High Vaccination Rates Research Articles

Factors associated with acute watery diarrhea among children aged 0–59 months in Obongi District, Uganda, April 2022: A case–control study

BackgroundDiarrheal diseases, are major concerns for Ugandan children; persistent in Obongi District despite high rotavirus vaccination rates (2019–2021). The district recorded the country's highest annual acute watery diarrhea (AWD) incidence from 2017 to 2021. Our study, conducted in April 2022, assessed AWD risk factors among 0–59-month-old children in Obongi. MethodsWe conducted a 1:2 (193:386) unmatched case–control study. A case was a child (0–59 months) with ≥ 3 loose/liquid stools/day, negative malaria/pneumonia tests, residing in Itula/Parolinya subcounty from 1 to 30 April 2022. Medical records from 10 facilities were reviewed. Simple random sampling identified cases, who were interviewed, and controls were randomly chosen from non-AWD neighboring households. Child health cards provided vaccination details. We used logistic regression to identify factors associated with AWD. ResultsAmong 193 cases and 386 controls, 104 (54 %) cases and 183 (47 %) controls were male, 58 (30 %) cases and 127 (33 %) controls were aged 12–23 months, 187 (97 %) cases and 369 (96 %) controls had received at least one dose of rotavirus vaccine, 58 (30 %) cases and 120 (34 %) controls treated drinking water. Comorbidity presence (undernutrition, diabetes, HIV) (AOR = 12; CI: 2.5–53), caregiver's unwashed hands post-toilet (AOR = 3.9; CI: 1.2–13), and borehole vs. piped water (AOR = 4.0; CI: 1.7–9.6) linked to AWD. ConclusionModifiable factors, including failure of caregivers to wash their hands with soap after visiting toilets and use of borehole water were associated with AWD, suggesting that community sensitization on handwashing at critical times, using clean water and soap, and expanded use of piped water could reduce AWD incidence in this area.

Molecular Determinants of Drug Resistance and Mutation Patterns in Influenza Viruses Circulating in Poland Across Multiple Epidemic Seasons: Implications for Vaccination Strategies.

BACKGROUND According to the WHO, up to 650 000 people die each year from seasonal flu-related respiratory illnesses. The most effective method of fighting the virus is seasonal vaccination. However, if an infection does occur, antiviral medications should be used as soon as possible. No studies of drug resistance in influenza viruses circulating in Poland have been systematically conducted. Therefore, the aim of the present study was to investigate the drug resistance and genetic diversity of influenza virus strains circulating in Poland by determining the presence of mutations in the neuraminidase gene. MATERIAL AND METHODS A total of 258 clinical specimens were collected during the 2016-2017, 2017-2018, and 2018-2019 epidemic seasons. The samples containing influenza A and B were analyzed by RT-PCR and Sanger sequencing. RESULTS Differences were found between the influenza virus strains detected in different epidemic seasons, demonstrating the occurrence of mutations. Influenza A virus was found to be more genetically variable than influenza B virus (P<0.001, Kruskal-Wallis test). However, there was no significant difference in the resistance prevalence between the influenza A subtypes A/H1N1/pdm09 (4.8%) and A/H3N2/ (6.1%). In contrast, more mutations of drug-resistance genes were found in the influenza B virus (P<0.001, chi-square test). In addition, resistance mutations appeared en masse in vaccine strains circulating in unvaccinated populations. CONCLUSIONS It seems important to determine whether the influenza virus strains tested for drug resistance as part of global influenza surveillance are equally representative of viruses circulating in populations with high and low vaccination rates, for all countries. Our results suggest that countries with low levels of influenza immunization may constitute reservoirs of drug-resistant influenza viruses.

The Effect of Being Vaccinated and National Vaccination Rates on Individuals' Cognitions, Emotions, and Economic Expectations: Evidence from Israel.

