Low Vaccination Research Articles

13-Valent pneumococcal conjugate vaccines vaccination innovative strategy in Weifang City, China: a case study

The World Health Organization (WHO) prioritizes pneumococcal disease as a vaccine-preventable disease and recommends the inclusion of pneumococcal conjugate vaccines (PCV) in national immunization programs worldwide. However, PCV is not included in the National Immunization Program in China and has low vaccination coverage due to its high cost. To address this, Weifang City implemented an innovative strategy for a 13-valent PCV (PCV13) on June 1, 2021. This strategy aimed to provide one dose of PCV13 free of charge for children aged 6 months to 2 years in registered households and to adopt a commercial insurance model with one dose of PCV13 free of charge in 2023 for children over 2 years old. The Health Commission of Weifang and other departments conducted a comprehensive investigation and considered various factors, such as vaccine effectiveness, safety, accessibility, vaccine price, and immunization schedules, for eligible children (under 5 years old). Stakeholder opinions were also solicited before implementing the policy. The Commission negotiated with various vaccine manufacturers to maximize its negotiating power and reduce vaccine prices. The implementation plan was introduced under the Healthy Weifang Strategy. Following the implementation of this strategy, the full course of vaccination coverage increased significantly from 0.67 to 6.59%. However, vaccination coverage is still lower than that in developed countries. Weifang's PCV13 vaccination innovative strategy is the first of its kind in Chinese mainland and is an active pilot of non-immunization program vaccination strategies. To further promote PCV13 vaccination, Weifang City should continue to implement this strategy and explore appropriate financing channels. Regions with higher levels of economic development can innovate the implementation of vaccine programs, broaden financing channels, improve accessibility to vaccination services, and advocate for more localities to incorporate PCV13 into locally expanded immunization programs or people-benefiting projects. A monitoring and evaluation system should also be established to evaluate implementation effects.Graphical

Polio outbreak response, Yemen.

A decrease in vaccine coverage in conflict-affected areas has placed Yemen at higher risk of polio outbreaks caused by vaccine-derived poliovirus strains. In response to polio outbreaks, the Yemeni health ministry and partners initiated multiple vaccination campaigns to deliver vaccines to children. We also implemented several measures to enhance communication, education, health promotion and hygiene, especially in camps for internally displaced people. In 2009, Yemen achieved polio-free status and maintained it until 2019. However, the ongoing political conflict since 2015, coupled with challenges in delivering the polio vaccine to conflict-affected areas, resulted in two polio outbreaks: 35 cases caused by vaccine-derived poliovirus strain 1 between 2019 and 2021, and 230 cases due to vaccine-derived poliovirus strain 2 between November 2021 and December 2022. In response to the first outbreak, by the end of 2020, we vaccinated 7.2 million children through nationwide vaccination campaigns, except in Sa'ada governorate due to a ban by the authorities. By the end of 2021, 3 800 313 children younger than 5years had received polio vaccines. For the second outbreak, by the end of 2022, 4 463 389 vaccines had been given to children younger than 10years, and 1 217 423 to those younger than 5years. Vaccination campaigns in conflict-affected areas with low vaccine coverage remain crucial in eradicating polio. Efforts are needed to reach vulnerable groups such as displaced populations. Advocacy, communication and social mobilization actions help ensure broader public inclusion and participation in vaccination efforts to prevent polio outbreaks.

Detection and Characterization of Web-Based Pediatric COVID-19 Vaccine Discussions and Racial and Ethnic Minority Topics: Retrospective Analysis of Twitter Data.

