Effectiveness Of Vaccination Program Research Articles

Rotavirus strains in children less than 5 years of age: A case control study

BackgroundGlobally, rotavirus A (RV) is a leading cause of acute gastroenteritis (AGE) in young children under 5 years. The main aim of this study was to describe the prevalence of RV in children with and without diarrhea whose age ranged from 3 months to 5 years from two different hospitals of Nepal. We also described the diversity of rotavirus circulating during the pre-vaccination period in Nepal between 2006–2009. Materials and methodsA total of 2400 stool samples collected from children's years with diarrhea (cases, N = 1200) and without diarrhea (controls, N = 1200) were tested for the presence of RV by both enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction (RT-PCR). All samples positive for RT PCR and/or ELISA were further characterized for G and P genotypes by conventional RT-PCR. ResultsIn total, 500 of the 2398 (20.8 %) samples (424 cases and 76 controls), were positive for RV. The most frequently detected G-types were G12, G1, and G9 and P-types were P[8] and P[6]. The predominant genotypes G12P[6], G12P[8], G1P[8] and G9P[8] were identified in 27.8 %, 24.2 %, 11.8 % and 10.8 % of the samples, respectively. ConclusionThis study observed high prevalence of G12P[6] rotavirus circulating in Nepal before vaccine introduction and they may pose an emerging challenge to current and future vaccine. Therefore, continuous molecular surveillance of circulating genotypes and emerging rotavirus strain should be carried out to better understand the effectiveness of vaccination program.

Immunization and Screening Methods for Cervical Carcinoma in Developing Nations: A Detailed Review

Objective: Cervical cancer remains a significant public health challenge in developing countries, disproportionately affecting women in these regions due to limited access to effective screening and vaccination programs. This review synthesizes the current literature on the implementation strategies, effectiveness, and challenges of cervical cancer screening and Human Papillomavirus (HPV) vaccination programs in developing countries, aiming to highlight successful models and identify gaps in current practices. Screening, for cervical cancer in developing countries faces numerous obstacles, including logistical challenges, lack of awareness, and insufficient healthcare infrastructure. Despite these hurdles, strategies such as single-visit approaches, leveraging low-cost HPV DNA testing, and utilizing mobile health units have shown promise in increasing screening coverage and early detection rates. The prerequisites for effective screening highlighted include affordability, cultural acceptability, and the ability to implement large-scale screening with limited resources. HPV vaccination presents a primary prevention measure with the potential to significantly reduce the incidence of cervical cancer. However, vaccination programs in developing countries encounter challenges in vaccine procurement, distribution, and achieving high coverage rates among the target population. Innovations in vaccine delivery, education campaigns to raise awareness, and partnerships with international health organizations are crucial for overcoming these barriers.This comprehensive review underscores the need for a multifaceted approach to cervical cancer prevention in developing countries, encompassing improvements in screening and vaccination strategies, health system strengthening, community engagement, and international collaboration. By learning from successful models and addressing identified gaps, there is a significant opportunity to reduce the burden of cervical cancer in these regions and move closer to achieving global health equity.

Prevención y detección precoz del cáncer cervicouterino

Cervical cancer is a global health challenge, with high incidence and mortality rates, particularly in countries with lower levels of human development. The progression of cervical cancer is well understood, from human papillomavirus infection to precancerous lesions and invasive cancer. This disease can be prevented through effective vaccination and early detection programs, which allow timely treatments, especially for pre-invasive conditions. In 2020, the World Health Organization launched a global initiative to eliminate cervical cancer, introducing the 90-70-90 strategy. This intervention seeks 90% vaccination coverage in girls under 15 years of age, at least two HPV screenings before the age of 45, and timely treatment for 90% of diagnosed patients. This paper aims to describe national and international updates in cervical cancer prevention, highlighting the progress of primary and secondary prevention with regards to decreasing its incidence.

