Choice Of Vaccine Research Articles

Parental Online Information Access and Childhood Vaccination Decisions in North America: Scoping Review

BackgroundImmunizing children throughout their early years prevents the spread of communicable disease and decreases the morbidity and mortality associated with many vaccine-preventable diseases. Searching online allows individuals rapid access to health information.ObjectiveThe purpose of this review was to develop an understanding of the existing literature of parents’ online health information-seeking behaviors to inform their vaccination choices for their children and to identify gaps in the literature around parents’ use of online health information and their vaccination choices.MethodsA scoping review of peer-reviewed literature from Canada and the United States was performed. The following databases were utilized to perform the search: PubMed, CINAHL, Nursing & Allied Health Database, Scopus, and PsycINFO. The purpose of this review was to examine parents’ use of online information seeking related to vaccine information and to understand how parents utilize this information to inform decisions about vaccinating their children. Of the 34 papers included in the review, 4 relevant themes and subthemes were identified: information seeking, online information resources, online vaccine content, and trust in health care providers.ResultsExamination of the literature revealed conflicting information regarding parents’ use of social media and online resources to inform decisions around vaccinating their children. There is evidence of significant misinformation regarding vaccine risks online. Parents’ digital health literacy levels are unknown and may affect their ability to appraise online vaccination information.ConclusionsParents are seeking vaccine information from online sources. However, the influence of online vaccine information on parental vaccine practices remains uncertain.

Facebook Pages, the "Disneyland" Measles Outbreak, and Promotion of Vaccine Refusal as a Civil Right, 2009-2019.

Objectives. To understand changes in how Facebook pages frame vaccine opposition.Methods. We categorized 204 Facebook pages expressing vaccine opposition, extracting public posts through November 20, 2019. We analyzed posts from October 2009 through October 2019 to examine if pages' content was coalescing.Results. Activity in pages promoting vaccine choice as a civil liberty increased in January 2015, April 2016, and January 2019 (t[76] = 11.33 [P < .001]; t[46] = 7.88 [P < .001]; and t[41] = 17.27 [P < .001], respectively). The 2019 increase was strongest in pages mentioning US states (t[41] = 19.06; P < .001). Discussion about vaccine safety decreased (rs[119] = -0.61; P < .001) while discussion about civil liberties increased (rs[119] = 0.33; Py < .001]). Page categories increasingly resembled one another (civil liberties: rs[119] = -0.50 [P < .001]; alternative medicine: rs[84] = -0.77 [P < .001]; conspiracy theories: rs[119] = -0.46 [P < .001]; morality: rs[106] = -0.65 [P < .001]; safety and efficacy: rs[119] = -0.46 [P < .001]).Conclusions. The "Disneyland" measles outbreak drew vaccine opposition into the political mainstream, followed by promotional campaigns conducted in pages framing vaccine refusal as a civil right. Political mobilization in state-focused pages followed in 2019.Public Health Implications. Policymakers should expect increasing attempts to alter state legislation associated with vaccine exemptions, potentially accompanied by fiercer lobbying from specific celebrities.

Understanding hesitancy around vaccines and vaccination: an umbrella review

Abstract Background Vaccination has been evaluated and was found to be the most successful and cost-effective interventions to preventing illness and improve health outcomes. However, internationally, an increase in vaccine hesitancy has led to a decrease in vaccination uptake. We conducted an umbrella review to assess the factors related to under-vaccination and non-vaccination from a global perspective. Methods PubMed, EMBASE and Science Direct were searched from inception to December 2019 for systematic reviews and meta-analyses that examined the factors affecting vaccination choices. No restrictions on language, publication date, vaccination type, setting, or population were applied. Narrative and extensive reviews were excluded. A narrative synthesis was undertaken to present the results thematically. Results Twenty-two systematic reviews met the inclusion criteria. The published evidence on this topic shows that, overall, a variety of complex factors exist related to vaccine hesitancy. Across all articles included, the main areas of concern were around vaccine safety and efficacy. Mistrust towards vaccine-related bodies (e.g. pharmaceutical companies, health professionals, researchers etc.), inconvenience, cost, and overall lack of information/knowledge were also identified as major barriers to vaccine uptake. Barriers vary depending on population, place and vaccines. Conclusions Our results show a variety of complex factors influencing the decision to accept, delay or reject some or all vaccines, indicating the necessity of a multi-faceted approach to address them in order to improve vaccine coverage. Key messages The results of this review show that concerns regarding vaccine safety and efficacy were the most significant barriers. Further research, policies, programs, and community-driven initiatives are needed to enhance acceptability and uptake of vaccination.

