Vaccination Policy Research Articles

Tężec w Polsce w latach 2020-2022

BackgroundTetanus is an infectious disease caused by the bacterium <i>Clostridium tetani,</i> which produces a neurotoxin (tetanospasmin) that causes spastic paralysis. This disease can only be prevented by vaccination. Tetanus is very rare in EU countries, where it mainly affects people over 60 years of age. Tetanus is a serious health problem in countries with low vaccination rates and poor hygiene conditions, and neonatal tetanus is a particularly significant problem in these countries. In Poland, according to the Vaccination Program, mandatory vaccinations against tetanus should be given to children and adolescents up to the age of 19.ObjectiveThe aim of the study was to assess the epidemiological situation of tetanus in Poland in 2020-2022.Material and methodsThe assessment of the epidemiological situation of tetanus in Poland in 2020-2022 was made based on the interpretation of data from the annual bulletins "Infectious diseases and poisonings in Poland" for 2020-2022 and the bulletins "Vaccinations in Poland" for 2020-2022 as well as data from individual epidemiological reports on diseases registered in the "Epibaza" system.ResultsIn 2020, 2 cases of tetanus were registered in Poland, in 2021 – 5 cases, and in 2022 also 5 cases. The total incidence in 2020 was 0.005 per 100 000 people, in 2021 and 2022 – 0.013 per 100 000 and was lower compared to the median for 2015-2019 (0.031). In 2020-2021, all reports concerned hospitalized people, while in 2022 one person was treated as an outpatient. No cases were recorded in people under 30 years of age.ConclusionsIn Poland, a decrease in the number of reported tetanus cases was observed in 2020-2022 compared to previous years. Sporadic tetanus cases in Poland are recorded mainly in older age groups but also occur among adults under 60 years of age. The cases can be associated with the lack of booster vaccinations in adults.

Union Responses to Workplace COVID-19 Vaccine Mandates in Canada

This article explores union responses to workplace-based covid-19 vaccine mandates in Canada. Specifically, the authors examine the complex interplay of factors that drove unions to adopt their respective positions on vaccine mandates and to frame those positions in particular ways for the benefit of their members and the wider public. Interviews with key informants, along with analysis of documents and arbitration decisions, reveal a disjuncture between the discursive quality of certain unions’ positions and their actual positions. In particular, media framing of unions as either “for” or “against” vaccine mandates oversimplified or misrepresented the actual positions adopted. In response, the article introduces a typology of union positions that distinguishes between support for mandatory-vaccination policies and support for voluntary-vaccination policies and reveals that the vast majority of unions favoured the latter. The authors further reveal that workplace vaccine mandates were both internally divisive and disorienting for unions, given the central role labour organizations play in managing workplace disputes and representing the interests of workers, both individually and collectively.

ATTITUDES AND AWARENESS OF THE POPULATION OF CENTRAL AND WESTERN REGIONS OF UKRAINE TOWARDS VACCINATION

In the modern world, vaccination is the most eff ective and evidence- based method of preventing the onset and severity of infectious diseases. Today, the WHO has identifi ed vaccine hesitancy as a global public health threat [25]. The social and cultural background of people infl uences their perception of vaccines, which prompted us to investigate this problem. Aim. To study the infl uence of sociodemographic factors on vaccination attitudes of children and adults in the central and western regions of Ukraine.Materials and methods. A cross- sectional study was conducted, which included a survey of the population of diff erent social status. The study was conducted in accordance with the tenets of the Declaration of Helsinki. The study protocol was approved by the bioethics committee. We also analyzed literature data from PubMed, Medscape and CSC. The work was performed within the framework of the research project 0122U000039 «Improvement of methods of diagnosis, treatment and rehabilitation of the most common diseases of childhood». No confl icts of interest exist.Research results and discussion. 1000 respondents were interviewed by questionnaire from Kyiv, Cherkasy, Kirovograd, Khmelnytsky, Zhytomyr, Chernivtsi, Ternopil, Rivne, Volyn, Ivano- Frankivsk, Lviv regions. The data obtained indicate that barriers to vaccination are caused by low awareness of vaccination, excessive negative infl uence of opinion leaders, prevalence of myths and falsifi cations about vaccination, lack of health care resources and low supply of recommended vaccines, and forced migration. Low awareness and low vaccination coverage are also associated with low awareness among health workers who do not work directly with vaccines, falsifi cation of vaccination data, and the presence of anti-vaccine health workers. The negative attitude of parents towards vaccination is also very important, as it aff ects their children.Conclusions.1. Fear of side eff ects, long-term complications, and doubts about the quality of vaccines have been identifi ed as factors in vaccine refusal.2. The most common groups of vaccine refusers are the elderly (53.3 %) and men (16.8 %).3. The high cost of vaccines that are not included in the list of mandatory vaccines is one of the reasons for the decrease in vaccination rates.4. Improved communication between the doctor and the patient is one of the factors increasing the vaccination rate among the population.5. Information about the availability of vaccines and places of vaccination, peculiarities of the post-vaccination period and information about the possible consequences of ignoring vaccination should be provided in the media (television, radio), especially among the elderly.

