Childhood Immunization Research Articles

Social norms, vaccine confidence, and interpersonal communication as predictors of vaccination intentions: Findings from slum areas in Varanasi, India

In recent years, India has seen significant improvements in childhood immunization, but rates among the urban poor remain stagnant. Disruptions during COVID-19 pandemic have created further challenges. This paper focuses on how social norms, vaccine confidence, and interpersonal communication independently and jointly affect vaccine intentions among caregivers of infants living in six slum areas in Varanasi, India. Data for this study come from the baseline assessments conducted before implementing the Happy Baby Program, an intervention to improve vaccination attitudes and intentions. In-person interviews (N = 2,058) were conducted with caretakers of children up to two years old. Analyses showed that interpersonal communication about vaccines, descriptive norms, injunctive norms, and vaccine confidence were each associated with intentions to vaccinate in both a bivariate and, except for injunctive norms, a multivariate model. In addition, we found significant interactions among these variables, suggesting that the roles of interpersonal communication and vaccine confidence attenuated the relationship between social norms and vaccination intention. Overall, our model explained 46.2 % of the variance in vaccine intention. Given the strengths of the relationships observed in this study, intervention strategies should focus on enhancing social norms and vaccine confidence to promote vaccination.

Correlates of Zero-Dose Status among Children Aged 12-23 Months in the Luambo Health District, Democratic Republic of Congo: A Matched Case-Control Study.

(1) Background: "Zero-dose" (ZD) refers to a child who has not received any doses of the pentavalent (diphtheria-tetanus-pertussis-Haemophilus influenzae type b (Hib)-hepatitis B) vaccine. ZD children are vulnerable to vaccine-preventable diseases (VPDs). Luambo health district (HD) is one of 26 HDs in Kasai Central Province in Democratic Republic of the Congo and had the largest number of ZD children in 2021. This study was conducted to identify factors associated with ZD status among children in Luambo HD. (2) Methods: We conducted a mixed-methods study of children aged 12-23 months in Luambo HD. (3) Results: A total of 445 children aged 12-23 months were included in the study, including 89 cases and 356 controls. Children who were born in Angola (AOR = 3.2; 95% CI = 1.1 to 9.8; p = 0.046), born at home (AOR = 5.2; 95% CI = 2.1 to 12.5; p < 0.001), whose mothers did not receive antenatal care (AOR = 4.4; 95% CI = 1.2 to 16.3; p = 0.023), or did not know any vaccine preventable disease (AOR = 13.3; 95% CI = 4.6 to 38.4; p < 0.001) were more likely to be ZD than their counterparts. In addition, perceptions of children's parents influenced child immunization. (4) Conclusions: Factors associated with being a ZD child suggest inequalities in vaccination that need to be addressed through appropriate interventions. Maternal and child health services need to be strengthened while also targeting children's fathers. This will make it possible to considerably reduce the proportion of ZD and undervaccinated children and effectively fight against VPDs.

Unpacking the impact of COVID-19 on child immunization: evidence from Ghana

BackgroundWith the onset of the COVID-19 pandemic, governments implemented social distancing regulations to limit the spread of the disease. Some health experts warned that these measures could negatively affect access to essential health services, such as routine childhood immunizations. Others noted that without these regulations, COVID-19 cases would increase, leading to overburdened health systems.MethodsWe analyze four years (2018–2021) of monthly administrative data on childhood immunizations in all administrative districts in Ghana and exploit variations in social distancing regulations across districts. Given variations in social distancing regulations across Ghanaian districts, we can further differentiate between the effect of public lockdowns and the effect of the pandemic.ResultsWe find that child immunizations in Ghana declined by 6% during the public lockdown in April 2020, but the country compensated with higher vaccination rates starting in June, and immunization services recovered to pre-pandemic growth levels by 2021. Time-critical vaccines, such as polio, were not affected at all. We do find a substantially larger disruption in April 2020 (14%) and a slower recovery in 2020 in the 40 lockdown-affected districts. Interestingly, vaccination rates already decreased in February and March by about 5% before the public lockdown and before the pandemic had reached Ghana, but with the pandemic already spreading globally and in the news.ConclusionOur results indicate that the negative effect on child immunization was less severe and shorter than predicted by experts. Fear of COVID-19 and delayed vaccination campaigns had a substantial impact on childhood immunization while rising COVID-19 cases and moderate social distancing regulations did not seem to affect immunization rates.

