Adult Vaccination Research Articles

Information networks of healthcare professionals in Europe on older adult vaccines: Network analysis

Abstract Background and objectives Healthcare professionals (HCP) have a key role in raising awareness and informing older adult patients about vaccines. However, HCPs are sometimes unaware of existing vaccines or have little knowledge on them. This study aimed to identify the information flows within HCP networks and to find out which HCPs play a key role in interprofessional information transfer. Methods An online questionnaire was distributed in Hungary (HU), Italy (IT), the Netherlands (NL) and France (FR) among HCPs, such as general practitioners (GP), medical specialists (MS), public health physicians (PHP), pharmacists, specialists elderly care (SEC) and nurses. The questionnaire included a case study in which a new vaccine for older adults was about to be made available. HCPs were asked whom they would contact for additional information and by whom they would be contacted on their turn, to reveal the information flow. Data were analyzed using social network analysis, comparing the results between countries. Results Preliminary results show the top three information providers. These were identical for NL and IT, with the MS being contacted by the highest number of different HCP-types, followed by the GP and PHP. FR and HU had GP ranked first and MS second. The PHP ranked also third in HU, but in FR it was the geriatrician instead. The main requesters of information were pharmacists (IT, HU), GPs (NL) and community nurses (FR). Hospital nurses (IT, FR), SEC (NL) and GPs (HU) ranked second on the number of HCP-types they would contact for information on a new vaccine. Conclusions In each country GPs and MS were the most important information providers in the HCP network when a new vaccine is introduced. Main information requesters varied per country and were pharmacists, GPs, nurses, and SEC. Thus, GPs were both main information providers and requesters (NL, HU). Key messages • Our study identified the HCP-(information)network regarding (new) vaccines for older adults. GPs and MS are the main providers of information, while pharmacists, nurses, and GPs are main requesters. • Identifying the HCPs in the information network makes it possible to specifically target key HCPs and to provide them with tailormade information on new vaccines.

Experiences of catch-up vaccination among adult migrants in the UK: An in-depth interview study

Abstract WHO's Immunization Agenda 2030 emphasises equitable access to vaccination across the life course, including migrants who may have missed childhood vaccinations due to disrupted healthcare systems or differing vaccination schedules. Uptake of adult catch-up vaccination is thought to be poor in the UK, but limited evidence exists to explain this. In-depth semi-structured interviews were carried out across two studies with different adult migrant populations on views and experiences around vaccination. Study 1 recruited those resident <10 years in the UK from a range of backgrounds (remote interviews, 09/2020-01/2022, REC2020.0058) and Study 2 (in-person, 01/2022-03/2022, REC2021.0128) engaged Congolese and Angolan migrants. Interviews were conducted in English, Lingala or French and were audio-recorded, transcribed, and analysed through qualitative content analysis in NVivo 12. 71 participants were interviewed (mean age 43.6 [SD:12.4], 69% female, mean 9.5 [SD:7] yrs in UK). Most reported having never been offered or asked about vaccination history in the UK. Participants more often reported being offered seasonal or selective vaccinations (flu [n = 20], travel-related [n = 8], pregnancy-related [pertussis, n = 7]) compared to catch-up vaccines (MMR (n = 3), DTP (n = 3)) in the UK. Generally, participants were not aware of catch-up vaccination but viewed it mostly positively. Concerns included side effects, barriers to attending primary care facilities, and vaccination fatigue. Trust was an important factor in vaccination decisions, and participants expressed varying levels of trust towards healthcare professionals’ recommendations and the NHS. There is a need to increase opportunities for catch-up vaccination in primary care by incentivisation of catch-up vaccination and education of healthcare professionals. Low trust and concerns around safety exist in some migrant groups, for which tailored information campaigns or community-led interventions could be developed. Key messages • There is a need to increase opportunities for catch-up vaccination in primary care. • Low trust and concerns around safety exist in some migrant groups, for which tailored information campaigns or community-led interventions could be developed.

