High Vaccination Research Articles

‘It was just the given thing to do’: exploring enablers for high childhood vaccination uptake in East London’s Bangladeshi community—a qualitative study

BackgroundDespite being an underserved ethnic minority group, characteristics which have been associated with low vaccine uptake, the Bangladeshi community in the UK exhibits high childhood vaccination uptake for several vaccines,...

EVALUATION OF POPULATION-LEVEL IMMUNITY TO SARS-COV-2 ACROSS BULGARIA (END OF 2023)

Background: The COVID-19 pandemic in Bulgaria was characterized by a high mortality rate and vaccination efforts yielded suboptimal results. Understanding population immunity is important as new SARS-CoV-2 variants continue to emerge. This study aimed to assess the seroprevalence of SARS-CoV-2 antibodies in the general population of Bulgaria and examine demographic variations in antibody presence. Materials and methods: In December 2023, 1895 serum samples were randomly collected from healthy individuals across all 28 provinces. Samples were tested for SARS-CoV-2 spike protein-specific IgG antibodies using ELISA method. A subset of the positive samples was subsequently tested for neutralizing antibodies. Seroprevalence was analyzed by sex, age group, and geographic region. Statistical analyses were conducted using SPSS v.26. Results: Overall seroprevalence was 91.9%, with similar rates between males (91.6%) and females (92.0%). Seroprevalence was highest in the 18-39 age group (95.1%) and lowest in those over 65 (89.3%). Regional seroprevalence ranged from 80.0% to 98.3%. Among samples tested for presence of neutralizing antibodies, 90.5% were positive, indicating effective immune response. Conclusions: The high seroprevalence suggests widespread prior exposure to SARS-CoV-2 and/or vaccination among the Bulgarian population. The strong presence of neutralizing antibodies might provide potential protection against severe disease. Targeted interventions towards older age groups could be appropriate in order to sustain immunity as COVID-19 remains a public health concern.

Current situation, challenges and suggestions for influenza vaccination among the elderly in China

The elderly population in China faces a significant burden of influenza, but the influenza vaccination rate among this group remains far below international recommended standards due to factors such as the underdeveloped adult immunization service system, high vaccination costs, and insufficient awareness among both the elderly and healthcare professionals. It is recommended that China implement a free or reimbursement policy influenza vaccination for elderly in border regions, improve the adult immunization service system, enhance the awareness of healthcare professionals and the elderly, and strengthen the research and post-vaccination monitoring of vaccines tailored to the elderly population to increase the influenza vaccination rate among the elderly.

What are parents' preferences for Human Papillomavirus vaccination promotion messages and communication? Application of a discrete choice experiment to a French Caribbean setting

IntroductionHuman Papillomavirus (HPV) vaccine uptake in the French Caribbean has remained below 25% since introduction in 2007, which is well behind national and international targets. Using a discrete choice experiment (DCE), we explored parental preferences around HPV vaccination and optimized communication content in a sample of parents of middle-school pupils in Guadeloupe.MethodsWe conducted a cross-sectional survey in public and private middle age schools in Guadeloupe in June 2023 using an online questionnaire. Across a series of nine hypothetical scenarios, participants were asked to decide to vaccinate or not and how certain they were about this choice. Scenarios differed by five attributes (diseases characteristics, vaccine safety, health professionals or institutions promoting vaccination, social conformity and optimal vaccination age). We used random effect logit and linear regression models to estimate the effects of attribute levels on vaccine acceptance and vaccine eagerness.ResultsA total of 389 parents out of the 23,184 pupils’ parents completed the DCE survey. The attributes with a significant effect size on theoretical vaccine acceptance were "social conformity" and "optimal vaccination age”. Overall, the odds of scenarios stating high vaccine coverage in adolescents were at least 1.8 (95% CI: 1.2—2.6) times more likely to yield theoretical vaccine acceptance compared to a low vaccine uptake reference. The odds of providing scientific explanation along with age yielded theoretical vaccination acceptance respectively up to 3.2 times higher (95% CI: 1.7 to 6.1) in parents reporting an un vaccinated child and not intention to vaccinate. For vaccine eagerness, we observe significant positive effects of communication content overall when stating high vaccination uptake in adolescents or scientific evidence along with age or mentioning cancer prevention. Parents always refusing vaccination remained unsensitive to communication contents.Discussion and conclusionThese original DCE results highlighted the need for tailoring specific HPV vaccination promotion communication in a French Caribbean setting. Contextual features such as sexuality concerns as regard to age and peers’ adhesion to vaccination have to be thoroughly considered. The nationwide HPV vaccination campaign in middle schools should adapt communication in order to raise HPV vaccine uptake in the French Caribbean.

