Booster Dose Research Articles

School-Entry Vaccine Policies: States' Responses To Federal Recommendations Varied From Swift To Substantially Delayed.

School-entry immunization requirements are a valuable strategy to reduce the spread of vaccine-preventable diseases. This research examined the temporal relationship between recommendations issued by the federal Advisory Committee on Immunization Practices (ACIP) and corresponding school-entry requirements adopted by states for adolescent meningococcal ACWY (MenACWY) and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines. A legal epidemiological review of statutes, regulations, and state agency guidance identified school-entry policies across fifty states and Washington, D.C. Researchers measured the number of months between the date of an ACIP recommendation and the effective dates for state policies that were in place through the 2023-24 school year. All fifty-one jurisdictions had school-entry requirement policies for Tdap vaccination, and thirty-six had school-entry requirements for MenACWY vaccination. The average period between ACIP's recommendations and state policy adoption was 4.94, 9.61, and 8.24 years for Tdap and for MenACWY first and booster doses, respectively. This analysis found diverse timelines and notable delays for both Tdap and MenACWY school-entry requirement policies. This heterogeneity and patchwork of state requirements underscores the need for ACIP to evaluate the role of these policies in reducing vaccine-preventable diseases across the United States.

The effect of intensive praziquantel administration on vaccine-specific responses among schoolchildren in Ugandan schistosomiasis-endemic islands (POPVAC A): an open-label, randomised controlled trial

Vaccine responses differ between populations and are often impaired in rural and low-income settings. The reasons for this are not fully understood, but observational data suggest that the immunomodulating effects of parasitic helminths might contribute. We hypothesised that Schistosoma mansoni infection suppresses responses to unrelated vaccines, and that suppression could be reversed-at least in part-by intensive praziquantel administration. We conducted an open-label, randomised controlled trial of intensive versus standard intervention against S mansoni among schoolchildren aged 9-17 years from eight primary schools in Koome islands, Uganda. Children were randomly allocated to either an intensive group or a standard group with a computer-generated 1:1 randomisation using permuted blocks sizes 4, 6, 8, and 10. Participants in the intensive group received three praziquantel doses (approximately 40 mg/kg) 2 weeks apart before first vaccination at week 0, and every 3 months thereafter. Participants in the standard group were given one dose of approximately 40 mg/kg praziquantel after the week 8 primary endpoint. Participants in both groups received the BCG vaccine (Serum Institute of India, Pune, India) at week 0; the yellow fever (Sanofi Pasteur, Lyon, France), oral typhoid (PaxVax, London, UK), and first human papillomavirus (HPV) vaccination (Merck, Rahway, NJ, USA) at week 4; and the HPV booster and tetanus-diphtheria vaccine (Serum Institute of India) at week 28. The primary outcome was vaccine response at week 8 (except for tetanus and diphtheria, which was assessed at week 52). The primary analysis population was participants who were infected with S mansoni at baseline, determined retrospectively using either plasma circulating anodic antigen (CAA) or stool PCR. The safety population comprised all randomly allocated participants. The trial was registered at the ISRCTN Registry (ISRCTN60517191) and is complete. Between July 9 and Aug 14, 2019, we enrolled 478 participants, with 239 children per group. 276 (58%) participants were male and 202 (42%) participants were female. Among participants who were positive for S mansoni at baseline (171 [72%] in the intensive group and 164 [69%] in the standard group) intensive praziquantel administration significantly reduced pre-vaccination infection intensity (to median 30 CAA pg/mL [IQR 7-223] vs 1317 [243-8562], p<0·001) compared with standard treatment. Intensive praziquantel administration also reduced week 8 HPV-16-specific IgG response (geometric mean ratio 0·71 [95% CI 0·54-0·94], p=0·017), but had no effect on other primary outcomes. Among all participants (regardless of S mansoni status at baseline) intensive praziquantel administration significantly improved week 8 BCG-specific IFNγ ELISpot response (1·20 [1·01-1·43], p=0·038). Recognised adverse effects of praziquantel were reported more frequently in the intensive group. There were no recorded serious adverse events in either group. We show evidence suggesting that praziquantel administration improves the BCG-specific cellular response, but not humoral responses to other vaccines. Despite observational evidence that helminths impair vaccine response, these results show minimal immediate benefits of reducing helminth burden. The effect of longer-term helminth control should be investigated. UK Medical Research Council. For the Luganda translation of the abstract see Supplementary Materials section.

