Universal Immunization Program Research Articles

A Pre-Experimental Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge Regarding Universal Immunization Programme Among Mothers of Under 5 Years Children in Selected Areas of District Mandi (HP)

A Pre-Experimental Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge Regarding Universal Immunization Programme Among Mothers of Under 5 Years Children in Selected Areas of District Mandi (HP)

Human papillomavirus vaccine for cervical cancer prevention in India: new improvement and way forward

Cervical cancer is the malignant abnormal changes in the tissues of cervix mostly transmitted through the human papilloma virus. Prophylactic vaccination against HPV is effective strategy to prevent cervical cancer. India has access to two types of vaccines that are licensed worldwide, the bivalent cervarix and the quadrivalent Gardasil. The drug controller general of India has authorized “CERVAVAC” a new HPV vaccination that is less expensive and is being offered in India as a single dose for females between the ages of 9 and 19 years. The government said in February 2024 that girls between the ages of 9 and 14 will receive the HPV vaccine as part of universal immunization programme. There are significant obstacles to vaccination implementation in India like lack of epidemiological evidences for illness prioritization, vaccine duration, parental attitude and vaccine acceptance. The WHO's goal of eradicating cervical cancer by 2030 depends on implementing socially and culturally relevant public awareness campaigns after educational initiatives for healthcare professionals.

Potential impact of rotavirus vaccine introduction in India’s Universal Immunisation Programme on private sector vaccine utilisation: an interrupted time series analysis

BackgroundDespite free immunisation services through the Universal Immunisation Programme (UIP), around 14% of Indian households seek immunisation in the private sector. We examined the potential impact of rotavirus vaccine (RVV) introduction in the Universal Immunisation Programme (UIP) on private-sector rotavirus vaccine utilisation.MethodsWe analysed nationally representative private-sector vaccine sales data. The intervention under consideration is RVV introduction in the UIP in selected Indian states. The outcome is the ‘monthly RVV sales volume’—a proxy for vaccine utilisation. We performed a Poisson regression interrupted time series analysis to detect the pre-intervention trend, post-intervention level change and trend change relative to the pre-intervention for monthly rotavirus vaccine utilisation.ResultsPoisson segmented regression analysis showed that immediately after RVV introduction in the UIP private-sector RVV sales showed a decline in Rajasthan by 37.4% (Incidence Risk Ratio (IRR): 0.626; 95% CI: 0.504–0.779), in Tamil Nadu by 26% (IRR: 0.740; 95% CI: 0.513–1.068), in Uttar Pradesh-East by 72.2% (IRR: 0.278; 95% CI: 0.178–0.436) and in Kerala by 3% (IRR: 0.970; 95% CI: 0.651–1.447). Rajasthan, Tamil Nadu and Kerala had sustained reduction in the postintervention trend relative to the preintervention trend by 20.1% (IRR: 0.799; 95% CI: 0.763–0.836), 6.4% (IRR: 0.936; 95% CI: 0.906–0.967) and 3.3% (IRR: 0.967; 95% CI: 0.926–0.960) per month, respectively. However, in Haryana and UP-west, in the first-month post-UIP introduction, the private-sector RVV sales increased by 101% and 3.8%, respectively which was followed by a sustained decrease of 14.2% (IRR: 0.858; 95% CI: 0.688–1.070) and 5.8% (IRR: 0.942; 95% CI: 0.926–0.960) per month, respectively. In terms of long-term impact, the private sector RVV sales post-UIP introduction decreased at a monthly rate of 4.4% (IRR: 0.956, 95% CI: 0.939–0.974) in Rajasthan but increased by 5.5% (IRR: 1.055; 95% CI: 1.040–1.070) in UP-east, 0.3% (IRR: 1.003, 95% CI: 0.976–1.031)) in Kerala and 0.2% (IRR: 1.002, 95% CI: 0.993–1.011) in Tamil Nadu whereas Haryana and UP-west had a reduction in RVV utilisation by 2.8% (IRR: 0.972; 95% CI: 0.955–0.990) and 1% (IRR: 0.990; 95% CI: 0.982–0.998), respectively.ConclusionsThe study provides evidence that access to RVV through UIP leads to a reduction in private-sector RVV utilisation. We recommend strengthening UIP to expand the basket of new vaccines.