Understanding the relationship between stay-at-home measures and vaccine shortages: a conventional, heterogeneous, and fractional dynamic approach

In light of the global prevalence of a highly contagious respiratory disease, this study presents a novel approach to address the pressing and unanticipated issues by introducing a modified vaccination and lockdown-centered epidemic model. The rapid spread of the disease is attributed to viral transmissibility, the emergence of new strains (variants), lack of immunization, and human unawareness. This study aims to provide policymakers with crucial insights for making informed decisions regarding lockdown strategies, vaccine availability, and other control measures. The research adopts three types of models: deterministic, heterogeneous, and fractional-order dynamics, on both theoretical and numerical approaches. The heterogeneous network considers varying connectivity and interaction patterns among individuals, while the ABC fractional-order derivatives analyze the impact of integer-order control in different semi-groups. An extensive theoretical analysis is conducted to validate the proposed model. A comprehensive numerical investigation encompasses deterministic, stochastic, and ABC fractional-order derivatives, considering the combined effects of an effective vaccination program and non-pharmaceutical interventions, such as lockdowns and shutdowns. The findings of this research are expected to be valuable for policymakers in different countries, helping them implement dynamic strategies to control and eradicate the epidemic effectively.

Age-time-specific transmission of hand-foot-and-mouth disease enterovirus serotypes in Vietnam: A catalytic model with maternal immunity

Hand, foot and mouth disease (HFMD) is highly prevalent in the Asia Pacific region, particularly in Vietnam. To develop effective interventions and efficient vaccination programs, we inferred the age-time-specific transmission patterns of HFMD serotypes enterovirus A71 (EV-A71), coxsackievirus A6 (CV-A6), coxsackievirus A10 (CV-A10), coxsackievirus A16 (CV-A16) in Ho Chi Minh City, Vietnam from a case data collected during 2013–2018 and a serological survey data collected in 2015 and 2017. We proposed a catalytic model framework with good adaptability to incorporate maternal immunity using various mathematical functions. Our results indicate the high-level transmission of CV-A6 and CV-A10 which is not obvious in the case data, due to the variation of disease severity across serotypes. Our results provide statistical evidence supporting the strong association between severe illness and CV-A6 and EV-A71 infections. The HFMD dynamic pattern presents a cyclical pattern with large outbreaks followed by a decline in subsequent years. Additionally, we identify the age group with highest risk of infection as 1-2 years and emphasise the risk of future outbreaks as over 50% of children aged 6-7 years were estimated to be susceptible to CV-A16 and EV-A71. Our study highlights the importance of multivalent vaccines and active surveillance for different serotypes, supports early vaccination prior to 1 year old, and points out the potential utility for vaccinating children older than 5 years old in Vietnam.

Eco‐friendly materials for next‐generation vaccination: From concept to clinical reality

AbstractThe vaccine is a premier healthcare intervention strategy in the battle against infectious infections. However, the development and production of vaccines present challenges in terms of complexity, cost, and time consumption. Alternative methodologies, such as nonthermal plasma and plant‐based technologies, have emerged as potential alternatives for conventional vaccine manufacturing processes. While plasma‐based approaches offer a rapid and efficient pathogen inactivation method devoid of harsh reagents, plant‐based techniques present a more economically viable and scalable avenue for vaccine production. The imperative urges these approaches to address pressing global health challenges posed by emerging and recurring infectious diseases, surpassing the limitations of traditional vaccine fabrication methods. The primary goal of this review is to provide a comprehensive overview of the current research landscape, covering conceptualization, production, and potential advantages of plasma‐based and plant‐based vaccines. Furthermore, exploring the obstacles and opportunities intrinsic to these strategies is undertaken, elucidating their potential impact on vaccination strategies. This systematic presentation specifies a detailed outline of recent vaccine research and developments, emphasizing the possibility of advanced green approaches to produce effective and secure vaccination programs.

