Increase Vaccination Coverage Research Articles

Estimating COVID-19 associated hospitalizations, ICU admissions, and in-hospital deaths averted in the United States by 2023-2024 COVID-19 vaccination: A conditional probability, causal inference, and multiplier-based approach.

COVID-19-associated hospitalizations, ICU admissions, and in-hospital deaths averted from 2023 to 2024 COVID-19 vaccination from the weeks of October 1, 2023, through April 21, 2024, were estimated via a novel multiplier model that utilized causal inference, conditional probabilities of hospitalization, and correlations between data elements in Monte Carlo simulations. Median COVID-19-associated hospitalizations averted were 68,315 (95% uncertainty interval [UI] 42,831-97,984), ICU admissions averted were 13,108 (95% UI 4459-25,042), and in-hospital deaths averted were 5301 (95% UI 101-14,230). Averted COVID-19-associated burden was highest in adults aged 65years and older (hospitalizations averted 57,665, 95% UI 35,442-84,006; ICU admissions averted 10,878, 95% UI 3104-21,591; in-hospital deaths averted 4779, 95% UI 0-13,132). Expanding the analytic period to comprise the weeks of September 24, 2023, through August 11, 2024, resulted in 107,197 COVID-19-associated hospitalizations averted (95% UI 80,692-137,643), 18,292 COVID-19-associated ICU admissions averted (95% UI 10,062-28,436), and 6749 COVID-19-associated in-hospital deaths averted (95% UI 2077-13,557). Older adults had the highest COVID-19-associated averted burden and potential to reduce burden further through increased vaccine coverage. 2023-2024 COVID-19 vaccinations reduced the burden of COVID-19-associated severe disease.

P-2174. Politics and Money? Mpox Vaccine Coverage in the US: A Study in Healthcare Variation

Abstract Background During the United States (US) mpox outbreak of 2022-2023, the federal government distributed mpox vaccines (JYNNEOS) to individual states for distribution to at-risk persons. For local distribution, there was no immediate federal funding available. The vaccines were not commercially available. Vaccination data was reported to states’ public health and the Centers of Disease Control and Prevention. There was considerable variation in vaccine coverage across different states. Mpox vaccine coverage and associated factors for US states. Methods Using public data, we sought to identify state-level factors associated with full mpox vaccine coverage (two doses), including: political identity, public health spending, public health staffing, diversity index, poverty rate, percentage of population at-risk, and mpox cases. Data sources were: 2020 presidential election result, Association of State and Territorial Health Officials, 2020 US Census, and the CDC. Univariate and multivariable linear regression was performed using all studied variables. P-value of < 0.05 was used to note statistical significance. Factors associated with mpox vaccine coverage: univariate linear regression. Results Nationally, average full mpox vaccine coverage for at-risk persons was 21%. Univariate analysis showed that Republican political status was associated with lower JYNNEOS vaccine coverage. Higher coverage was associated with higher public health spending per capita, increased diversity index, higher proportion of at-risk population, and greater number of absolute mpox cases. Multivariable analysis showed the following: Republican states achieved -5.65% lower vaccine coverage (p=0.036), each $1 increase in public health spending increased vaccine coverage by 0.05% (p=0.000), each additional MSM++ (men who have sex with men [MSM] on HIV pre-exposure prophylaxis plus MSM with HIV) per 1,000 people increased vaccine coverage by 1.5% (p=0.000), and each additional mpox case increased vaccine coverage by 0.003% (p=0.032). Multicollinearity check showed low correlation among tested variables. Factors associated with mpox vaccine coverage: multivariable linear regression. Conclusion Higher mpox vaccine coverage was achieved in US states with Democratic political orientation, higher public health funding, higher proportion of at-risk population, and higher mpox cases. Additional analyses toward equitable vaccine access are needed. Disclosures All Authors: No reported disclosures

Population-level Impact of HPV Vaccination on the Incidence of Genital Warts in Sweden.