Understanding Factors that Contributes to Vaccine Hesitancy in the COVID-19 Context: The Intersection of Trust in Institutions, Socioeconomic Status and Demographic Factors

Vaccine hesitancy has become a major global public health challenge, threatening the success of vaccination programs. Despite the fact that vaccines have proven effective in fighting infectious diseases, millions of people are still hesitant to get vaccinated, especially during the pandemic. This paper identifies vaccine hesitancy in the COVID era and examines the factors that contribute to vaccine hesitancy, including a lack of trust in health institutions, misinformation, and other cognitive and demographic factors. Drawing on examples from around the world, including Africa and Brazil, this article further explores the social and political determinants that influence vaccine uptake. While Brazil has shown relatively high vaccine acceptance rates due to trust in local vaccines and the urgency of the pandemic, Africa faces great hesitation due to mistrust and misinformation. By addressing misinformation, restoring public trust and confidence in vaccines, and involving communities in the decision-making process, public health initiatives can effectively combat vaccine hesitancy and mitigate ongoing threats to global health

The Uptake of the Influenza Vaccine in Patients With Cystic Fibrosis: A Retrospective Study.

Children with cystic fibrosis are more likely to become severely unwell with influenza-associated illness compared to children without chronic lung disease. The provision of accessible influenza vaccinations is essential in the prevention of infection. To describe the prevalence of the influenza vaccine uptake in children with cystic fibrosis from 2016 to 2020 at a single tertiary paediatric hospital site and determine if the COVID pandemic of 2020 and the introduction of telehealth encounters affected the vaccine uptake. A retrospective study of children with cystic fibrosis aged 6 months to 18 years who reside in South Australia was performed using the Women's and Children's Hospital (WCH) Respiratory Department cystic fibrosis database from 2016 to 2020. The Australian Immunisation Register (AIR) was used to determine vaccination status during this period. One hundred and eighty two children with cystic fibrosis were identified, one hundred and seventy two of whom vaccination records were available on the Australian Immunisation Register. Proportion of eligible patients who were vaccinated ranged from 66% to 88% in the years 2016-2019. There was no significant decrease in uptake during the COVID-19 pandemic in 2020 (75%). Despite the introduction of Telehealth reviews in 2020 majority (66%) of patients continued to have exclusive face-to-face appointments, of which 73% received the vaccination. Vaccination coverage of those who received combination of Telehealth and face-to-face was 81%. The high influenza vaccination rate of South Australian children with cystic fibrosis is consistent with rates seen in other tertiary centres globally. This study demonstrated that the pandemic and introduction of Telehealth appointments did not have any impact in the uptake of the influenza vaccination in our South Australian population.

Patterns and Predictors of COVID-19 Vaccine Uptake Among U.S. Active Duty Service Members, 2020-2022: Implications for Future Pandemics.

