Provision Of Immunization Services Research Articles

Informal health sector and routine immunization: making the case for harnessing the potentials of patent medicine vendors for the big catch-up to reduce zero-dose children in sub-Saharan Africa.

The COVID-19 pandemic caused a surge in the number of unimmunized and under-immunized children in Africa. The majority of unimmunized (or zero-dose) children live in hard-to-reach rural areas, urban slums, and communities affected by conflict where health facilities are usually unavailable or difficult to access. In these settings, people mostly rely on the informal health sector for essential health services. Therefore, to reduce zero-dose children, it is critical to expand immunization services beyond health facilities to the informal health sector to meet the immunization needs of children in underserved places. In this perspective article, we propose a framework for the expansion of immunization services through the informal health sector as one of the pillars for the big catch-up plan to improve coverage and equity. In African countries like Nigeria, Ethiopia, Tanzania, and the Democratic Republic of Congo, patent medicine vendors serve as an important informal health sector provider group, and thus, they can be engaged to provide immunization services. A hub-and-spoke model can be used to integrate patent medicine vendors into the immunization system. A hub-and-spoke model is a framework for organization design where services that are provided by a central facility (hub) are complimented by secondary sites (spokes) to optimize access to care. Systems thinking approach should guide the design, implementation, and evaluation of this model.

Progress Toward Measles Elimination - World Health Organization Eastern Mediterranean Region, 2019-2022.

In 2015, all 22 World Health Organization Eastern Mediterranean Region (EMR) countries and areas (countries) pledged to achieve measles elimination by 2020. Despite success in several countries, most countries in the region still have not eliminated measles. This report updates a previous report and describes progress toward measles elimination in EMR during 2019-2022. During that period, estimated regional coverage with the first and second doses of a measles-containing vaccine (MCV) was 82%-83% and 76%-78%, respectively. During 2019-2022, approximately 160 million children were vaccinated during national or subnational supplementary immunization activities. Reported confirmed regional measles incidence decreased from 29.8 cases per 1 million population in 2019 to 7.4 in 2020, but then increased 68%, to 50.0 in 2022 because of challenges providing immunization services and conducting surveillance during the COVID-19 pandemic. Surveillance indicators deteriorated in 11 (50%) of the 22 EMR countries. During 2019-2022, four countries in the region were verified as having achieved measles elimination, but other countries reported immunity gaps and increased measles incidence in 2022. To achieve measles elimination in EMR, national immunization programs, especially in those countries with high measles incidence, will need to continue to recover from the COVID-19 pandemic, increase overall vaccination coverage to close immunity gaps, and maintain high-quality disease surveillance.

Unfolding COVID-19 vaccine communication campaigns in China's neighborhoods: a qualitative study of stakeholders' narratives.

The Chinese state has recently implemented the COVID-19 Vaccine Communication Campaign (CVCC) to counter vaccine hesitancy. Nonetheless, the extant literature that examines COVID-19 vaccine acceptance has less represented COVID-19 vaccine communication efforts. To address this lacuna, we qualitatively explored how CVCCs were organized in Chinese communities by investigating 54 Chinese stakeholders. This study indicates that the CVCC was sustained by top-down political pressure. CVCCs' components involve ideological education among politically affiliated health workers, expanding health worker networks, training health workers, implementing media promotion, communicating with residents using persuasive and explanatory techniques, encouraging multistakeholder partnerships, and using public opinion-steered and coercive approaches. While CVCCs significantly enhanced COVID-19 vaccine acceptance, lacking open communication, stigmatizing vaccine refusers, insufficient stakeholder collaboration, and low trust in the COVID-19 vaccination program (CVP) eroded the validity of CVCCs. To promote the continuity of CVCCs in China, CVCC performers are expected to conduct open and inclusive communication with residents. Furthermore, CVP planers should create robust partnerships among health workers by ensuring their agreements on strategies for implementing CVCCs and optimize COVID-19 immunization service provision to depoliticize CVPs. Our study will not only deepen global audiences' understanding of CVCCs in authoritarian China but also offer potential neighborhood-level solutions for implementing local and global public health communication efforts.