First bipolar episode following booster dose of COVID-19 vaccination

Introduction and importance: The interactions between the susceptibility of the host and some of the COVID-19 vaccine components happened. Viral infections, including COVID-19, are related to the pathogenesis of bipolar disorder (BD). These findings could trigger an initial bipolar episode. Case presentation: A 48-year-old Syrian married female, presented to the out-clinic of Modern Medical Centre Hospital, in July 2022 for episodes of sub-maniac/mania episodes, which began within 15 days after the booster dose of COVID-19 vaccination, preceded by depressive mood. Both family and personal past psychiatric and/or trauma history were negatives. Initiation of carbamazepine 600 mg/day showed significant improvement within 3 days; 3 months later, carbamazepine dose was decreased to 200 mg/day, as there were no clinical symptoms. Clinical discussion: mRNA vaccines of COVID-19 increase the levels of type I interferon (INF), an inflammatory cytokine that creates a signal leading to the expression of interleukins, INF, and tumor necrosis factor-alpha. The pathology of BD is also unclear. Genetic predisposition, immunological effects, and the classification of BD, itself, as an autoimmune disease play a role. Although rapid improvement following treatment, prolonged and maintenance treatment by essentially mood stabilizer should be considered in bipolar episodes initiated by COVID-19 vaccination. Rare data are available about maniac episodes after COVID-19 infection, but to our knowledge, we reported the first case of bipolar onset after the booster vaccination of COVID-19. Conclusion: Bipolar disease can present following a booster dose of COVID-19 vaccination in previously healthy people.

Booster vaccination normalizes postvaccination immunity in patients with severe asthma

Booster vaccination normalizes postvaccination immunity in patients with severe asthma

Analysis of immunological and biochemical parameters after booster dose vaccination using protein-based and inactivated virus vaccine for safety

IntroductionHeterologous vaccines enhance the immune response to new variants and allow flexibility in booster administration when the original vaccine is unavailable. Studies show that heterologous boosters can generate comparable or superior antibody responses compared to homologous boosters. Considering rare side effects is essential in evaluating COVID-19 vaccines, especially those associated with ChAdOx1-S (AstraZeneca) and Ad26.COV2.S (Janssen), including blood clotting and idiopathic thrombocytopenia. Severe side effects, such as myocarditis and pericarditis, may occur after Pfizer or Moderna boosters but are rare. MethodsThis study administered two vaccines: the Sinopharm inactivated virus vaccine and the Razi-CoV-Pars (RCP) booster. Various evaluations included biochemical markers, coagulation factors, autoimmune antibodies, and antibodies against concerning variants. ResultsAll 90 participants exhibited a notable rise in antibody levels against the variant of concern (VOC). Participants receiving the Razi-CoV-Pars booster after Sinopharm/BBIBP-CorV showed significantly higher antibody levels (Wuhan ∼ 3.25 times, Delta ∼4 times, Omicron ∼ 14 times) compared to those receiving Sinopharm's homologous vaccine. No significant changes (P: <0.05) were found in LDH, CPK, CK-MB, ANA, and Anti-CCP levels. However, individuals receiving Sinopharm's booster after two doses showed a significant increase (4 cases) in D-Dimer levels. ConclusionThe Razi-CoV-Pars vaccine demonstrates a favorable safety profile and promising potential as an effective booster against current variants, particularly due to its significant protective titer against Omicron.

