Vaccination Site Research Articles

Childhood Influenza Vaccination and Its Determinants during 2020-2021 Flu Seasons in China: A Cross-Sectional Survey.

Young children aged 6−59 months are recommended as one of the priority groups for seasonal influenza vaccination in China. This study assessed influenza vaccination coverage and the factors associated with vaccination uptake among children in three Chinese provinces. In September 2021, 2081 caregivers with children <5 years completed self-administered questionnaires as part of a cross-sectional survey. Logistic regression was used to assess determinants of childhood influenza vaccination. A total of 43.63% of respondents reported vaccinating their children against influenza during the 2020−2021 flu season. Caregivers who lived in Anhui province, had a bachelor degree or above, and an annual household income <20,000 RMB were more likely to vaccinate their children against influenza. Confidence in the importance (OR: 2.50; 95%CI: 1.77−3.54), safety (OR: 1.60; 95%CI: 1.29−1.99), and effectiveness (OR: 1.54; 95%CI: 1.23−1.93) of influenza vaccine was significantly associated with childhood vaccine acceptance. Respondents who saw that other caregivers were vaccinating their children had significantly higher odds of vaccinating their own children. Caregivers’ receiving positive influence from healthcare workers (OR: 1.33; 95%CI: 1.00−1.77), family members, or friends (OR: 1.30; 95%CI: 1.14−1.49) were also significantly associated with childhood influenza vaccination. Poor access, including conflicts between caregivers’ availability and vaccination service schedules and inconvenient transportation to the vaccination site were negatively associated with childhood flu vaccination. To promote childhood influenza vaccination, public health information campaigns need to target wealthier and less educated caregivers to enhance caregivers’ confidence in influenza vaccination. Targeted interventions are also needed to optimize access to vaccination services, including extending vaccination service hours and increasing the number of vaccination sites close to residential areas. Interventions are also needed to encourage primary care providers to play a greater role in promoting vaccination. Finally, the dissemination of related information and the public response need to be monitored for the timely understanding of public perceptions.

Evaluation of Rapid Dot-Immunoassay for Detection Orthopoxviruses Using Laboratory-Grown Viruses and Animal's Clinical Specimens.

The aim of the work was an experimental evaluation of the characteristics of the kit for the rapid immunochemical detection of orthopoxviruses (OPV). The kit is based on the method of one-stage dot-immunoassay on flat protein arrays using gold conjugates and a silver developer. Rabbit polyclonal antibodies against the vaccinia virus were used as capture and detection reagents. The sensitivity of detection of OPV and the specificity of the analysis were assessed using culture crude preparations (monkeypox virus, vaccinia virus, rabbitpox virus, cowpox virus, and ectromelia virus), a suspension from a crust from a human vaccination site as well as blood and tissue suspensions of infected rabbits. It has been shown that the assay using the kit makes it possible to detect OPV within 36 min at a temperature of 18-40 °C in unpurified culture samples of the virus and clinical samples in the range of 103-104 PFU/mL. Tests of the kit did not reveal cross-reactivity with uninfected cell cultures and viral pathogens of exanthematous infections (measles, rubella and chicken pox). The kit can be used to detect or exclude the presence of a virus threat in samples and can be useful in various aspects of biosecurity. The simplicity of analysis, the possibility of visual accounting the and interpretation of the results make it possible to use the test in laboratories with a high level of biological protection and in out-of-laboratory conditions.

