Routine Childhood Vaccination Research Articles

The public health challenge of addressing communities with sub-optimal uptake of routine childhood vaccinations in Israel

The public health challenge of addressing communities with sub-optimal uptake of routine childhood vaccinations in Israel

Is the intention to vaccinate enough? Systematic variation in the value of timely vaccinations and preferences for monetary vs non-monetary incentives among pregnant women in southern Tanzania.

Globally, approximately 19.7 million children remain under-vaccinated; many more receive delayed vaccinations. Sustained progress towards global vaccination targets requires overcoming, or compensating for, incrementally greater barriers to vaccinating hard-to-reach and hard-to-vaccinate children. We prospectively assessed pregnant women's valuations of routine childhood vaccinations and preferences for alternative incentives to inform interventions aiming to increase vaccination coverage and timeliness in southern Tanzania. Between August and December 2017, 406 women in their last trimester of pregnancy were enrolled from health facilities and communities in the Mtwara region of Tanzania and asked contingent valuation questions about their willingness to vaccinate their child if they were (a) given an incentive, or (b) facing a cost for each vaccination. Interval censored regressions assessed correlates of women's willingness to pay (WTP) for timely vaccinations. Participants were asked to rank monetary and non-monetary incentive options for the timely vaccination of their children. All women expected to get their children vaccinated according to the recommended schedule, even without incentives. Nearly all women (393; 96.8%) were willing to pay for vaccinations. The average WTP was Tanzania Shilling (Tsh) 3,066 (95% confidence interval Tsh 2,523-3,610; 1 USD∼Tsh 2,200) for each vaccination. Women's valuations of timely vaccinations varied significantly with vaccine-related knowledge and attitudes, economic status, and rural vs urban residence. Women tended to prefer non-monetary over monetary incentives for the timely vaccination of their children. Women placed a high value on timely childhood vaccinations, suggesting that unexpected system-level barriers rather than individual-level demand factors are likely to be the primary drivers of missed vaccinations. Systematic variation in the value of vaccinations across women reflects variation in perceived benefits and opportunity costs. In this setting, nonmonetary incentives and other interventions to increase demand and compensate for system-level barriers hold significant potential for improving vaccination coverage and timeliness. NCT03252288.

Opposition to Routine Child Vaccination Grows.

Vaccination rates, which declined during the pandemic, have yet to recover.

Evaluation of the Turkish Population's Perspective on COVID-19 Vaccine Hesitancy and Routine Childhood Vaccine Applications: National Survey Study.

It is important to evaluate the attitude of society towards vaccines to understand the rates of acceptance and hesitance towards vaccination, which are essential components of public health and epidemiology. This study aimed to evaluate the perspective of the Turkish population on COVID-19 status, rate of vaccination, and also to evaluate the reasons for refusal to vaccinate, vaccine hesitancy, and related factors. A total of 4539 participants were included in this population-based descriptive and cross-sectional study. The Nomenclature of Territorial Units for Statistics (NUTS-II) was used to obtain a representative sample and for this purpose Turkey was divided into 26 regions. Participants were randomly selected based on the demographic features and population ratios of the selected regions. The following parameters were evaluated: sociodemographic characteristics and perspectives on COVID-19 vaccines, Vaccine Hesitancy Scale Adapted to Pandemics (VHS-P), and Anti-Vaccine Scale-Long Form (AVS-LF) questions. A total of 4539 participants, 2303 (50.7%) male and 2236 (49.3%) female, aged between 18 and 73 years, were included in this study. It was observed that 58.4% of the participants had hesitations towards COVID-19 vaccination, and 19.6% were hesitant about all childhood vaccinations. Those who did not have the COVID-19 vaccine, who did not think that the COVID-19 vaccine was protective, and who had hesitation to vaccinate against COVID-19 had significantly higher median scores on the VHS-P and AVS-LF scales, respectively (all p < 0.01). Those who did not have their children vaccinated in childhood and who were hesitant about childhood vaccinations, had significantly higher median scores on the VHS-P and AVS-LF scales, respectively (all p < 0.01). Although the rate of vaccination for COVID-19 was 93.4% in the study, hesitation to vaccinate was 58.4%. The median score of the scales of those who were hesitant about childhood vaccinations was higher than individuals who did not have any hesitation. In general, the source of concerns about vaccines should be clearly seen, and precautions should be taken.

