Complete Vaccination Research Articles

Vaccine adherence to vaccination schedule among male HIV-positive patients: a single-center study

Abstract Background The study centre collaborated with the public health service to recover the vaccinations missed during the COVID-19 pandemic. Vaccinations against pneumococcus (PCV/PPV), human papillomavirus (HPV9) and herpes zoster (HZric) have been offered to people living with HIV/AIDS (PLWHA) in care at the clinic. This study aims to estimate vaccine adherence in men with HIV/AIDS to the proposed vaccination schedule. Materials and Methods In this retrospective observational study, data were extracted from the regional platform of vaccinations, including 941 males LWHA in care in 2022. Chi-squared tests were performed to assess differences in adherence according to the risk of transmission and nationality. Results The mean age was 52.97 years (SD = 13.1). Italian patients were 88.6%. Regarding the risk of HIV transmission, 828 (88%) men who have sex with men (MSM) and 113 (12%) heterosexual men (ETX) were included. About anti-SARS-CoV-2 (COV), 884 patients (93.94%) completed the primary cycle, 793 (84.27%) received the 3rd dose, 335 (35.6%) the 4th dose, 120 (12.75%) the 5th dose. The complete vaccination course was carried out by 488 patients (51.86%) for PCP/PPV, 487 (51.75%) for MenACWY, 485 (51.54%) for MenB, 277 (29.44%) for anti-Haemophilus Influenzae, 303 (32.2%) for HPV9, 286 (30.39%) for HZric and 427 (45.38%) for anti-Tetanus and Diphtheria. The adherence to the 3rd and 4th doses of COV, HPV9 and HZ2 vaccines was higher for MSM than ETX (p < 0.05). Italian patients had higher adherence to the 4th dose of the COV and MENACWY vaccines than the foreigners (p < 0.05). Conclusions Overall, adherence to the vaccination programme was low, except for the COV vaccine. This study provides an overview of vaccination coverage. It lays the groundwork for a more in-depth analysis to identify determinants of vaccine adherence among PLWHA, which will be further investigated by the studies of the INF-ACT project, aiming to assess all determinants of vaccine hesitancy. Key messages • Monitoring adherence to the vaccination schedule is crucial in order to detect critical issues early and take intervention. • The finding of low vaccination adherence in our study alerts us to the possible risks of low vaccination coverage, particularly in a fragile population such as people living with HIV/AIDS.

Effect of school-based HPV vaccine campaigns on inequalities in uptake in France: the PrevHPV trial

Abstract Background HPV vaccination is recommended in France for all adolescents aged 11-14. Coverage has increased over recent years but remains below 50% by age 15, with social disparities by area deprivation level, parental education and income. We analysed the effect of school-wide campaigns on adolescent vaccine uptake and related disparities. Methods PrevHPV is a controlled cluster-randomised trial to assess the effectiveness and efficiency of a multi-component intervention targeting middle schools and general practitioners. Sixty-one French middle schools were randomised in a partial factorial design to one of six intervention arms, some of which included school-based vaccine campaigns combined with in-class education and motivation. We assessed HPV vaccine status using online questionnaires that were administered in class to pupils (aged 13-15 years) at baseline and after 5 months. Using linear regression, we explored the decomposed effect of campaigns on vaccine uptake and interactions of the effect with sociodemographic variables. Results In total, 2639 adolescents provided complete vaccination data on both questionnaires, with a ≥ 1-dose coverage of 24% at baseline. Among previously unvaccinated pupils (N = 2017), 21% (7%) of girls (boys) in the control group reported receipt of first vaccine dose during the follow-up period, compared to 49% (33%) in arms with vaccine campaigns. Adjusting for baseline vaccine intention, vaccine campaigns increased the 5-month probability of a first dose by 25 (95% confidence interval: 19-31) percentage points compared to the control group. The effect of vaccine campaigns on student-reported vaccine uptake did not substantially vary by school area deprivation level, parental education level, or family multilingualism (compared to French monolingual family). Conclusions School-based campaigns substantially increased vaccine coverage among all adolescents within a short time period. Yet, underlying disparities in HPV vaccination were unchanged. Key messages • School-based vaccine campaigns can quickly increase HPV vaccine uptake among adolescents. • Vaccination campaigns need tailored implementation strategies to eventually reduce social disparities in HPV vaccination.

