Low Vaccination Rates Research Articles

Low Influenza Vaccine Uptake; What is the Impact in Hospitalised Children

Seasonal influenza is an RNA virus spread by droplets. The burden of disease is significant, particularly in children under five, and in those with underlying health conditions. Vaccination against influenza is effective and recommended for all children aged 2-16, and those from 6 months of age with underlying health conditions. We completed a retrospective study examining the notes of all patients presenting to a large tertiary children’s hospital in the UK with confirmed seasonal influenza over the 2022/2023 season. 238 children were included in this study. 88/238 (37.0%) children in our cohort were under 2. 112/238 (47.1%) were discharged from ED. 41/238 (17.2%) were admitted for observation for 24 hours. 41/238(17.2%) stayed 3 days or longer. 1 child passed away. Overall 73/238 (30.6%) had a significant comorbidity, in those under 2 13/88 (14.8%) had a comorbidity. 13/238 (5.4%) were admitted to PICU or HDU. 30/238 (12.6%) received Oseltamivir, 114/238 (47.8%) children were given antibiotic therapy at presentation for a presumed secondary bacterial infection. 13/238 (5.4%) were vaccinated 14 days or more prior to presentation. 0 children admitted to HDU or PICU were vaccinated. Due to delays and vaccine availability and hesitancy we had very low rates of vaccination. Our results show the impact of influenza on an unvaccinated cohort. Just under half of all children were given antibiotics for a presumed secondary bacterial infection. We highlight that a significant number did not have an underlying comorbidity. This is most notable in the under 2 cohort. This reinforces data supporting the importance of vaccination in children and raises the question of whether we should extend our vaccination program to cover all children over 6 months of age.

Improving Childhood Vaccination Rates with Process Innovation in Central Zone, Alberta.

This project aimed to accurately assess the current state of routine immunization program delivery in a Central Zone community in Alberta and provide actionable recommendations supported by literature review. Engaging with frontline public health nurses responsible for immunization program delivery in the community, contributing factors to low vaccination rates, process inefficiencies and policy gaps were identified. Based on additional literature, strategies to mitigate these gaps with the goal of increasing vaccination rates were proposed and validated. Although in this case, strategies to mitigate process inefficiencies were the most supported given program funding, a multi-pronged approach is still recommended to drive long-term improvements in vaccination rates.

Inherent Attitudes or Misplaced Policies? Explaining COVID-19 Vaccine Hesitancy in Romania

hesitancy toward COVID-19 vaccines was not particularly high in Romania at the beginning of the vaccination campaign. Nevertheless, the country became one of the laggards in the European Union in terms of vaccination rates. We aim to provide an empirical explanation for this phenomenon based on a representative survey conducted in November–December 2021. We test the influence of various factors on vaccine hesitancy, such as personal experiences with the disease, trust in relevant institutions, general worldviews, and the contact with certain institutions, such as the Romanian Orthodox Church, and general practitioners. Furthermore, we find that three COVID-specific cognitive factors played a crucial role in this respect, namely the evaluation of anti-COVID state measures, belief in COVID-related conspiracy theories, and, especially, fears of negative effects of COVID-19 vaccines. The high explanatory power of these three factors also shows that low vaccination rates were not inevitable consequences of some “inherent” attitudinal characteristics widespread in the Romanian society; on the contrary, vaccine hesitancy has developed as an unfortunate side effect of weak crisis management, as the government and relevant state institutions failed to properly utilize key organizational resources, such as the national network of general practitioners, and proved to be unable to dissipate fears and countervail the spread of conspiracy theories, while emergency measures did not resonate enough among the Romanian public.

Molecular Determinants of Drug Resistance and Mutation Patterns in Influenza Viruses Circulating in Poland Across Multiple Epidemic Seasons: Implications for Vaccination Strategies.

