High Vaccination Coverage Research Articles

COBERTURA VACINAL NA REGIÃO NORDESTE NO PERÍODO PRÉ E PANDÊMICO ENTRE DOS ANOS DE 2018 A 2022: UM ESTUDO DESCRITIVO

ABSTRACT The study aimed to analyze vaccination coverage in the northeast region in the pre- and pandemic period between the years 2018 to 2022. This work was configured as an epidemiological and retrospective, descriptive study, analyzing secondary data, obtained from the Health Information System for Primary Care - SISAB and data collected from the National Health Survey (PNS) and Unified Health System (DATASUS). Thus, vaccination coverage in the northeast region decreased in the years 2019, 2020 and 2021, with 2021 having the lowest vaccination coverage, with 35.33% coverage in the region. In 2018, when all the states of the northeast were analyzed, the state of Sergipe had the highest vaccination coverage, reaching 100% coverage. Regarding the proportion of 1-year-old children vaccinated in PHC against Diphtheria, Tetanus, Pertussis, Hepatitis B, infections caused by Haemophilus influenzae type b and inactive Poliomyelitis, it was found that in 2018, Maceió, Salvador, Fortaleza, São Luís and Natal reached 100% vaccination coverage, while other capitals had varied rates. In 2022, there was a significant drop in all northeastern states. In addition, it was possible to observe that the highest hepatitis B vaccination coverage in the northeast region was in 2018, which reached 89.52% of vaccination coverage. It is expected that the study will assist policies to combat vaccination coverage in the northeast region, in addition to contributing to the literature and medical sciences in a broad way. Keywords: Immunization Schedule; Collective Immunity; Hepatitis B vaccine.

Determinants of Under-Immunization Among Children Between 0 and 59 Months in Buea Municipality, South Western Cameroon: Implications for National Immunization Campaign

Introduction: Under-immunization remains a major global public health concern. The World Health Organization (WHO) reports that approximately 20 million children globally are not fully vaccinated, with more than half of these children residing in Africa. African countries including Cameroon face unique challenges in achieving high vaccination coverage. This study aimed to determine the prevalence and determinants of under-immunization among children aged 0–59 months in Buea, Cameroon to contribute to effective national immunization policy. Methods: This cross-sectional study used the World Health Organization Behavioural and Social Determinants of vaccination tool to collect data from 438 caregivers of children aged 0–59 months in the city of Buea. Data were collected on socio-demographics, immunization factors, and health system variables for the study cohort. Results: It was found that 25.11% of children in urban Buea were under-immunized. Children in Buea Town were three times more likely to be under-immunized than those in Molyko (AOR = 3.0, 95% CI: 1.3–7.3, p = 0.013). Children of separated caregivers were 0.2 times less likely to be under-immunized than those of widowed caregivers (AOR = 0.2, 95% CI: 0.1–0.9, p = 0.036). Children whose caregivers did not receive unsolicited advice were 2.1 times more likely to be under-immunized (AOR = 2.1, 95% CI: 1.2–3.4, p = 0.006). Children living less than 1 mile from health facilities were 2.9 times more likely to be under-immunized than those living more than 10 miles away (AOR = 2.9, 95% CI: 1.1–7.5, p = 0.030). Children of caregivers employed in the private sector were 4.3 times more likely to be under-immunized compared to those of unemployed caregivers (AOR = 4.3, 95% CI: 1.1–16.2, p = 0.031). Children in non-owned/non-rented houses were 0.3 times less likely to be under-immunized compared to those in rented houses (AOR = 0.3, 95% CI: 0.1–0.9, p = 0.030). Children whose caregivers did not discuss vaccination concerns with healthcare workers were 0.6 times less likely to have under-immunized children (COR = 0.6, 95% CI: 0.3–0.9, p = 0.020). Conclusions: It was concluded that under-immunization is a significant public health problem in the city of Buea. Interventions that target the quality of services, community engagement, and the unique challenges faced by different caregiver groups, are needed.

A cross-country network analysis of disease infodemics: Looking through the lens of the COVID-19 pandemic.

Infodemics surrounding pandemics and epidemics have persisted for centuries and continue to impede efforts to promote high vaccination coverage. We explored the complex interplay between COVID-19 vaccination attitudes and COVID-19-related infodemics across Germany, Ghana, India, and New Zealand using the novel network analysis. We conducted an online cross-sectional survey and recruited 1822 participants from the general populations of India (n=411), New Zealand (n=413), Ghana (n=523), and Germany (n=413) to complete COVID-19 infodemic measures and demographics questions. Predictors of less favourable COVID-19 vaccination attitudes included the apocalypse-related infodemic in India, compared to all countries, as well as the not harmful belief of COVID-19 in New Zealand, compared to India and Germany, and in Ghana compared to India. COVID-19 origin-related infodemics were found to positively impact COVID-19 vaccination attitudes in Ghana and New Zealand only. The most influential infodemics in each of the countries studied-Ghana, New Zealand, Germany, and India-were the beliefs in bioweapons, 5G technology, apocalypse, and bat consumption, respectively. Across all countries, there were consistent strong positive connections between the infodemics. Our results suggest that country-specific infodemics significantly impact COVID-19 vaccination attitudes, with variations observed between nations. While the infodemics can reinforce each other and complicate public health efforts during pandemics, understanding the interactions between the central infodemic in each country and others can aid in developing more effective strategies to counter their influences. This highlights the importance of targeted public health interventions that address the unique dynamics of local infodemics during pandemics, epidemics, and Pathogen X outbreaks.