Rebound in epidemic control: how misaligned vaccination timing amplifies infection peaks

In this study, we explore the dynamic interplay between the timing of vaccination campaigns and the trajectory of disease spread in a population. Through modeling and comprehensive data analysis of model output, we have uncovered a counter-intuitive phenomenon: initiating a vaccination process at an inopportune moment can paradoxically result in a more pronounced second peak of infections. This “rebound” phenomenon challenges the conventional understanding of vaccination impacts on epidemic dynamics. We provide a detailed examination of how improperly timed vaccination efforts can inadvertently reduce the overall immunity level in a population, considering both natural and vaccine-induced immunity. Our findings reveal that such a decrease in population-wide immunity can lead to a delayed, yet more severe, resurgence of cases. This study not only adds a critical dimension to our understanding of vaccination strategies in controlling pandemics but also underscores the necessity for strategically timed interventions to optimize public health outcomes. Furthermore, we compute which vaccination strategies are optimal for a COVID-19 tailored mathematical model, and find that there are two types of optimal strategies. The first type prioritizes vaccinating early and rapidly to reduce the number of deaths, while the second type acts later and more slowly to reduce the number of cases; both of them target primarily the elderly population. Our results hold significant implications for the formulation of vaccination policies, particularly in the context of rapidly evolving infectious diseases.

The Revival of Cholera Vaccines: The Century-Old Making of a Global Success Story

Cholera vaccines have existed since the nineteenth century but were largely considered an ineffective control strategy for much of their history. However, in 2012, cholera vaccination campaigns were piloted in Haiti and Guinea using a preexisting vaccine formula. These initial efforts quickly expanded to dozens of countries. A global stockpile of millions of doses was established, positioning cholera vaccines as a cornerstone to the Global Task Force on Cholera Control’s Roadmap to ending cholera by 2030. What factors contributed to this remarkable turnaround? This piece explores the epistemic, moral, and industrial reconfigurations that sustained the crafting of a global vaccine success story and its ramifications within a shifting global health landscape, including the potential displacement of water and sanitation interventions. The research is based on my participation in cholera vaccine introductions as a medical NGO worker and on symmetric ethnographic fieldwork conducted in African settings targeted for reactive cholera vaccination and in global North centers influencing global cholera vaccine policy.

Measles surveillance data analysis and serological survey in Quzhou, China, 2014–2024: an assessment of progress toward measles elimination

BackgroundMeasles is a disease that can be eliminated through vaccination. In recent years, measles incidence and mortality have been greatly reduced.MethodsAnalyze measles surveillance data from 2014 to 2023 and measles seroepidemiological characteristics of healthy populations in 2024 to assess progress toward measles elimination.ResultsA total of 35 measles cases were reported in the surveillance system from 2014–2023 in Quzhou, with an average annual incidence of 1.6/1 million. Since 2019, the incidence of measles has been lower than 0.5/1 million. A serological survey of 257 healthy people showed that the positive rate of measles IgG antibody was 90.3%, and the immunity of all age groups except 0–5 years old was lower than 95%, which did not reach the threshold of 95% herd immunity required for eliminating measles.ConclusionAlthough the incidence of measles in Quzhou is low, the immunity of healthy people to measles infection is insufficient. Measles is still in the control phase, not in the elimination phase. Inadequate immunity in the population may be due to the failure to achieve ≥95% vaccination coverage and low immunogenicity of the vaccine. Recommends that the quality of routine immunization data be assessed and monitored to verify reported vaccination coverage; at the same time, improve vaccination services and optimize vaccination policies to increase actual vaccination coverage. In addition, it is recommended to adjust the MMR immunization strategy, changing the time of the first MMR vaccination from 8 months of age to 12–15 months of age, and the second dose at 4 to 6 years of age.