BACKGROUND According to the WHO, up to 650 000 people die each year from seasonal flu-related respiratory illnesses. The most effective method of fighting the virus is seasonal vaccination. However, if an infection does occur, antiviral medications should be used as soon as possible. No studies of drug resistance in influenza viruses circulating in Poland have been systematically conducted. Therefore, the aim of the present study was to investigate the drug resistance and genetic diversity of influenza virus strains circulating in Poland by determining the presence of mutations in the neuraminidase gene. MATERIAL AND METHODS A total of 258 clinical specimens were collected during the 2016-2017, 2017-2018, and 2018-2019 epidemic seasons. The samples containing influenza A and B were analyzed by RT-PCR and Sanger sequencing. RESULTS Differences were found between the influenza virus strains detected in different epidemic seasons, demonstrating the occurrence of mutations. Influenza A virus was found to be more genetically variable than influenza B virus (P<0.001, Kruskal-Wallis test). However, there was no significant difference in the resistance prevalence between the influenza A subtypes A/H1N1/pdm09 (4.8%) and A/H3N2/ (6.1%). In contrast, more mutations of drug-resistance genes were found in the influenza B virus (P<0.001, chi-square test). In addition, resistance mutations appeared en masse in vaccine strains circulating in unvaccinated populations. CONCLUSIONS It seems important to determine whether the influenza virus strains tested for drug resistance as part of global influenza surveillance are equally representative of viruses circulating in populations with high and low vaccination rates, for all countries. Our results suggest that countries with low levels of influenza immunization may constitute reservoirs of drug-resistant influenza viruses.

COVID-19 Vaccine Perspective From Adolescents' Lens in the US.

Introduction The COVID-19 pandemic has presented an unprecedented global health issue. The World Health Organization estimates 773 million confirmed cases and 7 million deaths. Vaccination continues to be the most effective way to prevent COVID-19 and has demonstrated safety and efficacy in all age groups. Though a lot of studies have looked at COVID-19 vaccination acceptance and hesitancy in adults, there is scarce research addressing adolescent vaccination readiness. COVID-19 infection in this age group may result in lost school days, school and community transmission, and loss of productivity for parents. Aim This study aims to determine COVID-19 vaccination rates and factors influencing its acceptance and hesitancy in adolescents in a community setting. Methods A voluntary survey was conducted at a local high school in May 2023. Information was collected about the demographics of adolescents and the educational background of parents/guardians. The survey assessed the COVIDvaccine rate, reasons for COVID-19 vaccine acceptance or refusal, number of doses of COVID-19 vaccine and boosters received, prior history of COVID-19 infection, source of information on COVID-19 vaccine, flu vaccine acceptance by the students, and whether they would be willing to take a COVID-19 vaccine booster. Results Four hundred participants, ranging in age from 13 to 19, were surveyed. The vaccination rate in boys was comparable to that in girls. 72% received at least one COVID-19 vaccine, and 66% were considered completely vaccinated. Of those completely vaccinated, 80% had undergone further updated COVID-19 booster vaccinations. Adolescents whose parents/guardians were college graduates had a higher vaccination rate than those whose parents/guardians were not. Caucasians and Asians had a higher vaccination rate compared to African Americans and mixed races. The vaccination rate was not statistically different in adolescents with prior COVID-19 infection versus no prior infection. Flu vaccination was associated with higher COVID-19 vaccination rates. Lack of trust was an important reason for vaccine hesitancy, along with questions about efficacy, concerns about side effects, parent/guardian decisions, and religious reasons. Protecting oneself, family/friends, and community were the major reasons to take the vaccine. Parents/guardians, physicians, peers, television, social media, flyers, and schools were the primary sources that adolescents relied on for information about the COVID-19 vaccination. Conclusion Lower education attainment among parents/guardians, African Americans, and mixed races was associated with lower vaccination rates. Lack of trust in the vaccine, questions about efficacy, and fear of side effects were the most frequently cited reasons for vaccine hesitancy. Parent/guardian influence and religious reasons were other significant reasons for vaccine hesitancy. Flu vaccination was associated with higher COVID-19 vaccination rates. Understanding factors influencing COVID-19 vaccination will allow us to address barriers to COVID-19 vaccination and other vaccinations appropriate for this age group. Educating adolescents in schools, involving local and state health departments to increase awareness about the vaccine, and educating parents and guardians along with the teenagers can help increase the acceptance of the vaccine. These interventions will also positively affect the acceptance of the booster and prepare us for any future pandemics.

