Assessment Of Vaccination Status Research Articles

Prevalence and Risk Factors of Postacute Sequelae of COVID-19 in Adults With Systemic Autoimmune Rheumatic Diseases.

Incidence and manifestations of postacute sequelae of coronavirus disease 2019 (PASC) are poorly defined among immunosuppressed populations. We reported, phenotyped, and assessed risk factors for PASC in adults with systemic autoimmune diseases. Persons aged ≥ 18 years with systemic autoimmune diseases were recruited into a national, prospective observational cohort of SARS-CoV-2 vaccination and infection between December 2020 and April 2021. Serial surveys assessed vaccination status, SARS-CoV-2 infection incidence, and disease flares. Participants reporting SARS-CoV-2 infection received a questionnaire assessing symptom duration, severity, and quality of life (QOL) effect; PASC was defined as ≥ 1 symptom persisting for > 12 weeks. PASC syndromes were mapped by overlapping symptom domains. Characteristics were compared between participants who did vs did not report PASC. Among 1615 participants, 590 (36.5%) reported SARS-CoV-2 infection and were sent PASC surveys, 299 (50.7%) of whom responded > 12 weeks following the reported infection. Respondents were 91.6% female, 91.2% White, median (IQR) age was 48 (40-60) years with median (IQR) 3 (2-3) vaccine doses at time of first infection. Common diagnoses included inflammatory arthritis (38.5%) and inflammatory bowel disease (14.4%). Eighty-nine of 299 (29.8%) reported PASC, with the most reported symptom domain being neurological/psychological (83.1%); 84% reported an effect on QOL. Participants with PASC reported lower number of preceding vaccines (median [IQR] 2 [2-3] vs 3 [2-3]; P < 0.001) and more reinfections (16.9% vs 5.7%; P = 0.004). In a large, real-world cohort, 29.8% of persons with systemic autoimmune disease reported PASC, often affecting QOL. Preceding vaccination may reduce PASC, whereas multiple infections may increase risk, supporting ongoing booster vaccine campaigns and efforts to limit breakthrough infections.

Abstract 12752: Comparing Informatics Methods to Identify Guideline Directed Therapy From the Electronic Health Record

Introduction: AHA Get with The Guidelines (GWTG) is a proven in-hospital approach to improving patient outcomes. The Heart Failure (HF) quality measures for quadruple therapy includes angiotensin receptor/neprilysin inhibitors, beta blockers, aldosterone receptor antagonists, and sodium-glucose transport inhibitors, device counseling, vaccination status assessment, and follow up. Capturing guideline directed therapy (GDT) retrospectively can be done in several ways including the current process of manual review of electronic records, abstraction, and submission to the HF Registry. A SmartPhrase can contribute to adherence of GDT at discharge more efficiently. Research Question: Our research question was, “Can the use of a SmartPhrase improve adherence to AHA HF guidelines?” Goal: To prompt clinicians to address GDT to meet the quality metrics endorsed by the AHA by providing a template for documentation of these therapies in the discharge summary or progress note. Methods: We compared our adherence to the GWTG-HF quality measures prior to after implementing a standard HF DC Checklist SmartPhrase. We evaluated whether the improvement was associated with the SmartPhrase. A Health Information student undertook a project with her preceptor, a Quality Data Manager to analyze SmartPhrase use by providers. Results: We found significant improvement in most GWTG-HF quality measures, including GDT quadruple therapy post-sharing this SmartPhrase. Downstream potential benefits to improved adherence to these HF GDT metrics are improvement in 30-day readmissions. Positive trends in the GWTG-HF quality metrics included an overall improvement from Q1 2022 baseline data for quadruple GDT therapy of 37.2% to Q1 2023 of 80.4%. Conclusions: The adoption of the SmartPhrase improved adherence to the quality metrics. Use of the SmartPhrase varied by provider. Providers used the dot phrase as it was given to them by the team or by copying and pasting the phrase. The use of copy and paste made tracking the use of the SmartPhrase difficult to track electronically. We are exploring additional methods to improve efficient documentation including natural language (NLP).