Interventions addressing routine childhood immunization and its behavioral and social drivers.

Despite the advances in vaccination, there are still several challenges in reaching millions of children in low- and middle-income countries (LMICs). In this review, we present an extensive summary of the various strategies used for improving routine immunization in LMICs to aid program implementers in designing vaccination interventions. Experimental and quasi-experimental impact evaluations conducted in LMICs evaluating the effectiveness of interventions in improving routine immunization of children aged 0-5 years or the intermediate outcomes were included from 3ie's review of systematic reviews. Some additional impact evaluation studies published in recent years in select LMICs with large number of unvaccinated children were also included. Studies were coded to identify interventions and the barriers in the study context using the intervention framework developed in 3ie's Evidence Gap Map and the WHO's Behavioral and Social Drivers (BeSD) of vaccination framework, respectively. Qualitative analysis of the content was conducted to analyze the intervention strategies and the vaccination barriers that they addressed. One hundred and forty-two impact evaluations were included to summarize the interventions. To address attitudinal and knowledge related barriers to vaccination and to motivate caregivers, sensitization and educational programs, media campaigns, and monetary or non-monetary incentives to caregivers, that may or may not be conditional upon certain health behaviors, have been used across contexts. To improve knowledge of vaccination, its place, time, and schedule, automated voice messages and written or pictorial messages have been used as standalone or multicomponent strategies. Interventions used to improve service quality included training and education of health workers and providing monetary or non-monetary perks to them or sending reminders to them on different aspects of provision of vaccination services. Interventions like effective planning or outreach activities, follow-up of children, tracking of children that have missed vaccinations, pay-for-performance schemes and health system strengthening have also been used to improve service access and quality. Interventions aimed at mobilizing and collaborating with the community to impact social norms, attitudes, and empower communities to make health decisions have also been widely implemented.

Immune enhancing measures in Children

Children are the epitome of innocence and purity therefore the child’s health care should include specific biological and psychological needs that must be ensured to the survival and healthy development of the child, the future adult. They are in constant danger of developing infections due to underdeveloped immune system. Ayurveda emphasizes not only treating diseases but also by maintenance of health by improving immunity of the body. Several measures are considered to enhance the immunity in children. To ameliorate the immunity Acharya Kashyapa described a special formulation by the name Lehana in which herbal drugs are mixed with Madhu (honey) and Sarpi (clarified butter) to the child for the first time. Suvarnaprashna is another method adopted for physical and mental development in newborn and preschool children. Phalaprashan Samskara is a ritual or sacrament acknowledged by him where the first solid food is introduced to the baby that helps in strengthening the bodily tissues. In our classics as a part of Dinacharya, Abhyanga and Snana helps to keep child’s immune system performing at its peak by stimulating the lymphatic system. Nidra (adequate sleep) contributes to child’s overall wellbeing and establishing healthy sleep habits with recommended amount of sleep for their age is an absolute necessity to rejuvenate the body. Daily practice of Yogasana and Pranayam in children helps them to boost their immune system by synchronizing their mind and body. Encouraging children to follow an Ayurvedic routine helps in balancing and enhancing their innate capacity to grow, heal and thrive.