Assessment of severity and feto-maternal outcomes among COVID-19 infected pregnant females hospitalized at tertiary care center in western Nepal

Objective: There is a paucity of data assessing the severity of coronavirus disease 2019 (COVID-19) infection and feto-maternal outcomes in pregnant women in Nepal, especially during the third wave of the pandemic with the Delta variant. This study aimed to severity as well as maternal-fetal outcomes among pregnant women with COVID-19 infection. Methods: In this cross-sectional study carried out amongst COVID-19 positive pregnant women visiting our institution for 6 months from January through June 2022, data surrounding COVID-19 severity and fetal outcomes were collected in a structured questionnaire. Disease severity was categorized based on the NIH (National Institutes of Health) severity classification. Descriptive statistics were used to describe the outcomes. Results: A total of 105 pregnant females infected with COVID-19 during the third wave were included in our study. The participants ranged from 16 through 40 years, mean gestational age being 36.6 weeks. Most of the women (40.55%) belonged to Brahmin and Chhetri ethnic backgrounds. About half (48.55%) of females were asymptomatic and four patients had severe disease requiring intensive care management. Only 13 pregnant females underwent vaccination. Of the 91 females that underwent delivery at our center, 77 (84.62%) were term. The rate of cesarean delivery was slightly higher (51.65%) than normal delivery. None of the babies born to COVID-positive pregnant females tested positive for COVID-19 and there were no stillbirths or any congenital anomalies. The majority of babies (68.14%) had normal fetal weight. Conclusion: Severe COVID-19 infection and adverse maternal-fetal outcomes during the third wave of COVID-19 infection with the Delta variant in Nepal were less than in other regions of the world despite low rates of vaccination.

Vaccine Attitudes and Uptake Among Latino Residents of a Former COVID-19 Hotspot

Abstract: Early in the COVID-19 pandemic, the Centers for Disease Control and Prevention identified Prince William County (PWC), Va. as a hotspot with a high disease rate among Latinos. This study uses spatial, survey, and qualitative data to understand attitudes towards vaccine uptake among PWC Latinos. A quantitative analysis (n=266) estimates the association for vaccine acceptance among Latinos. Next, qualitative interviews with Latinos (n=37) examine vaccine attitudes. Finally, a spatial analysis identifies clusters of social vulnerability and low vaccine uptake in PWC and adjacent counties. Our findings show that a substantial proportion of PWC Latinos had low vaccination rates as of December 2022, two years after the vaccine's release. Side effects and safety and approval concerns were cited in both the quantitative and qualitative studies. Persistent vaccine disparities are concerning given the high hospitalization and mortality rates that prevailed among Latinos early in the pandemic.

Changes of influenza vaccination rate and associated influencing factors after the COVID-19 pandemic in Shanghai, China

