for 21.41 % and 20.79 %, respectively. The main reason for zero-dose/drop-out vaccination was "Guardians regarded the immunization service time as inappropriate", accounting for 72.27 %. CONCLUSION The coverage level and service quality of routine immunization in Beijing were relatively high. However, as influenced by COVID-19 epidemics, both on-time and in-time vaccination rates decreased significantly, except for BCG and HepB. Under the background of COVID-19 pandemic, the keys to maintain high level of vaccination coverage include flexible immunization service time to ensure the guardians bringing their children for vaccination timely, and more attention from providers to the doses after children's first birthday.
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Affiliation(s)
- Wen-Yan Ji
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Dong-Lei Liu
- Department of Vaccines Management and Supply, Beijing Center for Disease Control and Prevention, Beijing 100013, PR China
| | - Rui Yu
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Liang Miao
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Qian-Li Yuan
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Luo-Dan Suo
- Institute of Immunization, Beijing Center for Disease Control and Prevention, Beijing, PR China
| | - Jian-Ping Yu
- Office of Beijing Center for Disease Control and Prevention, Beijing 10013, PR China.
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31
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Lawal TV, Atoloye KA, Adebowale AS, Fagbamigbe AF. Spatio-temporal analysis of childhood vaccine uptake in Nigeria: a hierarchical Bayesian Zero-inflated Poisson approach. BMC Pediatr 2023; 23:493. [PMID: 37773112 PMCID: PMC10540393 DOI: 10.1186/s12887-023-04300-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Globally, child mortality and morbidity remain a serious health challenge and infectious diseases are the leading causes. The use of count models together with spatial analysis of the number of doses of childhood vaccines taken is limited in the literature. We used a Bayesian zero-inflated Poisson regression model with spatio-temporal components to assess the number of doses of childhood vaccines taken among children aged 12-23 months and their associated factors. METHODS Data of 19,564 children from 2003, 2008, 2013 and 2018 population-based cross-sectional Nigeria Demographic and Health Survey were used. The childhood vaccines include one dose of Bacillus-Calmette-Guérin; three doses of Diphtheria-Pertussis-Tetanus; three doses of Polio and one dose of Measles. Uptake of all nine vaccines was regarded as full vaccination. We examined the multilevel factors associated with the number of doses of childhood vaccines taken using descriptive, bivariable and multivariable Bayesian models. Analysis was conducted in Stata version 16 and R statistical packages, and visualization in ArcGIS. RESULTS The prevalence of full vaccination was 6.5% in 2003, 14.8% in 2008, 21.8% in 2013 and 23.3% in 2018. Full vaccination coverage ranged from 1.7% in Sokoto to 51.9% in Anambra. Factors associated with the number of doses of childhood vaccines taken include maternal age (adjusted Incidence "risk" Ratio (aIRR) = 1.05; 95% Credible Interval (CrI) = 1.03-1.07) for 25-34 years and (aIRR = 1.07; 95% CrI = 1.05-1.10) for 35-49 years and education: (aIRR = 1.11, 95% CrI = 1.09-1.14) for primary and (aIRR = 1.16; 95% CrI = 1.13-1.19) for secondary/tertiary education. Other significant factors are wealth status, antenatal care attendance, working status, use of skilled birth attendants, religion, mother's desire for the child, community poverty rate, community illiteracy, and community unemployment. CONCLUSION Although full vaccination has remained low, there have been improvements over the years with wide disparities across the states. Improving the uptake of vaccines by educating women on the benefits of hospital delivery and vaccines through radio jingles and posters should be embraced, and state-specific efforts should be made to address inequality in access to routine vaccination in Nigeria.