E-portfolio in Learning and Assessment of Community Medicine for Medical Undergraduate Students

Background: A portfolio is a specific collection of student work and achievements in various areas. E-portfolio is an electronic collection that serves the purpose of storage and showcase with the ease of access for both students and evaluators. The knowledge and skills regarding immunization in medical students are of utmost importance for the successful implementation and conduction of the Universal Immunization Program in the country. Hence, this study proposed to use e-portfolio for learning and assessment of immunization in medical undergraduates. Aim and Objectives: The aims of this study were as follows: to develop an e-portfolio for learning and assessment in community medicine, to improve the knowledge of immunization schedules of undergraduates using e-portfolio, to improve the vaccination and counseling skills of undergraduates using e-portfolio, and to obtain feedback regarding the e-portfolio from students and faculty. Methodology: This interventional educational study was conducted at a tertiary care medical college including 48 students of Phase III MBBS after informed consent was signed. Prevalidated questionnaire and checklist were used for data collection. Students wrote reflections and uploaded their videos of immunization skills and counseling on the e-portfolio and 5 faculty members assessed the students and provided feedback to students. Feedback on the e-portfolio was taken at the end, and descriptive and qualitative analysis was done. Ethical approval for the study was obtained from the institutional ethics committee. Results: The e-portfolio was found to be effective in showcasing the progress and learning of the students. E-portfolio improved knowledge, skills, self-directed learning, and reflective writing. The competency of immunization improved after the use of e-portfolio (P < 0.001). Faculty and students had high satisfaction with the e-portfolio and found the e-portfolio to be innovative, convenient to use, and easily accessible. Conclusions: E-portfolio is user-friendly and effective in imparting and assessing immunization competency. The use of this intervention for other topics is recommended.

Roadmap to Success: Illustrating Insights from a KAP Study on Cervical Cancer Prevention and HPV Vaccination

Introduction Cervical cancer is a public health challenge in low- and middle-income countries, with India ranking among the highest in cervical cancer burden. The World Health Organization (has set ambitious targets for cervical cancer elimination by 2030, emphasizing the importance of human papillomavirus (HPV) vaccination and screening. In response, the National Technical Advisory Group of Immunization recommends the introduction of HPV vaccination for all eligible girls aged 9 to 14 years in India under the Universal Immunization Program. However, successful implementation requires both vaccine availability and changes in health care providers' knowledge, attitudes, and practices (KAP) regarding cervical cancer prevention and HPV vaccination. Methodology This study aims to assess KAP among clinicians regarding cervical cancer and HPV vaccination. A cross-sectional survey collected responses from 451 practicing gynecologists and medical practitioners across 15 states of India. The questionnaire sought insights into patient inquiries, information sources, awareness levels, methods of patient education, and common myths and misconceptions. Results Results indicate a high prevalence of patient inquiries about cervical cancer and the HPV vaccine, emphasizing the need for accurate and accessible information. While doctors were generally knowledgeable, misconceptions persisted among patients, including beliefs about low risk, inevitability of cervical cancer, and concerns about vaccine safety. Doctors primarily relied on verbal communication for patient education, suggesting potential for utilizing digital platforms and visual aids to enhance outreach. Insights Insights from doctors underscored the importance of addressing misinformation and leveraging various communication channels, including social media, posters, and celebrity endorsements, to improve awareness and acceptance of vaccination. Disparities in vaccine availability and administration rates highlighted the need for targeted interventions to ensure equitable access. Limitations Limitations of the study included its cross-sectional design and reliance on self-reported data, which may introduce bias. However, findings suggest a need for ongoing medical education and collaboration with stakeholders to drive awareness and acceptance of HPV vaccination. Conclusion In conclusion, while gynecologists and medical practitioners demonstrate adequate KAP regarding cervical cancer prevention, there is room for improvement in patient education and communication strategies. Refining educational materials and strengthening communication channels would enhance awareness and reduce cervical cancer burden.

