Low Vaccination Research Articles

Comparing factors influencing seasonal influenza vaccine acceptance and intentions among Chinese university students residing in China and UK: A cross-sectional study

ABSTRACT University students, who face an elevated risk of influenza due to close living quarters and frequent social interactions, often exhibit low vaccine uptake rates. This issue is particularly pronounced among Chinese students, who encounter unique barriers related to awareness and access, emphasizing the need for heightened attention to this problem within this demographic. This cross-sectional study conducted in May-June 2022 involved 1,006 participants (404 in the UK, 602 in Mainland China) and aimed to explore and compare the factors influencing influenza vaccine acceptance and intentions between Chinese university students residing in the UK (C-UK) and Mainland China (C-M). The study employed a self-administered questionnaire based on the Theoretical Domains Framework and Capability Opportunity Motivation-Behavior model. Results revealed that approximately 46.8% of C-UK students received the influenza vaccine in the past year, compared to 32.9% of C-M students. More than half in both groups (C-UK: 54.5%, C-M: 58.1%) had no plans for vaccination in the upcoming year. Knowledge, belief about consequences, and reinforcement significantly influenced previous vaccine acceptance and intention in both student groups. Barriers to vaccination behavior included insufficient knowledge about the influenza vaccine and its accessibility and the distance to the vaccine center. Enablers included the vaccination behavior of individuals within their social circles, motivation to protect others, and concerns regarding difficulties in accessing medical resources during the COVID-19 pandemic. The findings of this study offer valuable insights for evidence-based intervention design, providing evidence for healthcare professionals, policymakers, and educators working to enhance vaccination rates within this specific demographic.

Sero-prevalence and Risk Factors Study of Foot and Mouth Disease and Farmers Perception on Vaccinating Cattle against the Disease in Sidama Region, South Ethiopia

Foot and mouth disease (FMD) is a severe, highly contagious viral disease of livestock that has a significant economic impact. A cross-sectional study was conducted from September 2019 to June 2020 in three selected districts of Sidama region, southern Ethiopia with the objectives of determining the sero-prevalence of cattle against foot and mouth disease virus (FMDV), identifying potential risk factors and assessing farmers' perception on vaccination against FMD. Purposive and systematic random sampling techniques were employed to select the districts and study animals, respectively. A total of 510 cattle were tested for FMDV antibodies using 3ABC-ELISA. The overall cattle and herd level sero-prevalence were 15.5% and 24.7%, respectively. Among the considered risk factors age, herd size, and season were significantly associated with the sero-positivity of FMDV (P<0.05). Out of 120 farmers interviewed84.2% had never vaccinated their cattle against FMDV. Inaccessibility (83.7%) and unaffordable cost (72.1%) of the vaccine were mentioned as leading causes for the low vaccination practice in the current study areas. Majority of the respondents (68.3%) don’t perceive vaccinating cattle against FMDV as one of the preventive measures. In districts with lower perception of farmers on vaccinating their cattle against FMDV, higher sero-prevalence of the disease were recorded. The present serological and questionnaire survey indicated that the presence of FMD sero-positive animals in the current study area. Therefore, an integrated strategy for disease control has to be designed and implemented which could include enhancing farmers’ perception about the use of vaccination in preventing FMD and government provision of vaccines at an affordable cost to the farmers.

Spatiotemporal variability in socioeconomic inequalities in COVID-19 vaccination in Catalonia, Spain