Vaccine equity implementation: exploring factors influencing COVID-19 vaccine delivery in the Philippines from an equity lens

BackgroundDuring the early phase of the COVID-19 vaccine rollout, low and middle-income countries (LMICs) were facing challenges in achieving equitable vaccine delivery. Few studies have contextualized global vaccine distributive injustice into national-specific contexts to understand its impact on vaccine delivery from an equity perspective. We aimed to investigate factors influencing equitable COVID-19 vaccine delivery in the Philippines and to provide recommendations to enhance equitable vaccine delivery in LMICs to prepare for future health emergencies.MethodsThe Health Equity Implementation Framework was employed to guide this qualitative study. We recruited participants using purposeful and snowballing sampling strategies. Semi-structured interviews were conducted with participants in person, online, or over the phone. A reflective thematic analysis approach was employed to analyze data.ResultsWe recruited 38 participants including seven high-level stakeholders from the public and private sectors, 14 health workers, and 17 community members in the province of Negros Occidental, Philippines. Equitable delivery of COVID-19 vaccines was influenced by an interplay of multiple factors operating in different domains. Contextually, the rapidly evolving nature of the COVID-19 virus, ongoing scientific advancements, and international negotiations directed national-level vaccine policies. Political commitment and support were recognized as crucial drivers for successful vaccine delivery, with a strong emphasis on health information framing and communication and adherence to human rights principles. The vulnerability of the health system significantly impacted the timely and effective distribution of vaccines. Furthermore, the geographical characteristics of the Philippines presented unique logistical challenges to vaccine delivery. At the recipient domain, individual perceptions of vaccines, shaped by their socioeconomic status, exposure to (mis)information, social influence, and entrenched religious beliefs, played a major role in their vaccine decisions and thus vaccine coverage regionally. Additionally, vaccine characteristics and operational challenges related to its distribution also impacted fair allocation.ConclusionsThe findings highlight the urgent need for LMICs to strengthen their health system resilience and sustainability and use multilevel strategies to build public trust to improve vaccine uptake and coverage. Moreover, each LMIC must be attentive to its unique contextual factors to develop tailored implementation strategies to promote equitable vaccine distribution.

School-Entry Vaccine Policies: States' Responses To Federal Recommendations Varied From Swift To Substantially Delayed.

School-entry immunization requirements are a valuable strategy to reduce the spread of vaccine-preventable diseases. This research examined the temporal relationship between recommendations issued by the federal Advisory Committee on Immunization Practices (ACIP) and corresponding school-entry requirements adopted by states for adolescent meningococcal ACWY (MenACWY) and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines. A legal epidemiological review of statutes, regulations, and state agency guidance identified school-entry policies across fifty states and Washington, D.C. Researchers measured the number of months between the date of an ACIP recommendation and the effective dates for state policies that were in place through the 2023-24 school year. All fifty-one jurisdictions had school-entry requirement policies for Tdap vaccination, and thirty-six had school-entry requirements for MenACWY vaccination. The average period between ACIP's recommendations and state policy adoption was 4.94, 9.61, and 8.24 years for Tdap and for MenACWY first and booster doses, respectively. This analysis found diverse timelines and notable delays for both Tdap and MenACWY school-entry requirement policies. This heterogeneity and patchwork of state requirements underscores the need for ACIP to evaluate the role of these policies in reducing vaccine-preventable diseases across the United States.