The Pandemic's Shadow: Measles Vaccination Challenges and Trends

Measles is a highly contagious, serious disease caused by a virus. Before the introduction of measles vaccine in 1963, major epidemics occurred approximately every 2-3 years and caused an estimated 2.6 million deaths each year (1). Government of India launched Universal Immunization Program in 1985, which provides vaccination against 8 life threatening disease including measles and 65% vaccine coverage was achieved. In order to increase the vaccination coverage, Mission Indradhanush was launched in phased manner which aimed to fully immunize more than 90% of newborn by 2020. India has adopted the National strategic Plan for achieving and sustaining measles and Rubella elimination in India and has vaccinated over 324 million children between 2017 and 2020 through MR vaccination campaign (2). Due to the lag, India had shifted its self-imposed deadline to eliminate measles to 2023 and launched another vaccination campaign in 2021 called the Intensified Mission Indradhanush 3.0, targeting unvaccinated children.

Developments and Trends of Immunization in India: A Narrative Review.

Immunization is a critical component of public health, and it undergoes various trends and developments over time. Immunization is considered one of humanity's most remarkable journeys. It has helped save countless lives and will help save more if the goals of the 2030 Immunization Agenda (IA2030)are achieved. India is home to one of the largest global immunization programs. Immunization trends refer to the patterns and changes in the development of vaccines, the use of vaccines, and vaccination programs within a nation. There have been various trends in vaccine development and immunization in India. Trends can be influenced by various factors, including vaccine coverage, new vaccines, vaccine hesitancy, advances in medical science, technological innovations, public-private partnerships, public health policies, and public awareness. India has the world's largest immunization program regarding the number of vaccinations delivered, the recipients, the geographic spread, and the human resources required. In this review, we give an overview of various trends in immunization in India dating from the ancient era. A search of the PubMed, Scopus, and Google Scholar databases from 1945 to February 2024was done to conduct a narrative review. This review includes English-language publications. This narrative review was conducted to summarize the government of India's actions and strategies for immunization and vaccine development and also to trace the trends in immunization in India. It covers various vaccination programs of the Indian government and measures that were made to fight vaccine hesitancy and to enhance vaccination coverage such as developing vaccination roadmaps, scheduling vaccinations, utilizing digital health technology, monitoring vaccinations, and developing creative techniques.India has the world's largest Universal Immunization Program,vaccinatingaround 29 million pregnant women and 26.5 million infants annually.These trends reflect India's ongoing commitment to immunization as a component of public health policy and efforts to address existing and emerging health challenges.

Factors influencing vaccine acceptance in pregnancy during the COVID-19 pandemic: A multicenter study from West Bengal, India