Evaluation of an iELISA for detection and quantification of rabies antibodies in domestic dog sera

Many rabies endemic-countries have recognized rabies as a public health problem that can be eliminated. As a result, some countries have started implementing small-scale vaccination programs with the aim of scaling them up. Post-vaccination serological monitoring is crucial to assess the efficacy of these programs. The recommended serological tests, the rapid fluorescent focus inhibition test, and the fluorescent antibody virus neutralization (FAVN) are accurate; however, the procedures require considerable expertise and must be carried out in high containment facilities, which are often not available in rabies endemic countries. Given these constraints, enzyme linked immunosorbent assays (ELISAs) have been considered as alternative methods to neutralization tests. This is the first study to evaluate, under field conditions, the performance of the commercial rabies indirect-ELISA (iELISA), the PlateliaTM Rabies II kit ad usum Veterinarium kit, using sera from domestic dogs. Serum samples were collected from two groups of community dogs in northern Tanzania: i) dogs with no history of vaccination against rabies (n = 100) and ii) dogs vaccinated with the Nobivac Canine Rabies® vaccine (n = 101) four weeks previously. When compared to the gold standard FAVN test, the iELISA was found to be 99% specific and 98% sensitive and there was a significant correlation between the two tests (p < 0.001, r = 0.92). Given these findings, we conclude that the PlateliaTM Rabies II kit ad usum Veterinarium can be considered a valuable tool for the rapid assessment of vaccination status of animals in vaccination programs.

A90 IMPLEMENTATION OF NATIONAL GUIDELINES ON THE MANAGEMENT OF VACCINE PREVENTABLE ILLNESS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: PERCEIVED BARRIERS AND INTERVENTION FUNCTIONS AMONGST GASTROENTEROLOGISTS

Abstract Background Vaccination uptake amongst patients with IBD remains suboptimal. Studies evaluating effectiveness of interventions designed to improve vaccine uptake have not assessed perceived barriers and solutions related to implementation of evidence-based guidelines for vaccine preventable illness (VPI). Purpose The aim of this study was to identify barriers and facilitators for evidence-based management of VPI in IBD. Method A semi-structured interview was conducted with gastroenterologists. Interview questions were developed and guided by the COM-B and TDF evidence-based implementation science frameworks. A brief intake questionnaire was administered to collect participant demographic and clinical practice information. Gastroenterologists were recruited through direct local contact via email by the investigators. Sixty minute interviews were recorded and transcribed for data analysis. Using thematic analysis, codes from the study data will be generated to identify themes. The data will be categorized into the coding scheme and themes created using an inductive coding approach. Result(s) As of October 2022, 5 interviews were conducted. Mean participant age was 47.8 years, with 60% identifying practice in an urban/academic setting compared to a rural/community setting (20%). Preliminary major themes included 1) assessing vaccination status and recommending appropriate vaccines are the responsibility of the gastroenterologist 2) gastroenterologists need more support to administer vaccines in clinical practice 3) barriers to implementation of VPI guidelines include lack of access to a family physician, limited time, vaccine hesitancy, and incomplete understanding of coverage/access to vaccines and 4) intervention themes include use of clinical decision support tools embedded into the workflow of healthcare providers, need for support from allied healthcare providers, increased need for third party support, and more education/CME relating to management of VPI in clinical practice. Specific knowledge gaps include 1) uncertainty relating to what vaccines are covered financially 2) lack of knowledge of risk factors for specific VPI such as pneumococcus and meningococcus and 3) how to administer live vaccines in patients already on immunosuppressants. Conclusion(s) Preliminary qualitative themes suggest that although gastroenterologists acknowledge the importance of managing VPI in patients with IBD, perceived resource, policy, and educational barriers exist. The qualitative data from this study will be used to design and implement customized, evidence-based implementation strategies for managing VPI that are sensitive to the local environment. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland.