АНАЛИЗ ИНФЕКЦИОННОЙ ЗАБОЛЕВАЕМОСТИ У ДЕТЕЙ РЕСПУБЛИКИ САХА (ЯКУТИЯ) С 2012 ПО 2021 ГГ.

The public health of the population, especially children, is determined to a large extent by morbidity and mortality rates. Currently, infectious diseases account for up to 70 % in the structure of all childhood morbidity and about 80 % in the structure of infant mortality. More than 30 new nosological forms of infectious diseases have been identified, in connection with which the concept of «new infections» has been introduced. At the same time, the level of infectious morbidity is not stable and is subject to fluctuations, which are associated both with the influence of natural factors, the emergence of new infections, and with the implementation of preventive measures. An analysis of the data on the dynamics of infectious morbidity in children and adolescents in Yakutia showed a similar picture. It became obvious that optimistic ideas about the possibility of eliminating infectious diseases turned out to be untenable. The epidemiological situation regarding the incidence of «preventable infections» in children remains tense, which is largely due to defects in the routine vaccination of children. Using the example of HBV, diphtheria and rubella vaccination, we have significant success. However, an example of a measles outbreak in 2019-2020 showed the importance of mass vaccination coverage. The incidence of pertussis also becomes high with large fluctuations in different years. Indicators of infectious diseases are directly dependent on the coverage of children with preventive vaccinations. Among infectious diseases against which there are no means of mass immunization, in the present, as in previous years, the first place belongs to acute infections of the upper respiratory tract, the causative agents of which are more than 200 viruses. An important place in the infectious morbidity of children belongs to acute intestinal infections. The lack of a complete etiological decoding of infectious diseases is a serious problem. The change in the epidemiological situation in the country during the COVID-19 pandemic has revealed a number of problems and opportunities for their solution. The pandemic period has shown that fairly simple and inexpensive anti-epidemic measures have a good effect.

Exploring Determinants of COVID-19 Vaccine Acceptance, Uptake, and Hesitancy in the Pediatric Population: A Study of Parents and Caregivers in Saudi Arabia during the Initial Vaccination Phase.

This study aims to assess COVID-19 vaccine acceptance, uptake, and hesitancy among parents and caregivers of children in Saudi Arabia during the initial rollout of pediatric COVID-19 vaccination. An electronic survey was used to collect data from participants who visited a COVID-19 vaccine center. The survey included demographic data, COVID-19 vaccine status among participants and their children, and reasons for vaccine acceptance or rejection. The Vaccine Hesitancy Scale (VHS) tool was also employed to assess vaccine hesitancy and attitudes toward the COVID-19 vaccine and routine childhood vaccination. Multivariate binary regression analysis was used to identify predictors of actual COVID-19 vaccine uptake among children. Of the 873 respondents included in the analysis, 61.5% were parents and 38.5% were other caregivers. Of the participants, 96.9% had received the COVID-19 vaccine. Six hundred and ninety-four participants accepted the vaccine for their children, with the main reasons being an endorsement by the Saudi Ministry of Health (60%) and the importance of going back to school (55%). One hundred and seventy-nine participants would not vaccinate their children, with the most common reasons being fear of adverse effects (49%) and inadequate data about vaccine safety (48%). Factors such as age, COVID-19 vaccination status, self-rated family commitment level, attitudes toward routine children's vaccines, and participants' generalized anxiety disorder (GAD7) score did not significantly correlate with children's COVID-19 vaccination status. Parents were less likely to vaccinate their children compared to other caregivers, and participants with a higher socioeconomic status were more likely to vaccinate their children. Vaccine acceptance and uptake were high during the initial pediatric COVID-19 vaccination rollout in Saudi Arabia. Still, the ongoing endorsement of the Ministry of Health and healthcare authorities should continue to advocate for better vaccine uptake in children.

