Routine Vaccination Research Articles

Optimal multimodal multi-echelon vaccine distribution network design for low and medium-income countries with manufacturing infrastructure during healthcare emergencies

In the event of routine immunizations for containing disease outbreaks, the Expanded Programme on Immunization (EPI) led Low and Medium-Income Countries (LMICs) follow a four-tier distribution network. Such a network is suitable for LMICs importing vaccines rather than manufacturing and may not be suitable for healthcare emergencies. Recent shift from routine immunizations to pandemic-orientation, calls for large-scale multimodal distribution models. This paper proposes a cold chain network for LMICs with manufacturing hubs during health emergencies, integrating vaccine manufacturers and incorporating multiple transportation modes. The problem is formulated as a Mixed Integer Quadratically Constrained Programming (MIQCP) problem, to minimize ‘Cumulative Transportation Time’ (CTT) with the minimal number of trips. To solve large-scale problems the paper also proposes a novel algorithm that divides certain parts of the network and retains the edges that are likely to give better solutions. The proposed model extends the existing body of the literature by introducing features such as vehicle choice between locations, generalized hierarchical structure, network decomposition, and appropriateness with LMIC networks. We conduct numerical experiments to validate the proposed algorithm using data from India. The results show that the proposed model saves cumulative transportation time along the optimally generated network when compared with the actual vaccine supply network in India during healthcare emergencies. The proposed algorithm is also faster than the formulation giving comparable results while solved in a commercial solver.

Impact of COVID-19 Pandemic on Routine Immunization Among Tribal Children in Odisha: A Rapid Epidemiological Survey

Impact of COVID-19 Pandemic on Routine Immunization Among Tribal Children in Odisha: A Rapid Epidemiological Survey

Human papillomavirus vaccine coverage among immigrant adolescents in Alberta: a population-based cohort study.

Little is known about human papillomavirus (HPV) vaccination among immigrant children in Canada. We conducted a study in Alberta, Canada to assess HPV vaccine coverage among school-aged immigrant children compared with non-immigrant children. This cohort study analysed population-based linked administrative health data to measure HPV vaccine coverage for 346749 school-aged children, including 31656 immigrants. Coverage was examined at 12y of age from 2008 to 2018 for females, and from 2014 to 2018 for males and both sexes combined; vaccine series completion was considered receipt of three doses, with initiation (one or more dose) as a supplementary analysis. Multivariable logistic regression examined the association of vaccine coverage with migration status, adjusting for sociodemographic variables. Between 2014 and 2018, HPV vaccination coverage among immigrant children at age 12y was significantly higher (52.58%) compared with non-immigrant children (47.41%). After controlling for place of residence, income quintile, biological sex and year, immigrant children had 1.10 greater odds (95% confidence interval 1.07 to 1.14) of receiving three doses of HPV vaccine compared with non-immigrant children. Immigrants from Asia and Africa had the highest coverage (60.25-68.78%), while immigrants from North America, Oceania and South America had the lowest coverage (39.97-48.36%). It is encouraging that immigrant children had higher HPV vaccine coverage compared with non-immigrants. Among immigrants, routine immunization promotion strategies should be tailored based on the country of origin.

How did the introduction of the measles-containing vaccine second dose (MCV2) affect measles vaccine uptake? – evidence from Nigeria

ABSTRACT Nigeria has the highest burden of measles worldwide, as measles vaccine uptake remains low. Recently, the second dose of the measles-containing vaccine (MCV2) was introduced as part of the routine immunization (RI) program, and this study examined how it changed the uptake of the measles vaccine and the factors associated with vaccination behavior. The Nigeria Multiple Indicator Cluster Survey (MICS) 2021 was used to compare measles vaccination uptake as well as factors associated with vaccination uptake between children before MCV2 introduction (cohort 1) and after the introduction (cohort 2). The overall rate of measles vaccine uptake was higher among cohort 1 (64%–95%) than among cohort 2 (56%–92%) in all zones because of younger age among cohort 2. The dropout from the first to second measles vaccines was similar between the cohorts (around 24%). Higher maternal education levels and higher household wealth levels were both correlated with the vaccine uptake or both cohorts but a positive correlation between the dropout and mother’s education level was observed only among cohort 2, especially in the North West and South West zones. The positive correlation between the dropout and mother’s education level among cohort 2 indicates that the introduction of MCV2 as part of RI might have helped to narrow the disparity in measles vaccine uptake in North West and South West zones. Further study is required to investigate strategies employed to reduce the disparity in these zones to apply nationwide.