Sweden introduced HPV vaccination in 2006, administered through opportunistic, subsidized, catch-up and school-based programs. Notably, genital warts (GW) are the first observable clinical outcome following infection by HPV-6/11, targeted by vaccination. We aim to gain knowledge of the incidence of GW in Sweden and evaluate its change throughout vaccination programs. This ecological study used Swedish registers to obtain national population data and cases of genital warts from 2006-2018 in men and women aged 15-44. We used Poisson models to evaluate GW incidence change after vaccination in reference to a pre-vaccination period, stratified by age and sex. As well as, to estimate incidence change of GW in birth cohorts eligible for vaccination compared to a pre-vaccination cohort. Finally, we estimated GW cases averted in each vaccinated cohort. The incidence of GW decreased during periods following HPV vaccination. In 2016-2018, over a decade after vaccination availability, incidence decreased by 89% (95% CI 83-93), 73% (95% CI 71-75), 50% (95% CI 43-56) and 20% (95% CI 10-28) in women aged 15-19, 20-24, 25-29 and 30-34, respectively. A similar reduction was observable in men, although of lesser magnitude. We estimated 18,890 and 12,343 GW cases averted among vaccinated cohorts of women and men, respectively. We report on population-level decreases of GW incidence in women and men following increased vaccination coverage. Cohorts eligible for school-based vaccination recorded the largest decrease in GW incidence in Sweden to date. For the period under study, decreases among men could be attributed to herd effects.

P-615. Knowledge, attitudes and practice towards routine vaccination among medical students, Kazakhstan, 2023

Abstract Background In Kazakhstan, coverage for childhood immunizations has decreased in recent years. Healthcare workers have the ability to increase vaccine coverage if they are sufficiently trained and have correct knowledge, attitudes and practices (KAP) related to routine immunizations. To assess whether interventions are needed in pre-service medical training, we needed to understand current vaccine KAP in medical students.Table 1.Participant characteristics Methods We conducted a cross-sectional study among senior medical students in 3 universities in Karaganda, Astana and Almaty, from March to May 2023. We used multivariable logistic regression to test association with adequate knowledge, attitudes, and practices (KAP); threshold for adequate scores for questions in each domain was 70%. Adjusted odds ratios (OR) and 95% confidence intervals (CI) are reported.Figure 1.Factors associated with vaccine practice among medical students in Kazakhstan Results We interviewed 3,956 students: 1,716 (43%) in Astana, 1,313 (33%) in Almaty, and 927 (24%) in Karaganda. Of these, 74% were female, and 65% were 21-23 years old. Additionally, 89% were studying general medicine, 8% pediatrics, and 3% public health. Fewer than half (38%) reported having received training on vaccination. Adequate KAP scores were 11% for knowledge, 55% for attitudes, and 17% for practices. Most (74%) believed common myths about routine vaccinations, including 62% believing that the flu vaccine causes flu. Knowledge scores < 70% were associated with attitude scores < 70% (OR: 1.72; CI=1.37–2.17) and practice scores < 70% (OR: 1.66; CI=1.30–2.11). Attitude scores < 70% were associated with being male vs female (OR: 1.25; CI=1.07–1.47), living with anyone < 18 years old vs not (OR: 1.37; CI=1.08–1.73), and living in Astana vs Karaganda (OR: 1.69 CI=1.41–2.03). Practice scores < 70% were associated with living with anyone >65 years old vs not (OR: 1.32; CI=1.03–1.72), Islam religion vs no religion (OR: 2.03; CI=1.65–2.50) and having attitude score < 70% vs ≥70% (OR: 2.99; CI=2.45–3.66). Conclusion Our study revealed markedly low levels of correct KAP related to routine immunizations. These results demonstrate the need to increase training on vaccination among medical students, especially among pediatric and general medicine students who will be involved in immunizations. Trainings should address common myths about routine immunizations. Disclosures All Authors: No reported disclosures

P-614. Acceptance of vaccination - strategies for populations of Ukrainian children migrating to Poland

Abstract Background The presence of a significant number of refugees from Ukraine in Poland creates a need to understand and improve the immunisation status of children in this population. UNICEF and WHO data indicate potential challenges in maintaining adequate vaccination coverage in the refugee population. In this context, this study aims to identify factors influencing vaccination decisions among parents of Ukrainian children living in Poland. The main objective of this project is to increase vaccination coverage among Ukrainian children (0-5 years) in Poland. Methods A pilot study to identify the main barriers and determinants of vaccination decisions among parents of newly arrived war migrants from Ukraine was conducted online and included a group of 187 refugees from Ukraine, most of whom were women. Participants in the study were analysed in terms of their barriers and concerns about vaccinating their children. Results Preliminary results of the survey indicate that the main sources of information about vaccination for Ukrainian parents are doctors and the media. The most commonly reported barriers include difficulties in accessing health services, lack of knowledge about vaccination schedules, and language barriers. Concerns about returning to Ukraine and lack of information about the effects of vaccines are also important. Based on the findings, a behaviour change strategy based on the COM-B theoretical model and a systems approach is proposed. The implemented education and outreach activities, supported by media campaigns and psychosocial support, should aim to increase the capability, motivation and opportunity of Ukrainian parents to make informed decisions about vaccination. Between 24.02.2022 and 31.01.2024, 37,315 Ukrainian children aged 0-5 years were vaccinated in Poland. Conclusion The effectiveness of interventions should be further investigated; however, the available evidence suggests that a comprehensive approach involving a variety of systems can contribute to improving the immunisation status of children among the Ukrainian refugee population in Poland. Disclosures All Authors: No reported disclosures