Individual Preferences for COVID-19 Vaccination in China

Background: Vaccinations are an effective choice to stop disease outbreaks, including COVID-19. There is little research on individuals’ COVID-19 vaccination decision-making. In this study, we aimed to determine individual preferences for COVID-19 vaccinations in China, and to assess the factors influencing vaccination decision-making to facilitate vaccination coverage. Methods: A D-efficient discrete choice experiment was conducted across 6 Chinese provinces selected by the stratified random sampling method. Vaccine choice sets were constructed using seven attributes: vaccine effectiveness, side-effects, accessibility, number of doses, vaccination sites, duration of vaccine protection, and proportion of acquaintances vaccinated. Conditional logit and latent class models were used to identify preferences. Findings: Although all seven attributes were proved to significantly influence respondents’ vaccination decision, vaccine effectiveness, side-effects and proportion of acquaintances vaccinated were the most important. We also found a higher probability of vaccinating when the vaccine was more effective; risks of serious side effects were small; vaccinations were free and voluntary; the fewer the number of doses; the longer the protection duration; and the higher the proportion of acquaintances vaccinated. Higher local vaccine coverage created altruistic herd incentives to vaccinate rather than free-rider problems.The predicted vaccination uptake of the optimal vaccination scenario in our study was 84.77%. Preference heterogeneity was substantial. Individuals who were older, had a lower education level, lower income, higher trust in the vaccine and higher perceived risk of infection, displaing a higher probability to vaccinate. Interpretation: Preference heterogeneity among individuals should lead health authorities to address the diversity of expectations about COVID-19 vaccinations.To maximize COVID-19 vaccine uptake, health authorities should promote vaccine effectiveness; pro-actively communicate the absence or presence of vaccine side effects; and ensure rapid and wide media communication about local vaccine coverage. Funding Statement: This work was supported by China Postdoctoral Science Foundation (grant number 2019M662392) and Qingdao Postdoctoral Foundation Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by Nanjing Medical University Ethics Committee (No.2020565) and the face-to-face survey conducted by trained researchers.

A Novel Cre Recombinase-Mediated In Vivo Minicircle (CRIM) DNA Vaccine Platform for Veterinary Application.

Minicircle DNA (mcDNA) has been considered to be an alternative choice of traditional DNA vaccine due to its much smaller size, resulting in more efficient antigen synthesis, enhanced and long-lasting adaptive immune response, especially cellular immune response. However, the disadvantages such as relative high cost and labor intensiveness severely restrict its direct application in the field of veterinary vaccine. Here, we describe a novel Cre Recombinase-mediated In vivo McDNA platform, named CRIM, in which the parental plasmid could spontaneously transform into mcDNA by itself after transfection or oral administration. This CRIM vaccine platform might serve as a novel oral antigen delivery system for any infectious diseases, especially for veterinary application.

Impacts of expanding provider choice for free flu vaccination among the elderly in Korea

The Korean government, to increase the vaccination rates, implemented the policy expanding provider choice for free seasonal influenza vaccine for the elderly through contracting the provision of immunization to the private sector in 2015. Using the annual nationally representative individual between 2014–2017, this study explores the impacts of the policy change by using a difference-in-differences approach. Results show that influenza vaccine uptake at private clinics increases by 12 percentage points after the policy change. However, this effect is offset by a reduction in uptake at public health centers by 13 percentage points. As a result, we find no evidence that the policy increases overall vaccination coverage among the elderly. These results indicate that policymakers need to explore the reasons for vaccine hesitancy before delivering interventions.