Roll-out of a universal childhood COVID-19 vaccine programme for 12-15 year olds in Northern Ireland

Abstract On 3rd September 2021 the UK Chief Medical Officers (CMOs) jointly published a recommendation that all children aged 12-15 years be offered the COVID-19 vaccine. They concluded that, further to the minimal advantage at individual level for this age group, vaccination would likely help reduce transmission within schools, thus providing a sufficient extra advantage necessary to introduce the programme. In recommending this to Ministers, UK CMOs recognised that the overwhelming benefits of vaccination for adults were not as clear-cut for young people aged 12-15. Children, young people and their parents would need to understand potential benefits, potential side effects and the balance between them. The roll out of the programme had to be undertaken at pace. In NI it was decided that the school setting would be the optimum delivery location as it maximises uptake and reduces inequalities in uptake. A multi-agency project implementation group was formed. The vaccine programme was delivered between October-December 2021, and it brought unique challenges, including; safety concerns around a new vaccine; delays in policy announcements; creation of public and professional resources with complex evidence; anti-vax sentiment and security issues; scale and pace of rollout; and communication with multiple stakeholders. Engagement with schools and teaching unions was crucial, with bespoke support resources developed to aid this. This unique implementation process highlighted the success of the existing school-based vaccine delivery model in NI. It provided opportunities to work closely with education colleagues, and to develop innovative materials for communication of balanced public health messages to a variety of audiences. It also presented unique challenges such as anti-vax discourse and concern around vaccine side-effects. It is unclear if these challenges led to a lower uptake than seen in other school-based vaccine programmes (40.6%). Key messages • The implementation of the COVID-19 vaccine in children aged 12-15 years presented unique challenges however the school-based delivery model was deemed a success. • Further investigation into the uptake is warranted.

Adult Vaccination Unit Experience: City Hospital Model

Adult Vaccination Unit Experience: City Hospital Model

Willingness to receive Herpes Zoster vaccination among adults and older people: A cross sectional study in Italy

The objective of this study was to explore the Herpes Zoster (HZ) knowledge and the willingness to receive the HZ vaccination in adults and older people in Italy. The study was conducted on a sample of patients aged ≥65 years and over 50 years with chronic conditions who went to the clinics of general practitioners (GPs) in Campania region, Italy. Data was collected with a questionnaire administered through an interview. Multivariate logistic regression analysis was performed. 427 participants (83.2 %) had heard about HZ infection and correctly knew the main symptoms of the HZ disease, and 196 of them (45.9 %) were aware of the main complications of the infection, such as post-Herpetic Neuralgia (NPE) and Herpes Zoster ophthalmicus (HZO). Only 61 participants (11.8 %) had heard of the availability of a vaccination against HZ in Italy and 39 of them (63.9 %) knew that the vaccination is recommended in at-risk patients aged at least 50 years and for adults aged ≥65 years. 137 participants (26.6 %) had a positive attitude toward the willingness to receive the HZ vaccination. Participants aged 50–64 years, those who have more than one chronic disease, those who have received at least one recommended vaccination, those who had a positive attitude on the usefulness of HZ vaccination, and those who feel the need to receive additional information about HZ vaccination were more likely to have a positive attitude toward the willingness to receive the HZ vaccination. It is needed to implement effective strategies to improve HZ vaccination coverage in order to protect especially frail patients from the most serious complications of the disease.

Comparative Cost-Effectiveness Analysis of Respiratory Syncytial Virus Vaccines for Older Adults in Hong Kong.

