Strategic Advisory Group Research Articles

Measuring vaccine acceptance and knowledge within health professions education

BackgroundRecent rises in the incidence of vaccine-preventable illnesses and suboptimal vaccine acceptance are considered a consequence of accumulating misinformation. Evidence-based approaches to patient-provider communication are key to addressing vaccine hesitancy. ObjectivesThe aim of this study was to assess vaccination attitudes and foundational knowledge among healthcare professions students. MethodsA 72-item survey was developed to assess vaccine attitudes and knowledge about vaccination among health professions students. The survey incorporated 14 demographics questions, 41 attitude questions, and 17 knowledge questions. 16 of the attitude questions, derived from a set of core questions used to diagnose vaccine hesitancy from the WHO Strategic Advisory Group of Experts on Immunization (SAGE) Vaccine Hesitancy Matrix, were analyzed together to derive a vaccine acceptance score. Results295 anonymous survey responses were collected between July 2019 and November 2020. Respondents represented students enrolled in medical, dental, pharmacy, optometry, and biomedical science health professions programs. Respondents scored 82.0% ± 0.8% (mean ± standard error of the mean) on questions that gauged vaccine acceptance. The mean vaccine acceptance score was 85.4% ± 1.0% for medical students and 88.0% ± 1.6% for biomedical science students. The mean knowledge score across all programs was 67.7% ± 1.1%. The greatest proficiency in knowledge scores was seen amongst medical students (79.0% ± 1.3%). ConclusionsAmongst the different health professions, students in the fields of medicine and biomedical sciences had the highest levels of vaccine acceptance attitudes and knowledge. The vaccine acceptance score can be utilized by health professions educators to guide vaccine education for future health professionals to better prepare them to address vaccine hesitancy and educate patients on vaccination.

Ethical considerations for the modification of routine human papillomavirus immunisation schedules

On April 6, 2022, WHO's Strategic Advisory Group of Experts on Immunization (SAGE) changed the recommendation on the human papillomavirus (HPV) vaccination schedule for girls aged 9–14 years from a two-dose regimen to either a two-dose or one-dose regimen. 1 WHOHighlights from the meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization. https://cdn.who.int/media/docs/default-source/reproductive-health/sage_april2022meetinghighlights_11apr2022_final.pdf?sfvrsn=21bcfb4f_3Date: April 11, 2022 Date accessed: April 16, 2022 Google Scholar The rationale provided for this change was that a single dose of any of the WHO-prequalified HPV vaccines is less resource-intensive and results in greater population coverage than two doses, but still provides a high level of individual protection. 1 WHOHighlights from the meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization. https://cdn.who.int/media/docs/default-source/reproductive-health/sage_april2022meetinghighlights_11apr2022_final.pdf?sfvrsn=21bcfb4f_3Date: April 11, 2022 Date accessed: April 16, 2022 Google Scholar This off-label recommendation was made despite cautionary warnings from drug manufacturers, ongoing clinical trials, and with some of the evidence only boasting a moderate degree of certainty. 1 WHOHighlights from the meeting of the Strategic Advisory Group of Experts (SAGE) on Immunization. https://cdn.who.int/media/docs/default-source/reproductive-health/sage_april2022meetinghighlights_11apr2022_final.pdf?sfvrsn=21bcfb4f_3Date: April 11, 2022 Date accessed: April 16, 2022 Google Scholar

Moderna (mRNA Vaccine) for COVID-19: A Leap in Vaccine World


 
 
 
 In December 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) appeared and spread worldwide, triggering a pandemic of respiratory illness. So, there was an urgent need for vaccines worldwide. The mRNA-based vaccines are undergoing an accelerated phase of development during this pandemic. WHO has issued interim guidelines for administering the Moderna mRNA-1273 vaccine against COVID-19 based on advice given by the Strategic Advisory Group of Experts on Immunization (SAGE). The significant future directions for study would be comparing and elucidating the immune processes triggered by mRNA vaccine platforms, developing existing methods focused on these mechanisms, and introducing new clinical trials of these vaccines against additional disease targets.
 This study aims to reveal the important role and contribution of the Moderna mRNA-1273 vaccine to COVID-19 vaccinology.
 Moderna mRNA-1273 vaccine could be the keystone of modern vaccinology in the context of the COVID-19 pandemic.
 