Childhood vaccination trends during 2019 to 2022 in Tanzania and the impact of the COVID-19 pandemic

ABSTRACT The COVID-19 pandemic has significantly disrupted healthcare systems at all levels globally, notably affecting routine healthcare services, such as childhood vaccination. This study examined the impact of these disruptions on routine childhood vaccination programmes in Tanzania. We conducted a longitudinal study over four years in five Tanzanian regions: Mwanza, Dar es Salaam, Mtwara, Arusha, and Dodoma. This study analyzed the trends in the use of six essential vaccines: Bacille Calmette-Guérin (BCG), bivalent Oral Polio Vaccine (bOPV), Diphtheria Tetanus Pertussis, Hepatitis-B and Hib (DTP-HepB-Hib), measles-rubella (MR), Pneumococcal Conjugate Vaccine (PCV), and Rota vaccines. We evaluated annual and monthly vaccination trends using time-series and regression analyses. Predictive modeling was performed using an autoregressive integrated moving average (ARIMA) model. A total of 32,602,734 vaccination events were recorded across the regions from 2019 to 2022. Despite declining vaccination rates in 2020, there was a notable rebound in 2021, indicating the resilience of Tanzania’s immunization program. The analysis also highlighted regional differences in vaccination rates when standardized per 1000 people. Seasonal fluctuations were observed in monthly vaccination rates, with BCG showing the most stable trend. Predictive modeling of BCG indicated stable and increasing vaccination coverage by 2023. These findings underscore the robustness of Tanzania’s childhood immunization infrastructure in overcoming the challenges posed by the COVID-19 pandemic, as indicated by the strong recovery of vaccination rates post-2020. We provide valuable insights into the dynamics of vaccination during a global health crisis and highlight the importance of sustained immunization efforts to maintain public health.

A pharmacokinetic randomised interventional study to optimise dihydroartemisinin-piperaquine dosing for malaria preventive treatment in Malawian infants: A protocol for the OPTIMAL study

Background A newer malaria preventive treatment, dihydroartemisinin-piperaquine (DP), has been identified as an effective alternative to sulfadoxine-pyrimethamine, to which malaria parasites are increasingly becoming resistant. However, how best to dose DP to safely prevent malaria in infants when aligned with routine health facility visits remains unresolved. As infants are usually excluded from participating in early dose optimisation clinical trials, the present study seeks to shift the paradigm and develop optimised DP dosing strategies for malaria preventive treatment in infants. Methods A randomised, single-blind, placebo-controlled, two-arm, interventional study will be conducted in southern Malawi. At 10 weeks (2.5 months) of age, 220 eligible infants will be randomised to receive DP (intervention group, n=110) or placebo (control group, n=110) with routine vaccines. They will be followed until 12 months of age and receive three further DP or placebo treatment courses at 14 weeks, six- and nine months. Infants in the intervention group will contribute capillary samples for piperaquine concentrations pre-dose and at three-, seven-, 14- and 28-days post-DP dosing as well as capillary samples pre-dose and on day 28 post-DP to quantify malaria parasitaemia using microscopy and quantitative PCR. In the control group, infants will contribute capillary blood samples for malaria parasitaemia at the same time points as the intervention group. Malaria incidence and adverse events will be compared between the two groups. Population pharmacokinetic-pharmacodynamic modelling techniques will be applied to derive feasible, optimised, efficacious, and safe DP dosing strategies for malaria preventive treatment in infancy. Conclusions The findings will provide the much-needed evidence to inform DP dosing for malaria preventive treatment in infants when administered with routine health facility visits. Additionally, they will help inform optimal DP dosing for malaria treatment in infants. The trial was registered with the Pan African Clinical Trials Registry; (PACTR202211575727659) on 8 November 2022. Protocol version 3.1, dated 29 September 2022.