Healthcare workers’ attitudes on mandates, incentives, and strategies to improve COVID-19 vaccine uptake: A mixed methods study

ABSTRACT Healthcare workers are a trusted health information source and are uniquely positioned to reduce the burden of the COVID-19 pandemic. The purpose of this sequential exploratory mixed methods study was to understand attitudes of healthcare workers working in Massachusetts during the COVID-19 pandemic regarding strategies to improve COVID-19 vaccine utilization, including vaccine mandates and incentives. Fifty-two individuals completed one-on-one interviews between April 22nd and September 7th, 2021. The survey was developed based on findings from the interviews; 209 individuals completed the online survey between February 17th and March 23rd, 2022. Both the interview and survey asked about attitudes toward COVID-19 vaccine and booster mandates, incentives, and strategies to improve vaccination rates. Most participants were female (79%-interview, 81%-survey), Caucasian (56%, 73%), and worked as physicians (37%, 34%) or nurses (10%, 18%). Overall, nuanced attitudes regarding vaccine and booster mandates were expressed; many supported mandates to protect their patients’ health, others emphasized personal autonomy, while some were against mandates if job termination was the consequence of declining vaccines. Similarly, views regarding vaccine incentives differed; some considered incentives helpful, yet many viewed them as coercive. Strategies believed to be most effective to encourage vaccination included improving accessibility to vaccination sites, addressing misinformation, discussing vaccine safety, tailored community outreach via trusted messengers, and one-on-one conversations between patients and healthcare workers. Healthcare workers’ experiences with strategies to improve utilization of COVID-19 vaccines and boosters have implications for public health policies. Generally, efforts to improve access and education were viewed more favorably than incentives and mandates.

Primary care is the ideal setting to promote COVID-19 vaccination for children.

Primary care is the ideal setting to promote COVID-19 vaccination for children.

DDDR-29. THE HYDROGEL-CXCL9-MRNA (HCM) VACCINE RESULTS IN SIGNIFICANT ANTI-TUMOR EFFICACY THROUGH RECRUITMENT OF NATURAL KILLER (NK) CELLS

Abstract INTRODUCTION: Immunotherapy for GBM has resulted in limited benefits to overall survival due to the targeting of limited antigens and the hostile TME. Our group has developed a patented vaccine platform that combines an mRNA-nanoparticle with CXCL9 loaded polyethylene glycol (PEG) hydrogel. The HCM vaccine is given SQ and recruits a diverse immune cell population to deliver a large payload of mRNA. The objective of these studies was to evaluate the efficacy and mechanisms of action of the HCM vaccine. METHODS: C57BL/6 mice underwent intracranial implantation of KR158 glioma cells. The HCM vaccine was formulated with total tumor mRNA, DOTAP, CXCL9 and PEG hydrogel created in collaboration with the College of Engineering. Survival studies were analyzed with the Mantel-Cox test. Flow cytometry and ELISA data was analyzed using ANOVA. Graphpad was used for statistical analysis. RESULTS: KR158-glioma intracranial tumor bearing mice were treated with SQ injection of the HCM vaccine (total tumor mRNA, DOTAP, CXCL9, PEG hydrogel). KR158 tumor bearing animals are resistant to treatment with radiation, temozolomide and other immunotherapy platforms in our laboratory. Treatment animals lived significantly longer compared to control animals (35 days versus 22 days, p &amp;lt; 0.0001). In a separate experiment, the fat pad was collected after vaccination and flow cytometry revealed recruitment of dendritic cells (DCs), CD4 and CD8 T cells and NK cells. Large numbers of antigen specific CD8 T cells were found in the spleen and within the TME after vaccination. When NK cells were blocked (NK 1.1 blocking antibody), the survival benefit from the vaccine was completely abrogated. NK cells were found to increase antigen presentation and available IFN-gamma within the PEG hydrogel scaffold. CONCLUSION: The HCM vaccine demonstrates efficacy in resistant murine glioma models and the efficacy is dependent on recruitment of NK cells at the site of vaccination.

Utilizing Listening Sessions to Assess COVID-19 Vaccine Acceptance among Asian Americans in Michigan.