Identifying Preferred Features of Influenza Vaccination Programs Among Chinese Clinicians Practicing Traditional Chinese Medicine and Western Medicine: Discrete Choice Experiment.

Achieving high vaccine coverage among clinicians is crucial to curb the spread of influenza. Traditional Chinese medicine (TCM), rooted in cultural symbols and concepts without direct parallels in modern Western medicine, may influence perspectives on vaccination. Therefore, understanding the preferences of TCM clinicians towards influenza vaccines is of great importance. To understand preferences for features of influenza vaccination programs and identify the optimal influenza vaccination program among clinicians practicing TCM and Western medicine. We conducted a discrete choice experiment with a national sample of 3085 Chinese clinicians from various hospital levels (n=1013 practicing TCM) from January to May 2022. Simulations from choice models using the experimental data generated the coefficients of preference and predicted the uptake rate of different influenza vaccination programs. Clinicians were grouped by vaccine preference classification through a latent class analysis. All included attributes significantly influenced clinicians' preferences for choosing an influenza vaccination program. An approximate hypothetical 60% increase of vaccine uptake could be obtained when the attitude of the workplace changed from "no notice" to "encouraging of vaccination"; there was an approximate hypothetical 35% increase of vaccine uptake when vaccination campaign strategies changed from "individual appointment" to "vaccination in a workplace setting." In the entire sample, about 30% (946/3085) of clinicians preferred free vaccinations, while 26.5% (819/3085) comprehensively considered all attributes, except vaccination campaign strategies, when making a decision about choosing an influenza vaccination program. Clinicians who practiced TCM, worked in tertiary hospital, or had at least a postgraduate degree exhibited a lower preference for free vaccinations. Clinicians who practiced Western medicine, worked in primary hospital, or had at most a bachelor's degree had a higher preference for vaccinations in workplace settings. Offering a range of influenza vaccination programs targeting the preferred attributes of different clinician groups could potentially encourage more clinicians, including those practicing TCM, to participate in influenza vaccination programs.

Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis

IntroductionGross domestic product (GDP) has been shown to affect government spending on various budget heads including healthcare and the purchase and distribution of vaccines. This vulnerable situation has been exacerbated...

Cross-sectional, laboratory-based study of measles seroprevalence in Oman

Background: Since the introduction of vaccination in Oman in 1981, measles incidence has decreased, and Oman achieved measles elimination in 2019. Measles cases in the country are currently import-related. Aim: To understand the measles immunity profile of the Omani population and identify high-risk groups. Methods: A total of 1990 anonymous blood samples out of 2032 samples collected from all regional referral hospitals and one private laboratory in Oman from November 2015 to January 2016 were tested for measles immunoglobulin G. We grouped the study population into 4 birth cohorts and analysed the data using SPSS version 16.0. We used the χ2 to test for statistical significance and used Kruskal-Wallis test to calculate the geometric mean for each age group. P < 0.05 was considered statistically significant. Results: The overall measles seropositivity was 84.0%. Seronegativity was significantly higher among the 15–20 years (34.0%) and 20–35 years (24.0%) age groups. There was no significant difference in seropositivity by gender and nationality. Seropositivity was 72.7% in the 1987–1996 cohort and 70.1% in the 1997–2006 cohort. The mean measles antibody level was 2318.5 IU/ml Conclusion: This study revealed a measles immunity gap among some age groups in Oman, indicating the need for sustained high vaccination coverage, robust surveillance, targeted vaccination campaigns, and timely outbreak response

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.

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.

Factors associated with vaccination coverage in children up to 15 months old, born in 2017-2018 in the city of Natal/RN, Brazil: a population-based survey.

To estimate vaccination coverage and analyze factors associated with full vaccination among children up to 15 months old in the city of Natal-RN, Brazil. Population-based survey with data recorded on children's vaccination cards and interviews conducted in 2020 and 2021. Analysis of factors associated with complete vaccination was performed by calculating prevalence ratios (PR) and 95% confidence intervals (95%CI) using Poisson regression. Among 688 children studied, vaccination coverage was 45.4% (95%CI 37.2;53.9) and 15.5% (95%CI 10.6;22.2) for valid and on-time doses, respectively. Higher vaccination coverage was associated with females (PR=1.08; 95%CI 0.78;1.48) and socioeconomic strata C and D (PR=1.44; 95%CI 1.03;2.02). The results demonstrate that the city of Natal has low vaccination coverage for all immunobiologicals.