ObjectivesSocioeconomic inequalities have played a significant role in the unequal coverage of the COVID-19 vaccine. The objectives of this study were to (1) assess the socioeconomic inequalities in COVID-19 vaccination coverage in Catalonia, Spain; (2) analyse the spatial variation over time of these inequalities; and (3) assess variations in time and space in the effect of vaccination on inequalities in COVID-19 outcomes. Study designA mixed longitudinal ecological study design was used. MethodsCatalonia is divided in to 373 Basic Health Areas. Weekly data from these Basic Health Areas were obtained from the last week of December 2020 until the first week of March of 2022. A joint spatio-temporal model was used with the dependent variables of vaccination and COVID-19 outcomes, which were estimated using a Bayesian approach. The study controlled for observed confounders, unobserved heterogeneity, and spatial and temporal dependencies. The study allowed the effect of the explanatory variables on the dependent variables to vary in space and in time. ResultsAreas with lower socioeconomic level were those with the lowest vaccination rates and the highest risk of COVID-19 outcomes.In general, individuals in areas that were located in the upper two quartiles of average net income per person and in the lower two quartiles of unemployment rate (i.e., the least economically disadvantaged) had a higher propensity to be vaccinated than those in the most economically disadvantaged areas. In the same sense, the greater the percentage of the population aged ≥65 years, the higher the propensity to be vaccinated, while areas located in the two upper quartiles of population density and areas with a high percentage of poor housing had a lower propensity to be vaccinated.Higher vaccination rates reduced the risk of COVID-19 outcomes, while COVID-19 outcomes did not influence the propensity to be vaccinated. The effects of the explanatory variables were not the same in all areas or between the different waves of the pandemic, and clusters of excess risk of low vaccination in the most disadvantaged areas were detected. ConclusionsCOVID-19 vaccination inequalities in the most disadvantaged areas could be a result of structural barriers, such as the lack of access to information about the vaccination process, and/or logistical challenges, such as the lack of transportation, limited Internet access or difficulty in scheduling appointments. Public health strategies should be developed to mitigate these barriers and reduce vaccination inequalities.

Do Not Leave Your Patients in the Dark-Using American College of Rheumatology and European Alliance of Associations for Rheumatology Recommendations for Vaccination in Polish Adult Patients with Autoimmune Inflammatory Rheumatic Diseases.

(1) Introduction: Patients with autoimmune inflammatory rheumatic diseases (AIIRD) face a higher infectious risk compared to the general population. As per the ACR and EULAR recommendations, vaccinations against influenza, COVID-19, pneumococci, and tetanus are recommended for most patients with AIIRD. (2) Objectives: This study aimed to assess vaccination coverage among Polish AIIRD patients and identify factors influencing it. (3) Patients and Methods: This study was conducted at the reference rheumatological center in Poland between May 2023 and October 2023. The study participants completed a questionnaire covering their knowledge of vaccination recommendations, actual vaccination status, factors affecting their decision to vaccinate, and their perspectives on immunization. (4) Results: This study involved 300 AIIRD patients and 60 controls. Both groups exhibited comparably low vaccination rates for all diseases (the highest for COVID-19-52% in both groups and the lowest for pneumococci-7.7% and 10%, respectively). Knowledge about recommended vaccinations was limited among patients in both groups. AIIRD patients were also not aware that they should avoid live vaccines. The primary motivators for vaccination among AIIRD patients were fear of infection (up to 75%) and medical advice (up to 74.6%). Conversely, the predominant reasons for non-vaccination were a lack of knowledge that vaccination is recommended (up to 74.7%) and concerns about potential adverse effects (up to 48.6%). Many patients reported not receiving vaccination recommendations from either primary care physicians or rheumatologists. (5) Conclusions: To enhance vaccination coverage among AIIRD patients in Poland, it is essential to educate them about vaccinations during routine medical consultations, emphasizing the increased risk of infection, informing them about recommended vaccinations, and clarifying doubts about adverse effects.