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Affiliation(s)
- Temitayo Victor Lawal
- Department of Epidemiology and Medical Statistics, College of Medinec, University of Ibadan, Ibadan, Nigeria
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, FCT Nigeria
| | - Kehinde Adebola Atoloye
- Department of Epidemiology and Medical Statistics, College of Medinec, University of Ibadan, Ibadan, Nigeria
- Viable Knowledge Masters, Abuja, FCT Nigeria
- Viable Helpers Development Organization, Abuja, FCT Nigeria
| | - Ayo Stephen Adebowale
- Department of Epidemiology and Medical Statistics, College of Medinec, University of Ibadan, Ibadan, Nigeria
- Population and Health Research Entity, Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Adeniyi Francis Fagbamigbe
- Department of Epidemiology and Medical Statistics, College of Medinec, University of Ibadan, Ibadan, Nigeria
- Division of Population and Behavioural Science, School of Medicine, Health Data Science Unit, University of St Andrews, St Andrews, UK
- Institute of Applied Health Sciences, School of Medicine, Medicinal Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- Research Methods and Evaluation Unit, Institute for Health & Wellbeing, Coventry University, Coventry, UK
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Tu P, Smith D, Parker T, Pejavara K, Michener JL, Lin C. Parent-Child Vaccination Concordance and Its Relationship to Child Age, Parent Age and Education, and Perceived Social Norms. Vaccines (Basel) 2023; 11:1210. [PMID: 37515026 PMCID: PMC10384156 DOI: 10.3390/vaccines11071210] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
Researchers established that parental vaccination status often predicts that of their children, but a limited number of studies have examined factors influencing dyadic concordance or discordance (i.e., same or different vaccination status or intent for both members). We investigated how child versus parent age as well as parents' perceptions of their respective friends' immunization behavior impacted un/vaccinated parents' decisions regarding vaccinating their child. An online survey obtained the COVID-19 vaccination status and views of 762 parents of 5-17-year-old children. More than three-quarters of all dyads were concordant; 24.1% of vaccinated parents would not vaccinate their child, with greater hesitancy for younger children and among younger or less educated parents. Children of vaccinated parents and of parents who thought most of their child's friends were vaccinated were 4.7 and 1.9 times, respectively, more likely to be vaccinated; unvaccinated parents were 3.2 times more likely to accept the vaccine for their child if they believed most of their friends would vaccinate their children. Further, parents who reported that most of their friends were vaccinated were 1.9 times more likely to have obtained the vaccine themselves, illustrating the influence of social norms. Regardless of their own vaccination status, parents of unvaccinated children were more likely to be politically conservative. If communities or circles of friends could achieve or convey a vaccinated norm, this might persuade undecided or reluctant parents to vaccinate their children. Future research should examine the effects of community behavior and messages highlighting social norms on pediatric vaccine uptake.
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Affiliation(s)
- Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
| | - Taylor Parker
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
| | - Kartik Pejavara
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
| | - J Lloyd Michener
- Department of Family Medicine & Community Health, Duke University, Durham, NC 27708, USA
| | - Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27708, USA
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Salalli R, Dange JR, Dhiman S, Sharma T. Vaccines development in India: advances, regulation, and challenges. Clin Exp Vaccine Res 2023; 12:193-208. [PMID: 37599804 PMCID: PMC10435768 DOI: 10.7774/cevr.2023.12.3.193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/02/2023] [Accepted: 05/05/2023] [Indexed: 08/22/2023] Open
Abstract
One of the most significant medical advancements in human history is the development of vaccines. Progress in vaccine development has always been greatly influenced by scientific human innovation. The main objective of vaccine development would be to acquire sufficient evidence of vaccine effectiveness, immunogenicity, safety, and/or quality to support requests for marketing approval. Vaccines are biological products that enhance the body's defenses against infectious diseases. From the first smallpox vaccine to the latest notable coronavirus disease 2019 nasal vaccine, India has come a long way. The development of numerous vaccines, driven by scientific innovation and advancement, combined with researcher's knowledge, has helped to reduce the global burden of disease and mortality rates. The Drugs and Cosmetics Rules of 1945 and the New Drugs and Clinical Trials Rules of 2019 specify the requirements and guidelines for CMC (chemistry, manufacturing, and controls) for all manufactured and imported vaccines, including those against coronavirus infections. This article provides an overview of the regulation pertaining to the development process, registration, and approval procedures for vaccines, particularly in India, along with their brief history.
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Affiliation(s)
- Rakshita Salalli
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Jyoti Ram Dange
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Sonia Dhiman
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Teenu Sharma
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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Otero-Romero S, Lebrun-Frénay C, Reyes S, Amato MP, Campins M, Farez M, Filippi M, Hacohen Y, Hemmer B, Juuti R, Magyari M, Oreja-Guevara C, Siva A, Vukusic S, Tintoré M. ECTRIMS/EAN consensus on vaccination in people with multiple sclerosis: Improving immunization strategies in the era of highly active immunotherapeutic drugs. Mult Scler 2023; 29:904-925. [PMID: 37293841 PMCID: PMC10338708 DOI: 10.1177/13524585231168043] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/30/2023] [Accepted: 03/19/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND With the new highly active drugs available for people with multiple sclerosis (pwMS), vaccination becomes an essential part of the risk management strategy. OBJECTIVE To develop a European evidence-based consensus for the vaccination strategy of pwMS who are candidates for disease-modifying therapies (DMTs). METHODS This work was conducted by a multidisciplinary working group using formal consensus methodology. Clinical questions (defined as population, interventions, and outcomes) considered all authorized DMTs and vaccines. A systematic literature search was conducted and quality of evidence was defined according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. The recommendations were formulated based on the quality of evidence and the risk-benefit balance. RESULTS Seven questions, encompassing vaccine safety, vaccine effectiveness, global vaccination strategy and vaccination in sub-populations (pediatric, pregnant women, elderly and international travelers) were considered. A narrative description of the evidence considering published studies, guidelines, and position statements is presented. A total of 53 recommendations were agreed by the working group after three rounds of consensus. CONCLUSION This first European consensus on vaccination in pwMS proposes the best vaccination strategy according to current evidence and expert knowledge, with the goal of homogenizing the immunization practices in pwMS.
