Assess Vaccination Coverage Research Articles

Promoting vaccination for newly arrived migrants: a multistakeholder collaboration pilot

Abstract Access to vaccinations for Newly Arrived Migrants (NAMs) is a critical public health issue. In the context of the project ‘Increased Access for Newly Arrived Migrants-AcToVax4NAM’ (Grant No. 101018349, 3rd EU Health Program), DPHID-SAP and GLOB-ISS conducted a pilot aimed at developing and testing a system pathway to promote and vaccinate NAMs. The pilot began with the creation of a team between researchers from DPHID-SAP and GLOB-ISS, professionals from two services of the Local Health Authority and from a first reception centre (CAS) in Rome area. An integrated knowledge translation approach was used, which facilitated the collaborative development of strategies and actions of the pilot. The team then reached out to other ‘professionals FOR health’ involved in the vaccination process of NAMs, i.e. physicians from Temporarily Present Foreigners (STP) outpatient clinics, General Practitioners and Pediatricians. Between July 2023 and April 2024, four actions were developed. 1) analysis of the current access of NAMs to vaccination services and the subsequent development of a contextualized pathway to facilitate vaccinations for NAMs, including catch-up strategies; 2) identification of informed consent and other materials needed to be included in the pathway; subsequently, translated in 10 languages; 3) implementation of vaccine literacy session for CAS staff and NAMs; 4) improvement of immunization information flows to enable assessment of vaccination coverage of NAMs. To evaluate the pilot, the vaccination rate observed during the pilot (January-April 2024) was compared to that occurring in 2023, showing a 36.5-fold increase in the vaccination rate (4 x 100 person-year in 2023 and 155 x 100 p/y in 2024; RR = 36.5 (95%CI 14.6-117.6). The pilot highlighted that a research collaborative approach among various actors facilitated the access to vaccination for NAMs and was an opportunity to turn knowledge into action. Key messages • It is essential to ensure equitable vaccination coverage to reduce under-immunized groups. • Access to vaccination is a key element of the right to health and for collective health protection and it should be a shared responsibility.

Comprehensive Spatial-Temporal and Risk Factor Insights for Optimizing Livestock Anthrax Vaccination Strategies in Karnataka, India.

Anthrax, a zoonotic disease affecting both livestock and humans globally, is caused by Bacillus anthracis. The objectives of this study were the following: (1) to identify environmental risk factors for anthrax and use this information to develop an improved predictive risk map, and (2) to estimate spatial variation in basic reproduction number (Ro) and herd immunity threshold at the village level, which can be used to optimize vaccination policies within high-risk regions. Based on the anthrax incidences from 2000-2023 and vaccine administration figures between 2008 and 2022 in Karnataka, this study depicted spatiotemporal pattern analysis to derive a risk map employing machine learning algorithms and estimate Ro and herd immunity threshold for better vaccination coverage. Risk factors considered were key meteorological, remote sensing, soil, and geographical parameters. Spatial autocorrelation and SaTScan analysis revealed the presence of hotspots and clusters predominantly in the southern, central, and uppermost northern districts of Karnataka and temporal cluster distribution between June and September. Factors significantly associated with anthrax were air temperature, surface pressure, land surface temperature (LST), enhanced vegetation index (EVI), potential evapotranspiration (PET), soil temperature, soil moisture, pH, available potassium, sulphur, and boron, elevation, and proximity to waterbodies and waterways. Ensemble technique with random forest and classification tree models were used to improve the prediction accuracy of anthrax. High-risk areas are expected in villages in the southern, central, and extreme northern districts of Karnataka. The estimated Ro revealed 11 high-risk districts with Ro > 1.50 and respective herd immunity thresholds ranging from 11.24% to 55.47%, and the assessment of vaccination coverage at the 70%, 80%, and 90% vaccine efficacy levels, all serving for need-based strategic vaccine allocation. A comparison analysis of vaccinations administered and vaccination coverage estimated in this study is used to illustrate difference in the supply and vaccine force. The findings from the present study may support in planning preventive interventions, resource allocation, especially of vaccines, and other control strategies against anthrax across Karnataka, specifically focusing on predicted high-risk regions.

