Catch-up Vaccination Research Articles

Impact of catch-up vaccination on aluminum exposure due to new laws and post social distancing

BackgroundThe COVID-19 pandemic has placed significant stressors on the medical community and on the general public. Part of this includes patients skipping well-child visits to reduce risk of exposure to SARS-CoV-2 virus. Published estimates of the duration of whole-body aluminum (Al) toxicity from vaccines in infants from birth to six months indicate that CDC's recommended vaccination schedule leads to unacceptably long periods of time in which infants are in aluminum toxicity (as measured by %AlumTox). MethodsWe utilize these established clearance and accumulation models to calculate expected per-body-weight whole-body toxicity of aluminum from vaccines considering for children of all ages under CDC's Catch-Up schedule from birth to ten years, assuming social distancing for 6 months. Our updated Pediatric Dose Limit (PDL) model assumes a linear improvement in renal function from birth to two years. ResultsOur results indicate that due diligence in considering alternative spacing and use of non-aluminum containing vaccines when possible will reduce whole body toxicity and may reduce risk of morbidity associated with exposure to aluminum. ConclusionsWhile reduction or elimination of aluminum exposure from all sources is always a good idea, our results indicate that careful consideration of expected aluminum exposures during regular and Catch-Up vaccination is found to be especially important for infants and children below 2 years of age. We urge caution in the mass re-starting of vaccination under CDC’s Catch-Up schedule for children under 12 months and offer alternative strategies to minimize per-day/week/month exposure to aluminum hydroxide following the COVID-19 period of isolation.

"No jab, no pay": catch-up vaccination activity during its first two years.

ObjectivesTo assess catch‐up vaccination of older children and adolescents during the first two years of the “No jab, no pay” policy linking eligibility for federal family assistance payments with childhood vaccination status.Design, setting, participantsCross‐sectional analysis of Australian Immunisation Register data on catch‐up vaccination of children aged 5 to less than 7 years before (January 2013 – December 2014; baseline) and during the first two years of “No jab, no pay” (December 2015 – December 2017), and of children aged 7 to less than 10 years and young people aged 10 to less than 20 years (“No jab, no pay” period only).Main outcomesCatch‐up vaccination rates for measles–mumps–rubella vaccine second dose (MMR2), by age group, Indigenous status, and socio‐economic status; catch‐up vaccination of children aged 5 to less than 7 years (third dose of diphtheria–tetanus–pertussis vaccine [DTPa3], MMR1), before and after introduction of “No jab, no pay”.ResultsThe proportion of incompletely vaccinated children aged 5 to less than 7 years who received catch‐up DTPa3 was higher under “No jab, no pay” than during the baseline period (15.5% v 9.4%). Of 407 332 incompletely vaccinated people aged 10 to less than 20 years, 71 502 (17.6%) received catch‐up MMR2 during the first two years of “No jab, no pay”, increasing overall coverage for this age group from 86.6% to 89.0%. MMR2 catch‐up activity in this age group was greater in the lowest socio‐economic status areas than in the highest status areas (29.1% v 7.6%), and also for Indigenous than for non‐Indigenous Australians (35.8% v 17.1%). MMR2 catch‐up activity in 2016 and 2017 peaked mid‐year.ConclusionsLinking family assistance payments with childhood vaccination status and associated program improvements were followed by substantial catch‐up vaccination activity, particularly in young people from families of lower socio‐economic status.

The performance of routine immunization in selected African countries during the first six months of the COVID-19 pandemic.