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Affiliation(s)
- Susana Otero-Romero
- Department of Preventive Medicine and Epidemiology, Vall d’Hebron Barcelona Hospital, Barcelona, Spain Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d’Hebron Barcelona Hospital, Barcelona, Spain
| | | | - Saúl Reyes
- Fundación Santa Fe de Bogotá, Bogotá, Colombia School of Medicine, Universidad de los Andes, Bogotá, Colombia Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Maria Pia Amato
- Department NEUROFARBA, University of Florence, Florence, Italy IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Magda Campins
- Department of Preventive Medicine and Epidemiology, Vall d’Hebron Barcelona Hospital, Barcelona, Spain
| | - Mauricio Farez
- Centro para la Investigación de Enfermedades Neuroinmunológicas (CIEN), FLENI, Buenos Aires, Argentina
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy Vita-Salute San Raffaele University, Milan, Italy
| | - Yael Hacohen
- Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, UK Department of Neuroinflammation, Queen Square Multiple Sclerosis Centre, UCL Institute of Neurology, London, UK
| | - Bernhard Hemmer
- Department of Neurology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Rosa Juuti
- Multiple Sclerosis International Federation, London, UK
| | - Melinda Magyari
- Department of Neurology, Danish Multiple Sclerosis Center and the Danish Multiple Sclerosis Registry, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Celia Oreja-Guevara
- Department of Neurology, Hospital Clínico San Carlos, IdISSC, Departamento de Medicina, Universidad Complutense, Madrid, Spain
| | - Aksel Siva
- Department of Neurology, School of Medicine, Istanbul University Cerrahpasa, Cerrahpasa, Istanbul, Turkey
| | - Sandra Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-inflammation, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
- Centre des Neurosciences de Lyon, Observatoire Français de la Sclérose en Plaques, INSERM 1028 et CNRS UMR5292, Lyon, France Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France
| | - Mar Tintoré
- Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d’Hebron Barcelona Hospital, Barcelona, Spain
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Rajkhowa P, Dsouza VS, Kharel R, Cauvery K, Mallya BR, Raksha DS, Mrinalini V, Sharma P, Pattanshetty S, Narayanan P, Lahariya C, Brand H. Factors Influencing Monkeypox Vaccination: A Cue to Policy Implementation. J Epidemiol Glob Health 2023; 13:226-238. [PMID: 37119512 PMCID: PMC10148003 DOI: 10.1007/s44197-023-00100-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Following the mpox 2022 outbreak, several high-income countries have developed plans with inclusion criteria for vaccination against the mpox disease. This study was carried out to map the factors influencing mpox vaccination uptake to help address the challenges and increase vaccination confidence. METHODS This was a study based on Tweet analysis. The VADER, Text Blob, and Flair analyzers were adopted for sentiment analysis. The "Levesque conceptual framework for healthcare access" was adopted to evaluate the factors impacting access and the decision to get mpox vaccination. Consolidated Criteria for Reporting Qualitative Research (COREQ) criteria were adopted. FINDINGS A total of 149,133 tweets were extracted between 01/05/2022 and 23/09/2022. Around 1% of the random tweets were used for qualitative analysis. Of the 149,113, tweets were classified as positive, negative and neutral, respectively, by (a) VADER: (55,040) 37.05%, (44,395) 29.89%, and (49,106) 33.06%, (b) TextBlob: (70,900) 47.73%, (22,729) 15.30%, and (54,921) 36.97%, and (c) Flair: (31,389) 21.13%, (117,152) 78.87%, and 0.00%. Sentiment trajectories revealed that communication, stigmatization, accessibility to and availability of vaccines, and concerns about vaccine safety as factors influencing decision-making in the content and flow of tweets. INTERPRETATION Twitter is a key surveillance tool for understanding factors influencing decisions and access to mpox vaccination. To address vaccine mistrust and disinformation, a social media-based risk communication plan must be devised. Adopting measures to remove logistical vaccination hurdles is needed. Obtaining fact-based information from credible sources is key to improving public confidence.