Immunogenicity of Non-Living Anthrax Vaccine Candidates in Cattle and Protective Efficacy of Immune Sera in A/J Mouse Model Compared to the Sterne Live Spore Vaccine.

The Sterne live spore vaccine (SLSV, Bacillus anthracis strain 34F2) is the veterinary vaccine of choice against anthrax though contra-indicated for use with antimicrobials. However, the use of non-living anthrax vaccine (NLAV) candidates can overcome the SLSV limitation. In this study, cattle were vaccinated with either of the NLAV (purified recombinant PA (PrPA) or crude rPA (CrPA) and formaldehyde-inactivated spores (FIS of B. anthracis strain 34F2) and emulsigen-D®/alhydrogel® adjuvants) or SLSV. The immunogenicity of the NLAV and SLSV was assessed and the protective efficacies evaluated using a passive immunization mouse model. Polyclonal IgG (including the IgG1 subset) and IgM responses increased significantly across all vaccination groups after the first vaccination. Individual IgG subsets titres peaked significantly with all vaccines used after the second vaccination at week 5 and remained significant at week 12 when compared to week 0. The toxin neutralization (TNA) titres of the NLAV vaccinated cattle groups showed similar trends to those observed with the ELISA titres, except that the former were lower, but still significant, when compared to week 0. The opsonophagocytic assay indicated good antibody opsonizing responses with 75% (PrPA+FIS), 66% (CrPA+FIS) and 80% (SLSV) phagocytosis following spores opsonization. In the passive protection test, A/J mice transfused with purified IgG from cattle vaccinated with PrPA+FIS+Emulsigen-D®/Alhydrogel® and SLSV had 73% and 75% protection from challenge with B. anthracis strain 34F2 spores, respectively, whereas IgG from cattle vaccinated with CrPA+FIS+Emulsigen-D®/Alhydrogel® offered insignificant protection of 20%. There was no difference in protective immune response in cattle vaccinated twice with either the PrPA+FIS or SLSV. Moreover, PrPA+FIS did not show any residual side effects in vaccinated cattle. These results suggest that the immunogenicity and protective efficacy induced by the NLAV (PrPA+FIS) in the cattle and passive mouse protection test, respectively, are comparable to that induced by the standard SLSV.

High-Dose Inactivated Influenza Vaccine Quadrivalent for Older Adults.

To review the efficacy and safety of the high-dose inactivated influenza vaccine quadrivalent (HD-IIV4) in the prevention of influenza in older adults. A literature search was performed using PubMed and Google Scholar with the search terms high-dose, influenza vaccine, and quadrivalent. Other resources included the Centers for Disease Control and Prevention (CDC), the prescribing information, and the manufacturer's website. All relevant English-language articles of studies assessing the efficacy and safety of HD-IIV4 were included. HD-IIV4 is licensed by the Food and Drug Administration for the prevention of influenza in adults aged 65 years and older. The safety and immunogenicity of HD-IIV4 was demonstrated in a phase 3 trial, and the efficacy of the trivalent formulation (HD-IIV3) was demonstrated in a phase 3b-4 trial. HD-IIV4 carries a warning regarding the occurrence of Guillain-Barré syndrome. Adverse reactions, including injection-site pain and myalgia, were reported more frequently with HD-IIV4 than with HD-IIV3. Although the CDC recommends any age-appropriate influenza vaccine for adults aged 65 years and older, HD-IIV4 was associated with improved immunogenicity against the added B strain and HD-IIV3 provided better protection against influenza than the standard-dose vaccine. Other influenza vaccines have weaker evidence of efficacy in older adults. Therefore, HDIIV4 should be recommended as the vaccine of choice in adults aged 65 years and older. HD-IIV4 has proven immunogenic, safe, and effective in preventing influenza in older adults and should be recommended as the vaccine of choice in this patient population.