Despite pediatric populations representing a smaller proportion of COVID-19 cases and having a less severe prognosis, those belonging to racial and ethnic minority groups are at an increased risk of developing more severe COVID-19-related outcomes. Vaccine coverage is crucial to pandemic mitigation efforts, yet since the start of the COVID-19 pandemic, vaccine hesitancy has increased and routine pediatric immunizations have decreased. Limited research exists on how vaccine hesitancy may contribute to low pediatric COVID-19 vaccine uptake among racial and ethnic minority populations. This study aimed to characterize COVID-19 vaccine-related discussion and sentiment among Twitter users, particularly among racial and ethnic minority users. We used the Twitter application programming interface to collect tweets and replies. Tweets were selected by filtering for keywords associated with COVID-19 vaccines and pediatric-related terms. From this corpus of tweets, we used the Biterm Topic Model to output topics and examined the top 200 retweeted tweets that were coded for pediatric COVID-19 vaccine relevance. Relevant tweets were analyzed using an inductive coding approach to characterize pediatric COVID-19 vaccine-related themes. Replies to relevant tweets were collected and coded. User metadata were assessed for self-reporting of race or ethnic group affiliation and verified account status. A total of 863,007 tweets were collected from October 2020 to October 2021. After outputting Biterm Topic Model topics and reviewing the 200 most retweeted tweets, 208,666 tweets and 3905 replies were identified as being pediatric COVID-19 vaccine related. The majority (150,262/208,666, 72.01%) of tweets expressed vaccine-related concerns. Among tweets discussing vaccine confidence, user replies expressing agreement were significantly outweighed by those expressing disagreement (1016/3106, 32.71% vs 2090/3106, 67.29%; P<.001). The main themes identified in the Twitter interactions were conversations regarding vaccine-related concerns including adverse side effects, concerns that the vaccine is experimental or needs more testing and should not be tested on pediatric populations, the perception that the vaccine is unnecessary given the perceived low risk of pediatric infection, and conversations associated with vaccine-related confidence (ie, the vaccine is protective). Among signal tweets and replies, we identified 418 users who self-identified as a racial minority individual and 40 who self-identified as an ethnic minority individual. Among the subcodes identified in this study, the vaccine being protective was the most discussed topic by racial and ethnic minority groups (305/444, 68.7%). Vaccine-related concerns can have negative consequences on vaccine uptake and participation in vaccine-related clinical trials. This can impact the uptake and development of safe and effective vaccines, especially among racial and ethnic minority populations.

Long-term vaccination strategies to mitigate the impact of SARS-CoV-2 transmission: A modelling study.

Vaccines have reduced severe disease and death from Coronavirus Disease 2019 (COVID-19). However, with evidence of waning efficacy coupled with continued evolution of the virus, health programmes need to evaluate the requirement for regular booster doses, considering their impact and cost-effectiveness in the face of ongoing transmission and substantial infection-induced immunity. We developed a combined immunological-transmission model parameterised with data on transmissibility, severity, and vaccine effectiveness. We simulated Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) transmission and vaccine rollout in characteristic global settings with different population age-structures, contact patterns, health system capacities, prior transmission, and vaccine uptake. We quantified the impact of future vaccine booster dose strategies with both ancestral and variant-adapted vaccine products, while considering the potential future emergence of new variants with modified transmission, immune escape, and severity properties. We found that regular boosting of the oldest age group (75+) is an efficient strategy, although large numbers of hospitalisations and deaths could be averted by extending vaccination to younger age groups. In countries with low vaccine coverage and high infection-derived immunity, boosting older at-risk groups was more effective than continuing primary vaccination into younger ages in our model. Our study is limited by uncertainty in key parameters, including the long-term durability of vaccine and infection-induced immunity as well as uncertainty in the future evolution of the virus. Our modelling suggests that regular boosting of the high-risk population remains an important tool to reduce morbidity and mortality from current and future SARS-CoV-2 variants. Our results suggest that focusing vaccination in the highest-risk cohorts will be the most efficient (and hence cost-effective) strategy to reduce morbidity and mortality.