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Affiliation(s)
- Priyobrat Rajkhowa
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
- Department of International Health, Care and Public Health Research Institute-CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Viola Savy Dsouza
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Rashmi Kharel
- Institute for Global Health, University College London (UCL), London, UK
| | - K Cauvery
- Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - B Rashmi Mallya
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - D S Raksha
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - V Mrinalini
- Department of Clinical Psychology, Manipal College of Health Professions, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Preejana Sharma
- Department of Psychiatric (Mental Health) Nursing, Manipal College of Nursing, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Sanjay Pattanshetty
- Department of International Health, Care and Public Health Research Institute-CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
- Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India.
| | - Prakash Narayanan
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India.
| | - Chandrakant Lahariya
- Integrated Department of Pediatrics and Community Medicine, Foundation for People-centric Health Systems, New Delhi, 110029, India
| | - Helmut Brand
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
- Department of International Health, Care and Public Health Research Institute-CAPHRI, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Pecetta S, Nandi A, Weller C, Harris V, Fletcher H, Berlanda Scorza F, Pizza M, Salisbury D, Moxon R, Black S, Bloom DE, Rappuoli R. Vaccines for a sustainable planet. Sci Transl Med 2023; 15:eadf1093. [PMID: 36857432 DOI: 10.1126/scitranslmed.adf1093] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The health of the planet is one objective of the United Nations' Sustainable Development Goals. Vaccines can affect not only human health but also planet health by reducing poverty, preserving microbial diversity, reducing antimicrobial resistance, and preventing an increase in pandemics that is fueled partly by climate change.
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Affiliation(s)
| | - Arindam Nandi
- Population Council, New York, NY, USA.,One Health Trust, Washington, DC, USA
| | | | - Vanessa Harris
- Amsterdam University Medical Center, Department of Internal Medicine, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands.,Amsterdam Institute for Infection and Immunity, Amsterdam, Netherlands
| | - Helen Fletcher
- Janssen Pharmaceutical Companies of Johnson & Johnson, London, UK.,London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | - Richard Moxon
- Department of Paediatrics, Oxford University, Oxford, UK
| | - Steve Black
- Global Vaccine Data Network, Auckland, New Zealand
| | - David E Bloom
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
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37
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Huang J, Cheung CKM, Keung VMW, Lo ASC, Chan SC, Pang WS, Li QHY, Mui LWH, Lee A, Wong MCS. Factors Associated with Vaccination Uptake among Young Children: A Follow-Up Study of 1799 Toddlers. Vaccines (Basel) 2023; 11:vaccines11030535. [PMID: 36992119 DOI: 10.3390/vaccines11030535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023] Open
Abstract
Childhood vaccination is crucial to protect young children from harmful infectious diseases. This study aimed to investigate the recent childhood immunization rate of recommended and additional vaccinations and identify the factors affecting the vaccination uptake of young children in Hong Kong. The self-administrated questionnaires were distributed to parents of toddlers aged 2 to 5. They were asked to provide information on (1) socioeconomic demographic factors; (2) experiences during pregnancy; and (3) the medical history of the toddler. A total of 1799 responses were collected. Children were more likely to be fully vaccinated when they were at a younger age (aOR = 0.61, 95% CI: 0.48–0.78, p < 0.001), the first child in the family (aOR second-born = 0.62, 95% CI: 0.48–0.81, p < 0.001; aOR third-born = 0.33, 95% CI: 0.19–0.55, p < 0.001), had a higher household income (aOR HKD 15,000–HKD 29,999 = 1.80, 95% CI: 1.27–2.55, p = 0.001; aOR ≥ HKD 30,000 = 3.42, 95% CI: 2.39–4.90, p < 0.001; compared with <HKD 15,000), or with mothers in older age groups (aOR 35–39 years old = 2.45, 95% CI = 1.22–4.93, p = 0.012; aOR ≥ 40 = 2.90, 95% CI = 1.24–6.77, p = 0.014; compared with ≤ age 24). The uptake of any additional vaccination was 71%. Children who were older (aOR = 1.32, 95% CI: 1.02–1.70, p = 0.036), the first child in the family (aOR second-born = 0.74, 95% CI: 0.56–0.99, p = 0.043; aOR third-born = 0.55, 95% CI: 0.32–0.96, p = 0.034), with higher household income (aOR ≥ HKD 30,000 = 1.61, 95% CI: 1.10–2.37, p = 0.016), were exposed to second-hand smoke from the father (aOR: 1.49, 95% CI: 1.08–2.07, p = 0.016), experienced hospitalization (twice or more—aOR: 1.44, 95% CI: 1.04–1.99, p = 0.027), or were fully vaccinated (aOR: 2.76, 95% CI: 2.12–3.60, p < 0.001) were associated with a higher chance of taking an additional vaccine. To encourage the vaccination rate, more attention should be given to families with more children, low-income families, and younger mothers.
