National Immunization Schedule Research Articles

Modelling the Cost-Effectiveness of Hepatitis A in South Africa.

The World Health Organization (WHO) recommends the consideration of introducing routine hepatitis A vaccination into national immunization schedules for children ≥ 1 years old in countries with intermediate HAV endemicity. Recent data suggest that South Africa is transitioning from high to intermediate HAV endemicity, thus it is important to consider the impact and cost of potential routine hepatitis A vaccination strategies in the country. An age-structured compartmental model of hepatitis A transmission was calibrated with available data from South Africa, incorporating direct costs of hepatitis A treatment and vaccination. We used the calibrated model to evaluate the impact and costs of several childhood hepatitis A vaccination scenarios from 2023 to 2030. We assessed how each scenario impacted the burden of hepatitis A (symptomatic hepatitis A cases and mortality) as well as calculated the incremental cost per DALY averted as compared to the South African cost-effectiveness threshold. All costs and outcomes were discounted at 5%. For the modelled scenarios, the median estimated cost of the different vaccination strategies ranged from USD 1.71 billion to USD 2.85 billion over the period of 2023 to 2030, with the cost increasing for each successive scenario and approximately 39-52% of costs being due to vaccination. Scenario 1, which represented the administration of one dose of the hepatitis A vaccine in children < 2 years old, requires approximately 5.3 million vaccine doses over 2023-2030 and is projected to avert a total of 136,042 symptomatic cases [IQR: 88,842-221,483] and 31,106 [IQR: 22,975-36,742] deaths due to hepatitis A over the period of 2023 to 2030. The model projects that Scenario 1 would avert 8741 DALYs over the period of 2023 to 2030; however, it is not cost-effective against the South African cost-effectiveness threshold with an ICER per DALY averted of USD 21,006. While Scenario 3 and 4 included the administration of more vaccine doses and averted more symptomatic cases of hepatitis A, these scenarios were absolutely dominated owing to the population being infected before vaccination through the mass campaigns at older ages. The model was highly sensitive to variation of access to liver transplant in South Africa. When increasing the access to liver transplant to 100% for the baseline and Scenario 1, the ICER for Scenario 1 becomes cost-effective against the CET (ICER = USD 2425). Given these findings, we recommend further research is conducted to understand the access to liver transplants in South Africa and better estimate the cost of liver transplant care for hepatitis A patients. The modelling presented in this paper has been used to develop a user-friendly application for vaccine policy makers to further interrogate the model outcomes and consider the costs and benefits of introducing routine hepatitis A vaccination in South Africa.

Vaccination of premature newborns

Premature newborns are most vulnerable to the severe infectious diseases. The timeliness of vaccination in this group of children is extremely important. Historically, however, vaccination coverage for premature newborns has been significantly reduced due to unjustified contraindications. This is due to the fear of developing post-vaccination complications and the opinion that the immune response to vaccines in preterm newborns is reduced. In addition, in our country, there are no approved federal clinical guidelines for the vaccination of premature newborns, which determines the lack of a unified approach among medical workers and raises doubts among parents.The article presents a review of Russian and foreign literature data, highlighting the state of the problem of timeliness and completeness of vaccination coverage of premature newborns. Features of the immunity of a child born prematurely and the possibility of an adequate response to vaccine antigens in various degrees of prematurity. According to the list of the National Immunization Schedule, scientific and practical data on the safety and efficacy of vaccines registered in Russia, the benefits of complying with approved schedule and the positive non-specific effects of individual vaccines are given. Data on the specific prevention of RS-virus infection are presented. It has been shown that conditions that can develop after vaccination and are characteristic of prematurity are not directly related to the vaccine and that premature newborns is able to develop a sufficient immune response. Accordingly, children born prematurely should be immunized in accordance with the passport age with the stabilization of the child’s condition and adequate weight gain.