Exploring the reasons behind low COVID-19 vaccination coverage in ethnic minorities–A qualitative study among Arabic-speaking public in Denmark

AimsIn Denmark, COVID-19 infection rates have been higher, and vaccination coverage has been lower in areas with many residents from ethnic minority backgrounds. This study aimed to explore COVID-19 vaccination perceptions among Arabic-speaking minorities in Denmark. Materials and MethodsA total of 16 individuals, varying in age, gender, education, employment, health, vaccination status, and the Arabic-speaking country of origin, were recruited and interviewed in Arabic. The interviews were transcribed verbatim, translated into English, and analyzed using directed thematic analysis. ResultsMost interviewees had some knowledge about how vaccines work to prevent infections; however, a wide spectrum of opinions about the effectiveness and safety of COVID-19 vaccines and vaccination policies in Denmark emerged. COVID-19 vaccination issues were extensively discussed in Arabic-speaking communities, but consensus was rarely reached. Many participants felt confused and only took vaccines for practical considerations, such as travel. Due to language barriers, some participants experienced difficulties in understanding vaccination-related information in electronic invitations from the health authorities and at vaccination centers, with family members often stepping in to provide translations. ConclusionsSystematic efforts to actively disseminate translated COVID-19 vaccination information are needed to support ethnic minority individuals in making informed decisions.

Assessing the prevalence and patterns of COVID-19 vaccine side effects among Syrian adults: A cross-sectional study

AimThis study aimed to assess the prevalence and patterns of COVID-19 vaccine side effects among Syrian adults, with a focus on the AstraZeneca and Sputnik Light vaccines, in light of the low vaccination rate in Syria (below 18%) attributed to fear of side effects. MethodA cross-sectional study was conducted between January and May 2022, using probability-based and convenient sampling strategies. Data was collected through online, paper, and face-to-face questionnaires that included demographic and vaccine-related questions. ResultOut of 3,766 participants, the majority were female (56.7 %) and aged 18–24 years (53.3 %). Most participants had a university-level qualification (71.2 %) and were related to the medical sector (53.2 %). A significant proportion (47.0 %) received AstraZeneca, Sputnik Light (22.1 %) and Sinopharm (14.7 %). Common side effects included sleepiness and lethargy (50.0 %), fever and chills (45.0 %), and pain/swelling at the injection site (35.9 %). Multivariate logistic regression analysis revealed that male (OR: 0.57, CI: 0.48–0.68) and participants aged 45–65 years (OR: 0.53, CI: 0.40–0.70) were less likely to experience side effects. Participants who believed COVID-19 posed a high threat to their personal life had higher odds of side effects (OR: 1.74, CI: 1.22–2.46). Vaccine type was also associated with side effects, with Sputnik Light (OR: 2.52, CI: 1.85–3.46) and AstraZeneca (OR: 1.61, CI: 1.26–2.05) having increased odds. ConclusionOur study found that COVID-19 vaccines are well tolerated among the Syrian population, with short-term side effects that typically resolve within three days. These findings are expected to bolster vaccination rates through enhanced public confidence and acceptance.

Geospatially clustered low COVID-19 vaccine rates among adolescents in socially vulnerable US counties

COVID-19 vaccinations are widely available across the United States (U.S.), yet little is known about the spatial clustering of COVID-19 vaccinations. This study aimed to test for geospatial clustering of COVID-19 vaccine rates among adolescents aged 12–17 across the U.S. counties and to compare these clustering patterns by sociodemographic characteristics.County-level data on COVID-19 vaccinations and sociodemographic characteristics were obtained from the COVID-19 Community Profile Report up to April 14, 2022. A total of 3,108 counties were included in the analysis. Global Moran’s I statistic and Anselin Local Moran’s analysis were used, and clustering patterns were compared to sociodemographic variables using t-tests. Counties with low COVID-19 vaccinated clusters were more likely, when compared to unclustered counties, to have higher numbers of individuals in poverty and uninsured individuals, and higher values of Social Vulnerability Index (SVI) and COVID-19 Community Vulnerability Index (CCVI). While high COVID-19 vaccinated clusters, compared to neighboring counties, had lower numbers of Black population, individuals in poverty, and uninsured individuals, and lower values of SVI and CCVI, but a higher number of Hispanic population. This study emphasizes the importance of addressing systemic barriers, such as poverty and lack of health insurance, which were found to be associated with low COVID-19 vaccination coverage.