Assessment of vaccine management performance in health facilities of Mwanza Region, Tanzania: a cross-sectional study

BackgroundEffective Vaccine Management (EVM) initiative provides the platform needed to monitor and assess the vaccine supply chain system to identify strengths and weaknesses of the system at all levels and enhance the development of continuous improvement plan to strengthen the system. This study was conducted to determine the vaccine management performance in Health Facilities of Mwanza Region, Tanzania.MethodsThis was a descriptive cross-sectional study that was carried out in 102 health facilities providing immunization services from eights districts of Mwanza Region in Tanzania. The World Health Organization (WHO) effective vaccine management assessment tools were used to collected data. Both quantitative and qualitative (through key informant interviews) approaches were used. The quantitative data were analysed using the existing WHO criteria for analysing effective vaccine management assessment data, while deductive thematic analysis was used for the qualitative data.ResultsThe finding shows that the overall score for vaccine management performance was 53% which is below the WHO acceptable minimum score of 80%. None of the health facilities had reached the benchmark but only 67% had an average performance (> = 50–< 80%). The highest health facility score was 76% and the lowest being 27%. Among the categories assessed, the highest score was on information technology with 72%, while the lowest was on standard operating procedures with a score of 43%. The major challenges which contributed to low performance were lack of training, low knowledge about vaccine management practices, unavailability of standard operating procedures (SOPs), and limited financial resources to support operations for vaccine management practices. Skills gap, incomplete stock records and management, as well as low availability of SOPs were the key challenges reported that affected vaccine management practices.ConclusionsEffective vaccine management performance was low across all districts under the study. Increasing personnel capacity and ensuring availability of resources to support operations were reported as key interventions in improving vaccine management practices. Hence, effectively working on continuous improvement plan with key highlighted actions is highly recommended to all actors from national level to sub-national level managers and healthcare workers as frontline vaccine handlers.

Technical guidelines for seasonal influenza vaccination in China (2023-2024)

Technical guidelines for seasonal influenza vaccination in China (2023-2024)

The evaluation of quality of immunization services of children in Primary Medical Sanitary Centers in Oron, Akwa Ibom state, Nigeria

Nigeria, with its low routine immunization coverage and wild poliovirus reservoir, significantly contributes to overall regional burden of vaccine-preventable diseases. Since introduction of the EPI in 1974 (which later became the National Program of Immunization), Nigeria's immunization program suffered from declining coverage. The poor quality of immunization affects service utilization, even where they are provided for free, just as immunization services are. The quality assessment will provide both notion of degree of satisfaction of clients with services and framework for revision of program priorities, strategies and components Purpose of the study is to evaluate quality of immunization services provided to children in primary health centers in Oron, Akwa Ibom State, Nigeria. The study targets to identify strengths and weaknesses of immunization services, to evaluate level of compliance with national and international standards of immunization and to develop corresponding recommendations. The study seeks to contribute to body of knowledge about quality of children immunization services in Nigeria, particularly in context of primary health centers. The study may help to improve delivery of immunization services in the region and to ensure that more children will be vaccinated and protected against vaccine-preventable diseases. The cross-sectional descriptive study of quality of immunization services in primary health centers was carried on in Akwa Ibom State, Nigeria. The variables as indicators such as physical environment, resource availability, client satisfaction etc. were utilized and included into questionnaire. The study covered 402 caregivers and 152 medical workers in 12 primary health centers. The client questionnaire, facility staff questionnaire, facility checklist, personal observation,focus group discussion guide and client flow chart were applied. The results demonstrated that quality of immunization services was poor. The caregivers were dissatisfied both with reception by providers and too long waiting time. The attitude of health care providers was also mentioned as cause of dissatisfaction. This study demonstrated that community health extension workers constituted majority (39.4%) of immunization service providers. Out of 152 health care providers that participated in the study, 92 (60.9%) had attended in-service training on immunization within previous two years. The comparison of staff categories with attendance at in-service training established statistically significant difference (p=0.0072), suggesting that whether one attended in-service training or not depended on category of staff one belongs to. Of all staff, 112 workers (73.3%) knew proper vaccine storage temperature while 40 (26.7%) did not. The health care providers who do not know proper vaccine storage temperature may administer vaccines with compromised potency. Most of health care providers (149 or 98.0%) were aware that clients have particular rights that in overall is referred as client rights. Only by knowing rights of clients providers would be expected to respect these rights. The client right with which most of providers were agreed was right to information (105 or 70.2%). While right with which most providers were disagree (52 or 34.0%)) was right to choice of where and when access immunization services. The study conducted thorough quality assessment of children imunization services in primary health centers in Oron, Akwa Ibom State, Nigeria. The results revealed both strengths and weaknesses in delivery of immunization services to children in the region. While there were areas of average performance due to experienced and trained health care workers, there were also areas of concern with inadequate cold chain storage and insufficient record-keeping practices. The study recommends to improve quality of immunization services in the region, including strengthening cold chain system, ensuring adequate record-keeping practices and implementing regular training and supervision of medical workers. These measures are crucial to ensure that more children are vaccinated and protected against vaccine-preventable diseases. The results of the study contribute to body of knowledge on quality of children immunization services in Nigeria and emphasize importance to continue efforts improving delivery of immunization services to children. There is hope that proposed recommendations will become a basis for policy decisions making and ultimately will result in better health outcomes for children in Oron, Akwa Ibom State and beyond.