Infant antibody levels following 10-valent pneumococcal-protein D conjugate and DTaP-Hib vaccinations in the first year of life after maternal Tdap vaccination: An open-label, parallel, randomised controlled trial

BackgroundMaternal antibody levels after Tdap vaccination during pregnancy may affect infant primary antibody responses to pertussis, Tetanus toxoid (TT), Diphtheria toxoid (DT) vaccinations and pneumococcal vaccines with diphtheria toxin mutants like CRM197 as carrier protein. MethodsMothers were recruited in an open label randomised parallel controlled trial in 2014–2016 through midwifes. They received Tdap [Boostrix] at 30–32 weeks of pregnancy (n = 58) or within 48 h after delivery (n = 60). Infants received DTaP-IPV-Hib-HepB [Infanrix Hexa] and 10-valent protein D conjugated pneumococcal conjugate vaccine (PHiD-CV10 [Synflorix]) at age 3, 5 and 11 months. We now report on infant specific IgG levels towards DT, TT, Haemophilus influenzae type b polyribosylribitol phosphate (Hib PRP) and PHiD-CV10 before and after primary- and booster vaccination as secondary study endpoints; pertussis antibodies were the primary endpoint of the study. This trial is registered in clinicaltrialsregister.eu (EudraCT 2012–004006-9) and trialregister.nl (NTR number NTR4314). FindingsPost primary vaccinations, antibody levels to DT, but not TT, were significantly lower after Tdap vaccination during pregnancy compared to controls (GMC ratio 0.4, 95% CI 0.3–0.6 and 0.9, 95% CI 0.6–1.2, respectively). Antibodies to serotype 19F were significantly lower in the maternal Tdap group, whereas there were no differences in antibody levels to Hib PRP and the other 9 pneumococcal serotypes. Post booster vaccinations, no significant differences were observed, except for DT. InterpretationMaternal Tdap vaccination results in significant interference with infants responses not only to DT but also to conjugated pneumococcal vaccines containing DT mutants as carrier proteins. These interactions after maternal Tdap vaccination need to be taken into account when designing infants’ national immunization schedules and choice of vaccines. FundingThe Dutch Ministry of Health, Welfare and Sport.

Herd immunity and a vaccination game: An experimental study.

Would the affected communities voluntarily obtain herd immunity if a cure for COVID-19 was available? This paper experimentally investigates people’s vaccination choices in the context of a nonlinear public good game. A “vaccination game” is defined in which costly commitments (vaccination) are required of a fraction of the population to reach the critical level needed for herd immunity, without which defectors are punished by the natural contagion of epidemics. Our experimental implementation of a vaccination game in a controlled laboratory setting reveals that endogenous epidemic punishment is a credible threat, resulting in voluntary vaccination to obtain herd immunity, for which the orthodox principle of positive externalities fails to account. The concave nature of the infection probability plays a key role in facilitating the elimination of an epidemic.

Case for persuasion in parental informed consent to promote rational vaccine choices

There have been calls for mandatory vaccination legislation to be introduced into the UK in order to tackle the national and international rise of vaccine-preventable disease. While some countries have...