The Case against compulsory vaccination: the failed arguments from risk imposition, tax evasion, ‘social liberty’, and the priority of life

Arguments for mandatory or compulsory vaccination must justify the coercive infringement of bodily integrity via the injection of chemicals that permanently affect a body’s inner constitution. Four arguments are considered. The allegedly libertarian argument declares unvaccinated persons a threat; accordingly, vaccination could take the form of justifiable defence of self and others. This argument conflates material and statistical threats. The harsh coercive measures permissible in defence against the former are not permissible in prevention of the latter. The argument from tax evasion claims that people can be permissibly coerced into bearing their fair financial burdens of community life and likens this to sharing burdens in the face of a viral threat. The argument fails to demonstrate that vaccination would be fair, permissible in spite of potential lethal side-effects, and sufficiently similar to taxation despite the categorical difference between temporary deprivation of money and permanent deprivation of one’s original inner bodily constitution. The argument from ‘social liberty’ claims that the loss of freedom due to mandatory vaccination is only apparent, namely outweighed by corresponding gains in freedom. This argument conflates freedom as the absence of coercion with freedom as the presence of options for action. It fails to give the former its due weight and to demonstrate that persons may be coerced into increasing the options of others. The argument from the priority of life elevates the protection of life to an absolute value. This is unwarranted and leads to counterintuitive implications. Without better arguments, mandatory vaccination must be rejected.

Global landscape of COVID-19 vaccination programmes for older adults: a descriptive study.

To minimise severe cases and deaths from COVID-19 among high-risk populations such as older adults (aged 60years and older), it is crucial to monitor and update vaccination strategies. In this study, we aim to provide a global profile of the current COVID-19 vaccination programmes for older adults, including vaccination policies, coverage rates, and vaccine demand. We used publicly available data on the COVID-19 vaccines used, vaccination schedules, indicated age groups, and age-specific country-level vaccine coverage, updated through to July 20, 2024. Data on vaccination policy were extracted from publicly available sources in the following priority: (1) official sources (ie, government websites, health department websites, and official reports); (2) resources integrated by institutions or organisations (ie,European Center for Disease Prevention and Control, Africa Center for Disease Prevention and Control, and COVAX); and (3) cross-validated news and media reports derived from government or health department sources. We estimated coverage gaps to achievement of two specific objectives: (1) immunising 100% of older adults with primary series and a booster dose, as per WHO's goal; and (2) surpassing WHO's goal by administering one extra booster dose to 80% of older adults or achieving 80% coverage of a 2023-24series vaccine. 192countries reported their use of COVID-19 vaccines for older people, of which 71vaccine products have been used for older adults and 79countries have deployed 22vaccines containing components against variants of concern; 122countries offered a second booster dose or a special booster dose, while others used only primary series or one booster dose. 96countries prioritised older people for vaccination. Among countries with available data, the median proportion of individuals completing a primary series was 81% (IQR 58·3-92·0), for a first booster was 53% (14·1-81·7), for a second booster was 44·3% (13·5-69·7), and for a 2023-24series vaccination was 23·6% (6·6-52·4), with large differences by region. Coverage of the second booster and the 2023-24series was lower in individuals aged 60-70years than in older age groups. To achieve the WHO target of 100% coverage for older populations with primary series and a booster dose, 1·01doses per person are required, and to attain an 80%coverage for a second booster or 2023-24series, surpassing WHO's goal, 1·43doses per person are required. Progress of COVID-19 vaccination programmes for older adults is uneven across countries, emphasising an ongoing challenge to achieve vaccine equity for this high-risk age group. Therefore, it is essential to establish robust and timely vaccination surveillance systems, especially to facilitate data-driven policies that promote COVID-19 vaccination campaigns worldwide. Key Program of the National Natural Science Foundation of China.

The evolution of vaccine mandates: from historical perspectives to contemporary applications