Seroconversion among children with HBsAg-positive mothers in Indonesia and factors affecting the anti-HBs titers

Background and aimAround 2% of newborns are at risk of hepatitis B virus (HBV) infection from their mothers. To prevent this, infants born to HBsAg-positive mothers are given hepatitis B immune globulin (HBIG) and hepatitis B (HB) vaccine as immunoprophylaxis. This study aims to investigate the efficacy of immunoprophylaxis in infants born to HBsAg-positive mothers and the contributing factors. MethodsThe study was conducted on a group of 87 children, ranging from nine months to under 36 months, born to HBsAg-positive mothers and received immunoprophylaxis within 24 h after birth followed by a national immunization schedule at the Community Health Center (CHC) in three administrative cities of DKI Jakarta. We measured the levels of HBsAg and anti-HBs, and utilized ordinal logistic regression models to identify factors that influence the anti-HBs titers after vaccination. ResultsOut of 87 children, only one child had positive HBsAg results. The data showed that 88.5% of the children had seroprotection with anti-HBs levels ≥10 mIU/mL. Additionally, 48.3% of the children had a high protective response with anti-HBs levels ≥100 mIU/mL, while 11.5% had a non-protective response. Children under one year of age, with a family history of HBV carriers, and who received five doses of the HB vaccine exhibited higher levels of anti-HBs titer category with adjusted OR 3.9 (95%CI: 1.3–11.6), 5.3 (95%CI: 1.1–27.4), and 8.3 (95%CI: 2–34.8), respectively. ConclusionThe administration of HBIG and HB vaccine successfully prevented vertical transmission, resulting in a high seroprotection rate.

Gender-Neutral HPV Vaccine in India; Requisite for a Healthy Community: A Review.

Human papillomavirus (HPV) affects approximately 80% of individuals, irrespective of gender, and is implicated in various cancers. Existing HPV vaccines, while safe and effective, do not sufficiently protect males when administered solely to females. This review, triggered by the urgent need to address this gap and reduce the associated stigma, aims to evaluate the introduction of a gender-neutral HPV vaccine, GARDASIL-9, in India. The primary objective is to assess the necessity and feasibility of incorporating the gender-neutral HPV vaccine into India's national immunization program. This integration is crucial to ensure equitable access for all children and to mitigate the substantial burden of HPV. A literature search was conducted using databases such as Google Scholar, PubMed, government websites, and relevant publications. Keywords included "gender-neutral vaccine", "HPV vaccine", and "Indian population". The central research question guiding this review is: How necessary and feasible is the inclusion of a gender-neutral HPV vaccine in India's national immunization schedule to ensure equitable access for all children and reduce the HPV burden? The review inclusion criteria comprised studies addressing the prevalence of HPV infections, HPV vaccination awareness among both genders, the cost-effectiveness of gender-neutral vaccines, current HPV vaccination status, and future perspectives specific to India. Studies not meeting these criteria were excluded. The review highlights that introducing a gender-neutral HPV vaccine in India is imperative. Including males in vaccination efforts significantly reduces the overall disease burden and helps in reducing the stigma associated with HPV. A comprehensive vaccination program, bolstered by education and awareness campaigns, and its inclusion in the national immunization schedule is essential. This approach ensures equitable access to the vaccine for all children, fostering a healthier community, preventing HPV-related cancers, and enhancing public health outcomes in India.