National vaccination program compliance in northern Lisbon's primary healthcare: 2022 assessment

Abstract Background The National Vaccination Program (NVP) aims to protect all citizens and residents of Portugal from communicable diseases, safeguarding public health. It is coordinated by the Directorate-General of Health and locally implemented by the primary healthcare centers. Currently, a 95% vaccination coverage is set for all vaccines, except for human papillomavirus (HPV) which is 85%. Methods Assess the accomplishment of NVP in 2022, based on the national vaccination platform, for the 15 primary healthcare units of Northern Lisbon. The evaluation included the proportion of users who I) completed vaccination schedule at the recommended age (recommended NVP), and II) completed vaccination schedule, regardless administration date (fulfilled NVP), according to birth cohort. Results The 2021 and 2022 cohorts achieved a 95% vaccination coverage target for the 4 evaluated vaccines; the 2020 cohort only achieved for 3/5 vaccines evaluated, due to a lower vaccination against tetanus (93.42%) and Neisseria meningitidis B (94.58%). Both 2015 and 2016 cohorts missed the vaccination target for tetanus (89.75% and 88.89%, respectively) and measles (92.84% and 91.12%, respectively). The vaccination target for HPV was not achieved in any of the evaluated cohorts, highlighting the low coverage in males (46.26%) and females (52.34%) from 2012. Concerning tetanus, an increasing trend coverage was found along the cohorts from 1956 (54.47%) to 2016 (91.23%). Conclusions Globally, the NVP targets were achieved in several cohorts. However, immunization against HPV and among older cohorts fell short of expectations. Several factors contribute to explain this low coverage, such as vaccine stock-out (for HPV and N. meningitidis B); residing abroad; private health care follow up without proper vaccine registration; vaccine hesitancy. On the other hand, the positive variation in immunization coverage for most of the assessed vaccines reflects some strategies used to increase adherence. Key messages • The accomplishment of vaccination schedules is key to safeguard individuals and communities from vaccine-preventable illnesses. • The continuous assessment of vaccination targets and trend monitoring is critical to implement strategies to increase vaccine coverage and safeguard public health.

Vaccination choices among pregnant women: findings from the MAMI-MED cohort

Abstract Background According to the Italian National Immunization Plan 2023-2025, vaccinations against Measles, Mumps, Rubella (MMR), Varicella and Human Papillomavirus (HPV) are indicated for women of childbearing age. During pregnancy, vaccination against Diphtheria, Tetanus, and Pertussis (DTaP), and Seasonal Influenza are recommended. The present analysis aimed to estimate vaccination choice and its main determinants among pregnant women. Methods We used data from the “MAMI-MED” cohort, an ongoing prospective study on mother-child dyads established in December 2020. Socio-demographic information (i.e., age, educational level and employment) were assessed at enrollment, during the first trimester visit at the Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima (Catania, Italy). Self-reported maternal vaccination status was collected at delivery. Results Among 1004 women with a complete vaccination assessment, 83.5% were vaccinated against MMR, 87.4% against DTaP, 68.3% against Varicella, while only 23.7% and 9.4% against HPV and Seasonal Influenza, respectively. During pregnancy, only 8.7% and 21.1% of women were vaccinated against DTaP and Seasonal Influenza, respectively. The lack of information was the main ground for refusal, accounting for 93.7% for HPV, 82.5% for Influenza, 64.7% for DTaP, 31.8% for MPR, and 18.9% for Varicella. Women vaccinated against HPV and MMR were younger than their unvaccinated counterpart (p < 0.001 and p = 0.023, respectively). The logistic regression showed that the odds of being vaccinated against HPV increased with increasing age, adjusting for education and employment (OR = 1.12; 95% CI = 1.09-1.16; p < 0.001). Conclusions The analysis showed modest vaccination coverages, mainly depending on the lack of information about vaccination programs. Moreover, we observed that younger women were more aware of HPV vaccination, which probably reflects improvements in the national vaccination program over the years. Key messages • It is necessary to increase knowledge about vaccination among women in the reproductive age. • Social determinants should be assessed to understand the barriers that might affect vaccination choice.