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Affiliation(s)
- Junjie Huang
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Calvin K M Cheung
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Vera M W Keung
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Amelia S C Lo
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Sze Chai Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing Sze Pang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Queenie H Y Li
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lancelot W H Mui
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Albert Lee
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Martin C S Wong
- Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- The School of Public Health, Peking University, Beijing 100871, China
- The School of Public Health, The Chinese Academy of Medical Sciences and The Peking Union Medical Colleges, Beijing 100006, China
- The School of Public Health, Fudan University, Shanghai 200433, China
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Summan A, Nandi A, Shet A, Laxminarayan R. The effect of the COVID-19 pandemic on routine childhood immunization coverage and timeliness in India: retrospective analysis of the National Family Health Survey of 2019-2021 data. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 8:100099. [PMID: 36285007 PMCID: PMC9584865 DOI: 10.1016/j.lansea.2022.100099] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/27/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
Background The COVID-19 pandemic has disrupted health systems globally. We estimated the effect of the pandemic on the coverage and timeliness of routine childhood immunization in India through April 2021. Methods We used data from India's National Family Health Survey 2019-2021 (NFHS-5), a cross-sectional survey which collected immunization information of under-five children from a nationally representative sample of households between June 2019 and April 2021. We used a mother fixed-effects regression model - accounting for secular trends and confounding factors - to compare COVID-affected children with their COVID-unaffected siblings (n = 59,144). Children who were eligible for a vaccine after January 30, 2020 (date of the first COVID case in India) were considered as the COVID-affected group and those eligible for a vaccine before this date were included in the COVID-unaffected group. Coverage of the following vaccine doses was considered-Bacillus Calmette-Guérin (BCG), hepatitis B birth dose (hepB0), DPT1 (diphtheria, pertussis, and tetanus, first dose), DPT2, DPT3, polio1, polio2, polio3, and measles first dose (MCV1). Indicators of vaccine coverage and vaccine timeliness (defined as receiving a dose within 45 days of minimum eligibility age) were separately examined. Findings Immunization coverage was lower in COVID-affected children as compared with unaffected children, ranging from 2% lower for BCG and hepB0 to 9% for DPT3 and 10% for polio3. There was no significant difference in MCV1 coverage. Coverage reduction was greater for vaccines doses given in later age groups. The rate of timely receipt of polio and DPT vaccine doses was 3%-5% lower among COVID-affected children relative to unaffected children. Among population subgroups, COVID-affected male children and those from rural areas experienced the highest reduction in vaccine coverage. Interpretation Children in India experienced lower routine immunization coverage and greater delays in immunization during the COVID-19 pandemic. Funding The Bill & Melinda Gates Foundation.
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Affiliation(s)
| | - Arindam Nandi
- One Health Trust, Washington, DC, USA
- The Population Council, 1 Dag Hammarskjold Plaza, New York, NY, 10017, USA
| | - Anita Shet
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ramanan Laxminarayan
- One Health Trust, New Delhi, India
- High Meadows Environmental Institute, Princeton University, NJ, USA
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Farfán-García ED, Kilic A, García-Machorro J, Cuevas-Galindo ME, Rubio-Velazquez BA, García-Coronel IH, Estevez-Fregoso E, Trujillo-Ferrara JG, Soriano-Ursúa MA. Antimicrobial (viral, bacterial, fungal, and parasitic) mechanisms of action of boron-containing compounds. VIRAL, PARASITIC, BACTERIAL, AND FUNGAL INFECTIONS 2023:733-754. [DOI: 10.1016/b978-0-323-85730-7.00026-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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40
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Okai GA, Abekah-Nkrumah G. The level and determinants of COVID-19 vaccine acceptance in Ghana. PLoS One 2022; 17:e0270768. [PMID: 35802742 PMCID: PMC9269973 DOI: 10.1371/journal.pone.0270768] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/16/2022] [Indexed: 12/11/2022] Open
Abstract
Objective
As part of the efforts to curb the COVID-19 pandemic, the government of Ghana has received several shipments of approved vaccines, and administration has begun in the country. Studies examining the determinants of COVID-19 vaccine acceptance in Ghana were mostly conducted before the vaccination exercise. Vaccine acceptance decisions however vary with time and hence, peoples’ decisions may have changed once vaccines became accessible. This study examines the level and determinants of COVID-19 vaccine acceptance among adult Ghanaians during the vaccination exercise.