Vaccination equity: Exploring immunization coverage for selected vaccines in urban Bengaluru’s elderly community

Abstract Introduction: Globally, the proportion of elderly individuals is steadily increasing, posing significant challenges for health-care systems. Vaccination plays a crucial role in preventing vaccine-preventable diseases and associated morbidity and mortality in the elderly. In India, there is no national immunization schedule dedicated to the elderly group. This study aimed to explore the vaccination coverage for selected vaccines, namely pneumococcal conjugate vaccine, Influenza, and coronavirus disease 2019 (COVID-19), among the elderly residing in urban Bengaluru. Methods: A cross-sectional study was conducted between January and March 2023. Data were collected from 132 elderly participants living in three wards of Rajajinagar, Bengaluru. A structured questionnaire was used to collect sociodemographic data, health conditions, and vaccination status. The data were analyzed using EPI data 3.1 Software, and the Chi-square test and Fisher’s exact test were used to assess the association of demographic variables with vaccine intake. Results: The results showed that vaccination uptake for influenza and pneumococcal vaccines was nil, while for COVID-19 vaccines, 4.5% of participants had not taken any dose, 6.8% had taken the first dose, 57.6% had taken the second dose, and 31.1% had taken the booster dose. Sociodemographic analysis revealed significant associations between vaccine uptake and variables such as age, socioeconomic status (below the poverty line card holder), and body mass index. Conclusion: The low uptake of vaccines in the elderly population highlights the need for specialized strategies and initiatives to increase vaccination coverage. The study recommends suitable measures to improve vaccination coverage among elderly, creating awareness among healthcare professionals and the general population, and enhancing vaccine accessibility and availability to promote healthy aging in India.

Results and prospects of rotavirus immunisation in the Russian Federation

Scientific relevance. Rotavirus disease and its consequences remain a leading vaccine-preventable cause of mortality in young children. Russia has not yet included rotavirus immunisation in the national vaccination schedule, but paediatric rotavirus vaccines are provided under several regional immunisation programmes.Aim. The authors aimed to review literature covering Russian clinical evidence of the safety and effectiveness of rotavirus vaccines and to analyse the prospects for the development of the national immunisation programme for young children using the available rotavirus vaccines and considering promising pipeline ones.Discussion. Local epidemiological studies on a range of pathogens suggest that rotaviruses are the most common cause of acute intestinal infections, especially in children under 3 years of age. Since Russia’s first rotavirus vaccine approval in 2012, the healthcare system has acquired sufficient experience with rotavirus vaccines to evaluate the safety and effectiveness of rotavirus immunisation. Long-term monitoring of the rotavirus A genotypes circulating in the country shows that currently available rotavirus vaccines cover the majority of identified rotavirus isolates. Local observational studies confirm the favourable safety profile of rotavirus vaccines and demonstrate notable effectiveness of vaccination. In the regions with high immunisation coverage, the overall morbidity has declined dramatically in vaccinated children compared to unvaccinated children; some of these regions have reported only individual hospital visits or admissions for acute intestinal infections.Conclusion. This review demonstrates that rotavirus immunisation should be included in the Russian National Immunisation Schedule.

Rotavirus genotypes in children under five years hospitalized with diarrhea in low and middle-income countries: Results from the WHO-coordinated Global Rotavirus Surveillance Network.

Rotavirus is the most common pathogen causing pediatric diarrhea and an important cause of morbidity and mortality in low- and middle-income countries. Previous evidence suggests that the introduction of rotavirus vaccines in national immunization schedules resulted in dramatic declines in disease burden but may also be changing the rotavirus genetic landscape and driving the emergence of new genotypes. We report genotype data of more than 16,000 rotavirus isolates from 40 countries participating in the Global Rotavirus Surveillance Network. Data from a convenience sample of children under five years of age hospitalized with acute watery diarrhea who tested positive for rotavirus were included. Country results were weighted by their estimated rotavirus disease burden to estimate regional genotype distributions. Globally, the most frequent genotypes identified after weighting were G1P[8] (31%), G1P[6] (8%) and G3P[8] (8%). Genotypes varied across WHO Regions and between countries that had and had not introduced rotavirus vaccine. G1P[8] was less frequent among African (36 vs 20%) and European (33 vs 8%) countries that had introduced rotavirus vaccines as compared to countries that had not introduced. Our results describe differences in the distribution of the most common rotavirus genotypes in children with diarrhea in low- and middle-income countries. G1P[8] was less frequent in countries that had introduced the rotavirus vaccine while different strains are emerging or re-emerging in different regions.