Ticks represent very important vectors of human and zoonotic pathogens, and tick-borne diseases (TBDs) are diagnosed with increasing frequency. Therefore, the aim of this retrospective study was to describe patients presenting with a complaint of tick bite in the emergency department (ED) of a large university hospital in Switzerland. Data were collected by searching for keywords in the routine clinic database to identify cases from 1 July 2012 to 30 June 2020. The patients' data were screened for preexisting diseases and demographic and clinical characteristics. We included 415 patients collected over a period of 8 years, with highest admission frequencies from May to July. Of these, 82% were outpatients, 15.9% admitted to a hospital ward, and five to intensive care. The patients were allocated to three groups. The first group represented patients with erythema chronica migrans (ECM), which is pathognomonic for Lyme borreliosis (n = 45). Accordingly, 89% of cases in this group of patients were treated with antibiotics. The second group represented patients with other tick bite-associated erythema (n = 139). In this group, no particular clinical symptoms or laboratory findings were found. Finally, the largest group represented patients in which the tick bite was no longer visible (n = 201). This group of patients had significantly more evidence of neurological disorders (52%) and were treated at a higher rate with non-steroidal anti-inflammatory (29%) or antiviral (13%) drugs. Although the vaccination status for tick-borne encephalitis virus (TBEV) was not systematically evaluated, at least 10% of the latter group was vaccinated, indicating another source for neurological disease. Furthermore, only 14% of the tested patients were positive for IgM or IgG against TBEV. This retrospective study indicates the presence of many undiagnosed neurological diseases following tick bites that could be caused by TBEV or an unknown infectious agent. Taken together, although tick bites were not very frequently seen in the present tertiary ED, the frequent presence of neurological symptoms demands a more systematic assessment of vaccination status and TBEV serology as well as further diagnostic evaluations in patients that report tick bites and neurological symptoms.

COVID-19 vaccine acceptability, and uptake among people living with HIV in Uganda.

Despite being a priority population for COVID-19 vaccination, limited data are available regarding acceptability of COVID-19 vaccines among people living with HIV (PLWH) in Sub-Saharan Africa. We described COVID-19 vaccine acceptability and factors associated with vaccine acceptability among PLWH in Uganda. This was a cross-sectional study conducted among PLWH, aged ≥18 years, enrolled participants who were seeking HIV care from six purposely selected accredited ART clinics in Kampala. We obtained data on vaccine acceptability defined as willingness to accept any of the available COVID-19 vaccines using interviewer-administered questionnaires. In addition, we assessed vaccination status, complacency regarding COVID-19 disease, vaccine confidence, and vaccine convenience. Factors associated with COVID-19 vaccine acceptability were evaluated using modified Poisson regression with robust standard errors. We enrolled 767 participants of whom 485 (63%) were women. The median age was 33 years [interquartile range (IQR) 28-40] for women and 40 years [IQR], (34-47) for men. Of the respondents 534 (69.6%,95% confidence interval [CI]: 66.3%-72.8%) reported receiving at least one vaccine dose, with women significantly more likely than men to have been vaccinated (73% vs. 63%; p = 0.003). Among the unvaccinated 169 (72.7%, 95% CI: 66.6%-78.0%) were willing to accept vaccination, had greater vaccine confidence (85.9% had strong belief that the vaccines were effective; 81.9% that they were beneficial and 71% safe for PLWH; 90.5% had trust in health care professionals or 77.4% top government officials), and believed that it would be easy to obtain a vaccine if one decided to be vaccinated (83.6%). Vaccine acceptability was positively associated with greater vaccine confidence (adjusted prevalence ratio [aPR] 1.44; 95% CI: 1.08-1.90), and positive perception that it would be easy to obtain a vaccine (aPR 1.57; 95% CI: 1.26-1.96). vaccine acceptance was high among this cohort of PLWH, and was positively associated with greater vaccine confidence, and perceived easiness (convince) to obtained the vaccine. Building vaccine confidence and making vaccines easily accessible should be a priority for vaccination programs targeting PLWH.