Israel was the first nation to establish a vaccination program during the COVID-19 pandemic. Thus, its citizens could look to no other country to help them judge its influence. People's predictions of their safety should depend on whether they were vaccinated, whereas their predictions regarding the COVID-19 pandemic should be based on the degree of progress of the vaccination program. We expected people to understand that the program would improve their safety by reducing the number of infected people around them. An original panel survey was conducted covering the pandemic's first year. Respondents reported their vaccination status, emotions, evaluations of their safety, and predictions about the spread of COVID-19 and the Israeli gross domestic product. Estimates of fixed-effects models using the survey data suggest that being vaccinated affected people's cognitions about their own safety and their emotions but not their expectations regarding the situation in Israel as a whole. In contrast, the vaccination rate in Israel affected only the respondents' expectations about the spread of COVID-19, their own income, and Israel's gross domestic product. Being vaccinated is important for people's personal emotional and cognitive relief during a pandemic. A high vaccination rate improves people's economic expectations, which is important to the recovery of economic activity.

Education on the Importance of Immunization for Infants at Puskesmas Tamalanrea Jaya Makassar City

&#x0D; Immunization of infants is one of the most important steps in maintaining their health and well-being. This article discusses the importance of immunization in infants, including its benefits, the types of immunizations recommended, and their positive impact on society. Immunization in infants helps protect them from serious diseases that can be life-threatening, such as measles, polio, tetanus, and hepatitis. By immunizing babies according to the schedule recommended by health authorities, parents can help build the baby's immune system so that they are more resistant to infection and disease. In addition to protecting vaccinated babies, immunization also plays an important role in creating herd immunity. With high vaccination rates in communities, infectious diseases have little chance of spreading, protecting even individuals who cannot yet be vaccinated or who are immune to the disease. There are still many myths and concerns about immunization that can deter parents from immunizing their babies. Therefore, it is important for medical personnel and health professionals to provide accurate education about the benefits of immunization and help answer questions and concerns parents may have. By understanding the importance of immunization for infants, it is hoped that public awareness will increase and vaccination rates will continue to increase. This will result in a healthier generation and reduced morbidity and death from immunization-preventable diseases.&#x0D;

Investigating the rise of Omicron variant through genomic surveillance of SARS-CoV-2 infections in a highly vaccinated university population.

Novel variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to emerge as the coronavirus disease 2019 (COVID-19) pandemic extends into its fourth year. Understanding SARS-CoV-2 circulation in university populations is vital for effective interventions in higher education settings and will inform public health policy during pandemics. In this study, we generated 793 whole-genome sequences collected over an entire academic year in a university population in Indiana, USA. We clearly captured the rapidity with which Delta variant was wholly replaced by Omicron variant across the West Lafayette campus over the length of two academic semesters in a community with high vaccination rates. This mirrored the emergence of Omicron throughout the state of Indiana and the USA. Further, phylogenetic analyses demonstrated that there was a more diverse set of potential geographic origins for Omicron viruses introduction into campus when compared to Delta. Lastly, statistics indicated that there was a more significant role for international and out-of-state migration in the establishment of Omicron variants at Purdue. This surveillance workflow, coupled with viral genomic sequencing and phylogeographic analyses, provided critical insights into SARS-CoV-2 transmission dynamics and variant arrival.

Trust in COVID-19 information sources and vaccination status: Exploring social inequalities and differences within the four United Kingdom nations using a representative survey.

To explore how the use of, and trust in, different sources of advice and information on COVID-19 differed across the four UK nations and between different sociodemographic groups and their associations with COVID-19 vaccination status. We used a UK-wide representative survey conducted in July 2021, which included data on uptake of COVID-19 vaccination, trust in information sources, use of sources and geographical and sociodemographic variables. We used multivariate logistic regression to identify factors associated with completed or planned COVID-19 vaccination. Trust in the NHS, followed by trust in scientists, were the strongest predictors of vaccination intention. NHS websites were the most used (56% across the UK); only the Scottish government website had a higher level of reported use (58%). Using either source was associated with a positive vaccination status as were use of the GP and television as sources of advice. Use of social media, family and friends, and 'none' of the sources enquired about, were all linked to a lower likelihood of being or intending to get vaccinated. Compared to those in England, respondents in other UK nations were less likely to trust the central UK government for advice on COVID-19. There was considerable variation by age in trust and use of some, but not all, sources of advice, with predicted probabilities ranging from 35% among the youngest age group to 62% among those aged 65years or older. There were also significant differences by annual household income and by occupational class for trust in government, with higher incomes correlating with greater likelihood of trust. This study demonstrates high levels of trust in the key sources of public health advice and there was a positive association between using official sources of advice and vaccination intentions, even in the context of overall high vaccination rates. Our findings highlight the need for the UK and devolved governments to value the importance of public trust in the health system and take appropriate measures to avoid undermining such trust.

