National Immunization Schedule Research Articles

Determination of immunisation status of children between 2-5 years of age who attending to teaching institute with concern to both national immunization schedule and optional vaccines

Background: In order to know the causes for non-immunisation, search for societal reasons for primary immunisation along with evaluating coverage. Aim of this current study is to determine the immunisation status of children between 2-5 years of age who are attending teaching health care centre with concern to both National Immunisation Schedule and Optional vaccines. Methods: Study analysed the children's immunisation status, factors affecting their immunisation coverage, and reasons for partial or incomplete immunisation. The information was obtained from the parents using a questionnaire. Information such as socio-demographic variables, immunisation status, causes of their partial immunisation and lack of immunisation. The "vaccination card and the recall" approach was used to determine the recipient's immunisation status. Results: Study found that 70.4% of children had received all recommended vaccinations. Lack of information and ignorance are significant contributors to under-immunization. Other statistically significant contributing factors for the low immunisation coverage include female gender, rural background, low socioeconomic status, born at home, lower mother age, and being from a joint household. BCG vaccination coverage was higher than pentavalent vaccine coverage, probably because of multiple doses needed. Only 77% of kids received vitamin A solution. Conclusions: Paediatrician should mention the next vaccination date and dose at each appointment in order to lower the vaccination dropouts. Parents should be informed regarding the date of vaccination of their child through SMS message, calls, and social media groups.

Dynamics of Timely Vaccination Among Tender-Age Infants in two Subjects of Russian Federation with the Lowest Immunization Coverage in 2020: Serial Cross-Sectional Study

Background. It was revealed in 2020 that immunization of children in decreed times in several subjects of Russian Federation was below the standard level. Therefore, monitoring of timely vaccination in children of these regions was relevant. Objective. The aim of the study is to evaluate changes in the timeliness of vaccination in children of two subjects of Russian Federation with low immunization rates according to 2020 data. Methods. Immunization of children born in 2015–2017 and 2020–2022 were studied according to the form of federal statistical monitoring (FFSM) No. 6 and vaccination record cards (form No. 063/y) obtained from children's polyclinics of the Republic of Bashkortostan (two in 2020 and three in 2023) and the Republic of Sakha (Yakutia) (two in 2020 and four in 2023). The vaccination timeliness among children against infections from the national immunization schedule (NIS) list was determined. The timeliness of vaccination was evaluated by the proportion of children who received the required number of vaccine doses against each of the infection from the NIS list by the decreed age among all persons of the decreed age. Results. Data from 998 records was analyzed. The increase in timely vaccination against all vaccine-controlled infections in children was revealed. The proportion of children vaccinated according to the NIS has increased by 1.5–4 times. Timely vaccination of 95% children in the decreed age (by FFSM No. 6) was achieved in the Republic of Sakha (Yakutia) against tuberculosis, hepatitis B, measles, rubella, and mumps, and in the Republic of Bashkortostan against measles, rubella, and mumps. The increase in the multivalent vaccines’ usage and simultaneous administration of several vaccines has been discovered. Conclusion. Monitoring the level of documented immunization and timely vaccination in children allows effectively control routine immunization quality. Implementation of multivalent vaccines and simultaneous administration of several vaccines in routine immunization provides radical change in the vaccination rate in pediatric population.

National Concept of Development of Vaccine Prophylaxis in Russia

The article is dedicated to outlining the conceptual directions for the development of vaccination in the Russian Federation. The provisions of the concept are formulated based on the authors' years of research on vaccination issues and analysis of data from domestic and foreign scientific literature. The main provisions of the concept aim at strengthening the state policy in the field of vaccination, reconstructing and expanding enterprises for the production of domestic vaccines, developing and improving immunobiological medicinal products against current infections, refining the National Immunization Schedule and Vaccination Schedule according to epidemiological indications; further promoting the WHO's "lifelong immunization" strategy; developing regional immunization programs; implementing a risk-oriented approach in the development of immunization programs; developing a system for monitoring post-vaccination complications; implementing epidemiological surveillance of vaccination as a methodology for assessing the strategy and tactics of immunization in accordance with the epidemiological situation; ensuring commitment to vaccination among the population, healthcare workers, and legislative and executive authorities.

High burden of human papillomavirus infection among men in Guangzhou, South China: Implications for HPV vaccination strategies.