ABSTRACT The vaccination rate for seasonal influenza remains low in most regions of China. It is essential to understand the factors that associated with the low influenza vaccination rate in various populations after the COVID-19 pandemic. A cross-sectional survey was conducted with residents in Pudong New Area, Shanghai, China. Respondents’ vaccination condition during the 2021–2022 flu season and the reasons for receiving or not receiving influenza vaccine were investigated. Binary logistic regression was conducted to explore potential factors influencing vaccination uptake. 2,476 of 14,001 respondents received an influenza vaccine, with a total coverage of 17.68% (95% CI: 17.05%, 18.32%). Children had the highest vaccination coverage (35.68%; 95% CI: 34.02, 37.33), followed by adults (12.75%; 95% CI: 11.91%, 13.58%) and elderly individuals (11.70%, 95% CI: 10.78%, 12.62%). For children, lower household income was an significant promoting factor. For adults, factors significantly associated with vaccination were household income, sex, and education level. For elderly, factors significantly associated with vaccination were household income, education level, living state, and having underlying diseases. (P < .05)The main reason for vaccine hesitancy among children was worried about side effects (21.49%), for adults and elderly was self-rated good health (adults: 37.14%, elderly people: 30.66%). The overall influenza vaccination coverage rate in Shanghai, especially among elderly individuals, is lower than many developed countries. Appropriate strategies and programs targeting different populations need to be implemented to enhance influenza vaccine coverage.

Factors Influencing Knowledge and Acceptance of Nonavalent Human Papillomavirus Vaccine Among University Population in Southern China: A Cross-Sectional Study.

Vaccine hesitancy among young Chinese remains a challenge, contributing to low vaccination rates for the nonavalent Human Papillomavirus (HPV) vaccine. This study evaluated the knowledge and acceptance of this vaccine among students at a southern Chinese university and identified factors influencing these outcomes. This cross-sectional, anonymous questionnaire survey was conducted from April to November 2023 at a multi-campus university in southern China. The questionnaire was comprised of three sections: the first collected demographic data; the second evaluated students' knowledge of the nonavalent HPV vaccine on a scale from 0 to 15, with cut-off points at 5 and 10 delineating low, medium, and high knowledge levels, respectively; the third section assessed vaccine acceptance on a scale from 8 to 40, using scores above the 50th percentile as the benchmark for positive acceptance. Among the participants, 18% demonstrated low-level, 40.20% medium-level, and 41.70% high-level knowledge of the nonavalent HPV vaccine. Notably, 71.95% of respondents showed positive acceptance, whereas 28.05% expressed negative acceptance. Male students and those with lower economic conditions (monthly living expenses below 1000 RMB, P = 0.004; 1000-1499 RMB, P = 0.012) exhibited lower knowledge levels. As for acceptance, female students and those with higher monthly living expenses (1000-1499 RMB, P = 0.007; 1500-1999 RMB, P = 0.002; over 2000 RMB, P = 0.002) demonstrated greater vaccine acceptance. A positive correlation was noted between the level of knowledge and vaccine acceptance (rs = 0.256, P < 0.001). Gender and economic status are significantly associated with nonavalent HPV vaccine knowledge and acceptance among university students. These findings highlight the potential impact of targeted educational initiatives, especially for economically disadvantaged male students, in enhancing vaccine uptake rates.

Mapping trends and hotspots in research on global influenza vaccine hesitancy: A bibliometric analysis.

Influenza is one of the most widespread respiratory infections and poses a huge burden on health care worldwide. Vaccination is key to preventing and controlling influenza. Influenza vaccine hesitancy is an important reason for the low vaccination rate. In 2019, Vaccine hesitancy was identified as one of the top 10 threats to global health by the World Health Organization. However, there remains a glaring scarcity of bibliometric research in that regard. This study sought to identify research hotspots and future development trends on influenza vaccine hesitation and provide a new perspective and reference for future research. We retrieved publications on global influenza vaccine hesitancy from the Web of Science Core Collection database, Scopus, and PubMed databases from inception to 2022. This study used VOSviewer and CiteSpace for visualization analysis. Influenza vaccine hesitancy-related publications increased rapidly from 2012 and peaked in 2022. One hundred and ninecountries contributed to influenza vaccine hesitation research, and the United States ranked first with 541 articles and 7161 citations. Vaccines-Basel was the journal with the largest number of published studies on influenza vaccine hesitations. MacDonald was the most frequently cited author. The most popular research topics on influenza vaccine hesitancy were (1) determinants of influenza vaccination in specific populations, such as healthcare workers, children, pregnant women, and so on; (2) influenza and COVID-19 vaccine hesitancy during the COVID-19 pandemic. The trend in the number of annual publications related to influenza vaccine hesitancy indicating the COVID-19 pandemic will prompt researchers to increase their attention to influenza vaccine hesitancy. With healthcare workers as the key, reducing vaccine hesitancy and improving vaccine acceptance in high-risk groups will be the research direction in the next few years.

