Vaccination Recommendations Research Articles

Comparison of Survivorship Care Guidelines for Patients With Lymphoma: Recommendations for Harmonization and Future Research Agenda.

Lymphomas are a heterogeneous group of diseases that develop in individuals of all ages and have variable prognoses. Improved survival resulting from therapy advances has led to the emergence of diverse late effects. Although several (US)-based organizations have developed survivorship guidelines, the distinct features of lymphoma subtypes and diverse therapies used raise concerns regarding their applicability to lymphoma survivors. We compared survivorship recommendations (outside primary disease monitoring) between US clinical guidelines. We extracted information from 17 guidelines from five US-based organizations: ASCO (n = 11), American Cancer Society (n = 1), Children's Oncology Group (n = 1), Center for International Blood and Marrow Transplant Research (n = 1), and the National Comprehensive Cancer Network (n = 3). Guidelines were evaluated to determine whether they offer recommendations on physical effects, psychosocial and quality of life (QOL), and health promotion and prevention. Comparisons were focused on second primary malignancy, cardiovascular complications, and vaccination. Survivorship recommendations on physical effects and psychosocial and QOL mainly differ in the timing and approaches for screening. Vaccination recommendations were primarily derived from other cancer populations. Identified research gaps were a lack of understanding of the risk of late effects across lymphoma subtypes, the role of social determinants of health in survivorship, and the lack of a survivorship care model that integrates lymphoma subtypes and treatment exposures. This study raises awareness about the complexity and challenges of managing survivors under the umbrella diagnosis of lymphoma. The inconsistency and incompleteness of existing guidelines may lead to suboptimal survivorship care. We propose expert-based research priorities to address gaps and unmet needs to help develop risk-based follow-up recommendations to optimize survivorship care for lymphoma survivors.

Influenza Vaccine Effectiveness Against Symptomatic Influenza in Primary Care: A Test Negative Case Control Study Over Two Influenza Seasons 2022/2023 and 2023/2024 in Ireland.

Live attenuated influenza vaccine (LAIV) is recommended in Ireland for all children aged 2-17 years. Quadrivalent influenza vaccine (QIV) is recommended for all others eligible for vaccination, including those ≥ 18 years with underlying medical conditions and all aged ≥ 65 years. We aimed to estimate influenza vaccine effectiveness (IVE) against acute respiratory infection (ARI) presentations to primary care due to influenza over two influenza seasons in Ireland, to inform vaccination recommendations and communication campaigns. We undertook a test-negative case control study within the Irish sentinel general practice surveillance network as part of the Vaccine Effectiveness Burden and Impact Studies (VEBIS) network. We compared influenza vaccination status among influenza PCR positive cases with influenza PCR negative controls, both with ARI presentations, of all ages. We estimated IVE using logistic regression adjusting for age, onset time, medical conditions and sex. In 2022/2023, there were 288 cases and 765 controls. In 2023/2024, there were 567 cases and 1832 controls. In 2022/2023, overall IVE was 42% (95% CI 9 to 64) and 50% (95% CI -30 to 83) in 2- to 17-year-olds. Overall IVE in 2023/2024 was 35% (95% CI 15 to 51) and 68% (95% CI 30 to 87) in 2- to 17-year-olds. Influenza vaccination reduced the risk of influenza among ARI patients presenting to general practice, demonstrating the benefits of vaccination, particularly among children. Promotion of the seasonal influenza vaccine to recommended groups, should remain a public health priority. Targeted vaccination campaigns for children promoting LAIV should emphasise the effectiveness of LAIV in children.