SARS-CoV-2 (COVID-19) hospitalizations and deaths have been in the forefront of healthcare and public health for the past two years. Despite widespread vaccinations campaigns, infection rates and serious illness and death remain high among immigrant and minority communities. There are many factors that increase the risk of hospitalization and death, including overall health of the individual as well as environmental and socioeconomic factors. Seven virtual listening sessions with 39 Asian American adults were conducted to assess acceptance of COVID-19 vaccines. Lack of access, confusion on eligibility, distrust of mass vaccination sites, and fear of long-term side effects were primary barriers to vaccine acceptance. Perspectives on the vaccines varied by ethnic groups, with Bangladeshi and Yemeni participants more likely to have negative views. Our findings show that while national statistics of the broad category "Asian" indicate higher COVID-19 vaccination rates than other minority groups, there are Asian ethnic groups that may not follow these trends. These groups are important to prioritize as they may be at increased risk for exposure and severe illness. However, these groups can be difficult to access for reasons such as language barriers and cultural norms. Information from these listening sessions was used to create resources and programs to clarify misconceptions and increase access to COVID-19 vaccines.

Analysis Of Communication And Hr Implementation Of The Covid-19 Vaccination Program In The Elderly In North Musi Rawas District

The study, titled "Analysis of the Implementation of the Covid-19 Vaccination Program for the Elderly in North Musi Rawas Regency," aims to determine the implementation of the COVID-19 vaccination program for the elderly in North Musi Rawas Regency.Techniques and tools for collecting data through in-depth interviews and observations, as well as using qualitative methods with case study designs, ensure that the data is presented in a complete description to describe a phenomenon observed in real-life contexts if the boundaries between phenomena and contexts do not appear clear and if multiple sources of evidence are needed. The conclusion in the study regarding the implementation of the Covid-19 vaccination program for the elderly in North Musi Rawas Regency is that it is still experiencing obstacles and that it is difficult for the elderly to get the vaccine because the long queue results in the elderly being tired and the access to vaccination sites is far, so if there is a further vaccine, it is advisable to do a door-to-door. The factors that influence this implementation are resources and communication.

Systemic and Local Disease Manifestations Following COVID-19 Vaccination

Abstract Introduction/Objective COVID-19 vaccine-related lymphadenopathy, particularly in the ipsilateral axilla, is a relatively well-known side effect of mRNA vaccines with many reports in radiology, but less is known regarding histopathology and additional sites of lymphadenopathy, as well as other localized potential vaccine-related mass manifestations. In addition to a case of minimal change disease, we report two cases here with associated systemic and local pathologic changes related to COVID-19 vaccination. Methods/Case Report In case #1, a 17-year-old male presented with a 2.4 cm left postauricular mass. He had originally noticed the mass six months prior and thought that it had recently been growing. The mass was soft, nonfluctuant, and nontender to palpation. Given the risk of malignancy, a resection was performed. Histology showed an enlarged lymph node composed of mixed inflammatory cell components consistent with lymphoid hyperplasia and no evidence of malignancy. On further chart review, the patient had received his second COVID-19 vaccination just prior to noticing the mass enlarging. A SARS-CoV-2 Anti-Spike IgG assay was as high as 24,396 AU/ml, suggesting that this benign lymphadenopathy was most likely related to his vaccination. For case #2, a 47-year-old male developed a painless right deltoid mass shortly after receiving his vaccination at the same area that subsequently increased in size over seven months to 6.5 cm. Imaging showed a heterogeneous mass within the deltoid muscle concerning for malignancy and a biopsy was performed. Sections showed wavy, bland spindle cells with nuclei staining diffusely positive for beta-catenin, consistent with fibromatosis at his vaccination site. Results (if a Case Study enter NA) NA. Conclusion In summary, these case reports show potential systemic and local reactive effects in response to COVID-19 vaccination.

Evaluation of medical services from the perspective of COVID-19 vaccine demand satisfaction in Hangzhou, China.