 
 

Adult Vaccine Hesitancy Scale in Arabic and French: Protocol for Translation and Validation in the World Health Organization Eastern Mediterranean Region.

BackgroundThe world as we know it changed during the COVID-19 pandemic. Hope has emerged with the development of new vaccines against the disease. However, many factors hinder vaccine uptake and lead to vaccine hesitancy. Understanding the factors affecting vaccine hesitancy and how to assess its prevalence have become imperative amid the COVID-19 pandemic. The vaccine hesitancy scale (VHS), developed by the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunization, has been modified to the adult VHS (aVHS) and validated in English and Chinese. To our knowledge, no available aVHS has been designed or validated in Arabic or French.ObjectiveThe aim of this research is to translate the aVHS from its original English language to Arabic and French and validate the translations in the WHO Eastern Mediterranean region.MethodsThe study will follow a cross-sectional design divided into 5 phases. In phase 1, the original aVHS will be forward-translated to Arabic and French, followed by backward translation to English. An expert committee will review and rate all versions of the translations. Expert agreement will then be measured using the Cohen kappa coefficient (k). In phase 2, the translated aVHS will be pilot-tested with 2 samples of participants (n=100): a group that speaks both Arabic and English and another that speaks French and English. Participants’ responses to the English version will also be collected. In phase 3, responses will then be compared. Descriptive statistics and paired t tests or one-way analyses of variance (ANOVA) and Pearson correlation coefficient will be used in the preliminary validation. In phase 4, prefinal versions (Arabic and French) will be tested with larger sample sizes of Arabic speakers (n=1000) and French speakers (n=1000). Sociodemographic information and vaccination status will be collected and used for further analysis. In phase 5, the scale's statistical reliability and internal consistency will be measured using Cronbach alpha. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) will be used to examine the model fit resulting from the EFA. ANOVA and regression models will be constructed to control for confounders. All data will be electronically collected.ResultsAs of January 2022, the scale had been translated to Arabic and French and was undergoing the process of back translation. All data collection tools have been prepared (ie, sociodemographics, vaccination status, and open-ended questions) and are ready to go into their electronic formats. We expect to reach the desired sample size in this phase by June 2022.ConclusionsThis study will provide researchers with a validated tool to assess adult vaccine hesitancy within populations that speak Arabic and/or French and provide a road map to scale translation and ensure cross-cultural adaptation.International Registered Report Identifier (IRRID)PRR1-10.2196/36928

Nationwide introduction of HPV vaccine in Zimbabwe 2018-2019: Experiences with multiple cohort vaccination delivery.

The World Health Organization (WHO) recommends the human papillomavirus (HPV) vaccine for girls aged 9-14 years for cervical cancer prevention and encourages vaccinating multiple cohorts in the first year to maximize impact. The HPV vaccine was introduced nationwide in Zimbabwe in 2018 through a 1-week school-based campaign to multiple cohorts (all girls 10-14 years old), followed by a single cohort (grade 5 girls in school and age 10 girls out-of-school) in 2019. During the 2019 campaign, the multiple cohort's second dose was concurrently delivered with the single cohort's first dose. We interviewed national-level key informants, reviewed written materials, and observed vaccination sessions to document HPV vaccine introduction in Zimbabwe and identify best practices and challenges. Key informants included focal persons from government health and education ministries, in-country immunization partners, and HPV Vaccine Strategic Advisory Group members. We conducted a desk review of policy/strategy documents, introduction plans, readiness reports, presentations, and implementation tools. Vaccination sessions were observed in three provinces during the 2019 campaign. Key informants (n = 8) identified high cervical cancer burden, political will, vaccine availability, donor financing, and a successful pilot program as factors driving the decision to introduce the HPV vaccine nationally. The school-based delivery strategy was well accepted, with strong collaboration between health and education sectors and high community demand for vaccine identified as key contributors to this success. Challenges with transitioning from a multiple age-based to single grade- and age-based target population as well as funding shortages for operational costs were reported. Zimbabwe's first multiple cohort, school-based HPV vaccination campaign was considered successful-primarily due to strong collaboration between health and education sectors and political commitment; however, challenges vaccinating overlapping cohorts in the 2019 campaign were observed. Integration with existing health and vaccination activities and continued resource mobilization will ensure sustainability of Zimbabwe's HPV vaccination program in the future.