SEI3R2D2V: Pandemic Modeling and Analysis of Its Latent Factors: A Case Study of COVID-19 in India

For densely populated developing countries, such as India, where due to a lack of general and public awareness, limited data collection and compilation facilities, and inherent limitations of the available diagnostic test, accurate modeling of the pandemic is more challenging. Thus, a realistic model for predictions is required in order to formulate more effective strategic policies to control the COVID-19 pandemic using limited available resources. In this article, we propose a time-varying epidemiological model with two classes of compartments, reported and unreported, and consider influential latent factors, for example, undetectable infections, the false-negative rate of testing, testing hesitancy, vaccination efficacy, dual contact dynamics, and the possibility of reinfection in recovered as well as vaccinated individuals. For simulation purposes, we consider the COVID-19 data of India from March 13, 2020, to January 20, 2022. Furthermore, we provide a sensitivity analysis of various latent factors and predictions for the third wave in India. Simulated results suggest that India is able to control COVID-19 for the first time after the second wave, as observed from the trajectory of effective reproduction number. Moreover, for unseen or coming variants of virus for which vaccine efficacy is low, the available vaccine requires a high vaccination rate to control future waves.

SWOT-TOWS ANALYSIS OF THE PANDEMIC STRATEGIES APPLIED IN ROMANIA BETWEEN 2020-2021

This paper outlines pandemic management strategies, focusing on effective health policy improvements in Romania. Utilizing SWOT and TOWS analysis, it develops attack, defense, adaptation, and survival strategies to mitigate threats, leverage strengths, address weaknesses, and maximize national benefits. Emphasizing early disease detection and non-pharmaceutical interventions as crucial in pandemic control, the study highlights the importance of high vaccination rates. It advocates for health crisis management through the innovation of existing policies and the introduction of new methods, demonstrating the efficacy of the SWOT-TOWS approach in global health policy development

Modeling the response of an endangered rabbit population to RHDV2 and vaccination

AbstractRabbit hemorrhagic disease virus 2 (RHDV2), recently detected in the western United States, has the potential to cause mass mortality events in wild rabbit and hare populations. Currently, few management strategies exist other than vaccination. We developed a spatially explicit model of RHDV2 for a population of riparian brush rabbits (Sylvilagus bachmani riparius), a subspecies of brush rabbit classified as endangered in the United States, on a subsection of the San Joaquin River National Wildlife Refuge. The goal of our model was to provide guidance regarding vaccination strategies for an endangered rabbit species. Our model predicts that increased interactions between rabbits (a proxy for landscape connectivity) and disease transmission rates among susceptible hosts (individual brush rabbits and conspecifics) have the greatest influence on the outcome of a potential vaccination campaign. Our model projects that across a range of parameter estimates (given an RHDV2 incursion), the median estimated population size with a 0%–10% vaccination rate after 1 year is 538 rabbits (95% Confidence Interval [C.I.] 69–1235), approximately 36% of the expected size of the study population of 1470 rabbits without an RHDV2 introduction. With a 10%–20%, 20%–30%, or 30%–40% vaccination rate, the median estimated population size increased to 628 rabbits (95% C.I. 130–1298), 723 rabbits (95% C.I. 198–1317), and 774 rabbits (95% C.I. 228–1410), respectively. These estimates represent 43%, 49%, and 53% of the expected population size without an RHDV2 introduction. Overall, a 1% increase in vaccination rate was associated with a six rabbit (95% C.I. 5–7) increase in total remaining population size. This result is dependent on assumptions regarding environmental transmission, home range size (and contact rates of rabbits). Given the relatively short lifespan of rabbits and the potential need for boosters, vaccination programs are most likely to be successful for small target populations where relatively high vaccination rates can be maintained.