The outbreak of COVID-19 has had a huge global impact, and it continues to test the resilience of medical services to emergencies worldwide. In the current post-epidemic era, vaccination has become a highly effective strategy to prevent the spread of COVID-19. However, using conventional mathematical models to evaluate the spatial distribution of medical resources, including vaccination, ignore people's behaviors and choices and make simplifications to the real world. In this study, we use an enhanced model based on the Theory of People Behavior (TPB) to perform a macro analysis of the satisfaction ability of medical resources for vaccination in Hangzhou, China, and attribute the city to a three-level structure. According to the allocation, the supply capacity of vaccination sites is calculated and divided into four categories (good, normal, not bad, and bad). Meanwhile, we raise an assumption based on the result and the general development law of the city and analyze the reasons for the impact of personal behavior on the spatial distribution of medical resources, as well as the relationship between the demand distribution and spatial distribution of medical resources and future development strategies. It is considered that the overall medical resources, especially vaccination in Hangzhou, feature the situation of central supply overflow, and are found to hardly meet the needs of population points in surrounding areas, requiring a more flexible strategy to allocate facilities in these areas.

Mosque as a COVID-19 vaccination site in collaboration with a private clinic: A short report from Osaka, Japan

Ethnic minorities are vulnerable to disasters, including the COVID-19 pandemic. Vaccination strategies that do not leave ethnic minorities behind are required. This is a report on the use of Osaka Islamic Center, a mosque, as a group vaccination site for an ethnic minority group in Osaka, Japan, from August to September 2021. We aimed to discuss (1) the process of turning the mosque to a vaccination site, (2) the linguistic and religious considerations made, and (3) the reasons people got vaccinated at the mosque. We interviewed stakeholders and vaccine recipients in December 2021. The survey shows that the mosque administrators voluntarily collaborated with a private clinic to become a vaccination site after learning of another mosque that had undertaken a similar venture. On the day of the vaccination, the mosque administrators' experiences with a large vaccination site informed the smooth operation of the site. They made linguistic considerations (i.e., having volunteers fill out medical questionnaires and administrators aid in language interpretation) and religious considerations (i.e., dividing the space and time of vaccination according to gender) for foreign Muslims. In particular, linguistic considerations were favorably accepted by vaccination recipients and were considered a factor that encouraged them to get vaccinated. The mosque also linked unvaccinated people to the clinic even after finishing vaccination at the mosque, suggesting that it may have played a role in ensuring they were not left behind. This case is expected to stimulate activities performed in mosques and by ethnic minority groups in future disasters.

Safety and Outcomes of a Plasmid DNA Vaccine Encoding the ERBB2 Intracellular Domain in Patients With Advanced-Stage ERBB2-Positive Breast Cancer