Analysis of health claims data on vaccination coverage in older adults in Bavaria, Germany: Influenza, pneumococcus and herpes zoster

BackgroundVaccination is essential, especially in older adults whose immune system function declines with age. The COVID-19 pandemic and its associated lockdowns temporarily disrupted routine vaccination services. We aimed to assess vaccination coverage for Influenza, Pneumococcus, and Herpes zoster among older adults in Bavaria over time and investigate potential pandemic effects on these rates. MethodsBased on health claims data from the Bavarian Association of Statutory Health Insurance Physicians (KVB), we estimated the percentage of adults aged 60 years and older vaccinated following the German Standing Committee on Vaccinations (STIKO) recommendation for Influenza (2012−2021), Pneumococcus (2017–2021) and Herpes zoster (2019–2021), stratified by sex and 10-year age groups. Using time series regression analysis, we estimated the effect of the pandemic period (2020−2021) on quarterly Influenza and Pneumococcal vaccination rates. ResultsIn the first year of the pandemic (2020), Influenza, Pneumococcus and Herpes zoster coverage in both sexes increased by 9.9, 8.7, and 2.5 percentage points (pp), respectively. In 2021, Influenza coverage decreased by 4.7 pp., while Pneumococcus and Herpes zoster coverage increased by 2.7 and 3.8 pp., respectively. Influenza and Pneumococcal vaccinations showed a seasonal pattern, with vaccinations occurring mainly in the fourth quarter; this pattern was distorted for Pneumococcus during the pandemic. Per the time series regression analysis, Influenza vaccination rates in the fourth quarters of 2020 and 2021 were 7.86 (95 %CI: 5.10–10.62) and 8.87 (95 %CI: 5.80–11.54) pp. higher for males and females, respectively, compared to that of the pre-pandemic period. During the pandemic, the quarterly Pneumococcal vaccination rates increased by 0.68 (95 %CI: 0.19–1.18) pp. in males and 0.80 (95 %CI: 0.30–1.30) pp. in females. ConclusionThe heightened increase in vaccination rates observed in 2020 may have resulted from increased vaccination awareness during the pandemic. As the pandemic effect wanes, more efforts are needed to sustain and increase these vaccination rates.

National Vaccination Coverage Among Adolescents Aged 13-17 Years - National Immunization Survey-Teen, United States, 2023.

Based on safety and efficacy data, vaccinations are the best defense to protect persons and communities from serious vaccine-preventable diseases. The Advisory Committee on Immunization Practices recommends routine vaccination of adolescents aged 11-12 years with three vaccines including tetanus, diphtheria, and acellular pertussis vaccine; quadrivalent meningococcal conjugate vaccine; and human papillomavirus vaccine. CDC analyzed data from the 2023 National Immunization Survey-Teen for 16,658 adolescents aged 13-17 years (born during January 2005-December 2010) to assess vaccination coverage in 2023, recent trends in coverage by birth year, and trends in coverage by eligibility for the Vaccines for Children (VFC) program and birth year. In 2023, coverage with all routine vaccines recommended for adolescents was similar to coverage in 2022. Vaccination coverage among VFC-eligible adolescents was generally stable during the COVID-19 pandemic, except for a decrease in the percentage of VFC-eligible adolescents who were up to date with HPV vaccination by age 13 years among those born in 2010 compared with those born in 2007. Whereas coverage differences were found between VFC-eligible and non-VFC-eligible adolescents before the COVID-19 pandemic, coverage was similar among the most recent birth years in the survey. Providers should make strong recommendations for all routine vaccines and review adolescent vaccination records to verify if adolescents are up to date with all recommended vaccines.

Vaccination Coverage and Predictors of Vaccination among Children Aged 12-23 Months in the Pastoralist Communities of Ethiopia: A Mixed Methods Design.