Pneumococcal Polysaccharide Conjugated Vaccines and the Problem of Changing Circulating Serotypes of Pneumococcus

Relevance. In 2007, WHO recommended pneumococcal conjugate vaccines (PCV) be included in national immunization schedules for young children. By 2020, 145 countries, including Russia, were using PCV. Aims. To identify vaccines with high epidemiological and immunological efficacy against various forms of pneumococcal infection, including carriage. Conclusions. It has been shown that PCV has high epidemiological and immunological efficacy against various forms of pneumococcal infection, including carriage. It was revealed that the mass use of PCV, leading to the elimination of "vaccine" serotypes, is simultaneously accompanied by the spread of cases of infection due to serotypes not included in vaccines, which significantly reduces the positive effect of vaccination. This requires frequent replacement of serotype polysaccharides in the vaccine in accordance with the serotypes of circulating strains. An alternative to PCV can be vaccines based on pneumolysin, surface pneumococcal proteins, whole – cell and live attenuated, protein-based subunit vaccines, etc. vaccine variants.

Childhood vaccination coverage and regional differences in Swiss birth cohorts 2012–2021: Are we on track?

AimsMany western countries are challenged by delayed and insufficient vaccination coverage rates in children, and thus missing WHO coverage targets. This study aimed to estimate vaccination coverage and timeliness in Swiss children over a decade. Furthermore, we evaluated the impact of COVID-19, regional variations, and the adherence to the amended vaccination schedule in 2019. MethodsRetrospective observational study with Swiss health insurance claims data including birth cohorts 2012–2021 of children continuously observed until ages 13, 25, and 48 months respectively. We used population-weighted proportions and time-to-event analyses to describe coverage and timeliness of diphtheria/tetanus/pertussis/poliomyelitis/haemophilus influenzae type b (DTaP-IPV-Hib), measles/mumps/rubella (MMR), hepatitis B (HBV), pneumococcal (PCV), and meningococcal (MCV) vaccinations according to the national schedule. The potential impact of COVID-19 and vaccination schedule adherence were evaluated descriptively. Logistic regression was used to investigate regional factors potentially associated with non-vaccination. Results120,073 children, representing between 12 and 17 % of all Swiss children born in corresponding years, were included. Coverage remained stable or improved over the years. The 2019 amendment of the national immunization schedule was associated with an increase of ~10 % points in full coverage in Swiss children for DTaP-IPV-Hib, MMR and HBV despite the concurrent COVID-19 pandemic. Nonetheless, full vaccination coverage remained below 90 % with many vaccination series being delayed or not completed. The comparison across the different vaccines revealed large differences in coverage. Moreover, we observed large regional differences in non-vaccination with children living in rural and German-speaking areas more likely to be entirely unvaccinated. ConclusionFull vaccination coverage in Swiss children is still below 90 % with many vaccinations administered delayed. Given regional differences, missed or delayed booster vaccinations, and differences in vaccine-specific acceptability, more effort may be needed to achieve national vaccination targets.