Two respiratory syncytial virus (RSV) vaccines (AREXVY® and ABRYSVO®) were recently approved for older adults in the US. This study aimed to evaluate the cost-effectiveness of AREXVY® and ABRYSVO® from the Hong Kong public healthcare provider's perspective. A two-year decision-analytical model was developed to examine the outcomes of a single RSV vaccination (AREXVY® or ABRYSVO®) compared to no vaccination. Primary outcomes included RSV-related health outcomes, direct medical costs, quality-adjusted life-year (QALY) loss, and incremental cost per QALY (ICER). RSV vaccines are not yet marketed in Hong Kong, base-case analysis, therefore, benchmarked US RSV vaccine prices at 4 levels (25%, 50%, 75%, 100%). AREXVY® and ABRYSVO® (versus no vaccination) gained 0.000568 QALY and 0.000647 QALY, respectively. ICERs of ABRYSVO® (26,209 USD/QALY) and AREXVY® (47,485 USD/QALY) were lower than the willingness-to-pay threshold (49,594 USD/QALY) at 25% US vaccine price. The RSV attack rate was a common influential factor at all vaccine price levels. The probabilities of AREXVY® and ABRYSVO® to be most cost-effective were 0.10% and 97.68%, respectively, at 25% US vaccine price. Single vaccination of ABRYSVO® or AREXVY® for older adults appears to gain QALYs over 2 years in Hong Kong. The cost-effectiveness of AREXVY® and ABRYSVO® is subject to vaccine price and RSV attack rate.

Assessment of adherence to routine vaccination schedules in oncology patients.

Patients diagnosed with cancer are at an increased risk of infection. Vaccines remain one of the most critical public health strategies in limiting infectious diseases, with a heightened importance in cancer patients. Data across the general US population indicates that vaccine adherence rates are suboptimal across all adult vaccine schedules. This study aims to define vaccine adherence rates within the oncology population. This retrospective cohort study includes adult patients with a new cancer diagnosis. Vaccine administrations for COVID-19 (SARS-CoV-2), influenza, pneumococcal, tetanus/diphtheria/pertussis (TDaP), herpes zoster (RZV), human papillomavirus (HPV), and hepatitis B (hepB) were assessed. The primary outcome was complete vaccine adherence. Two hundred and eighty-three oncology patients were included. The median age at diagnosis was 63 years old, and most subjects were females (60%). The two most common malignancies were gastrointestinal and breast cancer at 26.5% and 15.2%, respectively. Suboptimal vaccine adherence rates were observed across the entire oncology population. Complete adherence was observed in only 1.4% of patients. Vaccine specific adherence rates were as follows, SARS-CoV-2: 38.9%; influenza: 11.4%; pneumococcal: 12.7%; TDaP: 13.1%; RZV: 3.5%; HPV: 0%; and hepB: 34%. Among the vaccine schedules assessed, SARS-CoV-2 vaccination rates were the highest with 38.9% of patients being fully adherent and 73% receiving at least one dose. Lower vaccine adherence rates were observed in oncology patients compared to currently published rates. Providers and pharmacists can play a role in assessing and counseling patients on the importance of vaccine adherence before chemotherapy is initiated and after a remission is obtained.

Comparative Analysis of IgG Antibody Titers Induced by Three Different SARS-COV-2 Vaccines in Healthy Adults of Pakistan.

Covid-19 is a contagious disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). In order to control this disease, different effective vaccines have been developed. This study is an attempt to determine the strength and duration of immunogenicity of various established vaccines. This cross-sectional, observational study was conducted to compare the efficacy of three different vaccines; Pfizer BNT 162b2, Sinovac, and CanSino, respectively, after a duration of 3months, in the healthy adult population of Pakistan. In this study 371 healthy participants (aged 12-25years) of both genders (male and females) were enrolled. The blood sample was drawn 90days after the complete vaccination process. The humoral response (IgG) was analyzed by electrochemiluminescence immunoassay (ECLIA) method with Roche Anti-SARS-CoV-2 S analyzer kit. Descriptive statistical analysis was performed using IBM SPSS statistics version 22 and P < 0.05 was considered significant. The mean antibody titer in Pfizer-group was 12,536.35U/mL, followed by 5168.68U/mL in the Sinovac group and 4284.32U/mL in the CanSino group. The Pfizer-group showed gender-specific significant differences, with higher antibody levels in males (P = 0.006) as compared to Sinovac and Cansino groups. The Mean IgG antibody levels of the Pfizer-vaccinated group were significantly higher than the Sinovac-vaccinated group and the CanSino-vaccinated group (P = 0.000, each). However, the mean difference between the Sinovac-vaccinated group and the CanSino-vaccinated group was not significant. Vaccine-induced seropositivity was found in the whole cohort. The mRNA-based vaccine produced the highest immune response, and thus, it is recommended for future application.