This study assessed vaccination coverage and its associated factors among children aged 12-23 months in pastoralist Ethiopia. It was conducted in three woredas of the Afar region using a community-based cross-sectional mixed methods design with quantitative and qualitative methods. A total of 413 mothers with children aged 12-23 months participated in the quantitative study via a simple random sampling technique. Logistic regression was used to identify factors associated with vaccination, and thematic analysis techniques were used for qualitative data. The percentage of patients who received full vaccination was 25%. Based on vaccination card observations, the dropout rate from Pentavalent-1 to Pentavalent-3 was found to be 2.9%. Logistic regression analysis revealed significant associations between mothers and caretakers with formal education, those who owned mobile phones, had antenatal care (ANC) visits, and birthed at a health facility with full vaccination. The overall proportion of full immunization is lower than the target set by the World Health Organization (WHO). The findings suggest that programs and policy makers should prioritize improving the access and enrolment of women and caretakers, promoting mobile phone ownership, and encouraging ANC visits and the promotion of health facility deliveries, as these are associated with higher rates of immunization.

Factors influencing vaccine acceptance in pregnancy during the COVID-19 pandemic: A multicenter study from West Bengal, India

ABSTRACT Influenza, COVID-19, tetanus, pertussis and hepatitis B pose increased risk for pregnant women and infants and could be mitigated by maternal immunization. In India Tetanus-diphtheria (Td) and COVID-19 vaccines are recommended during pregnancy, while influenza and tetanus-acellular pertussis-diphtheria (Tdap) vaccines are not. We conducted a multicenter study from November 2021 to June 2022 among pregnant women (n = 172) attending antenatal clinics in three public hospitals in West Bengal, to understand the factors that influence women’s decisions to get vaccinated during pregnancy. Questions assessed vaccination coverage, knowledge, intention and willingness to pay for influenza vaccine, and factors influencing decisions to get Td, influenza, and COVID-19 vaccines. 152/172 (88.4%) women were vaccinated with Td, 159/172 (93%) with COVID-19, 1/172 (0.6%) with influenza, and none with Tdap. 10/168 (6%) had received hepatitis B vaccine (HBV). Community health workers advice was crucial for Td uptake and, the belief of protection from COVID for COVID-19 vaccines. Most women were unaware about Tdap (96%), influenza (75%), and influenza severity during pregnancy and infancy (85%). None were advised for influenza vaccination by healthcare providers (HCP), albeit, 93% expressed willingness to take, and pay INR 100–300 (95% CI: ≤100 to 300–500) [$ 1.3–4.0 (95% CI: ≤1.3, 4–6.7)] for it. Vaccination on flexible dates and time, HCP’s recommendation, proximity to vaccination center, and husband’s support were most important for their vaccination decisions. Women were generally vaccine acceptors and had high uptake of vaccines included in the Universal Immunization Program (UIP). Inclusion of influenza, Tdap, and HBV into UIP may improve maternal vaccine uptake.

Insufficient vaccine coverage and vaccine hesitancy in people living with HIV: A prospective study in outpatient clinics in the Paris region

Vaccine prevention strategies play a crucial role in the management of people living with HIV (PLWH). The aim of this study was to assess vaccination coverage and identify barriers to vaccine uptake in PLWH in the Paris region.A cross-sectional survey was conducted in PLWH in 16 hospitals in the Paris region. The vaccination status, characteristics, opinions, and behaviors of participants were collected using a face-to-face questionnaire and from medical records.A total of 338 PLWH were included (response rate 99.7 %). The median age of participants was 51 years (IQR: 41–58). Vaccination coverage was 77.3 % for hepatitis B (95 % CI: 72.3–81.8 %), 62.7 % for hepatitis A (57.3–67.9 %), 61.2 % for pneumococcal vaccines (55.8–66.5 %), 56.5 % for diphtheria/tetanus/poliomyelitis (DTP) (51.0–61.9 %), 44.7 % for seasonal influenza (39.3–50.1 %), 31.4 % for measles/mumps/rubella (26.4–36.6 %) and 38.5 % for meningococcal vaccine (13.9–68.4 %). The main reason for vaccine reluctance was related to the lack of vaccination proposals/reminders. The overall willingness to get vaccinated was 71.0 % (65.9–75.8 %). In the multivariable analysis, several factors were associated with a higher vaccine uptake; for DTP vaccine: higher education level, having vaccination records, being registered with a general practitioner; for seasonal influenza vaccine: age > 60 years, higher education level, being employed.The overall vaccination coverage was suboptimal. Development of strategies reducing missed opportunity to offer vaccines is needed.