COVID-19 vaccine or booster uptake and hesitancy for children aged 6 months–5 years in the United States: A national descriptive study using the household pulse survey between March and May 2023

The Centers for Disease Control and Prevention recommends that children aged 6 months–5 years (children under 5) receive multiple doses of COVID-19 vaccine, including updated (bivalent) COVID-19 vaccine. However, since the updated vaccines became available for children under 5, there has been limited knowledge regarding hesitancy toward the original vaccine or boosters in vaccinating children. To address this gap, this study utilized data from the Household Pulse Survey conducted from March 1, 2023 to May 8, 2023 (Phase 3.8). The purpose of the study was to examine the proportion of children under 5 who had received at least one dose of COVID-19 vaccine and to assess the likelihood of vaccination, categorized as willingness to vaccinate, moderate hesitancy, and strong hesitancy. Additionally, we identified sociodemographic factors that may influence the level of vaccine hesitancy for children. Overall, 24.5 % (95 % CI: 22.2–26.8) of children under 5 had received at least one dose of the COVID-19 vaccine, with the highest percentage among non-Hispanic Asians (42.1 %, 95 % CI: 36.4–47.8). Respondents who had not received the vaccine showed a statistically significant decrease in their inclination to vaccinate children. There was a higher level of vaccine hesitancy among females compared to males regarding vaccinating children under 5. As household income and educational attainment decreased, there was an observed increase in the proportion of individuals showing strong vaccine hesitancy. Households without health insurance had significantly lower vaccine uptake and higher rates of strong vaccine hesitancy compared to those with health insurance. Parents, guardians, and healthcare providers play essential roles in vaccinating children under 5. Targeted interventions are needed to address vaccine hesitancy and promote the importance of booster doses in the vaccination of children.

Clinical features of and severity risk factors for COVID-19 in adults during the predominance of SARS-CoV-2 XBB variants in Okinawa, Japan.

Since 2023, COVID-19 induced by SARS-CoV-2 XBB variants have been a global epidemic. The XBB variant-induced epidemic was largest in the Okinawa Prefecture among areas in Japan, and healthcare institutions have been burdened by increased COVID-19 hospitalizations. This study aimed to evaluate the clinical features of XBB variant-induced COVID-19 and risk factors for severe COVID-19. This retrospective study included adult patients hospitalized for COVID-19 between May and July 2023 at four tertiary medical institutions in Okinawa, Japan. Patients with bacterial infection-related complications were excluded. According to oxygen supplementation and intensive care unit admission, patients were divided into two groups, mild and severe. Patient backgrounds, symptoms, and outcomes were compared between both groups, and the risk factors for severe COVID-19 were analyzed using a multivariate logistic regression model. In total of 367 patients included, the median age was 75 years, with 18.5% classified into the severe group. The all-cause mortality rate was 4.9%. Patients in the severe group were more older, had more underlying diseases, and had a higher mortality rate (13.2%) than those in the mild group (3.0%). Multivariate logistic regression analysis showed that diabetes mellitus was an independent risk factor for severe COVID-19 (95% confidence interval [CI], 1.002-3.772), whereas bivalent omicron booster vaccination was an independent factor for less severe COVID-19 (95% CI, 0.203-0.862). This study implies that assessing risk factors in older adults is particularly important in the era of omicron variants.

Markers of T-cell dysfunction and not inflammaging predict the waning of humoral responses to SARS-CoV-2 mRNA booster vaccination in people with HIV.

In this prospective longitudinal study, we evaluated the durability of humoral responses to SARS-CoV-2 mRNA booster vaccination in 93 people with HIV, exploring the possible role of T-cell dysfunction and inflammaging biomarkers in predicting antibody waning. We found that, despite a negligible influence of the inflammaging milieu, low CD4/CD8 ratio and CD4+CD127+ percentage as well as high CD8+CD38+CD45RO+ percentage are associated with faster antibody waning, in turn contributing to our understanding of the determinants of COVID-19 vaccine-elicited immune response in this population.