Streptococcus pneumoniae and influenza vaccination rates in oncological patients — data from Germany

ObjectivesDue to disease- or therapy-associated immunosuppression, oncological patients suffer from significantly higher morbidity and mortality due to infections transmitted by respiratory pathogens such as Streptococcus pneumoniae and influenza virus. Although the German Standing Committee on Vaccination (STIKO) provides specific recommendations for vaccination against these pathogens, there is no data on vaccination rates in this high-risk population.MethodsData from the interventional EVO study were analyzed to provide information on vaccination rates against Streptococcus pneumoniae and influenza virus in oncological patients. Numbers presented in this publication summarize baseline and follow-up data of the control group; thus, data were not influenced by the intervention.ResultsData of 370 patients were analyzed; 20.5% of patients were treated for hematological malignancies and 79.5% for solid cancer. 28.1% of patients had received vaccination against influenza and 32.2% against Streptococcus pneumoniae; for the latter only 7.3% according recommendations. While vaccination rates where even lower for patients with thoracic carcinoma (influenza 26.7% and Streptococcus pneumoniae 6.0% according to STIKO recommendations), rates in patients with multiple myeloma were remarkably higher (39.0% and 14.6%).ConclusionsDespite strong recommendations to vaccinate and the clear clinical need to prevent infections in the vulnerable group of oncological patients, only the minority was vaccinated against Streptococcus pneumoniae or influenza, underlining the urgent need for better vaccination strategies in this high-risk population.

Myths and misinformation associated with vaccine incompleteness: A survey study

ObjectiveVaccine hesitancy is a relevant driver of backslides in immunization rates globally. Myths and misinformation are key contributors to vaccine hesitancy. We aimed to investigate associations between beliefs in popular vaccine myths and vaccine incompleteness. MethodsIn this survey, participants were asked questions on current vaccination status; barriers and motivations for vaccination; and beliefs regarding popular myths: the measles vaccine causes autism in children; acquiring the disease is preferable to facing vaccine side effects; and natural immunity developed from getting the disease is better than the immunity elicited by vaccination. We assessed the effect of failing to disagree with the myths on current vaccination status. ResultsOf 4305 participants, 933 (22 %) were partially vaccinated and 61 (1 %) were fully unvaccinated; 403 (10 %) failed to disagree with the autism myth; 411 (10 %) failed to disagree with the side effects myth; and 904 (22 %) failed to disagree with the natural immunity myth. Failing to disagree with the myths was significantly associated with vaccine incompleteness. ConclusionVaccine-related myths are associated with both partial and total vaccine incompleteness in Brazil. Practice implicationsStrategies to improve adherence to vaccination recommendations should include interventions to limit the spread or elucidate vaccine-related myths and misconceptions.

Evolution and Impact of Hepatitis A Epidemiology in Europe-Systematic Literature Review of the Last 20 Years.

While globally hepatitis A (hepA) infections occur in 150 million people annually, European high-income countries now have a low endemicity. However, this results in a more susceptible adult population which is prone to severe illness. To determine current epidemiological characteristics, we performed a systematic literature review to assess the severity of hepA disease in the past two decades in 11 European countries (i.e., Denmark, France, Germany, Greece, Hungary, Italy, the Netherlands, Spain, Sweden, Switzerland and the United Kingdom). Literature search was performed using PubMed and Embase between 1 January 2001 and 14 April 2021. Search terms included the disease (hepA), the 11 selected countries, the term 'outbreaks' and its synonyms, outcomes and terms for hepA virus circulation. In total, 43 records reported data on hepA disease outcomes. Hospitalisation rates varied between the countries, with annual rates exceeding 50% at least once in seven countries. The lowest hospitalisation rates were reported for the Netherlands (≤ 32%) and the highest for Greece (≥ 81%). Liver failure, haemorrhagic and other complications were rarely reported, and case fatality rates were low (0.03%-0.26%). Our findings are consistent with the trends observed globally. This systematic literature review highlights the need to increase awareness of hepA risks and to strengthen prevention strategies. Continuous monitoring of epidemiological data is crucial to assess which populations would most benefit from prevention, mainly with respect to future vaccination recommendations.

Self-reported hepatitis A and B vaccination coverage among men who have sex with men (MSM), associated factors and vaccination recommendations in 43 countries of the WHO European Region: results from the European MSM Internet Survey, EMIS-2017.