Hesitance and Misconceptions about the Annual Influenza Vaccine among the Saudi Population Post-COVID-19.

(1) Background: Vaccination is a cornerstone of public health strategy for mitigating the morbidity and mortality associated with seasonal influenza. However, vaccine hesitancy and misconceptions pose significant barriers to this effort, particularly in the context of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the transfer of COVID-19 vaccine hesitancy to the influenza vaccine and to identify misconceptions about the influenza vaccine among the Saudi population in the post-COVID-19 era. (2) Methods: A web-based, cross-sectional study was conducted between February and June 2023 using a questionnaire adapted from the Adult Vaccine Hesitancy Scale (aVHS). The questionnaire was disseminated to 589 Saudi residents, aged 18 and above, with access to digital devices. Data were analyzed via logistic regression analysis to determine the associations between vaccine hesitancy, knowledge of influenza, and baseline characteristics. (3) Results: This study found that 37.7% of respondents exhibited vaccine hesitancy, while 56.7% demonstrated good knowledge about influenza. There was a significant relationship between nationality and vaccine hesitancy (p-value > 0.05), with non-Saudi respondents exhibiting higher hesitancy. Logistic regression analysis revealed significant associations between vaccine hesitancy, age, and nationality. Meanwhile, participants with higher educational qualifications showed greater knowledge about influenza. (4) Conclusions: The findings highlight an important crossover of COVID-19 vaccine hesitancy to influenza vaccines. This study underscores the need for targeted public health interventions to address misconceptions about the influenza vaccine, particularly among certain demographic groups, in order to improve influenza vaccine uptake in the post-COVID era.

Modification and Validation of the Vaccine Hesitancy Scale for Turkish Adult Vaccination.

Background and Purpose: For public health, it is important to investigate vaccine hesitancy, determine populations reluctant for vaccines, and investigate barriers and facilitators for vaccination in these groups. This study aims to modify and validate the Vaccine Hesitancy Scale specific to adults in Turkish society. Methods: The study, which was designed as a methodological and survey type, was conducted using a Google questionnaire with 720 participants who met the inclusion criteria with a convenient sampling method. Results: After factor and reliability analysis, a 2-factor, 10-item scale with an acceptable and perfect range of fit index values emerged. It has been observed that individuals who are young, single, do not have children, have vaccine allergy, and do not believe that the vaccine will protect the society are adversely affected by the environment, and those who do not have COVID-19 and flu have a high level of hesitancy to vaccine. Conclusions: The Vaccine Hesitancy Scale is a valid and reliable tool to detect vaccine hesitation in adults in Turkish society.

Phase II, Safety and Immunogenicity of RAZI Cov Pars (RCP) SARS Cov-2 Vaccine in Adults Aged 18–70 Years; A Randomized, Double-Blind Clinical Trial

BackgroundThis study explores the safety and immunogenicity of the Razi-Cov-Pars (RCP) SARS Cov-2 recombinant spike protein vaccine. MethodIn a randomized, double-blind, placebo-controlled trial, adults aged 18–70 were randomly allocated to receive selected 10 µg/200 µl vaccine strengths or placebo (adjuvant). It included two intramuscular injections at days 0 and 21, followed by an intranasal dose at day 51. Immediate and delayed solicited local and systemic adverse reactions after each dose up to a week, and specific IgG antibodies against SARS Cov-2 spike antigens two weeks after the 2nd dose were assessed as primary outcomes. Secondary safety outcomes were abnormal laboratory findings and medically attended adverse events (MAAE) over six months follow up. Secondary immunogenicity outcomes were neutralizing antibody activity and cell-mediated immune response. ResultBetween May 27th and July 15th, 2021, 500 participants were enrolled. Participants' mean (SD) age was 37.8 (9.0), and 67.0 % were male. No immediate adverse reaction was observed following the intervention. All solicited local and systemic adverse events were moderate (Grade I-II). Specific IgG antibody response against S antigen in the vaccine group was 5.28 times (95 %CI: 4.02–6.94) the placebo group with a 75 % seroconversion rate. During six months of follow-up, 8 SAEs were reported, unrelated to the study intervention. The participants sustained their acquired humoral responses at the end of the sixth month. The vaccine predominantly resulted in T-helper 1 cell-mediated immunity, CD8+ cytotoxic T-cell increase, and no increase in inflammatory IL-6 cytokine. ConclusionRCP vaccine is safe and creates strong and durable humoral and cellular immunity. Trial registration(IRCT20201214049709N2).

Vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake among adults in Greece

ObjectivesInsufficient adult vaccination coverage rates remain an international challenge. This nationwide study aimed at exploring vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake, following the recommendations of the National Immunization Program for adults. Study designThis was a multicenter, mixed-methods study conducted at 23 primary care units in six different regions of Greece. MethodsA pretested questionnaire was administered to three randomly selected adults who visited each practice daily for 30 consecutive working days. ResultsAmong the 1571 participants, vaccination coverage for influenza in the high-risk groups was 55%, 36% for pneumococcal disease, 12% for herpes zoster (HZ), 21% for tetanus, 33% for measles, and 11% for hepatitis B. Perception of low susceptibility to disease due to good health status, concerns about side-effects and vaccines' efficacy, and mistrust in pharmaceutical companies were among common factors associated with the vaccines uptake. The strongest factor associated with the participants’ vaccination status was their doctor's recommendation (odds ratio [95% confidence interval] influenza: 6.06 [4.52–8.14], pneumococcal disease: 15.73 [10.98–22.52], HZ: 17.01 [9.05–31.96], tetanus: 23.93 [16.20–35.35], measles: 33.47 [16.85–66.47], and hepatitis B: 73.92 [17.47–312.74]). Being well-informed about each vaccine was also a predictor of its uptake. ConclusionsVaccination coverage was suboptimal and especially low in tetanus, HZ, and hepatitis B immunization. Person-centered approach, with provision of appropriate information about vaccines' safety and efficacy, responding to each patient's needs, as well as physicians' strong recommendation for vaccination are considered crucial to advocate against the spread of vaccine misinformation and increase vaccination coverage.

A Phase 3, randomized, non-inferiority study of a heterologous booster dose of SARS CoV-2 recombinant spike protein vaccine in adults

Due to waning immunity following primary immunization with COVID-19 vaccines, booster doses may be required. The present study assessed a heterologous booster of SII-NVX-CoV2373 (spike protein vaccine) in adults primed with viral vector and inactivated vaccines. In this Phase 3, observer-blind, randomized, active controlled study, a total of 372 adults primed with two doses of ChAdOx1 nCoV-19 (n = 186) or BBV152 (n = 186) at least six months ago, were randomized to receive a booster of SII-NVX-CoV2373 or control vaccine (homologous booster of ChAdOx1 nCoV-19 or BBV152). Anti-S IgG and neutralizing antibodies (nAbs) were assessed at days 1, 29, and 181. Non-inferiority (NI) of SII-NVX-CoV2373 to the control vaccine was assessed based on the ratio of geometric mean ELISA units (GMEU) of anti-S IgG and geometric mean titers (GMT) of nAbs (NI margin > 0.67) as well as seroresponse (≥ 2 fold-rise in titers) (NI margin −10%) at day 29. Safety was assessed throughout the study period. In both the ChAdOx1 nCoV-19 prime and BBV152 prime cohorts, 186 participants each received the study vaccines. In the ChAdOx1 nCoV-19 prime cohort, the GMEU ratio was 2.05 (95% CI 1.73, 2.43) and the GMT ratio was 1.89 (95% CI 1.55, 2.32) whereas the difference in the proportion of seroresponse was 49.32% (95% CI 36.49, 60.45) for anti-S IgG and 15% (95% CI 5.65, 25.05) for nAbs on day 29. In the BBV152 prime cohort, the GMEU ratio was 5.12 (95% CI 4.20, 6.24) and the GMT ratio was 4.80 (95% CI 3.76, 6.12) whereas the difference in the proportion of seroresponse was 74.08% (95% CI 63.24, 82.17) for anti-S IgG and 24.71% (95% CI 16.26, 34.62) for nAbs on day 29. The non-inferiority of SII-NVX-CoV2373 booster to the control vaccine for each prime cohort was met. SII-NVX-CoV2373 booster showed significantly higher immune responses than BBV152 homologous booster. On day 181, seroresponse rates were ≥ 70% in all the groups for both nAbs and anti-S IgG. Solicited adverse events reported were transient and mostly mild in severity in all the groups. No causally related SAE was reported. SII-NVX-CoV2373 as a heterologous booster induced non-inferior immune responses as compared to homologous boosters in adults primed with ChAdOx1 nCoV-19 and BBV152. SII-NVX-CoV2373 showed a numerically higher boosting effect than homologous boosters. The vaccine was also safe and well tolerated.

