Basic Vaccination Research Articles

Exploring determinants of basic childhood vaccination coverage in Bangladesh: a generalized Poisson regression analysis

IntroductionChildhood vaccination is crucial for safeguarding children against potentially life-threatening diseases. This study aims to investigate the significant factors influencing vaccination coverage among children aged 12–59 months in Bangladesh.MethodsThe study utilizes cross-sectional data from the 2017–18 Bangladesh Demographic and Health Survey. A Kruskal–Wallis test is employed in bivariate analysis to identify significant predictors associated with childhood immunizations. A generalized Poisson regression model is applied to assess the impact of various risk factors on children’s incomplete vaccination status.ResultsChildren born in the Sylhet division show lower chances of receiving immunizations. Additionally, children whose mothers are younger, have no education or only primary education, and are unemployed, are less likely to be fully vaccinated. Furthermore, children born into smaller families, first birth, those whose mothers had access to media, and those who received more than four antenatal visits during pregnancy are more likely to have received all recommended vaccines.ConclusionImplementing targeted interventions to improve childhood vaccination coverage, particularly among vulnerable populations such as young and uneducated mothers with middle-income status, is crucial. Enhancing media access, promoting the utilization of antenatal care at health care facilities, and raising awareness about the benefits of vaccination can help ensure optimal vaccination coverage among children in Bangladesh.

Antibody response to SARS-CoV-2 natural and breakthrough infection in patients undergoing maintenance hemodialysis: A prospective cohort study over 4 months

BackgroundPatients undergoing maintenance hemodialysis (MHD) are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, the antibody response of these patients to natural and breakthrough infections remains poorly understood. MethodsBetween January 15, 2023, and February 15, 2023, a total of 53 patients undergoing MHD and diagnosed with SARS-CoV-2 infection at The Affiliated Hospital of Hangzhou Normal University were enrolled. They were categorized into the natural (n = 40) and breakthrough infection groups (n = 13) based on their vaccination status before infection. Comprehensive data, including basic clinical information, vaccination status, and routine post-infection blood parameters, were collected from all participants. Blood specimens were drawn monthly after infection, and SARS-CoV-2 receptor-binding domain (RBD) immunoglobulin (Ig) G and IgM tests were conducted. The study included continuous follow-up over 4 months. ResultsDuring the acute phase of infection, the SARS-CoV-2 RBD IgM positivity was 5 % in patients undergoing MHD who were naturally infected and 15.4 % in those with breakthrough infections. Four months after infection, SARS-CoV-2 RBD IgG positivity in patients with natural and breakthrough infection was 77.5 % and 100 %, respectively. Patients undergoing MHD with breakthrough infection exhibited higher SARS-CoV-2 RBD IgG titers (751.21 signal-to cutoff ratio, S/CO [interquartile range, IQR, 30.54–1173.63]) than those with natural infections (3.43 S/CO [IQR, 1.12–15.6]) (p < 0.0001). No significant differences were observed in SARS-CoV-2 RBD IgG between males and females or among those aged <70 and ≥70 years. Patients who received three doses of the inactivated vaccine produced significantly higher SARS-CoV-2 RBD IgG levels after infection than those who received one or two doses; these differences were significant. ConclusionsAlthough patients undergoing MHD exhibit a low rate of SARS-CoV-2 RBD IgM positivity following infection, those vaccinated with inactivated vaccines can generate elevated SARS-CoV-2 RBD IgG levels, particularly those who receive three doses.

Hubungan Dukungan Suami Terhadap Sikap Ibu Untuk Imunisasi Bayi di Puskesmas Peureulak Barat Aceh Timur Tahun 2024

One reason for the lack of information regarding the economic costs of disability or death and the benefits of immunisation when children in the vicinity are not fully immunised is the discovery of signatures. Many people are confused by the terms vaccination and immunisation. Immunisation is given to neonates as soon as possible because it can avoid primary diseases through vaccination. If the baby receives the right vaccination, he will be protected from dangerous diseases such as disabilities. Basic immunisation of infants and toddlers is a routine immunisation programme as well as an additional immunisation programme to prevent communicable diseases (PD3I) such as tuberculosis, diphtheria, pertussis, tetanus, polio, hepatitis B, and measles to reduce morbidity, mortality and disability in infants and children. BCG once, DPT-HB three times, Polio four times, HB Uniject once, and measles once are the basic vaccines. These vaccines must be given to all infants to prevent diseases from entering the body. The method used was analytical survey research. Exploration of how and why this phenomenon occurs is the goal of the analytical survey research approach.