Pendampingan dan penyuluhan imunisasi dasar lengkap

Introduction: Immunization is the most effective and efficient public health effort in preventing several dangerous diseases. The large role of immunization in saving the world community from pain, disability, and even death due to diseases that can be prevented by immunization such as Smallpox, Polio, Tuberculosis, Hepatitis B, Diphtheria, Measles, Rubella, Tetanus, Pneumonia, Meningitis, and encephalitis. Objective: to increase parents' knowledge through mentoring and counseling about the importance of complete basic immunization for babies at Posyandu Mekar Jaya Batu-batu environment, Darma sub-district. Method: Community service activities carried out include assistance and education regarding complete basic immunization for children. The media used is leaflet material.Implementation of community service uses the community outreach method, namely involving the community and students during the implementation process Result: From the results of the pre-test analysis, most mothers did not know about the importance of stimulation, early intervention detection and growth and development, but after counseling, the post-test results showed that almost all mothers understood the importance of complete basic immunization. Conclusion: From the community service activities that have been carried out at Posyandu Mekar Jaya in the Batu-Batu neighborhood, Darma Village by the community service team of STIKES Bina Generasi Polewali Mandar, it can be concluded that complete basic immunization assistance and counseling activities have been carried out for children and this activity has received a positive response. From partners, it can be seen that during counseling there is quite intensive communication interaction and increased knowledge and high awareness of carrying out complete basic immunization for their children through posyandu/puskesmas. Community service activities can be used as a reference or reference for respondents' knowledge about complete basic immunization for children

Dynamics of &lt;i&gt;Streptococcus pneumoniae&lt;/i&gt; serotype structure in children for the period 2016–2022

BACKGROUND: The need for microbiological monitoring of the distribution of pneumococcal serotypes is associated with changes that occur during routine immunization of children with pneumococcal vaccines. AIM: To characterize the changes in the serotype structure of Streptococcus pneumoniae obtained from healthy preschool children between 2016 and 2022. MATERIALS AND METHODS: In total, 1250 healthy children aged 6 years attending kindergartens were examined in multicenter studies (2016–2018 and 2020–2022). Nasopharyngeal pneumococcal isolates (n=265) were obtained using the culture method. S. pneumoniae serotype was determined using polymerase chain reaction. RESULTS: Between 2016 and 2018, the prevalence of pneumococcal carriage decreased from 27.3 to 17.3%, and by 2022, it increased to 25.6%. Moreover, the correspondence of S. pneumoniae serotypes to the antigenic composition of the 13-valent pneumococcal vaccine decreased from 48.8 to 9.4% and the composition of the 20-valent vaccine from 75.6 to 39.1%. The proportion of “non-vaccine” types of pneumococcus increased from 22% in 2016 to 61% in 2022. Among the “non-vaccine” serotypes/groups, 15AF, 6CD, 23A, and 35F/47F were predominant, and new variants were also discovered: 23B and 35B. The serotypes included in the 13-valent conjugate vaccine were detected among unvaccinated children and were represented by variants 19F, 6A and 6B, 23F. Throughout the observation period, pneumococci of serotypes/groups 15BC, 11AD, and 10A were detected with high frequency. CONCLUSIONS: Because of the elimination of a significant part of S. pneumoniae “vaccine” serotypes in 2016–2022, the concordance of circulating variants with the antigenic composition of pneumococcal conjugate vaccines significantly decreased. In addition, the new types detected with high frequency are not included in existing pneumococcal vaccines, which necessitates the creation of new immunobiological drugs for pneumococcal infection prevention.

Evolution of the Antigenic Landscape in Children and Young Adults with COVID-19 and MIS-C

There is minimal knowledge regarding the durability of neutralization capacity and level of binding antibody generated against the highly transmissible circulating Omicron subvariants following SARS-CoV-2 infection in children with acute COVID-19 and those diagnosed with multisystem inflammatory syndrome in children (MIS-C) in the absence of vaccination. In this study, SARS-CoV-2 neutralization titers against the ancestral strain (WA1) and Omicron sublineages were evaluated in unvaccinated children admitted for COVID-19 (n = 32) and MIS-C (n = 32) at the time of hospitalization (baseline) and at six to eight weeks post-discharge (follow-up) between 1 April 2020, and 1 September 2022. In addition, antibody binding to the spike receptor binding domain (RBD) from WA1, BA.1, BA.2.75, and BA.4/BA.5 was determined using surface plasmon resonance (SPR). At baseline, the children with MIS-C demonstrated two-fold to three-fold higher binding and neutralizing antibodies against ancestral WA1 compared to those with COVID-19. Importantly, in children with COVID-19, the virus neutralization titers against the Omicron subvariants at six to eight weeks post-discharge reached the same level as those with MIS-C had at baseline but were higher than titers at 6–8 weeks post-discharge for MIS-C cases. Cross-neutralization capacity against recently emerged Omicron BQ.1, BQ.1.1, and XBB.1 variants was very low in children with either COVID-19 or MIS-C at all time points. These findings about post-infection immunity in children with either COVID-19 or MIS-C suggest the need for vaccinations in children with prior COVID-19 or MIS-C to provide effective protection from emerging and circulating SARS-CoV-2 variants.