High levels of ERBB2 (formerly HER2)-specific type 1 T cells in the peripheral blood are associated with favorable clinical outcomes after trastuzumab therapy; however, only a minority of patients develop measurable ERBB2 immunity after treatment. Vaccines designed to increase ERBB2-specific T-helper cells could induce ERBB2 immunity in a majority of patients. To determine the safety and immunogenicity of 3 doses (10, 100, and 500 μg) of a plasmid-based vaccine encoding the ERBB2 intracellular domain (ICD). Single-arm phase 1 trial including 66 patients with advanced-stage ERBB2-positive breast cancer treated in an academic medical center between 2001 and 2010 with 10-year postvaccine toxicity assessments. Data analysis was performed over 2 periods: January 2012 to March 2013 and July 2021 to August 2022. Patients were sequentially enrolled to the 3 dose arms. The vaccine was administered intradermally once a month with soluble granulocyte-macrophage colony-stimulating factor as an adjuvant for 3 immunizations. Toxicity evaluations occurred at set intervals and yearly. Peripheral blood mononuclear cells were collected for evaluation of immunity. Biopsy of vaccine sites at weeks 16 and 36 measured DNA persistence. Safety was graded by Common Terminology Criteria for Adverse Events, version 3.0, and ERBB2 ICD immune responses were measured by interferon-γ enzyme-linked immunosorbent spot. Secondary objectives determined if vaccine dose was associated with immunity and evaluated persistence of plasmid DNA at the vaccine site. A total of 66 patients (median [range] age, 51 [34-77] years) were enrolled. The majority of vaccine-related toxic effects were grade 1 and 2 and not significantly different between dose arms. Patients in arm 2 (100 μg) and arm 3 (500 μg) had higher magnitude ERBB2 ICD type 1 immune responses at most time points than arm 1 (10 μg) (arm 2 compared with arm 1, coefficient, 181 [95% CI, 60-303]; P = .003; arm 3 compared with arm 1, coefficient, 233 [95% CI, 102-363]; P < .001) after adjusting for baseline factors. ERBB2 ICD immunity at time points after the end of immunizations was significantly lower on average in patients with DNA persistence at week 16 compared with those without persistence. The highest vaccine dose was associated with the greatest incidence of persistent DNA at the injection site. In this phase 1 nonrandomized clinical trial, immunization with the 100-μg dose of the ERBB2 ICD plasmid-based vaccine was associated with generation of ERBB2-specific type 1 T cells in most patients with ERBB2-expressing breast cancer, and it is currently being evaluated in randomized phase 2 trials. ClinicalTrials.gov Identifier: NCT00436254.

A Polio Epidemic Is Averted.

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times. In August 1961, the incidence of polio was rising in and around Syracuse, New York, and oral polio vaccine had just been made available. In this article from AJN's May 1962 issue, Syracuse Department of Health director of nursing Alyce Rooney details the rapid planning that resulted in the administration of more than 400,000 polio vaccines over a period of just three days. In an incredible effort over less than two weeks, vaccine was obtained and repackaged, vaccination sites were secured, staff assignments were made, and the vaccines were given. After a high of 46 Syracuse-area polio cases in August, the number dropped to 18 in September and none in October. More than 50 years later, vaccine hesitancy has become a roadblock to today's vaccination campaigns. In this issue, research by Roberts and colleagues provides an understanding of vaccine hesitancy among nurses, which may inform the development of policies, campaigns, and interventions aimed at increasing nurse vaccination rates.-Betsy Todd, MPH, RN.

ODP209 Impact of an Educational Intervention on Rates of Physician-Performed Counseling on COVID-19 Vaccination in Patients With Diabetes

Abstract Background Roughly half of the people who died from COVID-19 infection under the age of 65 years had diabetes mellitus(1). People with type 1 or 2 diabetes mellitus are 3 times more likely to be hospitalized or experience severe COVID-19 infection compared with people without diabetes mellitus(2). We aimed to evaluate the impact of an educational quality improvement intervention on the rates of physician-performed counseling for patients with diabetes mellitus regarding COVID-19 vaccination at a university hospital in an underserved community. Methods Patients 18 years and older with type 1 or 2 diabetes mellitus presenting from May 1st to October 31st, 2021 were included. Via chart review, we recorded the number of patients who were asked about their vaccination status and the number of unvaccinated patients who received verbal and/or written counseling before and after an educational intervention performed on August 1st. The intervention consisted of a formal presentation to endocrinology fellows on how to counsel patients with diabetes regarding COVID-19 vaccination and provided them a patient hand-out with answers to frequently asked questions and information on vaccination sites at the hospital and in the community. Results 328 patients with diabetes, mean age 59 years, type 2 diabetes 92% (n=301) and type 1 diabetes 8% (n=27), were seen during the six month period. 82% (n=268) were vaccinated, 12% (n=40) were unvaccinated, and 6% (n=20) had unknown vaccination status. 56% (n=183) were asked about their vaccination status. Of the unvaccinated patients, 60% (n=24) were counseled. Prior to the intervention, 155 patients were seen and 31% (n=48) were asked about their vaccination status, 15% (n=23) were unvaccinated, and of the unvaccinated 39% (n=9) were counseled. After our intervention, 173 patients were seen and 78% (n=135) were asked about their vaccination status. 12% (n=12) were unvaccinated and of these 71% (n=15) were counseled. We found a statistically significant increase in rates of recording vaccination status (31% vs. 78%, p-value &amp;lt;0. 001) and counseling rates for those unvaccinated (39% vs. 71%, p-value 0. 016) before and after the intervention. Of the total unvaccinated patients counseled throughout the six month period (n=24), 13% (n=3) received vaccination afterwards and 16% (n=4) did not receive vaccinations, while vaccination status remains unknown in 71% (n=17). Conclusion As patients with diabetes mellitus are at increased risk of severe disease from COVID-19, it is clinically meaningful for endocrinologists to counsel patients regarding COVID-19 vaccination. Following our educational intervention, we found a significant improvement in rates of physician-performed counseling on COVID-19 vaccination at a university hospital, caring for one of the nation's most underserved communities for diabetes mellitus.