Vaccine mandates have been used to minimize the duty days lost and deaths attributable to infectious disease among active duty Service members (ADSMs). In response to the global COVID-19 pandemic, in August 2021, the U.S. DoD issued a COVID-19 vaccine mandate for all ADSMs. This study aimed to investigate COVID-19 vaccine uptake among the ADSM population, as well as factors associated with timing of COVID-19 vaccine receipt. This study included ADSMs on active duty between January 1, 2020, and June 30, 2022. Univariate analyses investigated associations between demographic factors (age, sex, race, ethnicity, branch of service, rank, and state of residence) and COVID-19 diagnosis with the following outcomes: (1) time to primary series initiation in relation to the DoD vaccine mandate, (2) time between doses of the 2-dose primary series, and (3) time between booster eligibility and receipt. This research received an exempt determination by the USU Human Research Protection Program. In total, 1,799,466 ADSMs were included, with 90% receiving ≥1 COVID-19 vaccine dose during the study period and 77% initiating the primary series prior to the mandate. Over 80% of ADSMs received a complete primary series, with 96% of those adhering to the recommended regimen. The history of COVID-19 diagnosis was associated with the later receipt of all doses. COVID-19 vaccine uptake was high among all ADSMs, with the majority initiating the primary series before the mandate. The high vaccine uptake among ADSMs shown here may be used as a guide to both military and civilian pandemic policy and outreach efforts related to enhanced vaccine uptake.

Variability in Vaccine Response and Trajectory in Early Childhood and Association with Demographic Variables, Antibiotic Exposure and Infection Proneness.

We sought to explore the variability of antibody responses to multiple vaccines during early life in individual children, assess the trajectory of each child longitudinally, determine the associations of demographic variables and antibiotic exposures with vaccine-induced immunity, and link vaccine responsiveness to infection proneness. In 357 prospectively-recruited children, age six through 36 months, antibody levels to 13 routine vaccine antigens were measured in sera at multiple time points and normalized to their respective protective thresholds to categorize children into four groups: very low, low, normal, and high vaccine responder. Demographic variables and frequency of antibiotic exposure data were collected. Participants were followed to determine change in vaccine groups over time and occurrences of infections. Vaccine-induced antibody levels persisted over time as very low, low, normal, or high in individual children and changed post-primary through post-booster immunizations against multiple antigen types, including toxoids, purified proteins, polysaccharide-protein conjugates, recombinant proteins and inactivated viruses. Factors influencing persistence or change in vaccine response group were assessed. Children who did not attend day care and African American/multiracial children had higher vaccine-induced antibody levels than White children. Children with lower vaccine-induced antibody levels had more frequent antibiotic exposures. Low vaccine responsiveness was linked to more frequent antibiotic-treated bacterial infections. When vaccine-induced antibody levels are used to define vaccine response groups, individual children may persist or change groups over time, which is associated with demographic variables and influenced by antibiotic exposures. Lower vaccine responsiveness can be linked to more frequent antibiotic-treated bacterial infections.

Modern Features and Particular Issues of Rotavirus Preventive Vaccination

Rotavirus is recognized as one of the worid’s most common pathogens of acute gastroenteritis among children (up to 5 years of age) and has significant impact on chiidhood morbidity and mortality. The recommended by WHO routine vaccination of infants against rotavirus infection has led to notable reduction in incidence, hospitalization and costs associated with rotavirus infection outcomes in countries that have achieved high vaccination coverage. However, we should be aware of several features of rotavirus vaccines implementation as their safety and efficacy depend on it. Despite the absence of rotavirus vaccination within the National Immunization Schedule in Russian Federation and extremely low coverage of rotavirus preventive vaccination, the authors receive many questions from practicing pediatricians regarding cases of rotavirus vaccination. This article includes complete answers for most relevant of them that arise during practical use of rotavirus vaccines.

Epidemiology of norovirus disease in the first 2 years of life: A prospective multisite cohort study in Lima, Peru.