BackgroundHepatitis A and B vaccinations are recommended for men who have sex with men (MSM), given their increased risk of infection. However, data on vaccination programmes are scarce.AimTo use information on vaccination recommendations and vaccine uptake among MSM in the WHO European Region to guide prevention.MethodsFrom a large pan-European MSM Internet Survey (EMIS-2017), we analysed data on self-reported hepatitis A and B vaccination status by age, education, financial coping, settlement size, outness (disclosure of sexual behaviour), migration history and diagnosis with hepatitis C or HIV, using multivariable logistic regression. Additionally, we collected information on national hepatitis A and B vaccination recommendations.ResultsWe present data of 113,884 MSM, median age 36 years (IQR: 27-47). Vaccination for hepatitis A and B was recommended and free for MSM in 7 and 18 of 43 countries, respectively. Of all respondents, 48% (n = 50,966) reported ever being vaccinated against hepatitis A, and 53% (n = 56,889) against hepatitis B. Odds for being vaccinated against hepatitis A increased with outness ('out to (almost) all' aOR: 1.78, 95% CI: 1.72-1.85 vs 'out to none') and were higher in countries where vaccination was recommended and free for MSM (aOR: 2.22, 95% CI: 1.29-3.82 vs 'no recommendation'). Results for hepatitis B were similar (outness: aOR: 1.81, 95% CI: 1.75-1.88 and MSM-specific vaccination recommendation: aOR: 2.44, 95% CI: 1.54-3.85).ConclusionLarge proportions of MSM in Europe remain vulnerable to hepatitis A and B, despite available vaccination. Implementation of MSM-specific vaccination recommendations and greater efforts to improve the societal climate for MSM are needed to address gaps in vaccine coverage.

Preventing Influenza Virus Infection and Severe Influenza Among Pregnant People and Infants.

The landscape of research on the benefits of influenza vaccines and antivirals to protect pregnant persons and infants has increased in recent years, while influenza vaccination rates and antiviral usage have declined. Pregnant people and infants <6 months of age are at increased risk of hospitalization with influenza, making protection of this population essential. Maternal influenza vaccination at any time during pregnancy is the best way to reduce the risk of influenza and severe influenza in both pregnant people and their infants <6 months of age. Influenza antiviral medications for pregnant people and infants are also recommended as early as possible if influenza is confirmed or suspected. This report will update on the current research on the benefits of influenza vaccination during pregnancy and influenza antiviral medication for the pregnant person and infant, current Advisory Committee on Immunization Practices recommendations for influenza vaccination in pregnancy and vaccination coverage rates, current influenza antiviral medication guidance and usage rates in pregnancy and among infants, and future directions for influenza pregnancy research. With over half a century of maternal influenza vaccination in the United States, we have improved protection for pregnant persons and infants against influenza, but we still have room for improvement and optimization with new challenges to overcome following the COVID-19 pandemic. By continuing to fill research gaps and increase vaccination coverage and antiviral usage, there is potential for significant reductions in the domestic and global burden of influenza in pregnant persons and infants.

Scoping the barriers to influenza and pneumococcal vaccinations from the perspectives of patients with cancer: is there a role for the pharmacist?

AbstractBackgroundRoutine immunisation for influenza and pneumococcal disease has the potential to reduce morbidity and mortality in patients with cancer.AimThis scoping review aims to determine barriers to influenza and pneumococcal vaccinations from the perspective of patients with cancer and to discuss the potential role of the pharmacist in impacting these barriers.DesignA systematic search of seven databases, including MEDLINE (Ovid), Cochrane Library, Informit (health), PubMed, and CINAHL (complete), from database inception to 6 June 2023 was conducted. Search terms included: 'cancer', 'vaccination', 'influenza', 'pneumococcal', and 'barrier'. Articles published in English that describe barriers to receiving vaccinations from the perspectives of patients with cancers were included. Barriers were thematically analysed.ResultsTwenty‐five articles met the inclusion criteria. Barriers identified in the literature were analysed into three key themes: healthcare professionals, patients, and healthcare system barriers. A key healthcare professional barrier was lack of recommendations from the treating oncologist or haematologist. Patient barriers included lack of information about the indication for vaccination as part of patients' cancer treatment and fear of side effects. Access to vaccination services was reported as a healthcare system barrier.ConclusionThis scoping review highlights the significant barriers to influenza and pneumococcal vaccination according to patients with cancer. Healthcare professionals, patients, and health systems were identified as key barriers. Enablers to improve vaccination rates include patient education, increased healthcare professional vaccine recommendations, and improved access. Although pharmacists have a potential role to play in addressing these barriers, the feasibility and impact of their involvement requires further research.