Corona Virus Disease 19 (COVID-19) Patient Profile in Klungkung

Introduction: Despite the effective global mass vaccination programs, which included booster shots, the emergence of new SARS-CoV-2 strains threatens to undo the enormous success achieved thus far in stopping its spread. This study aimed to assess the demographics of COVID-19 patients from February to May 2021. Methods: Data were collected using secondary data from the medical records of Klungkung Regional General Hospital, Klungkung, at the time range according to the study period. Statistical Package for the Social Sciences (SPSS) version 25.0 for Windows and Microsoft Excel 2016 were used for the statistical analysis. All quantitative data, such as age, length of stay, and neutrophil-to-lymphocyte ratio (NLR), were estimated using central location measures (mean range). Proportions were used to describe qualitative or category variables. Results: The demographic description of COVID-19 patients at Klungkung Regional General Hospital, Klungkung, found an average age of 51.94 years old. More patients were found to be male (55.4%) and did not have comorbidities (55.3%). Fourteen patients (14.4%) were gravid, and 37 patients (17.8%) were treated in the Intensive Care Unit (ICU). A total of 61 patients (29.3%) had desaturase with an NLR (mean) of 6.97 (51% increase). The average length of stay was 10.16 days, with the result of 24 patients dying (11.5%). Conclusion: Patients with COVID-19 were found to have milder symptoms with less use of the ICU, not all of them experienced decreased saturation, and the case fatality rate was 11.5%.

Intradermal Fractional ChAdOx1 nCoV-19 Booster Vaccine Induces Memory T Cells: A Follow-Up Study.

The administration of viral vector and mRNA vaccine booster effectively induces humoral and cellular immune responses. Effector T cell responses after fractional intradermal (ID) vaccination are comparable to those after intramuscular (IM) boosters. Here, we quantified T cell responses after booster vaccination. ChAdOx1 nCoV-19 vaccination induced higher numbers of S1-specific CD8+ memory T cells, consistent with the antibody responses. Effector memory T cell phenotypes elicited by mRNA vaccination showed a similar trend to those elicited by the viral vector vaccine booster. Three months post-vaccination, cytokine responses remained detectable, confirming effector T cell responses induced by both vaccines. The ID fractional dose of ChAdOx1 nCoV-19 elicited higher effector CD8+ T cell responses than IM vaccination. This study confirmed that an ID dose-reduction vaccination strategy effectively stimulates effector memory T cell responses. ID injection could be an improved approach for effective vaccination programs.

High Prevalence of Novel Sequence Types in Streptococcus pneumoniae That Caused Invasive Diseases in Kuwait in 2018.

Multilocus sequence typing (MLST) is used to gain insight into the population genetics of bacteria in the form of sequence type (ST). MLST has been used to study the evolution and spread of virulent clones of Streptococcus pneumoniae in many parts of the world. Such data for S. pneumoniae are lacking for the countries of the Arabian Peninsula, including Kuwait. We determined the STs of all 31 strains of S. pneumoniae from invasive diseases received at a reference laboratory from various health centers in Kuwait during 2018 by MLST. The relationship among the isolates was determined by phylogenetic analysis. We also determined the serotypes by Quellung reaction, and antimicrobial susceptibility by Etest, against 15 antibiotics belonging to 10 classes. There were 28 STs among the 31 isolates, of which 14 were new STs (45.2%) and 5 were rare STs (16.1%). Phylogenetic analysis revealed that 26 isolates (83.9%) were unrelated singletons, and the Kuwaiti isolates were related to those from neighboring countries whose information was gleaned from unpublished data available at the PubMLST website. Many of our isolates were resistant to penicillin, erythromycin, and azithromycin, and some were multidrug-resistant. Virulent serotype 8-ST53, and serotype 19A with new STs, were detected. Our study detected an unusually large number of novel STs, which may indicate that Kuwait provides a milieu for the evolution of novel STs. Novel STs may arise due to recombination and can result in capsular switching. This can impact the effect of vaccination programs on the burden of invasive pneumococcal disease. This first report from the Arabian Peninsula justifies the continuous monitoring of S. pneumoniae STs for the possible evolution of new virulent clones and capsular switching.

Frequency of PCV-2 viremia in nursery piglets from a Spanish swine integration system in 2020 and 2022 considering PRRSV infection status.