Comparison of Post-Vaccination Response between mRNA and Vector Vaccines against SARS-CoV-2 in Terms of Humoral Response after Six Months of Observation.

The emergence of the SARS-CoV-2 (COVID-19) pandemic has accelerated work on the creation of effective vaccines, both in terms of previously known vector vaccines and new-generation (mRNA) vaccines. The scientific research on vaccination against COVID-19 infection is limited; therefore, understanding how the immune system responds to vaccines is critical. In our study, we conducted a long-term analysis of the presence and persistence of the immune response via chemiluminescence, analyzing the level of IgG antibodies and neutralizing antibodies in subjects vaccinated with two types of mRNA (Comirnaty) and vector (Vaxzevria) vaccines. Healthcare workers and a group of teachers were recruited for this study according to the 2021 government-launched vaccination calendar. They received two doses of the Comirnaty or Vaxzevria vaccine. SRBD (spike-receptor binding domain) IgG antibody levels were measured monthly for 6 consecutive months with a chemiluminescent assay (CLIA) and neutralizing antibodies for two periods-1 and 5 months from the completion of the vaccination course. 168 people were recruited for this study: 135 people for the mRNA vaccine group and 33 people for the vector vaccine group. Comparing the serum IgG levels between the two types of vaccines, a significant difference in median values can be noted at all time points. In consecutive months, the mRNA-vaccinated group exhibited significantly higher SRBD levels compared to the vector group, with peak concentrations at one month after the complete vaccination cycle (745 AU/mL vs. 15.44 AU/mL; p < 0.001). Peak antibody concentration for the vector vaccine was observed one month later, at the third follow-up visit; however, the median IgG concentration was almost 7.7 times higher for the Comirnaty group. Both products were effective in stimulating neutralizing antibody production after vaccination. Higher median values were observed for the mRNA vaccines in both evaluations. At first evaluation, the median value for NA concentration in the Comirnaty group was 6 times higher than in the Vaxzevria group (median value 12.23 [IQR 27.3] vs. 1.7 [IQR 3.3]; p < 0.001. People vaccinated with the mRNA vaccine (Comirnaty) showed a stronger immune response to the vaccination than the group of people administered the vector vaccine (Vaxzevria). The Comirnaty group showed higher levels of IgG, including neutralizing antibodies, at all time points during the follow-up period, and this was independent of having had a SARS-CoV-2 infection. A natural decrease in antibody levels was seen within 6 months. A booster vaccination may be required. No serious side effects were observed in either group.

Impact of integrated preventive and curative health package on nutritional status of children under 2 years of age in the health area of Tama, Tahoua region (Niger).

Niger, relevant in light of current political coup, is one of the countries with the worst human development indicators, characterized by high fertility rates and extremely high infant mortality rates. Food insecurity in the region is alarming, leading to high malnutrition rates in children. This study aimed to evaluate an integral preventive-curative health program targeting children aged under 2 years in the health area of Tama, district of Bouza, Tahoua. Anthropometric follow-up data of 6,962 children aged under 2 years were included in this study. These children received complete vaccination and malaria chemoprevention, and those older than 6 months received nutritional supplementation with a small quantity of lipid-based nutrient supplements. Fundamental growth indicators (height-for-age, weight-for-height, weight-for-age, and middle-upper arm circumference) and the Composite Index of Anthropometric Failure were calculated at the beginning and end of the program (mean time spent in the program: 14.5 ± 6.6 months) The evolution of these indicators was compared with those of a sample from a vertical vaccination program conducted in the neighboring region of Madarounfa on similar dates. The proportion of children without anthropometric failure decreased from 59.5 to 40.2% (p < 0.001), with the categories that included stunting increasing the most. When analyzing the anthropometric indicators according to the months of compliance with the program, there was a slight improvement in the indicators of acute malnutrition, whereas those of chronic malnutrition worsened significantly. However, when compared with the Madarounfa sample, the children in the present study registered a significantly lower worsening in all three indicators: height-age (-0.46 vs. -2.44; p < 0.001), weight-height (+0.31 vs. -0.55; p < 0.001) and weight-age (-0.03 vs. -1.63; p < 0.001) difference. The comprehensive preventive-curative health program slightly slows the worsening of cumulative malnutrition in the early years of life in complex contexts, such as southern Niger.