Mapping geographical inequalities of incomplete immunization in Ethiopia: a spatial with multilevel analysis.

Immunization is one of the most cost-effective interventions, averting 3.5-5 million deaths every year worldwide. However, incomplete immunization remains a major public health concern, particularly in Ethiopia. The objective of this study is to investigate the geographical inequalities and determinants of incomplete immunization in Ethiopia. A secondary analysis of the mini-Ethiopian Demographic Health Survey (EDHS 2019) was performed, utilizing a weighted sample of 3,865 children aged 12-23 months. A spatial auto-correlation (Global Moran's I) statistic was computed using ArcGIS version 10.7.1 to assess the geographical distribution of incomplete immunization. Hot-spot (areas with a high proportion of incomplete immunization), and cold spot areas were identified through Getis-Ord Gi* hot spot analysis. Additionally, a Bernoulli probability-based spatial scan statistics was conducted in SaTScan version 9.6 software to determine purely statistically significant clusters of incomplete immunization. Finally, a multilevel fixed-effects logistic regression model was employed to identify factors determining the status of incomplete immunization. Overall, in Ethiopia, more than half (54%, 95% CI: 48-58%) of children aged 12-23 months were not fully immunized. The spatial analysis revealed that the distribution of incomplete immunization was highly clustered in certain areas of Ethiopia (Z-score value = 8.379419, p-value < 0.001). Hotspot areas of incomplete immunization were observed in the Afar, Somali, and southwestern parts of Ethiopia. The SaTScan spatial analysis detected a total of 55 statistically significant clusters of incomplete immunization, with the primary SaTScan cluster found in the Afar region (zones 1, 3, and 4), and the most likely secondary clusters detected in Jarar, Doola, Korahe, Shabelle, Nogob, and Afdar administrative zones of the Somali region of Ethiopia. Indeed, in the multilevel mixed-effect logistic regression analysis, the respondent's age (AOR: 0.92; 95% CI: 0.86-0.98), residence (AOR: 3.11, 95% CI: 1.36-7.14), living in a pastoralist region (AOR: 3.41; 95% CI: 1.29-9.00), educational status (AOR: 0.26; 95% CI: 0.08-0.88), place of delivery (AOR: 2.44; 95% CI: 1.15-5.16), and having PNC utilization status (AOR: 2.70; 95% CI: 1.4-5.29) were identified as significant predictors of incomplete immunization. In Ethiopia, incomplete immunization is not randomly distributed. Various factors at both individual and community levels significantly influence childhood immunization status in the country. It is crucial to reduce disparities in socio-demographic status through enhanced collaboration across multiple sectors and by bolstering the utilization of maternal health care services. This requires concerted efforts from stakeholders.