An Overview of Pediatric Pulmonary Complications During COVID-19 Pandemic: A Lesson for Future.

The pediatric community is considered a suitable target for controlling the spread and mortality of viral diseases. In late December 2019, a respiratory disease due to the novel coronavirus, later COVID-19, hit the globe. The COVID-19 global disruption had direct and indirect impacts on different aspects of child health. Therefore, surveillance, preventive approaches, and treatment plans for children came into the spotlight. This study aims to discuss the clinical pictures as well as laboratory and radiological findings of the infected children during the COVID-19 pandemic. The focus of this study is to express the clinical manifestations of respiratory disease in pediatric SARS-CoV-2, available therapeutic options, vaccine recommendations, and long COVID sequelae in affected children. This review could serve as a hint for upcoming challenges in pediatric care during future pandemics. The clinical presentation of COVID-19 in pediatrics can range from mild pulmonary disease to acute respiratory distress syndrome (ARDS). Supportive care is a crucial component of the management of pediatric COVID-19. However, the importance of specializing in how to treat patients with more severe conditions cannot be overstated. Additionally, clinicians must consider prevention strategies as well as potential complications. Although the infected patients are dipping day by day, there is a lack of clinical guidelines for pediatric SARS-CoV-2-associated pulmonary diseases. Understanding of the physicians about all aspects of pediatric care during the COVID-19 pandemic could lead to enhanced quality of future patient care and safety, reduced costs of health policies, and surveil the risk that patients with respiratory viruses can expose to society.

Human Papillomavirus Vaccination Awareness and Uptake among Healthcare Students in Japan

BackgroundThe vaccination rate for HPV (Human Papillomavirus) has remained significantly low in Japan because of the administrative suspension of active recommendation. This study investigates the awareness and uptake of the HPV vaccine among healthcare students in Japan following the reinstatement of active recommendation for young women in April 2022. MethodsA web-based survey was administered to 2,567 healthcare students from Okayama and Shujitsu Universities in Japan in July 2023. The survey assessed participants' backgrounds, immunization status, awareness of vaccine recommendations, and knowledge of cervical cancer across various demographics, including sex, academic year, and department (Medicine, Health Science, Pharmaceutical, and Dentistry). ResultsThe response rate was 36.3% (933 students; 181 male, 739 female, and 13 unspecified gender). The overall immunization rate among female students was 55.6%, with higher rates observed in medical (73.8%) and dental (63.0%) students. Awareness of the government's change in vaccine recommendation was notably high among female and senior male students. Over half of the female students (54.7%) reported receiving vaccinations based on their parents' advice. Among those unvaccinated but interested in future immunization, concerns about adverse reactions (47.4%) and challenges in scheduling vaccinations (29.1%) were predominant. ConclusionHealthcare students exhibited a higher HPV vaccination rate than the general population. Ongoing education to improve vaccine literacy is crucial for augmenting HPV vaccination rates in Japan.