Polysaccharide, Conjugate, and mRNA-based Vaccines are Immunogenic in Patients with Netherton Syndrome

BackgroundNetherton syndrome (NS) is a rare, severe genetic skin disorder, currently classified as an inborn error of immunity (IEI) due to previously reported immune dysregulation. We recently reported the results of an immunological evaluation showing no evidence for a relevant B- and/or T-cell mediated immunodeficiency, but immune responses after vaccination were not evaluated in that study. Therefore, we evaluated immune responses to three vaccine platforms in adult NS patients to further investigate the presence of a clinically relevant B- and/or T-cell immunodeficiency.MethodsVaccination responses in eight adult NS patients were assessed in a cross-sectional study performed between January and August 2022. Clinical patient data were retrospectively retrieved from electronic patient files. Immune responses to a polysaccharide Streptococcus pneumoniae vaccine (PPV23) and conjugate Haemophilus influenzae type b vaccine (ActHiB) were measured. SARS-CoV-2-specific (functional) antibody and T-cell responses following booster vaccination with an mRNA-based COVID-19 vaccine were compared to controls.ResultsNone of the included patients suffered from recurrent and/or severe infections that could be attributed to a B- and/or T-cell immunodeficiency. ActHiB induced immune responses were normal in 7/7 NS patients. PPV23 induced responses were absent in 1/7, diminished in 2/7, and normal in 4/7 patients. Levels of SARS-CoV-2-specific binding and neutralizing antibodies after mRNA-based COVID-19 booster vaccination in NS patients were comparable to controls. SARS-CoV-2-specific CD4 + T-cell responses were detectable in all NS patients. In contrast, SARS-CoV-2-specific CD8 + T-cell responses were detectable in only 2/6 NS patients. T-cell responses to a positive control antigen pool were comparable to controls.ConclusionsVaccine-induced immune responses were detectable after polysaccharide, conjugate and mRNA-based vaccination in our cohort of NS patients. A spectrum of responsiveness to vaccine challenges was found, with the ranges of vaccine responses overlapping those demonstrated in healthy control populations.

Serological Status of Vaccine and Hepatitis B Virus Exposure Among Children Under 5 and Aged 15–17 Years in Kampala, Uganda

Background: Pediatric hepatitis B virus (HBV) serostatus remains variably characterized, hardly determined at times, or documented as part of national monitoring of the Extended Programs for Immunization (EPI). Methods: We cross-sectionally characterized the seroprevalence of HBV vaccine and/or infection status among 501 and 288 children &lt;5 and 15–17 years old, respectively, in Kawempe Division, Kampala, Uganda, between May and August 2023. These children received HBV vaccination under the Uganda National Extended Program on Immunizations (UNEPI). Samples were qualitatively screened for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb or anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb or anti-HBe), and for hepatitis B core antibody (HBcAb or anti-HBc) using three different HBV Combo test rapid immunochromatographic diagnostic tests: Nova, Fastep, and Beright. Results: The seroprevalence of HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc was 1.52%, 27.75%, 0.88%, 0.63%, and 0.76%, respectively, for the combined study age groups. The HBsAg seroprevalence of 2.78% was almost 3.5-fold higher among adolescents when compared to the 0.8% observed in the under-5-year-olds. The qualitative seroprevalence of anti-HBs was 33.1% and 18.4% in the under-5 and among the 15–17-year-old study groups, respectively. Conclusions: The proportion of qualitatively detectable anti-HBs in both groups of vaccinated children is low and probably indicates reduced seroprotection. Consequently, a large proportion of children who received the hepatitis B vaccine under UNEPI may be at risk of HBV infection, especially adolescents. A booster dose of the Hepatitis B Vaccine may be required for adolescents.