Poliomyelitis alert on Tunisian borders: response and challenges

Abstract Introduction Poliomyelitis, which disappeared in Tunisia 30 years ago, should be the second disease to be eradicated after smallpox. However, a few endemic foci persist and its recent detection in some regions is causing great concern. On January 11, 2023, Tunisia received an alert with the notification of 2 polio cases in Algeria, the second of which was detected in November 2022 at about 400 KM from Tunisia. The objective of this study is to describe the results of the investigations following this alert as well as the prevention and response measures triggered. Methods We conducted an active search for acute flaccid paralysis (AFP) cases in all governorates and a retrospective search for possible unreported AFP cases hospitalized from November 1, 2022. Vaccination coverage was verified for catch-up if incomplete vaccination. Surveillance of poliovirus shedding in patients with primary immunodeficiencies (PIDs) was also conducted as well as other public health measures. Results As of April 20, 2023, 38 AFP cases have been reported through active search. Retrospective hospital-based surveillance has revealed 31 cases. In addition, 3142 children with deficient vaccination were identified, distributed differently by region. All of them were caught up with Inactivated polio vaccine (IPV). A total of 90 PIDs were followed up. The replacement of the Oral polio vaccine (OPV) dose at 6 months by IPV in the national immunization schedule as well as a request for verification of the possibility of using the new OPV2 in Tunisia and of the required requirements were made. Conclusions The risk of poliomyelitis resurgence in our country is not negligible. Sustained vigilance is necessary, particularly through ensuring high vaccination coverage and effective surveillance to rapidly detect any imported case. This is essential in view of the global context and the existence of outbreaks especially in certain African countries with which several exchanges and migratory flows remain. Key messages • The Poliomyelitis alert on Tunisian borders in January 2023 is a real threat, that should also be taken into consideration by neighboring countries. • Sustained vigilance is necessary, particularly through effective surveillance and appropriate vaccination strategy.

Designing an online educational program to improve immunisation service delivery for migrants and refugees in Australia and New Zealand

Migrants and refugees are likely to be under-immunised according to the host country's national immunisation schedule and may remain under-immunised post-resettlement for various reasons. In Australia and Aotearoa New Zealand, primary health care professionals including general practitioners and nurses provide the majority of routine and catch-up immunisations for migrants and refugees. However, immunisation service delivery for migrants and refugees is complex, with evidence that unmet training needs for immunisation providers, particularly in the development of catch-up plans, is a significant barrier to immunisation service delivery for this group. Targeted professional development opportunities for immunisation providers are essential to improve their awareness, confidence, and capability to improve immunisation service delivery for migrants and refugees. We developed an educational program to support learning for immunisation providers and equip them with the requisite knowledge and confidence to improve immunisation service delivery for refugees and migrants. The development of the multi-module online educational program drew on evidence-based web design principles, adult learning theories, and its content aimed to complement general immunisation training and align with the continuing professional development standards of Australian and New Zealand general practice and nursing colleges. Input from experts and feedback from a few selected providers in Australia and New Zealand added to the robustness of the program. This program has the potential to improve the understanding and capacity of immunisation providers, to improve vaccination experiences and increase overall vaccine uptake among migrants and refugees.

Reassurance of population immunity to diphtheria in England: Results from a 2021 national serosurvey

BackgroundDiphtheria is rare in England because of an effective national immunisation schedule that includes 5 doses of a diphtheria-containing vaccine at 2, 3, 4 months, preschool and adolescent boosters. However, in recent years there has been a notable increase in cases due to Corynebacterium ulcerans among older adults and evidence of endemic transmission of C. diphtheriae (normally associated with travel to endemic countries). We aimed to update 2009 estimates of diphtheria immunity considering the evolving epidemiology. MethodsResidual sera collected from diagnostic laboratories and general practitioners in England in 2021 were randomly selected and tested for diphtheria antibody, to estimate proportions protected per age group. Diphtheria antibody levels were defined as susceptible (<0.01 IU/mL), basic protection (0.01–0.099 IU/mL) and full protection (≥0.1 IU/mL). Immunity estimates were standardised to the England population and compared to 2009. ResultsBased on 3,745 residual sera tested, 89% (95%CI: 87%–90%) of the 2021 England population had at least basic diphtheria protection (vs. 90% [88%–92%] in 2009) and 50% (48%–52%) full protection (vs. 41% [38%–44%]). Higher antibody levels were observed in those aged 1 and under, 10–11, 12–15, 25–34 and 35–44 years compared to 2009. The largest proportion susceptible were observed in those aged 70+, 26% (21%–31%) vs 12% (7%–18%) in 2009. ConclusionsBasic diphtheria protection is comparable between 2021 and 2009. The increase in immunity in working age adults is likely due to the school leaver booster introduced in 1994. The current vaccination schedule is maintaining sufficient population immunity. However, we recommend clinicians remain vigilant to severe diphtheria outcomes in older adults, because of their observed susceptibility.