2382. Sociodemographic and Occupational Characteristics Associated with Delayed and Low COVID-19 Vaccine Uptake Among Healthcare Personnel: Monroe County, NY

Abstract Background Healthcare personnel (HCP) have remained at high risk for SARS-CoV-2 infection during the COVID-19 pandemic. High and timely COVID-19 vaccine uptake is crucial to protect this at-risk population. Our study aims to characterize HCP who delayed initiation of the primary series, and those who did not receive a booster dose. Methods Data for this analysis came from a cohort of HCP working at a large healthcare system in Monroe County, NY identified between 12/28/2020-12/01/2022. HCP were enrolled as part of the CDC Emerging Infections Program COVID-19 vaccine effectiveness study using a test-negative case-control design. Participants completed a standardized questionnaire assessing demographic and occupational characteristics. Verified COVID-19 vaccination history for each HCP was collected during the study period. HCP were categorized as having early or delayed vaccine initiation if they received their 1st mRNA COVID-19 vaccine between 12/14/2020-03/30/2021 (early) or 04/01/2021-09/28/2021 (delayed) after which employee vaccine mandates were implemented at this hospital system. HCP were also categorized as having received a 3rd mRNA COVID-19 booster dose or not after 09/24/2021. Logistic regression models were run to identify characteristics of HCP who delayed 1st dose receipt or did not receive a booster dose. Results Across the study period, 3,471 HCP were enrolled. Of these, 86.0% had early initiation of their 1st mRNA COVID-19 vaccine, and 82.8% received an mRNA booster dose. Low education, low household income, younger age (&amp;lt; 50), non-White race and public health insurance were all significant predictors of delayed receipt of 1st dose and lack of uptake of a booster. However, advanced professional role was only found to be a significant predictor of early 1st dose receipt (Figure 1). Sensitivity analyses, run by changing dates of early vs delayed initiation to later time points, validated these results.Figure 1.Sociodemographic and Occupational Characteristics Associated with COVID-19 Vaccine Coverage Among Healthcare Personnel (N=3,471) +Adjusted for gender, race/ethnicity, and education. ++Adjusted for gender and race/ethnicity. *Adjusted for professional role, educational attainment, and race/ethnicity. **Adjusted for gender, age, educational attainment, professional role, annual household income, and health insurance type. Other Role with Moderate or Minimal Patient Contact includes: Nonphysician behavioral health provider, chaplain, care coordinator, dietician, environmental services personnel, food services personnel, patient transport personnel, research personnel, social worker, student, facilitates maintenance personnel, medical equipment technician, laboratory personnel or pharmacist. Other Role with Substantial Patient Contact includes: Dental healthcare provider, emergency medical services personnel, occupational therapist, physical therapist or assistant, phlebotomist, respiratory therapist, radiology technician, speech-language pathologist, and surgical, medical or emergency technician. Conclusion Sociodemographic characteristics, rather than occupational, were predictive of high and timely vaccine uptake. Continual monitoring of COVID-19 vaccine uptake among HCP to identify those less likely to receive new booster doses will be crucial for maintaining high vaccination rates in this important population. Disclosures Ghinwa Dumyati, MD, Pfizer: Grant/Research Support

“Vaccine? No, thank you!” Social Media, Right-Wing Political Orientation and COVID-19 Vaccination Hesitancy: The Case of Pieria, Greece

This case study examines the situation of the regional unit Pieria (Greece) as a compelling instance of a regional unit with low vaccination coverage and a right-wing political orientation, depth, and historicity. Apart from the utilization of relevant literature, qualitative research was also conducted for the needs of this case study. A sample of 16 Greek citizens from Pieria, all of whom are voters of one of the three minor Greek right-wing parliamentary parties and have been vaccine hesitant and vocal on social media, is examined as an attempt to enhance our understanding on the role of social media and right-wing attitude regarding vaccine hesitancy within the context of this specific case.

Comparative pathogenomic analysis reveals a highly tetanus toxin-producing clade of Clostridium tetani isolates in Japan.