The role of big data analysis for resources optimization of immunization programmes in Pakistan.

Madam, The significance of Big Data Analysis (BDA) in optimizing immunization programmes in Pakistan emerges within the context of global and regional immunization challenges post the COVID-19 pandemic. Despite recovery efforts, a substantial number of children globally remain under-vaccinated, with 14.3 million zero-dose children in 2022.[1] South Asia, primarily India, has shown notable progress, exceeding pre-pandemic coverage levels.[2] In Pakistan, the Expanded Programme on Immunization (EPI) launched in 1978 aims to combat high under-five mortality rates due to vaccine-preventable diseases.[3] However, vaccine coverage remains suboptimal, with only 66% of children aged 12-23 months receiving basic EPI vaccines.[3] This is compounded by reduced doses administered later in schedules, influenced by limited access, awareness gaps, and insufficient vaccinators, especially in rural areas. [3] Big data analytics can help tackle challenges, improve resource allocation, and optimize immunization in Pakistan. The vital role of BDA in optimizing Pakistan's immunization programmes is rooted in its manifold health benefits. BDA aids disease prevention, identifies health risk factors, and enhances healthcare strategies.[4] Amid health emergencies like COVID-19, BDA leverages information technology to fortify health systems, enhancing decision-making, reducing errors, and conserving resources.[4] BDA's dynamic potential is evident. Its predictive tools swiftly pinpoint high-risk patients, streamlining care and elevating healthcare outcomes.[4] BDA draws insights from vast datasets for informed decisions. A recent study conducted in Sindh, increased vaccinator attendance from 44% to 88%, by factoring in results of BDA of Electronic Immunization Registries into their decision making.[5] BDA of antigen administration during accelerated outreach efforts revealed substantial boosts, compared to routine activities.[5] These findings spurred continued efforts in high-risk areas, showcasing BDA's impact in project acceleration and resource optimization.[5] This case highlights BDA's transformative role, enhancing immunization programs through data-driven insights. To harness the potential of BDA in immunization, Pakistan's healthcare system requires a digital overhaul. This entails prioritizing active patient data collection, storage, and analysis on a national scale. Collected data would facilitate targeted vaccination efforts in vulnerable areas. Storing data supports future research and predictive analysis, offering insights into current measures' efficacy and enabling necessary adjustments. A robust data analysis infrastructure, coupled with healthcare professional training, is essential. Cost-effective data security is vital. Digital registries in tertiary care hospitals and rural centres can aid government analysis. This holistic approach seeks to establish a digital healthcare ecosystem, involve the public, and implement data-driven solutions for improved immunization and overall public health in Pakistan.

Prevalence of stunting and its correlates among children under 5 in Afghanistan: the potential impact of basic and full vaccination

BackgroundChild stunting is prevalent in low and middle-income countries (LMICs), but an information gap remains regarding its current prevalence, correlates, and the impact of vaccination against this condition in Afghanistan. This study aimed to determine the prevalence and correlates of moderate and severe stunting and the potential impact of basic and full vaccination among children under five in Afghanistan.MethodsThis is a secondary analysis of the 2022-23 Afghanistan Multiple Indicators Cluster Survey (MICS) including 32,989 children under 5. Descriptive statistics were employed to describe the distribution of independent variables and the prevalence of stunting across them. Chi-square analysis was used to examine the association between each independent variable with stunting. Multinomial logistic regression was used to examine the risk of stunting across different independent variables.ResultsA total of 32,989 children under 5 years old were included in this study. Of those 44.7% were stunted with 21.74% being severely stunted. Children aged 24–35 and 36–47 months faced the highest risk as compared to those aged 1–5 months. The prevalence was lower in female children and they were less likely to experience severe stunting. Stunting was more prevalent in rural areas, with children there 1.16 to 1.23 times more likely to be affected than urban counterparts. Lower wealth correlated with higher stunting. Younger maternal age at birth (≤ 18) correlated with increased stunting risks, particularly in severe cases. Parental education was inversely related to stunting; higher education levels in parents, especially fathers, were associated with lower stunting rates. Households with more than seven children showed a 25% and 44% higher risk of moderate and severe stunting, respectively, compared to families with 1–4 children. Improved sanitation, but not drinking water sources, was linked to reduced stunting in the adjusted model. Vaccination had a protective effect; in the adjusted analysis, basic and full vaccinations significantly lowered the risk of severe stunting by 46% and 41%, respectively.ConclusionIn this nationally representative study, the prevalence of stunting was substantial (44.7%) in Afghan children. Additionally, the findings emphasize the critical factors associated with child stunting and underscore the protective role of vaccination against this condition, which provides policymakers with directions for policy efforts and intervention strategies to reduce child stunting in Afghanistan.