Abstract Luigi Sacco pioneered efforts in 19th-century Italian vaccination campaigns when mandatory vaccination practices began as a public health strategy. We bridge past and present through a systematic review of both historical and contemporary vaccine mandate policies. While Sacco’s early initiatives, characterised by compulsory vaccination and effective communication strategies, set foundational principles for vaccine mandates, the modern era, especially during the COVID-19 pandemic, has seen a significant shift in the nature and application of vaccine mandates. Recent legislative changes across various countries have introduced stricter mandates aimed at managing public health crises. For instance, Italy and France, deeply impacted by reduced vaccine uptake and subsequent measles outbreaks, responded by reinforcing vaccine mandates. These countries aimed to mitigate the dual challenges of achieving high vaccination coverage and combating growing vaccine hesitancy. Comparative analysis of recent legislative changes reveals a trend towards increasing coerciveness in vaccine mandates, reflecting a blend of functional and political pressures driving government decisions. This trend is evident in the legislative adjustments made in California, Australia, France, and Italy, where heightened penalties and reduced exemptions were introduced to counteract declining public compliance. The synthesis of these experiences highlights the critical role of robust, credible communication and the nuanced application of mandates that consider societal and cultural contexts. Contemporary strategies are characterised by targeted interventions aimed at specific populations, reflecting the complex interplay of social, political, and health dynamics in vaccine policy. The enduring relevance of vaccine mandates underscores the necessity of flexible, responsive public health strategies that effectively address both long-standing and emergent vaccine hesitancy and coverage challenges. Speakers/Panelists Carlo Signorelli HSR, Milan, Italy Maria Gańczak Department of Infectious Diseases, University of Zielona Góra, Zielona Góra, Poland

Świnka w Polsce w 2022 roku

BackgroundMumps, also known as Sudden parotitis, is a viral disease whose main source of infection is the sick/infected person. It posed a serious public health threat in Poland before the introduction of mandatory vaccination. In 2003, Poland introduced the Immunization Program, which included a two-dose vaccination against mumps as part of the MMR (measles, mumps and rubella) vaccine for all children.ObjectiveThe study aimed to assess the epidemiological situation of mumps in Poland in 2022 compared to previous years, including an analysis of the impact of the COVID-19 pandemic.Material and methodsThe analysis of the epidemiological situation of mumps in Poland in 2022 was based on the interpretation of data published in the annual bulletin: "Infectious Diseases and Poisonings in Poland in 2022" and "Vaccinations in Poland in 2022".ResultsIn 2022, 922 cases of mumps were registered in Poland. This was a 90.5% increase compared to 2021 when 484 cases were recorded. The total incidence was 2.4 per 100,000 residents, 84.6% higher than in 2021. The highest incidence of 3.4 per 100 000 residents was registered in the Mazowieckie voivodeship, and the lowest, as in the previous year, was 1.0/100 000 residents in the Dolnośląskie voivodeship. The highest incidence (12.9/100 000) was recorded in children aged 0-4 and 5-9 (16.1/100 000). The incidence in men (3.0/100 000) was higher than in women (1.9/100 000). In 2022, the number of hospitalizations for mumps in Poland was 20, an increase of 122.2% compared to 2021, when 9 people were hospitalized.ConclusionsThe year 2022 showed an overall upward trend in registered mumps cases. The decrease in the number of mumps cases in 2021 was a result of the ongoing pandemic. The restrictions implemented during the pandemic period contributed to a decrease in the number of cases of various droplet-transmitted diseases, including mumps. Still, the observed number of mumps cases in 2022 remains below levels observed during the pre-pandemic COVID-19 period (2019).

2.I. Scientific session: Addressing vaccine hesitancy: from understanding determinants to implementing targeted strategies

Abstract Supported by NextGenerationEU (no. PE00000007) and EU4Health (VAXaction), the workshop will present a pan-European perspective on vaccine hesitancy and the effectiveness of counteracting interventions, especially when facing potentially pandemic infectious threats. Analysing human responses to epidemics is crucial to improve mathematical disease modelling and develop strategies to monitor behaviours during outbreaks, including assessing levels of vaccine hesitancy. This session will explore the multifaceted issue of vaccine hesitancy, which remains a significant barrier to achieving optimal vaccination coverage and is identified as one of the top threats to global health. By integrating theoretical frameworks with practical applications, the workshop aims to present a comprehensive overview of strategies employed to mitigate hesitancy across various demographics and regions. The first presentation will cover a thorough overview of the strategies employed to counteract vaccine hesitancy, leveraging existing infrastructure, health promotion policies, and educational initiatives. It will also explore the role of digital health tools and regulatory measures, such as health passes and nudging techniques, in enhancing vaccination uptake. Furthermore, the session will cover a systematic review of immunisation information systems (IISs) and the proposal of an innovative unvaccinated registry. This part of the workshop will delve into technological advancements and the integration of behavioural insights, which are essential for enhancing vaccine coverage and informing public health strategies. Another significant aspect of the discussion will be the evolution of vaccine mandates, from their historical roots to their contemporary applications. This discussion will reflect on policy shifts necessitated by emerging public health challenges and the need for adaptable strategies that can respond effectively to fluctuating vaccine coverage and acceptance rates. Panel discussions will feature notable experts such as Prof. Carlo Signorelli, President of the Italian NITAG, and Prof. Maria Ganczak, Vice President of the EUPHA Infectious Diseases Control section. These discussions will provide a comparative analysis of vaccination policies across different European countries, highlighting diverse approaches to mandates and the implementation of public health interventions aimed at combating vaccine hesitancy. By providing a unified approach to understanding and combating vaccine hesitancy, we aim to facilitate a critical exchange of ideas and strategies among experts in the field. It will serve as a dynamic platform for discussing evidence-based interventions tailored to specific population needs, enhancing public health outcomes across Europe. This engaging session promises to offer valuable insights into the complexities of vaccine hesitancy and the collaborative efforts required to address this global health challenge effectively. Key messages • Enhanced data collection and analysis are essential to combat vaccine hesitancy, allowing for tailored interventions that address specific community needs and barriers to vaccination. • Effective strategies against vaccine hesitancy require historical understanding and flexibility to adapt to new challenges, ensuring public health policies are responsive and culturally sensitive.

