Vaccine Cost Research Articles

Equity in vaccination policies to overcome social deprivation as a risk factor for invasive meningococcal disease

ABSTRACT Introduction Social deprivation is associated with poorer healthcare access. Vaccination is among the most effective public health interventions and achieving equity in vaccination access is vitally important. However, vaccines are often reimbursed by public funds only when recommended in national immunization programs (NIPs), which can increase inequity between high and low socioeconomic groups. Invasive meningococcal disease (IMD) is a serious vaccination-preventable disease. This review focuses on vaccination strategies against IMD designed to reduce inequity. Areas covered We reviewed meningococcal epidemiology and current vaccination recommendations worldwide. We also reviewed studies demonstrating an association between social deprivation and risk of meningococcal disease, as well as studies demonstrating an impact of social deprivation on uptake of meningococcal vaccines. We discuss factors influencing inclusion of meningococcal vaccines in NIPs. Expert opinion Incorporating meningococcal vaccines in NIPs is necessary to reduce inequity, but insufficient alone. Inclusion provides clear guidance to healthcare professionals and helps to ensure that vaccines are offered universally to all target groups. Beyond NIPs, cost of vaccination should be reimbursed especially for disadvantaged individuals. These approaches should help to achieve optimal protection against IMD, by increasing access and immunization rates, eventually reducing social inequities, and helping to protect those at greatest risk.

Factors affecting willingness to participate in vaccine clinical trials in an underdeveloped country: perspective from Nepal

ABSTRACT Due to the inherent complex nature of clinical trials, individual’s willingness to participate and hence, enrollment in a clinical trial maybe challenging. When it comes to vaccine clinical trial in children, informed consent needs to be secured from the parents or legally acceptable representatives (LARs). Some of the factors which contribute to hesitancy in taking part in clinical trials are based on the level of education, living standards, part of the world they live, associated burden of disease, fear of different procedures in clinical trial, side effects, limited understanding, limited time, and mistrust with Investigational product. This study included 201 parents/LARs, who approached Kanti Children Hospital site in Kathmandu with the interest to get their children enrolled in a vaccine clinical trial with objectives of describing the reasons for agreeing or disagreeing to participate in the vaccine clinical trial, factors affecting decision making, and finding the major concerns of parents/LARs. The acceptance for the study vaccine was 136 (67.7%) whereas denial was 65 (32.3%). This study showed that age, education level, family structure, advice from family and friends, and medical guidance play important roles in willingness of parents to get their child enrolled in the trial. If a proper counseling is done, fear of blood sampling is not a big factor which is contrary to the belief among clinical researchers. Safety of vaccine, frequency of injections, and cost of vaccine were the main concerns of the parents, which need to be addressed extensively while planning for any clinical trial in children.

Costs of seasonal influenza vaccination in South Africa.

BackgroundInfluenza accounts for a substantial number of deaths and hospitalisations annually in South Africa. To address this disease burden, the South African National Department of Health introduced a trivalent inactivated influenza vaccination programme in 2010.MethodsWe adapted and populated the WHO Seasonal Influenza Immunization Costing Tool (WHO SIICT) with country‐specific data to estimate the cost of the influenza vaccination programme in South Africa. Data were obtained through key‐informant interviews at different levels of the health system and through a review of existing secondary data sources. Costs were estimated from a public provider perspective and expressed in 2018 prices. We conducted scenario analyses to assess the impact of different levels of programme expansion and the use of quadrivalent vaccines on total programme costs.ResultsTotal financial and economic costs were estimated at approximately USD 2.93 million and USD 7.91 million, respectively, while financial and economic cost per person immunised was estimated at USD 3.29 and USD 8.88, respectively. Expanding the programme by 5% and 10% increased economic cost per person immunised to USD 9.36 and USD 9.52 in the two scenarios, respectively. Finally, replacing trivalent inactivated influenza vaccine (TIV) with quadrivalent vaccine increased financial and economic costs to USD 4.89 and USD 10.48 per person immunised, respectively.ConclusionWe adapted the WHO SIICT and provide estimates of the total costs of the seasonal influenza vaccination programme in South Africa. These estimates provide a basis for planning future programme expansion and may serve as inputs for cost‐effectiveness analyses of seasonal influenza vaccination programmes.