Mandating COVID‐19 vaccinations for children: Attitudes of Western Australian parents

AbstractAustralian governments have used vaccine mandates to drive high uptake of routine childhood vaccines and adult Coronavirus Disease 2019 (COVID‐19) and influenza vaccines. We sought to understand the attitudes of Western Australian parents regarding mandating COVID‐19 vaccines for children, interviewing 44 parents of children aged up to 18 years between May and December 2021. Transcripts were analysed to ascertain parents' attitudes and sources of reasoning. Over half of the parents supported COVID‐19 vaccine mandates for children, while the rest had opposing, nuanced or indifferent views. Participants invoked community and health‐related reasoning; policy and government‐related reasoning; and concerns based on practical implementation. There was a high degree of consistency in parents' attitudes toward COVID‐19 vaccines and whether they supported mandating them for children, although some who planned to delay vaccination nevertheless supported the idea of mandates. Some participants reported that a mandate would prompt them to vaccinate, but others were willing to accept the consequences of keeping their children unvaccinated, or said that a mandate would not affect them as they would vaccinate regardless. Understanding how parents think and feel about mandating COVID‐19 vaccines with educational exclusions or financial penalties is critical to inform policymakers, who may consider these strategies for future pandemic vaccines.

Routine child immunizations in India during the COVID-19 pandemic

Disruptions in health service delivery and utilization during the COVID-19 pandemic may have caused many children worldwide to not receive vital preventative health services. We investigate the pandemic’s effects on routine childhood vaccinations in India, which has the world’s largest child immunization program. Using data from the Government of India’s health management information system and interrupted time series analyses, we estimate district-level changes in routine child vaccinations during the pandemic relative to typical monthly vaccinations in the pre-pandemic period. Our results indicate there were significant reductions in child vaccinations during the pandemic, with declines being extremely large in April 2020 when a strict national lockdown was in place. For example, district-level administration of the final required dose in the polio series declined by about 60% in April 2020 relative to the typical monthly vaccination levels observed prior to the pandemic. Vaccinations subsequently increased but largely remained below levels observed before the outbreak of COVID-19. Additional declines in vaccinations occurred in 2021 during the second wave of COVID-19 infections in India. Heterogeneity analyses suggest that vaccinations declined the most in districts with the strictest lockdowns and in districts with low health system capacity at baseline. There is a vital need for corrective actions, such as catch-up vaccination campaigns, to limit the deleterious consequences that will arise for the children who missed routine immunizations during the COVID-19 pandemic.

A Systematic Review of Factors That Influence Parents’ Views and Practices around Routine Childhood Vaccination in Africa: A Qualitative Evidence Synthesis

A Cochrane review which explored the factors that influence caregivers' views and practices around routine childhood vaccines worldwide was conducted by Cooper and colleagues. After sampling 154 studies that met their inclusion criteria, the authors included 27 studies in their synthesis, of which 6 were from Africa. The aim of the current review was to synthesise all 27 studies conducted in Africa. We wanted to determine if the inclusion of additional African studies will change any of the themes, concepts or theory generated in the Cochrane review. Our review found that parents' views and practices regarding childhood vaccination in Africa were influenced by various factors, which we categorised into five themes, namely, ideas and practices surrounding health and illness (Theme 1); social communities and networks (Theme 2); political events, relations, and processes (Theme 3); lack of information or knowledge (Theme 4); and access-supply-demand interactions (Theme 5). All of the themes identified in our review were also identified in the Cochrane review except for one theme, which was lack of information or knowledge. This finding will help to promote vaccine acceptance and uptake in Africa by developing and implementing interventions tailored to address lack of knowledge and information around vaccines.