following the declaration of the COVID-19 pandemic on 11 March 2020, countries started implementing strict control measures, health workers were re-deployed and health facilities re-purposed to assist COVID-19 control efforts. These measures, along with the public concerns of getting COVID-19, led to a decline in the utilization of regular health services including immunization. we reviewed the administrative routine immunization data from 15 African countries for the period from January 2018 to June 2020 to analyze the trends in the monthly number of children vaccinated with specific antigens, and compare the changes in the first three months of the COVID-19 pandemic. thirteen of the 15 countries showed a decline in the monthly average number of vaccine doses provided, with 6 countries having more than 10% decline. Nine countries had a lower monthly mean of recipients of first dose measles vaccination in the second quarter of 2020 as compared to the first quarter. Guinea, Nigeria, Ghana, Angola, Gabon, and South Sudan experienced a drop in the monthly number of children vaccinated for DPT3 and/or MCV1 of greater than 2 standard deviations at some point in the second quarter of 2020 as compared to the mean for the months January-June of 2018 and 2019. countries with lower immunization coverage in the pre-COVID period experienced larger declines in the number of children vaccinated immediately after the COVID-19 pandemic was declared. Prolonged and significant reduction in the number of children vaccinated poses a serious risk for outbreaks such as measles. Countries should monitor coverage trends at national and subnational levels, and undertake catch-up vaccination activities to ensure that children who have missed scheduled vaccines receive them at the earliest possible time.

Increasing vaccination coverage: The school entry vaccination record check program in Guizhou Province China, 2003–2018

BackgroundGuizhou Province of China implements a vaccination program specifying that children’s vaccination records are to be checked upon entry to kindergarten and primary school; children missing one or more recommended vaccinations are to be offered the missed vaccinations; school-level vaccination coverage levels are assessed at the time of school enrollment and six months later to monitor compliance rates. MethodsWe obtained the number of doses of each vaccine in the national immunization schedule that were administered before and six months after kindergarten and school enrollment and reported to Guizhou Province during 2004 through 2018. We determined temporal trends in coverage of the second dose of measles-containing vaccine (MCV2) and other vaccines, incidence of measles, and number of school-based measles outbreaks. ResultsMCV2 coverage at kindergarten entry increased from 53% in 2004 to 98% in 2018. Among children missing one or more vaccinations, the six-month catch-up rate of MCV2 increased from 80% in 2004 to 99% in 2018. Among primary school children, coverage of MCV2 and other recommended vaccines had similar increases. The annual incidence of measles among Guizhou’s total population declined from 280 per million in 2003 to 0.3 per million in 2018. There have been no measles outbreaks in kindergartens or schools since 2015. ConclusionsChecking vaccination record at kindergartens and primary schools and providing necessary catch-up vaccination was associated with increased coverage of measles and other vaccines, lower incidence of measles, and an apparent end to school-based measles outbreaks. Guizhou’s experience of checking vaccination records at school enrollment led to implementation of this strategy in other provinces. In 2019, the kindergarten and school entry vaccination record check program was incorporated into China’s national vaccine law.

5.H. Workshop: Developing more responsive systems to deliver catch-up vaccination to migrants arriving in Europe

Abstract Background and Objectives Migrants are thought to be one of several under-immunised groups in Europe, and involved in outbreaks of vaccine preventable diseases - including the recent large pan-European outbreak of measles. They may be under-immunised because of poor functioning of the health systems in countries they come from, because of barriers to catch-up vaccination and health services on arrival to Europe, and vaccine hesitancy may play a role. Amid substantial migration to Europe in recent years, ECDC public health guidelines for newly arrived migrants to EU/EEA countries have defined new recommendations, including focusing on catch-up vaccination in adult migrants. Yet there is an urgent need to better define what strategies work to improve vaccine coverage and to better understand the views of migrant communities, which will be the focus of this workshop. In this workshop we will explore various facets of migration and vaccination in the European context, and seek audience participation in better defining innovative implementation models and models of best practice to improve vaccine coverage in migrant populations residing in the region. Workshop plan The workshop will start with 15-minute presentations by each of the 4 speakers (to include a short Q&A after each talk). This will then move into a 30-minute audience discussion centred around seeking specific feedback on examples of innovation, good practice, and lessons learned across EU/EEA countries in engaging migrants and improving vaccine coverage in this group. Speakers and topics Sally Hargreaves (St George's, University of London): Are migrants to Europe an under-immunised group and involved in outbreaks? implications for health systems, policy, and practice. Elizabeth de Vito (Università degli Studi Di Cassino e del Lazio Meridionale, Italy) Barriers and facilitators to catch-up vaccination in migrant populations: defining effective and cost-effective implementation strategies. Ines Campos-Matos (Public Health England, UK) Vaccination on the move for asylum seekers and refugees: evidence, policies and practicalities. Christina Louka (University of Groningen, The Netherlands) Perspectives of asylum seekers, refugees, and other migrant groups on approaches to catch-up vaccination on arrival to Europe. Key messages Migrants are likely to be an under-immunised group in Europe, with new ECDC guidelines outlining key recommendations for catch-up vaccination on arrival. There is a need to better define more effective strategies to improve vaccine coverage in migrant populations in Europe.