The Platform trial In COVID-19 vaccine priming and BOOsting (PICOBOO) booster vaccination substudy protocol

BackgroundCoronavirus-2019 (COVID-19) vaccination in Australia commenced in February 2021. The first vaccines recommended for use were AZD1222 and BNT162b2, both delivered as a two-dose primary schedule. In the absence of sustained immunity following immunisation, recommendations for booster vaccination have followed. It is likely that periodic boosting will be necessary for at least some Australians, but it is unknown what the optimal booster vaccines and schedules are or for whom vaccination should be recommended.MethodsThe Platform Trial In COVID-19 priming and BOOsting (PICOBOO) is a multi-site, multi-arm, randomised, Bayesian adaptive platform trial evaluating different booster vaccine interventions in immunocompetent children and adults, stratified by their primary vaccination schedule and age. Participants are randomised to receive one of three licensed COVID-19 booster vaccines available for use in Australia. PICOBOO aims to generate evidence about the immunogenicity, reactogenicity, and cross-protection of different booster vaccine strategies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants/subvariants. The protocol structure specifying PICOBOO is modular and hierarchical. We have previously published the PICOBOO core (master) protocol. Here, we detail the substudy protocol which outlines the study processes which are specific to PICOBOO participants enrolled in the booster vaccination substudy.DiscussionPICOBOO is an adaptive platform trial evaluating different COVID-19 booster vaccination strategies to generate evidence to inform immunisation practice and policy. The modular and flexible protocol structure is intended to enable investigators to respond with agility to new research questions as they arise, such as immunogenicity targeting emergent virus variants, and the immunogenicity and reactogenicity of new vaccines as they become available for use.Trial registrationAustralian and New Zealand Clinical Trials Register ACTRN12622000238774; registered on 10/02/2022. Protocol V8.0_23112023.

Predictors of Human Papillomavirus (HPV) Vaccine Acceptability Among Physicians, Their Knowledge on Cervical Cancer, and Factors Influencing Their Decision to Recommend It.

In Saudi Arabia, the HPV vaccine is administered to young females through school-based immunization programs; however, the program's efficacy depends on parental consent, with physicians acting as primary determinants in parental decision-making regarding HPV vaccination. In this cross-sectional study, we recruited 128 physicians and assessed their knowledge and attitudes toward cervical cancer, HPV, and the HPV vaccine, and unraveled predictors of HPV vaccine acceptability and factors that would influence recommending the vaccine. Although the major factor that influenced recommending the vaccine negatively was the fear of vaccine side effects, a positive influence of the physician's personal reading (91%), recommendations from colleagues (88%), and government directives (87%) provided reassurance and increased confidence in recommending the vaccine. Longer clinical experience and institutional awareness were found to be a predictors of favorable recommendation of HPV vaccination. Physicians in vaccine-related medical specialty with more than 4 years of experience were 5 to 6 times more likely to have positive attitude and better knowledge regarding HPV and HPV vaccination. A notable finding was that participants who reported knowing a woman suffering from cervical cancer had more positive attitudes compared to those who did not. This study identified physicians' personal reading, peer recommendations, and government directives as factors affecting the physicians' decision to recommend HPV vaccine, and found that longer clinical experience and institutional awareness were predictors influencing physicians to recommend the vaccine. It also emphasizes on the influence of healthcare providers in promoting the HPV vaccination and the need for designing interventions targeting specific demographic and professional groups that would be more effective in improving better knowledge and promoting positive attitudes towards these critical public health issues.

2022 AAHA Canine Vaccination Guidelines (2024 Update).

Vaccination is a cornerstone of canine preventive healthcare and one of the most cost-effective ways of maintaining a dog's health, longevity, and quality of life. Canine vaccination also serves a public health function by forming a barrier against several zoonotic diseases affecting dogs and humans. Canine vaccines are broadly categorized as containing core and noncore immunizing antigens, with administration recommendations based on assessment of individual patient risk factors. The guidelines include a comprehensive table listing canine core and noncore vaccines and a recommended vaccination and revaccination schedule for each vaccine. The guidelines explain the relevance of different vaccine formulations, including those containing modified-live virus, inactivated, and recombinant immunizing agents. Factors that potentially affect vaccine efficacy are addressed, including the patient's prevaccination immune status and vaccine duration of immunity. Because animal shelters are one of the most challenging environments for prevention and control of infectious diseases, the guidelines also provide recommendations for vaccination of dogs presented at or housed in animal shelters, including the appropriate response to an infectious disease outbreak in the shelter setting. The guidelines explain how practitioners can interpret a patient's serological status, including maternally derived antibody titers, as indicators of immune status and suitability for vaccination. Other topics covered include factors associated with postvaccination adverse events, vaccine storage and handling to preserve product efficacy, interpreting product labeling to ensure proper vaccine use, and using client education and healthcare team training to raise awareness of the importance of vaccinations.