Health and healthcare of people with learning disabilities in the United Kingdom through the COVID‐19 pandemic

AbstractBackgroundDuring the COVID‐19 pandemic in the United Kingdom, many health services were withdrawn from people with learning disabilities, with negative impacts on people's health. What has happened to people's health and healthcare as we move beyond the pandemic?MethodsAccess to health services and health status were tracked for 550 UK adults with learning disabilities, using structured online interviews with people with learning disabilities and online surveys with family members or paid carers. Information was provided four times, from Wave 1 (in the winter 2020/2021 ‘lockdown’) to Wave 4 (autumn 2022, over a year after public health protections stopped).FindingsBy Wave 4, most people with learning disabilities had had COVID‐19, although high vaccination rates limited the number of people hospitalised. There was little evidence that use of GP services, community nurses, other therapists or annual health checks had increased over time, and at Wave 4 more people were having difficulty getting their medicines. People's health did not substantially improve over time. People with profound and multiple learning disabilities had poorer health and were less likely to be accessing health services.ConclusionsImprovements in access to health services for people with learning disabilities after the pandemic have not yet happened.

Factors associated with extent of COVID-19 outbreaks: A prospective study in a large hospital network

The COVID-19 pandemic has generated numerous hospital outbreaks. This study aimed to identify factors related to the extent of nosocomial COVID-19 outbreaks in the largest French public health institution. An observational study was conducted from July 2020 to September 2021. Outbreaks were defined as at least 2 cases, patients and/or health care workers (HCWs), linked by time and geographic location. Logistic regression was performed to identify risk factors for large outbreaks among nine variables: variant, medical ward, COVID-19 vaccination rate and incidence among HCWs and Paris population, number of weekly COVID-19 tests among HCWs and the positivity rate, epidemic waves. Within 14 months, 799 outbreaks were identified: 450 small ones (≤6 cases) and 349 large ones (≥7 cases), involving 3,260 patients and 3,850 HCWs. In univariate analysis, large outbreaks were positively correlated to geriatrics wards, COVID-19 incidence, and rate of weekly positive tests among HCWs; and negatively correlated to intensive care units, variant Delta, fourth wave, vaccination rates of the Paris region's population and that of the HCWs. In multivariate analysis, factors that remained significant were the type of medical ward and the vaccination rate among HCWs. Intensive care unit and high vaccination rates among HCWs were associated with a lower risk of large COVID-19 outbreaks, as opposed to geriatric wards, which are associated with a higher risk.

Unraveling the politics-science nexus: diverse strategies in US states’ termination of mask policies

ABSTRACT This study investigates the intentional termination decision of a public health tool (i.e. face-mask policy) in the absence of knowledge regarding the duration of the pandemic. We acknowledge that policy termination is a complicated decision-making process that necessitates multiple considerations. Gleaning perspectives from the literature on the politics-science divide and policy termination theory, two distinct sets of factors emerge as influential: political considerations (i.e. governor’s ideology and public opinion) and scientific considerations (i.e. vaccination rate and healthcare resources). We conduct a fuzzy-set Qualitative Comparative Analysis to examine how explanatory factors interplay in diverse ways in shaping mask termination decisions. The results show three equally important pathways in elucidating mask termination decisions: two pathways explained how Republican and Democratic Governors draw upon diverse considerations to end the mask use, respectively. The third path underscores that a level high vaccination rate would explain most states’ mask termination decisions. The results highlight the complexity inherent policy-making during a public health crisis. This study offers a glimpse into the varied approaches adopted by states to navigate the exit from the pandemic. In the broader context of public administration, this study sheds light on how states bridge the gap between politics and science.