C. tetani is a spore-forming, anaerobic bacterium that produces a toxin causing muscle stiffness and paralysis. Tetanus is preventable with the toxoid vaccine, but it remains a significant public health threat in regions with low vaccine coverage. However, there are relatively few isolates and limited genomic information available worldwide. In Japan, about 100 cases are reported each year, but there have been no nationwide surveys of isolates, and no genomic information from Japanese isolates has been published. In our study, we analyzed the genomes of 151 strains from a limited survey of soil in Kumamoto, Japan. Our findings revealed a high degree of genetic diversity, and we also identified a subset of strains that produced significantly more toxin, which provides new insights into the pathogenesis of tetanus. Our findings lay the foundation for future studies to investigate the distribution and evolution of C. tetani in Japan and neighboring countries.

The Social Contagion Potential of Pro-Vaccine Messages on Black Twitter

ABSTRACT Black Americans in the US not only suffered from disproportionately high hospitalization and death rates throughout the pandemic but also from the consequences of low COVID-19 vaccination rates. This pattern of disparity is linked to distrust of public health systems that originates from a history of medical atrocities committed against Black people. For that reason, mitigation of race-based inequity in COVID-19 impacts might find more success in grassroots information contagion than official public health campaigns. While Black Twitter is well-positioned as a conduit for such information contagion, little is known about message characteristics that would afford it. Here, we tested the impact of four different message frames (personalization, interactive, fear appeal, neutral) on the social contagion potential of bi-modal social media messages promoting COVID-19 vaccinations and finding personalized messages to be the most shareable. Wary of recommending personalization as the blueprint for setting a social contagion health campaign in motion, we probed further to understand the influence of individual-level variables on the communicability of personalized messages. Subsequently, regression models and focus group data were consulted, revealing that thinking styles, vaccine confidence levels, and attitudes toward social media were significant factors of influence on the contagion potential of personalized messages. We discussed the implications of these results for health campaigns.

Molecular and Pathological Characterization of Classical Swine Fever Virus Genotype 2 Strains Responsible for the 2013-2018 Outbreak in Colombia.

Classical swine fever (CSF) is a highly contagious transboundary viral disease of domestic and wild pigs. Despite mass vaccination and continuous eradication programs, CSF remains endemic in Asia, some countries in Europe, the Caribbean and South America. Since June 2013, Northern Colombia has reported 137 CSF outbreaks, mostly in backyard production systems with low vaccination coverage. The purpose of this study was to characterize the virus responsible for the outbreak. Phylogenetic analysis based on the full-length E2 sequence shows that the virus is closely related to CSF virus (CSFV) genotype 2.6 strains circulating in Southeast Asia. The pathotyping experiment suggests that the virus responsible is a moderately virulent strain. The 190 nucleotide stretch of the E2 hypervariable region of these isolates also shows high similarity to the CSFV isolates from Colombia in 2005 and 2006, suggesting a common origin for the CSF outbreaks caused by genotype 2.6 strains. The emergence of genotype 2.6 in Colombia suggests a potential transboundary spread of CSFV from Asia to the Americas, complicating the ongoing CSF eradication efforts in the Americas, and emphasizes the need for continuous surveillance in the region.

Variability of Vaccine Responsiveness in Young Children.

Variability in vaccine responsiveness among young children is poorly understood. Nasopharyngeal secretions were collected in the first weeks of life for measurement of cytokines/chemokines seeking a biomarker, and blood samples were collected at age 1 year to identify vaccine responsiveness status, defined as low vaccine responder (LVR), normal vaccine responder (NVR), and high vaccine responder (HVR), to test for vaccine antigen-induced immune memory and for antigen-presenting cell (APC) function. Significantly lower specific cytokine/chemokine levels as biosignatures, measurable in nasopharyngeal secretions at infant age 1-3 weeks, predicted LVR status compared to NVR and HVR children. Antibiotic exposures were correlated with increased occurrence of LVR. At age 1 year, LVRs had fewer CD4+ T-helper 1 and T-helper 2 memory cells responsive to specific vaccine antigens. APC responses observed among LVRs, both at rest and in response to Toll-like receptor 7/8 stimulation by R848, were suboptimal, suggesting that altered innate immunity may contribute to immune deficiency in LVRs. Cytokine biosignatures in the first weeks of life may predict vaccine responsiveness in children during the first year of life. Antibiotic exposure is associated with LVR in children. CD4+ T-cell memory induction and APC deficiencies occur in LVR children.