Association of provider HPV vaccination training with provider assessment of HPV vaccination status and recommendation of HPV vaccination

ABSTRACT The delivery of strong HPV vaccine recommendations hinges on the expertise of healthcare providers (HCPs) in assessing patients’ status and recommending HPV vaccination. We conducted a population-based cross-sectional study of HCPs practicing in Texas to examine the relationship between HPV vaccination training of HCPs and HPV vaccination status assessment and recommendation. Logistic regression analyses were used to assess the association between HCPs’ formal training and recency of training in HPV vaccination promotion or counseling with HPV vaccination status assessment and recommendation. Of the 1,283 HCPs who completed the online survey, 43% had received training in HPV vaccination promotion or counseling, 47% often/always assess HPV vaccination status, and 59% often/always recommend HPV vaccination. Compared with HCPs who received no training, those who received training had over four times higher odds (adjusted odds ratio [AOR]: 4.32; 95% CI: 3.06–6.10) of often/always assessing HPV vaccination status and over three and half times higher odds (AOR: 3.66; 95% CI: 2.73–4.90) of often/always recommending HPV vaccination. Furthermore, HCPs who recently received HPV vaccination training had higher odds of HPV vaccination status assessment and recommendations than those without training. Hispanic HCPs had higher odds of often/always assessing HPV vaccination status and recommending vaccination than did non-Hispanic White HCPs. Also, nurses and physician assistants had lower odds of often/always assessing HPV vaccination status and recommending HPV vaccination than did physicians. Targeted and continuous training of HCPs in HPV vaccination promotion or counseling is needed to increase HPV vaccination status assessment, recommendation, and uptake rates.

Assessment of Vaccination Status in Professional Football Players in Low Categories in Greece.

Background: There are limited data on the vaccination practices of footballers in low professional categories in Greece and Europe. The aim of this study was to investigate the vaccination practices followed by the medical staff of the low professional football categories in Central Greece. Methods: A questionnaire was developed and included questions on the vaccination practices of football players. The participants were chief medical officers of the fifteen low-category football teams in Central Greece. Overall, 10 out of 15 chief medical officers participated (response rate: 67%). Results: All participants recommended only the tetanus monovalent vaccine in cases with deep trauma of athletes. Influenza, pneumococcal vaccine, and Hepatitis A and B vaccines were not recommended by the medical officers. This was also the case for measles, mumps, rubella (MMR) vaccine and meningococcal vaccine with strains A, C, Y, W. Participants reported the lack of specific guidelines for vaccination in professional footballers. Conclusions: The recent study showed poor vaccination practices in low categories of professional football teams in Central Greece. The qualitative view of the respondents revealed the importance of the absence of guidelines on vaccination of football players.

Predictors of COVID-19 Vaccination Among EMS Personnel.

IntroductionUnvaccinated emergency medical services (EMS) personnel are at increased risk of contracting coronavirus disease 2019 (COVID-19) and potentially transmitting the virus to their families, coworkers, and patients. Effective vaccines for the severe acute respiratory syndrome coronavirus 2 virus exist; however, vaccination rates among EMS professionals remain largely unknown. Consequently, we sought to document vaccination rates of EMS professionals and identify predictors of vaccination uptake.MethodsWe conducted a cross-sectional survey of North Carolina EMS professionals after the COVID-19 vaccines were widely available. The survey assessed vaccination status as well as beliefs regarding COVID-19 illness and vaccine effectiveness. Prediction of vaccine uptake was modeled using logistic regression.ResultsA total of 860 EMS professionals completed the survey, of whom 74.7% reported receiving the COVID-19 vaccination. Most respondents believed that COVID-19 is a serious threat to the population, that they are personally at higher risk of infection, that vaccine side effects are outweighed by illness prevention, and the vaccine is safe and effective. Despite this, only 18.7% supported mandatory vaccination for EMS professionals. Statistically significant differences were observed between the vaccinated and unvaccinated groups regarding vaccine safety and effectiveness, recall of employer vaccine recommendation, perceived risk of infection, degree of threat to the population, and trust in government to take actions to limit the spread of disease. Unvaccinated respondents cited reasons such as belief in personal health and natural immunity as protectors against infection, concerns about vaccine safety and effectiveness, inadequate vaccine knowledge, and lack of an employer mandate for declining the vaccine. Predictors of vaccination included belief in vaccine safety (odds ratio [OR] 5.5, P=<0.001) and effectiveness (OR 4.6, P=<0.001); importance of vaccination to protect patients (OR 15.5, P=<0.001); perceived personal risk of infection (OR 1.8, P=0.04); previous receipt of influenza vaccine (OR 2.5, P=0.003); and sufficient knowledge to make an informed decision about vaccination (OR 2.4, P=0.024).ConclusionIn this survey of EMS professionals, over a quarter remained unvaccinated for COVID-19. Given the identified predictors of vaccine acceptance, EMS systems should focus on countering misinformation through employee educational campaigns as well as on developing policies regarding workforce immunization requirements.