ABSTRACT Influenza, COVID-19, tetanus, pertussis and hepatitis B pose increased risk for pregnant women and infants and could be mitigated by maternal immunization. In India Tetanus-diphtheria (Td) and COVID-19 vaccines are recommended during pregnancy, while influenza and tetanus-acellular pertussis-diphtheria (Tdap) vaccines are not. We conducted a multicenter study from November 2021 to June 2022 among pregnant women (n = 172) attending antenatal clinics in three public hospitals in West Bengal, to understand the factors that influence women’s decisions to get vaccinated during pregnancy. Questions assessed vaccination coverage, knowledge, intention and willingness to pay for influenza vaccine, and factors influencing decisions to get Td, influenza, and COVID-19 vaccines. 152/172 (88.4%) women were vaccinated with Td, 159/172 (93%) with COVID-19, 1/172 (0.6%) with influenza, and none with Tdap. 10/168 (6%) had received hepatitis B vaccine (HBV). Community health workers advice was crucial for Td uptake and, the belief of protection from COVID for COVID-19 vaccines. Most women were unaware about Tdap (96%), influenza (75%), and influenza severity during pregnancy and infancy (85%). None were advised for influenza vaccination by healthcare providers (HCP), albeit, 93% expressed willingness to take, and pay INR 100–300 (95% CI: ≤100 to 300–500) [$ 1.3–4.0 (95% CI: ≤1.3, 4–6.7)] for it. Vaccination on flexible dates and time, HCP’s recommendation, proximity to vaccination center, and husband’s support were most important for their vaccination decisions. Women were generally vaccine acceptors and had high uptake of vaccines included in the Universal Immunization Program (UIP). Inclusion of influenza, Tdap, and HBV into UIP may improve maternal vaccine uptake.

Post-introduction evaluation (PIE) of rotavirus vaccine in India

BackgroundIndia became the first country in the WHO South-East Asia Region (SEAR) to introduce the rotavirus vaccine (RVV) in the Universal immunization programme (UIP) in 2016 with nationwide expansion by 2019. It was a landmark move to reduce the diarrheal disease burden in under-five children. To assess the implementation process of introduction of RVV, Post Introduction Evaluation (PIE) was conducted in March 2022. MethodsThe evaluation was conducted across 14 states, 28 districts and 28 health facilities to obtain a nationwide geographical inclusion. Stakeholders involved in program decision-making, planning, training, vaccine delivery, logistics, and communication from all levels (National, state, district, health facility, health worker, caregiver) were interviewed using standardized data collection tool for PIE (adapted from the standard WHO PIE questionnaire) and scripted on a digital tool. ResultsA total of 260 interviews were conducted. Political willingness, well-planned preparedness activities, securing vaccines timely, strong supply chain monitoring, availability of domestic RVV products, quality trainings and intense communication activities were the key factors identified for the successful RVV introduction. Key activities during the introduction included cold chain space assessment, trainings of healthcare workforce, dissemination of job aids, updation of recording & reporting formats and strengthening of AEFI surveillance. Lack of community awareness for immunization in a few areas, fear of AEFI amongst some caregivers and local issues with Alternate Vaccine Delivery (AVD) were some reported challenges in achieving high coverage for RVV. ConclusionsOverall, the nationwide roll-out of RVV was smooth and the vaccine has been well-accepted in the community. The assessment emphasizes on having a well-strategized operational and communication planning, which is very crucial for any new vaccine introduction.

Introduction of HPV vaccine in universal immunization programme of India: A step in the right direction for the elimination of cervical cancer.

Introduction of HPV vaccine in universal immunization programme of India: A step in the right direction for the elimination of cervical cancer.

Journey From a Digital Innovation to a Sustainable Health Worker Capacity-Building App in India: Experiences, Challenges, and Lessons Learned.

Health workers, especially auxiliary nurse midwives (ANMs), are among the most critical resources in improving the quality of immunization services and reducing vaccine hesitancy under the Universal Immunization Programme (UIP) in India. To improve health worker immunization skills, UIP trainings in India are primarily conducted through instructor-led classroom, cascade trainings. However, a 2018 capacity-building need assessment revealed several challenges involved in traditional classroom training, such as a single-time exposure to new guidelines, complicated logistics arrangements, a lack of refresher training, and varying quality of training. These complexities make it difficult to meet the timely knowledge and skill needs of every health worker effectively and uniformly in a rapidly changing scenario of UIP. To meet health worker capacity-building needs and address these challenges, Rapid Immunization Skill Enhancement (RISE), a learning management system (LMS) application, was conceptualized. The RISE LMS application was developed as a human-centered, interactive, continuous, and adaptable knowledge and skill-building platform for health workers engaged in the UIP. RISE complements existing classroom-based cascade training for health workers by leveraging digital technologies for faster, easier, and more effective knowledge transfer to accommodate the fast-changing needs of a dynamic health program like UIP. In this article, we share the challenges and strategic solutions to digital training applications, lessons learned, sustainability of the application, and the impact RISE has made in India, all of which stemmed from leadership, coordinated efforts from a team of skilled professionals, government acceptance, detailed planning, and continued stakeholder engagement.