Multicomponent Strategy Improves Human Papillomavirus Vaccination Rates Among Adolescents with Sickle Cell Disease

ObjectiveTo evaluate the effectiveness of a vaccine strategy bundle to increase HPV vaccine initiation and completion in a specialty clinic setting. Study DesignOur Hematology clinic utilized an implementation framework from October 1, 2018, to December 31, 2019, involving nurses, nursing coordinators, and clinicians in administering the HPV vaccination series to our adolescent sickle cell sample of nearly 500 patients. The bundle included education for staff on the need for HPV vaccine administration, provider incentives, vaccines offered to patients in SCD clinics, and verification of patients' charts of vaccine completion. ResultsFollowing the implementation of the bundle, the cumulative incidence of HPV vaccination initiation and completion improved from 28% to 46% and 7% to 49%, respectively. Both rates remained higher post-implementation as well. HPV vaccination series completion was associated with a decreased distance to the healthcare facility, lower state deprivation rank, and increased hospitalizations. ConclusionOur clinic's implementation strategy successfully improved vaccine completion rates among adolescents with SCD while continuing to educate staff, patients, and families on the importance of cancer prevention among people living with SCD.

Regular Humoral and Cellular Immune Responses in Individuals with Chronic Myeloid Leukemia Who Received a Full Vaccination Schedule against COVID-19.

Individuals with chronic myeloid leukemia (CML) constitute a unique group within individuals with oncohematological disease (OHD). They receive treatment with tyrosine kinase inhibitors (TKIs) that present immunomodulatory properties, and they may eventually be candidates for treatment discontinuation under certain conditions despite the chronic nature of the disease. In addition, these individuals present a lower risk of infection than other immunocompromised patients. For this study, we recruited a cohort of 29 individuals with CML in deep molecular response who were on treatment with TKIs (n = 23) or were on treatment-free remission (TFR) (n = 6), and compared both humoral and cellular immune responses with 20 healthy donors after receiving the complete vaccination schedule against SARS-CoV-2. All participants were followed up for 17 months to record the development of COVID-19 due to breakthrough infections. All CML individuals developed an increased humoral response, with similar seroconversion rates and neutralizing titers to healthy donors, despite the presence of high levels of immature B cells. On the whole, the cellular immune response was also comparable to that of healthy donors, although the antibody dependent cytotoxic activity (ADCC) was significantly reduced. Similar rates of mild breakthrough infections were observed between groups, although the proportion was higher in the CML individuals on TFR, most likely due to the immunomodulatory effect of these drugs. In conclusion, as with the healthy donors, the vaccination did not impede breakthrough infections completely in individuals with CML, although it prevented the development of severe or critical illness in this special population of individuals with OHD.

Assessment of adherence to routine vaccination schedules in oncology patients.

Patients diagnosed with cancer are at an increased risk of infection. Vaccines remain one of the most critical public health strategies in limiting infectious diseases, with a heightened importance in cancer patients. Data across the general US population indicates that vaccine adherence rates are suboptimal across all adult vaccine schedules. This study aims to define vaccine adherence rates within the oncology population. This retrospective cohort study includes adult patients with a new cancer diagnosis. Vaccine administrations for COVID-19 (SARS-CoV-2), influenza, pneumococcal, tetanus/diphtheria/pertussis (TDaP), herpes zoster (RZV), human papillomavirus (HPV), and hepatitis B (hepB) were assessed. The primary outcome was complete vaccine adherence. Two hundred and eighty-three oncology patients were included. The median age at diagnosis was 63 years old, and most subjects were females (60%). The two most common malignancies were gastrointestinal and breast cancer at 26.5% and 15.2%, respectively. Suboptimal vaccine adherence rates were observed across the entire oncology population. Complete adherence was observed in only 1.4% of patients. Vaccine specific adherence rates were as follows, SARS-CoV-2: 38.9%; influenza: 11.4%; pneumococcal: 12.7%; TDaP: 13.1%; RZV: 3.5%; HPV: 0%; and hepB: 34%. Among the vaccine schedules assessed, SARS-CoV-2 vaccination rates were the highest with 38.9% of patients being fully adherent and 73% receiving at least one dose. Lower vaccine adherence rates were observed in oncology patients compared to currently published rates. Providers and pharmacists can play a role in assessing and counseling patients on the importance of vaccine adherence before chemotherapy is initiated and after a remission is obtained.