A scoping review of the reasons for and approaches to non-uptake of pertussis and influenza vaccinations in pregnant women in the United Kingdom and Ireland

BackgroundPertussis and influenza cause significant morbidity and mortality in pregnancy and the neonatal period. Maternal vaccination in pregnancy would reduce harm, but low vaccine uptake is a concern. This scoping review aimed to understand the reasons for, and approaches, to non-uptake of pertussis and influenza vaccinations in pregnant women in the UK and Ireland.MethodsThe inclusion criteria of this scoping review consist of pregnant women who avail of pertussis and influenza vaccines in the UK and Ireland. MEDLINE, EMBASE, Web of Science and CINAHL databases were searched in June 2021 and updated in October 2022. Searches were limited to English language reports published after 2011. We followed the Joanna Briggs Institute guidance on scoping reviews. Data were extracted and charted.ResultsFive themes emerged from the literature. Acceptability, as well as organisational and awareness issues, were overarching themes regarding reasons for and approaches to non-uptake of the vaccines respectively. Other themes included healthcare professional factors, information interpretation and pregnancy-related factors.ConclusionsWomen need clear, comprehensible information, ideally provided by their healthcare professionals, in a way that is meaningful and addresses their circumstances and risk perceptions. This research will serve as a base for future work that aims behaviour science interventions at the wider pregnant population as well as the target groups that have been identified in this review.

Potential contribution of vaccination uptake to occupational differences in risk of SARS-CoV-2: analysis of the ONS COVID-19 Infection Survey

ObjectivesTo assess variation in vaccination uptake across occupational groups as a potential explanation for variation in risk of SARS-CoV-2 infection.DesignWe analysed data from the UK Office of National Statistics COVID-19...

VACCINATION ATTITUDE AMONG HEALTHCARE WORKERS AT THE EARLY PHASE OF COVID-19 IN MALAYSIA

Background: Healthcare workers’ (HCWs) vaccination hesitancy during a pandemic can be problematic for the health system as these workers need to be fully vaccinated. Aims: This study aimed to determine the level of vaccine hesitancy and its associated factors among HCWs at the beginning of the COVID-19 pandemic. Methods: A cross-sectional study was conducted among randomly selected HCWs of a tertiary hospital in the state of Selangor, Malaysia, using an online questionnaire. The questions were designed to collect information on HCWs’ sociodemographic and health status and attitude towards vaccination. Higher scores for the four scales on attitude towards vaccination denote a higher level of vaccine hesitancy. Results: Of the 380 respondents (98% response rate), the overall score depicted low vaccine hesitancy despite the scores being slightly higher on worrying over unforeseen future effects and concerns about commercial profiteering. Women demonstrated a lower preference for natural immunity compared to men. Conclusion: In the context of this study, vaccine hesitancy among HCWs was low, which may indicate good acceptance. However, concerns about unforeseen future effects and commercial profiteering need to be addressed, and health education and promotion activities on the male workers in terms of preference for natural immunity need to be enhanced. Keywords: attitude, COVID-19, healthcare workers, vaccine hesitancy

Potential Impact of Public Communication on Emergency Presentations due to Headache during the Covid-19 Pandemic

Headache is a frequent presenting symptom in the emergency department. While most cases are of benign aetiology, it is crucially important to identify potentially dangerous underlying disorders. We hypothesized an increase in headache-related emergency presentations after venous thrombosis of cerebral sinuses had been identified as a rare side effect of vaccination with adenovirus vector-based Coronavirus-disease 2019 (COVID-19) vaccines and that information had been publicly communicated by the Paul Ehrlich Institute. Data from patients with the diagnosis of primary headache disorders or unspecified headache presenting to the Interdisciplinary Emergency Department of the University Medicine Mannheim were retrospectively analysed. Based on vaccination dashboard data published by the Federal Ministry of Health, calendar weeks 14-30 and 47-48, on the one hand, and 1-13 and 31-46, on the othe, were categorized into a variable "vaccination epoch" (14-30, 47-48: high vaccination activity if≥3 million weekly vaccinations in Germany; 1-13, 31-46: low vaccination activity if<3 million weekly vaccinations). The number of patients with headache was the dependent variable. A Poisson regression was performed to analyze whether the frequency of events, i. e., patient presentations, was a function of year (2019, 2021), epoch (high, low) and an interaction of year and epoch - the latter reflecting an impact of vaccination activity during the pandemic and expressed as incidence rate ratio. Compared to 2019, there was a more than 70% increase in presentations due to headache during periods of high vaccination activity in 2021 (p<0.001; 95% confidence interval 1.272-2.316), in 25% of presentations in 2021, patients considered their headache as vaccination-associated. Public communication and resulting nocebo effects may, among other factors, have contributed to our observation of increased numbers of emergency headache presentations, illustrating the impact of public distribution of medical information on practical aspects of emergency care during crises.