Summary of the National Advisory Committee on Immunization (NACI) Seasonal Influenza Vaccine Statement for 2024-2025.

The National Advisory Committee on Immunization (NACI) reviews the evolving evidence on influenza immunization and provides annual recommendations regarding the use of seasonal influenza vaccines. The NACI Statement on Seasonal Influenza Vaccine for 2024-2025 updates the NACI recommendations from the previous year. To summarize the 2024-2025 NACI seasonal influenza vaccine recommendations and to highlight new and updated information. For the development of the Statement on Seasonal Influenza Vaccine for 2024-2025, the NACI Influenza Working Group applied the NACI evidence-based process to assess available evidence and formulate recommendations. These recommendations underwent a thorough evaluation and were approved by NACI based on the available evidence. Key updates for the 2024-2025 influenza season include updated immunization recommendations reflecting changes in influenza epidemiology and revised guidance for vaccine administration during pregnancy and in older adults. The National Advisory Committee on Immunization recommends that any age-appropriate quadrivalent or trivalent influenza vaccine should be used for individuals six months of age and older who do not have contraindications or precautions. NACI reaffirms the importance of influenza vaccination with inactivated or recombinant influenza vaccines in pregnancy. Finally, NACI recommends that inactivated high-dose (IIV-HD), inactivated adjuvanted (IIV-Adj) or recombinant influenza vaccine (RIV) should be offered, when available, over other influenza vaccines for adults 65 years of age and older.

Effectiveness of the autumn 2023 COVID-19 vaccine dose in hospital-based healthcare workers: results of the VEBIS healthcare worker vaccine effectiveness cohort study, seven European countries, season 2023/24.

COVID-19 vaccination recommendations include healthcare workers (HCWs). We measured COVID-19 vaccine effectiveness (CVE) of the autumn 2023 dose against laboratory-confirmed SARS-CoV-2 infection in a prospective cohort study of 1,305 HCWs from 13 European hospitals. Overall CVE was 22% (95% CI: -17 to 48), 49% (95% CI: -8 to 76) before and -11% (95% CI: -84 to 34) after the start of BA.2.86/JN.1 predominant circulation. Autumn 2023 COVID-19 vaccination led to a moderate-to-low reduction in SARS-CoV-2 infection incidence in HCWs. Monitoring of CVE is crucial for COVID-19 prevention.

Incidence of tick-borne encephalitis (TBE) in the pediatric population at the University Hospitals of Strasbourg (HUS) and characterization of confirmed cases.

Tick-borne encephalitis (TBE) is a vector-borne disease caused by the TBE virus (TBEV). Although TBEV infection in children seems to lead to a milder clinical presentation, data in pediatrics are scarce. We aimed to determine the incidence of TBE among pediatric patients presenting with neurological symptoms from January 2020 to December 2022 at the University Hospital of Strasbourg (HUS), France. 462 Patients for whom cerebrospinal fluid (CSF) samples were available were included and categorized by age group: 0-4years, 5-9years, and 10-15years. Serological tests and RT-PCR were carried out on the CSF samples, and the positive results were confirmed by seroneutralization test (SNT). A CSF IL-6 assay was performed for confirmed cases. We retrospectively detected four TBE-confirmed cases. We found an incidence of 1.51 cases per 100,000 inhabitants in the pediatric population over 2020-2022. The four cases were girls, with a median age of 10.4years. The symptoms appeared in two cases in October 2022, outside the seasonal peak. Signs of encephalitis were present in two patients, and persistent sequelae were reported in three patients and two more than a year after hospitalization. None of the confirmed cases were vaccinated against TBEV despite frequent exposure to ticks.Intrathecal concentrations of IL-6 were increased for two patients; for one patient, the concentration was significantly higher than the values found in control cases. Our data highlight the need for early diagnosis and long-term follow-up of affected children and raise questions about the evolution of vaccination recommendations.