Norovirus is associated with 18% of acute gastroenteritis (AGE) cases worldwide. We aim to document the norovirus-related AGE incidence in peri-urban areas of Lima (Peru), evaluating the potential impact of a norovirus vaccine introduction. A prospective, community-based pediatric cohort study was established at two sites in Lima. Healthy children between 5 and 18 months were contacted weekly for AGE detection during a 6-month period. Stool samples from AGE cases were tested for norovirus by RT-PCR. Incidence and coinfection of norovirus-associated AGE were analyzed. All norovirus-positive samples were genotyped by Sanger DNA sequencing. Among 498 enrolled children, 461 (93%) completed the follow-up period. We detected 799 AGE cases, yielding 676 valid stool samples. Norovirus was detected in 216 samples (32%), with an incidence of 7.7 episodes per 100 child-months (95% CI: 6.7-8.8). Genotypes GII.4 (31%) and GII.6 (22%) were frequent. Campylobacter (43%) and Salmonella spp. (15%) were the most common coinfections with norovirus. Ninety-five percent of study children had received an oral rotavirus vaccine. Norovirus was the second most frequent cause of AGE in this Peruvian cohort with high rotavirus vaccine coverage. An effective norovirus vaccine would have an important public health benefit in this population.

High coverage and equitable distribution of COVID-19 vaccine uptake in two vulnerable areas in Bangladesh.

Bangladesh completed a primary series of COVID-19 vaccinations for about 86 individuals per 100 population as of 5 July 2023. However, ensuring higher coverage in vulnerable areas is challenging. We report on the COVID-19 vaccine uptake and associated factors among adults in two vulnerable areas in Bangladesh. We conducted a cross-sectional study between August and September 2022 in Duaripara, a slum in northeast Dhaka (in-migration site), and Tala, a disaster-prone sub-district in southwest Satkhira (out-migration site). We surveyed 1,239 adults in Duaripara and 1,263 adults in Tala from 625 and 596 randomly selected households, respectively. We reported coverage and examined associations between the uptake and demographic and socioeconomic characteristics using multilevel mixed-effects generalized linear regression models. We checked for spatial autocorrelation to assess geographical patterns in vaccine distribution. First- and second-dose coverage was about 91% and 80.4% in Duaripara and 96.6% and 92.2% in Tala, respectively. Individuals above 40 were more likely to be vaccinated (IRR: 1.12, p-value = 0.04 for Duaripara, and IRR: 1.14, p-value <0.01 for Tala). Professions requiring more outdoor interactions had a higher likelihood of receiving the vaccine. In Tala, television access (IRR: 2.09, p-value <0.01) and micro-credit membership (IRR: 1.50, p-value = 0.05) were positively associated with receiving a booster dose and negatively associated with smart-phone access (IRR: 0.58, p-value = 0.03). Moreover, temporarily migrated respondents were more likely to be unvaccinated (IRR: 0.87, p-value = 0.04). Income was not associated, indicating equitable distribution. Moreover, no geographical clustering was detected. The credit for high COVID-19 vaccine coverage in Bangladesh can be attributed to the country's longstanding success in implementing immunization programs, which relied on community mobilization and effective health education to generate demand. However, to ensure comprehensive coverage in vulnerable areas, targeted interventions can help increase uptake by addressing specific sociodemographic differences.

Small-area variation in child under-vaccination in India: a multilevel analysis of cross-sectional data from 36 states and Union Territories, 707 districts, and 22,349 small-area clusters

India has made exceptional advances in child immunisation, but subnational inequities in vaccination coverage impede attainment of key programmatic goals. Our study provides an up-to-date national portrait of local variations in child vaccination using a comprehensive set of indicators relevant to routine immunisation. Indicators representing unvaccinated (zero-dose) children, incomplete basic immunisation, and vulnerability to measles and polio, were constructed from India's 2019-2021 National Family Health Survey. We used four-level random effects logistic regression models to partition the total outcome variation over state, district and cluster levels, and produce precision-weighted estimates of prevalence across clusters. District-level prevalence and within-district variation using standard deviation measures were derived for each outcome. Boxplots graphically summarised the distribution of precision-weighted mean cluster prevalence by state. The analysis included 87,622 children aged 12-36 months. Clusters accounted for 67.6% (var: 1.36; SE: 0.127) of the variation among zero-dose children, and more than 50% for all indicators. Districts with a higher prevalence of under-vaccination tended to have higher within-district heterogeneity, interpretable as greater within-district child vaccination inequities. For vaccines administered in the first year of life, the northeastern states and Uttar Pradesh had the highest median under-vaccination. Despite India's high aggregate vaccine coverage, the distribution of small-area (cluster) mean prevalence highlighted pockets of low coverage in most states, suggesting ongoing vulnerability to measles and polio. Achieving India's vaccination goals requires a strategic shift towards identification and targeting of low-immunity clusters at the sub-district level. Canadian Institutes of Health Research.