Willingness-to-pay for COVID-19 vaccine in ten low-middle-income countries in Asia, Africa and South America: A cross-sectional study.

Vaccine hesitancy is considered as one of the greatest challenges to control the ongoing coronavirus disease 2019 (COVID-19) pandemic. A related challenge is the unwillingness of the general public to pay for vaccination. The objective of this study was to determine willingness-to-pay (WTP) for COVID-19 vaccine among individuals from ten low- middle-income countries (LMICs) in Asia, Africa, and South America. Data were collected using an online questionnaire distributed during February - May 2021 in ten LMICs (Bangladesh, Brazil, Chile, Egypt, India, Iran, Nigeria, Pakistan, Sudan, and Tunisia). The major response variable of in this study was WTP for a COVID-19 vaccine. The assessment of COVID-19 vaccine hesitancy was based on items adopted from the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) vaccine hesitancy scale constructs. In this study, 1337 respondents included in the final analysis where the highest number of respondents was from India, while the lowest number was from Egypt. A total of 88.9% (1188/1337) respondents were willing to pay for the COVID-19 vaccination, and 11.1% (149/1337) were not. The average WTP for COVID-19 vaccination was 87.9 US dollars ($), (range: $5-$200). The multivariate model analysis showed that the country, monthly household income, having a history of respiratory disease, the agreement that routine vaccines recommended by health workers are beneficial and having received the flu vaccination within the previous 12 months were strongly associated with the WTP. Based on the country of origin, the highest mean WTP for COVID-19 vaccine was reported in Chile, while the lowest mean WTP for the vaccine was seen among the respondents from Sudan. The availability of free COVID-19 vaccination services appears as a top priority in the LMICs for successful control of the ongoing pandemic. This is particularly important for individuals of a lower socio- economic status. The effects of complacency regarding COVID-19 extends beyond vaccine hesitancy to involve less willingness to pay for COVID-19 vaccine and a lower value of WTP for the vaccine.

COVID-19 Vaccine Uptake and its Determinants among Health Care Workers in Somali Region of Ethiopia

Aims: Healthcare workers are known to be at higher risk of COVID-19 infection and have a role in transmitting the infection to others in the work environment and communities. Public health measures and vaccination are the major strategies being implemented to prevent and control the infection. The study assessed COVID -19 vaccine uptake and its determinants among health care workers in Somali region of Ethiopia.
 Study Design: This was a cross-sectional analytical study.
 Place and Duration of Study: Somali Region in October 2021.
 Methodology: A structured self-administered questionnaire adapted from the WHO Strategic Advisory Group of Experts on Immunization vaccine hesitancy survey question was used and administered to 427 healthcare workers in eight selected sites. Bivariate analysis and multiple logistic regression were used to assess association between vaccine uptake and some selected determinants. The level of significance was set at a p-value<5%.
 Results: About 71% of the health workers have been vaccinated at least once and vaccination was significantly higher among those with perceived risk of being infected (χ2 =12.19, p<0.05), perceived benefit of the vaccine (χ2 = 47.30, p<0.05) and perceived protection of the vaccine for their communities (χ2 =22.13, p<0.05). About 45% of the respondents believed the vaccine was very safe and vaccination was significantly higher among those who believed the safety of the vaccine (χ2 = 23.06, p<0.05). Vaccine uptake was higher among medical doctors than other health professionals, (AOR = 2.32, 95% CI: 1.09–5.48), p<0.05. The study showed significant relationship between inclination towards vaccination and actual vaccination where about 78% of those who had desired to be vaccinated actually got vaccinated. Other factors associated with vaccination uptake were colleagues getting vaccinated and support by community and religious leaders to vaccination.
 Conclusion: The study identified key determinants to vaccine uptake among the health workers which included perceived risk of being infected, perceived benefit, safety of the vaccines and perceived protection of the vaccine for their communities. These require targeted Social and behavioural change communication strategies to address.