Comparative Analysis of IgG Antibody Titers Induced by Three Different SARS-COV-2 Vaccines in Healthy Adults of Pakistan.

Covid-19 is a contagious disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). In order to control this disease, different effective vaccines have been developed. This study is an attempt to determine the strength and duration of immunogenicity of various established vaccines. This cross-sectional, observational study was conducted to compare the efficacy of three different vaccines; Pfizer BNT 162b2, Sinovac, and CanSino, respectively, after a duration of 3months, in the healthy adult population of Pakistan. In this study 371 healthy participants (aged 12-25years) of both genders (male and females) were enrolled. The blood sample was drawn 90days after the complete vaccination process. The humoral response (IgG) was analyzed by electrochemiluminescence immunoassay (ECLIA) method with Roche Anti-SARS-CoV-2 S analyzer kit. Descriptive statistical analysis was performed using IBM SPSS statistics version 22 and P < 0.05 was considered significant. The mean antibody titer in Pfizer-group was 12,536.35U/mL, followed by 5168.68U/mL in the Sinovac group and 4284.32U/mL in the CanSino group. The Pfizer-group showed gender-specific significant differences, with higher antibody levels in males (P = 0.006) as compared to Sinovac and Cansino groups. The Mean IgG antibody levels of the Pfizer-vaccinated group were significantly higher than the Sinovac-vaccinated group and the CanSino-vaccinated group (P = 0.000, each). However, the mean difference between the Sinovac-vaccinated group and the CanSino-vaccinated group was not significant. Vaccine-induced seropositivity was found in the whole cohort. The mRNA-based vaccine produced the highest immune response, and thus, it is recommended for future application.

A national registry-based study on uptake of the first dose of MMR vaccine in 380 administrative regions in Poland, 2013-2016-2020.

Regular monitoring of the measles, mumps, and rubella (MMR) vaccine uptake quickly exposes immunity gaps in the population. In Poland, the first dose of the MMR vaccine is mandatory for children between 13 and 15 months of life. This study aimed to assess the uptake of the first dose of MMR vaccine in 380 administrative counties in Poland in 2020, as well as to analyze the MMR vaccine uptake trends in 2013-2016-2020. This study is an epidemiological retrospective national registry-based analysis. Data on mandatory childhood vaccinations in all 380 counties in Poland were collected from the epidemiological reports of the State Sanitary Inspectorate territorial representatives. MMR vaccine uptake was calculated as the percentage of children who received the first dose of MRR vaccine to all children subject to mandatory vaccination in the county. The uptake of the first dose of MMR vaccine decreased from 99.4% in 2013, to 95.5% in 2016 and 91.9% in 2020. In 2013, 93.2% of countys MMR vaccine uptake level reached the herd immunity level, followed by 77.1% of counties in 2016 and only 38.3% of countys in 2020. In 2020, two counties reached complete (100%) MMR vaccine uptake, and the lowest MMR vaccine uptake was 63.88%. Of the 380 counties in Poland, in 226 (61.1%) the MMR vaccine uptake level was lower than the herd immunity level, and a downward trend was observed. MMR vaccine uptake decreased with an increased number of residents in a county (r= -0.35; p<0.001). This study revealed that in 61% of administrative regions in Poland, the MMR vaccine uptake was below the herd immunity level. Regional differences in the MMR vaccine uptake were observed. A significant decrease in MMR vaccine uptake between 2013 - 2020 poses a risk of measles outbreaks.

Attitudes towards Vaccinations in a National Italian Cohort of Patients with Inflammatory Bowel Disease.