Family Psychological Responses in Implementing Booster Vaccination for COVID-19 in Schizophrenia as a Prevention of Covid-19 based on Positive Mental Health (PMH)

Background: Positive mental health (PMH) response for families who have schizophrenic patients in the implementation of vaccination is a double burden that occurs in efforts to prevent the Covid-19 Virus in schizophrenic patients. Purpose: The study aims to explain Family Psychological Responses to the implementation of booster vaccination in Schizophrenia as a Prevention of Covid-19 based on PMH. Methods: This means Between October and December 2022, there will be 127 families with schizophrenia-afflicted members. This study used a sequential explanatory design with a mixed methodology. PMH scale instrument was employed as the research tool in a community-based adult with the PMH scale's sensitivity. Results: Results of the study findings revealed that the overall PMH questionnaire of PMH scale included 6 items 1) General coping Rural (2.99 ±1.2); Urban (2.27 ±1.1) 2) Emotional support Rural (2.99±1.2); Urban (2.27 ±1.1); 3) Spirituality, Rural (2.99±1.8); Urban (2.29 ± 1.3), 4) Interpersonal Skill highest score Rural (2.99 ± 1.2); Urban (2.27 ±1.1), 5) Personal Growth &amp; Autonomous Rural (2.99 ±1.2); Urban (2.27 ±1.1), 6) Global Affect Rural (2.98 ±1.6); Urban (2.28 ±1.1). Conclusion: PMH psychological responses can occur in the implementation of booster vaccination in families of schizophrenia patients so Along with PMH, Negative Mental Health, and vaccination implementation in families of schizophrenia patients, it is important to pay attention to both (NMH).

Safety of the bivalent COVID-19 mRNA booster vaccination among persons aged over 18 years in the Republic of Korea

Safety of the bivalent COVID-19 mRNA booster vaccination among persons aged over 18 years in the Republic of Korea

Quantitating SARS-CoV-2 neutralizing antibodies from human dried blood spots.

In the earliest days of the COVID-19 pandemic, the collection of dried blood spots (DBS) enabled public health laboratories to undertake population-scale seroprevalence studies used to estimate rates of SARS-CoV-2 exposure. With SARS-CoV-2 seropositivity levels now estimated to exceed 94% in the United States, attention has turned to using DBS to assess neutralizing antibodies within cohorts of interest. With this goal in mind, we generated contrived DBS (cDBS) and whole blood-derived DBS from convalescent and vaccinated individuals and subjected DBS eluates to a battery of assays, including a SARS-CoV-2 multiplexed microsphere immunoassay (MIA), a receptor binding domain (RBD)-human ACE2 inhibition assay (iACE2), a cell-based pseudovirus neutralization assay, and real-time PCR-based surrogate neutralization assay (NAB-Sure). The DBS results were benchmarked against paired serum samples tested in a clinically validated SARS-CoV-2 plaque reduction neutralization titer (PRNT) assay. The results of an 8-plex MIA and NAB-Sure assays demonstrated highly significant correlations with PRNT values when evaluated with a panel of 86 paired serum-DBS samples. Both the MIA and NAB-Sure are adaptable to automated liquid handlers for high-throughput capacity. While neutralizing assays were limited to the ancestral SARS-CoV-2 WA1, this study nonetheless represents an important proof of concept demonstrating the potential utility of DBS as a biospecimen type for use in assessing immunity to SARS-CoV-2 at the community and population levels.IMPORTANCESARS-CoV-2 variants of concern continue to circulate globally and remain a serious health threat to large segments of the population. From a public health standpoint, identifying vulnerable communities based on immune status is critical in terms of vaccine booster recommendations. In this report, we investigated the utility of dried blood spots (DBS) as a biospecimen type from which to estimate SARS-CoV-2 neutralizing antibody titers. Using contrived and whole blood-derived DBS, we demonstrate that SARS-CoV-2 neutralizing antibodies are readily measurable in DBS eluates and correlate with plaque reduction neutralization titer (PRNT) values from paired serum samples. Moreover, several of the methods used to estimate SARS-CoV-2 neutralizing antibodies in DBS eluates are adaptable to high-throughput platforms.