Spread of COVID-19 Vaccine Misinformation in the Ninth Inning: Retrospective Observational Infodemic Study.

BackgroundShortly after Pfizer and Moderna received emergency use authorizations from the Food and Drug Administration, there were increased reports of COVID-19 vaccine-related deaths in the Vaccine Adverse Event Reporting System (VAERS). In January 2021, Major League Baseball legend and Hall of Famer, Hank Aaron, passed away at the age of 86 years from natural causes, just 2 weeks after he received the COVID-19 vaccine. Antivaccination groups attempted to link his death to the Moderna vaccine, similar to other attempts misrepresenting data from the VAERS to spread COVID-19 misinformation.ObjectiveThis study assessed the spread of misinformation linked to erroneous claims about Hank Aaron’s death on Twitter and then characterized different vaccine misinformation and hesitancy themes generated from users who interacted with this misinformation discourse.MethodsAn initial sample of tweets from January 31, 2021, to February 6, 2021, was queried from the Twitter Search Application Programming Interface using the keywords “Hank Aaron” and “vaccine.” The sample was manually annotated for misinformation, reporting or news media, and public reaction. Nonmedia user accounts were also classified if they were verified by Twitter. A second sample of tweets, representing direct comments or retweets to misinformation-labeled content, was also collected. User sentiment toward misinformation, positive (agree) or negative (disagree), was recorded. The Strategic Advisory Group of Experts Vaccine Hesitancy Matrix from the World Health Organization was used to code the second sample of tweets for factors influencing vaccine confidence.ResultsA total of 436 tweets were initially sampled from the Twitter Search Application Programming Interface. Misinformation was the most prominent content type (n=244, 56%) detected, followed by public reaction (n=122, 28%) and media reporting (n=69, 16%). No misinformation-related content reviewed was labeled as misleading by Twitter at the time of the study. An additional 1243 comments on misinformation-labeled tweets from 973 unique users were also collected, with 779 comments deemed relevant to study aims. Most of these comments expressed positive sentiment (n=612, 78.6%) to misinformation and did not refute it. Based on the World Health Organization Strategic Advisory Group of Experts framework, the most common vaccine hesitancy theme was individual or group influences (n=508, 65%), followed by vaccine or vaccination-specific influences (n=110, 14%) and contextual influences (n=93, 12%). Common misinformation themes observed included linking the death of Hank Aaron to “suspicious” elderly deaths following vaccination, claims about vaccines being used for depopulation, death panels, federal officials targeting Black Americans, and misinterpretation of VAERS reports. Four users engaging with or posting misinformation were verified on Twitter at the time of data collection.ConclusionsOur study found that the death of a high-profile ethnic minority celebrity led to the spread of misinformation on Twitter. This misinformation directly challenged the safety and effectiveness of COVID-19 vaccines at a time when ensuring vaccine coverage among minority populations was paramount. Misinformation targeted at minority groups and echoed by other verified Twitter users has the potential to generate unwarranted vaccine hesitancy at the expense of people such as Hank Aaron who sought to promote public health and community immunity.

Sisonke: reaching several goals together

Sisonke: reaching several goals together

Characteristics and perceptions associated with COVID-19 vaccination hesitancy among pregnant and postpartum individuals: A cross-sectional study.