Evaluation of the adherence of municipalities and states to the Ministry of Health’s microplanning for high-quality vaccination activities and the increase in vaccination coverage in Brazil

BackgroundImmunization is a significant public health achievement for the whole world, although the population’s adherence to vaccination efforts remains a concern. To address this, Brazil’s Ministry of Health introduced the concept of operational microplanning (OM) for high-quality vaccination activities (HQVA) in 2023 to ensure excellence in routine service and campaigns. OM is defined by structured interventions using assertive techniques to enhance the likelihood of covering a broader population previously unprotected from vaccine-preventable diseases.ObjectiveTo assess the adherence of states and municipalities to OM for HQVA and examine the relationship between adherence levels and increased vaccination coverage in Brazil.MethodsAdopting an epidemiological approach with an ecological design, this study analyzed data on the adherence of the 27 Brazilian federative units to HQVA, as reported through the REDCap electronic form in 2023, as per an agreement with the Ministry of Health. The criteria for assessing the states’ adherence to the OM included: (1) Formation of a coordination committee for the OM for HQVA; (2) Inclusion of representatives from Primary Care in the committee; (3) Inclusion of representatives from COSEMS in the committee; (4) Regular coordination meetings between health surveillance and primary care for vaccination actions; and (5) Utilization of a management tool for decision-making and strategic planning (e.g., SWOT). Adherence levels were categorized as: 0 = High adherence (responding positively to 4 or 5 criteria); 1 = Medium adherence (3 positive responses); 2 = Low adherence (2 or fewer positive responses). For municipalities, the adherence criteria were similar, excluding the COSEMS representation and focusing on the involvement of primary care representatives.ResultsThe findings indicated that 45.75% of municipalities achieved full adherence, implementing all the evaluated actions. Despite declaring adherence to the OM, ~ 30.68% of municipalities executed two actions, 19.27% only one, and 4.30% none. Among the states, 37.04% showed full adherence by employing all evaluated actions, with 33.33% executing four actions. States with higher adherence levels to the OM also had greater vaccination coverage (VC), particularly in 2023. Municipalities with complete adherence to the OM met the VC objectives for polio (D3), 10-valent pneumococcal (D2), and triple viral (D1) vaccines in 2023. In states with full adherence to the OM, most municipalities achieved the VC targets for all evaluated vaccines in 2023, showing statistical significance for pentavalent (D3), polio (D3), and 10-valent pneumococcal (D2) vaccines.ConclusionThe findings underscore the impact of OM on improving VC in Brazil, demonstrating that its effective implementation is correlated with meeting VC targets, especially in states and municipalities that enacted all recommended actions. Municipalities engaging in all OM actions met VC objectives for crucial vaccines, highlighting the OM’s positive influence on VC. Full adherence to the OM by states correlated with a notable rise in VC averages across all analyzed vaccines. This analysis suggests that higher adherence to OM improves VC outcomes, emphasizing the role of OM in these metrics and shows that comprehensive implementation of OM improves vaccination efforts and significantly boosts VC, particularly in states fully adhering to guidelines.

Facilitators and Barriers to COVID-19 Vaccine Uptake Among Meat Processing Workers in Nebraska: A Mixed-Methods Analysis Using the COM-B Model.

The meat processing industry was significantly impacted by the COVID-19 pandemic. Deemed essential, the meat processing workforce faced the risk of exposure to the SARS-CoV-2 virus. Along with other essential workforces, meat processing workers were prioritized in the national approach to receive COVID-19 vaccines by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices. This mixed methods study aimed to identify the facilitators and barriers to COVID-19 vaccine uptake by meat processing workers in Nebraska through interviews (n = 29), a survey (n = 857), and application of the COM-B model. We found that facilitators for vaccine uptake included having information about the vaccine available; providing vaccines at the workplace, in pharmacies, and throughout the community to increase accessibility; feeling that there was a social responsibility to get vaccinated; believing that the vaccine was protective; and the use of various incentives. Barriers for vaccine uptake included workers' personal health issues; not having the right information to make an informed decision; logistical and contextual issues that made it challenging to get vaccinated; the disconnect between faith and science; individual choice being highly valued; and uncertainty and misinformation causing fear of the vaccine. Understanding facilitators and barriers to vaccine uptake by meat processing workers is critical to informing public health interventions, evidence-informed guidelines and policies, and tailored messaging to increase vaccination coverage among an essential workforce that inherently assumes occupational risk during infectious disease events, such as the COVID-19 pandemic. Implications for public health practitioners are provided.