Ukrainian Legal Mentality: Approaches to the Definition

This article explores and comments on various methodological approaches to defining “legal mentalitet” and “legal mentality.” While these two terms are common in Ukrainian science, English-speaking countries exclusively use the term “mentality,” omitting “mentalitet.” Although the precise reasons for this discrepancy are unclear, the article establishes that the two terms share a close relationship in their nature.The article analyzes the ways and timeframes involved in the formation of legal mentality and examines the reasons for the lack of unity in legal science regarding the definition of legal mentality. The primary reason identified for this lack of unity is the examination of the phenomenon by scientists from different branches of science, each with distinct understandings of the concept.The article argues for the existence of the concept of Ukrainian legal mentality as a distinct group phenomenon with an exceptionally lengthy formation period. It also provides a definition of this concept, summarizing it as the internal subconscious attitude of the entire historical Ukrainian community toward the law and its corresponding impact on the implementation of legal behavior.Further, the article discusses the main differences between legal awareness and legal mentality. The author notes that while legal awareness and legal mentality are related in nature, they differ in the time required for formation, the ways they manifest, and the functions they perform in the human brain, virtually acting as legal consciousness and legal subconsciousness.In conclusion, the article emphasizes the importance of considering legal mentality during the lawmaking process. The author highlights that the constant disregard for Ukrainian legal mentality by lawmakers adversely affects the effectiveness of any legal initiative. As an illustrative example, the low vaccination rates in Ukraine are cited to demonstrate how the neglect of legal mentality during the lawmaking process can be not only ineffective but also dangerous.

Clinical Effectiveness of Ritonavir-Boosted Nirmatrelvir-A Literature Review.

Nirmatrelvir/Ritonavir is an oral treatment for mild to moderate COVID-19 cases with a high risk for a severe course of the disease. For this paper, a comprehensive literature review was performed, leading to a summary of currently available data on Nirmatrelvir/Ritonavir's ability to reduce the risk of progressing to a severe disease state. Herein, the focus lies on publications that include comparisons between patients receiving Nirmatrelvir/Ritonavir and a control group. The findings can be summarized as follows: Data from the time when the Delta-variant was dominant show that Nirmatrelvir/Ritonavir reduced the risk of hospitalization or death by 88.9% for unvaccinated, non-hospitalized high-risk individuals. Data from the time when the Omicron variant was dominant found decreased relative risk reductions for various vaccination statuses: between 26% and 65% for hospitalization. The presented papers that differentiate between unvaccinated and vaccinated individuals agree that unvaccinated patients benefit more from treatment with Nirmatrelvir/Ritonavir. However, when it comes to the dependency of potential on age and comorbidities, further studies are necessary. From the available data, one can conclude that Nirmatrelvir/Ritonavir cannot substitute vaccinations; however, its low manufacturing cost and easy administration make it a valuable tool in fighting COVID-19, especially for countries with low vaccination rates.

COVID-19 vaccination and transmission patterns among pregnant and postnatal women during the fifth wave of COVID-19 in a tertiary hospital in Hong Kong.