Analysis of adult vaccination in Shandong Province from 2018 to 2022

Objective: To analyze the utilization of adult vaccination among people aged 18 and above in Shandong Province from 2018 to 2022. Methods: Data on vaccination units in 2022 and individual cases of vaccination information for people aged 18 and above were extracted from the Shandong Immunization Information System. A descriptive analysis was conducted on the distribution of adult vaccination units and adult vaccination varieties. The total vaccination amount and vaccination rate were calculated. Results: By the end of 2022, there were 3 948 vaccination units providing adult vaccination in Shandong Province, with 0.36 adult vaccination clinics per 10 000 people. Adult vaccination including RabV(rabies vaccine for human use), InfV(influenza vaccine), HPV(human papillomavirus), HepB(hepatitis B vaccine), PPV23(23-valent pneumococcal polysaccharide vaccine), MenACYW135(meningococcal polysaccharide vaccine group ACYW135), MMR(measles, mumps and rubella combined attenuated live vaccine), HEV(hepatitise E vaccine), RZV(recombinant zoster vaccine), TV(tetanus vaccine) and HF(haemorrhagic fever with renal syndrome vaccine) vaccines were administered, with a cumulative dose of 40.056 9 million and an average of 0.1 doses per person per year from 2018 to 2022. The top three vaccines were RabV, InfV and HPV, accounting for 31.48%, 22.57%, and 15.93% of the total vaccination amount, respectively. The annual vaccination dose for adults increased from 3.477 3 million in 2018 to 13.308 6 million in 2022, with an average annual growth rate of 56.55%. The cumulative 5-year doses of RabV and TV were 15.90 doses per 100 people and 0.21 doses per 100 people. The average annual vaccination rate of InfV was 2.28%. The cumulative full vaccination rates of HPV, HepB, PPV23 and RZV were 12.44%, 1.61%, 0.52% and 0.17%, respectively. The cumulative 5-year doses of RabV and TV were 29.19 doses per 100 people and 0.43 doses per 100 people in the age group of 20 to<30 years old. The vaccination rates of InfV and PPV23 were 9.08% and 1.27% in the age group of 70 to<80 years old. The vaccination rate of RZV was 0.11% in the age group of 50 to<60 years old. The HPV vaccination rate was 18.09% in the age group of 20 to<30 years old, and the HepB, MenACYW135, MMR and HEV vaccination rates were 6.21%, 9.55%, 2.65%, and 2.83% in the 18-19 age group, respectively. Conclusion: There are relatively few types of adult vaccination in Shandong Province, with narrow coverage and low vaccination rates.