Online Resources: Coding for Vaccine and Immunization Administration Services

The costs of providing immunization services in a pediatric practice are not insignificant. It is important to use business and coding practices that protect a practice’s investment in these services. This article reviews American Academy of Pediatrics (AAP) online resources to assist members with financing and payment to support in-office immunization services. Among those resources are AAP vaccine financing and payment support resources AAP Vaccine Coding Table Assistance with vaccine payment issues

Quality assessment of childhood immunisation services in primary health centres in Oron, Akwa Ibom State, Nigeria

Introduction. With 20% of the African population, low routine immunization coverage, and a wild poliovirus reservoir, Nigeria contributes significantly to the overall regional burden of vaccine-preventable diseases. Since the introduction of the EPI in 1974 (which later became the National Programme on Immunization), Nigeria’s immunization program has suffered declining coverage. Poor quality affects service utilization, even where the services are provided free, just as immunization services are. Quality assessment will give an indication of the degree of satisfaction of clients with services as well as provide a framework for review of program priorities, strategies, and componentsPurpose of the study. The purpose of the study is to evaluate the quality of immunisation services provided to children in primary health centres in Oron, Akwa Ibom State, Nigeria. The study aims to identify the strengths and weaknesses of the immunisation services, assess the level of compliance with national and international standards for immunisation, and make recommendations for improvement where necessary. Additionally, the study seeks to contribute to the body of knowledge on the quality of childhood immunisation services in Nigeria, particularly in the context of primary health centres. Ultimately, the findings of this study may help to improve the delivery of immunisation services in the region and ensure that more children are vaccinated and protected against vaccine-preventable diseases. Materials and methods. This was a cross-sectional descriptive study of the quality of immunization services in Primary Health Centers in Akwa Ibom State, Nigeria. This study utilized some variables as indicators which included physical environment, resource availability, client satisfaction etc. formed into a questionnaire. The study involved 402 caregivers and 156 healthcare providers in 12 Primary Health Centers. The study utilized six instruments namely the Client questionnaire, Facility staff questionnaire, Facility Checklist, Personal Observation, Focus Group Discussion Guide, and Client Flow Chart.Outcomes. The results showed that the quality of immunization services was poor. The caregivers were dissatisfied with the reception by the providers. They were also not satisfied with the waiting time which they complained of as being too long. The attitude of the health care providers was also a cause of dissatisfaction.Discussion. This study found that the Community Health Extension Workers constituted the majority (39,4%) of the immunization service providers. Of the 152 healthcare providers that participated in the study, 92 (60,9%) had attended in-service training on immunization within the previous two years while 59 (39,1%) had not. A comparison of staff categories with attendance at in-service training showed a statistically significant difference (p=0.0072),suggesting that whether one attended in-service training or not depended on the category of staff he/she belongs to. One hundred and twelve (73,3%) of staff knew the correct vaccine storage temperature while 40 (26,7%) did not know. Healthcare providers who do not know the correct vaccine storage temperature may administer vaccines whose potency has been compromised. One-hundred and forty-nine (98,0%) healthcare providers were aware that clients have certain rights collectively referred to as clients’ rights. It is only by knowing the rights of clients that providers would be expected to respect these rights. The clients’ right to which most providers indicated strong agreement that clients are entitled to, was the right to information as indicated by 105 (70,2%) providers while the right to which most providers indicated disagreement was the right to choice of where and when to access services. Fifty-two (34,0%) health care providers felt clients were not entitled to this right.Conclusion. In conclusion, the study conducted a thorough quality assessment of childhood immunisation services in primary health centres in Oron, Akwa Ibom State, Nigeria. The findings reveal both strengths and weaknesses in the delivery of immunisation services to children in the region. While there were areas of average performance, such as experienced and trained healthcare workers, there were also areas of concern, such as inadequate cold chain storage and insufficient record-keeping practices.The study recommends that steps be taken to improve the quality of immunisation services in the region, including strengthening the cold chain system, ensuring adequate record-keeping practices, and implementing regular training and supervision of healthcare workers. These measures are crucial to ensuring that more children are vaccinated and protected against vaccine-preventable diseases.Overall, the findings of this study contribute to the body of knowledge on the quality of childhood immunisation services in Nigeria and underscore the importance of continued efforts to improve the delivery of immunisation services to children. It is hoped that the recommendations put forth in this study will inform policy decisions and ultimately lead to better health outcomes for children in Oron, Akwa Ibom State, and beyond