Porcine circovirus 2 (PCV-2) poses a significant economic threat for the swine industry, causing a range of diseases collectively referred to as porcine circovirus diseases (PCVDs). Despite PCV-2 vaccine effectiveness, the need for monitoring infectious pressure remains. PCV-2 coinfection with other pathogens like porcine reproductive and respiratory syndrome virus (PRRSV) can exacerbate disease severity and lead to PCV-2-systemic disease cases. Monitoring both PRRSV and PCV-2 in co-infected farms is crucial for an effective management and vaccination programs. The present cross-sectional study aimed to determine PCV-2 antibody levels in piglets at weaning and PCV-2 and PRRSV viremia in pooled serum samples at weaning (vaccination age) and at 6 and 9weeks of age from a Spanish swine integration system in 2020 (48 farms) and in 2022 (28 out of the 48 analysed previously). The frequency of PCV-2 detection in pools of piglet sera was 2.1% (2020) and 7.1% (2022) at vaccination age but increased at the end of the nursery period (10.4% in 2020 and 39.3% in 2022)in both years. Co-infections between PCV-2 and PRRSV were detected in a significant proportion of PRRSV positive farms (15% in 2020, and 60% in 2022). PCV-2 antibody levels(ELISA S/P ratios) at weaning were lower in PCV-2 qPCR positive farms at different sampling time-points (0.361 in 2020 and 0.378 in 2022) compared to PCV-2 qPCR negative ones (0.587 in 2020 and 0.541 in 2022). The 28 farms tested both years were classified in four different epidemiological scenarios depending on their PCV-2 virological status. Those PCV-2 qPCR negative farms in 2020 that turned to be positive in 2022 had a statistically significant increase of PRRSV RT-qPCR detection and a PCV-2 antibody levels reduction, facts that were not observed in the rest of the scenarios. This epidemiological study in farms from the same integration system determined the occurrence, in 2020 and in 2022, of PCV-2 and PRRSV infections in piglets during the nursery period by using pooled serum samples.

Predicted Cervical Cancer Prevention: Impact of National HPV Vaccination Program on Young Women in South Korea.

This study aimed to evaluate the effectiveness of the National HPV Vaccination Program of South Korea among its entire female population, particularly among younger age groups. We first predicted the incidence of cervical cancer over the next 20 years (2021-2040) using the Nordpred package based on Møller's age-period-cohort model under several scenarios for the National HPV Vaccination Program. We calculated the potential impact fractions (PIFs) and proportional differences under the current national vaccination programs, and alternative scenarios using the no-vaccination assumption as a reference. We estimated that the current national vaccination program would prevent 4.13% of cervical cancer cases and reduce the age-standardized incidence rate (ASR) by 8.79% in the overall population by 2036-2040. Under the alternative scenario of implementing the nine-valent vaccine, 5.13% of cervical cancer cases could be prevented and the ASR reduced by 10.93% during the same period. In another scenario, expanding the vaccination age to 9-17 years could prevent 10.19% of cervical cancer cases, with the ASR reduced by 18.57% during the same period. When restricted to ages <40 years, the prevention effect was remarkably greater. We predict that the current national HPV program will reduce its incidence by more than 30% between 2036 and 2040 in women aged <40 years. The effectiveness of the vaccination program in reducing the incidence of cervical cancer was confirmed, with a considerable impact anticipated in younger age groups.

Dynamic predictors of COVID-19 vaccination uptake and their interconnections over two years in Hong Kong

The global rollout of COVID-19 vaccines faces a significant barrier in the form of vaccine hesitancy. This study adopts a dynamic and network perspective to explore the determinants of COVID-19 vaccine uptake in Hong Kong, focusing on multi-level determinants and their interconnections. Following the framework proposed by the Strategic Advisory Group of Experts (SAGE), the study used repeated cross-sectional surveys to map these determinants at multiple levels and investigates their interconnections simultaneously in a sample of 15,179 over two years. The results highlight the dynamic nature of COVID-19 vaccine hesitancy in an evolving pandemic. The findings suggest that vaccine confidence attitudes play crucial roles in vaccination uptake, with their importance shifting over time. The initial emphasis on vaccine safety gradually transitioned to heightened consideration of vaccine effectiveness at a later stage. The study also highlights the impact of chronic condition, age, COVID-19 case numbers, and non-pharmaceutical preventive behaviours on vaccine uptake. Higher educational attainment and being married were associated with primary and booster vaccine uptake and it may be possible to leverage these groups as early innovation adopters. Trust in government acts as a crucial bridging factor linking various variables in the networks with vaccine confidence attitudes, which subsequently closely linked to vaccine uptake. This study provides insights for designing future effective vaccination programmes for changing circumstances.