Vaccination on the move for asylum seekers and refugees: evidence, policies and practicalities

Abstract Public Health England works alongside the International Organization for Migration to provide migration health assessments and a travel service to refugees entering the UK through the Gateway Resettlement Programme. As part of this programme, catch-up vaccination is offered to align these migrants with the UK schedule. IC-M will describe current UK approaches to improving vaccination coverage in migrants both to and within the country, and highlight lessons learned for European health systems.

Impact of Australian mandatory policies on immunisation services, parental attitudes to vaccination and vaccine uptake in a tertiary paediatric hospital

Abstract Introduction 'No Jab, No Play' and 'No Jab, No Pay' mandatory immunisation policies were introduced in the state of Victoria and Australia nationally in January 2016. They restrict access to childcare/kindergarten and family assistance payments respectively, for under-vaccinated children. We aimed to describe the proportion of attendees to immunisation services of a tertiary hospital, the Royal Children's Hospital Melbourne (RCH), who were motivated by the policies to discuss or catch up vaccination. We also explored the association between policy motivation, vaccine hesitancy (VH) and intent to seek medical exemption, with vaccine-uptake. Referrals to the Specialist Immunisation Clinic (SIC) were also reviewed. Methods Parents/Guardians and clinicians completed surveys October 2016-May 2017 from the nurse-led immunisation Drop in Centre (DIC) or physician-led SIC. Vaccine-uptake was measured using the Australian Immunisation Register at baseline, 1 and 7 months post-attendance. The association between vaccine-uptake, policy motivation and VH was explored by logistic regression. Results Of 607 children included, 393 (65%) were from the DIC and 214 (35%) SIC. 74 (12%) of parents were motivated by the policies to attend immunisation services and 19% were VH. Only 50% of VH parents planned to catch-up vaccination for enrolment to childcare/kindergarten. Fewer children were fully immunised at 7 months if their parents were VH (difference 18%; OR 0.24, CI 0.1-0.54,p<0.001) or seeking medical exemption (difference 33%, OR 0.08, CI 0.01-0.6, p 0.015). Conclusions The 'No Jab' policies motivated attendance to a tertiary immunisation service but children of vaccine hesitant parents and those seeking medical exemption to immunisation were less likely to be fully immunised post attendance, compared to baseline. These data will be used to inform a comprehensive evaluation of the impact of the policies, particularly the educational impact from loss of early childhood education.

Coverage of HPV vaccination programme in Friuli Venezia Giulia Region (Northern Italy).