Assessment of Vaccination Coverage Among Measles Cases in Children Aged 10 Months to 5 Years at Civil Hospital Karachi

Background: Measles remains a global health concern, particularly in developing countries, and despite improvements in global vaccination efforts, certain regions, including Pakistan, continue to report cases. This study aims to assess the frequency of vaccinated children among measles cases, shedding light on potential vaccine failure factors. Methodology: A comprehensive analysis was conducted on 139 children diagnosed with measles in an emergency department. The vaccination status of each child was determined through a thorough examination of their vaccination history and available vaccination cards. In cases where records were unavailable, relevant data were meticulously recorded on a standardized Performa. Results: Among the 139 children studied, 30.94% were found to have received vaccinations, and only 35.9% had completed the recommended two-dose schedule. The average age for receiving the first and second doses was 9.6±1.05 months and 15.67±0.82 months, respectively. Conclusion: The findings underscore that a substantial proportion of measles cases occurred in unvaccinated or partially vaccinated children, emphasizing the critical role of complete immunization. However, despite vaccination efforts, many children still contracted the disease, indicating the necessity for further in-depth research in this domain.

Use of private vaccination services by infants in Brazilian municipalities: National Vaccine Coverage Survey 2020.

To characterize the use of private services in infant vaccination and assess vaccination coverage according to the service used. : This was a national vaccination survey conducted in 2020 that estimated the use of private vaccination services and vaccination coverage among infants residing in state capitals and 12 inland municipalities. : Of the 37,801 participants, 25.1% (95%CI 23.2;27.2) used private services at least once, with higher proportions in capitals, larger cities and in the South and Southeast regions. Socioeconomic and demographic differences were identified among families, based on the service used. The coverage for the set of vaccines administered up to 24 months was 60.3% (95%CI 58.6;62.0) in the public service and 59.5% (95%CI 55.9;63.0) in private services, and up-to-date vaccines, 10.3% (95%CI 9.1;11.6) and 9.4% (95%CI 7.4;11.8), respectively. The use of private services was frequent, with low coverage for the set of vaccines, regardless of the type of service used, especially for up-to-date vaccines.

Vaccination practices and knowledge among adults with hemoglobinopathies in Greece: a nationwide survey.

Hemoglobinopathies, such as sickle cell disease and thalassemia, are genetic disorders that affect hemoglobin structure or production, leading to various health complications, including an increased risk of infections. Vaccinations play a crucial role in managing these conditions by providing essential protection against preventable diseases. Ensuring timely and appropriate immunizations is vital for reducing infection-related morbidity and improving the overall health and quality of life for affected individuals. Our objective was to assess vaccination coverage, as well as knowledge, attitudes, and practices toward vaccination in Greek patients with hemoglobinopathies. A nationwide survey of hemoglobinopathy patients in Greece using a 37-item questionnaire was conducted anonymously via Google Forms. It covered demographics, previous vaccinations, vaccine-preventable infections, beliefs about vaccines, and antibiotic prophylaxis post-splenectomy. The survey was distributed through Thalassemia and Sickle Cell Units and organizations. Participants were predominantly university-educated married women aged 30-50 years with transfusion-depended thalassemia (n = 149, 60.5%) or sickle cell anemia (n = 52, 21.1%). Reported childhood vaccination rates aligned with Greece's national immunization program. However, adult coverage was suboptimal across all age groups for measles (10%), varicella (27%), zoster (2% for over 50 years old individuals), hepatitis A (13.9% of those with chronic liver disease) and hepatitis B (41%), pneumococcal (81.3%), meningococcal (37%), tetanus (20.3%), and influenza (67.1%) vaccines compared to guidelines. Participants relied predominantly on healthcare providers for vaccine information but perceived limited engagement. Those over age 50 demonstrated lower adult vaccination rates and higher misconceptions compared to younger cohorts. Addressing educational and access gaps could help protect this vulnerable population. Our findings highlight the need for coordinated efforts to optimize adult immunization for those with hemoglobinopathies.