Impact of the COVID-19 lockdown on routine childhood vaccination coverage rates in Catalonia (Spain): a public health register–based study

ObjectiveThe aim of this study was to determine the impact of the lockdown measures adopted during the COVID-19 pandemic on routine childhood vaccination coverage rates in Catalonia (Spain) and to estimate its recovery once the progressive return to ‘normalcy’ had begun. Study designWe conducted a public health register–based study. MethodsRoutine childhood vaccination coverage rates were analysed in three periods: a first pre-lockdown period (from January 2019 to February 2020), a second lockdown period with full restrictions (from March 2020 to June 2020), and, finally, a third post-lockdown period with partial restrictions (from July 2020 to December 2021). ResultsDuring the lockdown period, most of the coverage rates remained stable, concerning the pre-lockdown period; however, when comparing the vaccination coverage rates in the post-lockdown period to the pre-lockdown period, we observed decreases in all types of vaccines and doses analysed, except for coverage with the PCV13 vaccine in 2-year-olds, which experienced an increase. The most relevant reductions were observed in measles-mumps-rubella and diphtheria-tetanus-acellular pertussis vaccination coverage rates. ConclusionsSince the beginning of the COVID-19 pandemic, there has been an overall decline in routine childhood vaccine coverage rates, and the pre-pandemic rates have not yet been recovered. Immediate and long-term support strategies must be maintained and strengthened to restore and sustain routine childhood vaccination.

What are the key pediatric public policy priorities as the COVID-19 pandemic persists?

The COVID-19 pandemic is not over, and its impact is just beginning to be felt on children. COVID-19 vaccines protect both the pregnant patient and newborns, and breastfeeding provides a key component of passive protective immunity. "Long COVID" has contributed to the current crisis in pediatric mental health, and vaccines confer protection against this long-term complication of COVID-19 disease. Vaccine misinformation is not only impacting compliance with maternal and pediatric COVID-19 immunization efforts, but also other routine childhood vaccinations. As a public health priority, we must improve our response to vaccine misinformation and find novel strategies to improve vaccine compliance.

Vaccine Hesitancy Among Canadian Mothers: Differences in Attitudes Towards a Pediatric COVID-19 Vaccine Among Women Who Experience Intimate Partner Violence.

Vaccine hesitancy (VH) in maternal decision-making is important to understand to achieve community immunity targets and optimize pediatric COVID-19 vaccine adoption. COVID-19 is exacerbating the risk of intimate partner violence (IPV) for women in abusive relationships, a known risk factor for maternal VH. This project aimed to: (1) determine if IPV impacts maternal VH in Canada; and (2) understand maternal attitudes towards routine childhood vaccines and a pediatric COVID-19 vaccine in Canada. As part of a cross-sectional, quantitative study, 129 women completed an online survey. IPV was assessed using the Abuse Assessment Screen and the revised, short-form Composite Abuse Scale. The Parent Attitudes about Childhood Vaccines scale evaluated maternal attitudes towards routine vaccinations and a COVID-19 vaccine. Questions informed by the World Health Organization's Increasing Vaccination Model (IVM) evaluated perceived barriers and facilitators to COVID-19 vaccination. In total, 14.5% of mothers were hesitant towards routine childhood vaccines, while 97.0% were hesitant towards a COVID-19 vaccine. Experiencing IPV was significantly associated with maternal COVID-19 VH (W = 683, p < 0.05). Social processes were identified as instrumental barriers and facilitators to COVID-19 vaccination, meaning that social norms and information sharing among social networks are critical in maternal vaccination decision-making. This study providesnovel evidence of maternal IPV significantly impacting VH and the presence of strong maternal VH specific to a COVID-19 vaccine in the Canadian context. Further research is required to fully understand the factors that build confidence and mitigate hesitancy in mothers, especially mothers who have experienced IPV.

Determinants of Parents Taking Their Children for Scheduled Vaccinations during COVID-19 Pandemic in South Africa.