Posibilities for use of whole genome sequencing (WGS) for the analysis of Streptococcus pneumoniae isolates.

Streptococcus pneumoniae (pneumococcus) is a Gram-positive coccus causing both non-invasive and invasive infectious diseases. Pneumococcal diseases are vaccine preventable. Invasive pneumococcal diseases (IPD) meeting the international case definition are reported nationally and internationally and are subject to surveillance programmes in many countries, including the Czech Republic. An important part of IPD surveillance is the monitoring of causative serotypes and their frequency over time and in relation to ongoing vaccination programmes. In the world and in the Czech Republic, whole genome sequencing (WGS) is increasingly used for pneumococci, which allows for serotyping from sequencing data, precise analysis of their genetic relationships, and the study of genes present in their genome. Whole-genome sequencing enables the generation of reliable and internationally comparable data that can be easily shared. Sequencing data are analysed using bioinformatics tools that require knowledge in the field of natural sciences with an emphasis on genetics and expertise in bioinformatics. This publication presents some options for pneumococcal analysis, i.e., serotyping, multilocus sequence typing (MLST), ribosomal MLST (rMLST), core genome MLST (cgMLST), whole genome MLST (wgMLST), single nucleotide polymorphism (SNP) analysis, assignment to Global Pneumococcal Sequence Cluster (GPSC), and identification of virulence genes and antibiotic resistance genes. The WGS strategies and applications for Europe and WGS implementation in practice are presented. WGS analysis of pneumococci allows for improved IPD surveillance, thanks to molecular serotyping, more detailed typing, generation of internationally comparable data, and improved evaluation of the effectiveness of vaccination programmes.

Typhoid fever.

Typhoid fever is an invasive bacterial disease associated with bloodstream infection that causes a high burden of disease in Africa and Asia. Typhoid primarily affects individuals ranging from infants through to young adults. The causative organism, Salmonella enterica subsp. entericaserovar Typhi is transmitted via the faecal-oral route, crossing the intestinal epithelium and disseminating to systemic and intracellular sites, causing an undifferentiated febrile illness. Blood culture remains the practical reference standard for diagnosis of typhoid fever, where culture testing is available, but novel diagnostic modalities are an important priority under investigation. Since 2017, remarkable progress has been made in defining the global burden of both typhoid fever and antimicrobial resistance; in understanding disease pathogenesis and immunological protection through the use of controlled human infection; and in advancing effective vaccination programmes through strategic multipartner collaboration and targeted clinical trials in multiple high-incidence priority settings. This Primer thus offers a timely update of progress and perspective on future priorities for the global scientific community.

Antibiotic consumption for sore throat and the potential effect of a vaccine against group A Streptococcus: a systematic review and modelling study

Antibiotic consumption can lead to antimicrobial resistance and microbiome imbalance. We sought to estimate global antibiotic consumption for sore throat, and the potential reduction in consumption due to effective vaccination against group A Streptococcus (Strep A). We reviewed and analysed articles published between January 2000 and February 2022, identified though Clarivate Analytics' Web of Science search platform, with reference to antibiotic prescribing or consumption, sore throat, pharyngitis, or tonsillitis. We then used those analyses, combined with assumptions for the effectiveness, duration of protection, and coverage of a vaccine, to calculate the estimated reduction in antibiotic prescribing due to the introduction of Strep A vaccines. We identified 101 studies covering 38 countries. The mean prescribing rate for sore throat was approximately 5 courses per 100 population per year, accounting for approximately 5% of all antibiotic consumption. Based on 2020 population estimates for countries with empiric prescribing rates, antibiotic consumption for sore throat was estimated to exceed 37 million courses annually, of which half could be attributable to treatment for Strep A. A vaccine that reduces rates of Strep A infection by 80%, with 80% coverage and 10 year's duration of protection, could avert 2.8 million courses of antibiotics prescribed for sore throat treatment among 5-14 year-olds in countries with observed prescribing rates, increasing to an estimated 7.5 million averted if an effective vaccination program also reduced precautionary prescribing. A vaccine that prevents Strep A throat infections in children may reduce antibiotic prescribing for sore throat by 32-87% depending on changes to prescribing and consumption behaviours. The Wellcome Trust, grant agreement number 215490/Z/19/Z.