Pro-religion attitude predicts lower vaccination coverage at country level

The COVID-19 pandemic has highlighted the urgent need to address vaccine coverage inequality. Despite calls from scientists and national organizations, progress in ensuring equitable access to vaccines has been slow. This study aims to reveal the COVID-19 vaccine coverage inequality and investigate the predictive effect of attitudes toward science and religion on real-word vaccination uptake. We draw on three high-quality, large-scale databases to unveil real-world vaccine coverage, which stood at an average of 53% of the population by mid-2022. The vaccination rate varies based on a country’s income, with higher-income nations having higher vaccination rates and faster vaccination speed. Regression models and a multiverse analysis reveal that both country-level attitudes towards science and religion, as well as religious faith, are linked to vaccination rate at the country level. Countries where a higher proportion of the population prioritize religious beliefs over scientific evidence when the two come into conflict tend to have lower vaccination coverage rates and slower vaccination speeds. These findings suggest that scientists and policymakers must take into account social and cultural characteristics of populations when addressing vaccine inequality.

First detection of Omicron variant BA.4.1 lineage in dogs, Chile

SARS-CoV-2’s rapid global spread caused the declaration of COVID-19 as a pandemic in March 2020. Alongside humans, domestic dogs and cats are also susceptible to infection. However, limited reports on pet infections in Chile prompted a comprehensive study to address this knowledge gap. Between March 2021 and March 2023, the study assessed 65 pets (26 dogs and 39 cats) from 33 COVID-19+ households alongside 700 nasal swabs from animals in households with unknown COVID-19 status. Using RT-PCR, nasal, fecal, and environmental samples were analyzed for the virus. In COVID-19+ households, 6.06% tested positive for SARS-CoV-2, belonging to 3 dogs, indicating human-to-pet transmission. Pets from households with unknown COVID-19 status tested negative for the virus. We obtained 2 SARS-CoV-2 genomes from animals, that belonged to Omicron BA.4.1 variant, marking the first report of pets infected with this lineage globally. Phylogenetic analysis showed these sequences clustered with human sequences collected in Chile during the same period when the BA.4.1 variant was prevalent in the country. The prevalence of SARS-CoV-2 in Chilean pets was relatively low, likely due to the country’s high human vaccination rate. Our study highlights the importance of upholding and strengthening human vaccination strategies to mitigate the risk of interspecies transmission. It underscores the critical role of the One Health approach in addressing emerging zoonotic diseases, calling for further research on infection dynamics and risk factors for a comprehensive understanding.

Intranasal sensitization model of alopecia areata using pertussis toxin as adjuvant.

Nasopharyngeal Bordetella pertussis (BP) colonization is common, with about 5% of individuals having PCR evidence of subclinical BP infection on nasal swab, even in countries with high vaccination rates. BP secretes pertussis toxin (PTx). PTx is an adjuvant commonly used to induce autoimmunity in multiple animal models of human disease. Colocalization of PTx and myelin from myelinated nerves in the nasopharynx may lead to host sensitization to myelin with subsequent autoimmune pathology. C57BL/6J female adult mice were given varied doses and schedules of intranasal PTx, MOG35-55 antigen, or controls to test whether intranasal administration of PTx and myelin oligodendrocyte peptide (MOG35-55) could induce experimental autoimmune encephalomyelitis (EAE) in mice. While we observed systemic cell-mediated immunity against MOG35-55, we did not observe EAE. Unexpectedly, many mice developed alopecia. We systematically investigated this finding. Patchy alopecia developed in 36.4% of mice with the optimized protocol. Pathology consistent with alopecia areata was confirmed histologically by documenting concomitant reduced anagen phase and increased telogen phase hair follicles (HFs) in biopsies from patches of hair loss in mice with alopecia. We also found reduced CD200 staining and increased CD3+T cells surrounding the HFs of mice with alopecia compared to the mice without alopecia, indicating HF Immune Privilege (HFIP) collapse. Systemic immune responses were also found, with increased proportions of activated T cells and B cells, as well as MHCII+ dendritic cells in peripheral blood and/or splenocytes. Finally, in mice initially exposed to intranasal MOG35-55 and PTx in combination, but not to either agent alone, splenocytes were shown to proliferate after in vitro stimulation by MOG35-55. Consistent with prior investigations, PTx exhibited a dose-response effect on immune cell induction and phenotype, with the lowest PTx dose failing to induce autoimmunity, the highest PTx dose suppressing autoimmunity, and intermediate doses optimizing autoimmunity. We propose that this is the first report of an autoimmune disease in an animal model triggered by colocalization of intranasal PTx and autoantigen. This model parallels a natural exposure and potential intranasal sensitization-to-pathology paradigm and supports the plausibility that nasopharyngeal subclinical BP colonization is a cause of alopecia areata.