To assess the frequency and associated characteristics of COVID-19 vaccine hesitancy among pregnant and postpartum individuals. Cross-sectional study. Prenatal care at a single academic tertiary care centre. Pregnant and postpartum individuals enrolled in prenatal care at a single academic tertiary care centre from 22 March 2021 to 2 April 2021, concurrent with state guidelines recommending COVID-19 vaccination in pregnancy. We used logistic regression to identify characteristics associated with COVID-19 vaccine hesitancy, and adjusted for: age, parity, race, trimester of pregnancy, and chronic comorbidities. COVID-19 vaccine hesitancy, defined as uncertainty or refusal of the vaccine, despite the availability of vaccine services, in accordance with the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on vaccine hesitancy. Of the 485 individuals screened and approached, 456 (94%) enrolled and completed the survey (435/456, 95% pregnant). The frequency of COVID-19 vaccine hesitancy was 46% (95%CI 41%-51%). Sociodemographic characteristics, including non-Hispanic Black race, younger age, lower education, public health insurance receipt, parity >1, and reported substance use, were associated with a higher odds of COVID-19 vaccine hesitancy, but not clinical risk conditions. Individuals who had a family or friend vaccinated for COVID-19, prior or planned vaccination for tetanus, diphtheria and acellular pertussis (Tdap) and/or influenza, and who perceived that vaccination benefited the baby were less likely to express COVID-19 vaccine hesitancy. COVID-19 vaccine hesitancy was frequent among pregnant and postpartum individuals. Those who may face barriers to accessing healthcare services were more likely to report vaccine hesitancy. These results can inform interventions to increase COVID-19 vaccine uptake in pregnancy. COVID-19 vaccination hesitancy is frequent among pregnant and postpartum individuals, and those who face barriers to accessing healthcare services are more likely to report COVID-19 vaccine hesitancy.

Vaccine hesitancy in case of under-5 vaccination in slums of Burdwan Municipality, West Bengal: A cross-sectional study

Background: There are multiple reasons for which a considerable proportion of the population remains unvaccinated, including vaccine hesitancy. Identifying the reasons behind vaccine hesitancy, especially in marginalized population, is essential. Aims and Objectives: The aims of the study were to estimate the magnitude and determinants of vaccine hesitancy related to under-5 vaccination in slums of Burdwan Municipality, West Bengal. Materials and Methods: A community-based descriptive study with cross-sectional design was conducted between September 2020 and January 2021 among 135 study subjects (under-5 children) selected by multistage random sampling. Data were collected by interviewing the primary caregivers of selected children using a predesigned schedule including vaccine hesitancy survey questionnaire by Strategic Advisory Group of Experts. Data analysis was done using SPSS v.20. Results: Vaccine hesitancy was found in case of 11.9% of the study subjects. Refusal was seen in 2.2%, only in case of birth doses, whereas hesitancy due to delay was seen in 9.7% in case of MR, JE, DPT, and OPV boosters. Stated reasons for hesitancy were – “vaccine was not needed” (47.4%), “fear of needles” (31.5%), and “not able to leave other work at home” (21.1%). Caregivers of 17% of the study subjects faced difficulty from getting their child immunized mainly due to timing of the clinic and lockdown. The presence of vaccine hesitancy was not associated with sociodemographic characteristics of the child or of the caregivers. Conclusion: Vaccine hesitancy was found to be low in the study area, it was mainly to birth doses and mostly due to lack of awareness among caregivers.

Human papillomavirus vaccination in the European Union/European Economic Area and globally: a moral dilemma.