Vaccine hesitancy in patients with solid tumors: a cross-sectional single-center survey

BackgroundVaccination rates are still suboptimal in cancer patients. Oncologists play a central role in recommending vaccines to their patients. Our goal was to investigate vaccine acceptance among cancer patients and understand the factors shaping their choices, thereby aiding physicians in better supporting their patients’ vaccination decisions.MethodsWe designed a prospective cross-sectional survey exploring vaccination status, attitudes, and reasons for hesitancy towards vaccinations against the main vaccine preventable diseases (VPDs) among patients undergoing active cancer treatment. The primary endpoint was to evaluate the proportion of vaccinated subjects in our cohort of cancer patients. The secondary endpoints were to assess the proportion of vaccinated subjects against different types of VPDs: flu, COVID-19, pneumococcal disease, Herpes Zoster (HZ).ResultsBetween 12 February and 01 March 2024, a total of three hundred and seventeen patients with cancer were invited to respond to the survey, 309 of whom (97%) agreed to do it. Two hundred seventy-three patients (0.88, 95% confidence interval [CI] 0.84–0.91) had received at least one vaccination. Two hundred thirty-one patients (74.76%) reported that at their first oncology visit their oncologist recommended vaccinations, primarily anti-flu (92.21%) and anti-SARS-CoV-2 (83.55%) vaccinations, while less frequently the anti-pneumococcal (42.42%) and anti-HZ (37%) vaccines were recommended. On the univariate analysis, age over 75 years (p = 0.041), marital status (p = 0.003) and the oncologist’s vaccine recommendation during the first visit (p < 0.001) were significantly associated to vaccine acceptance. At the multivariable analysis, these variables were independently associated with vaccine willingness. Overall in our cancer population, the two main reasons for vaccine hesitancy were the lack of recommendation by the oncologist (55.41%, n = 128) and the lack of awareness of the importance of vaccination in the context of oncological care (49.35%, n = 114).ConclusionsThis survey emphasizes the importance of vaccine counseling by the oncologist to their patients. Oncologists can motivate patients to receive the correct vaccine schedule by addressing doubts and concerns about the potential negative impact of the vaccine on cancer and cancer therapies.

Vaccinations in older adults: Optimization, strategies, and latest guidelines.

This article is a summary of the first AGS Symposium entitled "Update on Vaccination Strategies for Older Adults: Matching the Approach to the Individual and the Care Setting." Given declines in host defenses and immune function with aging, vaccinations play a pivotal role in fortifying older adults against preventable infections, resulting diseases, disability, and death. Current guidelines generally list recommendations applicable for an average older adult of a given chronological age. However, growing evidence indicates that heterogeneity in terms of factors as varied as biological sex, frailty, functional status, and multimorbidity may impact vaccine responses and clinical outcomes. As a result, clinicians will increasingly need to take these additional factors into consideration as they seek to improve outcomes through improved targeting of such aging-related heterogeneity. Moreover, efforts at protecting older citizens through vaccination must also include strategies to overcome barriers to the adoption of vaccine recommendations in varied settings including long-term care. This 2023 AGS Plenary Symposium sought to commence a broader dialogue across AGS and beyond on optimizing vaccinations for older adults, ensuring not only extended lifespans but also healthier and more active lives. This report is not a systematic review, and thus should not be considered comprehensive.