COVID-19 Positivity Following an In-Person Surgical Society Meeting: A Cross-Sectional Survey Study

IntroductionMany surgical societies have recently resumed in-person meetings after canceling or adopting virtual formats during the COVID-19 pandemic. These meetings implemented safety measures to limit viral exposure and ensure participant safety. While there have been anecdotal reports of COVID-19 cases after attendance, no large-scale assessments have been undertaken. The objective of this study was to evaluate COVID-19 positivity following an in-person surgical society meeting. MethodsAn online survey was administered to participants of the Society for Asian Academic Surgeons annual meeting, which was held in Chicago, Illinois in September 2021. This survey assessed vaccination status, in-person versus virtual conference attendance, and COVID-19 testing and symptoms in the 7 d immediately following the meeting. ResultsAmong the 220 meeting participants, 173 attended in person (79%). There were 91 survey respondents (41% response rate): 67% attending physicians, 27% trainees, and 6% medical students. Nearly, all (99%) reported being fully vaccinated against COVID-19. COVID-19 testing was sought within 7 d of the meeting by 15% of in-person respondents, and all reported negative results. Among individuals who were not tested, no one reported development of symptoms (cough, shortness of breath, fever, new loss of taste/smell, etc.). ConclusionsAmong in-person attendees of a recent surgical society meeting, no one reported positive COVID-19 testing after the meeting, and individuals who were not tested denied developing symptoms. While these results are encouraging, societies hosting meetings should continue to proactively assess the safety of in-person meetings to promptly identify outbreaks and opportunities for improvement.

COVID-19 Vaccination Status and Attitudes of Family Child Care Providers in Delaware, September 2021

Child care providers, including family child care (FCC) providers, are viewed as trusted sources of information for the parents and families they serve, and their vaccine behavior has been shown to be associated with parent beliefs and behaviors. This study sought to describe the COVID-19 vaccine behaviors and attitudes among FCC providers in Delaware. An online survey was distributed to all licensed FCC providers (N = 541) in September 2021. Survey items were drawn from validated instruments and assessed vaccination status, attitudes, and confidence in their ability to discuss COVID-19 vaccines with families. In total, 168 responses were recorded (31% response rate); 69.8% of respondents were fully vaccinated against COVID-19. The majority indicated that they would require (11.4%) or recommend (42.1%) the vaccine for children in their care, once approved by the FDA. Providers reported high levels of confidence in their ability to discuss both the benefits and risks of COVID-19 vaccines. FCC providers should be considered key messengers for the families they serve and may be helpful liaisons with state and local vaccination efforts. Input from FCC providers could be used to develop vaccine messaging and materials that are clear, consistent, and culturally responsive to the families of the children in their care.