While many European Union/European Economic Area (EU/EEA) countries recently expanded human papillomavirus (HPV) vaccination to boys, HPV vaccine supply is currently limited for girls in low- and middle-income countries (LMIC) that are severely affected by HPV.Globally, about 50% of countries have introduced HPV vaccination. Some LMIC with high burden of cervical cancer have not yet introduced HPV vaccination, or are reaching suboptimal vaccination coverage. While WHO issued a call for cervical cancer elimination in 2018, a global shortage of HPV vaccines is currently predicted to last at least until 2024.We reviewed national policies of EU/EEA countries and recommendations of the World Health Organization (WHO) Strategic Advisory Group of Experts on immunisation to discuss current challenges and dose-sparing options. Several EU/EEA countries have extended HPV vaccination to boys and the European Cancer Organisation has issued a resolution for elimination of all HPV-associated cancers in both sexes. The European Centre for Disease Prevention and Control concluded in its 2020 guidance that cost-effectiveness of extending routine vaccination to boys depends on several context-specific factors. The extension of HPV vaccination to boys in EU/EEA countries may affect global availability of vaccines. Temporary dose-sparing options could be considered during the COVID-19 post-pandemic period.

Update on Vaccine-Derived Poliovirus Outbreaks - Worldwide, January 2020-June 2021.

As of May 1, 2016, use of oral poliovirus vaccine (OPV) type 2 for routine and supplementary immunization activities ceased after a synchronized global switch from trivalent OPV (tOPV; containing Sabin strain types 1, 2, and 3) to bivalent OPV (bOPV; containing Sabin strain types 1 and 3) subsequent to the certified eradication of wild type poliovirus (WPV) type 2 in 2015 (1-3). Circulating vaccine-derived poliovirus (cVDPV) outbreaks* occur when transmission of Sabin strain poliovirus is prolonged in underimmunized populations, allowing viral genetic reversion to neurovirulence, resulting in cases of paralytic polio (1-3). Since the switch, monovalent OPV type 2 (mOPV2, containing Sabin strain type 2) has been used for response to cVDPV type 2 (cVDPV2) outbreaks; tOPV is used if cVDPV2 co-circulates with WPV type 1, and bOPV is used for cVDPV type 1 (cVDPV1) or type 3 (cVDPV3) outbreaks (1-4). In November 2020, the World Health Organization (WHO) Emergency Use Listing procedure authorized limited use of type 2 novel OPV (nOPV2), a vaccine modified to be more genetically stable than the Sabin strain, for cVDPV2 outbreak response (3,5). In October 2021, the Strategic Advisory Group of Experts on Immunization (WHO's principal advisory group) permitted wider use of nOPV2; however, current nOPV2 supply is limited (6). This report updates that of July 2019-February 2020 to describe global cVDPV outbreaks during January 2020-June 2021 (as of November 9, 2021)† (3). During this period, there were 44 cVDPV outbreaks of the three serotypes affecting 37 countries. The number of cVDPV2 cases increased from 366 in 2019 to 1,078 in 2020 (7). A goal of the Global Polio Eradication Initiative's (GPEI) 2022-2026 Strategic Plan is to better address the challenges to early CVDPV2 outbreak detection and initiate prompt and high coverage outbreak responses with available type 2 OPV to interrupt transmission by the end of 2023 (8).

Booster doses for inactivated COVID-19 vaccines: if, when, and for whom

Booster doses for inactivated COVID-19 vaccines: if, when, and for whom

Adaptation and validation of the Turkish version of the vaccine hesitancy 5 point Likert Scale

ABSTRACT The decrease in vaccine acceptance has been recognized as an emerging public health problem and there is therefore a need for reliable and validated tools that identify vaccine hesitancy. The objective of this study was to adapt and validate the Turkish version of the Vaccine Hesitancy 5-point Likert Scale which was originally developed by the WHO Strategic Advisory Group of Experts on Immunization. The study was carried out in a Family Health Center (FHC) in Istanbul over the period June 1-November 30, 2020. The participants were parents who had applied to the FHC for well-child visits and had a child ≤18 months of age. After the process of translation and back-translation, the Turkish version was pilot-tested, and its test-retest reliability was evaluated among 40 parents at a two-week interval. The validation was carried out with 306 parents through exploratory factor analysis. There was no statistical difference between the test-retest scores (p = .17). The intraclass correlation coefficient was 0.98 (p < .001). Cronbach’s alpha coefficient was 0.81. Factor analysis yielded two subscales that were named “confidence’ and ‘risk perception” and explained 63% of total variance. Our results suggest that the Turkish version of the Vaccine Hesitancy 5-point Likert Scale is a reliable and valid instrument.