to assess the completeness and timeliness of Human papillomavirus (HPV) vaccination programme in Friuli Venezia Giulia (FVG) Region (Northern Italy), notably by monitoring 2-dose coverage among girls before they turn 15 years old (referred to as "at 15") in each year between 2009 and 2018 and making a preliminary evaluation of coverage among boys at 13 years in 2016-2018. retrospective study. for each vaccine recipient, demographic information and history of HPV vaccine uptake from the digital FVG Vaccination Registry updated as of 31.12.2018 were extracted. Numerator data comprised all doses allocated to FVG residents. Age-specific denominators were derived from the FVG census in each examined year. Coverage estimates for the year 2018 were also provided by number of doses. coverage for a full course of HPV vaccine, defined as 2 doses in girls and boys younger than age 15 years but 3 doses in less young women. In FVG 52,217 females had received >=1 dose since 2008 and 12,152 males since 2015. >=2-dose coverage in girls at 15 increased from 42% in 2009 to 76% in 2015 and slightly declined afterwards (69% in 2018). In 2008, 3-dose coverage was 65%, 74%, and 59% in females aged 16-17, 18-19, and 20-26 years, respectively. In the same year, 2-dose coverage in boys at 13 years was 54%, similar to the coverage in girls at 13 years (57%). this paper shows the achievements of routine and catch-up HPV vaccination in FVG. While coverage in girls at 15 years of age peaked in 2015 and slightly diminished in subsequent years, the coverage in boys at 13 in 2018 had already approached the coverage in same-age girls (57%). On account of the signs of weakening in girls' coverage, campaigns in support to HPV vaccination must be repeated, especially in favour of the most cost-effective group, i.e., girls before 15 years of age. The heavy burden posed by the COVID-19 emergency on other prevention-related activities makes a better targeted use of HPV vaccination even more necessary.

Barriers and facilitators to catch-up vaccination in migrant populations: defining effective and cost-effective implementation strategies

Abstract In this talk, EdV will discuss barriers and facilitators to vaccination uptake in a range of diverse migrant groups in Europe, explore the role of vaccine hesitancy in vaccine uptake in migrant populations, and define effective and cost-effective strategies to improve coverage.

Commentary: HPV Catch-Up Vaccination Reduces the Prevalence of HPV 16 and 18 Infections and Cervical Disease: A Retrospective Study

Commentary: HPV Catch-Up Vaccination Reduces the Prevalence of HPV 16 and 18 Infections and Cervical Disease: A Retrospective Study

Validation of mobile Decision Support System for scheduling age-appropriate immunizations

Abstract Background The prevalence of missed opportunities for immunization among children is estimated to be 32.2%. The introduction of new vaccines in EPI schedule and lack of training of frontline health workers (FHWs) on the guidelines for number and spacing of doses and manual construction of vaccine schedules based on a child's age deteriorates efficiencies of FHWs, especially in forecasting catch-up schedules. We have designed and tested the validity of an innovative Decision Support System Application Programming Interface (DSS-API) which will automatically generate an age-appropriate immunization schedule for a child. Methods Using a multi-country setting approach, DSS was deployed in six immunization facilities of Pakistan and Bangladesh between July 2019 to April 2020. Details of all visiting children were recorded in database. Information on date of birth and past immunization history was used by the DSS-API to determine an individualized age-appropriate immunization schedule. These schedules were compared to the gold standard's outputs calculated by an immunization expert. Results A total of 6,241 vaccination events were recorded from all the sites. Using area under the curve, the calculated sensitivity of DSS to determine age-appropriate immunization schedule was found between 99-100% for the individual EPI vaccines, while the specificity of the DSS algorithm was found between 98-100%. Conclusions DSS is a feasible feature that can be incorporated in Digital Immunization Registries to accurately schedule routine and catch-up immunizations and can effectively reduce Missed Opportunities for Immunizations by assisting FHWs through automatic construction of immunization schedules. Key messages DSS-API is a unique application that can improve process efficiencies of frontline health workers by automatic generation of accurate age-appropriate catch-up vaccine schedules. DSS has the potential to reduce missed opportunities for immunization (MOI) and improve immunization coverage and timeliness among children aged under 2 years.

Perspectives of asylum seekers, refugees, and other migrant groups on approaches to catch-up vaccination on arrival to Europe

Abstract Very few research studies to date have explored the views and concerns of the broad range of migrants residing in Europe around vaccination in general, vaccine hesitancy, and approaches to catch-up vaccination on arrival. In this talk, CL will discuss the current research in this area, and implications for policy and practice.

The influence of affect on HPV vaccine decision making in an HPV vaccine naïve college student population.