GeneXpert Ultra- a New Diagnostic Era for Childhood Tuberculosis

Introduction: Tuberculosis (TB) is a serious public health problem and a significant diagnostic and therapeutic challenge worldwide. Molecular diagnostic techniques are crucial in the World Health Organization’s new tubercular control strategy. Objective: The study aims to investigate the efficacy of GeneXpert Ultra in the diagnosis of childhood tuberculosis. Methods: A prospective cross-sectional study was carried out in the pediatric pulmonology ward and general pediatric ward of the Institute of Child and Mother Health (ICMH), Matuail, Dhaka. Child ages ranging from two months to fifteen years who were admitted to the pediatric pulmonology ward and general pediatric ward of ICMH during the period of December 2020 to November 2021 with a history of fever, cough, chest pain, evening rise of temperature, night sweats, weight loss were included in this study. Results: Among the study population (N=99), almost all the patients (91, 91.2%) had cough, thirty-six patients (36, 36.3%) had cough for 2 weeks, and about half of the patients (49, 49.5%) had a productive cough, ninety patients (90, 90.9%) had fever, around one-fifth of the patients, had a fever more than two weeks. About half of the patients (47, 47.5%) had a high-grade intermittent fever. Evening rise of temperature was seen in around one-fourth of the patients (24, 24.2%). MT test was positive for two patients (2, 2.0%) and doubtful for two patients (2, 2.0%)., Seventeen patients (17, 17.1%) specimens were collected from induced sputum, around three-fifths of the patients’ (70, 70.7%) specimens were collected from gastric aspirate, eighty-two patients (82, 82.8%) specimens were collected from the stool and one patient’s specimen (1, 1.0%)was collected from pus produced in BCG vaccine site. GeneXpert ultra was detected in thirteen patients (13, 13.1%) and was trace detected in six patients (6, 6.0%). Of the 13 patients, 7 patients (7, 53.8%) were diagnosed with pulmonary TB, two patients (2, 15.4%) were .....

Differences in Demographics of Vaccinees, Access to, and Satisfaction with SARS-CoV-2 Vaccination Procedures between German General Practices and Mass Vaccination Centers.

In the European Union, SARS-CoV-2 vaccines became available in December 2020. The vaccination campaign in Germany was initially implemented through mass vaccination centers and later joined by general practitioners (GPs) in spring 2021. This study compared population characteristics, perceived access barriers, and satisfaction with the vaccination procedure between vaccination centers and GP practices. A paper-based survey was distributed (07/2021-10/2021) among newly vaccinated individuals in ten GP practices (n = 364) and two vaccine centers (n = 474). Participants in vaccine centers were younger compared to participants in GP practices. GP preference was higher in older participants and those with pre-existing illnesses. Wait time at vaccination site was longer in GP practices, whereas travel distance to site was longer for participants in vaccine centers. However, satisfaction with patient education and recommendation of site were more likely with increasing comprehensibility of the vaccination procedure and physicians' information as well as perceived sufficiency of patient education duration, factors that can be easily modified by all vaccination sites. Our results demonstrate that both types of vaccination sites complement each other in terms of accessibility and target population and that satisfaction with the vaccination procedure can be promoted at all sites by an easy-to-understand process.