331 Evaluation of Triage Screening for Influenza Vaccination Status in the Emergency Department

Seasonal influenza places significant burden on emergency medical care and is estimated to result in 3.9 million annual emergency department (ED) encounters. Lack of access to primary medical care is associated with greater utilization of ED services. Increasingly, the ED is providing preventive care to patients, such as influenza vaccines. The objective of this study was to evaluate vaccination screening at triage to determine the potential impact of an ED-based influenza vaccine program on unvaccinated patients. This was a retrospective study of ED encounters within a single health system between October 1, 2018 and April 30, 2019. All 19 EDs, 6 freestanding EDs and 13 hospital-based EDs, were included. Data was obtained from the electronic medical record (EPIC). Encounters were reviewed to determine if influenza vaccination status was assessed at ED triage. Assessment of vaccination status by registered nurses is encouraged but not mandatory during ED triage. Influenza vaccination is not routinely offered. Encounters in which triage screening was completed had responses categorized as vaccinated, unvaccinated, or vaccination status unknown. During the study period, 359, 310 encounters occurred across 19 EDs. Screening for vaccination status was completed for 204, 173 encounters, representing 56.8% of all encounters (95% CI 0.567 to 0.57). Screening was more frequent at freestanding EDs [60%, (95% CI 0.596 to 0.604)] compared to hospital based EDs [56.2%, (95% CI 0.56 to 0.563, p < 0.001)]. Of the encounters that were screened, 73, 311 patients reported being vaccinated against influenza [35.9%, (95% CI 0.357 to 0.361)] and 103, 276 patients reported being unvaccinated [50.6%, (95% CI 0.504 to 0.508)]. Patients 0-17 years [55.5%, (95% CI 0.55 to 0.561)] or 18-64 years [57.9%, (95% CI 0.577 to 0.582)] were more likely to report being unvaccinated against influenza compared to those 65 years or older [25.7%, (95% CI 0.253 to 0.261, p < .001)]. In total, 56.8% of patients were screened for vaccination status. Patient’s report being unvaccinated against influenza in more than half of all ED encounters. Pediatric patients and adults < 65 years of age are more likely to be unvaccinated against influenza and represent a target population for ED vaccination. Increased vaccination screening is needed to accurately assess opportunities for ED-based vaccination efforts.

COVID-19 Vaccine Uptake and Intent Among Emergency Healthcare Workers: A Cross-Sectional Survey.

Objective:Vaccine hesitancy limits population protection from SARS-CoV (coronavirus disease [COVID-19]). Vaccine hesitancy among healthcare workers (HCW) could put patients and coworkers at risk.Methods:We surveyed 475 emergency department and emergency medical service workers from January to February 2021 to determine vaccine intent/uptake, perceived COVID-19 vulnerability, and factors associated with vaccine intent/uptake.Results:Although 79% of HCWs received or had plans to receive the COVID-19 vaccine, 21% had no intent/were unvaccinated; intent/uptake was lower among females (odds ratio [OR] = 0.34) and those with a history of COVID-19 infection (OR = 0.55), and higher among those with advanced degrees (OR = 3.53) and high perceived COVID-19 vulnerability (OR = 1.99).Conclusions:This study provides a timely assessment of vaccination status among frontline HCWs and highlights subgroups who may be at high risk of exposure and transmission.

Trends in HPV Vaccination Initiation and Completion Within Ages 9–12 Years: 2008–2018

Routine human papillomavirus (HPV) vaccination is recommended at ages 11 to 12 years and may be initiated as early as 9 years of age. Data were derived from the National Immunization Survey-Teen, spanning 2008-2018. Using health care provider-verified vaccination histories, we examined trends in human papillomavirus vaccination up-to-date (HPV-UTD) rates within ages 9 to 12 years. Furthermore, we assessed vaccination status by sociodemographic factors and US state of residence. Overall, amid evidence of recent stagnation, HPV vaccination between ages 9 to 12 increased over the years. Initiation rates rose from 17.3% in 2008 to 62.8% in 2018, and HPV-UTD rates rose from 13.5% in 2011 to 32.8% in 2018. After the inception of gender-neutral HPV vaccination, HPV-UTD rates between 2011 and 2018 rose by 31.9% among boys and only 6.6% among girls. For most of the study period, non-Hispanic Black and Hispanic individuals had higher rates of initiation and HPV-UTD than non-Hispanic white individuals. In 2018, vaccination initiation rates exceeded 70% in several states; however, HPV-UTD rates in most US states were <50%, excluding Rhode Island (61.6%), Colorado (58.7%), Hawaii (53.5%), District of Columbia (53.2%), and Ohio (50%). HPV vaccination within ages 9 to 12 years is suboptimal. To leverage the substantial benefits of HPV vaccination within this age range, it is imperative that conscious efforts are taken at the national and state levels to promote HPV vaccination for this age group.