Evaluating Accuracy of AI-Generated Travel Vaccine Recommendations: GPTs in Public Health

Abstract Introduction Artificial intelligence (AI), particularly generative pre-trained transformers (GPTs), holds promise for enhancing public health strategies like travel vaccine recommendations. This pilot study evaluated GPTs’ accuracy in delivering tailored vaccine advisories compared to standards set by public health professionals. Integrating AI’s data analysis capabilities into healthcare decision-making could improve recommendation precision and personalization. Methods This retrospective study analyzed GPT travel vaccine recommendation accuracy against a gold standard from health professionals for 90 travelers visiting various countries. Sociodemographic data and vaccine recommendation outcomes were examined. Accuracy assessments were stratified by age, sex, country of travel, duration of travel, type of travel, and specific vaccines. Results Preliminary results showed an 77.43% overall accuracy across all vaccine recommendations. Specific vaccine accuracies varied, with 97.78% alignment for hepatitis A, 93.51% for typhoid fever and 89.36% for rabies. However, lower accuracies were observed for cholera (33.33%) and encephalitis (56.25%). Moderate accuracies were noted for yellow fever (75%), 74.07% for malaria prophylaxis, diphtheria and tetanus (63.33%), and dengue (57.58%). Stratified analyses are expected to provide more realistic results and highlight discrepancies in certain groups. Conclusions This pilot demonstrates GPTs can be a valuable tool for supporting international vaccination professionals, but they are still not a substitute for these professionals, achieving 77.43% overall accuracy. Recommendations include: a) Educate health professionals in the use of GPTs, b) Developing guidelines for ethical and accurate AI use in public health, c) Using AI to strengthen surveillance and response systems. Combining AI with traditional strategies aims to optimize international traveler health outcomes. Key messages • Using artificial intelligence can optimize and facilitate the task of clinical consultancy in traveler’s advice. • It is necessary to establish guidelines for AI use to ensure ethical and accurate applications.

Developing HPV Vaccination Communication Strategies: Assessing Knowledge, Attitudes, and Barriers Among Healthcare Professionals in Kazakhstan.

Cervical cancer, predominantly caused by human papillomavirus, remains a major public health issue globally and in Kazakhstan, where it ranks among the most common cancers in women. A pilot HPV vaccination programme in Kazakhstan was suspended in 2017 due to mass parental refusals, and it is planned to be restarted in the coming years. This study aims to assess the knowledge, attitudes, barriers, and sources of information about HPV and the HPV vaccine among healthcare professionals in Kazakhstan. A cross-sectional study (December 2022-May 2023) involving 1189 healthcare professionals in Kazakhstan used a self-administered questionnaire. Statistical analysis included descriptive statistics, mean knowledge score, between-group comparisons, and binary logistic regression to identify factors linked to higher knowledge and vaccine recommendation. The study found that the average knowledge score for HPV and the HPV vaccine among participants was 11 out of a possible 18. Correct answers to the questionnaire were observed more frequently among physicians than among nurses (p < 0.001). In our study, 72.6% of healthcare professionals expressed a positive intention to recommend the HPV vaccine. The likelihood of recommending the HPV vaccine was significantly higher among those with higher knowledge of HPV and its vaccine (OR 1.8; 95% CI 1.3-2.5; p < 0.001), those familiar with cervical cancer patients (OR 2.0; 95% CI 1.5-2.8; p < 0.001), and those with positive attitudes towards the COVID-19 vaccine and childhood vaccination (OR 2.3 and 1.5, respectively). Healthcare professionals identified key barriers to HPV vaccination, including public mistrust (49.4%), fear of side effects (45.9%), and insufficient knowledge among healthcare professionals themselves (30.3%). Information from the internet, including articles and journals, was the most commonly used source of information, followed by social media and colleagues. The disparities identified call for a tailored, multifaceted communication strategy that addresses the diverse needs of health professionals to address the differences in awareness between different groups, in order to ensure successful implementation and coverage of HPV vaccination across Kazakhstan.