The epidemiological and clinical aspects of Human Papillomavirus (HPV) infection in women have been extensively studied. However, there is a lack of information regarding HPV characteristics in males. In this study, we conducted a retrospective and observational study of 3737 consecutive male individuals attending outpatient clinics of Guangdong Women and Children Hospital from 2012 to 2023 in Guangzhou, South China, to determine the age- and genotype-specific prevalence of HPV in men. The results showed the overall prevalence of HPV among men was 42.15% (1575/3737), with variations ranging from 29.55% to 81.31% across distinct diagnostic populations. Low-risk HPV6 (15.47%), HPV11 (8.94%), and high-risk HPV52 (5.51%) were the most common types. The annual HPV prevalence decreased significantly (Z = -3.882, p < .001), ranging from 31.44% to 52.90%. 28.77% (1075/3737) of men manifested infection with a singular HPV type, predominantly identified as a low-risk type. The age-specific distribution of HPV infections revealed distinctive peaks in the < 25 y age group (47.60%, 208/437) and the 40-44 y age group (44.51%, 154/346). Notably, the positive rate of Chlamydia trachomatis was significantly higher among HPV-positive individuals in comparison to HPV-negatives (16.14% vs. 11.25%, p < .05). Our findings reveal a substantial prevalence of HPV infection among outpatient men in Guangzhou, South China. It is recommended to consider the inclusion of HPV vaccination for adolescent males in national immunization schedules, once an adequate supply of vaccines is accessible.

IJCM_263A: Vaccine Hesitancy in Tribal Communities: A Study on Parents of children under 5 years of age

Background: People who delay or refuse vaccines for themselves or their children are presenting a growing challenge for countries seeking to close the immunization gap. Objective: To determine the proportion of vaccine hesitancy and associated factors among informants of children under five years of age (U-5) within tribal communities in Wayanad. Methodology: A cross sectional study was carried out in tribal colonies of Kalpetta taluk of Wayanad District. Sample size was calculated to 168 based on a study on vaccine hesitancy conducted among tribals at Murshidabad where the prevalence of vaccine hesitancy was 36.9% with an absolute error (d) = 7%. Out of the 175 colonies in the taluk of Kalpetta, 11 colonies were randomly selected. Informants of children ages &lt; 5 years Vaccine hesitancy among parents and guardians was assessed individually for each child in the household. If the informants were hesitant to give any vaccine included in the national immunization schedule they were listed as vaccine hesitant. A total of 208 U-5 children informants were interviewed. Vaccine hesitancy was assessed by adopted SAGE questionnaire. Results: Mean age of the informants was 30.3 + 7.90 and of U-5 children were 2.87 years + 1.45. Majority of the informants were mothers of U-5 children (88.5%), more than 3/4th of the informants belonged to Paniya tribe, most of the participants were unemployed (64.9%). Vaccine hesitancy to any of the vaccine in the immunization schedule was found among 23 participants (11%), majority were hesitant to take Pentavalent vaccine 12(5.76%). Fear of needles, too many vaccinations at 1 sitting and adverse effects following vaccinations were common reasons for being hesitant. Conclusion: The vaccination program is driven by health workers reducing vaccine hesitancy, however with greater motivation and awareness among the community vaccine hesitancy can be further reduced.

IJCM_205A: A qualitative study to assess factors affecting the uptake of measles vaccine in a metropolitan city