The impact of vaccine-linked chemotherapy on liver health in a mouse model of chronic Trypanosoma cruzi infection.

Chagas disease, chronic infection with Trypanosoma cruzi, mainly manifests as cardiac disease. However, the liver is important for both controlling parasite burdens and metabolizing drugs. Notably, high doses of anti-parasitic drug benznidazole (BNZ) causes liver damage. We previously showed that combining low dose BNZ with a prototype therapeutic vaccine is a dose sparing strategy that effectively reduced T. cruzi induced cardiac damage. However, the impact of this treatment on liver health is unknown. Therefore, we evaluated several markers of liver health after treatment with low dose BNZ plus the vaccine therapy in comparison to a curative dose of BNZ. Female BALB/c mice were infected with a bioluminescent T. cruzi H1 clone for approximately 70 days, then randomly divided into groups of 15 mice each. Mice were treated with a 25mg/kg BNZ, 25μg Tc24-C4 protein/ 5μg E6020-SE (Vaccine), 25mg/kg BNZ followed by vaccine, or 100mg/kg BNZ (curative dose). At study endpoints we evaluated hepatomegaly, parasite burden by quantitative PCR, cellular infiltration by histology, and expression of B-cell translocation gene 2(BTG2) and Peroxisome proliferator-activated receptor alpha (PPARα) by RT-PCR. Levels of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were quantified from serum. Curative BNZ treatment significantly reduced hepatomegaly, liver parasite burdens, and the quantity of cellular infiltrate, but significantly elevated serum levels of ALT, AST, and LDH. Low BNZ plus vaccine did not significantly affect hepatomegaly, parasite burdens or the quantity of cellular infiltrate, but only elevated ALT and AST. Low dose BNZ significantly decreased expression of both BTG2 and PPARα, and curative BNZ reduced expression of BTG2 while low BNZ plus vaccine had no impact. These data confirm toxicity associated with curative doses of BNZ and suggest that while dose sparing low BNZ plus vaccine treatment does not reduce parasite burdens, it better preserves liver health.

Knowledge, Attitudes, Intentions and Vaccine Hesitancy among Postpartum Mothers in a Region from the Northwest of Romania.

This study aims to identify the presence of vaccine hesitancy and the factors that could have determined it in a group of mothers in the postpartum period, with an evaluation of both the level of knowledge and information, as well as the attitudes, perceptions, intentions and sources of information about vaccination. The study was based on a survey-Vaccine Hesitancy Identification Survey-applied in two maternity wards from Bihor County and structured into six subscales (34 items). Based on the answers to the key questions ("Which of the following statements best describes your plans for vaccinating your child?"-item 1 of subscale 4; "Overall, how hesitant do you consider yourself to be about vaccinating your child?"-item 4 of subscale 4), we identified two groups: the group of mothers without hesitant behavior (non-hesitant), called the group pro vaccine (GPV), and the group of mothers with hesitant behavior, called the group non vaccine (GNV). Vaccine hesitancy was identified in our study in 47.28% of the participants (191 of the 404 mothers included). Most of them come from an urban environment (57.59%), have university and post-secondary education (58.64%) and are prim parous (58.64%). The behavior of participants from GNV is influenced by a low level of knowledge and information regarding vaccination and by concerns related to adverse reactions, new vaccines and the number of vaccines administered. Also, this group is characterized by an increased perception of the risks related to vaccination, while the perception of the risks associated with the disease is low. For all subscales, important differences were registered between the two groups in favor of GPV, a group characterized by positive attitudes and perceptions and a better level of knowledge compared to GNV. This study aims to represent a starting point for the organization and running of information campaigns regarding vaccination at the level of Bihor County, especially in areas with low vaccination coverage, where this behavior is identified.