Knowing the Antibody Status may influence compliance of health care workers to COVID-19 booster dose

Abstract Background Previous studies showed that the fourth SARS-CoV-2 vaccine dose has a protective effect against infection, as well as against severe disease and death. This study aimed to examine whether knowledge of a high level antibody after the 3rd dose may reduce compliance to the 4th booster dose among health care workers. Methods We conducted a prospective cohort study among health care workers vaccinated with the first three doses at Rambam Healthcare Campus, a tertiary hospital in northern Israel. Participants underwent a serological test before the 4th booster vaccine was offered to all of them, with results provided to participants. The population was divided into two groups: those with antibody below 955 AU/ml, and those with 955 AU/ml and higher, a cutoff found protective in a previous study. Multiple logistic regression was carried out to compare the compliance to the 4th booster between the two groups, adjusted for demographic and clinical variables. Results After adjusting for the confounding variables, the compliance was higher in those with antibody levels below 955 AU/ml (OR = 1.41, P = 0.05, 95% CI 1.10-1.96). In addition, male sex, and age of 60 years and above were also associated with higher vaccination rate (OR = 2.28, P &amp;lt; 0.001, 95% CI 1.64 - 3.17), (OR = 1.14, P = 0.043, 95% CI 1.06 - 1.75), respectively. Conclusions Knowledge of the antibody status may affect compliance with the booster dose. Considering waning immunity over time, reduced compliance may affect the protection of health care workers who declined the 4th dose. Key messages • Knowing the antibody status may affect compliance of health care workers with the booster dose. • Reduced compliance of health care workers may affect their protection.

COVID-19 vaccine effectiveness and hybrid immunity in the respiratory season of 2022-23 in Hungary

Abstract Background There has been an increase in COVID-19 vaccine hesitancy among the general population, accompanied by a decline in confidence that vaccines provide adequate protection. We estimated the effectiveness of the COVID-19 vaccines (CVE) and hybrid immunity against medically attended COVID-19 during the 2022-2023 respiratory season in Hungary. Methods We conducted a test-negative design study involving 68 GPs. Patients aged ≥18 years presenting with acute respiratory infection were swabbed. Cases and controls were patients testing positive and negative for SARS-CoV-2 by RT-PCR, respectively. Exposure was defined as having received at least one COVID-19 booster dose, taking into account the time since the last vaccination. CVE was estimated using logistic regression, adjusted for symptom onset date, age, chronic condition and sex. Results We included 247 cases and 1073 controls in the analysis. 196 samples were sequenced, and Omicron BA.5, BQ.1 and XBB.1 were the most frequent sub-variants. The CVE was 52.9% (95% CI: 15.2-73.9%), and 72.3% (95% CI: 32.0-88.7%) in the 18-59, and 60+-year-old population who received the final dose within the past year, respectively. Self-reported COVID-19 in the previous 60-365 days did not confer protection against reinfection, however, when combined with booster vaccination, it reduced the risk of COVID-19 by 63.0% (95% CI: −28.0-89.3%) and 87.6% (95% CI: 26.4-97.9%) among the 18-59 and 60+ age groups, respectively. Conclusions Booster vaccination within one year after the last dose confers significant protection against symptomatic infection, particularly among the elderly. Those who have previously been infected with SARS-CoV-2 may also benefit from booster vaccinations. Key messages • COVID-19 booster campaigns must be intensified, focusing mainly on the elderly. • Providing clear guidance on the timing and target groups of vaccination and emphasising the benefits of vaccination can help to achieve higher coverage.

Preferences regarding the Booster Dose of Covid-19: a cross-sectional study in Central Italy