Background: Measles is a communicable and potentially fatal, but vaccine- preventable disease. India has set a target of 95% vaccination coverage for Measles-Rubella elimination by the end of 2023 with the help of Intensified Mission Indradhanush (IMI 5.0). The National Immunization Schedule of India recommends two doses of Measles-Rubella (MR) vaccine at 9 months and 16-24 months. The immunization coverage dropped across the globe during the COVID-19 pandemic during the year 2020-2021. Consequently, there was a recent surge in measles cases in some Indian states. The state of Maharashtra reported over 3000 cases; and its capital city Mumbai reported with over 400 cases in December 2022. Various factors such as fear of side effects, lack of information and ignorance have been found to influence vaccine uptake. Objective: To determine the factors associated with the uptake of measles vaccine in the community. Methodology: The study data collection was conducted during November- December 2023, in the M-east municipal ward of Mumbai, using Qualitative research methods until data saturation, i.e., In-depth Interviews and Focus- Group Discussions. 1. On a one-to-one basis, In-depth Interviews (IDI) were conducted among health authorities and healthcare workers involved in the immunization program, from the Public Health Department of Mumbai. 2. Focus-Group Discussions were conducted with a homogenous group of participants comprising mothers of under-five children, and healthcare workers. Results: The most common barriers in measles vaccination that emerged was fear of side effects and overworked healthcare workers, while the motivating factors were good rapport between the community and healthcare workers and communicating health-related information. One of the core themes that emerged was the need for strengthening routine immunization services. Conclusion: Tremendous efforts are taken by the public health systems and healthcare workers in the community for ensuring good quality healthcare, including routine immunization. However, establishing a good rapport and building trust among the community members is the need of the hour for ensuring a robust immunization coverage uniformly across the nation.

A case of co-infection with head lice and varicella in a child: considerations for rational management

A case of co-infection with head lice and varicella in a child: considerations for rational management

Etiologies of Mild and Moderate Diarrheal Illness among Children in Consuelo, Dominican Republic.

Since the rotavirus vaccine was included in the Dominican Republic's national immunization schedule in 2012, the microbiologic etiologies of acute gastroenteritis have not been described. This study aimed to determine the contribution of rotavirus as an etiology of acute gastroenteritis over a 12-month period in children under 5 years of age in both an inpatient and an outpatient setting in Consuelo, Dominican Republic. All children who were seen at Niños Primeros en Salud clinic or admitted to Hospital Municipal Dr. Angel Ponce Pinedo for acute gastroenteritis during January 2021-April 2022 were enrolled in the study. Stools were evaluated for rotavirus, enteric parasites, and pathogenic bacteria. Pathogen detection was compared between outpatients and inpatients and on the basis of child's vaccination status. From 181 children enrolled, 170 stool samples were collected, 28 (16.5%) from inpatients and 142 (83.5%) from outpatients. Rotavirus was the most commonly detected pathogen and was proportionately more common among hospitalized children, with nine (32.1%) cases among hospitalized children and 16 (11.3%) among outpatient children. (Pearson χ2 = 8.1, P = 0.004). Among patients with a positive rotavirus result, vaccination rate was lower among moderate (hospitalized) (three of six; 50%) compared with mild (outpatient) diarrhea patients (12 of 15; 80%). Giardia lamblia (10%) was the next most prevalent pathogen detected in both inpatients and outpatients using standard laboratory measures. Despite the availability of rotavirus vaccination, rotavirus remains a common cause of gastrointestinal illness among children under 5 years of age in our cohort. Incomplete vaccination status was associated with hospitalization for gastrointestinal illness.

Using intervention mapping to develop an implementation strategy to improve timely uptake of streamlined birth-dose vaccines in the Democratic Republic of the Congo.

Despite the policy recommendation and effectiveness of administering the hepatitis B birth-dose vaccine (HepB-BD) to newborns to prevent mother-to-child hepatitis B transmission, timely uptake remains an issue. Countries adopting the HepB-BD to their national immunization schedule report programmatic challenges to administering the vaccine within the recommended 24-hour window after delivery. Further, while the World Health Organization recommends streamlining three birth-dose vaccines (HepB-BD, BCG, and OPV0), scarce Sub-Saharan(SSA)-based literature reports on a streamlined and timely approach to birth-dose vaccines. As more SSA countries adopt the new birth-dose vaccine to their immunization schedules, a systematically developed implementation strategy-Vaccination of Newborns-Innovative Strategies to Hasten Birth-Dose vaccines' delivery (VANISH-BD)-will facilitate the adoption and implementation of timely birth-dose vaccine uptake. In this paper, we describe the development of the implementation strategy using intervention mapping, an evidence-based and theory-driven approach. We report on the development of our intervention, beginning with the needs assessment based in Kinshasa Province, Democratic Republic of the Congo (DRC), informing step 1 of intervention mapping. The intervention is contextually relevant, locally produced, sustainable, and designed to improve timely birth-dose vaccine uptake in the DRC. We intend to inform future implementers about improving timely and streamlined birth-dose vaccine uptake and for VANISH-BD to be adapted for similar contexts.

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.

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.