Scheduled or routine childhood vaccinations are known for their effectiveness in eradicating fear for many life-threatening and disabling diseases and saving lives globally. This paper is aimed at assessing determinants of parents taking their children for scheduled vaccinations during the COVID-19 pandemic in South Africa. Data used for this paper were obtained from the Human Sciences Research Council's (HSRC) COVID-19 Online Survey titled "One Year Later Survey", which was conducted between 25 June and 11 October 2021 in South Africa. Multivariate logistic regression analysis was performed to achieve this study goal. Findings showed that just over half of parents (56.7%) reported taking their children for scheduled vaccinations across the country. Males were significantly less likely (aOR = 0.53 95% CI [0.45-0.61], p < 0.001) to have taken their children for scheduled vaccinations than females. Parents' experiences and views were among key determinants of parents having taken their children for scheduled vaccinations in South Africa. Parents who had never taken influenza (flu) vaccines were significantly less likely (aOR = 0.33 [0.28-039], p < 0.001) to have taken their children for scheduled vaccinations than those who had taken flu vaccines. Parents who did not know anyone who had personally experienced serious side effects to any vaccine were significantly less likely (aOR = 0.77 [0.66-0.90], p = 0.001) to have taken their children for scheduled vaccinations than those who knew anyone who had experienced them. Parents who did not think vaccines were a good way to protect communities from disease were significantly less likely (aOR = 0.50 [0.33-0.77], p = 0.001) to have taken their children for scheduled vaccinations than those who thought vaccines were a good way to protect communities from disease. These findings are of significance especially during the time when the country is still struggling to reach a substantial proportion of its population vaccinated for COVID-19. Thus, these findings may be relevant in determining parents' intentions to have their children receive the South African Department of Health recommended vaccines for their respective age group.

Parents' Attitudes toward COVID-19 Vaccination: A Study from Two Centers in Istanbul

Abstract Objective Vaccination is an important measure for the prevention of coronavirus disease 2019 (COVID-19). In the present study, we aimed to evaluate parents' attitudes toward vaccinating themselves and their children. We also searched whether information about the multisystem inflammatory syndrome in children (MIS-C), a severe complication of COVID-19, could change parents' decisions on vaccinating their children. Methods A questionnaire form consisting of sociodemographic features, COVID-19 vaccination practices, and knowledge about MIS-C was applied to parents of children attending Bezmialem Vakıf University Hospital from March through June 2022. Factors affecting vaccine hesitancy were evaluated. Results Among 383 parents, COVID-19 history was present in 248 (64.8%), and 165 (43.1%) were hesitant to vaccinate themselves. The number of cases where both parents had received at least one dose of COVID-19 vaccine was 256/354 (72.3%). The most common reasons for vaccine hesitancy were vaccines being new in 53/165 (32.1%) and fears of side effects in 95/165 (57.6%). Parents' hesitation toward vaccination of their children with the COVID-19 vaccine was highest for the 0 to 6 age group (78.9%) (73.6% in the 6–12 age group, and 47.3% in the 12–18 age group). In total, 365/383 (95.3%) parents did not have an opinion about MIS-C. After information was given, 62.5% of the 302 participants who opposed vaccinating children under 6 years changed their decision to have their children vaccinated. Conclusion Although routine childhood vaccinations were performed in 99% of children, more than half of parents were hesitant to vaccinate their children with the COVID-19 vaccine. The majority did not have an opinion about MIS-C. Briefings by pediatricians about complications of COVID-19 will help avoid vaccine hesitancy.

Measles and travel: an update for general practice nurses

Measles remains a risk for international travellers. The ongoing COVID-19 pandemic has interrupted many routine childhood vaccine schedules worldwide, resulting in an upsurge in measles cases. A travel consultation is an opportunity to offer measles, mumps and rubella (MMR) vaccine for both personal protection of individual travellers and as a public health intervention.

The impact of the COVID-19 pandemic on parents' perceptions and acceptance of routine childhood vaccination in Canada: A national longitudinal study.

A decline in routine vaccination was reported by some countries early in the COVID-19 pandemic. In the context of the pandemic, determinants of routine childhood vaccination may have changed. Changes over time in parents' perceptions of routine vaccines and intentions for their children during the pandemic have not been fully explored. Understanding changes provides opportunities to promote routine childhood vaccines and address factors that may compromise parents' acceptance. We conducted longitudinal analysis of two sequential national surveys during the pandemic (Dec 2020 and Oct/Nov 2021) to assess changes over time in Canadian parents' perceptions of routine childhood vaccines, intentions to vaccinate, access for their children≤17years, and differences among sociodemographic characteristics. McNemar-Bowker tests were used to determine changes in parents' responses collected at two time points. Of the 650 parents in the sample, 25.1% with a child≤6years and 20.5% with a child 7-17years perceived that routine childhood vaccines were more important because of the pandemic. Between the two time points, parents' confidence in the safety (72.8% to 80.2%, p<.001) and effectiveness (81.7% to 85.2%, p=.007) of routine vaccines increased, parents were more engaged in vaccine decision-making (73.4% to 79.8%, p=.006), and everyday stress preventing vaccination decreased (78.8% to 68.5%, p<.001). Acceptance of routine vaccines increased (82.9% to 86.5%, p=.021), but more parents were undecided about influenza vaccination (12.6% to 20.3%, p=.002). Compared to parents with 1 child, those with 2 children reported increased vaccination acceptance (82.6% to 87.4%, p=.024). Under the spotlight of COVID-19, parents' confidence in routine vaccines, engagement in decision-making, and vaccination acceptance increased. Vaccination providers should support parents' decision-making as they navigate routine childhood vaccine uncertainties. Differences in parents' acceptance of routine and influenza vaccines for their children highlight the need for targeted communication strategies for specific vaccines.