Vaccine hesitancy and consequences for vaccination coverage in children at 24 months of age, born in 2017-2018, living in the state capitals, Federal District and 12 inner region cities of Brazil.

To analyze vaccine hesitancy associated factors and repercussions on vaccination coverage. Cohort of children born in 2017-2018, living in Brazilian state capitals, Federal District (FD), and 12 inner region cities, stratified by socioeconomic level. National Vaccination Coverage Survey (2020) data on hesitancy, access and programmatic difficulties were obtained by interview and coverage was calculated from vaccination card dose and date records. 37801 children were studied, 31001 in the capitals/FD, 6800 in the inner cities. Hesitation between 38.8(95%CI 33.6;44.4) and 57.9(95%CI 54.1;61.6) in high versus low stratum; 64.1(95%CI 58.9;68.9) to 41.7(95%CI 38.4;45.8) among mothers with <8 years of schooling versus 16 years or more; 42.1(95%CI 38.2;46.2) to 55.0(95%CI 52.0;54.7) among private service users versus public service only users. Coverage: full=7.2(95%CI 1.0;38.3); 25.3(95%CI 18.7;33.3) for hesitant people; and 44.7(95%CI 43.0;46.4) for the remainder. High vaccine hesitancy in several groups affecting vaccination coverage and hindering vaccination target achievement. Access problems and programmatic difficulties contribute to low coverage.

A Missed Opportunity? Exploring Changes in Influenza Vaccination Coverage During the COVID-19 Pandemic: Data From 12 Countries Worldwide.

Vaccination is a key measure in influenza control, yet global coverage rates remain low, although previous research reported an increase in influenza vaccination coverage rates (VCR) after the onset of the COVID-19 pandemic. This study aims to assess whether these changes were sustained over time by analyzing VCR trends from 2012 to 2023 in the countries included in the FluCov project. Data on influenza VCR from 2012 to 2023 for different age and risk groups were extracted from national health organizations and international sources for countries included in the FluCov project. For coverage rates in the older adults, segmented regression models were used to test if 2020 marked a significant change in VCR trends. Moreover, polynomial regression models were fitted for each country with VCR in the period 2012 to 2020 to predict coverage rates for 2021 to 2023 and to compare these to the actual coverage rates for 2021 to 2023. For the elderly, we retrieved influenza VCR data for 12 countries. In 2020, VCR among elderly increased in 10 countries, but the increase was statistically significant in Spain and England only. Moreover, all countries except Spain reverted to levels within the confidence intervals of trends modeled using pre-2020 data. Although influenza VCR increased in 2020, these changes were statistically significant in only two out of 12 countries, and no consistent, sustained increase was observed afterward, except in Spain. The findings suggest the need for continuous monitoring of VCR and the implementation of strategies to promote and maintain high vaccination coverage rates.

Spatial co-distribution of tuberculosis prevalence and low BCG vaccination coverage in Ethiopia