Stakeholders’ experiences with school-based immunization programs during the COVID-19 pandemic in the Canadian Maritimes: A qualitative study

BackgroundSchool-based immunization programs (SBIP) support access to routine vaccines for adolescents. Across Canada, the COVID-19 pandemic and subsequent public health measures affected SBIP and vaccine uptake. The objectives of this study were to explore 1.) stakeholders' experiences with SBIP and changes to programs during COVID-19 in Nova Scotia, Prince Edward Island and New Brunswick, and 2.) how the pandemic affected parents' and adolescents’ vaccine views. Study designSemi-structured interviews with decision makers, healthcare providers, teachers, parents and adolescents between February–August 2023. MethodsThe COM-B model and Theoretical Domains Framework informed interview guides. Deductive and inductive analyses saw participant quotes mapped to relevant model components and domains by two coders. Belief statements were generated within each stakeholder group then compared to identify themes and subthemes. ResultsParticipants (n = 39) identified five themes: 1) enablers to SBIP delivery, 2) barriers to SBIP delivery, 3) desired changes to SBIP delivery, 4) student anxiety, and 5) vaccination views and changes since the COVID-19 pandemic. Public health measures facilitated more space for clinics, as did taking smaller cohorts of students. School staff-healthcare provider relationships could help or hinder programs, particularly with high turnover in both professions during the pandemic. Adolescents played a passive role in vaccine decision making, with mothers often being the sole decision maker. We did not identify any changes in hesitancy towards routine vaccines since the pandemic. ConclusionsWe identified a range of barriers and enablers to SBIP, many of which were exacerbated by the pandemic. Efforts are needed to ensure SBIP and catch-up programming remains accessible for all adolescents to catch-up on missed vaccines before graduation. Parents and adolescents’ vaccination views suggest changes in vaccine coverage since the pandemic may be due to accessibility of services rather than vaccine hesitancy. Future research is needed to engage adolescents in their vaccine decisions.

Progress Toward Poliomyelitis Eradication - Worldwide, January 2022-December 2023.

In 1988, poliomyelitis (polio) was targeted for eradication. Global efforts have led to the eradication of two of the three wild poliovirus (WPV) serotypes (types 2 and 3), with only WPV type 1 (WPV1) remaining endemic, and only in Afghanistan and Pakistan. This report describes global polio immunization, surveillance activities, and poliovirus epidemiology during January 2022-December 2023, using data current as of April 10, 2024. In 2023, Afghanistan and Pakistan identified 12 total WPV1 polio cases, compared with 22 in 2022. WPV1 transmission was detected through systematic testing for poliovirus in sewage samples (environmental surveillance) in 13 provinces in Afghanistan and Pakistan, compared with seven provinces in 2022. The number of polio cases caused by circulating vaccine-derived polioviruses (cVDPVs; circulating vaccine virus strains that have reverted to neurovirulence) decreased from 881 in 2022 to 524 in 2023; cVDPV outbreaks (defined as either a cVDPV case with evidence of circulation or at least two positive environmental surveillance isolates) occurred in 32 countries in 2023, including eight that did not experience a cVDPV outbreak in 2022. Despite reductions in paralytic polio cases from 2022, cVDPV cases and WPV1 cases (in countries with endemic transmission) were more geographically widespread in 2023. Renewed efforts to vaccinate persistently missed children in countries and territories where WPV1 transmission is endemic, strengthen routine immunization programs in countries at high risk for poliovirus transmission, and provide more effective cVDPV outbreak responses are necessary to further progress toward global polio eradication.