Do Not Leave Your Patients in the Dark-Using American College of Rheumatology and European Alliance of Associations for Rheumatology Recommendations for Vaccination in Polish Adult Patients with Autoimmune Inflammatory Rheumatic Diseases.

(1) Introduction: Patients with autoimmune inflammatory rheumatic diseases (AIIRD) face a higher infectious risk compared to the general population. As per the ACR and EULAR recommendations, vaccinations against influenza, COVID-19, pneumococci, and tetanus are recommended for most patients with AIIRD. (2) Objectives: This study aimed to assess vaccination coverage among Polish AIIRD patients and identify factors influencing it. (3) Patients and Methods: This study was conducted at the reference rheumatological center in Poland between May 2023 and October 2023. The study participants completed a questionnaire covering their knowledge of vaccination recommendations, actual vaccination status, factors affecting their decision to vaccinate, and their perspectives on immunization. (4) Results: This study involved 300 AIIRD patients and 60 controls. Both groups exhibited comparably low vaccination rates for all diseases (the highest for COVID-19-52% in both groups and the lowest for pneumococci-7.7% and 10%, respectively). Knowledge about recommended vaccinations was limited among patients in both groups. AIIRD patients were also not aware that they should avoid live vaccines. The primary motivators for vaccination among AIIRD patients were fear of infection (up to 75%) and medical advice (up to 74.6%). Conversely, the predominant reasons for non-vaccination were a lack of knowledge that vaccination is recommended (up to 74.7%) and concerns about potential adverse effects (up to 48.6%). Many patients reported not receiving vaccination recommendations from either primary care physicians or rheumatologists. (5) Conclusions: To enhance vaccination coverage among AIIRD patients in Poland, it is essential to educate them about vaccinations during routine medical consultations, emphasizing the increased risk of infection, informing them about recommended vaccinations, and clarifying doubts about adverse effects.

Testing novel facial recognition technology to identify dogs during vaccination campaigns

A lack of methods to identify individual animals can be a barrier to zoonoses control. We developed and field-tested facial recognition technology for a mobile phone application to identify dogs, which we used to assess vaccination coverage against rabies in rural Tanzania. Dogs were vaccinated, registered using the application, and microchipped. During subsequent household visits to validate vaccination, dogs were registered using the application and their vaccination status determined by operators using the application to classify dogs as vaccinated (matched) or unvaccinated (unmatched), with microchips validating classifications. From 534 classified dogs (251 vaccinated, 283 unvaccinated), the application specificity was 98.9% and sensitivity 76.2%, with positive and negative predictive values of 98.4% and 82.8% respectively. The facial recognition algorithm correctly matched 249 (99.2%) vaccinated and microchipped dogs (true positives) and failed to match two (0.8%) vaccinated dogs (false negatives). Operators correctly identified 186 (74.1%) vaccinated dogs (true positives), and 280 (98.9%) unvaccinated dogs (true negatives), but incorrectly classified 58 (23.1%) vaccinated dogs as unmatched (false negatives). Reduced application sensitivity resulted from poor quality photos and light-associated color distortion. With development and operator training, this technology has potential to be a useful tool to identify dogs and support research and intervention programs.

COVID-19 Vaccination Coverage and Factors Influencing Vaccine Hesitancy among Patients with Inborn Errors of Immunity in Latvia: A Mixed-Methods Study.