Pneumococcal carriage and serotype distribution in children with nephrotic syndrome

BackgroundPatients with nephrotic syndrome (NS) are at a higher risk of developing invasive pneumococcal disease (IPD). Pneumococcal carriage studies are helpful tools for detecting potentially infectious serotypes and guiding immunization efforts. Pneumococcal nasopharyngeal colonization is common, and IPD can easily occur in an immunosuppressed state. Limited information is available regarding the frequency of pneumococcal carriage in individuals with NS. The aim of this study was to evaluate pneumococcal carriage and serotype distribution in children with NS.MethodsPneumococcal carriage was detected by real-time PCR assays from nasopharyngeal swab samples from 98 children with NS, and 100 healthy controls. Isolates were serotyped by real-time PCR.ResultsThe pneumococcal carriage rate was 44.9% in children with NS. Regarding the recommendation about pneumococcal immunization in children with NS, the vaccination rate was low. Also, non-PCV13 serotypes have been detected in at least 25% of PCV13-vaccinated children. There is no statistically significant difference in total pneumococcal carriage rate, PCV13 serotype carriage rate, or non-PCV13 serotype carriage rate between children with NS and healthy controls (p > 0.05 for all).ConclusionsThe pneumococcal carriage rate was similar between children with NS and healthy controls. However, because children with NS have an increased risk for IPD, the serotype distribution of children with NS can demonstrate the improved protection offered by new pneumococcal vaccines. Regular monitoring for IPD is crucial for assessing the evolving sero-epidemiology of pneumococcal infections and evaluating the effectiveness of vaccines for children with NS.Graphical A higher resolution version of the Graphical abstract is available as Supplementary information

Of Money and Men: A Scoping Review to Map Gender Barriers to Immunization Coverage in Low- and Middle-Income Countries.

Among the multiple factors impeding equitable childhood immunization coverage in low- and middle-income countries (LMICs), gender barriers stand out as perhaps the most universal. Despite increasing recognition of the importance of gender considerations in immunization programming, there has not yet been a systematic assessment of the evidence on gender barriers to immunization. We conducted a scoping review to fill that gap, identifying 92 articles that described gender barriers to immunization. Studies documented a range of gender influencers across 43 countries in Africa and South Asia. The barrier to immunization coverage most frequently cited in the literature is women's lack of autonomous decision-making. Access to immunization is significantly impacted by women's time poverty; direct costs are also a barrier, particularly when female caregivers rely on family members to cover costs. Challenges with clinic readiness compound female caregiver's time constraints. Some of the most important gender barriers lie outside of the usual purview of immunization programming but other barriers can be addressed with adaptations to vaccination programming. We can only know how important these barriers are with more research that measures the impact of programming on gender barriers to immunization coverage.

Parents’ attitudes towards the No Jab No Play legislation in Western Australia: a mixed methods study

BackgroundMandates provide a relatively cost-effective strategy to increase vaccinate rates. Since 2014, five Australian states have implemented No Jab No Play (NJPlay) policies that require children to be fully immunised to attend early childhood education and childcare services. In Western Australia, where this study was conducted, NJNPlay legislation was enacted in 2019. While most Australian families support vaccine mandates, there are a range of complexities and unintended consequences for some families. This research explores the impact on families of the NJNPlay legislation in Western Australia (WA).MethodsThis mixed-methods study used an online parent/carer survey (n = 261) representing 427 children and in-depth interviews (n = 18) to investigate: (1) the influence of the NJNPlay legislation on decision to vaccinate; and (2) the financial and emotional impacts of NJNPlay legislation. Descriptive and bivariate tests were used to analyse the survey data and open-ended questions and interviews were analysed using reflexive thematic analysis to capture the experience and the reality of participants.ResultsApproximately 60% of parents intended to vaccinate their child. Parents who had decided not to vaccinate their child/ren were significantly more likely to experience financial [p < 0.001] and emotional impacts [p < 0.001], compared to those who chose to vaccinate because of the mandate. Qualitative data were divided with around half of participants supporting childhood immunisation and NJNPlay with others discussing concerns. The themes (a) belief in the importance of vaccination and ease of access, (b) individual and community protection, and (c) vaccine effectiveness, safety and alternatives help understand how parents’ beliefs and access may influence vaccination uptake. Unintended impacts of NJNPlay included: (a) lack of choice, pressure and coercion to vaccinate; (b) policy and community level stigma and discrimination; (c) financial and career impacts; and (d) loss of education opportunities.ConclusionsParents appreciation of funded immunisation programs and mandates which enhance individual and community protection was evident. However for others unintended consequences of the mandate resulted in significant social, emotional, financial and educational impacts. Long-term evidence highlights the positive impact of immunisation programs. Opinions of impacted families should be considered to alleviate mental health stressors.

