Vaccination Recommendations Research Articles

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.

Identifying key challenges and optimizing approaches for training of health care professionals for HPV vaccination programmes

Healthcare professionals (HCPs) play a crucial role in building vaccine confidence and promoting vaccination programmes. HCP vaccination recommendations are often the strongest predictor of vaccine uptake, influencing individuals' acceptance of and demand for vaccination. However, HCP training on human papillomavirus (HPV) vaccination faces challenges in some countries, including Ethiopia, Malawi, and Uganda. This study summarizes the discussions held during the Coalition to Strengthen HPV Immunization Community Symposium in Africa, the field experiences of co-authors, and expert opinions to inform its findings. Key challenges faced in these countries are maintaining regular and comprehensive HCP training, ensuring continuity due to staff turnover, reaching all health facilities, and including teachers as key mobilizers. Funding constraints, limited communication materials, and human resource shortages can further impact training effectiveness. Recommendations for strengthening HCP training on HPV vaccination programmes include providing adequate training to all HCPs, refresher training, including private sector HCPs and teachers, leveraging local training institutions, and integrating HPV vaccine training into pre-service HCP academic curricula. These actions would be essential for improving HPV vaccine coverage and working towards cervical cancer elimination goals.

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.

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.

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

Background: 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. Methods: 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. Results: 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 &lt; 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 &lt; 0.001), those familiar with cervical cancer patients (OR 2.0; 95% CI 1.5–2.8; p &lt; 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. Conclusions: 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.

Vaccination in the post pandemic era - a qualitative study of the experiences of Somali immigrants

Abstract Background The Somali population is the largest non-European immigrant group in Norway and past studies have indicated lower coverage for both childhood vaccines and COVID-19. However, little is known about views and experiences of vaccination among this group and how their experiences might impact their vaccination decision-making process. This study explored views and experiences with vaccination among Somali immigrants in Norway. Methods We conducted semi-structured interviews with 15 participants in the fall of 2022. To better understand the participants’ perceptions of vaccine information, the data was inductively analyzed using a reflexive thematic analysis. Results Based on the thematic analysis, we focused on four sub themes: 1) the impact of COVID-19 on views of vaccines; 2) new versus old vaccines; 3) childhood vaccination; 4) trust in vaccines. The study found that the participants’ experiences during the pandemic have impacted their views on vaccination in general. Many of the participants expressed positive views and high levels of trust in the Norwegian health authorities and their vaccination recommendations. It was found that having sufficient information and trust in vaccination recommendations contributed to higher vaccine readiness. Viewing vaccines as new and insufficiently tested or researched, as well as lacking information about potential side-effects, increased participants’ hesitancy when faced with vaccination decisions. Among the parents in this study, postponing the measles-mumps-rubella-vaccine due to fear of autism was a common occurrence. Conclusions The current study fills an important gap in knowledge about views, experiences, and vaccination decisions among the Somali population in Norway. Knowledge from this study can help adapt better vaccine information and further improve the prevention of infectious diseases in Norway in general and for under-vaccinated groups in particular. Key messages • Having sufficient information and trust in vaccination recommendations contributed to higher vaccine readiness. • Viewing vaccines as new and insufficiently tested/researched, as well as lacking information about potential side-effects, increased participants’ vaccine hesitancy.

Vaccination Coverage among Institutionalized Elderly Population: A Case Study in Cascais, Portugal