Methods
The study was a cross-sectional online survey involving Ghanaian adults (18 years and above) eligible to take the COVID-19 vaccine. The study was conducted from 18th May 2021 to 14th July 2021 and the questionnaire was answered by 362 respondents. Snowball sampling technique was utilized to obtain the respondents. Probit regression analysis was used to identify factors influencing COVID-19 vaccine acceptance.
Key findings
Only 62.7% of the respondents indicated that they will accept the COVID-19 vaccine if provided. The regression results revealed that the decision to accept the COVID-19 vaccine was influenced by occupation, perceived susceptibility, perceived benefits and attitudes towards the vaccines.
Conclusion
The findings suggest that government must implement strategies to enhance positive attitudes toward vaccines, increase the risk perception of contracting the virus and also educate the populace about the benefits of the vaccine.
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Affiliation(s)
- Grace Adjei Okai
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Accra, Ghana
| | - Gordon Abekah-Nkrumah
- Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Accra, Ghana
- * E-mail:
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41
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Capturing the value of vaccination within health technology assessment and health economics: Literature review and novel conceptual framework. Vaccine 2022; 40:4008-4016. [PMID: 35618559 DOI: 10.1016/j.vaccine.2022.04.050] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Vaccination provides significant health gains to individuals and society and can potentially improve health equity, healthcare systems and national economies. Policy decisions, however, are rarely informed by comprehensive economic evaluations (EE) including vaccination's wide-ranging value. The objective of this analysis was to focus on health technology assessment systems to identify relevant value concepts in order to improve current EE of non-pandemic vaccines. METHODS Following a literature review, a novel Value of Vaccination (VoV) framework was developed with experts in vaccine EE from developed countries with established health technology assessment systems. RESULTS Forty-four studies presenting value frameworks or concepts applicable to vaccination were included. Eighteen unique value concepts relevant to EE were identified and defined. These were categorised within the VoV framework using three dimensions, moving from a narrow payer perspective to a more expansive and societal perspective. The dimensions were: (I) conventional payer perspective concepts (e.g., health gains in vaccinees, direct medical costs); (II) conventional societal perspective concepts (e.g., indirect health/economic gains to caregivers/households, productivity in vaccinees); and (III) novel societal concepts (e.g., financial risk protection, peace of mind, societal health gains, healthcare systems security, political stability, social equity and macroeconomic gains). While good quality evidence and methods are available to support concepts in Dimensions I and II, further work is needed to generate the required evidence for vaccination impact on Dimension III concepts. CONCLUSIONS The devastating effect on nations of the COVID-19 pandemic has helped to highlight the potential far-reaching benefits that many vaccination programmes can offer. This VoV framework is particularly relevant to policy decisions considering EE, and the potential future expansion of non-pandemic vaccination value considerations. The framework helps to understand and compare current value considerations across countries and payer versus societal perspectives. It provides decision-makers with a transparent and logical path to broaden consideration of VoV in EE.
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Alakeely M, Almutari A, Masud N, Altulaihi B. Preparedness of Primary Health Care Leaders During COVID-19 Outbreak, Riyadh, Saudi Arabia: A Qualitative Study. Risk Manag Healthc Policy 2021; 14:4339-4351. [PMID: 34703343 PMCID: PMC8541794 DOI: 10.2147/rmhp.s331903] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/08/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Our study aims to explore the preparedness of the frontline leaders of the primary health care (PHC) centres in dealing with the COVID-19 pandemic and to understand their experiences in implementing preventive interventions necessary to routinise health care service delivery. Methods A qualitative exploratory study was conducted using in-depth interviews with the participants in English. The interviews were transcribed verbatim, and inductive coding followed by thematic analysis was performed using NVivo version 12. Participants Six participants in charge of managing their respective primary health care settings were included in the study. Purposive sampling was used to identify participants until saturation was reached. After agreement, the interviews were scheduled as per availability. Results The results were grouped into three major themes and nine subthemes. Most leaders reported that they were trained in pandemic preparedness, but there was a lack of focused readiness to handle a massive-scale, infectious disease outbreak or pandemic. The initial lack of guidelines specific to COVID-19 was a barrier in making decisions related to staff and patient care. Services were interrupted initially and there was lack of staff since many acquired COVID-19 and were isolated. The shortage of the staff was delt by repurposing staff from other departments to the essential care services. Fears related to pandemic was one of the main concerns reported among staff and patients. Several initiatives were taken to ensure staff safety and uninterrupted service delivery to patients. The use of technology was an effective mechanism in preparing for the pandemic. Conclusion This qualitative study helped in understanding the experiences of primary health care leaders during the COVID-19 pandemic. The facilities lacked overall preparedness at the beginning of the pandemic; however, many initiatives were taken in course of time to ensure smooth operations and continued service delivery to the patients.