PIN88 THE EXAMINATION OF THE PARENTAL DECISION ON CHOOSING VARICELLA VACCINATION

The target of our research is the examination of the parental decision on varicella vaccination, reasons and influencing factors contributing to the parents` choice. We distributed the questionnaire of our self-constructed cross-section analysis in Szombathely, Vas county in 2018. Our elective criterion was the parents who nurture 1-3-year-old children and participated in health visitor care and varicella vaccination. We analyzed the data of the 89 ratable questionnaires with Microsoft Excel 10 program by applying descriptive statistics and c2-test. The symptoms of the varicella were recognized by three fourths of the parents but the typical complications were identified by only two fifths of them however most of them, one third of the responders chose the vaccination because of their fear of the complications. The confident parental decision on choosing varicella vaccination was not influenced by their income (p>0.05), the content extensiveness of the expert`s information (p>0.05), or the number of their children (p>0.05). The parents` knowledge on the complications preventable by vaccination was not related to the information of the experts (family pediatrist, health visitor), the media or the relatives (p>0.05), or the personal experience of their earlier varicella infection (p>0.05). In the families where the per capita income was below the minimum wage the choice of varicella vaccination was not influenced by the experts` high quality information on the vaccine (p>0.05) or the personal experience of varicella infection (p>0.05). However, we proved significant difference between the price of the vaccine influencing the parental decision and the income of the families (p<0.05). Most of the parents made a confident decision on choosing varicella vaccination even if their knowledge proved to be incompetent in this matter and in the future the essential task, of the experts is to develop the parents` knowledge on this topic.

The binomial nature of immunization session size distributions and the implications for vaccine wastage

In this paper we demonstrate that immunization session size distributions are governed by binomial statistics and determined by just two readily available programmatic parameters, the birth cohort of the catchment area and the session frequency. Given this new knowledge, the unavoidable component of an immunization facility’s opened vial wastage rate can be determined algebraically for each vial size and discard time. This has significant positive programmatic implications for immunization session planning, vaccine needs forecasting, vaccine wastage monitoring, and vaccine product specification and choice. Further operational research is required to field test the different applications of the model and to inform the development of tools and guidance.

Comparing vaccination hesitancy in Polish migrant parents who accept or refuse nasal flu vaccination for their children

This study investigates the background to low uptake of nasal influenza vaccination in Polish pupils in Edinburgh, Scotland. In autumn 2018, one week after their child's nasal flu vaccination sessions, 365 Polish parents were sent a questionnaire exploring influences on their vaccination choices. The questionnaire included a series of 10 vaccine hesitancy questions recommended by the WHO SAGE Working Group on Vaccine Hesitancy.128 questionnaires were returned representing 43.4% of vaccinated, 41.9% of refusing and 23.8% of non-consent form returning parents. Responses highlighted concerns about side effects, new vaccines and the accuracy of professional advice and information sources. There was complacency expressed about vaccination against diseases that are not common any more. Vaccine refusers were consistently more negative about all aspects vaccination and more likely to answer 'don't know'. Almost half of refusers were uncertain about the quality of health information offered to them.Polish migrants in Scotland come with their beliefs about vaccination and modify these as they acculturate to the UK system. They also continue to be influenced by developments and opinions, norms and values from their home country, as well as diaspora media. We have highlighted issues of concern among Polish migrants as a group and gained additional insights by comparing responses of parents who have refused or accepted vaccination. These insights can inform and target messages and strategies to build confidence and encourage immunisation, which should lead to improved vaccine uptake among ethnic population groups.

Evaluating the cost-effectiveness of a sequential pneumococcal vaccination compared to single-dose vaccination strategy for adults in Hong Kong

ABSTRACT Two vaccines, 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), are widely available for the prevention of pneumococcal disease in adults. However, it is unclear how cost-effective these pneumococcal vaccine choices are in the Hong Kong healthcare environment. We aimed to assess the cost-effectiveness of a sequential administration of PCV13 followed by PPSV23 compared to a single dose of PPSV23 vaccination for pneumococcal disease control in Hong Kong adults aged ≥65 years and individuals aged 20–64 years with immunocompromising and chronic conditions. A previously developed deterministic cohort sequential model was applied to compare the outcomes of two vaccination strategies from a societal perspective. Population-specific model input, including incidence, mortality, case-fatality, risk group distribution, vaccination costs, disease management, and productivity loss, was estimated from a Hong Kong-wide electronic medical database. Costs were valued in US$ in 2017. Vaccination strategies with an incremental cost-effectiveness ratio (ICER, defined as incremental cost per QALY saved) less than one local GDP per capita ($46,193 in 2017) were defined as highly cost-effective. Deterministic sensitivity analyses (SA) were conducted. Compared with single-dose PPSV23, sequential vaccination of PCV13 followed by PPSV23 was cost-saving for adults aged ≥20 years. In the deterministic SA, the base-case results were robust for tested parameter uncertainties. Future vaccination policies should consider the cost-effectiveness of a sequential vaccination strategy as a measure to reduce the vaccine-preventable pneumococcal disease burden in Hong Kong.