The emergence and successful elimination of SARS-CoV-2 dominant strains with increasing epidemic potential in Taiwan’s 2021 outbreak

Taiwan’s experience with severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003 guided its development of strategies to defend against SARS-CoV-2 in 2020, which enabled the successful control of Coronavirus disease 2019 (COVID-19) cases from 2020 through March 2021. However, in late-April 2021, the imported Alpha variant began to cause COVID-19 outbreaks at an exceptional rate in Taiwan. In this study, we aimed to determine what epidemiological conditions enabled the SARS-CoV-2 Alpha variant strains to become dominant and decline later during a surge in the outbreak. In conjunction with contact-tracing investigations, we used our bioinformatics software, CoVConvert and IniCoV, to analyze whole-genome sequences of 101 Taiwan Alpha strains. Univariate and multivariable regression analyses revealed the epidemiological factors associated with viral dominance. Univariate analysis showed the dominant Alpha strains were preferentially selected in the surge’s epicenter (p = 0.0024) through intensive human-to-human contact and maintained their dominance for 1.5 months until the Zero-COVID Policy was implemented. Multivariable regression found that the epidemic periods (p = 0.007) and epicenter (p = 0.001) were two significant factors associated with the dominant virus strains spread in the community. These dominant virus strains emerged at the outbreak’s epicenter with frequent human-to-human contact and low vaccination coverage. The Level 3 Restrictions and Zero-COVID policy successfully controlled the outbreak in the community without city lockdowns. Our integrated method can identify the epidemiological conditions for emerging dominant virus with increasing epidemiological potential and support decision makers in rapidly containing outbreaks using public health measures that target fast-spreading virus strains.

Strengthening immunization programs through innovative sub-national public-private partnerships in selected provinces in the Democratic Republic of the Congo

BackgroundLow immunization coverage rates in the Democratic Republic of Congo (DRC) have been reflective of challenges with vaccine access, support and delivery in the country. Motivated by measles and vaccine-derived polio virus (VDPV) outbreaks in 2016–17 and low vaccination rates, the provinces of Haut Lomami and Tanganyika were identified as pilot locations for an innovative approach focused on establishing a consortium of partners supporting local government. This approach was formalized through Memorandums of Understanding (MoUs) between the Bill and Melinda Gates Foundation and Provincial governments in 2018. A third province, Lualaba, established an MoU in 2021. MoU implementationThese MoUs were 5-year partnerships designed to aid provinces in meeting four key objectives: 80 % immunization coverage, management/elimination of polio/cVDPV outbreaks, improvement of vaccine accessibility, and transfer of immunization service management to provincial leadership. OutcomesDuring the MoU period, Haut-Lomami saw an increase in full immunization coverage, from 35.7 % (MICS 2018) to 88.9 % (VCS 2021–22), the highest in country. A sharp drop in percentage of zero-dose children was observed in the 3 provinces, confirming improved access to immunization services. Tanganyika saw initial improvement in full immunization coverage, followed by a drop in the VCS 2021–22 due to COVID-19 and healthcare worker strikes. Coverage improved in Tanganyika in the 2023 VCS. The 3 provinces increased their financial contributions to routine immunization and are now the top contributing provinces. While no cVDPV cases were recorded in 2020 and 2021, cVDPV1 and cVDPV2 outbreaks are afflicting the 3 provinces since 2022. ConclusionsUltimately, the provincial MoUs were successful in bolstering provincial autonomy and capacity building with the biggest success being a drop in zero-dose children. While not all objectives have been met, the MoU approach served as an innovative program for key aspects of strengthening routine immunization in the DRC.

Public perception of the resumption of HPV vaccine recommendation in Japan: Twitter content analysis.