Perceptions and barriers to the annual influenza vaccine compared with the coronavirus disease 2019 vaccine in an urban underserved population

BackgroundFor a vaccine to be successful, communities must perceive it as important, safe, effective, and necessary. However, there are many barriers and hesitancies to vaccination. Underserved patient populations may face additional challenges related to access and cost. Because community pharmacists improve vaccine access and increase vaccination rates, it is beneficial for pharmacists to understand perceptions and barriers to vaccinations in their community to increase vaccine confidence. ObjectivesThis study aims to assess and compare barriers and perceptions of the annual influenza to the coronavirus disease 2019 (COVID-19) vaccine for underserved patients of a charitable pharmacy. MethodsPatients who qualified to receive medications from an outpatient charitable pharmacy took an electronic survey when receiving medications. The survey incorporated questions developed by the World Health Organization’s Strategic Advisory Group of Experts on Vaccine Hesitancy on a 5-point Likert scale. Questions about the influenza and COVID-19 vaccines mirrored one another. Demographic data such as age, race, sex, and education level were also collected. ResultsOf the 189 patients surveyed at the charitable pharmacy, 71.7% were 55 years old and older and 58.9% were female. Of note, 78% and 77% of participants agreed or strongly agreed that the influenza and COVID-19 vaccines, respectively, were important for the health of others in their community. Adverse effects and the cost of the COVID-19 vaccine were noted to be statistically significantly more of a concern with the COVID-19 vaccine than that of the influenza vaccine (P < 0.001). ConclusionEnsuring equitable vaccine access, promoting the COVID-19 vaccine as free, and eliciting and addressing individual persons’ concerns related to vaccine safety and adverse effects are all important ways pharmacists and other health care providers and community stakeholders can help promote vaccine confidence within the populations they serve.

Parental Attitudes and Hesitancy About COVID-19 vs. Routine Childhood Vaccinations: A National Survey.

Objectives: To quantify parental acceptance of the COVID-19 vaccine and assess the vaccine hesitancy (VH) for COVID-19 vs. childhood vaccines.Methods: Eight vaccine hesitancy scale (VHS) items, adopted from WHO's Strategic Advisory Group of Immunization (SAGE), were used to assess VH for COVID-19 vaccine vs. routine childhood vaccines. We distributed the online survey to parents with the commence of the national childhood COVID-19 vaccination program in Saudi Arabia.Results: Among 3,167 parents, 47.6% are decided to vaccinate their children against COVID-19. The most common reasons for refusal were inadequate safety information (69%) and worry about side effects (60.6%). Parents have a significantly greater positive attitudes toward children's routine vaccines vs. the COVID-19 vaccine, with higher mean VHS (±SD) = 2.98 ± 0.58 vs. 2.63 ± 0.73, respectively (p-value < 0.001). Parents agreed more that routine childhood vaccines are more essential and effective as compared to the COVID-19 vaccine (Cohen's D: 0.946, and 0.826, consecutively; T-test p-value < 0.00). There is more parental anxiety about serious side effects of the COVID-19 vaccine vs. routine childhood vaccines (Cohen's D = 0.706, p-value < 0.001). Parents who relied on the Ministry of Health information were more predicted (OR = 1.28, p-value = 0.035) to intend to vaccinate as opposed to those who used the WHO website (OR = 0.47, −53%, p-value < 0.001). In a multivariate logistic regression analysis, the factors associated with intention to vaccinate children were parents who received COVID-19 vaccine, older parents, having children aged 12–18, and parents with lower education levels.Conclusions: Significant proportion of parents are hesitant about the COVID-19 vaccine because they are less confident in its effectiveness, safety, and whether it is essential for their children. Relying on the national official healthcare authority's website for the source of information was associated with increased acceptance of childhood COVID-19 vaccination. As parental intention to vaccinate children against COVID-19 is suboptimal, healthcare authorities could boost vaccine uptake by campaigns targeting hesitant parents.