Comparison of pneumococcal immunogenicity elicited by the PCV13 and PCV15 vaccines in adults 18 through 49 years of age

AimPneumococcal conjugate vaccines (PCV13, PCV15, PCV20) effectively target the capsular polysaccharides of the most common disease-causing Streptococcus pneumoniae serotypes. In this short communication, we analyzed healthy participants who received PCV13 and PCV15 vaccines as part of a recently concluded exploratory clinical trial and report antibody responses to the 13 shared serotypes (1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) as well as functional OPA responses to serotype 3. MethodsSera from 87 adult participants (18 through 49 years of age) randomized to receive either PCV13 or PCV15 were collected (n = 46 or n = 41, respectively), from 17 study centers in the US. IgG concentrations of the 13 shared serotypes and serotype 3-specific OPA titers were analyzed before and 1 month after vaccination using internally validated assays. ResultsAt 1 month after vaccination, IgG GMCs of the 13 shared serotypes in PCV13 were similar to those for PCV15. Specifically, serotype 3 OPA GMTs and 95% CIs were similar 1 month after vaccination for PCV13 (62.9 [48.9, 80.9]) and PCV15 (71.1 [50.9, 99.2]). ConclusionIn healthy participants who received either PCV13 or PCV15, similar serotype-specific responses were observed between all shared serotypes when a uniform validated internal assay was used. Of note, data from this study suggest that both vaccines induce similar functional antibody responses against pneumococcal serotype 3.

Efficacy and feasibility of SMS m-Health for the detection of adverse events following immunisation (AEFIs) in resource-limited setting-The Zimbabwe stimulated telephone assisted rapid safety surveillance (Zm-STARSS) randomised control trial