The European Society for Immunodeficiencies recommends that all patients with inborn errors of immunity (IEI) without contraindications should receive SARS-CoV-2 vaccination. The aim of this study was to investigate the reasons that discourage IEI patients from receiving the recommended vaccination and to assess vaccination coverage among IEI patients in Latvia. In this multicenter mixed-methods study, the vaccination status of all patients with IEI within two tertiary centers in Latvia was reviewed using electronic health records. Semi-structured interviews were conducted with 16 IEI patients who did not undergo vaccination, and a thematic analysis was performed. A total of 341 patients (49.3% female; median age 19.7 years (IQR:17)) were included in the quantitative part. The proportion of fully vaccinated individuals aged ≥ 12 years was 66.8%-70.9% with patients with selective IgA deficiency and 58.8% with other IEI (χ² = 14.12, p < 0.001). The proportion of fully vaccinated individuals aged 5-11 years was 11.1%. Age was associated with vaccination status: younger patients were found to have a significantly lower likelihood of receiving vaccination (U = 8585, p < 0.001). The five main themes identified were as follows: (1) fear and uncertainty; (2) risk and benefit assessment: COVID-19 vaccine-is it worth it? (3) external influences: the dark horse of the decision-making-people around us; (4) individuals against the system; and (5) beliefs about vaccination and COVID-19. Under-representation of certain IEI groups and recall bias are possible limitations of this study. While most reasons for hesitancy were similar to those previously described in the general population, disease-specific concerns were also identified.

Assessment of Vaccination Coverage of Children Aged 12-23 Months in the Provinces of Ituri and Haut-Katanga, Democratic Republic of the Congo in 2019

Assessment of Vaccination Coverage of Children Aged 12-23 Months in the Provinces of Ituri and Haut-Katanga, Democratic Republic of the Congo in 2019

Estimation of Owned and Street Dog Population by Quesionnire Survey and Mark-Recapture Method in Three Urban Areas: Bishoftu, Dukem and Modjo Towns

The understanding of the structure of free-roaming and owning dog population’s estimation is of extreme importance for the planning and monitoring of dog population control strategies, animal welfare and health. The methods used to estimate the abundance of this group of dogs are more complex than the ones used with domiciled owned dogs. We point to enhancements necessary for the implementation of the studies and to potential updates and revisions to the recommendations of the World Health Organization with respect to the estimation of free-ranging and owning dog populations. Rabies is a fatal viral disease of animals and people. People usually infected via bites from an infected animal (e.g. dog). Post Exposure Prophylaxis (PEP) has to initiate immediately after bite wounds of suspected rabid animals in order to avoid fatalities. The situation of rabies poorly known in Ethiopia. Questionnaire survey was conducted in selected blocks in Dukem, Bishoftu and Modjo towns in order to capture information on dog population size estimates using mark-resight surveys has provided useful baseline data for understanding the population dynamics of dogs at the study sites. Mark-resight surveys provide useful information for designing and managing the logistics of dog vaccination or assessing vaccination coverage and for evaluating the impact of neutering programs on the size and structure of dogs’ populations over time. As part of a dog born zoonosis disease risk assessment project, surveys conducted to estimate the size of the dog population and to describe dog management practices of households belonging to different ethnic groups. A markedrecapture method employed and the number of unowned dogs estimated. A total of 599 dog owning households and 276 non-dog household interviewed from at selected 19 blocks at study sites. Owned dogs were more likely male, local breed and for the purpose of used to guard. These households kept their dogs either fully restricted, semi and free roaming but full restriction have reported only at the higher percentage of the total dog households. By counted method, study the ownerless dogs higher than owning and semi-restricted dogs.

Vaccination coverage in rural Burkina Faso under the effects of COVID-19: evidence from a panel study in eight districts