Effect of the HPV vaccination programme on incidence of cervical cancer and grade 3 cervical intraepithelial neoplasia by socioeconomic deprivation in England: population based observational study

ObjectivesTo replicate previous analyses on the effectiveness of the English human papillomavirus (HPV) vaccination programme on incidence of cervical cancer and grade 3 cervical intraepithelial neoplasia (CIN3) using 12 additional...

Reducing Tetanus Vaccine Pain in Filipino Pregnant Women: Helfer Skin Tap Technique Efficacy

Reducing Tetanus Vaccine Pain in Filipino Pregnant Women: Helfer Skin Tap Technique Efficacy

Acute hepatitis B outbreak in a nursing home for the disabled in Türkiye.

Although hepatitis B is vaccine-preventable, it remains a significant health problem. To the best of our knowledge, this is the first hepatitis B outbreak report from Türkiye. To investigate the cause of hepatitis B outbreak in a nursing home for the disabled and make recommendations for prevention. An outbreak of acute hepatitis B was declared in a nursing home for the disabled following the admission of 3 patients from the home in a hospital. Collaborative response was initiated with the Provincial Health Directorate through the Public Health Infectious Diseases Department. We began tracking the infection and monitoring active cases. Audits and controls were carried out to determine the source, establish protection and control measures, and prevent further transmission. Six of the 65 nursing home residents were diagnosed with acute hepatitis B. Four of them had diabetes and their blood glucose levels were monitored for at least 12 months. Two of the patients had received dental treatment in the last 6 months. The frequency of both variables, which may be an indication of the transmission route, was statistically significantly greater in the acute hepatitis B group. All the patients who could be sequenced were identified as genotype D. While 3 patients recovered fully, 2 were diagnosed with chronic hepatitis B and one died due to fulminant hepatitis. Standard routine immunization should be implemented as a preventive measure for acute hepatitis B. Frequent supervision and training on hygiene practices and safety precautions should be conducted for care staff working in collective residential facilities.

Hesitancy towards R21/Matrix-M malaria vaccine among Ghanaian parents and attitudes towards immunizing non-eligible children: a cross-sectional survey

BackgroundThe newly developed malaria vaccine called “R21/Matrix-M malaria vaccine” showed a high safety and efficacy level, and Ghana is the first country to approve this new vaccine. The present study aimed to evaluate the rate of vaccine hesitancy (VH) towards the newly developed malaria vaccine among parents who currently have children who are not eligible for the vaccine but may be eligible in the near future. Additionally, the study aimed to identify the factors that could potentially influence VH.MethodsA cross-sectional survey using both online-based questionnaires and face-to-face interviews was conducted in Ghana from June to August 2023. The survey specifically targeted parents of ineligible children for vaccination, including those aged less than 5 months or between 3 and 12 years. The Parent Attitudes about Childhood Vaccination (PACV) scale was used to assess parental VH.ResultsA total of 765 people participated in this study. Their median age was 36.0 years with an interquartile range of 31.0–41.0 years, 67.7% were females, 41.8% completed their tertiary education, 63.3% were married, 81.6% worked in non-healthcare sectors, and 59.7% reported that their monthly income was insufficient. About one-third (34.5%) of the parents were hesitant to give their children the R21/Matrix-M malaria vaccine. The following predictors were associated with VH: working in the healthcare sector (adjusted odds ratio (AOR) = 0.50; 95% confidence interval (CI) 0.30–0.80; p = 0.005), having the other parent working in the healthcare sector (AOR = 0.54; 95% CI 0.30–0.94; p = 0.034), and not taking scheduled routine vaccinations (AOR = 1.90; 95% CI 1.27–2.84; p = 0.002).ConclusionsAddressing VH is crucial for optimizing R21/Matrix-M vaccine coverage in Ghana's malaria control strategy. By tackling VH issues, Ghana can effectively safeguard children's health in malaria-prone areas.