Impact of universal immunization program with monoclonal antibody nirsevimab on reducing the burden of serious bronchiolitis that need pediatric intensive care.

Nirsevimab appears to have an important impact on reducing the number and length of stay of PICU admissions due to RSV bronchiolitis. • Bronchiolitis is the mostcommon viral infection of the lower respiratory tract in infants. • It represents 13% of the total pediatric intensive care admissions, typically during winter. This is one of the causes that produces a collapse in the health care systems all around the world. • In October 2023, universal immunization with monoclonal antibody nirsevimab of all children under 6 months of age was started in the majority of autonomous communities in Spain. • Recent publications from the nirsevimab clinical trials have evidenced a high RSV protective effect, but data on its effect on real life patients who require pediatric intensive care unit admission are missing.

Childhood vaccinations and the demand for children: Long-term evidence from India

Childhood vaccinations can increase population growth in the short term by improving the survival rates of young children. Over the long run, reductions in child mortality rates are associated with lower demand for children and lower fertility rates (known as “demographic transition”). Vaccination programs could potentially aid demographic transition by lowering child mortality and improving future health, schooling, and labor market outcomes of vaccinated mothers, but these long-term demographic benefits remain untested. We address this major gap in the literature by examining the associations of India’s national childhood vaccination program (the Universal Immunization Programme or UIP) with future demand for children. We combine data on the district-wise rollout of UIP during 1985–1990 with fertility preference data of 625,000 adult women from the National Family Health Survey of India 2015–2016. We include women who were born five years before and after the rollout period (1980–1995) and were cohabiting with a partner at the time of the survey. We divide these 20–36-year-old women into two groups: those who were exposed to UIP at birth (treatment group) and those who were born before the program (control group). After controlling for individual- and household-level factors and age and district fixed effects, treatment group women are 2% less likely to have at least one child and want 2% fewer children in their lifetime as compared with the control group. The negative associations with at least one childbirth are larger for more educated and richer women, while the associations with desired number of children is larger for uneducated and poorer women.

Awareness About Child Immunization among Women in Rural Area of District Jalaun

Introduction; Universal Immunization Programme (UIP) is one of the largest public health programmes targeting close of 2.67 crore newborns and 2.9 crore pregnant women annually. It is one of the most cost-effective public health interventions and largely responsible for reduction of vaccine preventable under-5 mortality rate. Under UIP, immunization is providing free of cost against 12 vaccine preventable diseases. Mission Indra dhanush (MI) was launched in December 2014 and aims at increasing the full immunization coverage to children to 90 % (1). Mother play a very important role in child immunization, so awareness and correct knowledge about immunization is very essential in women, keeping this thing in mind, the present study was undertaken. Aims and objectives;1. To assess the awareness about child immunization among women in rural area.2. To know the correct knowledge of vaccine given in children among women .Material and methods;A cross sectional study was carried out in a rural area of district Jalaun. Aata block was selected randomly for study area. RHTC Aata was selected and women attending the OPD during month of August to October were included in study. Sample size were calculated and 140 mothers were interviewed by using predesigned and pretested questionnaire after taking verbal consent and data was collected and analyzed using appropriate statistical tool. Results; mostly women had heard about immunization in children (82.1%) and most of the women got information from health workers like ASHA/ANM followed by family and friends. vaccine given to child that shows knowledge about BCG/POLIO/MMR was found good but average about DPT and HEPATITIS. Very few women had knowledge about HIB, JE and ROTA vaccine. Conclusion; need to focus on education and awareness programme on women regarding child immunization in rural areas.