BackgroundImproving infant immunization completion and promoting equitable vaccination coverage are crucial to reducing global under-5 childhood mortality. Although there have been hypotheses that the impact of the COVID-19 pandemic would decrease the delivery of health services and immunization campaigns in low- and middle-income countries, the available evidence is still inconclusive. We conducted a study in rural Burkina Faso to assess changes in vaccination coverage during the pandemic. A secondary objective was to examine long-term trends in vaccination coverage throughout 2010–2021.MethodsUsing a quasi-experimental approach, we conducted three rounds of surveys (2019, 2020, 2021) in rural Burkina Faso that we pooled with two previous rounds of demographic and household surveys (2010, 2015) to assess trends in vaccination coverage. The study population comprised infants aged 0–13 months from a sample of 325 households randomly selected in eight districts (n = 736). We assessed vaccination coverage by directly observing the infants’ vaccination booklet. Effects of the pandemic on infant vaccination completion were analyzed using multi-level logistic regression models with random intercepts at the household and district levels.ResultsA total of 736 child-year observations were included in the analysis. The proportion of children with age-appropriate complete vaccination was 69.76% in 2010, 55.38% in 2015, 50.47% in 2019–2020, and 64.75% in 2021. Analyses assessing changes in age-appropriate full-vaccination coverage before and during the pandemic show a significant increase (OR: 1.8, 95% CI: 1.14–2.85). Our models also confirmed the presence of heterogeneity in full vaccination between health administrative districts. The pandemic could have increased inequities in infant vaccination completion between these districts. The analyses suggest no disruption in age-appropriate full vaccination due to COVID-19. Our findings from our sensitivity analyses to examine trends since 2010 did not show any steady trends.ConclusionOur findings in Burkina Faso do not support the predicted detrimental effects of COVID-19 on the immunization schedule for infants in low- and middle-income countries. Analyses comparing 2019 and 2021 show an improvement in age-appropriate full vaccination. Regardless of achieving and sustaining vaccination coverage levels in Burkina Faso, this should remain a priority for health systems and political agendas.

Between mandatory vaccination and the COVID-19 pandemic: effects on the vaccination coverage trend inaprovince of Southern Italy.

Although vaccination is considered an extraordinarily effective and safe tool for the prevention of infectious diseases, from 2013 to 2016 CVs at national level showed a downward trend, falling well below the 95% threshold recommended by the WHO to limit the circulation of viruses and bacteria in the community and to obtain the so-called herd effect in addition to the protection of individual vaccinated individuals. The aim of the study was to assess vaccination coverage data following the introduction of Law 119/2017 and in like to COVID-19 pandemic the impact on vaccination coverage. The study was conducted from 1 October 2019 to 1 October 2022, using the OnVac programme. The analysis of the coverage rates of hexavalent vaccination during the entire study period shows that there was an increase in vaccinations during the two-year period 2020-2021, followed by a drastic decrease down to values below 95%. where variable coverage was noted between the two genders with higher percentages in the female sex. Contrary to expectations, 2021 did not allow the recovery of the defaulting cohorts, with a drop in coverage much higher than in previous years (with values approaching the values of 2008), not only for polio, diphtheria and tetanus, but also for measles, mumps, rubella, chicken pox and HPV, effectively getting worse over the previous decade. immunization challenges need to be addressed to ensure that every child, adolescent or patient at risk is immunized, especially but not only for COVID-19.

Vaccination Coverage Among Adolescents Aged 13-17 Years - National Immunization Survey-Teen, United States, 2022.

Three vaccines are routinely recommended for adolescents to prevent pertussis, meningococcal disease, and cancers caused by human papillomavirus (HPV). CDC analyzed data from the 2022 National Immunization Survey-Teen for 16,043 adolescents aged 13-17 years to assess vaccination coverage. Birth cohort analyses were conducted to assess trends in vaccination coverage by age 13 years (i.e., before the 13th birthday) and by age 14 years (i.e., before the 14th birthday) among adolescents who were due for routine vaccination before and during the COVID-19 pandemic. Cross-sectional analysis was used to assess coverage estimates among adolescents aged 13-17 years. In 2022, vaccination coverage by age 14 years among adolescents born in 2008 continued to lag that of earlier birth cohorts and varied by sociodemographic factors and access to health care compared with coverage among earlier birth cohorts. Vaccination coverage by age 13 years among adolescents born in 2009 was similar to coverage estimates obtained before the COVID-19 pandemic. Among all adolescents aged 13-17 years, 2022 vaccination coverage levels did not differ from 2021 levels; however, initiation of the HPV vaccination series decreased among those who were insured by Medicaid. Coverage with ≥1 dose of tetanus, diphtheria, and acellular pertussis vaccine and ≥1 dose meningococcal conjugate vaccine was high and stable (around 90%). Providers should review adolescent vaccination records, especially among those born in 2008 and those in populations eligible for the Vaccines for Children program, to ensure adolescents are up to date with all recommended vaccines.