Determinants and prevalence of zero-dose children in Somalia: Analysis of the 2020 Health Demographic Survey data.

Despite global progress in childhood vaccination coverage, fragile and humanitarian countries, with high burden of infectious diseases, continue to report a significant number of zero-dose and under-vaccinated children. Efforts to equitably reach zero-dose children remain thus critical. This study assesses the prevalence and determinants of zero-dose children in fragile context of Somalia. We used secondary data from 2020 Somali Health and Demographic Survey (SHDS) to determine status of unvaccinated children aged between 12 to 23 months. Variables related to socio-demographic, household, health seeking, and community level factors were extracted from the SHDS data. Variables that were shown to be significantly associated with zero-dose children at p< 0.05 in the single logistic regression analysis were identified and included in a final multiple logistic regression analysis. A total of 2,304 women and their children aged between 12-23 months were used to determine the prevalence and determinants of zero dose children in Somalia. Approximately 60.2% of the children were zero dose children and did not receive any dose of the four basic routine vaccines. Children living in rural and nomadic areas were more likely to be zero dose (aOR 1.515, 95% CI: 1.189-1.93). Mother with primary education and above (aOR 0.519, 95% CI: 0.371-0.725), those who attended antenatal care (aOR 0.161, 95% CI: 0.124-0.209) and postnatal care (aOR 0.145, 95% CI: 0.085-0.245) and listen frequently to radio (aOR 2.212, 95% CI: 1.106-4.424) were less likely to have children with zero dose than with their counterparts. Majority of children under two years of age in Somalia are reported to be zero dose children. Context and population specific interventions that target vulnerable mothers and their children, in rural and nomadic areas, and from lower wealth quintile index families with no education and adequate access to antenatal and postnatal care remain critical.

Factors Associated with the Giving of Basic Inactivated Poliovirus Vaccine (IPV) Immunisation

Inactivated Poliovirus Vaccine (IPV) immunisation is given starting from 2-3 months of age with three consecutive doses with an interval of 6-8 weeks. IPV immunisation is one of the key steps in polio control efforts. However, there are still challenges in achieving optimal immunisation coverage in some areas. The aim was to determine the factors associated with the provision of IPV basic immunisation. This type of research uses descriptive analytics with a Cross Sectional approach where data on both variables are collected at the same time or at one time. Sampling using simple random sampling using the formula as many as 164 samples. The instruments used in the study were questionnaires and KMS Statistical tests used were chi-square. Results: The results of this study report that there is a significant relationship between knowledge (p value 0.000), work (p value 0.000), posyandu cadres (p value 0.000), posyandu officers (p value 0.000), and family support (p value 0.000) with the provision of IPV Basic Immunisation in the Working Area of Puskesmas Pulau Panggung. There is an influence of knowledge, occupation, posyandu cadres, posyandu officers, and family support on the provision of IPV basic immunisation. This study suggests that health workers should be more active in providing information to local mothers by providing information through counselling and putting up posters, banners and distributing leaflets about the importance of IPV to children or by providing information from house to house.

Determinant factors of vaccination timeliness and completeness for children under five in low and middle-income countries in the last fifteen years: A systematic review