Abstract Background Examining information sources, communication channels, and preferred content formats is crucial for adapting and improving future communication strategies in vaccination campaigns. This study aims to evaluate the information and communication preferences regarding the booster dose of Covid-19 among employees of the Central Tuscany Local Health Authority (CT-LHA). Methods From July to October 2022, a questionnaire was administered to 7,000 out of approximately 15,000 CT-LHA employees. The questionnaire analyzed communication, organizational, and access aspects regarding preferences for the Covid-19 booster dose. The sample was stratified into healthcare workers (HCWs) and non-healthcare workers (NHCWs). Chi-squared tests were performed using STATA, with the significance level set at 95%. Results The returned questionnaires were 1,885 (26.9%), with the majority being HCWs (64.4%). HCWs rated the quality of communication significantly lower compared to NHCWs, who rated it very high (p &amp;lt; 0.05). HCWs also rated the ease of booking the Covid-19 booster dose and access modalities to vaccination significantly lower than NHCWs (p &amp;lt; 0.05). NHCWs expressed a preference for receiving scientific information from Ministry of Health tutorials, while HCWs preferred information from their general practitioner (p &amp;lt; 0.05). HCWs preferred to receive organizational information from healthcare management, while NHCWs preferred information from vaccination physicians (p &amp;lt; 0.05). Additionally, HCWs preferred company operating procedures for disseminating information, whereas NHCWs preferred corporate communications circulars (p &amp;lt; 0.05). Conclusions HCWs and NHCWs showed differences in perceived quality of communication, ease of access to vaccination services, and preferred sources of information. HCWs rated the quality of communication and access to vaccination services lower than NHCWs. This results suggest the need for tailored communication strategies to effectively reach both groups. Key messages • Health organizations need to develop targeted communication approaches that address the specific needs and preferences of their employees. • Flexibility and adaptability are crucial to adapt communication methods and channels to strengthen vaccination initiatives and promote public health outcomes.

Driving policy changes: RISE-Vac lessons learnt and recommendations

Abstract The RISE-Vac project consortium applied evidence-based public health methods to collate, assess, and analyze all the evidence generated through project activities, including literature review and prospective data collection on quantitative and qualitative aspects of vaccine services implementation in prison settings. A multi-sectorial and inter-disciplinary group of experts was set-up including health professionals, statisticians, social scientists and people with lived experience from civil society organisations, health services, prison administrations, academia and international agencies. A set of recommendations, advice, and policy options on how to increase vaccine uptake, targeted to people in prison and using a citizen-centred approach, were developed and tailored to specific needs profiles of different prison population subgroups. Vaccinations to be considered in prison settings were grouped according to target population and/or public health objective into: Seasonal vaccinations and vaccination during outbreak; Childhood life-course vaccinations (booster doses); Vaccinations for cancer prevention; Vaccination for older population groups and people with chronic conditions. In consideration of the diversity of the countries participating in the project, their epidemiological context and available resources and infrastructures, a multi-tiered approach for the development and implementation of models for vaccination services implementation in prison settings was devised, encompassing core vaccinations, such as HBV, Flu, COVID-19 and tetanus, as well as expanded vaccination offer to respond to enhanced health needs and to promote equity of health outcomes, including e.g. HPV vaccination.

Estimating the impact of the COVID-19 vaccination programme in Ireland: December 2021-March 2023

Abstract Background In Autumn 2023, COVID-19 booster vaccines were offered to all those aged ≥50 years in Ireland. There was concern that vaccine fatigue would impact uptake. We aimed to quantify the direct impact of the COVID-19 vaccination programme on averted outcomes in individuals aged ≥50 years, during a period of Omicron variant dominance, to inform vaccination strategy and public health communication. Methods We conducted a retrospective observational study from December 2021 to March 2023 in Ireland. We considered as averted outcomes symptomatic SARS-CoV-2 presentations to primary care, emergency department (ED) presentations, hospitalisations, intensive care unit (ICU) admissions and deaths due to COVID-19. We used an adapted formula from other vaccine impact published studies, including national data on notified outcomes, vaccine coverage data and vaccine effectiveness (VE) estimates, sourced from the WHO’s live systematic VE review, to estimate the count and prevented fraction of outcomes in ≥ 50-year-olds averted by the COVID-19 vaccination programme. The number of expected outcomes in the absence of vaccination was calculated by summing the counts of outcomes observed and outcomes averted. Results Between December 2021 and March 2023, the COVID-19 vaccination programme averted 48,551 symptomatic presentations to primary care (36% of expected), 9,517 ED presentations (53% of expected), 102,160 hospitalisations (81% of expected), 3,303 ICU admissions (89% of expected) and 15,985 deaths (87% of expected). Conclusions During Omicron dominance, the COVID-19 vaccination programme averted symptomatic and severe outcomes, including deaths due to COVID-19, underscoring the benefits of COVID-19 vaccination. In the context of vaccine fatigue emerging as an important public health issue in Ireland and internationally, these findings can inform future COVID-19 booster vaccination programmes and communication about the reason for and importance of COVID-19 vaccination. Key messages • The COVID-19 vaccination programme in Ireland prevented illness and death in people aged ≥50-years. Vaccination therefore protected population health and the healthcare system. • These findings can be used to inform future COVID-19 vaccination policies, planning for winter, pandemic preparedness and communisation about the importance of ongoing COVID-19 vaccination programmes.