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Affiliation(s)
- Maha Alakeely
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Arwa Almutari
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Radiology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nazish Masud
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Research Unit, Department of Medical Education, College of Medicine, King Saud BIN Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Bader Altulaihi
- Department of Family Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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Pilewski KA, Kramer KJ, Georgiev IS. Simultaneous Immunization with Multiple Diverse Immunogens Alters Development of Antigen-Specific Antibody-Mediated Immunity. Vaccines (Basel) 2021; 9:vaccines9090964. [PMID: 34579201 PMCID: PMC8473051 DOI: 10.3390/vaccines9090964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/17/2021] [Accepted: 08/25/2021] [Indexed: 11/24/2022] Open
Abstract
Vaccination remains one of the most successful medical interventions in history, significantly decreasing morbidity and mortality associated with, or even eradicating, numerous infectious diseases. Although traditional immunization strategies have recently proven insufficient in the face of many highly mutable and emerging pathogens, modern strategies aim to rationally engineer a single antigen or cocktail of antigens to generate a focused, protective immune response. However, the effect of cocktail vaccination (simultaneous immunization with multiple immunogens) on the antibody response to each individual antigen within the combination, remains largely unstudied. To investigate whether immunization with a cocktail of diverse antigens would result in decreased antibody titer against each unique antigen in the cocktail compared to immunization with each antigen alone, we immunized mice with surface proteins from uropathogenic Escherichia coli, Mycobacterium tuberculosis, and Neisseria meningitides, and monitored the development of antigen-specific IgG antibody responses. We found that antigen-specific endpoint antibody titers were comparable across immunization groups by study conclusion (day 70). Further, we discovered that although cocktail-immunized mice initially elicited more robust antibody responses, the rate of titer development decreases significantly over time compared to single antigen-immunized mice. Investigating the basic properties that govern the development of antigen-specific antibody responses will help inform the design of future combination immunization regimens.
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Affiliation(s)
- Kelsey A. Pilewski
- Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (K.A.P.); (K.J.K.)
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Kevin J. Kramer
- Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (K.A.P.); (K.J.K.)
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Ivelin S. Georgiev
- Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (K.A.P.); (K.J.K.)
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Vanderbilt Institute for Infection, Immunology, and Inflammation, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Department of Electrical Engineering and Computer Science, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Program in Computational Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- Correspondence:
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Summan A, Nandi A, Deo S, Laxminarayan R. Improving vaccination coverage and timeliness through periodic intensification of routine immunization: evidence from Mission Indradhanush. Ann N Y Acad Sci 2021; 1502:110-120. [PMID: 34263929 PMCID: PMC9291841 DOI: 10.1111/nyas.14657] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/11/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023]
Abstract
Only an estimated 62% of Indian children under the age of 2 years are fully immunized. We examined the association between India's Mission Indradhanush (MI)-a periodic intensification of the routine immunization program-which was implemented in phases across districts between March 2015 and July 2017, and routine vaccination coverage and timeliness among children. We used data from a 2015 to 2016 national survey of children (n = 29,532) and employed difference-in-difference regressions to examine binary indicators of receipt of 11 vaccines and whether vaccines were received at recommended ages. The full immunization rate was 27% higher among children under 2 years old residing in MI phase 1 and 2 districts (intervention group) as compared with those residing elsewhere (control group). The rate of receiving all vaccines at recommended ages was 8% higher in the intervention group. Receiving doses of oral polio vaccine (OPV) birth dose, OPV dose 1 (OPV1), OPV2, OPV3, bacillus Calmette-Guérin, and hepatitis B birth dose vaccines were 9%, 9%, 11%, 16%, 5%, and 19% higher in the intervention group than the control group, respectively. More research is required on the cost-effectiveness of investing in MI-type programs as compared with routine immunization.