Background: Vaccination is one of the most effective disease prevention efforts in reducing morbidity and mortality in infants and children. In achieving health status for all, the World Health Organization (WHO) launched a policy aimed at achieving universal vaccination for children. As a result, this program succeeded in significantly reducing global child deaths from 12.6 million in 1990 to 6.3 million in 2013. Purpose: To explore the factors influencing of vaccination timeliness and completeness for children under five in low and middle-income countries in the last fifteen years. Method: A systematic review of articles searched through PubMed and Google Scholar from 2009 to 2024. Retrieved articles were screened using selected items from a systematic review and flow diagram meta-analysis (PRISMA). The inclusion criteria in this review were articles in English or Indonesian that discussed factors that influence the completeness of basic vaccinations for children under five. Results: Eight of the 244 articles were obtained from database searches. In general, the factors that influence the completeness of vaccination are divided into several levels, namely individual, family, community and country. At the individual and family level, the factors identified are knowledge, education, healthy living behavior, marital status, number of family members, number of children, child spacing, child birth order, economy, and family support. At the community and country level, several factors influence, among others, visits by health workers, providing information about vaccinations, officers' attitudes, living in poor, urban areas, illiterate communities, and the country's fertility rate. Conclusion: Socioeconomics is still a factor influencing the completeness of vaccination in low and middle income countries in the last 15 years. Various existing factors should be evaluated and solutions sought that can be adapted and implemented, such as training for health workers, communication training for health workers, health education approaches for heads of families, increasing access to health services by utilizing technology, and so on. Suggestion: Developing countries need innovative approaches to identify and understand factors associated with the social determinants of vaccination programs.

Incomplete immunization uptake and associated factors among children aged 12–23 months in sub-Saharan African countries; multilevel analysis evidenced from latest demography and health survey data, 2023

BackgroundIn 1974, the World Health Organization (WHO) established the Expanded Program on Immunization to control vaccine-preventable diseases, saving millions of lives annually. However, the coverage of basic vaccines recommended by the WHO in Africa was only 75%, which fell short of the goal of 90% by 2015. To formulate effective policies and implementation programs to reduce incomplete vaccination rates, it is important to conduct a study to determine the factors contributing to incomplete immunization among children aged 12–23 months.MethodsThe study was conducted in 16 sub-Saharan African countries, using data extracted from the latest DHS data. It was a community-based cross-sectional survey that used two-stage stratified probability sampling sample designs. The vaccination coverage was assessed using vaccination cards and mother recalls. Multilevel multivariable logistic regression was used to determine the extent of incomplete immunization and the individual and community-level factors associated with partial immunization among children aged 12–23 months. Variables with a p-value less than 0.05 were considered statistically significant predictors of incomplete immunization.ResultA total of 35, 193 weighted samples were used to determine the pooled prevalence of partial immunization. The pooled prevalence of incomplete immunization was 36.06%. In the final model factors significantly associated were: being uneducated mother(AOR:1.75;95%CI:1.48,2.05), being an unemployed mother (AOR:1.16;95%CI:1.09,1.23), no history of family planning utilization (AOR: 1.71; 95% CI: 1.61, 1.84), non-antenatal care (AOR: 1.79; 95% CI: 1.58, 2.04), non-postnatal care (AOR: 1.25; 95%CI: 1.17, 1.35), rural residence(AOR:1.50;95%CI:1.37,1.63), home delivery (AOR: 2.04; 95%CI:1.89, 2.21), having children more than five (AOR: 1.56; 95%CI: 1.13, 2.17), and non-utilization of health insurance (AOR: 1.74; 95%CI: 1.48, 2.05).ConclusionThe pooled prevalence of incomplete immunization was found to be high in this investigation. Based on the findings of the study we recommended that policymakers and stakeholders prioritize enhancing prenatal and postnatal care, contraception, and reducing home birth rates to minimize the rate of incomplete immunization.

Zorg voor mensen met hiv in de eerste lijn: samenvatting van een multidisciplinaire richtlijn

The management of people living with HIV in primary care: summary of a multidisciplinary guideline HIV infection has evolved from a lethal to a chronic condition thanks to antiretroviral therapy (ART). General practitioners (GPs) provide care to patients with chronic conditions in collaboration with specialist care and are thus supposed to integrate, together with the HIV reference centre (HRC), certain aspects of the medical follow-up of patients living with HIV into their daily practice. This article is a summary of the recent guideline for the care of people living with HIV in primary care. It describes, besides the context and the conditions for the post-test counselling interview after the confirmation of the positive HIV diagnosis and during the follow-up consultations, the 3 main components in the care of patients with HIV: linkage to care, retention in care and adherence to ART, and how GPs can support patients in this. In addition, GPs have the task to monitor the overall health of patients living with HIV (basic vaccinations, comorbidities, risk factors, screening programmes, drug interactions with ART), as well as the HIV-specific aspects, such as vaccinations to prevent the risk of co-infections (hepatitis A virus, hepatitis B virus) and avoid infections (pneumococcal, influenza, COVID-19, HPV) where they are at a higher risk of complications. The sexual and reproductive health of patients with HIV can be monitored in primary or secondary care, according to the patient’s preference. The care of patients living with HIV is a joint responsibility of the GP and the HRC. The guideline clearly indicates when referral to the HRC is necessary.