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.

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.

Epidemiological Characteristics of Mumps Cases in the Kingdom of Bahrain From 2012 to 2022.

Mumps is a vaccine-preventable disease caused by the paramyxovirus affecting the salivary gland and may be complicated byorchitis, oophoritis, and encephalitis. This study aims to describe the epidemiology, clinical presentation, and transmission of mumps cases in the Kingdom of Bahrain between 2012 and 2022. A retrospective cross-sectional study was conducted using national surveillance data of confirmed mumps cases, including all age groups and both Bahraini and non-Bahraini nationals, from January 2012 to December 2022. A total of 258 cases were recorded, with the majority being male (159, 61.6%). Most patients (255, 98.8%) presented with parotid gland swelling, and 9 (3.5%) required hospitalization. Only 63 (24%)patients had documented vaccination history. Incidence rates varied, with peaks in 2013, 2015, and 2019. The highest incidence was observed in children aged 0-4 years in 2012, shifting to the 5-14 years age group from 2013 to 2015, and then returning to the 0-4 years age group from 2016 to 2022. Overall, there is a downward trend in mumps cases in Bahrain. The study shows a declining trend in mumps incidence in Bahrain. The high incidence in young children emphasizes the need to maintain high vaccination coverage. Enhanced surveillance, timely outbreak investigations, interventions, and public health vaccine campaigns are essential to sustain progress. This comprehensive analysis provides baseline data and a foundation for strengthening mumps prevention and control efforts in Bahrain.

High seroprevalence to SARS-CoV-2 among healthcare and non-healthcare workers of the ophthalmology center

Background. The pandemic of COVID-19 raised safety concerns for healthcare workers while non-medical personnel were left unattended. Comparing the levels of seroprevalence to SARS-CoV-2 and vaccination in different employee groups will allows us to assess the risk of infection and develop a strategy to minimize the spread of infections in medical institutions in future.The aim. To identify the level of seroprevalence to SARS-CoV-2 for seven groups of medical center workers. Methods. The seroprevalence to SARS-CoV-2 was analyzed in 361 employees of the ophthalmology center in mid-2021. Data on the level of specific IgM and IgG antibodies were compared with questionnaire, including occupation data.Results. Depending on occupation, workers were divided into seven groups. The average seroprevalence rate for all employees was 82.3 %, and the percentage of vaccinated employees was 27.4 %. The lowest level of seroprevalence was found in the group of maintenance staff (55.0 %) which is significantly lower (p ˂ 0.05) than in the groups of doctors (84.4 %), nurses (85.6 %), administrative stuff (82.6 %) and cafeteria stuff (77.7 %). The seroprevalence rate for cleaning staff was 84.6 % and for pharmacy workers it was 80 %. The highest vaccination coverage was among doctors – 50.0 %, the lowest was among cafeteria and kitchen staff – 7.4 %.Discussion. We believe the high seroprevalence is associated with asymptomatic spread of SARS-CoV-2.Conclusions. High seroprevalence was among doctors and nurses, pharmacy workers, canteen workers, cleaners, as well as administration workers. Anti-epidemic measures for these groups will reduce the spread of infectious diseases and help retain staff during the seasonal increase in incidence.

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 (<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.

Alveolar macrophages are early targets of mumps virus

Formerly a common childhood pathogen, mumps virus (MuV) remains active worldwide, despite relatively high vaccine coverage. MuV is thought to infect the upper respiratory tract before disseminating to other organs; however, the early cellular targets of MuV in vivo are unknown. To address this, we generated a green fluorescent protein (GFP)-tagged vaccine strain (JL5) of MuV to infect leukocytic cell lines and found that replication was greatest in monocytes. Infection of peripheral blood mononuclear cells (PBMCs) also showed that both JL5 and a circulating strain of MuV (Iowa 2006; genotype G), preferentially infected monocytes. Further, monocyte-derived macrophages showed high susceptibility to MuV, with genotype G infecting macrophages to a much greater extent. While mice are generally resistant to MuV infection, we inoculated immunocompetent Rosa26-tdTomato mice intranasally with a GFP and Cre recombinase tagged MuV to determine whether monocytes/macrophages are important targets in vivo. We observed a small population of tdTomato+ cells within the lungs, which included epithelial cells; however, the vast majority were alveolar macrophages (AMs). To validate these findings, we infected murine AMs isolated from Rosa26-tdTomato mice with the GFP and Cre recombinase tagged MuV and found that while MuV could enter AMs, as determined by tdTomato positivity, only a small percentage of these expressed GFP, suggesting that inhibition in murine cells occurs postentry. To translate these findings, we infected cells from human bronchoalveolar lavage fluid with MuV and found that most infected cells were AMs. These findings highlight the high susceptibility of AMs and provide a basis for early MuV pathogenesis and subsequent dissemination.