PSX-16 The Effects of Vaccination Program and Grazing Season on Beef Cattle Milk Fatty Acid Composition When Grazing Native Rangeland in New Mexico

Abstract The objectives of this study were to evaluate the impact of vaccine program and progression of grazing season on beef cow milk fatty acid composition. In 2015, Fifty-one Angus-crossed beef heifers were randomly assigned to receive a modified-live viral vaccine (MLV; Bovishield Gold 5 FP) or killed viral vaccine (KV; Cattlemaster Gold 5 FP) against BVDV beginning at 3 months of age and for the duration of their lifespan in the herd. In 2019, 2020, and 2021, milk samples were collected on days 1, 63, and 205 of lactation. Milk samples were subjected to fatty acid analysis using Gas Chromatography. Data were analyzed as a completely randomized design with repeated measures using SAS. Milk concentrations of 16:0, 18:0, 18:1n-9, 18:2n-6, 18:3n-3, or total fatty acids when expressed as mg/g were not affected by vaccine treatment (P ≥ 0.58). However, milk 16:0 concentrations decreased linearly (P &amp;lt; 0.0001) as the grazing season progressed from day 1 to day 205 of lactation. This was despite a linear increase (P = 0.05) in forage concentrations of 16:0. Milk concentrations of 18:0 decreased linearly throughout lactation (P = 0.002). Likewise, milk concentrations of 18:1n-9 decreased throughout lactation (P &amp;lt; 0.0001). Milk concentrations of 18:2n-6 declined linearly (P &amp;lt; 0.0001) as the grazing season progressed into the fall weaning period. Interestingly, milk concentration of 18:3n-3 did not change (P = 0.62) with time. Biohydrogenation intermediates were reduced in concentration and did not vary across grazing season (P ≥ 0.06) Total fatty acids decreased throughout lactation (P &amp;lt; 0.0001). Total fatty acid content of forage did increase linearly (P = 0.02), which would suggest milk production (volume) and de novo milk fatty acid synthesis altered milk composition more so than forage fatty acid composition. In conclusion, vaccine treatment did not affect milk composition. However, grazing season progression resulted in decreased milk fatty acid concentrations from day 1 to day 205 of lactation.

Vaccine Immunity in Children After Hematologic Cancer Treatment: A Retrospective Single-center Study.

Children lose their vaccine-induced protection and are particularly vulnerable to vaccine-preventable diseases after chemotherapy. However, revaccination guidelines are heterogeneous, and there is often a lack of revaccination post-treatment. We conducted a retrospective study of children with hematologic cancer to evaluate vaccine immunity before and after the end of treatment and to determine whether the current institutional revaccination program based on vaccine serology results was followed and effective. Data of all children treated by chemotherapy between April 2015 and July 2021 were extracted from hospital medical records for analysis. Serum antibody levels and time of vaccination were evaluated for diphtheria, tetanus, Streptococcus pneumoniae , Haemophilus influenzae type b (Hib), measles, varicella, and hepatitis B. We included 31 patients (median age, 9 years). At cancer diagnosis, 90% of children were protected against tetanus, diphtheria, and measles; 65% to 67% were protected against pneumococcus and varicella; and 25% against hepatitis B. At the end of chemotherapy, 67% to 71% of patients were protected against tetanus, varicella, and measles; 40% remained protected against hepatitis B; and 27% to 33% against pneumococcus and diphtheria. Patients were revaccinated at various times after the end of treatment but not systematically. During the first-year post-treatment, 20% to 25% of children remained unprotected against pneumococcus, measles, and hepatitis B, one third against diphtheria, but all were protected against tetanus and varicella. An effective individualized vaccination program post-cancer based on serology results should be accompanied by an appropriate serology tracking method and follow-up to assess if booster doses are necessary. Our study supports vaccinating all children with a dose of the 13-valent pneumococcal conjugate at cancer diagnosis and at 3 months post-treatment with the combined diphtheria-tetanus-acellular pertussis/poliomyelitis vaccine/hepatitis B virus plus or minus Hib and 13-valent pneumococcal conjugate and meningococcal vaccine, including measles/mumps/rubella-varicella zoster virus vaccine if good immune reconstitution is present.