Codon usage bias of goose circovirus and its adaptation to host

Goose circovirus (GoCV), a potential immunosuppressive virus possessing a circular single-stranded DNA genome, is widely distributed in both domesticated and wild geese. This virus infection causes significant economic losses in the waterfowl industry. The codon usage patterns of viruses reflect the evolutionary history and genetic architecture, allowing them to adapt quickly to changes in the external environment, particularly to their hosts. In this study, we retrieved the coding sequences (Rep and Cap) and the genome of GoCV from GenBank, conducting comprehensive research to explore the codon usage patterns in 144 GoCV strains. The overall codon usage of the GoCV strains was relatively similar and exhibited a slight bias. The effective number of codons (ENC) indicated a low overall extent of codon usage bias (CUB) in GoCV. Combined with the base composition and relative synonymous codon usage (RSCU) analysis, the results revealed a bias toward A- and G-ending codons in the overall codon usage. Analysis of the ENC-GC3s plot and neutrality plot suggested that natural selection plays an important role in shaping the codon usage pattern of GoCV, with mutation pressure having a minor influence. Furthermore, the correlations between ENC and relative indices, as well as correspondence analysis (COA), showed that hydrophobicity and geographical distribution also contribute to codon usage variation in GoCV, suggesting the possible involvement of natural selection. In conclusion, GoCV exhibits comparatively slight CUB, with natural selection being the major factor shaping the codon usage pattern of GoCV. Our research contributes to a deeper understanding of GoCV evolution and its host adaptation, providing valuable insights for future basic studies and vaccine design related to GoCV.

Basic Vaccinations among Children Aged 12-23 Months in Northeast India: Trend, Pattern and Factors Influencing Low Coverage.

India has experienced tremendous progress in childhood immunization through centralized flagship programs since 1985. There is a wide variation of immunization coverage of children aged 12-23 months among Indian states and regions. The North East (NE) region, including eight sister states, has witnessed low immunization coverage (68.4%) with higher dropouts (25%) and nonvaccinations (7.0%). NE Indian states substantially improved childhood immunization from 22.8% in 1992-93 to 68.4% in 2019-2021; still, it is below the national average (77%) and the lowest among the Indian States/UTs. Highly predictive determinants for the outcome of childhood vaccination status include maternal characteristics antenatal care for pregnancy, place of delivery, education level, and media exposure. A large section of the backward hilly tribes is also needed special attention to improving the levels of childhood vaccinations in NE states.

Exploring trends and determinants of basic childhood vaccination coverage: Empirical evidence over 41 years.

Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children's Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.

Current situation of full vaccination with basic vaccines in children under 1 year old in Vietnam during 2017 - 2022

A cross-sectional study in 63 provinces/cities in Vietnam (2017 - 2022) was conducted to describe the current situation of full vaccination with basic vaccines in children under 1 year old in Vietnam during 2017 - 2022. The study results showed that the proportion of full vaccination with basic vaccines in children under 1 year old during 2017 - 2022 was 93.1%, still not reached the target of ≥ 95%, and decreased to only 90.7% in the 2020 - 2022 period, when Vietnam was under pressure from the COVID-19 pandemic. There were differences in this proportion between regions/areas and between times before or during the COVID-19 epidemic. It is necessary to increase attention and investment in the expanded vaccination activities, providing adequate vaccines, supplies and equipment, as well as improving the quality of human resources in the preventive health system to meet the increasing needs of child health protection, be ready to adapt to other difficulties that may be encountered in the future.