Pneumococcal Vaccination Coverage Among Adults at Risk in the Russian Federation

Relevance. Pneumococcal infection remains one of the most significant health problems worldwide. Vaccination of adults against it has been carried out in the Russian Federation for over 10 years. During this time, more than 9 million people have been vaccinated. However, data on the level of coverage among adults of certain risk categories are not routinely collected. Our study in 2019 showed that it was low in most groups. Given the significant increase in the volume of vaccination over the past five years, it seems appropriate to conduct a study to assess changes in the level of coverage.Aim. To study the level of vaccination coverage against pneumococcal infection in adult risk groups in the Russian Federation.Materials and methods. An observational descriptive retrospective epidemiological study was conducted. Information on the number and contingents of people vaccinated against pneumococcal infection was collected by sending a request to the executive authorities of the constituent entities of the Russian Federation in the field of healthcare. The depth of data collection was 8 years (from 2015 to 2023 inclusive), information was received from 74 out of 89 regions. In addition, federal statistical observation forms were used: No. 5 «Information on preventive vaccinations» and No. 6 «Information on the contingents of children and adults vaccinated against infectious diseases», data from the Unified Interdepartmental Information and Statistical System. The results obtained were compared with the indicators obtained in the 2019 study, which was conducted according to a similar design. The analysis was carried out using descriptive statistics methods.Results. The coverage rate of vaccination against pneumococcal infection among the adult population in the Russian Federation increased from 1.5% in 2018 to 7.7% in 2023. The most significant coverage rates were achieved among persons subject to conscription for military service (78.5%) and persons over 60 years old, living in residential care facilities (87.7%). By 2023, vaccination coverage has increased among the following risk categories: individuals with chronic bronchopulmonary diseases (from 15.1% in 2018 to 47.9% in 2023), chronic heart diseases (from 3.8% to 17.0%), patients with endocrine diseases (from 1.1% to 17.6%), liver diseases (from 4.0% to 12.0%), healthcare workers (from 4.9% to 19.7%), school and preschool employees (from 3.1% to 12.9%), employees of residential care facilities (homes for elderly, nursing homes, ect.) (from 0.1% to 26.9%), the elderly population as a whole (from 1.4% to 12.7%), and working-age men (from 1.4% to 7.0%). There was virtually no increase in coverage among all groups of immunocompromised patients (1.0% in 2018, 6.2% in 2023), the working population with risk factors harmful to the respiratory system (0.9% in 2018, 5.0% in 2023), workers in the oil and gas and chemical industries (1.3% in 2018, 1.8% in 2023).Conclusion. The obtained results indicate the need to develop a strategy of measures to promote increased vaccination coverage in risk groups that are insufficiently covered by vaccination against pneumococcal infection.

Optimizing vaccine uptake in sub-Saharan Africa: a collaborative COVID-19 vaccination campaign in Madagascar using an adaptive approach

BackgroundThe COVID-19 pandemic has highlighted the need for more effective immunization programs, including in limited resource settings. This paper presents outcomes and lessons learnt from a COVID-19 vaccination campaign (VC), which used a tailored adaptive strategy to optimise vaccine uptake in the Boeny region of Madagascar.MethodsGuided by the Dynamic Sustainability Framework (DSF), the VC implementation was regularly reviewed through multi-sectoral stakeholder feedback, key informant interviews, problem-solving meetings, and weekly monitoring of outcome indicators to identify and apply key adaptations. Qualitative data on processes were collected and analysed using a rapid assessment approach. Outcome indicators, including pre- and post-VC vaccine hesitancy and trends in vaccine doses administered, were analysed using generalized linear models. Additionally, vaccination coverage, geographic reach, and target population characteristics, and sustainability indicators, such as staff trained, facilities equipped, and degree of integration of operational and educational materials were also tracked.ResultsKey strategy adaptations included using a proactive campaign approach, community-led awareness and outreach, particularly in remote areas, and addressing cold chain, waste management, vaccine transport, and information technology (IT) equipment gaps. Over six months, 24,888 COVID-19 vaccines were administered. The adapted strategy led to an 8% increase in doses administered weekly (RR = 1.08, CI 95%: 1.01-1.15). However, vaccine hesitancy among the unvaccinated population remained unchanged (∆ = 0.02, CI 95%: -0.04-0.08). In terms of sustainability, 340 staff were trained, and 10 primary healthcare facilities were equipped and refurbished.ConclusionsImplementing collaborative, multi-sectoral vaccination strategies that integrate healthcare services with proactive outreach and community-driven campaigns are effective in increasing vaccine coverage in resource-limited settings. It demonstrates how theory-based adaptive strategies can enhance vaccination rates, even if they do not significantly impact COVID-19 vaccine hesitancy within the community. More generally, this initiative has important implications for adult vaccination programmes other than those related to COVID-19.