Knowledge of Adverse Events Following Immunization and Awareness of its Reporting System among Primary Healthcare Workers in Jigawa State

Background: Healthcare workers (HCWs) have an essential and pivotal role to play in gaining and maintaining public confidence in the safety of vaccines through operational Adverse Events Following Immunization (AEFI) surveillance. For primary healthcare workers to be able to do this work effectively they should have the knowledge to detect an AEFI and at the same time be conversant with the reporting system. Objective: This study determined the knowledge of Adverse Events Following Immunization and the awareness of its reporting system among HCWs in primary health care centers of Jigawa State. Methodology: A cross-sectional study was conducted among 290 HCWs working in immunization units, selected through a multistage sampling technique. Data were collected using a pre-tested self-administered structured questionnaire. The data collected was sorted, checked for completeness, and entered into computer analysis software (IBM SPSS version 20) for analysis. The results obtained were presented in tables and charts. All statistical tests were two-tailed with a p-value of &lt; 0.05 used as the statistical significance level. Results: About 167 (57.6%) of the respondents were aged between 21-30 years with a mean age of 31.3±7.4 years. The majority 278 (95.9%) of the primary HCWs were aware of AEFI, and seminars/workshops or training were the common sources of information on AEFI (216 (77.7%). Of the 278 primary HCWs that are aware of AEFI, only 120 (43.2%) could define AEFI correctly, and 142 (51.1%) and 87 (31.3%) could identify serious AEFI and non-serious (minor) as a type of AEFI respectively. Up to 213 (76.6%) of healthcare workers know the correct AEFI reporting flow, and only 44 (15.8%) know that only serious AEFI are reported. Conclusion: The majority of the primary healthcare workers were aware of AEFI and how to report it, but few had good knowledge of reporting it. The Jigawa State Primary Healthcare Development Agency in collaboration with Local government authorities should provide on the-job training on AEFI surveillance for the primary healthcare workers especially those that provide immunization services.

A Successful National and Multipartner Approach to Increase Immunization Coverage: The Democratic Republic of Congo Mashako Plan 2018-2020.