Influence of medical and social factors on parents' attitude to specific prevention of infectious diseases in children of the Saratov region during the new coronavirus infection pandemic

Objective: to analyze the influence of medical and social factors on the attitude of parents to the specific prevention of infectious diseases in children during the pandemic of a new coronavirus infection. Material and methods. Anonymous questioning of parents on the attitude to vaccination was conducted. A specially designed questionnaire included questions about attitudes towards vaccines included in the National Immunization Schedule, as well as those not included in it, in particular, the desire of parents to vaccinate their children against COVID-19 was assessed. In total, 153 people aged 17 to 42 took part in the survey — parents of children aged 1 to 14 years. Results. All parents under 18 years of age support vaccination in accordance with the National Vaccination Calendar; 52.1% of parents aged 18—25 years (p &lt; 0.001), 55.6% of parents aged 26—35 years (p &lt; 0.001 compared to parents under 18 years old), and 66.7% of parents over 35 years old (p &lt; 0.001 compared to parents under 18 years old and parents 18—35 years old). Conclusion. The main medical and social factors associated with the refusal to carry out preventive vaccinations for their children are: the age of parents under 35, incomplete higher education and trust in information received on the Internet. The results obtained indicate the need to determine the «risk group» among parents who express doubts about the need for vaccination. It is necessary to conduct educational programs for them in order to form a positive attitude towards the specific prevention of infectious diseases.

What factors contribute to parental vaccine hesitancy for children aged 0–5 years?

A growing proportion of children in England aged 0–5 years are not being vaccinated in line with the national immunisation schedule. Evidence suggests that this is, in part, due to parents declining all or some vaccinations. A deeper understanding of the reasons behind parental ‘vaccine hesitancy’ would enable effective health promotion approaches to ensure the success of childhood vaccination programmes. With this in mind, a literature review was conducted. Analysis of the selected papers identified emerging themes that contributed to parental vaccine hesitancy for children aged 0–5 years. These included a lack of parental perception that routine vaccines are needed; safety concerns for vaccines being offered; and a belief that a child’s immune system would be ‘overloaded’ if several vaccines were given at one time. The findings suggest a collaborative approach between parents, health professionals and stakeholders is needed to tackle the problem of parental vaccine hesitancy.

A Decade of Experience in the use of 13-Valent Conjugated Polysaccharide Pneumococcal Vaccine in Russian Federation

Pneumococcal infection remains a significant global health problem, and vaccination is the main measure for its prevention. To date, the period of use of pneumococcal conjugated polysaccharide vaccines in Russia exceeds 14 years, and 13-valent conjugated polysaccharide pneumococcal vaccine (PCV13) - more than 10 years. During this time, extensive experience has been accumulated in the use of this type of vaccines, and many studies have been carried out to evaluate their effectiveness and safety.The purpose of this review is to summarize the experience of using PCV13 in Russian Federation with an assessment of its epidemiological and clinical effectiveness. A search was made for scientific publications devoted to the study of the epidemiological efficacy, the safety as well as cost-effectiveness of PCV13 use in Russian Federation. The review included original studies published in Russian journals. The results of the studies carried out indicate the efficacy and safety of PCV13 for both adults and children. The effectiveness of immunization of children at risk (premature, suffering from congenital pathology, having chronic diseases and often ill) was demonstrated, the need and safety of the timely start of vaccination (from 2 months of age) of newborns was shown, the possibility of its combination with immunization against other infections within the framework of the national vaccination schedule, the importance of following the recommended vaccination schedule in accordance with the age of the child. The effectiveness of vaccination of adults suffering from chronic diseases has been shown both in terms of preventing the aggravation of the course of the underlying pathology and reducing the risk of pneumonia. Positive experience has been gained in immunizing adults from occupational risk groups - medical workers, conscripts and persons exposed to a harmful production factor and having occupational lung diseases. The conducted studies have shown a high cost-effectiveness of PCV13 vaccination, however, with any changes in price and epidemiological parameters, it is necessary to clarify the economic feasibility of vaccination under the changed conditions. Taking into account the positive experience gained in immunization, it seems appropriate to further maintain a high level of vaccination coverage of the child population, expanding risk groups among the adult population subject to vaccination against pneumococcal infection within the framework of the National Immunization Schedule, taking into account its epidemiological, clinical and economic efficiency.