On 12 November 2021, after a stagnation of 8.5 years, Japan decided to resume proactive recommendations for HPV vaccines. However, it is not known how the public reacted to the resumption of proactive recommendations for HPV vaccines, which are key elements in health communication that promote HPV vaccination. This study aimed to capture discussions on HPV vaccination on Twitter and to identify user characteristics, sentiments, discussed themes and their potential reach before and after 12 November 2021, when the Ministry of Health, Labour, and Welfare's decision to resume proactive recommendation for HPV vaccines was first reported by the media in Japan. This study conducted a content analysis of tweets related to HPV vaccines posted on 11 November and 12 November 2021. Tweets were coded in terms of user characteristics, sentiments (i.e. positive, negative and neutral) and themes. Reach was measured by the number of retweets, likes and followers. A total of 3623 tweets were identified. The results showed that approximately 50% of health professionals and researchers tweeted neutral content about HPV vaccines. The most frequently discussed theme was the safety and side effects of HPV vaccines, which was accompanied by mainly negative sentiments. Although health professionals and researchers are influential on Twitter, half of them tweeted neutrally about HPV vaccines. Influential professionals, such as health professionals and researchers, are expected to disseminate accurate information to correct misinformation and recommend HPV vaccination on Twitter to overcome the HPV vaccination crisis, which is characterized by the low vaccination rates.

Mitigating Hepatitis B Transmission: Urgent Call for Global Vaccination Strategies Among Healthcare Professionals

This study investigates the impact of hepatitis B (HB) vaccination among healthcare professionals in the Medina region, addressing the global concern of HB infection transmission. With only 25% of healthcare workers vaccinated, a significant gap exists in immunization coverage. The study reveals a lack of awareness among participants regarding HBV transmission to patients. To mitigate this, the research emphasizes the urgent need for establishing HBV vaccine promotion programs in primary care settings. Results underscore the importance of targeted education for healthcare workers to enhance vaccination rates and ultimately protect patients from hepatitis B infection. The findings call for immediate intervention and global collaboration to implement effective strategies in healthcare settings.&#x0D; Highlight:&#x0D; &#x0D; &#x0D; Low Vaccination Rate: Only 25% of healthcare workers in the Medina region are vaccinated against hepatitis B, indicating a substantial gap in immunization coverage among this critical population.&#x0D; &#x0D; &#x0D; Awareness Gap: The study highlights a significant lack of awareness among participants regarding the transmission of HBV to patients, underscoring the need for targeted educational initiatives.&#x0D; &#x0D; &#x0D; Urgent Intervention: The research emphasizes the immediate need for the establishment of hepatitis B vaccine promotion programs in primary care settings, calling for global collaboration to implement effective strategies and protect patients from hepatitis B infection.&#x0D; &#x0D; &#x0D; Keyword: Hepatitis B Vaccination, Healthcare Professionals, Immunization Coverage, HBV Transmission, Primary Care Settings

Trends in age-specific varicella incidences following the introduction of the general recommendation for varicella immunization in Germany, 2006–2022

BackgroundIn Germany, general childhood varicella vaccination has been recommended since 2004. A feared effect of low vaccination coverage is a possible shift in incidence from children to teenagers and young adults who are at higher risk of severe outcomes. If true, this shift would possibly necessitate changes to the national immunization strategy.We aimed to evaluate the effects of the general vaccination recommendation on age-specific varicella incidences in Germany in general and examine specifically whether a shift from children to teenagers (15 to 19 years) has occurred.MethodsTrends in age-specific incidences were evaluated using triangulation with the following datasets: national mandatory notification data (N) (2014–2022), billing data of the statutory health insurance associations (I) (2009–2017) and data from a doctor's sentinel system (S) (2006–2017). Similar clinical case definitions were used in N and S, while I used ICD-10-codes. Age groups were stratified as available in all three systems. Incidences per year were calculated based on the total population (N), the number of statutory health insured (I), and extrapolated from S to the total population.ResultsDuring all years of observation, age-specific incidences have dropped significantly across all age-groups for S und I. The age groups (under 10 years) with initially highest incidences were the ones with the strongest reductions (under 1 year: -90%, 1–4 years: -95.5%, 5–9 years: -89.2% for S; -67.7%, -78%, -79.3% for I). A single 53.1% increase in the low incidence in S among 15–19-year olds observed in 2017 compared to 2016 could not be confirmed in N or I. Increases in incidences during the first two years of N are probably due to improved notification behaviour over these years. In 2019, all age-specific incidences increased (N), with 15 to 19-year olds showing the highest relative increase (28.2%).ConclusionsSince the introduction of the general vaccine recommendation against varicella, incidences across all age-groups have declined significantly. Available data indicate no evidence for a shift in disease incidence to older age groups. Every incidence increase beyond childhood age should however be followed up closely. So far, children and adolescents have both benefitted from the current vaccination strategy.