The immunization system in the Democratic Republic of the Congo faces many challenges, including persistent large-scale outbreaks of polio, measles, and yellow fever; a large number of unvaccinated children for all antigens; minimal and delayed funding; and poor use of immunization data at all levels. In response, the Expanded Programme on Immunization within the Ministry of Health (MOH) collaborated with global partners to develop a revitalization strategy for the routine immunization (RI) system called the Mashako Plan. The Mashako Plan aimed to increase full immunization coverage in children aged 12-23 months by 15 percentage points overall in 9 of 26 provinces within 18 months of implementation. In 2018, we conducted a diagnostic review and identified gaps in coordination, service delivery, vaccine availability, real-time monitoring, and evaluation as key areas for intervention to improve the RI system. Five interventions were then implemented in the 9 identified provinces. According to the 2020 vaccine coverage survey, full immunization coverage increased to 56.4%, and Penta3/DTP3 increased to 71.1% across the Mashako Plan provinces; the initial objective of the plan was reached and additional improvements in key service delivery indicators had been achieved. Increases in immunization sessions held per month, national stock of pentavalent vaccine, and supervision visits conducted demonstrate that simple, measurable changes at all levels can quickly improve immunization systems. Despite short-term improvements in all indicators tracked, challenges remain in vaccine availability, regular funding of immunization activities, systematic provision of immunization services, and ensuring long-term sustainability. Strong commitment of MOH staff combined with partner involvement enabled the improvement of the entire system. A simple set of interventions and indicators focused the energy of managers on discrete actions to improve outcomes. Further exploration of the results is necessary to determine the long-term impact and generate all-level engagement for sustainable success in all provinces.

Challenges and opportunities to provide immunization services: Analysis of data from a cross-sectional study on a sample of pharmacists in a developing country.

Vaccine-preventable illnesses continue to be a global health concern as immunization coverage remains below its targets. National plans emphasize on the essential role of multidisciplinary efforts and approaches to vaccination programs. Pharmacists are globally getting involved in immunization services as important members of the healthcare team. This study aimed to determine barriers, and assess challenges and possible opportunities to provide immunization in the Lebanese pharmacy practice. This was a cross-sectional study that included pharmacists from all over Lebanon, as part of a national research to assess the role of pharmacists as immunizers. All registered pharmacists in Lebanon practicing in community, hospital, or other clinical settings were considered eligible for participation. A web-based self-administered validated questionnaire, which is initially developed by the American Pharmacists Association, was adapted with permission. A total of 315 pharmacists responded to the survey. Only 23.1% declared completing an immunization training program. Over half of pharmacists (58.4%) administer vaccines to patients. A significant association between lack of support from physicians to pharmacists (adjusted odds ratio [ORa] = 2.099, 95% confidence interval [CI] = 1.290-3.414, p = 0.003) and vaccine administration was found, while cost associated with professional development and additional training (ORa = 0.533, 95% CI = 0.287-0.989, p = 0.046) was inversely associated to it. Logistic, financial, and legislative requirements as essential necessities were determined to successfully expand pharmacist-led immunization services. The major barriers and challenges to vaccine administration by pharmacists comprised a lack of physicians' support and expenses associated with professional development and additional training. Pharmacists administer more vaccination despite lack of support from physicians; whereas they administer less vaccination due to cost associated with professional development and further training. The scope of pharmacy practice in Lebanon is not well recognized by other healthcare providers and stakeholders to include immunization services.

GAMBARAN PERILAKU ORANG TUA DALAM MEMBAWA ANAK IMUNISASI SELAMA MASA PANDEMI COVID-19

During the Covid-19 pandemic, the coverage of basic and advanced immunizations decreased. The purpose of this study was to describe the behaviour of parents in bringing their children immunized during the Covid-19 pandemic in the work area of Puskesmas III Denpasar Selatan. This study was a descriptive quantitative study with a cross sectional approach. The sampling technique was used non-probability sampling with purposive sampling technique. The sample used 71 parents which have babies and toddlers with the age of 0-24 months. The data were collected in the work area of Puskesmas III Denpasar Selatan for one month from March to April 2022. The research instruments used were Immunization Behavior Questionnaire during the Covid-19 pandemic. The result showed that most parents who have babies and toddlers aged of 0-24 months in the work area of Puskesmas III Denpasar Selatan have good immunization during the Covid-19 pandemic. Health service facilities are expected to be able to provide immunization services according to the technical instruction for immunization services during the Covid-19 pandemic so that parents feel safe when bringing their children for immunization.

Applying quality improvement tools to the Reaching Every District strategy: a mixed-methods examination of a systems strengthening approach to building the capacity of immunization managers and service providers in Ethiopia.