Assistance and Delivery of COVID-19 Vaccinations to Patients with Rare Diseases.

The COVID-19 vaccination campaign has been fortified by the positive effects of immunization: data from official government organizations and communication channels show that infection rates, hospitalizations, and deaths have continued to fall since its implementation. In Brazil, the effective and free National Vaccination Program has failed to prioritize patients with rare diseases, who have extreme comorbidities, and who adhere to the calendar prepared by the government. The question is why these "rare people" were not considered priorities during the vaccination program. This study aims to understand the reasoning behind this decision and to resume the debate around the rights of patients with rare diseases based on regular descriptors issued by official government agencies and by critics of rare disease issues in scientific articles. The objectives of this study were as follows: to analyze the dispensed care of rare disease patients in the COVID-19 vaccination campaign; to identify the procedures implemented by the National Vaccination Plan for the Brazilian population over 18 years of age and to evaluate the effectiveness of the plan implemented from the perspective of a "rare person".

A panoramic view of hospitalized young children in the metropolitan area of the valley of Mexico during COVID-19

ObjectivesThis work provides an overview of young children's (aged 0-9) infectious diseases epidemiology, by exploring the link between various comorbid conditions, COVID-19, and death rate. MethodsPublic data on hospitalized young children was obtained from national databases of the Mexican health care system from 2020-2022. Data included age, year of entry, gender, the time between admission to death (hospitalization time), date of death, comorbidities, and admissions to the intensive care unit. Children were separated into age groups and frequencies were calculated. Binary regression models were developed to determine the correlation of comorbidities and COVID-19 to death as calculated by odds ratios (OR). ResultsFrom 2020-2022, there were 11,815 hospitalizations among young children, of which 15.98% were due to COVID-19, 2.55% of hospitalizations resulted in fatalities from which 32.45% of deaths were COVID-19 related. The highest case-calculated fatality ratio of COVID-19 infected young children was estimated at 7.04% by early 2020, but dropped to 2.11% by the end of the second semester of 2022. The most frequent comorbidities associated with their hospitalization and death for the general population were intubation (OR: 17.967), pneumonia (OR: 2.263), diabetes (OR: 7.301), cardiovascular diseases (OR: 1.528) and COVID-19 (OR: 261). For the COVID-19-positive group, the most impactful comorbidities were intubation (OR: 20.232), pneumonia (OR: 3.057), and diabetes (OR: 12.824). ConclusionChildren's hospitalizations and deaths were common during the pandemic; wherein major comorbidities played an important role. Therefore, effective comorbidity management and vaccination programs are essential to reduce hospitalizations and deaths among young children.

Relationship Between Knowledge, Attitude and Motivation of Officers in Managing the COVID-19 Vaccine Cold Chain: A Systematic Review

Background: Vaccines are an important tool in preventing serious infectious diseases. Cold chain management is essential to maintain vaccine quality, including storage, transportation, and distribution at appropriate temperatures. This study aims to investigate the relationship between knowledge, attitudes, and motivation of health workers responsible for cold chain management of the COVID-19 vaccine. Method: This was a systematic literature review study by searching through databases: Google Scholar, PubMed, Semantic Scholar, and Frontiers, using some keywords. 76 relevant previous studies were found. After filtering for publication year (post-2019), they reviewed 19 articles' abstracts. However, 10 articles lacked information on vaccine officers' knowledge, attitudes, and motivation in cold chain management. Thus, only 9 articles were included in the review. Results: The results show that adequate knowledge, training, and understanding of guidelines significantly influence desired vaccine cold chain management practices. These studies also highlight the importance of understanding guidelines, efficient implementation, and sustainability aspects in vaccine management. Conclusion: This research concludes that to increase the effectiveness of vaccination programs, efforts are needed to increase knowledge, training, and implementation of guidelines among health workers responsible for the vaccine cold chain. Efforts to understand and implement sustainable practices are also crucial. The conclusions from this research can help decision-makers improve vaccine cold chain management to ensure the success of the vaccination program.