Strategies for Sustained Empowerment of Community Health Workers: A Qualitative Analysis of the Comprehensive Rural Health Project in Jamkhed, India.

To understand the core aspects of an empowerment-based Community Health Worker (CHW) training program, we studied the model of the Comprehensive Rural Health Project (CRHP) in Jamkhed, India-an organization known for facilitating empowerment of women as Village Health Workers (VHWs) and agents of community change. We define empowerment as a means by which individuals gain health and development-related skills and knowledge to facilitate positive change within their lives and communities. Using VHW training observations and semi-structured interviews with health workers and senior trainers, 6 themes were developed and applied in 4 focus group sessions with 18 multigenerational VHWs trained by the CRHP. Transcripts were qualitatively analyzed under 6 themes-selection, baseline training, continuing education and support, community participation, community empowerment, and commitment and longevity. Empowerment of VHWs was found to be an intentional process involving the creation of safe and supportive environments conducive to long-term participatory and experiential learning with professionals who facilitate and mentor. The impact of the baseline training is maintained through ongoing program-VHW interactions and knowledge reinforcement in both the field and training center. Importantly, these interactions reinforce VHWs' credibility and confidence in communities served. Community participation was found to be of key importance starting at the selection phase. The methods used for selection, training and ongoing support are critical to developing a cadre of competent, effective and motivated VHWs as well as fostering long-lasting self-development and leadership skills. Downstream effectiveness of community empowerment on health outcomes is demonstrated through indicators such as access to safe deliveries, declining child malnutrition rates, high vaccination rates as well as reductions in stigmatization of illness and caste discrimination.

Mechanisms Driving Online Vaccine Debate During the COVID-19 Pandemic

The prevalence of the anti-vaccine movement in today’s society has become a pressing concern, largely amplified by the dissemination of vaccine skepticism. During the early stages of the COVID-19 pandemic, the vaccination debate sparked controversial debates on social media platforms such as Twitter, which can lead to serious consequences for public health. What determines anti-vax attitudes is an important question for understanding the source of the campaigns and mitigating the misinformation spread. Compared with other countries, Türkiye differentiates itself with high vaccination rates and lack of political support for anti-vaxxers despite its highly polarized political system. Analyzing Turkish Twittersphere, we explore several mechanisms capturing content production and behaviors of accounts within the pro- and anti-vax segments in online vaccine-related discussions. Our findings indicate there is no relation between political stance and anti-vaccine attitude. Both supporters of vaccination (pro-vaxxers) and opponents (anti-vaxxers) can be found across the political spectrum. Moreover, linguistic differences reveal that anti-vaxxers employ more emotional language, while pro-vaxxers express more skepticism. Notably, automated accounts are less prevalent leading to difficulty in assessing genuine support for vaccines, while anti-vaccine bots produce slightly more content. These findings have crucial implications for vaccine policy, emphasizing the importance of understanding diverse language patterns and beliefs among anti-vaxxers and pro-vaxxers to develop effective communication strategies at the national level.

Assessment of the COVID-19 pandemic progression in Ecuador through seroprevalence analysis of anti-SARS-CoV-2 IgG/IgM antibodies in blood donors.