‘It's not for the children's sake’: A qualitative inquiry into the barriers and facilitators underlying parents' decision-making for vaccinating children against influenza in Denmark

Recently, the Danish Health Authority began recommending vaccinating children aged 2–6 years against seasonal influenza, underscoring the pivotal role of children in its transmission dynamics within the wider population and the need to protect vulnerable population groups after COVID-19. Under a third followed the recommendation. For the routine Danish childhood vaccine program coverage is usually well above 90%.Through a qualitative in-depth study with 28 key informants during the 2022/2023 influenza season, we investigated the barriers and facilitators of parents' decision-making for vaccinating their children against influenza. We found that parents' decision-making was influenced by a range of factors that present barriers or facilitators at the individual or collective levels, depending on personal antecedents and family situations. We also gained insights on how COVID-19 mass vaccination shaped parents’ attitudes and awareness toward influenza vaccination, explaining why many parents who fully complied with the COVID-19 recommendations elected to opt out of influenza.The implications of these findings extend beyond the concrete context of parent's decision-making regarding influenza vaccination, contributing to our understanding of vaccine confidence in at least two ways. First, the limited public controversy regarding childhood influenza vaccination allows for a perspective onto low vaccine uptake that does not resort to the usual framing of a well-defined “crisis”. Second, the interaction between COVID-19 vaccination and the childhood influenza vaccination reveals how the massive pressure on parents to vaccinate themselves and their children against COVID-19 contributed to an erosion of vaccine confidence in general.

Trends and projections of age-appropriate vaccination coverage in 41 low- and middle- income countries in Asia and Sub-Saharan Africa, 2000-2030.

Routine immunization programs have focused on increasing vaccination coverage, which is equally important for decreasing vaccine-preventable diseases (VPDs), particularly in low- and lower-middle-income countries (LMICs). We estimated the trends and projections of age-appropriate vaccination coverage at the regional and national levels, as well as place of residence and wealth index in LMICs. In total, 174 nationally representative household surveys from 2000 to 2020 from 41 LMICs were included in this study. Bayesian hierarchical regression models were used to estimate trends and projections of age-appropriate vaccination. The trend in coverage of age-appropriate Bacillus Calmette-Guérin (BCG), third dose of diphtheria, tetanus, and pertussis (DTP3), third dose of polio (polio3), and measles-containing vaccine (MCV) increased rapidly from 2000 to 2020 in LMICs. Findings indicate substantial increases at the regional and national levels, and by area of residence and socioeconomic status between 2000 and 2030. The largest rise was observed in East Africa, followed by South and Southeast Asia. However, out of the 41 countries, only 10 countries are estimated to achieve 90% coverage of the BCG vaccine by 2030, five of DTP3, three of polio3, and none of MCV. Additionally, by 2030, wider pro-urban and -rich inequalities are expected in several African countries. Significant progress in age-appropriate vaccination coverage has been made in LMICs from 2000 to 2020. Despite this, projections show many countries will not meet the 2030 coverage goals, with persistent urban-rural and socioeconomic disparities. Therefore, LMICs must prioritize underperforming areas and reduce inequalities through stronger health systems and increased community engagement to ensure high coverage and equitable vaccine access.

The Impact of Infant Bacille Calmette-Guérin Vaccination on the Immunogenicity of Other Vaccines: A Randomized Exploratory Study.

The effect of the Bacille Calmette-Guérin (BCG) vaccine on the immunogenicity of separately administered serogroup C meningococcal vaccine and other vaccinations was examined in 28 infants randomized to receive BCG at age ≤7 days, at 3 months or after study completion. Immunogenicity of the serogroup C meningococcal vaccine and other routine vaccines might be improved when BCG is administered in early infancy.