IntroductionThe mHealth active participant centred (MAPC) adverse events following immunisation (AEFI) surveillance is a promising area for early AEFI detection resulting in risk minimisation. Passive (spontaneous) AEFI surveillance is the backbone for vaccine pharmacovigilance, but has inherent drawbacks of under reporting, and requires strengthening with active surveillance methods. AimThe Zimbabwe stimulated telephone assisted rapid safety surveillance (Zm-STARSS) randomised controlled trial (RCT) sought to evaluate the efficacy and feasibility of AEFI detection using a short message service (SMS) and computer assisted telephone interview (CATI) approach. MethodA multicentre Zm-STARSS RCT enrolled consented adult vaccinees or parents or guardians of children receiving vaccines, including COVID-19 vaccines, at study vaccination clinics. At enrolment study participants were randomised to either SMS-CATI group or control group. SMS prompts were sent on days 0–2 and 14 post-vaccination to SMS-CATI group to ascertain if a medically attendance or attention due to an Adverse event following immunisation (AEFI) had occurred. However, no SMSs were sent to the control group. SMS-CATI group who responded “Yes” to SMS prompts were interviewed by research healthcare workers (RHCWs) who completed a CATI to determine if an AEFI had occurred whilst an AEFI in control group was determined from passive AEFI reporting channels. The primary study outcome was the AEFI detection rate in the SMS-CATI group compared to the control group. ResultsA total of 4560 participants were enrolled after signed informed consent, all were encouraged to report AEFIs and randomised automatically on 1:1 basis into two arms SMS CATI intervention group (n = 2280) and a control passive AEFI surveillance group (n = 2280) on day 0. A total of 704 (31 %) participants responded to the SMS prompts, with 75 % (528/704) indicating “No” and 25 % (176/704) reporting “Yes” to seeking medical attention or attendance post-immunisation. 69 % (121/176) completed a CATI survey but in only 36 % (44/121) was the AEFI confirmed. There were no AEFIs reported in control group participants. The detection rate of a AEFI associated with medically attendance or attention using the SMS-CATI methodology was 2 % (44/2280) on an intention to treat cohort. ConclusionDespite the low SMS response and CATI completion rate, we demonstrated that Zm-STARSS SMS system improves AEFI detection compared to passive AEFI surveillance. We recommend that this and similar approaches are explored further using cost-effective multi-channel digital approaches for holistic pharmacovigilance to improve AEFI detection in Low Middle-Income Countries (LMICs) for all vaccines.

Racial, Ethnic, and Geographic Disparities in Immunization Rates Among Patients With Inflammatory Bowel Disease.

Racial and ethnic disparities exist in the treatment of IBD. These disparities exist in adult vaccine uptake among the general population and may extend to patients with IBD. The primary aim of this study was to determine whether racial, ethnic, or geographic disparities existed in influenza vaccine uptake among patients with IBD. We performed a multicenter, retrospective cohort study evaluating adult vaccine uptake among patients with IBD seen at two tertiary referral centers between September 2019 and February 2020. The primary outcome was to determine if racial/ethnic and geographic disparities existed in influenza vaccine uptake for the two prior seasons. Our secondary outcomes were to determine if disparities existed for pneumococcal, zoster, or hepatitis B vaccines. Among the 2453 patients who met the inclusion criteria, most identified as non-Hispanic White (89.9%), were on immunosuppressive therapy (74.5%), and received the influenza vaccine in both seasons (56.0%). Older age (prevalence ratio (PR) 0.98; 95% confidence interval (95%CI) 0.98-0.99; P < .001) and non-Hispanic White patients (PR 0.76, 95%CI 0.59-0.98, P < 0.03) were significantly more likely to be immunized. Black patients (PR 1.37; 95%CI 1.18-1.59; P < .001) and those living in underserved geographic areas (PR 1.35; 95%CI 1.17-1.56; P < 0.001) were less likely to be immunized. Racial/ethnic and geographic disparities were identified for pneumococcal, zoster, and hepatitis B vaccine uptake. Racial and ethnic vaccination uptake disparities exist among patients with IBD; patients from medically underserved areas are also vulnerable to these disparities Studies identifying patient, provider, and system-level opportunities to address these disparities are needed.

Should Every Medical College have a Dedicated Vaccination Clinic?

Vaccination has been proven to be one of the most efficient and affordable health interventions available worldwide to prevent diseases and deaths. Global vaccination services had good coverage during 2022 yet 20.5 million children are still missing [1] their life saving vaccines. Establishing a dedicated vaccination clinic especially in the private institutions could be one solution to further improve childhood as well as adult vaccination coverage.

Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023

Respiratory syncytial virus (RSV) is a cause of severe respiratory illness in older adults. In May 2023, the Food and Drug Administration approved the first vaccines for prevention of RSV-associated lower respiratory tract disease in adults aged ≥60 years. Since May 2022, the Advisory Committee on Immunization Practices (ACIP) Respiratory Syncytial Virus Vaccines Adult Work Group met at least monthly to review available evidence regarding the safety, immunogenicity, and efficacy of these vaccines among adults aged ≥60 years. On June 21, 2023, ACIP voted to recommend that adults aged ≥60 years may receive a single dose of an RSV vaccine, using shared clinical decision-making. This report summarizes the body of evidence considered for this recommendation and provides clinical guidance for the use of RSV vaccines in adults aged ≥60 years. RSV vaccines have demonstrated moderate to high efficacy in preventing RSV-associated lower respiratory tract disease and have the potential to prevent substantial morbidity and mortality among older adults; postmarketing surveillance will direct future guidance.