Comparative Analysis of Childhood Immunization Programmes in Northern Ireland and China

Childhood immunization programs play a crucial role in safeguarding public health by preventing the spread of infectious diseases. This report compares and contrasts the childhood immunization programs in Northern Ireland (NI) and China, assessing their impact on public health outcomes. The respective programs, existing findings on their impact, criteria for comparison, and outcomes are discussed. The analysis reveals both similarities and differences between the two programs, highlighting implications for policy recommendations.

Pneumococcal Carriage in Burkina Faso After 13-Valent Pneumococcal Conjugate Vaccine Introduction and Before a Schedule Change.

In October 2013, Burkina Faso introduced 13-valent pneumococcal conjugate vaccine (PCV13) into the routine childhood immunization program using 3 primary doses with no booster. Previous pneumococcal carriage studies showed reductions in vaccine-type (VT) carriage in children aged <5 years but not in older age groups. We conducted a cross-sectional, age-stratified pneumococcal carriage study among healthy persons aged ≥1 month in Bobo-Dioulasso in March 2020. Pneumococci isolated by culture from nasopharyngeal swabs (all participants) and oropharyngeal swabs (participants aged ≥5 years) were serotyped by polymerase chain reaction; a subset was serotyped by Quellung. Using data from a study with the same design from March 2017, we examined changes in pneumococcal carriage by age group. Among 1005 (2017) and 1002 (2020) enrolled participants, VT carriage decreased (21.6% to 15.9%; adjusted prevalence ratio [aPR], 0.76 [95% confidence interval {CI}, .63-.92]). By age group, decline in VT carriage was significant among children aged 5-14 years (28.9% to 16.3%; aPR, 0.57 [95% CI, .39-.84]) but not among children aged <5 years (22.4% to 19.1%; aPR, 0.87 [95% CI, .70-1.09]) or adults aged ≥15 years (12.0% to 5.5%; aPR, 0.52 [95% CI, .26-1.05]). Between 3 and 6 years after PCV13 introduction, significant declines in VT carriage were observed in older children, possibly reflecting indirect effects of PCV13 use. VT carriage in children aged <5 years remained stable with almost 1 in 5 carrying VT pneumococci, suggesting limitations to a PCV schedule without a booster dose.

Contextualizing post day-one childhood immunization in-take drop-off rate in Nigeria: An assessment of working mothers in Ibadan

Background Contextualizing childhood immunization in the context of working mothers can boost coverage and completion. This study examines how informal working mothers perceive post-day-one routine immunization, and vaccines not covered under the National Program on Immunization (NPI), immunization schedules, timing, and duration. Methods The study was conducted in Ibadan, Nigeria and involved 1,044 quantitative and 73 qualitative samples of working nursing mothers. A mixed methods approach was used, including a semi-structured questionnaire to gather immunization experiences. Data were analyzed using descriptive statistics, chi-square test for proportions, and t-test for means (p&lt;0.05), while qualitative data were subjected to content analysis. Results The average age of mothers participating in this study was 31.39 years. The mean age of mothers at their first childbirth within the study group was 24.12 years. A significant majority of these mothers (95%) are married. Around three-quarters of women in this population ensured immediate immunization for their infants after birth, but less than a third achieved the complete age-specific vaccination series due to livelihood related causes, long waiting time spent in conventional immunization clinic. Around 40% of interviewed mothers vaccinated their children up to the third DPT dose, and just over 30% achieved full vaccination. Many informal working mothers, have concerning practice of adding 'supplements' to their children's immunization, driven by a lack of sufficient information about the vaccines. Some mothers also seemed unaware of these specialized vaccines. Conclusions Promoting complete immunization requires more than just raising awareness about childhood vaccinations but close and quick immunization service delivery is required. It is crucial for mothers to possess comprehensive knowledge about the mechanics and operation of immunization. Achieving this understanding could involve translating vaccine names and functions into indigenous terms, enhancing clarity and comprehension. Furthermore, a firm grasp of the immunization schedule significantly contributes to successful immunization completion.