The HPV vaccine is recommended for all adolescents starting at age 11, but coverage is low, especially in the young adult population. The CDC is prioritizing catch-up vaccination and has expanded recommendations for all young adults to age 26. College students may be ideal targets for HPV vaccine interventions as they typically have on-site clinics that offer prevention services and students are in the position to make decisions about their own healthcare. We examined the risk perceptions of 101 HPV vaccine-naïve college students, both in terms of risk cognition (beliefs about susceptibility to HPV-related cancers and genital warts) and affect (worry and fear regarding HPV-related health outcomes) as they relate to HPV vaccine intentions. Participants completed an online survey, reporting absolute and comparative risk perceptions for HPV-related cancers/genital warts, fear and worry related to getting HPV-related cancer and/or genital warts, desire for positive emotions, affective associations with the HPV vaccine, and intentions to get the HPV vaccine. More fear/worry about vaccination was directly associated with increased vaccine intentions. The perceived risk to intentions relation included an indirect effect via fear/worry. Desire for positive affect strengthened this relation. Positive affective associations with the HPV vaccine were also related to increased vaccine intentions. Given the public health impact of increasing HPV vaccine coverage for young adults, educational strategies framing the HPV vaccine positively while decreasing fear/worry related to negative health outcomes might increase interest in on-campus catch-up vaccination.

Outbreak of Measles in a Residential Home for the Intellectually Disabled in Singapore in 2019

A measles outbreak involving 19 adults in a home for the intellectually disabled occurred in Singapore in 2019. Further investigation, including a serological survey, was conducted. Mass vaccination and infection control measures were implemented, terminating further secondary transmission. Seropositivity among residents aged 40 to 49 years (90.7%; 95% confidence interval = 78.4%, 96.3%) was lower than among the Singapore adult population (P < .001). This sheltered population, like others previously reported in the literature, had lower measles immunity than the general community, possibly because of limited social interaction. Targeted catch-up vaccination for similarly vulnerable populations should be considered.

Human papillomavirus (HPV) vaccine status and knowledge of students at a university in rural Thailand

BackgroundHuman papillomavirus (HPV) is a sexually transmitted virus that causes cancers of the cervix, anus, vagina, penis, and oropharynx. HPV vaccination prevents HPV types that commonly cause these cancers. HPV vaccines have been approved in Thailand since 2007. However, the vaccination rate remains low, particularly in young people. ObjectivesThis study aimed to investigate the information level regarding HPV infection and vaccination in the younger Thai population, the self-reported vaccination rate, the vaccine intention, and factors affecting the intention. MethodsThis cross-sectional study enrolled a total of 521 undergraduate students (77% female). We used a 34 items self-administered questionnaire (18 questions assessing knowledge level). ResultsThe mean score of knowledge was 7.53 ± 4.95 (total score 18), indicating a low-to-moderate level of knowledge. Female gender and health-related majors were significant factors associated with greater knowledge. The self-reported vaccination rate was 1.9% among only female participants. Only 30.3% of the unvaccinated subjects had the intention to receive the vaccine. The factors affecting vaccine intention were female gender and having knowledge score ≥7. The barriers to HPV vaccination were cost (52.2%), and the perception of no need due to low-risk behavior (45.1%). ConclusionEducation programs on HPV infection and vaccination should be included in the curriculum earlier, if possible, since primary school because the vaccine works best before the onset of sexual activity. In university students, the education programs may encourage the sexually inexperienced students to receive the vaccines, as they are still the ideal group for catch-up vaccination. Moreover, parental education is essential, as national vaccination programs usually target younger people. Knowledge sharing by educated people and organizations could enhance the information level in the communities. Consequently, people become aware of primary prevention by vaccination, which may lead to an increase in vaccination rates and eventually decrease HPV-related cancers.

Progress Toward Hepatitis B Control - South-East Asia Region, 2016-2019.