While bacille-calmette–guerin (BCG) vaccination is one of the recommended strategies for preventing tuberculosis (TB), its coverage is low in several countries, including Ethiopia. This study investigated the spatial co-distribution and drivers of TB prevalence and low BCG coverage in Ethiopia. This ecological study was conducted using data from a national TB prevalence survey and the Ethiopian demographic and health survey (EDHS) to map the spatial co-distribution of BCG vaccination coverage and TB prevalence. A Bayesian geostatistical model was built to identify the drivers for the spatial distribution of TB prevalence and low BCG vaccination coverage. BCG vaccination coverage was defined as the number of children who received the vaccine divided by the total number of children born within five years preceding the EDHS surveys. Parameter estimation was done using binary logistic regression. Prediction maps for the co-distribution of high TB prevalence and low BCG vaccination coverage were created by overlying spatial prediction surfaces of the two outcomes. Posterior means and a 95% Bayesian credible interval (CrI) were used to summarize the parameters of the model. The national prevalence was 0.40% (95% confidence interval (CI) 0.34%, 0.47%) for TB and 47% (95% CI 46%, 48%) for vaccination coverage. Substantial spatial variation in TB prevalence and low BCG coverage was observed at a regional and local level, particularly in border areas of the country, including the Somali, Afar, and Oromia regions. Approximately 58% of the pixels (i.e., geographical area or spatial units) with high TB prevalence exhibited low BCG coverage in the same location. While travel time to cities (Mean = 0.28, 95% BCI: 0.15, 0.41) and distance to health facilities (Mean = 0.43, 95% CI 0.22, 0.63), were positively associated, population density (Mean = −0.04, 95% BCI −0.05, −0.02) was negatively associated, with the proportion of unvaccinated children for BCG indicating areas near health facilities and cities have better BCG coverage. However, there were no significant predictors for TB prevalence. Substantial spatial co-distribution between high TB prevalence and low BCG coverage was observed in some parts of the country, indicating that there are areas where the TB burden is not being adequately managed through the provision of vaccines in Ethiopia. Scaling up BCG vaccination coverage and TB diagnosis and treatment through improving access to health services in border regions such as Somalia and Afar would be important to reduce the prevalence of TB in Ethiopia.

A REVIEW OF THE EFFECTS OF SOCIOECONOMIC AND ENVIRONMENTAL FACTORS IN EXPLANING THE PARADOX BETWEEN VACCINATION RATES AND COVID-19 RELATED MORTALITY RATES

This study evaluates vaccination as a primary strategy to reduce COVID-19 deaths across 150 countries. By analyzing the correlation between full vaccination rates and mortality rates in January 2022, the study initially finds a positive association (r = 0.65, p-value &lt; .01). However, further regression analysis reveals a more complex relationship. A 1% increase in full vaccination correlates with a 0.7% rise in deaths per 100,000 people (p-value &lt; .001), even when considering GDP differences. This suggests that factors beyond vaccination, such as socioeconomic conditions, virus mutations, and healthcare resources (e.g., ventilators per capita), play a substantial role in determining mortality rates. The study's findings challenge the notion that vaccination alone can eradicate COVID-19. While vaccination is a crucial tool, it's essential to address the broader factors contributing to the virus's spread and its economic impact, particularly in countries with high vaccination rates but persistent mortality. This comprehensive approach is vital for effectively managing the pandemic and minimizing its long-term consequences.

Assessment of Vaccination Impact in PPR-Control Program Implemented in Southern States of India: A System Dynamics Model Approach

Mass vaccination against peste des petits ruminants (PPR) in two southern states of India, namely Andhra Pradesh and Karnataka, has reduced disease outbreaks significantly. The sporadic outbreaks reported now can be attributed in part to the recurring movement of sheep and goats between these contiguous states. This study assessed the present level of economic burden and impact of vaccination on the local system (one state), considering the exposure from the external system (neighboring state) using a system dynamic (SD) model. The SD model relies on interdependence, interaction, information feedback, and circular causality and captures potential feedback between disease control interventions and their impact on various epidemiological and economic outcomes. The data for parameterization of the model were collected through surveys, expert elicitation, and literature review. The sporadic outbreaks reported in recent years (&lt;10 outbreaks/year during 2022) were due to continuous “mass vaccination” for more than a decade. During 2021–2022, the PPR incidence was less in both the states, with an estimated loss of USD 26.30 and USD 22.86 million in Andhra Pradesh and Karnataka, respectively. The SD model results showed a systemic increase in flock size and offtakes and a decline in the number of infected and death cases under high vaccination coverage (75% and 100% coverage) compared to the low-coverage scenario. Hence, the coordinated inter-state vaccination efforts offer better prospects, as efforts in one state have positive externalities in terms of fewer outbreaks in a neighboring state.