The resurgence of pertussis in Central Serbia in the period from June to December 2023

Abstract Background There was a registered increase in the number of confirmed pertussis cases in Central Serbia between June and December 2023. Among the possible causes of pertussis resurgence are increased awareness of pertussis among healthcare workers, availability of the sensitive RT PCR method in diagnostic, the limited duration of vaccine-induced immunity as well as decline of immunization coverage influenced by the COVID-19 pandemic. Methods The nasopharyngeal samples from clinics and primary care departments were transferred to Institute of Public Health of Serbia. DNA was extracted from each sample using the MagMAX Viral/Pathogen kit. The presence of B. pertussis was determined using two PCR assays, VIASURE Bordetella Real Time PCR Detection Kit and Bosphore B. pertussis/parapertussis Genotyping Kit, Anatolia Geneworks. Results RT-PCR confirmed a total of 338 pertussis cases in Institute of Public Health of Serbia during the observed period. Most of confirmed cases were among children 9-14 years old (49,7%) followed by infants younger than 12 months (21,9%). The more severe cases were among the unvaccinated and uncomplete vaccinated infants, 78,4% of which required hospitalization with two deaths in this age group. Conclusions Based on the analysis of the obtained results, we can highlight the importance of using sensitive methods in pathogen detection. Rapid diagnosis, laboratory confirmation and notification ensure early public health intervention to minimize the spread of disease. Despite long tradition of mandatory immunization against pertussis in the Republic of Serbia, wanning of vaccine induced immunity poses potential risk for the resurgence of pertussis. For pertussis control, in the future, it will be essential to achieve high immunization coverage as well as to introduce a booster dose of pertussis containing vaccine for children aged 14 and to implement vaccination of pregnant women. Key messages • For the better pertussis control vaccination of adolescents and adults, as well as vaccination of pregnant women should be considered in the future vaccination policies. • Clinicians should consider pertussis in the differential diagnosis of persistent cough illness in people of all ages, even those previously immunized.

Systematic review of the literature about immunogenity and antibodies persistance of Tdap vaccination

Abstract Introduction In industrialized countries, routine use of pertussis vaccines has shifted the burden of pertussis disease from children to infants, adolescents and adults, leading to the necessity of booster doses. Materials and methods We prepared the review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) with the aim of a) to describe the immunogenity of the main available vaccines for adolescents and adults b) to describe antibodies persistance after immunization with the main vaccines available in childhood and adults and, also, possible co-administration and c) to identify the gold standard for adolescent and adult immunizations. Results Of 6906 records identified, after removing duplicate records, 12 RCT were included (people aged 11-73): of these 7 studies had only 1 control group, 4 studies had 2 control group and 1 had 5 control group; moreover, of the 12 studies included only 2 regarding co-administration and all were about immunogenity. 9 out 12 studies had a Jadad score above 3 points and 10 out 12 meet the criteria of Cocrane Back Review Group Criteria List for Methodological Quality Assessment. Discussion and conclusions We found a limited number of good-quality RCTs investigating our object. The five component vaccines, although containing a lower dosage of antigen, are found to be more effective than one components vaccines for prevention. Evidences support the use of 5- components vaccines for booster sessions in adolescence and adulthood. Key messages • Although 3-component and 5-component vaccines contain a lower dose of antigen, they are more effective than 1-component vaccines in the prevention of diphtheria-tetanus and Bordetella pertussis. • The robustness of the data and the analytical tests support the use of vaccines with reduced antigen concentration for decennial booster sessions in adolescence and adulthood.