Assessing the immunogenicity of three different inactivated polio vaccine schedules for use after oral polio vaccine cessation, an open label, phase IV, randomized controlled trial

BackgroundAfter global oral poliovirus vaccine (OPV) cessation, the Strategic Advisory Group of Experts on Immunization (SAGE) currently recommends a two-dose schedule of inactivated poliovirus vaccine (IPV) beginning ≥14-weeks of age to achieve at least 90% immune response. We aimed to compare the immunogenicity of three different two-dose IPV schedules started before or at 14-weeks of age. MethodsWe conducted a randomized, controlled, open-label, inequality trial at two sites in Dhaka, Bangladesh. Healthy infants at 6-weeks of age were randomized into one of five arms to receive two-dose IPV schedules at different ages with and without OPV. The three IPV-only arms are presented: Arm C received IPV at 14-weeks and 9-months; Arm D received IPV at 6-weeks and 9-months; and Arm E received IPV at 6 and 14-weeks. The primary outcome was immune response defined as seroconversion from seronegative (<1:8) to seropositive (≥1:8) after vaccination, or a four-fold rise in antibody titers and median reciprocal antibody titers to all three poliovirus types measured at 10-months of age. FindingsOf the 987 children randomized to Arms C, D, and E, 936 were included in the intention-to-treat analysis. At 10-months, participants in Arm C (IPV at 14-weeks and 9-months) had ≥99% cumulative immune response to all three poliovirus types which was significantly higher than the 77–81% observed in Arm E (IPV at 6 and 14-weeks). Participants in Arm D (IPV at 6-weeks and 9-months) had cumulative immune responses of 98–99% which was significantly higher than that of Arm E (p value < 0.0001) but not different from Arm C. InterpretationResults support current SAGE recommendations for IPV following OPV cessation and provide evidence that the schedule of two full IPV doses could begin as early as 6-weeks.

Determination of COVID-19 Vaccine Hesitancy Among University Students.

IntroductionWith the sudden outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), vaccines appear to be the most efficient measure in combating spread. However, vaccines are only effective if a community collectively uptakes vaccination. This approach is growing increasingly difficult with the emergence of ‘Vaccine Hesitancy.’ This paper aims to determine the association between university curricula and the degree of hesitancy for the COVID-19 vaccine.MethodsThe online questionnaire assessed demographic data, prior knowledge of vaccines, attitude towards COVID-19 vaccines using an adapted version of the WHO Strategic Advisory Group of Experts (SAGE) Working Group’s Vaccine Hesitancy Survey (VHS) and factors likely to motivate vaccine uptake. By using binary scoring, the degree of hesitancy among students was determined. Exploratory Factor Analysis (EFA) on VHS revealed underlying causes of hesitancy. To analyze the dependence between hesitancy and curriculum, a chi-squared test was conducted.ResultsMedical students scored higher for prior knowledge of vaccines (M = 3.54) as opposed to non-medical students (M = 3.49). Medical students responded favorably to COVID-19 vaccines with only 1.37% showing hesitancy for all nine items of VHS, compared to 2.55% of non-medical students. EFA produced three subscales within the VHS: lack of confidence, risk factor concern, and misinformation. The lack of confidence factor accounted for 65% of the data obtained. The chi-square test solidified that vaccine hesitancy is dependent on curriculum.ConclusionThe majority of non-medical students showed hesitancy towards obtaining COVID-19 vaccines compared to medical students who were more willing, largely owing to their knowledge and understanding of vaccines.

Meeting of the WHO Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH), June 2020 Conclusions and advice—Gong Zhenyu(Selective Translation), Gong Xunliang(Reviser)

Meeting of the WHO Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH), June 2020 Conclusions and advice—Gong Zhenyu(Selective Translation), Gong Xunliang(Reviser)