The Reaching Every District (RED) strategy, implemented in Ethiopia for over 15 years, has helped to improve immunization performance. However, recent demographic and health survey data indicate wide variations in immunization coverage. To address these disparities, quality improvement (QI) tools and methods were applied in phases to the RED strategy between 2011 and 2018 and were ultimately scaled to 103 districts in Ethiopia. Quantitative and qualitative data were collected from 2015-2018 to examine RED-QI uptake, practices, sustainability, and effects on Ethiopia´s routine immunization (RI) system. Qualitative interviews examined how RED-QI practices were carried out in each district, and quantitative data from a sample of health facilities provided information on the effects of RED-QI on the RI system. The RED-QI intervention increased the capacity of immunization managers and health workers to plan, implement, and monitor immunization activities, achieving expanded reach and enhancing the quality of services. RED-QI strengthened health workers´ capacity to identify and target communities for immunization, including in hard-to-reach areas. Improved planning resulted in expanded reach and greater equity in services. Immunization staff experienced enhanced capacity to plan immunization services, design approaches to address local challenges, reach target populations, and use data to monitor program performance. While challenges were noted with certain QI tools, assessments indicate that the RED-QI approach can be used in diverse contexts to strengthen RI.

Survey on Immunization Services for Children with Medical Conditions - China, 2022.

Children with medical conditions frequently experience under-immunization. Ensuring high-quality immunization services is crucial for enhancing vaccination coverage levels; nevertheless, the state of immunization service provision for children with medical conditions in China remains unclear. Immunization support for children with medical conditions in China demonstrates considerable variability and may be inadequate. Primary obstacles to the provision of immunization services include an absence of comprehensive vaccination recommendations and assessment guidelines for specific medical conditions, as well as inconsistencies among vaccine recommendations, package inserts, and expert consensus statements pertaining to the vaccination of children with medical conditions. The examination of provincial practices in providing immunization services for children with medical conditions, as well as understanding the barriers faced by National Immunization Program providers in administering vaccinations, can contribute to the improvement of immunization services for this population in China.

Challenges and barriers to immunization during COVID-19: An experience of parents/caregivers from a well-baby clinic of a tertiary care hospital of Eastern India

BackgroundImmunization in children is one of the best methods of preventing vaccine preventable diseases.With the onset of the COVID-19 pandemic,there have been disruptions in vaccine supply,its uptake and perception towards routine immunization, globally and in India. This study was planned to identify the challenges faced by the parents, the perceived barriers towards childhood immunization and perception regarding vaccination during the ongoing pandemic. MethodsA cross-sectional study was carried out in the well-baby clinic, providing immunization services. The informants were parents/caregivers of under-five children accompanying their children to the well-baby clinic within the study period. Data was collected using a semi-structured interviewer administered questionnaire and analysed using Epi-info software and p value less than 0.05 was considered to be statistically significant. ResultsDelay in immunization was noted in 62% of the children. The challenges stated by respondents for delay in immunization during this pandemic mostly were “fear about getting infected” (30%) and “someone instructed them not to take the child to the hospital if not ill” (13%). The most common perceived barriers were ‘no vaccination sites were open’ or ‘did not know where the baby can be vaccinated’. ‘Child should receive all vaccines’(99%) and ‘safety is more important than vaccination’ (83%)was the perception of respondents about immunization during the pandemic. ConclusionThough the respondents were aware of the need for timely vaccinations of their children, still a substantial delay was seen among majority of them due to fear of getting infected and unavailability of vaccines.

Hubungan Sikap Ibu dan Dukungan Keluarga dengan Kelengkapan Imunisasi Lanjutan pada Baduta di Puskesmas Amplas Kecamatan Medan Amplas Tahun 2022

Background: Many factors influence the completeness of basic immunization, such as parents, geographical location, vaccines, and health workers who provide immunization services. Even though the immunization program has been implemented well, there are still some immunization coverage that have not been achieved. Parents are the most important factor in scoring a child's complete immunization. Parents' participation in a health program is influenced by various factors and one of them is knowledge and attitudes towards the health program itself. Giving vaccines to children is the right way to anticipate the possibility of children being infected with diseases that are threatening at any time. Immunization functions to build a child's immunity against infectious diseases and dangerous diseases that can cause bodily defects. even death. Immunization given to children is the most effective way to protect children from tuberculosis (TB), diphtheria, pertussis (cocoon cough), tetanus (toothbrush). poliomyletis, measles, rubella and hepatitis B (Mai-imbi, 2021). During this time, parents had hepatitis B, meningitis, pneumonia and polio. VPD is a disease that is hoped to be eradicated or suppressed by implementing an immunization program Objective: Knowing the relationship between maternal attitudes and family support with the completeness of follow-up immunizations for young children at the Medan Amplas Community Health Center, Medan Amplas District in 2022. Method chi square test p value &lt; 0.05 means H0 is rejected and Ha is accepted, the statistical test results show a significant relationship. Results: There is a relationship between the mother's attitude of family support and the completeness of advanced immunization for children in 2022. Suggestions are provided for research and for research sites and for educational institutions regarding perennial wound care.