Incomplete immunization and associated factors among children 12-23 months in Aletawondo district, Sidama zone, South Ethiopia: Across-sectional study.

Immunization is one of the most cost-effective and commonly used public health strategies for preventing child mortality. The goal of this study was to determine the prevalence of incomplete immunization and associated variables in children aged 12-23 months in the Aleta Wondo district of Southern Ethiopia. The researchers utilized a community-based cross-sectional study approach. A modified World Health Organization-Expanded Program on Immunization cluster sampling method was used to choose 634 mothers/caregivers of children aged 12-23 months. Data were collected by trained data collectors between March and April 2019. Descriptive statistics and logistic regression were done. In this study, 138 (21.8%) of children were not completed their immunization. Mothers who were literate [AOR = 2.1; (95% CI: 1.1, 4.2)]. Home birth [AOR = 2.9; (95% CI: 1.7, 5.3)], walking time from home to vaccination site [AOR = 1.95; (95% CI: 1.1,3.3)], inconvenience times for vaccination service [AOR = 2.4; (95% CI: 1.3,4.5)], postponing vaccination session schedule [AOR = 2.4; (95% CI:1.1,5.4)], households not visited by health extension workers [AOR = 4.1; (95% CI: 2.2,7.4)], poorer knowledge about child immunization [AOR = 4; (95% CI:2.2,7.5)] were factors associated with incomplete immunization. Incomplete immunization was higher compared to the national target. It is necessary to strengthen the program by enhancing the number of outreach sites considering the size of the target group.

Covid-19 Vaccination and the issue of insurance status

Abstract Issue It is estimated, that 11000 - 14000 people that live in Zurich do not have health insurance (∼3% of pop.). Covid-19 vaccination in Switzerland required an online registration (‘Vacme') with name, address and health insurance number. Health insurance in Switzerland is only accessible to people with registered residence in the country. This systematically excluded people without right of residence, health insurance or internet access. Description To address this issue the health service of the city Zurich organized a vaccination site for the uninsured from 14.06.2021 onward. To achieve this a simplified registration procedure was established, which allowed us to offer Vaccination to everybody, independent of their insurance status. Instead of the health insurance number, on site personal used a dummy number and the address of our site to register those patients. To remove language and technological barriers. In order to lower, the inhibition threshold for people without legal residence the Police department was informed and agreed not to circulate the area of the vaccination site on vaccination days. Results Between 14.06.2021 and 19.02.2022, 880 people came for vaccination of which 603 (69%) were clearly identifiable as individuals from non-insured populations. (See Graph) Lessons It is therefore critical not to forget these people when organizing public health measures, especially when addressing a pandemic or other infectious diseases (HIV, Hepatitis). A group specific information approach is of paramount importance to reach such subpopulations. Non-insurance is a known barrier for universal access to care. Acknowledgements: We would like to thank the involved departments of the city Zurich, chief medical officer canton zurich, our collaboration partners and the staff of our vaccination site. Key messages

Where are children ages 5–17 years receiving their COVID-19 vaccinations? Variations over time and by sociodemographic characteristics, United States