Assessment of Vaccination Status and Associated Factors Among 9 to 12 Months Children in Central Ethiopia

Background: Immunization coverage is one of the indicators used to monitor progress towards the reduction of child morbidity and mortality, as it is one of the most cost-effective public health interventions(1). However many children around the world especially in developing countries like our country Ethiopia still remain incomplete or unvaccinated. For instance; as Ethiopian Demographic Health Survey 2011 shows fully vaccination coverage in urban and rural settings was 48.2% and 20.4%, respectively(2). Likewise the programmatic report on immunization of Adama town 2014/15 shows out of total targets 10,927 under one year age children 7867(72%) fully vaccinated; relatively lower achievement. Therefore this research designed for validation of the programmatic report by using scientific study and identifying factors associated with vaccination status of children at the target age, in each sampled kebeles, census of study population done to develop sampling frame. Objectives: This study was designed to assess the vaccination status and associated factors among 9 to 12 months children in Adama town, Oromia, Ethiopia. Methods: Community-based cross-sectional study design was employed from March to July. Mixed probability sampling technique (stratified random sampling, probability proportion to size and simple random sampling) were used at various stages of sampling to include 456 care takers of children 9-12 months. Data were collected within structured and pre tested questionnaire, entered into Epi.info version7 and analyzed using the statistical products and service solution (SPSS) version 21 computer software. Both descriptive and analytical methods were used to report the result. Bivariate and multivariate analyses were executed using binary logistic regression. To determine significance of association 95% confidence level was used. Results: from the planned sample, 437(96% response rate) of primary care takers of children age 9-12 months were included in the study of which 417(95%) were confirmed to complete routine vaccination. Using multivariate logistic regression models, factors significantly associated with complete immunization were age the child should complete vaccination (adjusted odd ratio [AOR], 16.2; 95% CI: 4.2-62.0) and health education given by health workers about vaccination (AOR, 3.2; 95% CI: 1.2-8.7), whereas parents/caretakers socio-demographic characteristics and the rest were not significantly associated with full immunization among children 9-12months. Conclusion and recommendation: fully vaccination status is higher than what is being reported by Adama town health office and factors significantly associated with the vaccination status in study setting are; at which age the child should complete vaccination and health education given by the health workers about vaccination. The town health office and health workers should be strengthened to raising awareness of the community on the benefit and about vaccine preventable diseases, which is also used to ensure quality of vaccination services. Funding Statement: There is no source of fund for this study. Declaration of Interests: The authors declare that there is no conflict of interest regarding the publication of this paper. Ethics Approval Statement: The study protocol was reviewed and approved by Ethical review committee of Oromia regional health bureau. Also permission to undertake the study was obtained from every relevant authority in the town including Adama town health office. Verbal informed consent was obtained from the participants prior to participation in the study.

Evaluation of INSTAND e.V.’s external proficiency testing program for tetanus and diphtheria antitoxin detection: Lessons for assessing levels of immunoprotection

ObjectivesThe aim of this study was to evaluate the development and status quo of the quality of high throughput in vitro diagnostic testing for tetanus and diphtheria antitoxin antibody (ATX) concentrations based on external quality assessment (EQA) data. MethodsWe analyzed manufacturer-specific data of 22 EQA surveys—each for the detection of tetanus and diphtheria ATX—to check the diagnostic strength of the corresponding in vitro diagnostic systems. ResultsWhile the results were mostly well aligned, individual surveys showed widely dispersed ATX concentrations. The medians of manufacturer collectives deviated from the overall median by up to 8.9-fold in the case of diphtheria ATX and by up to 3.5-fold in the case of tetanus ATX. Such a distribution in the results is particularly critical in the cut-off range for immunity and may lead to an incorrect assessment of vaccination status. ConclusionThese results were surprising as there are International Standards for both ATX; however, the results may be linked to the high ATX concentration of the reference material, which deviates considerably from clinically significant concentrations. To increase the accuracy and diagnostic strength of both assays, we recommend a recalibration of the test systems and verification of their traceability to the International Standards.