Knowledge, Attitude and Practice Regarding Hepatitis B among population of Sector O-9 Islamabad, A descriptive Cross Sectional Study

Background: Hepatitis B (HBV) remains a significant public health challenge globally, with varying prevalence and awareness levels across different regions. Understanding the Knowledge, Attitudes, and Practices (KAP) regarding HBV among different populations is crucial for effective public health interventions. Objective: This study aimed to assess the KAP regarding HBV among residents of Sector O-9, Islamabad, and to identify areas for potential health education and intervention. Methods: A descriptive, cross-sectional study was conducted involving 372 participants from Sector O-9, Islamabad. Data were collected using a prevalidated questionnaire covering demographic characteristics, and KAP related to HBV. The response rate was 87.94%. Data analysis included descriptive statistics and chi-square tests using SPSS software. Results: The majority of participants (73%) were aware of HBV, but specific knowledge gaps were evident, with 58% not recognizing HBV as a viral disease. Attitudinally, over 80% did not perceive themselves at risk for HBV. Regarding practices, while a high insistence on new blades for shaving was noted (100%), vaccination rates were low (26.4%), and consistent use of new syringes was reported by only 56.4%. The primary source of HBV information was through media and family/friends. Conclusion: The study revealed a reasonable level of general awareness about HBV among participants. However, specific knowledge gaps, low vaccination rates, and inconsistent preventive practices indicate the need for targeted health education and improved healthcare services. Public health interventions should focus on filling these gaps to enhance overall HBV management and control.

Antivirals for the treatment of mild and moderate COVID-19 in South Africa

While the majority of COVID‐19 cases in South Africa (SA) are mild, patients with severe COVID‐19 requiring hospitalisation present with significant morbidity and mortality and place a substantial burden on healthcare services. Given the low vaccine uptake in SA and other low‐ and middle‐income countries in sub‐Saharan Africa, the high prevalence of comorbidities and limited healthcare system capacity, evidence‐based interventions that reduce the risk of severe disease and death should be considered for implementation. Several antiviral classes have been newly developed or repurposed to treat COVID‐19 early after infection to retard progression to severe disease and reduce the risk of death, particularly in the elderly and/or in patients with comorbidities. COVID‐19 antivirals such as remdesivir, nirmatrelvir/ ritonavir and molnupiravir are safe and cost‐effective and have received either full approval or emergency use authorisation from regulators. Using a proposed test‐and‐treat strategy, judicious use of antivirals could be impactful.

Engaging staff to improve COVID-19 vaccination response at long-term care facilities (ENSPIRE): A cluster randomized trial of co-designed, tailored vaccine promotion materials

BackgroundCOVID-19 vaccination rates among long-term care center (LTCC) workers are among the lowest of all frontline health care workers. Current efforts to increase COVID-19 vaccine uptake generally focus on strategies that have proven effective for increasing influenza vaccine uptake among health care workers including educational and communication strategies. Experimental evidence is lacking on the comparative advantage of educational strategies to improve vaccine acceptance and uptake, especially in the context of COVID-19. Despite the lack of evidence, education and communication strategies are recommended to improve COVID-19 vaccination rates and decrease vaccine hesitancy (VH), especially strategies using tailored messaging for disproportionately affected populations. MethodsWe describe a cluster-randomized comparative effectiveness trial with 40 LTCCs and approximately 4000 LTCC workers in 2 geographically, culturally, and ethnically distinct states. We compare the effectiveness of two strategies for increasing COVID-19 booster vaccination rates and willingness to promote COVID-19 booster vaccination: co-design processes for tailoring educational messages vs. an enhanced usual care comparator. Our study focuses on the language and/or cultural groups that are most disproportionately affected by VH and low COVID-19 vaccine uptake in these LTCCs. ConclusionFinding effective methods to increase COVID-19 vaccine uptake and decrease VH among LTCC staff is critical. Beyond COVID-19, better approaches are needed to improve vaccine uptake and decrease VH for a variety of existing vaccines as well as vaccines created to address novel viruses as they emerge.