Impact of hepatitis B birth dose on immune response in Pakistani children: an open-label, non-inferiority randomized controlled trial, implications for achieving SDG target

Background Despite presence of hyperendemic areas, the national immunisation schedule in Pakistan does not include a hepatitis B birth dose, placing newborns at an additional risk of acquiring hepatitis B. This study aimed to assess the impact of adding hepatitis B birth dose in existing national vaccination schedule. Methods An open label, randomised controlled non-inferiority trial enrolled 296 healthy near-term mothers to intervention and control groups. Newborns in the intervention group received a hepatitis B birth dose along with routine immunisation vaccines, while control group newborns received vaccinations under the national schedule. Seroprotection was measured and compared at birth and 8 weeks after administering the third dose of pentavalent vaccine. The risk ratio of seroprotection was computed and compared with the delta value set at 5%. Results The study found that 95.8% of infants in the intervention group achieved seroprotection, which was significantly higher than the control group’s 58.7%. The difference in risk ratio of seroprotection was 1.62 (CI95: 1.37–1.93), with the upper limit of the CI below the delta margin, confirming non-inferiority. The time interval between birth and the first hepatitis B immunisation shot was a predictor of seroprotection, with an odds ratio of 1.79 (CI95: 1.01–2.9). Conclusion Our study indicates that adding a hepatitis B birth dose to the immunisation schedule in Pakistan is non-inferior to the existing one. This can also contribute towards Pakistan’s achievement of the SDG target of reducing hepatitis B surface antigen seroprevalence in children under 5 years of age. Trial Registration Number NCT04870021

Is It Not The Right Time To Consider Trivalent Mumps Vaccine (MMR) In The National Immunization Programme of Nepal? If Not Now, Then When?

Vaccination is the process of administration of a vaccine to help the immune system develop immunity from a disease resulting in reduction of child mortality, morbidity and disability in vaccine preventable diseases. Nepal started its pilot vaccination program in 1979 (2034 B.S) and after a decade (1989), the Expanded Program on Immunization (EPI) was followed to the whole country with the aim of universal vaccination in children. National immunization programme (NIP) provides vaccination services free of cost to the children living in marginalized communities and geographical regions difficult to reach through outreach sessions. Although many more vaccines have been added to the NIP of Nepal since then, vaccination against mumps is still missing. Nepalese children are being vaccinated with MR vaccine (measles and rubella) at 9 completed months and a booster at 15 months in spite of MMR (measles, mumps and rubella) vaccine. The time to re-think and consider mumps vaccine (MMR) in the immunization schedule of Nepal by the government of Nepal has arrived now. Including MMR vaccine in the national immunization schedule would ultimately result in the reduction of the outbreaks and associated morbidity that occur annually along with the economic benefits.