Unity in Diversity and Diversity in Unity-Vaccination Policies in EU Countries.

This article emphasizes the comprehensive importance of vaccination, exploring its role in disease prevention, addressing growing concerns around vaccine hesitancy, and underscoring the crucial need for high vaccination coverage rates. Our review examines EU-level and national policies on vaccination, utilizing EU sources, with a specific focus on regulatory and policy documents. Vaccination calendars in the EU were reviewed through the ECDC Vaccine Scheduler webpage. The parameters of this literature review were further selected in collaboration with an Emory Health sciences librarian using the following search terms: healthcare providers, communication, public health, informed consent, and bioethics. The analysis of limited articles on community engagement, moral and political philosophy, and public health ethics informs the ethical consideration of informed consent in public health interventions. Countries exhibit varying relationships between their vaccination programs and society, with technocratic and populist influences shaping vaccination policies. Europe demonstrates diversity in vaccination policies, with availability, funding, and scheduling reflecting distinct approaches to vaccination.

A nationwide study of two decades of invasive pneumococcal disease in the Faroe Islands, 2000-2023.

Invasive pneumococcal disease (IPD) remains a significant public health concern, particularly in vulnerable populations such as the elderly. This study focuses on the Faroe Islands, a unique setting for monitoring pneumococcal disease trends due to its high vaccination coverage and geographic isolation. To examine the prevalence, trends and serotype distribution of IPD in the Faroe Islands from 2000 to 2023, focusing on the impact of pneumococcal conjugate vaccines (PCVs) on disease incidence and serotype replacement. Eighty-six pneumococcal isolates, representing all registered cases of IPD in the Faroe Islands, were analysed during the study period. Data on patient demographics, serotype identification and vaccination history were collected from national health records. Temporal trends in vaccine-type (VT) and non-vaccine-type (nVT) serotypes were analysed, particularly following the introduction of PCV13 in 2010. Following the introduction of PCV13, a shift from VT to nVT serotypes was observed, while the overall IPD rate remained stable. Notably, there was an increase in IPD cases among the elderly population. The analysis indicated that serotype replacement contributed to a rise in nVT cases despite reducing VT-related IPD. The findings emphasise the need for ongoing evaluation of pneumococcal vaccine formulations and alternative strategies to address the increasing prevalence of nVT IPD. Higher-valency vaccines and sustained vaccination coverage are critical to mitigating the impact of serotype replacement and improving public health outcomes in the Faroe Islands.

Uptake and service preferences of human papillomavirus vaccination in men who have sex with men.

Human papillomavirus (HPV) vaccination could reduce HPV infection in men who have sex with men (MSM), but the published statistics on HPV vaccination uptake in MSM were scarce globally. This study estimated the uptake and profiled the service preferences of HPV vaccination of Chinese MSM in Hong Kong. Adult MSM were recruited through non-governmental organizations (NGOs) and online channels for completing an online baseline survey. Factors associated with self-reported history of HPV vaccination were identified using multivariable stepwise logistic regression model. Totally 701 Chinese MSM completed the online baseline survey, with the median age of 30 y (interquartile range [IQR] 26-35, range 18-67), and 23% of them had received HPV vaccination. More than half of vaccinated MSM (72%) rated convenient or very convenient for local HPV vaccination services. Among unvaccinated MSM, 50% considered high cost of HPV vaccine as the barrier of vaccination, 67% expressed willingness to pay below USD 128 per vaccine dose, and 65% preferred receiving vaccination in private clinics. MSM who had taken HIV pre-exposure prophylaxis (PrEP) (p < .001), had been tested for HPV (p = .018), and had (p = .005) multiple regular sex partners in the past 6 months were more likely to be vaccinated. The HPV vaccination uptake of Chinese MSM in Hong Kong remains low (23%), and high HPV vaccine cost is the main barrier. Preventive behaviors (HIV PrEP use and HPV testing) and high-risk sexual behavior (multiple regular sex partners) are potential targets for intervention to increase the uptake of HPV vaccination in MSM.