Immunogenicity of an AS01-adjuvanted respiratory syncytial virus prefusion F (RSVPreF3) vaccine in animal models

Respiratory syncytial virus (RSV) causes a high disease burden in older adults. An effective vaccine for this RSV-primed population may need to boost/elicit robust RSV-neutralizing antibody responses and recall/induce RSV-specific T cell responses. To inform the selection of the vaccine formulation for older adults, RSVPreF3 (RSV fusion glycoprotein engineered to maintain the prefusion conformation) with/without AS01 adjuvant was evaluated in mice and bovine RSV infection-primed cattle. In mice, RSVPreF3/AS01 elicited robust RSV-A/B-specific neutralization titers and RSV F-specific polyfunctional CD4+ T cell responses exceeding those induced by non-adjuvanted RSVPreF3. In primed bovines, RSVPreF3/AS01 tended to induce higher pre-/post-vaccination fold-increases in RSV-A/B-specific neutralization titers relative to non-adjuvanted and Alum-adjuvanted RSVPreF3 formulations, and elicited higher RSV F-specific CD4+ T cell frequencies relative to the non-adjuvanted vaccine. Though AS01 adjuvanticity varied by animal species and priming status, RSVPreF3/AS01 elicited/boosted RSV-A/B-specific neutralization titers and RSV F-specific CD4+ T cell responses in both animal models, which supported its further clinical evaluation as prophylactic candidate vaccine for older adults.

Health and economic outcomes of 20-valent pneumococcal conjugate vaccine compared to 15-valent pneumococcal conjugate vaccine strategies for adults in Greece.

Higher valency pneumococcal conjugate vaccines (PCVs) are expected to improve protection against pneumococcal disease through coverage of additional serotypes. The aim of the present study was to evaluate the cost-effectiveness of 20-valent pneumococcal conjugate vaccine (PCV20) compared to 15-valent pneumococcal conjugate vaccine (PCV15) alone or followed by 23-valent polysaccharide vaccine (PPV23) for adults in Greece. A published Markov model was adapted to simulate lifetime risk of clinical and economic outcomes from the public payer's perspective. The model population was stratified based on age and risk profile (i.e., low, moderate, or high-risk of developing pneumococcal disease). Epidemiologic parameters, serotype coverage and vaccines' effectiveness were based on published literature, while direct medical costs (prices €, 2022) were obtained from official sources. Main model outcomes were projected number of invasive pneumococcal disease (IPD) and all-cause non-bacteremic pneumonia (NBP) cases and attributable deaths, costs and quality-adjusted life-years (QALY) for each vaccination strategy. Sensitivity analyses were performed to ascertain the robustness of model results. Over the modeled time horizon, vaccination with PCV20 compared to PCV15 alone or PCV15 followed by PPV23 prevents an additional 747 and 646 cases of IPD, 10,334 and 10,342 cases of NBP and 468 and 455 deaths respectively, resulting in incremental gain of 1,594 and 1,536 QALYs and cost savings of €11,183 and €48,858, respectively. PSA revealed that the probability of PCV20 being cost-effective at the predetermined threshold of €34,000 per QALY gained was 100% compared to either PCV15 alone or the combination of PCV15 followed by PPV23. PCV20 is estimated to improve public health by averting additional pneumococcal disease cases and deaths relative to PCV15 alone or followed by PPV23, and therefore translates to cost-savings for the public payer. Overall results showed that vaccination with PCV20 was estimated to be a dominant vaccination strategy (improved health outcomes with reduced costs) over PCV15 alone or followed by PPV23 for prevention of pneumococcal disease in adults in Greece.