Vaccination in Diabetes: Updated Guidelines for 2024

Diabetes presents a significant public health challenge globally, with India emerging as a hotspot for the disease burden. The International Diabetes Federation (IDF) Diabetes Atlas 2021 highlights India with 1 in 7 adults affected with diabetes. Given the heightened susceptibility of individuals with diabetes to vaccine-preventable diseases, vaccination has become indispensable in comprehensive diabetes management. Major vaccines against influenza, pneumonia, hepatitis, shingles, varicella, tetanus, diphtheria, and pertussis infections are important for individuals living with diabetes. Despite strides in pediatric vaccination coverage through initiatives like the Universal Immunization Program (UIP), adult vaccination rates remain suboptimal in India. Vaccine hesitancy, compounded by factors such as inadequate education, affordability concerns, and accessibility issues, disproportionately affects this population. Even though there are multiple organizations recommending vaccination in adults, guidelines specific to the Indian population with diabetes are still lacking. This paper is an attempt to suggest the use of vaccines for people with diabetes in India. By advocating for increased awareness and accessibility to vaccines, healthcare providers can play a pivotal role in safeguarding the health of this vulnerable population. As the global community continues to combat diabetes and vaccine hesitancy, collaborative efforts are essential to ensure equitable access to life-saving vaccines and promote optimal health outcomes. This review examines the evolving landscape of vaccination in India, particularly focusing on adults with diabetes.

IJCM_212A: Assessment of Effective Vaccine Management in Government Health Facilities of Jammu district

Background: The success of immunization depends highly on the level of cold chain maintenance. For effective implementation and success of the Universal Immunisation Programme, proper maintenance of Cold Chain needs a great focus. In 2010, WHO and UNICEF launched the Effective Vaccine Management (EVM) initiative. EVM is a tool which assesses immunization supply chain logistics management. Objectives: To evaluate the performance of Immunization supply chain in cold chain points of Government Health Facilities (HF) of Jammu district Methodology: A facility based cross-sectional study was conducted in Jammu district of UT of J&K. The assessment was done during November 2021– October 2022 using WHO-UNICEF EVM assessment standalone questionnaire generated on EVM assessor app. Sample size and site selection were done using the WHO EVM site selection tool(v1.7-March 2014). A total of 31 HFs were assessed including Divisional Vaccine Store (SN) Results: None of the health facilities reached the WHO recommended overall score of >80%. The criterion scores showed that Facility infrastructure and equipment (E4) and waste management (E9) for District Vaccine Store (LD) was 83% & 86%. Vaccine management (E8) score for SN level & Government Hospital was 88% & 82%. Rest of the CCPs scored less than 80% for all the criteria(E2-E9). The scores of distribution of vaccines and dry goods (E7) were very low for Primary Health Centres (PHC) and Health & Wellness Centres (H&WC) i.e., 39% and 25%. The scores for all the categories(C1-C6) for various CCPs were below 80%. Management criteria scores for supportive supervision(M3) was 0% for all CCP except LD &PHC Conclusion: The overall performance of cold chain in Jammu district was below the recommended level. Supportive supervision, provision of safe disposal pits, power backup, micro plan, training of Cold Chain Handlers and provision of vaccine transportation facility can help in effective vaccine management

Mapping the Socio-Economic Inequalities among Children Aged 0-5 Years in India: A Benefit Incidence Analysis of Universal Immunization Programme

Mapping the Socio-Economic Inequalities among Children Aged 0-5 Years in India: A Benefit Incidence Analysis of Universal Immunization Programme

Expanded spectrum of varicella disease and the need for vaccination in India.