Role of Immunization in Adults with Diabetes in India: An Overview

Vaccination is one of the most cost-effective public health strategies. Millions of adults globally suffer from diseases preventable by vaccines. Vaccination in persons with diabetes mellitus is crucial for enhancing immunity, protecting against new infectious agents, and boosting the efficacy of childhood vaccines. It also reduces the community spread of infectious diseases. People with diabetes (PWD) are particularly vulnerable to infections such as Streptococcus pneumoniae, influenza, hepatitis B, and COVID-19 due to hyperglycemia-induced immune system alterations. As diabetes prevalence rises, so does the susceptibility of large populations to infectious diseases, resulting in serious complications and high mortality rates among PWD. Increasing vaccination coverage can significantly reduce mortality and improve health outcomes in PWD. Studies reveal a significant lack of awareness and knowledge about vaccines among PWD, with barriers including fear of complications, financial constraints, and lack of information. Healthcare providers should educate patients about the benefits of vaccinations, integrate vaccination recommendations into routine care, and address barriers through consistent guidance and support.

Lexicalisation in Media Reports of Recurrent Diphtheria Outbreak in Nigeria: Implications for Health Communication

Linguistic studies on media coverage of pandemics and outbreaks in Nigeria, including the COVID-19 pandemic, Ebola, and Lassa fever, have been extensive. However, the linguistic analysis of media reports on the diphtheria outbreak remains underexplored. This study addresses this gap by examining the lexical choices employed in framing the diphtheria outbreak in Nigeria. Twenty articles from four popular Nigerian newspapers – The Punch, The Guardian, The Vanguard, and The Premium Times – were examined to discover the prevalent frames and associated lexical choices. The articles were collected between January and August 2023, a significant period marked by the resurgence of the disease and extensive reporting on its impact on victims. Using frame theory and lexical priming theory as analytical frameworks, the study identified frames such as health crisis, victim, government response, global aid and response, vaccination shortfall/hesitancy, public health awareness, past antecedent, and collaborative effort. Common lexical choices included terms like “deadly,” “surge,” and “critical situation,” which emphasize fear and urgency. This emotive tone is used purposefully to attract readers’ attention and prime them to interpret the outbreak as an urgent public health issue. Frames like Public Health Awareness and Government Response are concerned with informing the public. Several other frames, most notably Vaccination Shortfall/Hesitancy and Collaborative Effort, serve as a rallying cry. They highlight the need for increased vaccination coverage, collaboration among stakeholders, and public participation in health measures. Through framing and lexical choices, the media shapes public opinion, influences perceptions, and guides individual and collective responses to health issues like the diphtheria outbreak. The relevance of this study lies in its contribution to understanding how media framing and lexical choices impact public health communication, ultimately aiding in more effective health crisis management and public engagement strategies.

Prevalence of Diarrhea Disease and Associated Factors Among Children Under 5 Years in Geshiyaro Project Implementation Sites in Ethiopia: A Cross-Sectional Study.