Efficacy of the COVID-19 vaccination in patients with asymptomatic or mild illness during the Omicron epidemic in Guangzhou: a multi-centre retrospective cohort study

Background Despite the widespread administration of coronavirus disease 2019 (COVID-19) vaccines, the impact on patients with asymptomatic to mild illness remains unclear. Here, we aimed to assess the efficacy of various vaccine doses and types on the duration of isolation duration and discharge rates, the viral shedding duration, and negative rates in asymptomatic to mild COVID-19 patients. Methods We included adult patients at the Fangcang isolation centres in Pazhou or Yongning between November and December 2022. We analysed data on basic demographics, admission details, laboratory indicators and vaccination information. Results A total of 6560 infected patients were included (3584 from Pazhou and 2976 from Yongning). Of these, 90.6% received inactivated vaccines, 3.66% received recombinant SARS-CoV-2 spike protein subunit vaccines and 0.91% received adenovirus vaccines. Among the 6173 vaccinated individuals, 71.9% received a booster dose. By day 9, the isolation rate reached 50% among vaccinated patients. On day 7.5, the positive rate among vaccinated individuals reached 50%. Conclusions Full vaccination was effective, with heterologous vaccines showing greater efficacy than inactivated vaccines alone. However, there was no significant difference in the vaccine protective effect 12 months after vaccination.

Immunisation coverage and factors associated with incomplete immunisation in children under two during the COVID-19 pandemic in Sierra Leone

BackgroundRoutine childhood immunisation is one of the most important life-saving public health interventions. However, many children still have inadequate access to these vaccines and millions remain (partially) unvaccinated globally. As the COVID-19 pandemic disrupted health systems worldwide, its effects on immunisation have become apparent. This study aimed to estimate routine immunisation coverage among children under two in Sierra Leone and to identify factors associated with incomplete immunisation during the COVID-19 pandemic.MethodsA cross-sectional household survey was conducted in three districts in Sierra Leone: Bombali, Tonkolili and Port Loko. A three-stage cluster sampling method was followed to enrol children aged 10–23 months. Information regarding immunisation status was based on vaccination cards or caretaker’s recall. Using WHO’s definition, a fully immunised child received one BCG dose, three oral polio vaccine doses, three pentavalent vaccine doses and one measles-containing vaccine dose. Following the national schedule, full immunisation status can be achieved at 9 months of age. Data were weighted to reflect the survey’s sampling design. Associations between incomplete immunisation and sociodemographic characteristics were assessed through multivariable logistic regression.ResultsA total of 720 children were enrolled between November and December 2021. Full vaccination coverage was estimated at 65.8% (95% CI 60.3%-71.0%). Coverage estimates were highest for vaccines administered at birth and decreased with doses administered subsequently. Adjusting for age, the lowest estimated coverage was 40.7% (95% CI 34.5%-47.2%) for the second dose of the measles-containing vaccine. Factors found to be associated with incomplete immunisation status were: living in Port Loko district (aOR = 3.47, 95% CI = 2.00-6.06; p-value < 0.001), the interviewed caretaker being Muslim (aOR = 1.94, 95% CI = 1.25–3.02; p-value = 0.015) and the interviewed caretaker being male (aOR = 1.93, 95% CI = 1.03–3.59, p-value = 0.039).ConclusionThough full immunisation coverage at district level improved compared with pre-pandemic district estimates from 2019, around one in three surveyed children had missed at least one basic routine vaccination and over half of eligible children had not received the recommended two doses of a measles-containing vaccine. These findings highlight the need to strengthen health systems to improve vaccination uptake in Sierra Leone, and to further explore barriers that may jeopardise equitable access to these life-saving interventions.

Vaccine Effectiveness Against Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection by Type and Frequency of Vaccine: A Community-Based Case-Control Study.

Although guidelines recommend vaccination for individuals who have recovered from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to prevent reinfection, comprehensive evaluation studies are limited. We aimed to evaluate vaccine effectiveness against SARS-CoV-2 reinfection according to the primary vaccination status, booster vaccination status, and vaccination methods used. This population-based case-control study enrolled all SARS-CoV-2-infected patients in Seoul between January 2020 and February 2022. Individuals were categorized into case (reinfection) and control (no reinfection) groups. Data were analyzed using conditional logistic regression after adjusting for underlying comorbidities using multiple regression. The case group included 7,678 participants (average age: 32.26 years). In all vaccinated individuals, patients who received the first and second booster doses showed reduced reinfection rates compared with individuals who received basic vaccination (odds ratio [OR] = 0.605, P < 0.001 and OR = 0.002, P < 0.001). Patients who received BNT162b2 or mRNA-1273, NVX-CoV2373 and heterologous vaccination showed reduced reinfection rates compared with unvaccinated individuals (OR = 0.546, P < 0.001; OR = 0.356, P < 0.001; and OR = 0.472, P < 0.001). However, the ChAdOx1-S or Ad26.COV2.S vaccination group showed a higher reinfection rate than the BNT162b2 or mRNA-1273 vaccination group (OR = 4.419, P < 0.001). In SARS-CoV-2-infected individuals, completion of the basic vaccination series showed significant protection against reinfection compared with no vaccination. If the first or second booster vaccination was received, the protective effect against reinfection was higher than that of basic vaccination; when vaccinated with BNT162b2 or mRNA-1273 only or heterologous vaccination, the protective effect was higher than that of ChAdOx1-S or Ad26.COV2.S vaccination only.