The resurgence of pertussis in Central Serbia in the period from June to December 2023

Abstract Background There was a registered increase in the number of confirmed pertussis cases in Central Serbia between June and December 2023. Among the possible causes of pertussis resurgence are increased awareness of pertussis among healthcare workers, availability of the sensitive RT PCR method in diagnostic, the limited duration of vaccine-induced immunity as well as decline of immunization coverage influenced by the COVID-19 pandemic. Methods The nasopharyngeal samples from clinics and primary care departments were transferred to Institute of Public Health of Serbia. DNA was extracted from each sample using the MagMAX Viral/Pathogen kit. The presence of B. pertussis was determined using two PCR assays, VIASURE Bordetella Real Time PCR Detection Kit and Bosphore B. pertussis/parapertussis Genotyping Kit, Anatolia Geneworks. Results RT-PCR confirmed a total of 338 pertussis cases in Institute of Public Health of Serbia during the observed period. Most of confirmed cases were among children 9-14 years old (49,7%) followed by infants younger than 12 months (21,9%). The more severe cases were among the unvaccinated and uncomplete vaccinated infants, 78,4% of which required hospitalization with two deaths in this age group. Conclusions Based on the analysis of the obtained results, we can highlight the importance of using sensitive methods in pathogen detection. Rapid diagnosis, laboratory confirmation and notification ensure early public health intervention to minimize the spread of disease. Despite long tradition of mandatory immunization against pertussis in the Republic of Serbia, wanning of vaccine induced immunity poses potential risk for the resurgence of pertussis. For pertussis control, in the future, it will be essential to achieve high immunization coverage as well as to introduce a booster dose of pertussis containing vaccine for children aged 14 and to implement vaccination of pregnant women. Key messages • For the better pertussis control vaccination of adolescents and adults, as well as vaccination of pregnant women should be considered in the future vaccination policies. • Clinicians should consider pertussis in the differential diagnosis of persistent cough illness in people of all ages, even those previously immunized.

The vital role of stakeholders and National Immunization Technical Advisory Groups (NITAGs)

Abstract To successfully implement comprehensive, multidisciplinary and interdisciplinary approaches, collaborative, cross-sectoral policy and strategies are essential. This is critical not only for addressing shared challenges but also for developing effective intervention strategies. One of the main hurdles in any collective action initiative is the ability to galvanize diverse stakeholders, each with their unique set of interests and capacity. EUVABECO is dedicated to conducting pilots, and developing implementation plans that are not only effective but also adaptable and sustainable across various healthcare settings in Europe. The healthcare environments across the pilot countries exhibit considerable variability, including differences in epidemiological trends, immunization information systems, vaccine nomenclature, and the dynamics of collaboration with National Immunization Technical Advisory Groups (NITAGs). Throughout implementation, the cooperation between these diverse stakeholders and NITAGs will be crucial, notably to share local vaccination policies for integration into the Clinical Decision Support (CDS) system. EUVABECO’s goal is to craft implementation plans that are flexible enough to be tailored to local needs, ensuring that interventions are both practical and effective in each unique context. This presentation will explore the vital role that stakeholders and NITAGs play in this process, highlighting the importance of their involvement for the success of EUVABECO’s initiatives.