Globally, infectious diseases such as pneumonia, diarrhea, and malaria are the leading causes of death for children under 5. Diarrheal disease is a significant public health concern and causes the death of approximately 525,000 children under the age of 5 every year. In Ethiopia, studies revealed that the prevalence of diarrhea among children under 5 years is alarming. However, there has been a shortage of studies regarding the predictors of diarrheal disease in Geshiyaro project implementation sites in Ethiopia. Therefore, this study aimed to fill this gap. A community-based cross-sectional study was conducted from June to July 2023. A total of 2937 participants were enrolled in this investigation. Descriptive and multivariate logistic regression analysis was performed using STATA version 16. The 2-week prevalence of diarrhea among children under 5 years was 11.8%. The following factors were significantly associated (p < 0.05) with the occurrence of childhood diarrhea: sex of the child (AOR: 1.6; 95% CI, 1.17-2.19), child age in a month (AOR: 0.5; 95% CI, 0.26-0.94), drinking water service (AOR: 2.6; 95% CI, 1.33-5.25), knowledge on diarrhea prevention (AOR: 1.4; 95% CI, 1.05-1.98), open defecation practice (AOR: 1.9; 95% CI, 1.33-2.74), and rotavirus vaccination (AOR: 1.8; 95% CI, 1.20-2.56). This study identified several factors contributing to diarrhea. Besides, it also studied and showed a larger number of children who were not receiving basic vaccines. Therefore, the government and partner organizations should implement effective interventions to increase vaccine coverage and reduce diarrhea.

Vaccination Promotion Strategies in the Elderly: Systematic Review and Meta-Analysis.

Background: The World Health Organization estimates that currently available vaccines prevent 2 to 3 million deaths worldwide each year. Preventing infectious diseases is an important public health priority to ensure healthy ageing and improve quality of life. This study's aim is to identify the best strategies to increase vaccination coverage in the elderly. Methods: A systematic review and meta-analysis were carried out, including a bibliographic search in the PubMed and Scopus databases. Studies in older people (60 years or older) on any type of intervention aimed at increasing vaccination coverage were included. The effect of the intervention was measured using the odds ratio (OR). Results: After applying the selection criteria, 20 studies were identified: 17 on influenza vaccines and 3 on other vaccines. Educational strategies obtained an OR = 1.63 (95% CI: 1.22-2.19, I2 = 0.59). Medical counselling obtained an OR = 3.13 (95% CI: 0.60-16.37, I2 = 0.95). Writing strategies obtained an OR = 1.14 (95% CI: 0.99-1.32, I2 = 0.93). Few studies reported the effect of free vaccination. Conclusions: The educational strategies proved to be more effective than the others in this study. Free vaccination and age may have important roles. Further studies are needed as research in this area remains limited.

Invasive pneumococcal disease in adults after the introduction of pneumococcal vaccination: a retrospective study in the metropolitan area of Zagreb, Croatia (2010-2022).

Invasive pneumococcal disease (IPD) is a severe form of illness caused by Streptococcus pneumoniae with high morbidity and mortality rate in the general population, particularly in children <5 years of age, adults ≥65 years of age and the immunocompromised. As known, pneumococcal vaccination lowers the risk of IPD so the aim of this study was to investigate whether the introduction of pneumococcal vaccination has influenced the incidence and mortality of IPD in adults in Croatia. A retrospective study was conducted among adult patients (aged ≥18 years) hospitalized due to IPD in the metropolitan area of Zagreb from 1st January 2010 to 31st December 2022. Number of vaccine doses distributed were obtained from the healthcare system. During the study period, 389 patients were hospitalized, of whom 214 (55.5%) were male. The annual incidence of IPD ranged from 0.6 to 4.1/100,000 population. A total of 185 (47.6%) patients were ≥ 65 years of age and 309 (79.4%) were ≥ 50 years of age. In 331 (85.1%) of the patients, at least one risk factor was identified, with age ≥ 65 years being the most common. Bacteremic pneumonia was the most frequent clinical presentation of IPD (66.3%). Indication for vaccination had 249 patients (64%) but only 11 patients (4.4%) were vaccinated. Also, 64 patients (16.5%) died. Serotype was determined in 233 (59.9%) of the isolates, with serotype 3 being the most frequent (49, 21%), followed by serotype 14 (38, 16.3%) and 19A (15, 6.4%). A total of 180 isolates (77.3%) were included in the 13-valent conjugate vaccine, 208 (89.3%) in the 20-valent conjugate vaccine and 212 (91%) in the 23-valent pneumococcal polysaccharide vaccine. The introduction of pneumococcal vaccination has led to a significant decrease in the incidence and mortality of IPD in adults. To further reduce morbidity and mortality from IPD, it is necessary to increase vaccine coverage in adults, particularly in individuals with risk factors. It may be beneficial to lower the recommended vaccination age from ≥65 to ≥50 years as the substantial difference in the incidence rates of IPD between these age groups was noticed.