Risk of vaccine preventable diseases in UK migrants: A serosurvey and concordance analysis

BackgroundVaccine preventable diseases (VPDs) such as measles and rubella cause significant morbidity and mortality globally every year. The World Health Organization (WHO), reported vaccine coverage for both measles and rubella to be 71 % in 2019, indicating an immunity gap. Migrants in the EU/EEA may be at high risk of VPDs due to under-immunisation and poor living conditions. However, there are limited data on VPD seroprotection rates amongst migrants living in the United Kingdom (UK). MethodsWe conducted an exploratory cross-sectional serosurvey amongst a sample of adult migrants living in Leicester, UK to: (a) determine seroprotection rates for measles, varicella zoster, and rubella in this group; (b) identify risk factors associated with seronegativity and, (c) understand if self-reported vaccine or diseases history is an effective measure of seroprotection. Participants gave a blood sample and completed a questionnaire asking basic demographic details and vaccine and disease history for the three VPDs. We summarised the data using median and interquartile range (IQR) for non-parametric continuous variables and count and percentage for categorical variables. We used logistic regression to establish predictors of seroprotection against these diseases. We examined the reliability of self-reported vaccination/disease history for prediction of seroprotection through a concordance analysis. Results149 migrants were included in the analysis. Seroprotection rates were: varicella zoster 98 %, rubella 92.6 % and measles 89.3 %. Increasing age was associated with seroprotection (OR 1.07 95 % CI 1.01–1.13 for each year increase in age). Migrants from Africa and the Middle East (aOR 15.16 95 % CI 1.31 - 175.06) and South/East Asia and Pacific regions (aOR 15.43 95 %CI 2.38 - 100.00) are significantly more likely to be seroprotected against measles as compared to migrants from Europe and Central Asia. The proportions of migrants unsure about their vaccination and disease history combined were 53.0 % for measles; 57.7 % for rubella; 43.0 % for varicella. There was no agreement between self-reported vaccination/disease history and serostatus. ConclusionOur findings suggest lower levels of seroprotection against measles in migrants living in Leicester, UK, with younger migrants and those from Europe and Central Asia more likely to lack seroprotection. A high proportion of surveyed migrants were unaware of their vaccination/disease history and self-reported vaccine/disease was a poor predictor of seroprotection against VPDs which is important for clinical decision-making regarding catch-up vaccination in this population. Our results, although derived from a small sample, suggest that there may be gaps in seroimmunity for certain VPDs in particular migrant populations. These findings should inform future qualitative studies investigating barriers to vaccine uptake in migrants and population-level seroprevalence studies aimed at determining individualised risk profiles based on demographic and migration factors.

Community-based COVID vaccination center ready for the switch towards a broad community-based prevention center: In Jan'21 the Flemish Region started the COVID vaccination in a public health mode, at 60 primary health care units.