Coronavirus Disease 2019 (COVID-19) is a severe respiratory illness caused by the RNA virus SARS-CoV-2. Globally, there have been over 759.4 million cases and 6.74 million deaths, while Ecuador has reported more than 1.06 million cases and 35.9 thousand deaths. To describe the COVID-19 pandemic impact and the vaccinations effectiveness in a low-income country like Ecuador, we aim to assess the seroprevalence of IgG and IgM antibodies against SARS-CoV-2 in a sample from healthy blood donors at the Cruz Roja Ecuatoriana. The present seroprevalence study used a lateral flow immunoassay (LFIA) to detect anti-SARS-CoV-2 IgG and IgM antibodies in months with the highest confirmed case rates (May 2020; January, April 2021; January, February, June, July 2022) and months with the highest vaccination rates (May, June, July, August, December 2021) in Quito, Ecuador. The IgG and IgM seroprevalence were also assessed based on sex, age range, blood type and RhD antigen type. The sample size was 8,159, and sampling was performed based on the availability of each blood type. The results showed an overall IgG and IgM seroprevalence of 47.76% and 3.44%, respectively. There were no differences in IgG and IgM seroprevalences between blood groups and sex, whereas statistical differences were found based on months, age range groups, and RhD antigen type. For instance, the highest IgG seroprevalence was observed in February 2022 and within the 17-26 years age range group, while the highest IgM seroprevalence was in April 2021 and within the 47-56 years age range group. Lastly, only IgG seroprevalence was higher in RhD+ individuals while IgM seroprevalence was similar across RhD types. This project contributes to limited data on IgG and IgM antibodies against SARS-CoV-2 in Ecuador. It suggests that herd immunity may have been achieved in the last evaluated months, and highlights a potential link between the RhD antigen type and COVID-19 susceptibility. These findings have implications for public health strategies and vaccine distribution not only in Ecuador but also in regions with similar characteristics.

Enhancing Human Papillomavirus Vaccination Rates through Better Knowledge? Insights from a Survey among German Medical Students.

Vaccination against human papillomavirus (HPV) significantly reduces the risk for malignant diseases like cervix, anal, or penile cancer. However, although vaccination rates are rising, they are still too low mirroring a lack of disease awareness in the community. This study aims to evaluate knowledge about HPV vaccination as well as the vaccination rate among German medical students. Medical students were surveyed during a German medical students' sports event. The self-designed survey on HPV vaccination consisted of 24 items. The data collection was anonymous. Among 974 participating medical students 64.9% (632) were women, 335 (34.4%) were male and 7 (0.7%) were nonbinary. Mean age was 23.1 ± 2.7 (± standard deviation; range 18-35) years. Respondents had studied mean 6.6 ± 3.3 (1-16) semesters and 39.4% (383) had completed medical education in urology. 613 (64%) respondents reported that HPV had been discussed during their studies. 7.6% (74) had never heard of HPV. In a multivariate model female gender, the knowledge about HPV, and having worked on the topic were significantly associated with being HPV-vaccinated. Older students were vaccinated less likely. Better knowledge and having worked on the topic of HPV were associated with a higher vaccination rate. However, even in this highly selected group the knowledge about HPV vaccination was low. Consequently, more information and awareness campaigns on HPV vaccination are needed in Germany to increase vaccination rates.

Análise de duas estratégias diferentes de vacinação em massa contra a raiva em cães e gatos.

ABSTRACT This study evaluated whether there were differences in vaccination coverage rates between municipalities with different vaccination strategies regarding the species and the coverage rates during different day periods. The vaccination period was categorized as M1 (morning; 09h00 am - 11h00 am), M2 (morning/afternoon; 11h00 am - 01h00 pm), M3 (afternoon; 01h00 pm - 03h00 pm), and M4 (afternoon; 03h00 pm - 05h00 pm). A repeated measures model compared the vaccination rate between periods and municipalities. The interaction between time and municipality was statistically significant (P &lt; 0.01), indicating that the vaccination rate difference between periods depended on the municipality analyzed. Results of the difference between proportions analysis revealed that municipality B vaccinated 3.3% (2.2%-4.4%, 95% confidence limits) less dogs and 20.1% (17.9%-22.4%, 95% confidence limits) less cats than the municipality A. In municipality A, the vaccination rate in period M1 was higher than in periods M3 (P = 0.07) and M4 (P &lt; 0.01). The vaccination rate was higher in M2 than in M4 (P &lt; 0.01). In municipality B, the vaccination rate in period M1 was higher than in M2 (P = 0.01). The vaccination rate in M2 was lower than that observed in M3 (P = 0.01) and M4 (P = 0.01). Based on these results, mass vaccination campaigns have better results during the week, with the highest vaccination rate at lunchtime.