Knowledge, Health Practices and Policies for Hepatitis for Midwifery and Nurses in Allied and District Hospital Faisalabad

Background: Hepatitis B Virus (HBV) is a critical global health concern with significant morbidity and mortality. Nurses and midwives, as frontline healthcare professionals, are particularly vulnerable to HBV infection. This study focuses on evaluating the knowledge, attitudes, and practices (KAP) related to HBV among these groups in Faisalabad, Pakistan, a region with limited existing research on this topic. Methods: A descriptive, cross-sectional study was conducted in two major public maternity hospitals in Faisalabad (District and Allied hospitals). A structured questionnaire, pre-tested for validity, was administered to assess the KAP towards HBV. Statistical analysis was performed using SPSS Version 21, applying chi-square tests to explore associations between categorical variables. Results: The study sampled 110 healthcare workers (nurses and midwives). Key findings included Knowledge to be 58.2% of participants had an average level of HBV knowledge, Attitudes to be A majority displayed a positive attitude towards HBV prevention, Practices to be 65.5% reported adhering to safe practices. However, a clear percentage of 51.8% had experienced needlestick injuries. Vaccination and PEP found to be only 40.9% completed the HBV vaccination series, and 50% held misconceptions regarding HBV post-exposure prophylaxis. Conclusion: The study reveals a considerable awareness of HBV among nurses and midwives in Faisalabad hospitals, yet highlights critical gaps in both knowledge, particularly concerning PEP, and practices, as evidenced by high rates of needlestick injuries and low vaccination completion. These findings call for intensified efforts in occupational safety, education on HBV, and increasing vaccination coverage among healthcare workers.

Substantial Disparities In COVID-19 Vaccine Uptake And Unmet Immunization Demand In Low- And Middle-Income Countries.

The two primary narratives that have emerged to explain low COVID-19 vaccine uptake in low- and middle-income countries are constrained accessibility and vaccine hesitancy. However, it is unclear how much each issue contributes to low uptake. This article examines these twin barriers to access. Using global survey data from 15,696 respondents across seventeen Western Pacific and African countries, collected between May 2022 and January 2023, we estimated the unmet demand for vaccines and examined its predictors. We found that among unvaccinated respondents, by the time of the survey, 50percent had unmet demand-meaning they were still willing to get vaccinated. Rates of unmet demand were highest in African countries and lowest in Western Pacific countries. The perceived accessibility of vaccines and respondents' age and sex were identified as consistent predictors of unmet demand. These issues suggest that inequitable supply continues to play a substantial role in limiting vaccine access. Targeted efforts to increase vaccination rates are necessary, particularly in countries with low coverage and high unmet demand. Policy efforts should address barriers to vaccine access, ensure accessibility and distribution of mRNA vaccines, and aim to overcome vaccine hesitancy-all critical factors in reducing unmet immunization demand and achieving higher vaccination rates across regions.

Abstract C067: Evaluation of data from a new mobile HPV vaccination program in South Carolina, U.S.