Framework: Each local “unit of care” has an average population of 100.000 people and is managed by local caregivers. Within two months (Jan-Feb'21), 80 vaccination centers were set up and launched. A central strategic center and logistic/financial support were created. A local team of municipal representatives and caregivers was composed. It resulted in a management team which launched the operational vaccination sessions.&#x0D; All citizens were invited by email, letter or SMS. An individual appointment was booked in the vaccination center matching the zip code of the citizen’s residence. Specific software enabled vaccination agenda management and its registration in Flanders’ central vaccination database.&#x0D; The initial goal was to cover at least 70% of the target population, but in the primary care unit “Voorkempen”, a coverage of 95,45% was reached.&#x0D; Vaccination center “Voorkempen” ‘s results: The health unit “Voorkempen” is a defined area, situated in the province of Antwerp and is composed of 6 municipalities which give home to 111.102 inhabitants.&#x0D; The campaign consisted of four periods :&#x0D; - Feb-Sep'21 : basic vaccination (97.763 citizens)&#x0D; - Oct'21-Feb'22 : 1st booster campaign for all 12+ ( 93.316 citizens).&#x0D; - May-June'22: extra booster exclusively for 80+ (7.153 citizens)&#x0D; - Sept-Oct'22 : 2nd booster for all 18+, (90.473 citizens)&#x0D; Lessons learned: &#x0D; 1.Flexible management by a limited number of managers (4) with daily meetings and quick decision making is essential and covers :&#x0D; A.The infrastructure in time and space.&#x0D; B.The IT environment including call center, vaccination agenda and HR management.&#x0D; C.Vaccination sessions planning : stock control and ordering, session planning and unfolding of a mobile team.&#x0D; D.HR management : staff recruitment &amp; selection, training, coaching, contracting, team composition, insurance, payroll.&#x0D; E.Operational vaccination sessions: reception and flow inside the vaccination center, problem solving, administrative check-in, vaccination, registration, surveillance.&#x0D; F.Vaccination registration : group registration in Vaccinnet as a base for COVID certification&#x0D; 2.The support of the municipalities was crucial : accountancy, logistic support, mass communication.&#x0D; 3.The primary healthcare providers’ trust and cooperation was established by constant communication, information and feedback.&#x0D; 4.The mobilization of local volunteers was overwhelming - it became a flexible group coping with unforeseen circumstances and unexpected events.&#x0D; 5.Population management: the data collection concerns local infection rates, hospitalizations and vaccination rates. Its analysis allowed quick reactions.&#x0D; Future: The broad experiences of the central management, people management and population management in this vaccination center can be used to improve preventive actions and early detection programs in different domains:&#x0D; -Infectious diseases including influenza: testing and vaccinations in a similar center as the COVID vaccination center, - new vaccines will be on the market soon.&#x0D; -Chronic diseases: early risk detection and risk management: lifestyle, healthy diet, exercising,…&#x0D; -Improvement of oncological screening programs (breast cancer, cervix cancer and colorectal cancer).&#x0D; -Geriatric stratification and early support&#x0D; -Mental health&#x0D; For the permanent switch to a local “prevention center”, political decisions, a legal framework and structural support is absolutely necessary.&#x0D;

The natural infection rates of vaccine-preventable diseases among children: A literature review

Background: Indonesia currently faces a triple burden of various disease problems, outbreaks of infectious diseases, and an increase in long-standing infectious diseases, new infectious diseases, and non-communicable diseases (NCDs). A report released in 2020 by the United Nations International Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) indicated that during the Covid-19 pandemic, the postponement of routine vaccinations resulted in approximately 80 million children aged less than or equal to 12 months being susceptible to diphtheria, measles, and polio.Purpose: To review previous research in analyzing the relationship between incomplete basic vaccination and the occurrence of vaccine-preventable disease (VPD) cases.Method: This study employed a literature review design, conducting a systematic review by selecting relevant articles pertaining to the research objective. The literature study selection process was adapted from the Preferred Reporting Items for Systematic Reviews (PRISMA-ScR). Inclusion criteria for this research encompassed originality, usage of both English and Indonesian languages, keywords covering basic vaccination, adverse events following vaccination, Integrated Healthcare Centervisits, education, and the role of Integrated Healthcare Centercadres.Results: Generally, community knowledge, attitudes, family support, and the role of cadres correlated with vaccination coverage achievement. However, some studies indicated no correlation between specific variables and the infants' basic vaccination status. To enhance vaccination coverage and client satisfaction, improving community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, as well as increasing vaccine availability and vaccination guidelines, are necessary.Conclusion: To improve vaccination coverage and client satisfaction, enhancements in community knowledge, attitudes, family support, the role of healthcare workers and Integrated Healthcare Centercadres, alongside increased vaccine availability and vaccination guidelines, are essential.Suggestion: It is advisable for the community to enhance knowledge, attitudes, and support for vaccination, especially among mothers and families. The active involvement of cadres in vaccination programs and public dialogue regarding the moral ethics of vaccination also need improvement.