In 2015, the World Health Organization (WHO) South-East Asia Region (SEAR)* reported an estimated 40 million persons living with chronic hepatitis B virus (HBV) infection and 285,000 deaths from complications of chronic infection, cirrhosis, and hepatocellular carcinoma (1). Most chronic HBV infections, indicated by the presence of hepatitis B surface antigen (HBsAg) on serologic testing, are acquired in infancy through perinatal or early childhood transmission (2). To prevent perinatal and childhood infections, WHO recommends that all infants receive at least 3 doses of hepatitis B vaccine (HepB), including a timely birth dose (HepB-BD)† (1). In 2016, the SEAR Immunization Technical Advisory Group endorsed a regional hepatitis B control goal with a target of achieving hepatitis B surface antigen (HBsAg) seroprevalence of ≤1% among children aged ≥5 years by 2020, which is in line with the WHO Global Health Sector Strategy on Viral Hepatitis 2016-2021 (2,3). The South-East Asia Regional Vaccine Action Plan 2016-2020 (SEARVAP) (4) identified the acceleration of hepatitis B control as one of the eight regional goals for immunization. The plan outlined four main strategies for achieving hepatitis B control: 1) achieving ≥90% coverage with 3 doses of HepB (HepB3), 2) providing timely vaccination with a HepB birth dose (HepB-BD), 3) providing catch-up vaccination of older children, and 4) vaccinating adult populations at high risk and health care workers (1,4). In 2019, SEAR established a regional expert panel on hepatitis B to assess countries' HBV control status. This report describes the progress made toward hepatitis B control in SEAR during 2016-2019. By 2016, all 11 countries in the region had introduced HepB in their national immunization programs, and eight countries had introduced HepB-BD. During 2016-2019, regional HepB3 coverage increased from 89% to 91%, and HepB-BD coverage increased from 34% to 54%. In 2019, nine countries in the region achieved ≥90% HepB3 coverage, and three of the eight countries that provide HepB-BD achieved ≥90% HepB-BD coverage. By December 2019, four countries had been verified to have achieved the hepatitis B control goal. Countries in the region can make further progress toward hepatitis B control by using proven strategies to improve HepB-BD and HepB3 coverage rates. Conducting nationally representative hepatitis B serosurveys among children will be key to tracking and verifying the regional control targets.

HPV16/18 prevalence in high-grade cervical lesions in an Australian population offered catch-up HPV vaccination

ObjectivesUsing laser capture microdissection (LCM) and sensitive human papillomavirus (HPV) genotyping, we aimed to determine the distribution of vaccine-preventable types in cervical intraepithelial neoplasia grade 3 (CIN3) lesions and adenocarcinoma in situ (AIS) in young women in Victoria, Australia, offered catch-up HPV vaccination, as a baseline for ongoing vaccine impact monitoring. We also compared findings with available pre-vaccination estimates from women with HPV detected on concurrently-collected cytology samples. MethodsConsecutive histologically-confirmed CIN3/AIS biopsies were collected between May 2011 and December 2014 from vaccine-eligible women (born after 30th June 1981). Genotypes present in whole tissue sections (WTS) were determined by a sensitive reverse hybridisation assay; RHA kit HPV SPF10-LiPA25, v1 (Labo Bio-medical Products). Where multiple genotypes were detected, lesions were isolated using LCM and genotyped. Cervical cytology samples from a pre-vaccine cohort had been previously collected and genotyped using HPV Linear Array HPV Genotyping Test (Roche Diagnostics). Mixed-genotype detections in this cohort were resolved to single-lesion-attributable genotypes using hierarchical attribution. ResultsOverall, 213 and 530 cases were included from pre- and post-vaccine time-periods, respectively. In 18–25 year-olds, the proportion of HPV16/18-positive CIN3/AIS decreased significantly over time from 69% in 2001–2005 (pre-vaccine), to 62% in 2011–2012 (post-vaccine), to 47% in 2013–2014 (p-trend = 0.004). There was no significant change in HPV16/18 in 26–32 year-olds (p-trend = 0.15). In 2013/14, nonavalent vaccine types accounted for 80% of CIN3/AIS in 18–25 year old women and 90% in 26–32 year old women. ConclusionFour to 8 years following implementation of HPV vaccination in Australia, approximately 70% of CIN3/AIS in young women was due to HPV16/18. Our data, despite some limitations due to change in methods between pre- and post-vaccine periods, suggests that for vaccine-eligible women aged 18–25 at the time of biopsy, the proportion of HPV16/18-attributable CIN3/AIS lesions is significantly declining post-vaccination.