Further analysis of determinants of Pentavalent and Measles immunizations dropouts among children under five years of age in Ethiopia from Mini-EDHS 2019

BackgroundGlobally, immunization prevents an estimated 2–3 million deaths from illnesses that can be prevented by vaccination. The predictors of Pentavalent and Measles immunization dropout were not investigated sufficiently. Therefore, this analysis was meant to determine the coverage, burden, and predictors of Pentavalent and Measles immunizations in Ethiopia.Materials and methodsThis study was a further analysis of the Mini Ethiopian Demographic Health Survey (EDHS) 2019, conducted with a nationally representative sample. In this study, immunization data was collected from a total sample of 3208 children of which 2004 (34.8%) children who received pentavalent 1 were considered for this study. Univariable, bi-variable, and multilevel mixed effect analysis was done using STATA version 17 Software. The mixed-effect model with the lowest AIC and BIC (information criteria) was chosen. A factor was designated as a significant predictor of immunization dropout if its p-value was less than 0.05 at 95% CI. The best-fitting model among the fitted models was ultimately chosen using the Akaike and Bayesian Information Criteria (AIC and BIC).ResultThe mean age of the head of the household was 37.6. The majority (68.9%) of the residents were from rural areas and of the total population, 64.9% have no formal education. Being residents of Afar increased the odds of dropping out by 3.28 (AOR = 3.28; 95% CI: 1.12, 9.56), whereas being residents of Addis Ababa reduced their odds of dropping out from prentavalent 3 by 68.1% (AOR = 0.319; 95% CI: 0.122, 0.833) compared to their Tigray counterparts. The dropout rate of Pentavalent 1 to measles 1 vaccination was 4.33 times higher among residents of Afar (AOR = 4.33; 95% CI: 1.38, 13.56). As the level of wealth increases, the quintile increases from poorer to richer compared to those in the poorest wealth quantile category, and marital status also affects the immunization dropout rate of their children.ConclusionsImmunization coverage of Ethiopian children was low and the dropout from pentavalent 1 and measles vaccination was high compared to the national and international targets to improve immunization coverage and reduce dropout. So different cost-effective interventions like Education provision for the community, decision-making facilitation, behavioral change support, and multi-system participation were required to increase vaccination coverage and reduce the vaccine dropout among children in Ethiopia.

CO6 Projected Public Health Benefits of Increasing Vaccine Coverage for COVID-19 Among Adults ≥ 50 Years of Age in the United States

CO6 Projected Public Health Benefits of Increasing Vaccine Coverage for COVID-19 Among Adults ≥ 50 Years of Age in the United States

Spatiotemporal evolution and transmission dynamics of Alpha and Delta SARS-CoV-2 variants contributing to sequential outbreaks in Cambodia during 2021

BackgroundTracking the emergence, introduction and spread of SARS-CoV-2 variants of concern are essential for informing public health strategies. In 2021, Cambodia faced two major epidemic waves of SARS-CoV-2 triggered by the successive rise of the Alpha and Delta variants.MethodsPhylodynamic analysis of 1,163 complete SARS-CoV-2 genomes from Cambodia, along with global sequences, were conducted between February and September 2021 to infer viral introductions, molecular epidemiology and population dynamics. The relationship between epidemic trends and control strategies were evaluated. Bayesian phylogeographic reconstruction was employed to estimate and contrast the spatiotemporal dynamics of the Alpha and Delta variants over time.ResultsHere we reveal that the Alpha variant displays rapid lineage diversification, accompanied by the acquisition of a spike E484K mutation that coincides with the national implementation of mass COVID-19 vaccination. Despite nationwide control strategies and increased vaccination coverage, the Alpha variant was quickly displaced by Delta variants that exhibits a higher effective reproductive number. Phylogeographic inference indicates that the Alpha variant was introduced through south-central region of Cambodia, with strong diffusion rates from the capital of Phnom Penh to other provinces, while the Delta variant likely entered the country via the northern border provinces.ConclusionsContinual genomic surveillance and sequencing efforts, in combination with public health strategies, play a vital role in effectively tracking and responding to the emergence, evolution and dissemination of future emerging variants.

State-level disparities in cervical cancer prevention and outcomes in the U.S.: a modeling study.