IMPACT OF THE COVID-19 PANDEMIC ON THE REGULAR IMMUNIZATION OF CHILDREN IN THE MOSTAR HEALTH CENTER

Introduction: Vaccines for protection against 10 infectious diseases are available in the Program of Regular Immunization in the Federation of Bosnia and Herzegovina. These vaccines save the lives of up to 3 million people worldwide every year. The latest report of the Institute of Public Health of the Federation of Bosnia and Herzegovina on regular immunization carried out during 2020 shows that the rate of vaccination of children during the 2019 coronavirus disease (COVID-19) pandemic with regular vaccines has decreased compared to previous years. Such a situation in the health system leads to a potential risk of outbreaks of infectious diseases that are prevented by vaccination.Objective: To examine the impact of the COVID-19 pandemic on the regular immunization of children in the Mostar Health Center.Materials and methods: A retrospective cross-sectional epidemiological study was conducted. Data on regular immunization of children from theMostar Health Center, Herzegovina-Neretva County in the Federation of Bosnia and Herzegovina from 2017, 2018, 2021 and 2022 were used.Results: A statistically significant difference was obtained in vaccination against measles, mumps and rubella during a period of four years. Vaccination with the mentioned vaccines was significantly higher in 2017 and 2018 than in 2021 and 2022.Conclusion: It was shown that the COVID-19 pandemic affected the regular immunization of children in the Mostar Health Center.Keywords: regular immunization of children, COVID 19 pandemic, MMR vaccine, Mostar

Vaccination and Immunization as Perceived by Badjao Parents in Surigao City, Philippines

Health authorities in the Philippines are tackling emerging infectious diseases among Filipino children by implementing precautionary measures, with a focus on strengthening immune systems. The cornerstone of their efforts is the 40-year-old Expanded Immunization Program (EPI), a key initiative by the Department of Health. This descriptive quantitative study aimed to inspire provision for Filipino children with safe vaccinations, addressing diseases like measles, diphtheria, tetanus, and whooping cough. The EPI has significantly reduced death and morbidity rates associated with preventable diseases. This study delves into the knowledge, attitudes, beliefs, and confidence among Badjao parents in Barangay Canlanipa, Surigao City, regarding children’s vaccination and immunization. The methodology included the utilization of researcher-made questionnaires and statistical tools such as the Frequency Count and Percentage, Mean and Standard Deviation, and Chi-Square Test. The study highlighted that despite challenges such as limited education and socioeconomic factors, many Badjao parents prioritized their children’s vaccination and immunization. However, the study revealed disparities in knowledge and confidence levels, emphasizing the need for targeted information campaigns. The study recommends targeted programs to promote the EPI’s benefits among the Badjao community and urges health authorities to conduct information drives. It also suggests exploring how personal experiences, like family illnesses, affect vaccination decisions. The study ultimately provides valuable insights for local stakeholders, healthcare providers, and future researchers, highlighting the importance of vaccination and immunization for children’s health.

Electronic Immunization Registry in Rwanda: Qualitative Study of Health Worker Experiences.

Monitoring childhood immunization programs is essential for health systems. Despite the introduction of an electronic immunization registry called e-Tracker in Rwanda, challenges such as lacking population denominators persist, leading to implausible reports of coverage rates of more than 100%. This study aimed to assess the extent to which the immunization e-Tracker responds to stakeholders' needs and identify key areas for improvement. In-depth interviews were conducted with all levels of e-Tracker users including immunization nurses, data managers, and supervisors from health facilities in 5 districts of Rwanda. We used an interview guide based on the constructs of the Human, Organization, and Technology-Fit (HOT-Fit) framework, and we analyzed and summarized our findings using the framework. Immunization nurses reported using the e-Tracker as a secondary data entry tool in addition to paper-based forms, which resulted in considerable dissatisfaction among nurses. While users acknowledged the potential of a digital tool compared to paper-based systems, they also reported the need for improvement of functionalities to support their work, such as digital client appointment lists, lists of defaulters, search and register functions, automated monthly reports, and linkages to birth notifications and the national identity system. Reducing dual documentation for users can improve e-Tracker use and user satisfaction. Our findings can help identify additional digital health interventions to support and strengthen the health information system for the immunization program.