Future actions and a call for ongoing support

Abstract The EUVABECO project is currently piloting a suite of innovative tools, including decision support systems, targeted screening tools, electronic vaccine leaflets, disease simulators, and cross-border vaccination cards. These tools have shown great promise in transforming vaccination practices within individual healthcare settings, contributing to building vaccine confidence and increasing protection against vaccine-preventable infections across the life course. As EUVABECO progresses to the crucial phase of implementing these pilots, active collaboration and sustained support from the multiple actors of the vaccine ecosystem in the implementing countries are essential. To ensure these tools are effectively adapted across different MS, they must be customised to meet local needs and the specific requirements of diverse healthcare environments. This involves integrating feedback from initial deployments. More than just a technical implementation, this phase is about fostering and maintaining robust partnerships with key stakeholders such as healthcare providers, policymakers, and National Immunization Technical Advisory Groups (NITAGs). The success of the EUVABECO project depends on continuous engagement and the sharing of knowledge and resources among all partners involved. This presentation seeks to reinforce the call for ongoing commitment and collaboration from existing stakeholders and to encourage new partners to join this transformative effort. This will foster a more harmonized approach to vaccination policies. Together, we aim to build a more resilient public health infrastructure, enhancing the preparedness and responsiveness to current and future vaccination challenges, ultimately improving resilience to health threats across the European Union.

Analysis of the mpox outbreak in Europe in 2022: vaccination rollout in the most affected countries

Abstract Background The mpox virus spreads through contact with infected material and causes flu-like symptoms and skin lesions. Common in Central and West Africa, a global rise in mpox cases in 2022 was observed, affecting mainly men who have sex with men. Methods The study analysed vaccination policies in the most affected WHO-EURO countries during the mpox outbreak, including the Netherlands, France, UK, Spain, Germany, Belgium, Portugal, and Switzerland. Epidemiological data from May to October 2022 (first wave) were compared. Additionally, the role of EU health institutions in assisting member states in controlling virus spread across the region was examined. Results By the end of May 2022, three countries (The Netherlands, France, and UK) initiated post-exposure vaccination shortly after the first case identification. Portugal, one of the most affected countries, implemented pre-exposure prophylaxis for high-risk groups by September, followed by Switzerland in November. Vaccination access for non-exposed priority groups varied, with France not requiring a medical prescription. EU cooperation in health was pivotal during the outbreak, with vaccines distributed through the EU4Health program budget via HERA to ensure preparedness. However, detailed information remains limited. Conclusions Countries’ responses to the mpox virus outbreak varied significantly, with discrepancies not always aligning with epidemiological data. These differences could stem from various factors, such as behavioural patterns, prior immunisation rates, and neighbouring countries’ policies. However, the unequal access to vaccines across the region underscores existing health disparities, particularly affecting stigmatised populations. Data on immunisation records were notably scarce in most countries, hindering thorough analysis of policy implementation and effectiveness. Additionally, further exploration is warranted into the role of LGBT associations and evidence of stigma surrounding the outbreak. Key messages • The mpox 2022 outbreak in Europe provides an important picture of cross-border health policies and public health responses for future emergences in a European cooperative environment. • Most national authorities provided limited information during the mpox 2022 outbreak; data on immunisation records and vaccine access is pivotal to assess countries’ health policies.

Estimating the impact of the COVID-19 vaccination programme in Ireland: December 2021-March 2023