Technical guidelines for seasonal influenza vaccination in China (2022-2023)

Technical guidelines for seasonal influenza vaccination in China (2022-2023)

Technical guidelines for seasonal influenza vaccination in China (2022-2023)

Technical guidelines for seasonal influenza vaccination in China (2022-2023)

Caregivers' Satisfaction with Routine Immunization Services in Primary, Secondary and Tertiary Health Institutions in Sokoto Metropolis, Nigeria

Background: Caregivers' satisfaction is one of the most frequently used outcome measures for quality of care offered by routine immunization (RI) service providers. It has been shown to positively influence compliance of caregivers with subsequent RI visits. This study assessed caregivers' satisfaction with RI services in primary, secondary and tertiary health facilities in Sokoto metropolis, Nigeria Materials and method: A descriptive cross-sectional study was conducted in three health facilities in Sokoto metropolis. A structured questionnaire was used to collect data from 217 caregivers who were selected via multistage sampling technique. Results: Mean age of respondents was 27 years ±5.49 and majority were Hausa-Fulani [183(84.3%)]. Majority of the caregivers in all the three categories of health facilities (HFs) surveyed spent more than 30 minutes to immunize their children (median total clinic wait time = 48 minutes). Caregivers were largely satisfied with most activities of the clinics; overall, 91.7% (n=199) of them were satisfied. Several factors were associated with caregivers' satisfaction; however, the significant predictors were tribe, providing adequate information about vaccine given to the child and availability of vaccines at all times (p&lt;0.05). Conclusion: Up to three-fourth of the caregivers spent more than half an hour to receive RI services however, the overall satisfaction was excellent. The main predictors of caregivers' satisfaction were tribe, provision of information regarding the vaccine and availability of vaccines at all times. There is need for more efforts to be made by heads of the HFs and service providers to reduce waiting time at the RI clinics and also ensure vaccines are available at all times.

Impact of an Additional Immunizing Pharmacist at an Interprofessional Student-led Clinic for the Underserved

Background: To streamline workflow during peak influenza season in our weekly student-led free Interprofessional Community Clinic (ICC), an additional pharmacist shift solely responsible for providing immunization services was implemented from October 2018 to February 2019. The objective of this study was to determine the impact of adding an immunizing pharmacist, in addition to a clinical pharmacist, on adherence to Centers for Disease Control and Prevention (CDC) vaccine recommendations and overall immunization rates at ICC.&#x0D; Methods: A retrospective chart review of patient visits from October 2017 to February 2019 was conducted. Vaccination rates and CDC recommendation adherence were compared to a historical control when an immunizing pharmacist was not scheduled. Chi-square analysis was performed on categorical data; Fisher’s exact test was used to assess impact of an immunizing pharmacist on vaccination rates and adherence to CDC recommendations. A p-value of &lt;0.05 was considered statistically significant. &#x0D; Results: A total of 78 patient visits and 58 unique patients were included. There was a significant increase in the adherence to CDC recommendations for pneumococcal vaccine when an immunizing pharmacist was present (p=0.02). There was no significant difference in the adherence to CDC recommendations for all other vaccines and overall vaccine rate between the two groups (p&gt;0.05). &#x0D; Conclusion: Implementation of an immunizing pharmacist in an interprofessional clinic significantly impacts the adherence to CDC recommendations for pneumococcal vaccine without significantly impacting the overall vaccine rate. Benefit of an additional pharmacist dedicated to vaccinations should be weighed for workflow improvement versus impact on vaccine adherence and rate.