Factors influencing human papillomavirus vaccination uptake in European women and adolescents: A systematic review and meta-analysis.

Cervical Cancer (CC) lingers as a severe public health issue due to low vaccination coverage and poor screening addressability. Hence, this systematic review explored psychological factors influencing the Human Papilloma Virus (HPV) vaccination uptake in European women. As of September 2022, PubMed, EMBASE, Scopus, and Web of Science were systematically searched to include English studies assessing diverse factors influencing vaccination uptake in European women. Only studies comparing vaccinated with unvaccinated women were included. Quality assessment, publication attrition assessment, and sensitivity analyses were performed. Eighteen studies were included, totaling a population of 18,611 participants. Results indicated that knowledge about HPV infection could positively influence vaccination rates with an Odds Ratio (OR) of 1.82 and a confidence interval (CI) between 1.27 and 2.61, showing statistical significance at a Z value of 3.24 with a p-value of 0.001. Neither knowledge about HPV vaccination (OR=1.39, CI: 0.73-2.65, Z=1.01, p=0.31) nor knowledge about CC screening (OR=1.05, CI: 0.55-1.98, Z=0,14, p=0.89) seem to affect vaccination rates. Regardless, intention to undertake CC screening (CCS) showed an OR=1.68 in favor of the group intending to perform it, with a CI between 1.37 and 2.07, showing statistical significance at a Z=4.94 and p=0.00001. Other aspects affecting vaccination uptake were fear of side effects, insufficient information, and belief that chances of being infected are low. Results demonstrated that diverse aspects could affect the vaccination intent, while personalized interventions focusing on population and country characteristics need to be assembled to mitigate vaccination coverage.

Salmonella Vaccine Study in Oxford (SALVO) trial: protocol for an observer-participant blind randomised placebo-controlled trial of the iNTS-GMMA vaccine within a European cohort

IntroductionInvasive non-typhoidal Salmonellosis (iNTS) is mainly caused by Salmonella enterica serovars Typhimurium and Enteritidis and is estimated to result in 77 500 deaths per year, disproportionately affecting children under 5...

Factors Related to Low COVID-19 Vaccination Rate in Pregnant and Postpartum Women with and without COVID-19.

This study focused on pregnant and postpartum women during the COVID-19 pandemic, aiming to determine the attitudes and behaviors of vaccinated and unvaccinated groups, and the vaccination behaviors in the groups with and without the disease. The reasons for refusing the vaccine were also questioned. This cross-sectional study was performed from September 2021 to October 2021. The study data were collected using a face-to-face questionnaire. The participants were pregnant women who applied to the hospital for routine antenatal care and were hospitalized, and women in the postpartum period. Additionally, pregnant and postpartum patients who were diagnosed with COVID-19 at the time of admission and were hospitalized and admitted to the intensive care unit due to this disease were also included in the study. A total of 1,146 pregnant and postpartum women who completed the questionnaire were included in our study. Only 43 (3.8%) of the participants were vaccinated; 154 (13.4%) of the participants had comorbidities. The number of COVID-19-positive patients was 153. The lack of sufficient information about the safety of the COVID-19 vaccine is the most common reason for the refusal. Vaccine refusal can significantly delay or hinder herd immunity, resulting in higher morbidity and mortality. Considering the adverse effects of COVID-19 on pregnancy, it is essential to understand pregnant and postpartum women's perceptions toward vaccination to end the pandemic.