Epidemiological Impact of Novel Preventive and Therapeutic HSV-2 Vaccination in the United States: Mathematical Modeling Analyses.

This study aims to inform herpes simplex virus type 2 (HSV-2) vaccine development, licensure, and implementation by delineating the population-level impact of vaccination. Mathematical models were constructed to describe the transmission dynamics in presence of prophylactic or therapeutic vaccines assuming 50% efficacy, with application to the United States. Catch-up prophylactic vaccination will reduce, by 2050, annual number of new infections by 58%, incidence rate by 60%, seroprevalence by 21%, and avert yearly as much as 350,000 infections. Number of vaccinations needed to avert one infection was only 50 by 2050, 34 by prioritizing those aged 15–19 years, 4 by prioritizing the highest sexual risk group, 43 by prioritizing women, and 47 by prioritizing men. Therapeutic vaccination of infected adults with symptomatic disease will reduce, by 2050, annual number of new infections by 12%, incidence rate by 13%, seroprevalence by 4%, and avert yearly as much as 76,000 infections. Number of vaccinations needed to avert one infection was eight by 2050, two by prioritizing those aged 15–19 years, three by prioritizing the highest sexual risk group, seven by prioritizing men, and ten by prioritizing women. HSV-2 vaccination offers an impactful and cost-effective intervention to prevent genital herpes medical and psychosexual disease burden.

Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation.

The American Cancer Society (ACS) presents an adaptation of the current Advisory Committee on Immunization Practices recommendations for human papillomavirus (HPV) vaccination. The ACS recommends routine HPV vaccination between ages 9 and 12years to achieve higher on-time vaccination rates, which will lead to increased numbers of cancers prevented. Health care providers are encouraged to start offering the HPV vaccine series at age 9 or 10years. Catch-up HPV vaccination is recommended for all persons through age 26years who are not adequately vaccinated. Providers should inform individuals aged 22 to 26years who have not been previously vaccinated or who have not completed the series that vaccination at older ages is less effective in lowering cancer risk. Catch-up HPV vaccination is not recommended for adults aged older than 26years. The ACS does not endorse the 2019 Advisory Committee on Immunization Practices recommendation for shared clinical decision making for some adults aged 27 through 45years who are not adequately vaccinated because of the low effectiveness and low cancer prevention potential of vaccination in this age group, the burden of decision making on patients and clinicians, and the lack of sufficient guidance on the selection of individuals who might benefit.

Evaluation of Hepatitis B, Hepatitis A, Measles, Rubella, Mumps and Varicella Antibody Seroprevalences in Vocational School of Health Students

Objective: In the present study, we investigated the seroprevalence of antibodies against hepatitis B, hepatitis A, measles, mumps, rubella and varicella viruses in adolescent students of a Vocational School of Health and aimed to contribute to the future studies intended to increase the vaccination rates of adolescent and health care workers in our country. Material and Method: Ninety-five students of the Vocational School of Health screened for hepatitis B, hepatitis A, measles, mumps, rubella and varicella who were referred to the vaccination unit of our hospital were included in this study. Results: The mean age of the students was 16.4±0.7 years (14- 18 years), 63.2% are girls, 36.8% are boys. None of the students received hepatitis A vaccine and varicella vaccine before. Of all the students, 16.9% tested positive for hepatitis B surface antibody, 8.4% tested positive for hepatitis A IgG, 77.9% tested positive for measles IgG, 92.3% tested positive for mumps IgG, 93% tested positive for rubella IgG and 88.5% tested positive for varicella IgG. Conclusion: In the present study, it was concluded that catch-up vaccination seems necessary for hepatitis A and varicella because contracting these two infections in this age group increases the complication risk caused by the high seronegativity of hepatitis A and the high incidence of natural varicella infection. Conducting similar studies for adolescents and healthcare providers in our country is important to determine pre-contact and post-contact strategies, assess cost-effectiveness of pre-vaccination serology and establish screening and immunization programs.