Mapping routine measles vaccination in low- and middle-income countries

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.

Varicella zoster immunity loss in multiple sclerosis patient treated with ocrelizumab

Ocrelizumab is a novel humanized anti-CD20 antibody used for treatment of relapsing remitting and primary progressive multiple sclerosis with evidence of inflammatory activity. Guidelines suggest assessing vaccination status and eventually vaccinate patients with multiple sclerosis before new disease modifying therapy initiation. However, there are not any specific recommendations about vaccinal immunity reassessment after ocrelizumab injection. We describe the case of a patient who loss varicella zoster vaccinal immunity after the first ocrelizumab infusion. It is advisable to reassess vaccinal immunity to isolate non-immune patients and to adopt suitable preventive measures, including close contacts vaccination and avoidance of contacts with active infection.

Vaccination in Inflammatory Bowel Disease: Utility and Future Perspective

Inflammatory bowel disease (IBD) is an immune-mediated disease, which often require lifetime treatment with immunomodulators and immunosuppressive drugs. Both IBD and its treatments are associated with an increased risk of infectious disease and mortality. Several of these diseases are vaccine preventable and could be avoided, reducing morbidity and mortality. However, vaccination rates among patients with IBD are lower than in the general population and both patients and doctors are not fully aware of the problem. Education campaigns and well planned vaccination schemes are necessary to improve vaccination coverage in patients with IBD. Immunomodulators and immunosuppressive drugs may reduce the seroprotection levels. For this reason, new vaccination schemes are being studied in patients with IBD. It is therefore important to understand which and when vaccines can be administrated based on immunocompetence or immunosuppression of patients. Usually, live-attenuated vaccines should be avoided in immunosuppressed patients, so assessing vaccination status and planning vaccination before immunosuppressive treatments are pivotal to reduce infection risk. The aim of this review is to increase the awareness of the problem and provide a quick reference for vaccination plan tailoring, especially for gastroenterologists and primary care physicians, who have the skills and knowledge to implement vaccination strategies.

Identifying vaccination rates of adult patients in ambulatory care clinics.

Background:While pharmacists have provided vaccinations to patients in the community pharmacy setting, pharmacist involvement within the medical office setting is not well documented in the literature. The American Society of Health-System Pharmacists reports that ambulatory care pharmacists are screening for and administering vaccinations at a declining rate, despite standards of practice. Vaccination rates for adults 19–64 years of age remain low, based on Healthy People 2020 goals, putting them at risk for vaccine-preventable diseases.Objectives:The aim of the study was to assess vaccination rates of ambulatory care pharmacy clinic patients aged 19–64 years and to compare the rates between three clinics and to Healthy People 2020 goals.Methods:This was a baseline retrospective analysis of vaccination rates for patients aged 19–64 years who attended at least one pharmacy clinic visit at one of the three medical office practices. Age, sex, medical conditions, cigarette or alcohol use, immunosuppressive medications, and vaccines recommended and received were recorded. Vaccination status was assessed according to the Advisory Committee for Immunization Practices recommendations. Data were collected from January 2016 to March 2017. The percentage of eligible patients who received each vaccine was determined overall and for each clinic.Results:There were 240 patients who met the inclusion criteria, with a mean age of 52.8 years. The percentage of patients with vaccination documented in the medical record was 25% for pneumococcal conjugate, 35.7% for pneumococcal polysaccharide, 26.9% for zoster vaccine live, 6.4% for hepatitis B, and 50.6% for tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis. Vaccination rates for pneumococcal conjugate, pneumococcal polysaccharide, and zoster vaccine live were below established Healthy People 2020 goals.Conclusion:Vaccination rates remain low in adults 19–64 years of age. Ambulatory care pharmacists should consider assessing vaccination status during clinic visits as a component of comprehensive vaccination programs.