Vaccination is a key strategy to control the coronavirus disease 2019 (COVID-19) pandemic. Safety concerns strongly influence vaccine hesitancy. Disease transmission during pregnancy could exacerbate risks of preterm birth and perinatal mortality. This study examined patterns of vaccination and transmission among pregnant and postnatal women during the fifth wave of COVID-19 in Hong Kong. The Antenatal Record System and Clinical Management System of the Hospital Authority was used to retrieve information concerning the demographic characteristics, vaccination history, COVID-19 status, and obstetric outcomes of women who were booked for delivery at Queen Mary Hospital in Hong Kong and had attended the booking antenatal visit from 1 July 2021 to 30 June 2022. Among 2396 women in the cohort, 2006 (83.7%), 1843 (76.9%), and 831 (34.7%) had received the first, second, and third doses of COVID-19 vaccine, respectively. Among 1012 women who had received the second dose, 684 (67.6%) women were overdue for their third dose. There were 265 (11.1%) reported COVID-19 cases. Women aged 20 to 29 years had a low vaccination rate but the highest disease rate (19.1%). The disease rate was more than tenfold higher in women who had no (20.3%) or incomplete (18.8%) vaccination, compared with women who had complete vaccination (2.1%; P<0.001). Acceptance of COVID-19 vaccination was low in pregnant women. Urgent measures are needed to promote vaccination among pregnant women before the next wave of COVID-19.

Between now and later: a mixed methods study of HPV vaccination delay among Chinese caregivers in urban Chengdu, China

BackgroundAdolescent girls in China have a low HPV vaccination rate. Although vaccination is recommended by the Chinese health authorities, the cost is not covered by the national immunisation programme. Vaccination delay, among other reasons such as supply shortage and poor affordability, may contribute to low uptake. This sequential mixed methods study aimed to identify potential factors of delayed HPV vaccination among Chinese adolescent girls.MethodsQuantitative data about the attitudes and perceptions of HPV vaccination were collected from 100 caregivers of 14–18-year-old girls using an online survey in Chengdu, China. The survey data informed a subsequent qualitative study using four focus group discussions. We conducted a descriptive analysis of the survey data and a thematic analysis of the qualitative data. The findings were interpreted using a health behaviour model adapted from the Health Belief Model and the Andersen’s Behavioural Model for Health Services Use.ResultsA total of 100 caregivers – 85 were mothers and 15 were fathers – participated in the survey; 21 caregivers joined focus group discussions. When asked about their intended course of action if the 9vHPV vaccine was out-of-stock, 74% chose to delay until the 9vHPV vaccine is available while 26% would consider 2vHPV or 4vHPV vaccines or seek alternative ways to procure the vaccine. Qualitative results confirmed that caregivers preferred delaying HPV vaccination for adolescent girls. The intent to delay was influenced by systemic barriers such as supply shortage and individual-level factors such as a preference for the 9vHPV vaccine, safety concerns, inadequate health communication, and the belief that adolescents were unlikely to be sexually active.ConclusionIn urban areas, Chinese caregivers’ intent to delay vaccination in favour of 9vHPV vaccine over receiving the more accessible options was influenced by a mix of individual and contextual factors. Focussed health communication strategies are needed to accelerate HPV vaccination among adolescents.

Vaccine hesitancy and hesitant adoption among nursing students in Texas

BackgroundAs the state facing the second-largest nursing workforce shortage in the U.S. and low vaccination rates among residents early in the pandemic, Texas provided a unique opportunity to examine vaccine hesitancy and hesitant adoption among nursing students in an environment where state-level executive orders prohibited mandatory vaccinations. MethodsThe purpose of this study was to describe the level of vaccine hesitancy and hesitant adoption among nursing students in the state of Texas. We used a convenient, opt-in, online survey of nursing students conducted between mid-April and mid-June 2022. The survey was distributed to all pre-licensure nursing programs in Texas. ResultsThe majority of survey respondents (n = 599) were between the ages of 18–28 (68 %), female (88 %) and white (57 %). Most received at least one dose of the COVID-19 vaccination (84 %). Of those receiving the vaccine, a high proportion (82 %) were identified as hesitant adopters. Respondents cited concerns about side effects (57 %) most frequently as the reason for vaccine hesitancy. ConclusionGiven the worldwide nursing shortage, factors potentially impacting the future workforce, such as vaccine hesitancy and hesitant adoption, must be closely monitored. More research is needed to understand the concerns of nursing students and the motivations of hesitant and non-hesitant adopters.