Determination of immunisation status of children between 2-5 years of age who attending to teaching institute with concern to both national immunization schedule and optional vaccines

Background: In order to know the causes for non-immunisation, search for societal reasons for primary immunisation along with evaluating coverage. Aim of this current study is to determine the immunisation status of children between 2-5 years of age who are attending teaching health care centre with concern to both National Immunisation Schedule and Optional vaccines. Methods: Study analysed the children's immunisation status, factors affecting their immunisation coverage, and reasons for partial or incomplete immunisation. The information was obtained from the parents using a questionnaire. Information such as socio-demographic variables, immunisation status, causes of their partial immunisation and lack of immunisation. The "vaccination card and the recall" approach was used to determine the recipient's immunisation status. Results: Study found that 70.4% of children had received all recommended vaccinations. Lack of information and ignorance are significant contributors to under-immunization. Other statistically significant contributing factors for the low immunisation coverage include female gender, rural background, low socioeconomic status, born at home, lower mother age, and being from a joint household. BCG vaccination coverage was higher than pentavalent vaccine coverage, probably because of multiple doses needed. Only 77% of kids received vitamin A solution. Conclusions: Paediatrician should mention the next vaccination date and dose at each appointment in order to lower the vaccination dropouts. Parents should be informed regarding the date of vaccination of their child through SMS message, calls, and social media groups.

Serotype epidemiology and antibiotic resistance of pneumococcal isolates colonizing infants in Botswana (2016-2019).

In 2012, Botswana introduced 13-valent pneumococcal conjugate vaccine (PCV-13) to its childhood immunization program in a 3+0 schedule, achieving coverage rates of above 90% by 2014. In other settings, PCV introduction has been followed by an increase in carriage or disease caused by non-vaccine serotypes, including some serotypes with a high prevalence of antibiotic resistance. We characterized the serotype epidemiology and antibiotic resistance of pneumococcal isolates cultured from nasopharyngeal samples collected from infants (≤12 months) in southeastern Botswana between 2016 and 2019. Capsular serotyping was performed using the Quellung reaction. E-tests were used to determine minimum inhibitory concentrations for common antibiotics. We cultured 264 pneumococcal isolates from samples collected from 150 infants. At the time of sample collection, 81% of infants had received at least one dose of PCV-13 and 53% had completed the three-dose series. PCV-13 serotypes accounted for 27% of isolates, with the most prevalent vaccine serotypes being 19F (n = 20, 8%), 19A (n = 16, 6%), and 6A (n = 10, 4%). The most frequently identified non-vaccine serotypes were 23B (n = 29, 11%), 21 (n = 12, 5%), and 16F (n = 11, 4%). Only three (1%) pneumococcal isolates were resistant to amoxicillin; however, we observed an increasing prevalence of penicillin resistance using the meningitis breakpoint (2016: 41%, 2019: 71%; Cochran-Armitage test for trend, p = 0.0003) and non-susceptibility to trimethoprim-sulfamethoxazole (2016: 55%, 2019: 79%; p = 0.04). Three (1%) isolates were multi-drug resistant. PCV-13 serotypes accounted for a substantial proportion of isolates colonizing infants in Botswana during a four-year period starting four years after vaccine introduction. A low prevalence of amoxicillin resistance supports its continued use as the first-line agent for non-meningeal pneumococcal infections. The observed increase in penicillin resistance at the meningitis breakpoint and the low prevalence of resistance to ceftriaxone supports use of third-generation cephalosporins for empirical treatment of suspected bacterial meningitis.