Abstract Vaccination stands as a cornerstone of public health, significantly reducing the morbidity and mortality associated with infectious diseases. However, the aging demographic, with declining homeostasis and immunosenescence, presents new challenges. Those residing in nursing homes face heightened risks of infectious diseases due to proximity and interactions with multiple staff members. In Portugal, elderly vaccination against tetanus/diphtheria (Td) is integrated into the National Vaccination Program, with additional official recommendations for pneumococcal (Pn), seasonal influenza, and COVID-19 vaccinations. Specific vaccination campaigns in nursing homes for influenza and COVID-19 are coordinated by Public Health Units. This study aimed to assess the vaccination coverage for these vaccines among the institutionalized elderly in Cascais municipality and evaluate the implementation of official recommendations. A survey of nursing homes in Cascais was conducted, and the vaccination status of residents was assessed through electronic records in February 2024. Statistical analysis was performed. Vaccination status for each vaccine was considered valid if individuals had received at least one dose of Pn13 or Pn23, a Td vaccine dose within the last 10 years, and vaccinations against influenza and COVID-19 within the last 6 months. Among 2189 institutionalized elderly in Cascais, 87% were vaccinated against both influenza and COVID-19, 39% against Td, and 17% against pneumococcal disease. While influenza and COVID-19 vaccination coverage is high, the tetanus/diphtheria vaccination rate is low, and pneumococcal vaccination is very low, despite official recommendations. This population remains at increased risk for preventable diseases. Monitoring vaccination status and implementing targeted vaccination campaigns are crucial for increasing coverage, realizing health and economic benefits and preventing severe diseases. Key messages • Vaccination is essential for safeguarding the health of institutionalized elderly populations. There is a need for targeted interventions to address preventable diseases and protect these individuals. • Monitoring vaccination status and implementing targeted campaigns are critical for increasing coverage and realizing health and economic benefits among elderly populations in nursing homes.

Influenza vaccine effectiveness in Ireland during two influenza seasons, 2022/23 and 2023/24

Abstract Background Live Attenuated Influenza Vaccine (LAIV) is recommended in Ireland for all children aged 2-17 years. Quadrivalent influenza vaccine is recommended for all others eligible for vaccination, including those aged ≥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. Methods We undertook a test-negative design case control study within the national sentinel surveillance General Practice network, as part of the European Vaccine Effectiveness Burden and Impact Studies (VEBIS) network. We compared influenza vaccination status among influenza Polymerase Chain Reaction (PCR) positive cases with influenza PCR negative controls, amongst patients consulting with ARI. We verified vaccination status using the national influenza vaccination database. We estimated end of season IVE for 2022/23, and mid-season IVE (up to 7th April 2024) for 2023/24, using multivariable logistic regression and adjusting for age, onset time, medical condition, and sex. Results In 2022/23, there were 288 cases and 765 controls. In 2023/24 there were 515 cases and 1,482 controls. Overall vaccination coverage was 23% in both seasons. Coverage in 2-17 year-olds was 10% in 2022/23 and 12% in 2023/24. In 2022/23, overall IVE was 42% (95%CI 9-54) and 50% (95%CI -30-83) in 2-17 year-olds. Overall IVE in 2023/24 was 37% (95%CI 16-54) and was 67% (95%CI 28-87) in 2-17 year-olds. Conclusions Influenza vaccination reduced medical attendance to primary care with ARI due to influenza, demonstrating benefits of vaccination, particularly among children. Influenza vaccination should continue to be offered and promoted to recommended groups, including children. Key messages • This study suggests that influenza vaccination protected population health and the health service from medical attendance to primary care with acute respiratory infection due to influenza. • Higher influenza vaccine effectiveness was observed in children aged 2-17 years. These findings can inform influenza vaccination programmes with LAIV for children in Ireland and internationally.

Bridges between evidence on vaccination intervention and Ukrainian migrant community needs in Poland