COVID-19 Crisis in Brazil: Post-Vaccination Seroprevalence and Infection in More and Less Vaccinated Municipalities in a Northeastern State.

Given the impact of the pandemic in Brazil, vaccination is essential to prevent illness and death. Thus, this study sought to compare, after vaccination, the circulation of SARS-CoV-2 and the response to vaccination in the least and most vaccinated municipalities of a Brazilian state during the height of the pandemic when the Omicron variant was dominant. We tested for the SARS-CoV-2 antigen and confirmed infection using an RT-qPCR and measured IgM and IgG antibodies in fully vaccinated participants from municipalities with higher and lower vaccination rates. We showed that participants from the least vaccinated municipalities were more likely to have detectable IgM antibodies and a positive antigen/RT-qPCR result for SARS-CoV-2 than participants from the most vaccinated municipalities. There were no differences between the vaccines used (BNT162b2, Ad26.COV2.S, AZD1222, and CoronaVac) and antibody production. Our study evaluated municipal vaccination coverage and its effects on mortality, infections, and anti-SARS-CoV-2 antibodies during a critical phase of the pandemic. The results suggest that higher vaccination coverage reduces acute cases and confers higher memory antibody levels against SARS-CoV-2. Even with a full vaccination schedule, individuals living in places with low vaccination rates are more susceptible to infection.

Measles Outbreaks in the Republic of Congo: Epidemiology of Laboratory‐Confirmed Cases Between 2019 and 2022

In Africa, measles epidemics are frequently reported, despite numerous preventive measures, such as vaccination, which targets children under 5 years of age. Unfortunately, the Republic of the Congo is not an exception to this major health concern. Indeed, many cases are reported annually. Here, we provide an overview of the epidemiological characteristics of laboratory‐confirmed measles cases from January 2019 to October 2022 as well as the risk factors associated with the occurrence of measles outbreak. Samples from suspected measles cases were collected across the country and sent to the National Laboratory of Public Health for confirmation. Specific IgM was tested using the enzyme‐linked immunosorbent assay (ELISA). Data were analyzed using descriptive and analytic statistics (p &lt; 0.05 was statistically significant). A total of 1330 samples were collected and analyzed. Over those 4 years, 537 samples were confirmed to be positive (40.3%) but with important disparities between years. A relatively low frequency of cases was reported in 2020. Overall, a progressive and significant evolution of positive cases was observed between 2019 and 2022, increasing from 16.8% in 2019 to 65.9% in 2022 (p &lt; 0.0001). We report a low vaccination rate among children (44.8%) and a significantly high positivity rate in this group (46.6%) (p &lt; 0.0008). No difference was reported according to the completeness of the vaccination scheme (p = 0.094). Females were slightly more exposed to this infection than males (p = 0.04; adjusted odds ratio [aOR]: 1.25 [1.01–1.6]), with an increased risk of exposure in rural areas (p = 0.0001; aOR: 0.41 [0.32–0.53]). The department of Pointe‐Noire had the highest positivity rate, while three other departments were considered high‐risk areas: Likouala (p = 0.0001; aOR: 3.18 [1.80–5.61]), Pool (p = 0.0001; aOR: 2.90 [1.70–4.95]), and Brazzaville (p = 0.0005; aOR: 0.52 [0.36–0.75]). This study calls for strengthening the epidemiological surveillance system and vaccination strategy in the country. It remains important to research factors that induce a high positive rate among vaccinated children by biological verification of the immunization.