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Affiliation(s)
- Amit Summan
- Center for Disease Dynamics, Economics & Policy, Washington, DC
| | - Arindam Nandi
- Center for Disease Dynamics, Economics & Policy, Washington, DC
| | - Sarang Deo
- Indian School of Business, Hyderabad, India
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, India.,High Meadows Environmental Institute, Princeton University, Princeton, New Jersey
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Paul A, Upreti K, Nepal S, Lohani J, Adhikari K, Rimal R. Rejoice architecture meets social norms to accelerate vaccination in Nepal: Protocol for a mixed-method quasi-experimental study. Gates Open Res 2020; 4:121. [PMID: 33870101 DOI: 10.12688/gatesopenres.13168.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Each year, 600,000 children under 5 years old die from vaccine-preventable diseases globally. Immunization is an effective way to prevent many diseases, saving two to three million lives per year. The Nepal National Government recommends vaccinations for all children for 11 diseases by 15 months of age. However, only 78% of children between 1-2 years of age have received all recommended vaccines and only 43% receive them at the age-appropriate times for which they are scheduled. Objectives: This protocol describes the development of an intervention - called "Rejoice Architecture" - that is informed by three theoretical perspectives: choice architecture, the broken windows theory, and the theory of normative social behavior. We also describe a mixed-methods approach to develop the intervention, which will improve the physical and social environments of health facilities in Makwanpur, Nepal. We hypothesize this intervention will improve immunization behaviors and intentions among mothers of children younger than 2 years, pregnant women, and prospective mothers. Methods: We describe the qualitative formative assessment to understand existing attitudes, norms, and behaviors among caregivers, healthcare workers, and government representatives. The formative assessment will include in-depth interviews, key informant interviews, and focus group discussions. We also describe the overall quasi-experimental study design, used to assess intervention impact. Impact: This study will contribute to the social and behavioral change communication intervention research by offering a novel strategy for increasing immunization. This study will also illustrate to policymakers the value of structural change for health service delivery.
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Affiliation(s)
- Alicia Paul
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Kamana Upreti
- Nepal Evaluation and Assessment Team, Kathmandu, 44600, Nepal
| | - Shraddha Nepal
- Nepal Evaluation and Assessment Team, Kathmandu, 44600, Nepal
| | - Jeevan Lohani
- Nepal Evaluation and Assessment Team, Kathmandu, 44600, Nepal
| | | | - Rajiv Rimal
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Nandi A, Kumar S, Shet A, Bloom DE, Laxminarayan R. Childhood vaccinations and adult schooling attainment: Long-term evidence from India's Universal Immunization Programme. Soc Sci Med 2020; 250:112885. [PMID: 32143089 PMCID: PMC7103780 DOI: 10.1016/j.socscimed.2020.112885] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 01/03/2020] [Accepted: 02/23/2020] [Indexed: 12/28/2022]
Abstract
Routine childhood vaccines are among the most cost-effective life-saving interventions. In addition, vaccines have been linked with reduced stunting and improved health and other outcomes in later life. However, evidence on such long-term benefits remain inadequate. In this study, we examined the associations between the initiation and implementation of the Universal Immunization Programme (UIP) in India and schooling attainment among adults. We obtained district-level data on the rollout of the UIP in 1985-1990 and matched those with data from the National Family Health Survey of India, 2015-2016. Adults who were born in the five years before and after the rollout period (1980-1995) and always lived in the same location were included in the analysis (n=109,908). We employed household, village or city ward, district, and state fixed-effects linear regression models, which incorporated a wide range of socioeconomic and demographic indicators and community-level infrastructure, amenities, and access to healthcare. We compared schooling attainment in years among individuals who were born during or after the UIP was implemented in their districts (intervention group) with those who were born before UIP implementation (control group). In household fixed-effects analysis, intervention group adults attained 0.18 (95% confidence interval [CI]: 0.02, 0.33; p<0.05) more schooling grades as compared with control group adults from the same household. In village or city ward, district, and state fixed-effects analysis, intervention group adults attained 0.23 (95% CI: 0.13, 0.32; p<0.001), 0.29 (95% CI: 0.19, 0.38; p<0.001), and 0.25 (95% CI: 0.1, 0.39; p<0.01) additional schooling grades, respectively, compared to the control group. In subgroup analyses, positive associations between UIP implementation and schooling grades were observed among women and among rural, urban, and richer households. Our results support the association of vaccines with improved school attainment.
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Affiliation(s)
- Arindam Nandi
- Center for Disease Dynamics, Economics & Policy, 1400 Eye St. NW, Suite 500, Washington, DC, 20005, USA.
| | - Santosh Kumar
- Department of Economics and International Business, College of Business Administration, Sam Houston State University, SHB 237F, Huntsville, TX, 77340, USA.
| | - Anita Shet
- Johns Hopkins Bloomberg School of Public Health, 415 N. Washington Street, Baltimore, MD, 21231, USA.
| | - David E Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building I 12th Floor, Suite 1202, Boston, MA, 02115, USA.
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, B-25, Lajpat Nagar II, New Delhi, Delhi 110024, India; Princeton Environmental Institute, Princeton University, Princeton, NJ, 08544, USA.
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Meshram P, Ratta A. Study of determinants of immunization status among under-five children attending OPD in a rural health center of the tertiary health care institute. J Family Med Prim Care 2020; 9:2724-2729. [PMID: 32984115 PMCID: PMC7491797 DOI: 10.4103/jfmpc.jfmpc_387_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/25/2020] [Accepted: 05/08/2020] [Indexed: 11/04/2022] Open
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