Varicella vaccine was first licensed in Japan and South Korea in 1989 for use in healthy children and was introduced in US in 1995. So far, 29 countries have adopted varicella vaccine in their universal immunization program (UIP). No Asian country, India included, has adopted the varicella vaccine as part of their UIP. The extra-cutaneous sites for VZV diseases are central nervous system and gastrointestinal tract, the expanded disease spectrum includes vasculopathy, myelitis, inflammatory bowel disease, perforated ulcers, and gastritis. The actual disease burden of varicella is not known as most of the infected individuals may not visit the physician. The amplifiable VZV DNA will not always be detectable in cerebrospinal fluid (CSF) samples in protracted illnesses such as vasculopathies, but demonstrable anti-VZV IgG in CSF has diagnostic value. The World Health Organization (WHO) position paper 2014 recommends two doses of varicella and zoster vaccines in targeted population. In India, varicella vaccine is not included in the UIP due to the cost and the belief that lifelong immunity occurs following primary infection. The expanded spectrum of VZV disease and the mounting body of evidence, however, suggest the need for both varicella and zoster vaccines in routine immunization schedule.

Assessing the Impact of the COVID-19 Pandemic on Maternal and Child Health Services: A Comprehensive Analysis of Government Initiatives in Northern India.

The coronavirus disease (COVID-19) pandemic has significantly impacted healthcare services globally, with particular challenges observed in maternal and child health (MCH) care. This study aimed to assess the impact of the pandemic on MCH services in northern India, focusing on key government programs. Data were collected from four major MCH programs in India: Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), and the Universal Immunization Program (UIP). The study compared MCH service utilization and outcomes during the pandemic period (March-September 2020) with the same period in 2019. Preliminary findings indicated a significant reduction in the utilization of MCH services during the pandemic, with a decrease observed in institutional deliveries, antenatal care visits, and immunization coverage. For instance, institutional deliveries declined by 30% compared with the previous year, with a similar decrease observed in antenatal care visits. Immunization coverage also decreased by approximately 25%, indicating a substantial decline in preventive care services. Challenges in accessing essential treatments for sick infants have also been reported, with a 40% decrease in the utilization of free treatment services under the JSSK program. The COVID-19 pandemic has substantially impacted MCH services in northern India, highlighting the vulnerability of these essential health programs during public health emergencies. Addressing the challenges identified in this study is crucial to ensuring the continuity and resilience of MCH services in similar settings.

Burden of chickenpox complications in Poland, 2006 to 2021: A comprehensive registry-based study.

BackgroundChickenpox, a vaccine-preventable disease caused by the varicella zoster virus, generally presents with mild symptoms but can cause complications necessitating hospitalisation. In Poland, since 2009, vaccination has been obligatory for children up to 12 years of age who are particularly vulnerable to infection and for children in their vicinity.AimTo examine the burden of chickenpox complications and the trends of hospitalisation arising from these complications over time in the Polish population.MethodsData spanning 2006-21 were sourced from the Polish Infectious Diseases Surveillance System, the Nationwide General Hospital Morbidity Study and the Statistics Poland death registry. Standardised and age-specific incidence rates, hospital discharge rates and number of deaths because of chickenpox were calculated. Moreover, the joinpoint regression model was used to analyse trends of annual hospital discharge rates.ResultsOver the analysed timeframe, 25,804 hospitalisations and 52 deaths attributable to chickenpox complications were documented, and 1.0% of chickenpox cases required hospitalisation because of chickenpox. Age-standardised hospitalisation rates varied between 2.3 and 9.6 per 100,000 population. The analysis revealed no statistically significant trend in overall hospital discharge rates from chickenpox complications. However, a notable increase in hospitalisation rates was observed in children aged 0-4 and among inhabitants of rural areas, with annual percentage changes of 4.9% and 3.4% respectively.ConclusionsOur findings suggest that the implementation of a universal chickenpox immunisation programme, supported by health education, should be considered to reduce the number of hospitalisations and nearly eliminate deaths because of chickenpox.