Abstract Background Vaccination coverage in Ukrainian migrants’ (UM) children is lower compared to their Polish counterparts. We aimed to identify and adapt effective evidence-based interventions which would address health system barriers to HPV/MMR vaccination in this community. Methods With the help of the Participatory Action Research (PAR) approach, 4 researchers, 6 experts, 6 UM, 7 Ukrainian GPs and 3 teachers identified and discussed transferability of promising HPV/MMR vaccination interventions and their adaptation from the Polish and contextual perspective. The Population-Intervention-Environment-Transfer Model of Transferability (PIET-T) model was used to accompany the steps for determining transferability. Results Three intervention elements were considered as capable for increasing HPV/MMR vaccination uptake: a health promoter, group educational sessions and an online provider training. Adaptations were needed to make them consistent with the contextual needs. The intervention was adapted to involve Ukrainian GPs delivering culturally sensitive education and a Ukrainian coordinator offering navigation support; barriers (lack of information/language barrier) were addressed. The education sessions for parents were taken into account as having potential to increase knowledge and facilitate making informed decisions regarding vaccination. The online education course was assessed as a strategy to possibly enhance GPs knowledge to let them make strong HPV/MMR vaccine recommendations to UMs. Conclusions Both, community-based PAR approach, and the PIET-T model, facilitated the assessment of intervention transferability and adaptation in terms of covering the individual context, pattern and needs of UMs community in Poland, to finally increase HPV/MMR vaccination uptake.

Vaccination Knowledge, Attitudes, Perceptions, and Educational Needs of Pharmacists in Singapore: A Cross-Sectional Study

Background: Singapore’s adult vaccination coverage is suboptimal, and this can be attributed to a lack of vaccination recommendations and misconceptions. Studies have explored pharmacists’ vaccination knowledge, attitudes, and practice behaviour overseas but limited information about pharmacists in Singapore is available. This study aims to investigate pharmacists’ vaccination knowledge, attitudes towards providing vaccination services, and their educational needs. Methods: A cross-sectional study was conducted on pharmacists in various practice settings using an anonymous online survey. Results: Pharmacists’ vaccination knowledge (median: 2; IQR: 1–3), confidence in providing vaccination services (median: 6; IQR: 5–8), and frequency of providing vaccination services (median: 2; IQR: 1–3) were only average. However, 74.3% of pharmacists agreed that they play an important role as vaccine advocates. Apparent differences in knowledge level (p = 0.008), confidence level (p = 0.001), attitude (p &lt; 0.001), and the frequency of educating patients (p = 0.001) and recommending vaccinations (p &lt; 0.001) were observed among pharmacists from different practice settings. The main barriers identified were discomfort with giving injections (38.5%) and a lack of skills or knowledge (28.3%) at the point of survey. Conclusions: Pharmacists see the importance of their role as vaccine advocates. However, their vaccination knowledge, confidence in providing vaccination services, and practice behaviours are only average due to inadequate training. Continuous professional education is required to increase pharmacists’ readiness to provide vaccination services.

Human papillomavirus vaccine to prevent CIN3 or worse (CIN3+): A nationwide case-control study in Japan.

An increase in cervical cancer incidence has been reported in Japan. The Ministry of Health, Labor, and Welfare of Japan has resumed the active recommendation of regular HPV vaccines in 2022. In Japan, the preventive effect of CIN3+ in the real world has not yet been demonstrated in age-adjusted cohort or case-control studies. This study aimed to estimate the effect of the HPV vaccine against CIN3+ in Japanese women. This nationwide case-control study from April 2013 to March 2020 targeted women aged 20-26 years old at the time of cervical screening. We compared HPV vaccination exposure between those with abnormal and those with normal cytology. Abnormal cytology was classified into cervical intraepithelial neoplasia (CIN)1+, CIN2+, and CIN3+. We calculated the odds ratio (OR) and 95% confidence interval (CI) of the above endpoints and vaccination exposure using the conditional logistic regression model and estimated vaccine effectiveness using the formula (1 -OR) × 100. A total of 2790 cases and 13,990 controls (one-to-five matching) were eligible in 37 municipalities in Japan. In this study, 61 CIN3 (2.2%) and 10 squamous cell carcinomas (SCC) (0.4%) were found. The OR for CIN3+ versus controls was 0.14 (95% CI, 0.03-0.75), equating to a vaccine effectiveness of 86%. Of the 10 patients who had SCC none were vaccinated. This nationwide case-control study in Japan demonstrated a substantial risk reduction in CIN3+ among women who did versus those who did not receive HPV vaccination.