The vaccination status of patients with inflammatory bowel disease (IBD) should be investigated before starting any treatment, and patients should eventually be vaccinated against vaccine-preventable diseases (VPDs). Patients with IBD may have suboptimal vaccination rates. The aim of this study was to evaluate the vaccination coverage, attitude towards vaccinations, and determinants among an Italian cohort of patients with IBD. AMICI, the Italian IBD patients' association, sent an anonymous web-based questionnaire in February 2021. Previous vaccination status and patients' attitudes towards vaccinations were recorded. We examined the factors influencing their attitudes using crude and adjusted odds ratios (adjORs) with 95% confidence intervals (CIs). Among the 4039 patients invited, 1252 patients (including 729 women, median age 47.7 [37-58]) completed the questionnaire, with a response rate of 25.3%. Respondents declared being vaccinated against tetanus (74.1%), flu (67.7%; last season), MMR (43.3%), HBV (37.1%), pneumococcus (29.1%), meningitis (20%), HAV (16%), VZV (15.3%), and HPV (7.6%). Complete vaccination history was not remembered by 20.7% of the patients. One thousand one hundred and twelve (88.8%) expressed a positive attitude towards vaccination, 91 (7.3%) were indifferent, and 49 (3.9%) reported being opposed to vaccinations. The belief of a possible return of VPDs with a decline in vaccination coverage rates was the factor most strongly related to a positive attitude towards vaccinations (adjOR 5.67, 95% CI 3.45-9.30, p-value < 0.001). A low vaccination rate against some VPDs was found among a national cohort of patients with IBD, despite a generally positive attitude towards vaccinations.

The effects of an inactivated vaccine against Staphylococcus spp. on udder health in primiparous dairy goats: A randomized controlled trial

Staphylococci are the primary pathogens causing clinical and subclinical mastitis in dairy goats. This randomized controlled trial (RCT) evaluates the impact of vaccination with VIMCO® (Hipra, Girona, Spain) on clinical mastitis (CM), gangrenous mastitis (GM), the occurrence of udder asymmetry, somatic cell count (SCC), total bacterial count (TBC) and 10-day average milk yield (10dMY) in primiparous goats. The RCT was performed on a commercial dairy goat farm with 3000 mainly Saanen goats from February to April 2022. A group of 350 pregnant primiparous goats (12 – 16 months of age) was randomly divided into a control group and a vaccinated group. The goats were followed from kidding until on average 72 days in milk (DIM). At on average 20 DIM, all primiparous goats were mixed into a group with 1600 non-vaccinated adult goats. At the first milking after kidding (T = 0), all primiparous goats were scored for clinical mastitis and udder asymmetry. After that, udder asymmetry was scored on T1 (on average 12 DIM) and T2 (on average 62 DIM). Gangrenous mastitis cases were recorded from the start of complete vaccination and during the entire trial period. In addition, individual daily milk yield was recorded automatically by the milking system, and somatic cell count (SCC) was determined once at T2. The prevalence of CM was significantly higher in the control group (5.6%) than in the vaccinated group (0.6%). There was a significantly higher prevalence of udder asymmetry in the control group (7.8%) compared to the vaccinated group (1.2%) at T0 and during the entire study period (16% in control group versus 7.6% in the vaccinated group). Dried-up udder halves and GM were rare and did not differ significantly between both groups. Also, the SCC measurement and the milk yield did not differ between the vaccinated and the control group. Altogether, we show that the VIMCO® vaccine prevents clinical signs of mastitis at the first milking after kidding and udder asymmetry during the first three months after kidding in primiparous goats. Therefore, the vaccine may contribute to udder health control. Effects on SCC, milk yield, the prevalence of dried-up udder glands and GM remain to be demonstrated.

Pediatric COVID-19 Vaccination in the Inpatient Setting.

The inpatient setting is often underutilized as a venue for providing pediatric vaccines. During the 2019 novel coronavirus (COVID-19) pandemic, our hospital began a vaccination program to provide access to COVID-19 vaccines for eligible pediatric inpatients. Our objective was to describe the establishment and assess the impact of a COVID-19 vaccination program for pediatric inpatients. All admitted patients were screened for eligibility and interest in inpatient COVID-19 vaccination upon admission from April 27, 2021 until February 12, 2022. For those eligible for vaccination, their interest was recorded and shared with the clinical team. The clinical team completed education and/or vaccination depending on individual case. Interest in inpatient vaccination and ultimate receipt of a vaccine was recorded and analyzed. During the study period, 1615 patients were eligible for inpatient vaccination and 1601 had their interest recorded on hospital admission. Twenty-one percent of these patients were interested, 50% declined, and 28% were unsure. Twenty-nine percent of those initially interested were given vaccine by the clinical team before discharge. Six percent of patients who were unsure and 2% of those who declined vaccine on admission were vaccinated before discharge. The inpatient setting can be an important venue to allow for education and discussion regarding pediatric COVID-19 vaccine and to improve access to vaccination for a traditionally under-vaccinated population. Challenges remain with consistent vaccine administration even for interested pediatric inpatients.