Микроэлементы и региональная частота аутоиммунного заболевания щитовидной железы среди детей России

В работе представлены данные о связи между региональной заболеваемостью российских детей аутоиммунной патологией щитовидной железы и содержанием в их волосах некоторых микроэлементов, обладающих адъювантным действием на иммунную систему. Изучены показатели по всем федеральным округам за 2008-2017 гг. Найдены положительные корреляции между региональной заболеваемостью тиротоксикозом и содержанием йода и ртути, но не алюминия в волосах детей. Предложена регрессионная модель таких взаимосвязей. Неблагоприятно сказываться на аутоиммунитете может увеличение экспозиции не только токсичным, но и эссенциальным микроэлементам сверх потребности. Полученные данные обсуждены в сопоставлении с мировой литературой по данной теме и в контексте предсказания и профилактики риска аутоиммунных тиропатий в педиатрии, в частности относительно оптимального выбора вакцин. Затронуты вопросы пермиссивного действия различных факторов мозаичности аутоиммунитета на результирующие изменения реактивности. Отмечено, что в законопроекте о сплошном обязательном йодировании поваренной соли в Российской Федерации не учтены региональные различия в обеспеченности микроэлементами.

Revelation of Immune Memory at the First Stage of Antigen-Specific Cell Response after Second Introduction of the Live Plague Vaccine

Background. The study of immune memory is necessary to evaluate the effectiveness of immunization against infection, including plague and to make a choice of vaccination scheme.Goals. The goal is to study the possible role of immune memory in the early stage of the antigen-specific response – the formation of cells with receptors for capsular (F1) and lipopolysaccharide (LPS) antigens of plague live EV vaccine.Methodology. Volunteers vaccinated with live plague vaccine EV for the first time (6 persons – group 1) and again (6 persons – group 2) were examined. In the mononuclear fraction of the blood of volunteers the cells binding antigens F1 and LPS Y. pestis (CBA) were determined.Results. In the volunteers group 2, the content of CBA at 2 days after vaccination was higher than in group 1. Between the 5th day and the end of the CBA detection, their content in group 2 decreased, and in group 1, it increased, but remained significantly less than in group 2 two days after immunization.Сonclusions. It is shown that the previous vaccination accelerates the first stage of the antigen-specific human response to second vaccination against plague. This reflects the role of immune memory in the formation of this stage of the immune response at vaccination against plague.

Burden and Prevention of HPV. Knowledge, Practices and Attitude Assessment Among Pre-Adolescents and their Parents in Italy.

Despite infections due to HPV nowadays represent the most common sexually transmitted diseases worldwide with recognized effective and safe preventive strategies, knowledge, attitudes; however, awareness on HPV is considerably low. The present study has two main objectives: 1. To conduct a literature review to analyze the evolution of preventive tools, the complexity of the vaccine choice process, and the challenges posed by HPV vaccine hesitancy and refusal among pre-adolescents and their parents; 2. To assess knowledge, practices and attitudes toward HPV infection and vaccination in a sample of Italian pre-adolescents and their parents. The observational study was carried out through the use of two anonymous and self-administered pre- and post-intervention questionnaires dedicated to the target populations. Between the administrations of the pre- and post-intervention questionnaires, an educational intervention on HPV infection and related diseases, and prevention strategies was conducted. All participants demonstrated suboptimal knowledge and positive attitudes in the pre-intervention questionnaire. Higher levels of knowledge and attitudes were observed among pre-adolescents thatused social networks and had heard of sexually transmitted diseases at home/school/physician and from parents and also who had heard of HPV from General Practitioners, Gynecologists, family members and newspapers. A significant increase in HPV vaccination awareness was observed among pre-adolescents after the educational sessions. Health education programs aimed at increasing knowledge, attitudes and awareness on HPV are needed to implement the outcomes of HPV immunization programs, especially if supported by the physicians involved in counselling and recommendation processes.