BackgroundKnowing the settings where children ages 5–17 years received COVID-19 vaccination in the United States, and how settings changed over time and varied by socio-demographics, is of interest for planning and implementing vaccination programs. MethodsData from the National Immunization Survey-Child COVID-19 Module (NIS-CCM) were analyzed to assess place of COVID-19 vaccination among vaccinated children ages 5–17 years. Interviews from July 2021 thru May 2022 were included in the analyses for a total of n = 39,286 vaccinated children. The percentage of children receiving their COVID-19 vaccine at each type of setting was calculated overall, by sociodemographic characteristics, and by month of receipt of COVID-19 vaccine. ResultsAmong vaccinated children ages 5–11 years, 46.9 % were vaccinated at a medical place, 37.1 % at a pharmacy, 8.1 % at a school, 4.7 % at a mass vaccination site, and 3.2 % at some other non-medical place. Among vaccinated children ages 12–17 years, 35.1 % were vaccinated at a medical place, 47.9 % at a pharmacy, 8.3 % at a mass vaccination site, 4.8 % at a school, and 4.0 % at some other non-medical place. The place varied by time among children ages 12–17 years but minimally for children ages 5–11 years. There was variability in the place of COVID-19 vaccination by age, race/ethnicity, health insurance, urbanicity, and region. ConclusionChildren ages 5–17 years predominantly received their COVID-19 vaccinations at pharmacies and medical places. The large proportion of vaccinated children receiving vaccination at pharmacies is indicative of the success in the United States of expanding the available settings where children could be vaccinated. Medical places continue to play a large role in vaccinating children, especially younger children, and should continue to stock COVID-19 vaccine to keep it available for those who are not yet vaccinated, including the newly recommended group of children < 5 years.

Applicability and benefits of telemedicine in the monitoring of monkeypox close contacts.

Monkeypox is a zoonotic disease caused by the monkeypox virus and classically presents as a vesicular rash accompanied by fever and lymphadenopathy. Singapore reported the first imported case of monkeypox infection on 21 June 2022, the first local unlinked case on 6 July 2022, and the first local linked case on 5 August 2022. Telemedicine was used in the management of monkeypox close contacts to (1) screen for the development of signs and symptoms consistent with monkeypox infection, (2) assess for successful post-exposure prophylaxis via direct visualisation of vaccination site morphological progression, (3) detect serious reactions arising from post-exposure prophylaxis administration, and (4) evaluate for deterioration in mental health status during the 21-day quarantine period. A case series of 13 close contacts who received post-exposure prophylaxis in the form of the ACAM2000 live Vaccinia virus preparation is presented, illustrating the safe and efficacious application of telemedicine in the clinical follow-up of quarantined close contacts throughout the 21-day incubation period, and post-exposure prophylaxis monitoring. Inherent limitations included difficulties in the assessment of sensitive areas such as the peri-genital and peri-anal regions and video quality-related issues.

COVID-19 vaccination at a mosque with multilingual and religious considerations for ethnic minorities: A case study in Kanagawa, Japan

During a disaster, such as a pandemic, ethnic minorities tend to be left behind due to linguistic and religious differences. In the COVID-19 vaccination process, measures to include them are necessary, including the utilization of their resources and networks. The functions and challenges of such measures should be explored in real-world cases. We targeted a case in Ebina, Kanagawa, Japan, where a mosque, being a hub of foreign Muslims, was used as a vaccination site. This was the first, and the only, case in Japan with the involvement of the local government. We aimed to detail (1) the linguistic and religious responses at the mosque, (2) the perceptions of vaccine recipients regarding linguistic and religious issues and considerations, and (3) the problems that arose when using the mosque. We conducted an e-mail survey of the local government and a field survey—field observations and interviews with relevant stakeholders (e.g., mosque managers and female vaccinees). The surveys found various linguistic (e.g., interpretation by mosque-related volunteers) and religious (i.e., separating vaccination spaces based on gender) considerations provided at the mosque, which the vaccinees favorably accepted. The measure likely promoted vaccination by increasing the intention to vaccinate and closing the intention-behavior gap. If some identified problems (e.g., complaints from the Japanese) are mitigated, the function of the mosque as a vaccination site would be further enhanced. The results also support the significant potential of mosques in Muslim-minority societies to approach ethnic minorities in disasters, including pandemics.