Abstract Purpose: Human papillomavirus (HPV) infections are linked to at least six different types of cancer. The Medical University of South Carolina (MUSC) Hollings Cancer Center (HCC) and Department of Pediatrics leaders identified less-than-optimal HPV vaccination rates in rural and medically underserved communities in South Carolina (SC) (80% in urban cities vs. 62% in rural areas). Forty-three percent of SC’s 46 counties include areas classified as rural by the U.S. Census, and 14% of the state’s population lives in rural areas. SC’s population demographics are typical of the Deep South region of the U.S. and primarily comprise non-Hispanic White (69%) and non-Hispanic Black (27%) residents, with a small but growing Hispanic/Latinx population (6.0%). SC compares unfavorably with the U.S. averages in educational levels and per capita and median household incomes. These social determinants of health-related factors contribute to lower levels of knowledge about, and access to, the HPV vaccine. Methods: To address the major public health issue of low HPV vaccination rates in rural SC, the MUSC HCC and Department of Pediatrics created a statewide community engagement-focused HPV Vaccination Van Program with funding from the HealthyMe/HealthySC (HMHSC) program and MUSC HCC. The Program launched in October of 2021. It provides HPV and other childhood vaccinations in school districts, HMHSC health clinics, and other community settings throughout SC, focusing on children aged 9–18 years who are eligible for the U.S. Centers for Disease Control and Prevention’s Vaccines for Children Program. The prioritization of the selection of counties for inclusion in the Program is based on geospatial analyses highlighting the current HPV vaccination rates in each county. Results: As of 5 June 2023, the Program has administered childhood vaccinations to 734 participants in 28/46 counties (60%) of SC. Three-hundred and forty-six of the participants received HPV vaccinations. They were predominantly female (56.4%), aged 4–18 years (97.1%), and self-identified as non-Hispanic White (46.0%), non-Hispanic Black (31.9%), Hispanic/Latino (14.9%), Asian American (1.2%), Multiracial (3.3%), or Other (2.4%), with 0.3% of the participants not reporting their racial/ethnic identification. Slightly more than half of the participants (52.9%) had Medicaid insurance and 25.1% reported having no insurance coverage. Conclusions: The number of children receiving the HPV vaccine through the Program, and the number of counties served, is expected to expand as the Program’s relationship with SC’s school districts and other community-based organizations grows. The Program provides a model for delivering mobile HPV vaccinations to rural children, thus reducing their cancer risk. Citation Format: Marvella E. Ford, Kathleen B. Cartmell, Angela M. Malek, Nhi Phuong Le, Chloe Keeve, I'Ayana Sanders, Jerlinda Ross, Melanie Slan, Joan McLauren, Mina Platt, Ellen Gomez, Jessica Zserai, Beth Poore, Christina Cody, Victoria Ladd, Mary S. Beattie, J. David Suddoth, Kapri Kreps, James R. Roberts. Evaluation of data from a new mobile HPV vaccination program in South Carolina, U.S. [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C067.

Health service factors affecting the COVID-19 vaccination campaign in a Ghanaian metropolis: A qualitative exploratory study

ObjectiveThe study sought to explore the perspectives of vaccinators on the health system factors that impacted the COVID-19 vaccination campaign.DesignThe study employed an exploratory-descriptive qualitative design. Key-informants’ interviews were conducted...

Knowledge and Awareness of Hepatitis B Infection Among Young Adults in Ekiti, Nigeria: Implications for Education and Vaccination.

Aim Hepatitis B is a preventable infection with transmission of the virus through sex, by blood and from mother to child during childbirth. Youngadults are prone to some of these risk factors, yet data on awareness and knowledge of hepatitis B among them is still limited in Nigeria and none from our locality. The purpose of this study was to assess the knowledge and awareness of hepatitis B among young adults attending a tertiary health institution in Nigeria with the aim of givingrecommendations based on the findings. Methods A total of 223 young adults who attended the adolescent and young adult clinic of the Family Medicine Department of the Ekiti State University Teaching Hospital, Ado Ekiti between 1March and 31May2023 were analyzed using a predesigned self-administered questionnaire. Knowledge of hepatitis B was assessed by asking 12 questions relating to awareness of the disease, basic knowledge, route of transmission, the seriousness of the disease when compared to human immunodeficiency virus (HIV), complications from the disease, their vaccination status and the number of doses received by the participants. Results The prevalence of awareness of hepatitis B among respondents was 88 (39.5%). Of the223 respondents studied, 158 (70.9%) had a poor knowledge scoreof the disease. There was a significant association between the highest educational background of the respondents and awareness of hepatitis B (p=0.05). Awareness of hepatitis B was also associated withprevious participation in any health screening (p=0.04) and vaccine awareness (p=<0.001). The majority of the respondents with good knowledge scores of hepatitis B preferred social media for disseminating information about their health (p=0.03). Out of all the participants studied, only one(0.4%) had completed the three doses of the hepatitis B vaccine with 11 (4.9%) of them yet to get fully vaccinated. Conclusion Efforts are needed to target social media platforms with information about hepatitis B and vaccination. With awareness campaigns of hepatitis B directed at various social media platforms, this population at risk couldbe educated about the disease and the benefits of vaccination. The low vaccination state among the respondents brought to the fore the urgent need for the government to ensure the provision of appropriate interventions for viral hepatitis among young adults.