Evaluation of the knowledge levels of 6th-year medical faculty students regarding routine vaccines recommended for healthcare workers

Evaluation of the knowledge levels of 6th-year medical faculty students regarding routine vaccines recommended for healthcare workers

Genetic polymorphism and evidence of signatures of selection in the Plasmodium falciparum circumsporozoite protein gene in Tanzanian regions with different malaria endemicity

BackgroundIn 2021 and 2023, the World Health Organization approved RTS,S/AS01 and R21/Matrix M malaria vaccines, respectively, for routine immunization of children in African countries with moderate to high transmission. These vaccines are made of Plasmodium falciparum circumsporozoite protein (PfCSP), but polymorphisms in the gene raise concerns regarding strain-specific responses and the long-term efficacy of these vaccines. This study assessed the Pfcsp genetic diversity, population structure and signatures of selection among parasites from areas of different malaria transmission intensities in Mainland Tanzania, to generate baseline data before the introduction of the malaria vaccines in the country.MethodsThe analysis involved 589 whole genome sequences generated by and as part of the MalariaGEN Community Project. The samples were collected between 2013 and January 2015 from five regions of Mainland Tanzania: Morogoro and Tanga (Muheza) (moderate transmission areas), and Kagera (Muleba), Lindi (Nachingwea), and Kigoma (Ujiji) (high transmission areas). Wright’s inbreeding coefficient (Fws), Wright’s fixation index (FST), principal component analysis, nucleotide diversity, and Tajima’s D were used to assess within-host parasite diversity, population structure and natural selection.ResultsBased on Fws (< 0.95), there was high polyclonality (ranging from 69.23% in Nachingwea to 56.9% in Muheza). No population structure was detected in the Pfcsp gene in the five regions (mean FST = 0.0068). The average nucleotide diversity (π), nucleotide differentiation (K) and haplotype diversity (Hd) in the five regions were 4.19, 0.973 and 0.0035, respectively. The C-terminal region of Pfcsp showed high nucleotide diversity at Th2R and Th3R regions. Positive values for the Tajima’s D were observed in the Th2R and Th3R regions consistent with balancing selection. The Pfcsp C-terminal sequences revealed 50 different haplotypes (H_1 to H_50), with only 2% of sequences matching the 3D7 strain haplotype (H_50). Conversely, with the NF54 strain, the Pfcsp C-terminal sequences revealed 49 different haplotypes (H_1 to H_49), with only 0.4% of the sequences matching the NF54 strain (Hap_49).ConclusionsThe findings demonstrate high diversity of the Pfcsp gene with limited population differentiation. The Pfcsp gene showed positive Tajima’s D values, consistent with balancing selection for variants within Th2R and Th3R regions. The study observed differences between the intended haplotypes incorporated into the design of RTS,S and R21 vaccines and those present in natural parasite populations. Therefore, additional research is warranted, incorporating other regions and more recent data to comprehensively assess trends in genetic diversity within this important gene. Such insights will inform the choice of alleles to be included in the future vaccines.

Is the African Vaccine Manufacturing Accelerator a decoupling mechanism?

This article explores how the African Vaccine Manufacturing Accelerator can support the sustainable production of vaccines in Africa. It highlights the value of the accelerator in relation to the Regional Vaccine Manufacturing Collaborative. The author proposes that this novel financing instrument should be well-designed and implemented in line with the targets of the Partnerships for African Vaccine Manufacturing. It should not be a decoupling tool to appease the institutional environment of the global vaccine market, but a sustainable demonstration of the goodwill and commitment of political and technical leaders to ensure equitable access to routine and epidemic-related vaccines in Africa.