Abstract Background In Autumn 2023, COVID-19 booster vaccines were offered to all those aged ≥50 years in Ireland. There was concern that vaccine fatigue would impact uptake. We aimed to quantify the direct impact of the COVID-19 vaccination programme on averted outcomes in individuals aged ≥50 years, during a period of Omicron variant dominance, to inform vaccination strategy and public health communication. Methods We conducted a retrospective observational study from December 2021 to March 2023 in Ireland. We considered as averted outcomes symptomatic SARS-CoV-2 presentations to primary care, emergency department (ED) presentations, hospitalisations, intensive care unit (ICU) admissions and deaths due to COVID-19. We used an adapted formula from other vaccine impact published studies, including national data on notified outcomes, vaccine coverage data and vaccine effectiveness (VE) estimates, sourced from the WHO’s live systematic VE review, to estimate the count and prevented fraction of outcomes in ≥ 50-year-olds averted by the COVID-19 vaccination programme. The number of expected outcomes in the absence of vaccination was calculated by summing the counts of outcomes observed and outcomes averted. Results Between December 2021 and March 2023, the COVID-19 vaccination programme averted 48,551 symptomatic presentations to primary care (36% of expected), 9,517 ED presentations (53% of expected), 102,160 hospitalisations (81% of expected), 3,303 ICU admissions (89% of expected) and 15,985 deaths (87% of expected). Conclusions During Omicron dominance, the COVID-19 vaccination programme averted symptomatic and severe outcomes, including deaths due to COVID-19, underscoring the benefits of COVID-19 vaccination. In the context of vaccine fatigue emerging as an important public health issue in Ireland and internationally, these findings can inform future COVID-19 booster vaccination programmes and communication about the reason for and importance of COVID-19 vaccination. Key messages • The COVID-19 vaccination programme in Ireland prevented illness and death in people aged ≥50-years. Vaccination therefore protected population health and the healthcare system. • These findings can be used to inform future COVID-19 vaccination policies, planning for winter, pandemic preparedness and communisation about the importance of ongoing COVID-19 vaccination programmes.

Health Facility Capacity and Health-care Worker Knowledge, Attitudes, and Practices of Hepatitis B Vaccine Birth-dose and Maternal Tetanus-Diphtheria Vaccine Administration in Nigeria: A Baseline Assessment.

Hepatitis B virus (HBV) and neonatal tetanus infections remain endemic in Nigeria despite the availability of safe, effective vaccines. We aimed to determine health facilities' capacity for hepatitis B vaccine birth dose (HepB-BD) and maternal tetanus-diphtheria (Td) vaccination and to assess knowledge, attitudes, and practices of HepB-BD and maternal Td vaccine administration among health facility staff in Nigeria. This was a cross-sectional study assessing public primary and secondary health facilities in Adamawa and Enugu States. A multistage sampling approach was used to select 40 facilities and 79 health-care workers (HCWs) from each state. A structured facility assessment tool and standardized questionnaire evaluated facility characteristics and HCW knowledge, attitudes, and practices related to HepB-BD and maternal Td vaccination. Frequencies and proportions were reported as descriptive statistics. The survey of 80 facilities revealed that 73.8% implemented HepB-BD and maternal Td vaccination policies. HepB-BD was administered within 24 h of birth at 61.3% of facilities and at all times at 57.5%. However, administration seldom occurred in labor and delivery (35%) or maternity wards (16.3%). Nearly half of the facilities (46.3%) had HCWs believing there were contraindications to HepB-BD vaccination. Among 158 HCWs, 26.5% believed tetanus could be transmitted through unprotected sex, prevented by vaccination at birth (46.1%), or by avoiding sharing food and utensils. 65% of HCWs knew HBV infection had the worst outcome for newborns. The limited implementation of national policies on HepB-BD and maternal Td vaccination, coupled with knowledge gaps among HCWs, pose significant challenges to timely vaccination, necessitating interventions to address these gaps.

Assessing Attitudes towards Vaccination: Demographic Influences among Parents of Preschool-Aged Children

Introduction: The attitudes towards vaccination of parents with preschool-aged children hold great significance for public health due to their critical impact on child health. Aim: This study aimed to determine the attitudes towards vaccination of parents with preschool-aged children and the key demographic factors influencing these attitudes. Method: The cross-sectional study was conducted with 223 parents reached through snowball sampling between March-May 2022. Data were collected using an Introductory Information Form and the Vaccination Attitudes Examination (VAX-TR) Scale. Analysis included Mann-Whitney U, Kruskal-Wallis H tests, and regression analyses. Results: Parents exhibited a moderately high negative attitude towards childhood vaccinations (2.94±0.99) and a high number of worries over unforeseen future effects (3.80±1.31). Parents who believed that vaccines are unnecessary, lacked sufficient information, were concerned about side effects, and did not adhere to mandatory vaccinations had significantly more negative attitudes towards childhood vaccinations(p