Evaluating Country Performance After Transitioning From Gavi Assistance: An Applied Synthetic Control Analysis.

Over the past decade, international development assistance for health has slowed. As donors seek to increase domestic cofinancing and ultimately transition countries from donor aid dependence, COVID-19 has severely constrained public budgets. The evaluation of sustainability and longer-term impacts of donor withdrawal is increasingly important. We assess vaccination coverage and post-neonatal mortality to estimate country performance of these outcomes among countries that no longer received assistance from Gavi, the Vaccine Alliance (Gavi) between 2000 and 2018. Using data from all countries receiving Gavi support between 2000 and 2020, we employed a synthetic control method to generate a pre-transition counterfactual with the same characteristics as the observation of interest to predict a future that empirically never existed. The synthetic unit is constructed from the weighted average of other units with good fit to the unit of interest before transition but did not transition. We found substantial heterogeneity after transitioning from Gavi assistance. China, Guyana, and Turkmenistan overperformed their expected coverage rates; Albania, Bhutan, China, Guyana, and Turkmenistan maintained coverage over 90%; and Bosnia and Herzegovina and Ukraine reported precipitous drop-offs that fell well below their synthetic controls. We also observed a vaccination coverage decline in 2020 for several countries after transitioning and most synthetic controls, which we attribute to COVID-19-related service disruptions. We recommend that Gavi adjust its transition model to systematically assess contextual externalities and risk. In addition, countries that no longer receive Gavi assistance can leverage technical assistance and communities of practice to mutually assist each other and other countries advancing toward transition. This could also foster intracountry accountability after transition. We also recommend that Gavi systematize post-transition assessments and evaluations that leverage the expertise and experience of graduated countries to encourage cross-learning.

COVID-19 vaccine uptake before and after a vaccine mandate at a major academic hospital: Trends by race/ethnicity and level of patient contact

ObjectivesTo assess vaccine coverage rates before and after implementation of a COVID-19 vaccine mandate among Health care Personnel (HCP) and demographic characteristics associated with vaccine uptake Design, Setting, and Participants: Cohort study conducted among 10,889 hospital employees followed from Dec 16, 2020 - October 31, 2021, at a large academic hospital in Philadelphia. Main Outcome and Measures: Time to COVID-19 vaccination and vaccine series completion rates before and after implementation of a COVID-19 vaccine mandate based on age, gender, race/ethnicity, and level of patient contact/occupational group. ResultsThe vaccination series completion rate was 86.0% prior to mandate announcement, and increased to 98.7% after mandate implementation. Rates before mandate announcement were highest among Asians (96.2%), Whites (94.0%), males (89.7%), employees ≥ 65 years of age (95.2%), and employees with direct patient care (physicians, 99.0%, and nurses, 93.3%). Hospital educational initiatives (including Town Halls and discussions with Black and Hispanic employees with the lowest vaccination rates) appeared to improve uptake. The largest increase in series completion after mandate announcement occurred among Blacks, those of other/multiracial backgrounds, and Hispanics (35.6%, 22.4%, and 10.8%, respectively) as well as those with some or no direct patient contact (24.5% and 18.3%, respectively). Medical or religious exemptions were approved for 64 (<0.6%) employees and 38 (<0.4%) left their positions (8 voluntary, 30 involuntary) specifically due to the COVID-19 vaccine mandate. No clinically meaningful differences by age, gender, or race/ethnicity for those who were vaccinated under the mandate versus those who left their positions were noted. Conclusions and RelevanceThese results suggest that while mandates may be challenging to institutions and enforcement unpopular, they play an important role in reducing hesitancy and securing high vaccination rates among HCP, a group at high risk of COVID-19 given their employment and who can be a source of disease transmission to patients.