Hepatitis B virus serology in first-degree relatives and spouses of patients with hepatocellular carcinoma at a Nigerian hospital

Abstract Background: The link between hepatitis B virus (HBV) infection and hepatocellular carcinoma (HCC) has been well established. There is a dearth of scientific data on the important phenomenon of familial clustering of these diseases in sub-Saharan Africa. This study evaluated the prevalence and risk of HBV infection in first-degree relatives and spouses of patients with HCC. Materials and Methods: This case–control study was conducted in a Nigerian hospital. A total of 211 first-degree relatives and spouses of confirmed 110 patients with HCC and 212 matched controls were consecutively recruited. All participants were screened for the HBV serological markers using the Aria lateral immunoassay kits. Logistic regression was used to determine the odds ratio while bivariate analysis was used to calculate χ2. Results: The prevalence of HBsAg was higher in the first-degree relatives and spouses of patients with HCC than in the controls (17.1% versus 3.3%, P &lt; 0.001, odds ratio 5.9, 95% confidence interval (CI): 2.6–13.7). Among the relatives, the prevalence of HBsAg positivity was highest in the parents and siblings of HCC patients compared with the children and spouses (P &lt; 0.0001). Furthermore, the relatives of female index patients had a higher prevalence of HBV than the relatives of the male HCC patients (75.0% versus 27.0%, p = 0.012). Significant risks for HBV infection included lower vaccination rate, low educational status and tattoo acquisition (p = 0.006, 0.010 and 0.023 respectively). Conclusion: This study provides important local-based population data (perhaps the first of its kind) supporting the scientific postulation of familial clustering of HBV infection and HCC. It also underscores the importance of targeting first-degree relatives and spouses of patients with HCC for HBV screening to reduce the infection and its sequelae.

The Effect of Hepatitis B Vaccine on Health Workers in Medina

This study aimed to assess hepatitis B virus (HBV) vaccination rates among healthcare professionals and understand their knowledge about HBV transmission. Conducted in a healthcare setting, the research employed survey methods to collect data on vaccination status and awareness levels. Alarmingly, only 25% of healthcare workers were found to be vaccinated against HBV, highlighting a significant gap in protection. Additionally, a considerable lack of awareness regarding HBV transmission was observed among the participants. These findings underscore the urgent need for targeted vaccination campaigns and educational initiatives within primary healthcare environments. The study advocates for mandatory HBV vaccination as a condition of employment for healthcare workers, coupled with ongoing infection prevention and control training. Further research is recommended to explore the prevalence of HBV infection among healthcare professionals in primary care settings and to assess the broader implications for public health. This study serves as a critical call to action for healthcare systems to prioritize HBV vaccination and education, thereby safeguarding both healthcare providers and patients from HBV infection risks. Highlights : Low Vaccination Rates: Only 25% of healthcare workers are vaccinated against HBV, indicating a critical need for improved vaccination coverage in healthcare settings. Knowledge Deficit: There is a significant lack of awareness among healthcare professionals about HBV transmission, necessitating educational programs. Policy Implications: The study advocates for mandatory HBV vaccination for healthcare workers, emphasizing the importance of infection control measures for public health safety. Keywords : Hepatitis B Vaccination, Healthcare Workers, Infection Prevention, Public Health, Vaccination Awareness

The COVID-19 Vaccination Problem and Its Solutions in the United States

With COVID-19 coming to an end, the challenges faced in its epidemic prevention process will undoubtedly play an exemplary role in the large-scale public health crisis that may be faced in the future. Among them, the promotion of vaccination is the first to bear the brunt. As one of the most effective means to curb the spread of the COVID-19 epidemic, the complete vaccination rate is not satisfactory in some countries, such as the United States. This is because, as a complex issue, the reasons for its emergence involve conflicts and trust between government credibility, race, culture, and religion. This article provides a detailed analysis of the reasons for the low complete vaccination rate in the United States and corresponding solutions. At the same time, it is expected that when other countries encounter similar government credibility crises or large-scale public health crises in the future, the example of the United States can be used as an effective reference.