Privacy-Preserving Solution for European Union Digital Vaccine Certificates

The recent COVID-19 pandemic situation highlights the importance of digital vaccine certificates. In response, the European Union (EU) developed EU Digital Vaccine Certificates to enable proof of non-infectivity and completed vaccinations. However, these solutions suffer from several shortcomings, such as ineffective certificate holder identification and a high violation of user privacy with the disclosure of sensitive information. In this work, we present a novel solution for privacy-preserving EU Digital Vaccine Certificates. Our solution solves the aforementioned privacy and security shortcomings and is in line with current EU legislation, i.e., the General Data Protection Regulation (GDPR), the upcoming revision of the electronic IDentification, Authentication, and trust Services (eIDAS), called regulation eIDAS 2.0, and the new tools that it envisages to be led by European digital identity. This identity is intended to allow citizens to prove their identity to access online services, share digital documents, or simply prove specific personal characteristics such as age without revealing their identity or other personal information. The core of our proposal is built on our novel attribute-based credential scheme, which can be easily implemented on various handheld devices, especially on Android smartphones and smartwatches. However, due to the lightweight nature of our scheme, it can also be implemented on constrained devices such as smart cards. In order to demonstrate the security, privacy, and practicality inherent in our proposal, we provide the security analysis of the cryptographic core along with a set of experimental results conducted on smartphones and smart cards.

COVID-19 vaccination and its influence on the disease severity among the COVID patients in a tertiary care hospital – A cross sectional study

Introduction: COVID-19 disease was a global health emergency from March 2020 till May 2023 with no effective drug to date. COVID-19 vaccines with other precautious measures like hand washing, disinfection, social distancing etc. were the only ways to decrease the burden of the disease worldwide. The study aimed to determine the association between COVID-19 vaccination and disease severity among COVID-19 patients admitted to a Government Medical College hospital. Methods: This cross sectional study included 983 COVID-19 patients admitted to a tertiary care hospital from March 2021 to December 2021. Secondary data were collected from the case sheets and vaccination details were collected from the patients over the phone and through COWIN App. Chi-square test and binary logistic regression were done and the p value and odds ratio were estimated. Results: 92.9% of study participants were unvaccinated, 2.7% were fully vaccinated, and 4.3% were partially vaccinated. Among fully vaccinated 11.1% had breathlessness, 0% ICU admission, 3.7% died, 20% had COVID pneumonia findings in CT lung, 9% had low lymphocyte levels which were statistically significantly lower than in partially vaccinated (39.5%, 41.9%, 7%, 18.6%, 59.3%, 65.1%, 76.9% respectively) and unvaccinated (31.1%, 27.7%, 2%, 4.6%, 48.2%, 45.2%, 68.4% respectively). Conclusion: Two doses of vaccines provided significant protection from severe forms of the disease. Partially vaccinated were affected more, which may be due to insufficient immunity gained and their careless attitude post-vaccination with decreased shielding behaviour. The present study shows that partial vaccination is not protective against the progression of COVID-19 disease severity. More focus should be made on full vaccination of the community and educating the public about complete vaccination and emphasis on preventive measures even after vaccination must be made to reduce the burden of COVID-19 in the community. Keywords: COVID-19; COWIN App; vaccination; coronavirus disease

Epidemiological study of vaccination against SARS-CoV-2 and its impact on COVID-19 progression in a cohort of patients in gran Canaria