Developing and refining the COVID-19 to Routine Immunization Information System Transferability Assessment (CRIISTA) tool: a decision support tool to leverage COVID-19 immunization information system investments for routine immunization

Abstract To achieve the Immunization Agenda 2030 vaccine equity vision of a world where everyone everywhere benefits from vaccines, it is essential to invest in immunization information systems that can support the identification, reach and monitoring of zero-dose and under-immunized children. The rapid nature of COVID-19 vaccine introduction led to the investment of new systems to collect, manage and use immunization data. While many digital health assessment tools exist, there is an absence of tools to support decision-makers to systematically assess the suitability of transferring an immunization information system from one health context to another. To address this gap, the COVID-19 to Routine Immunization Information System Transferability Assessment tool was developed, informed by literature review, expert consultation and usability testing. The tool is organized into five thematic areas: context, functionality, technology, users and resources. Each thematic area has questions about the COVID-19 immunization information system, the current and desired state of the routine immunization information system and the gaps between them. Suitability scores are then calculated to assess whether a COVID-19 immunization information system is suitable for routine immunization so governments can leverage these investments to strengthen routine immunization programs and the broader health information ecosystem. Abrégé Pour réaliser la vision du Programme pour la vaccination à l’horizon 2030 concernant l’équité vaccinale d’un monde où tout le monde, partout, bénéficie des vaccins, il est essentiel d’investir dans des systèmes d’information sur la vaccination capables d’appuyer l’identification, l’accès et le suivi des enfants zéro dose et insuffisamment vaccinés. La nature rapide de l’introduction du vaccin contre la COVID-19 a entraîné l’investissement dans de nouveaux systèmes de collecte, de gestion et d’utilisation des données sur la vaccination. Bien que de nombreux outils numériques d’évaluation de la santé existent, on ne dispose d’aucun outil pour aider les décideurs à évaluer systématiquement la pertinence du transfert d’un système d’information sur la vaccination d’un contexte de santé à un autre. Pour combler cette lacune, l’outil d’évaluation de la transférabilité de la COVID-19 au système d’information sur la vaccination de routine a été élaboré, éclairé par un examen documentaire, des consultations d’experts et des tests bêta. Cet outil s’articule autour de cinq domaines thématiques: contexte, fonctionnalité, technologie, utilisateurs et ressources. Chaque domaine thématique comprend des questions sur le système d’information sur la vaccination contre la COVID-19, l’état actuel et souhaité du système d’information sur la vaccination de routine et les écarts entre eux. Les scores de pertinence sont ensuite calculés pour évaluer si un système d’information sur la vaccination contre la COVID-19 convient à la vaccination de routine afin que les pouvoirs publics puissent tirer parti de ces investissements pour renforcer les programmes de vaccination de routine et l’écosystème de l’information sur la santé dans son ensemble. Resumen Para lograr la visión de la Agenda de Inmunización 2030 de un mundo donde todas las personas de todas partes se beneficien de las vacunas, es esencial invertir en sistemas de información sobre vacunación que puedan apoyar la identificación, el alcance y el monitoreo de niños con dosis cero y subvacunados. La rápida introducción de la vacuna COVID-19 condujo a la inversión en nuevos sistemas para recopilar, administrar y utilizar datos sobre vacunación. Si bien existen muchas herramientas digitales de evaluación de la salud, faltan instrumentos para ayudar a los responsables de la toma de decisiones a evaluar sistemáticamente la idoneidad de transferir un sistema de información sobre vacunación de un contexto sanitario a otro. Para corregir esta deficiencia, se creó el Marco de evaluación de la transferibilidad del sistema de información sobre la vacunación contra la COVID-19 a la vacunación sistemática (CRIISTA), sobre la base de la revisión de literatura, consultas a expertos y pruebas beta. El Marco está organizado en cinco áreas temáticas: contexto, funcionalidad, tecnología, usuarios y recursos. Cada área temática contiene preguntas referidas al sistema de información sobre la vacunación contra la COVID-19, el estado actual del sistema de información sobre la vacunación sistemática y su estado deseado, y las brechas entre ellos. Seguidamente, se calculan las puntuaciones de idoneidad para evaluar si un sistema de información sobre la vacunación contra la COVID-19 es adecuado para la vacunación sistemática, de modo que los Gobiernos puedan aprovechar estas inversiones para fortalecer los programas de vacunación sistemática y el sistema más amplio de información sanitaria.

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

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