Despite HPV vaccines' availability for over a decade, coverage across the US varies. While some states have tried to increase HPV vaccination coverage, most model-based analyses focus on national impacts. We evaluated hypothetical changes in HPV vaccination coverage at the national and state levels for California, New York, and Texas using a mathematical model. We developed a new mathematical model of HPV transmission and cervical cancer, creating US and state-level models, incorporating country- and state-specific vaccination coverage and cervical cancer incidence and mortality. We quantified the national and state-level impact of increasing HPV vaccination coverage to 80% by 2025 or 2030 on cervical cancer outcomes and the time to elimination defined as < 4 per 100k women. Increasing vaccination coverage to 80% in Texas over ten years could reduce cervical cancer incidence by 50.9% (95% credible interval [CrI]: 46.6-56.1%) by 2100, from 1.58 (CrI : 1.19-2.09) to 0.78 (CrI : 0.57-1.02) per 100,000 women. Similarly, New York could see a 27.3% (CrI : 23.9-31.5%) reduction, from 1.43 (CrI : 0.93-2.07) to 1.04 (Crl : 0.66-1.53) per 100,000 women, and California a 24.4% (CrI : 20.0-30.0%) reduction, from 1.01 (Crl : 0.66-1.44) to 0.76 (Crl : 0.50-1.09) per 100,000 women. Achieving 80% coverage in five years will provide slightly larger and sooner reductions. If the vaccination coverage levels in 2019 continue, cervical cancer elimination could occur nationally by 2051 (Crl : 2034-2064), but state timelines may vary by decades. Targeting an HPV vaccination coverage of 80% by 2030 will disproportionately benefit states with low coverage and higher cervical cancer incidence. Geographically focused analyses can better inform priorities.

Assessing the multidimensional impact of community-based cattle feedlot programs in the Eastern Cape, South Africa

Traditional cattle farming in the region faces numerous challenges, including limited market access, inadequate nutrition, and poor herd management, which hinder productivity and the livelihoods of farmers. This research explores whether structured feedlot programs can address these issues by enhancing agricultural productivity and improving farmer livelihoods. The study utilized quantitative data from 250 respondents and regression models to compare changes before and after participation in the feedlot programs. The findings reveal significant improvements in herd dynamics, with average herd size increasing by 40% and calving rates rising from 60 to 80%. Mortality and morbidity rates decreased by 50 and 47%, respectively. Regression analysis showed a positive impact on herd size (β = 20.00, p &amp;lt; 0.001) and a notable reduction in mortality (β = −0.30, p = 0.050). Animal performance also improved, with average daily gain (ADG) increasing by 60% and feed conversion ratio (FCR) improving by 25%. Health status was enhanced, indicated by a 50% reduction in disease incidence and an 80% increase in vaccination coverage. Regression results supported these improvements, showing significant positive effects of feedlot participation on ADG (β = 0.50, p &amp;lt; 0.001) and health status (β = −0.10, p &amp;lt; 0.005). Socio-economic benefits were also substantial, with household income increasing by 67% and new employment opportunities emerging. Food security improved significantly, with 85% of households reporting better access to food, and the average sales price per cattle increased by 50%. Regression analysis indicated strong positive impacts on household income (β = 1,500, p &amp;lt; 0.001) and food security (β = 300, p = 0.010). Factors influencing farmer participation in the feedlot programs included perceived benefits (β = 0.80, p &amp;lt; 0.001), access to training (β = 0.50, p &amp;lt; 0.005), and market access (β = 0.70, p &amp;lt; 0.001), while the cost of participation negatively affected involvement (β = −0.002, p = 0.050). Overall, the study demonstrates that community-based cattle feedlot programs significantly enhance herd dynamics, animal performance, and socio-economic conditions for farmers in the Eastern Cape Province, offering a viable strategy for improving rural livelihoods and agricultural productivity.

Secondary healthcare resource utilization and related costs associated with influenza-related hospital admissions in adult patients, England 2016 – 2020

ABSTRACT Introduction This study aims to investigate healthcare resource utilization and related costs for influenza virus infections in adults admitted into secondary care in England across four influenza seasons. Methods This study includes all influenza admissions from the Hospital Episode Statistics database (HES) across England, September 2016 to March 2020. Descriptive analyses and comparative modeling techniques were used to assess the impact of influenza on risk groups of interest. Results Influenza admissions were estimated to cost £401 M. Average admission costs were heavily impacted by age and comorbid status, with comorbid patients representing 91% of costs. Additionally, patients with comorbidities treated in secondary care cost twice as much as non-comorbid patients, after adjusting for age and gender. Comorbid patients also had increased length of stay (LOS) and admissions to ICU, with patients’ LOS being a core contributing factor to higher costs. Conclusion The study documents the substantial burden of influenza in England, emphasizing the impact of age and comorbid status on healthcare resource utilization (HCRU) and related costs. The data presented offers critical information to healthcare systems evaluating new strategies to alleviate the winter pressures on the NHS; highlighting the need to implement vaccination campaigns with enhanced vaccinations and increased vaccine coverage.