ObjectivesWe analyzed the impact of age, sex, vaccination against COVID-19, immunosuppressive treatment, and comorbidities on patients' risk of requiring hospital admission or of death. MethodsPopulation-based observational retrospective study conducted on a cohort of 19,850 patients aged 12 years or more, who were diagnosed with COVID-19 between June 1st and December 31st, 2021, in the island of Gran Canaria. ResultsHypertension (18.5%), asthma (12.8%) and diabetes (7.2%) were the most frequent comorbidities; 147 patients died (0.7%). The combination of advanced age, male sex, cancer, coronary heart disease, immunosuppressive treatment, hospital admission, admission to the intensive care unit, mechanical ventilation and lack of complete COVID-19 vaccination or booster dose was strongly predictive of mortality (p < 0.05); 831 patients required hospital admission and it was more frequent in men, older age groups, and patients with cancer, diabetes, arterial hypertension, chronic obstructive pulmonary disease, congestive heart failure or immunosuppressive treatment. The COVID-19 vaccine booster dose was associated with a lower risk of death ([OR] 0.11, 95% CI 0.06–0.21, p < 0.05) or hospital admission ([OR] 0.36, 95% CI 0.29–0.46, p < 0.05). ConclusionsCancer, coronary heart disease, and immunosuppressive treatment were associated with increased COVID-19 mortality. More complete vaccination was associated with lower risk of hospital admission or death. Three doses of the SARS-CoV-2 vaccine were highly associated with the prevention of death and hospital admission in all age groups. These findings suggest that COVID-19 vaccination can help bring the pandemic under control.

Follow-up of humoral immune response after HPV vaccination using first-void urine: A longitudinal cohort study.

Assessment of humoral immune responses following human papillomavirus (HPV) vaccination currently relies on invasive blood sampling. This longitudinal cohort study explores the usability of first-void urine as a noninvasive alternative sample for antibody detection. In this study, 58 women receiving three doses of the 9vHPV vaccine within a Gardasil9 (9vHPV) Phase III randomized controlled trial were included. Participants provided paired first-void urine and blood samples before vaccination (M0), 1 month after the third dose (M7), and ~3 years after the third dose (M43). Type-specific antibody responses to the 9vHPV types were analyzed in 174 first-void urine and 172 serum samples using a virus-like particle-based IgG multiplex enzyme-linked immunosorbent assay. Additionally, total human IgG concentrations were determined using the BioPlex assay. At M7, 1 month after complete 9vHPV vaccination, 95%-100% of first-void urine and 100% of serum samples had detectable concentrations, varying by HPV type. At M43, 84%-100% of first-void urine and 98%-100% of serum samples had HPV-specific antibody concentrations. Results show significant Spearman rank correlations between type-specific HPV-antibody concentrations for paired first-void urine and serum at all time points. This study confirms the potential feasibility of utilizing first-void urine as a noninvasive immunological sample within HPV vaccine trials.

Representation of ethnic and racial minority groups in European vaccine trials: a quantitative analysis of clinical trials registries

ObjectivesThe representation of ethnic minority groups in European vaccine trials is an important and hitherto unaddressed gap in the literature. The objectives of this study were to determine the proportion...

Improving human papilloma virus vaccination rates among adolescents.

The human papilloma virus (HPV) is the leading cause of cervical cancer worldwide and is responsible for genital warts and five other types of cancers. The HPV vaccine was introduced in 2006 and demonstrated to be safe and more effective than expected, yet adolescent rates of immunization in the United States remain low. Adolescent HPV vaccine rates were below the national average, and effective vaccine recommendation strategies were not used at an urban pediatric primary care office in southern Florida. The percentage of HPV vaccine rates in this primary care office were measured among adolescents ages 13-17 years using data obtained from Florida's state vaccine registry before implementation of the intervention, after the intervention, and monthly over a 90-day period. Interventions aimed to improve vaccine rates included implementing an HPV protocol consisting of education on providing a strong bundled recommendation, appointing a vaccine champion, implementing standing vaccine orders, and educational materials. The vaccine rates among adolescents increased by 11% for the initial dose, 7% for the second dose, and 6% for the vaccine completion rate. Chi-square test demonstrated statistical significance, for the initial vaccine. A nurse practitioner-led application of an evidenced-based HPV vaccine protocol positively affected the care of adolescents in this primary care setting.