Comparison of hepatitis B vaccine efficacy in Japanese students: a retrospective study

BackgroundTwo types of recombinant hepatitis B virus (HBV) vaccines are available in Japan. One type uses the antigen from genotype A (Heptavax-II®) and the other uses the antigen from genotype C (Bimmugen®). Potential differences in productivity of the hepatitis B virus surface (HBs) antibody between vaccines have not been studied in detail. We investigated the acquired level of immunity against HBV in association with two vaccines, their administration routes, and patient sex. We present the appropriate inoculation method based on the characteristics of each vaccine.MethodsData of 1135 medical and nursing students (481 men and 651 women) were used, each of whom was unvaccinated prior to recruitment and subsequently vaccinated three times prior to the study. The vaccine type and administration route differed according to the university department and enrolling year. The students were categorized into the following three groups: Bimmugen®-subcutaneous group, Heptavax-II®-subcutaneous group, and Heptavax-II®-intramuscular group. The total and sex-segregated positive rates of the HBs antibody among the three groups were compared using Pearson’s chi-square test. The effect of time between the HBs antibody test and vaccine administration on the HBs antibody level was also analyzed similarly.ResultsThe Bimmugen®-subcutaneous group showed the highest positive HBs antibody rate (92.0%) among the three groups. In the Heptavax-II® group, the positive rate was 66.3% in the subcutaneous injection group and 89.1% in the intramuscular injection group. There was a significant difference among these three groups. In terms of sex, women showed a significantly higher average positive rate than men in each group. In terms of effect of time between the HBs antibody test and vaccine administration, no significant differences were observed.ConclusionsBimmugen® is associated with more effective HBs antibody production than Heptavax-II® in Japanese students. However, the Heptavax-II® vaccine is an appropriate choice for HBV vaccination in areas where HB is caused predominantly by HBV genotype C. With both vaccines, women tended to acquire more immunogenicity than men. Intramuscular injection may be the preferred administration route due to the possibility of local reactions.

First year allopathic medical student attitudes about vaccination and vaccine hesitancy

First year medical students at an allopathic medical school regional campus were asked to complete a 10-question survey at both the beginning and the conclusion of a required course on immunology, hematology and oncology. The survey was designed to solicit student attitudes about vaccination and the students’ level of comfort with and exposure to vaccine hesitant patients. Surveys were administered to five consecutive classes from 2013 to 2017. Total response rate for completion of both surveys was 58.0% (178/307). Pre- and post-course surveys were administered to assess whether curricular experiences altered the students’ perceptions about vaccinations and their ability to counsel vaccine hesitant patients. Curricular elements were presented in several different formats aimed at increasing student knowledge about vaccinations and student capacity to work with vaccine hesitant patients and families (problem-based learning, didactic lecture and interactive panel discussion). In the pre-survey, the majority of students reported having already encountered people who decline vaccinations (78.8%). Additionally, in the pre-survey the majority of medical students expressed strong support for vaccination (99.6% agreed with the statement that Vaccinations are a great public health accomplishment) and strong disagreement with both of the assertions that childhood vaccines cause autism and vaccine preservatives cause adverse health effects. In response to questions about comfort level while talking with patients about vaccine choices, baseline responses demonstrated a moderately high level of comfort. Post-course surveys revealed a statistically significant increase in student-rated comfort level in talking with patients about vaccine choices (pre-survey 79.2% report comfort versus post 97.8%; p < 0.001). Though this study is limited to student self-reporting, survey responses suggest that targeted curricular elements can improve medical student confidence in counseling patients about vaccinations. Future curricular elements designed to directly observe student performance could provide verification of counseling skill acquisition.