Perception regarding routine childhood vaccinations: a cross-sectional study in Al-Qassim married population

Background: Vaccines are the most effective and risk-free health intervention available. Vaccination-related hesitancy is increasing in all countries, despite its global success. The current study aimed to assess the perception of the Qassim married population towards childhood vaccines and determine the factors affecting their decision regarding routine vaccination. Methods: This cross-sectional study was carried out using an online questionnaire (the SAGE group&amp;apos;s vaccine hesitancy scale). The questionnaire was distributed using Twitter and WhatsApp. To study the association between categorical variables, chi-sqaure test was used. Unpaired t-test was employed to compare the average and overall score for the Vaccine Attitude Scale between groups. Results: The questionnaires were completed by 416 respondents. Regarding vaccine hesitancy, 16.6% of the included parents were hesitant to get a vaccination for their children, and 7.93% refused vaccination with an 18.5% overall hesitancy/refusal. Responses showed an overall positive attitude towards childhood vaccinations. It was discovered that vaccine hesitancy and children&amp;apos;s vaccination status were significantly related, with 10% of the hesitant parents reporting that their children were never vaccinated compared to 0.86% of non-hesitant parents (p &amp;lt; 0.001). The overall attitude score was significantly higher in non-hesitant than hesitant respondents (42.2 ± 4.74 vs. 30.5 ± 7.28, p &amp;lt; 0.001). The most common reasons for vaccine hesitancy/ refusal were safety concerns (61%), lack of need (42.9%), and negative media information (41.6%). Vaccine hesitancy/refusal was less prevalent in males (36.6%) than females (63.4%), with a significantly higher overall score in males than females (41 ± 5.89 vs. 38.9 ± 8.05, p = 0.005). Conclusion: Findings from the current study showed moderate hesitancy and low refusal towards routine childhood vaccination in the married population in the Al-Qassim region and suggested a sound attitude towards routine vaccination. Awareness campaigns should be directed towards raising the knowledge regarding the importance of vaccination from an individual and community perspective to reduce hesitancy or refusal of vaccination.

A Systematic Review of Factors that Influence Parents' Views and Practices Around Routine Childhood Vaccination in Africa: A Qualitative Evidence Synthesis

A Systematic Review of Factors that Influence Parents' Views and Practices Around Routine Childhood Vaccination in Africa: A Qualitative Evidence Synthesis

CHILDHOOD VACCINATION: A DETERRENT TO COVID-19 IN CHILDREN?

Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) rst identied at Wuhan, China has rapidly spread worldwide to become a Public Health Emergency of International Concern (PHEIC). Despite the increasing number of COVID-19 cases during the pandemic, the number of pediatric cases reported remained low as per the existing reports. Clinical presentation of COVID-19 in children is found to be milder and prognosis better when compared to adult population. Though multiple theories are in vogue but the exact reason for the low incidence and milder clinical manifestations of COVID-19 among children remains obscure. This literature, discusses the possibility of cross reactivity between routine childhood vaccines and SARS-CoV-2, as a plausible explanation for the low incidence and milder clinical presentation of COVID-19 in children

Families’ Opinions and Attitudes Regarding Routine and Non-Routine Childhood Vaccines

Families’ Opinions and Attitudes Regarding Routine and Non-Routine Childhood Vaccines