CERVICAL CANCER AND ITS SCREENING: KNOWLEDGE, PRACTICES OF SCREENING AND VACCINATION AMONG SELECTED WOMEN HEALTHCARE PROFESSIONALS IN HOSPITALS OF KOLKATA, INDIA

Introduction: Cervical cancer is a major killer among women in less developed countries. It is a preventable disease if screened regularly and women are vaccinated. But late detection leads to poor outcomes and morbidity. The objective was to assess knowledge about Cervical cancer and its practices of screening and vaccination among women health care professionals. Methods: It was a descriptive, cross-sectional survey carried out through an online questionnaire among women healthcare professionals of 21-65 years in various hospitals in Kolkata city, India. Results: 72% (203) Participants had good knowledge, 19%(54) have moderate and 9%(25) had poor knowledge about Cervical cancer, its screening tests, and high-risk factors. Only 34(12.4%) had been completely vaccinated against Human papillomavirus (HPV). Also, 189(67%) women in this group never had a Papanicolaou (PAP) test. Conclusion: Most of the women had good knowledge about Cervical cancer, practices of screening and vaccination, but had not undergone screening or vaccination. A positive uptake towards Cervical cancer screening and vaccination protocols for themselves shall help them in better health promotion towards their clientele. More emphasis needs to be paid to disseminating health information and the importance of screening and vaccination. We need to recognize the need to include the HPV vaccine in the National Immunization Schedule. HPV vaccination and HPV-based PAP screening have the potential to reduce Cervical cancer incidence in the coming decades if implemented on a global basis.

Assessing vaccine effectiveness for varicella in Wuxi, China: a time-series analysis

Objective The varicella vaccine is not included in the national childhood immunization schedules in China. Varicella epidemics and outbreaks are frequently reported, and the evidence for the effectiveness of the varicella vaccine remains unclear. The aim of this study was to investigate varicella vaccine effectiveness in Wuxi, China. Methods Varicella surveillance data were extracted from the China Information System for Disease Control and Prevention, and vaccination data were obtained from the Vaccination Integrated Service Management Information System of Jiangsu Province, China. Time-series analysis approaches were used to estimate varicella vaccine effectiveness. Results A total of 16,093 varicella cases among children aged 1–6 years between January 2016 and December 2020 were analysed. A total of 217,297 children completed a two-dose varicella vaccination series. Compared with districts with lower vaccination rates, districts in Wuxi with higher varicella vaccination rates had a lower proportion of cases (p < 0.001). In the time-series approach, 0.8% fewer varicella cases were associated with a 1% increase in the two-dose varicella vaccination rate (p < 0.001), and similar effects were found in both the male and female populations. Conclusions Two-dose varicella vaccination was recommended as an effective health intervention to prevent varicella in Wuxi, China. Varicella vaccination is urgently needed in routine childhood immunisation programs.

Efficacy of HPV vaccine in preventing cervical cancer in the Tomsk region

Background. The age-standardized cervical cancer incidence rate in the Tomsk region in 2021 was consistently higher than the average for the Russian Federation (21.2 / 100,000 versus 13.6 / 100,000 women). Primary prevention of cervical cancer is best achieved by human papillomavirus (HPV) vaccination of girls. Aim. To evaluate HPV vaccine efficacy for the prevention of cervical cancer in the Tomsk region within the framework of implementation of two regional programs: “Prevention of gynecological cancer and rehabilitation of women diagnosed with gynecological cancer in 2008–2010” and “Urgent measures to improve cancer care for the population of the Tomsk region in 2011–2013”. Material and methods. We studied the tolerability and efficacy of HPV vaccination for the prevention of HPV-associated cervical cancer in 439 vaccinated girls aged 9–26 years during a follow-up time of 14-years. Results. The assessment of a 14-year follow-up study of the impact of HPV vaccination on HPV-associated cervical lesions has shown that HPV vaccine is safe and 100 % effective. Conclusion. Further prospects for primary prevention of cervical cancer before the introduction of vaccines against HPV infection in the national immunization schedule indicates the feasibility and real clinical effectiveness of the introduction of regional and regional programs with the development of a mathematical model for optimizing financial costs for primary prevention of cervical cancer, taking into account demographic parameters and socio-economic damage from cervical cancer in the study area.