The economic impact of heartwater on the South African livestock industry and the need for a new vaccine

Heartwater is a dangerous tick-borne disease for livestock farmers in South Africa and results in annual economic losses for the livestock industry. This study determined the total economic impact of heartwater in South Africa by calculating this disease's direct and indirect costs. Survey data from 272 livestock farmers from six provinces of South Africa was used for this study. Available heartwater research in South Africa only focused on the prevention and control of and vaccination against heartwater, with no research having undertaken an in-depth study of the total economic impact of this disease. The highest cost due to heartwater at provincial level was calculated for the Eastern Cape Province, followed by the North West and Mpumalanga Provinces. Heartwater has an enormous impact on the cattle industry, with an approximate R1 059 million losses experienced each year. The sheep industry experiences a total cost loss of approximately R168 million per year, with the goat industry experiencing about R39 million per year. The total economic impact of heartwater on the South African livestock industry is estimated at R1 266 million per annum. The direct cost contributed 66.47%, and indirect costs contributed 33.57% to the total cost of heartwater. The annual cost of heartwater vaccines contributed the least to the total cost of heartwater, with only 10% of the participants administering the heartwater vaccine. A total of 84.29% of the respondents indicated a need for a new and improved heartwater vaccine. This study emphasises the importance of heartwater in South Africa and farmers' high costs because of this disease. If an improved heartwater vaccine can be developed, the direct cost of heartwater will reduce, which is the bulk of its economic impact. This research can serve as a basis for future research on heartwater, where cost-benefit analyses could be conducted on heartwater's different prevention and control methods.

Cost-effectiveness analysis of BNT162b2 COVID-19 booster vaccination in the United States

ObjectivesTo evaluate the cost-effectiveness of a booster strategy in the United States. MethodsWe developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy of the Pfizer-BioNTech BNT162b2 (administered 6 months after the second dose) among older adults from a healthcare system perspective. ResultsCompared with 2 doses of BNT162b2 without a booster, the booster strategy in a 100,000 cohort of older adults would incur an additional cost of $3.4 million in vaccination cost but save $6.7 million in direct medical cost and gain 3.7 quality-adjusted life-years in 180 days. This corresponds to a benefit-cost ratio of 1.95 and a net monetary benefit of $3.4 million. Probabilistic sensitivity analysis indicates that a booster strategy has a high chance (67%) of being cost-effective. Notably, the cost-effectiveness of the booster strategy is highly sensitive to the population incidence of COVID-19, with a cost-effectiveness threshold of 8.1/100,000 person-day. If vaccine efficacies reduce by 10%, 30%, and 50%, this threshold will increase to 9.7/100,000, 13.9/100,000, and 21.9/100,000 person-day, respectively. ConclusionOffering the BNT162b2 booster to older adults aged ≥65 years in the United States is likely to be cost-effective. Less efficacious vaccines and boosters may still be cost-effective in settings of high SARS-CoV-2 transmission.

Cost-effectiveness of the 15-valent pneumococcal conjugate vaccine for high-risk adults in Switzerland

ABSTRACT Background Vaccination against pneumococcal disease (PD) has shown a favorable cost-effectivenessprofile for many national immunization programs. While vaccination efforts have concentrated on children, many adults with underlying illnesses face elevated risks of PD and death. A 15-valent pneumococcal conjugate vaccine (V114) is currently available offering protection against 15 different serotypes and can be used in adults. Research design and methods We examined the cost-effectiveness of V114 vaccination in high-risk adults, aged 18+, in Switzerland. To this end, a Markov model was constructed estimating the lifetime direct medical costs and clinical effectiveness of V114 vaccination on invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP). Results Considering 60% vaccine uptake and direct effects of vaccination, in total 760 IPD and 4,396 NBPP in- and outpatient cases could be prevented. Vaccinating high-risk adults with V114 led to CHF 37.4 million additional vaccination costs but saved CHF 14.4 million of medical treatment costs. V114 vaccination produced a gain of 2,095 QALYs and 6,320 LYs compared with no vaccination, leading to incremental cost-effectiveness ratios of CHF 17,866/QALY and CHF 15,616/QALY gained from a health care payer and societal perspective, respectively. Conclusions This evidence justifies the implementation of V114 vaccination among high-risk adults in Switzerland.

Assessment of Hepatitis B Vaccination Status and Associated Factors among Healthcare Workers in Bosaso, Puntland, Somalia 2020.

Introduction Hepatitis B virus disease is a viral infection caused by the hepatitis B virus (HBV), which is a major public health problem worldwide. According to the World Health Organization (WHO) estimate, two billion people worldwide have serologic evidence of past or present HBV infection. The risk of infection is high among health professionals due to the risk of occupational contact with fluids of infected patients and the risk of needle stick injury. This study is aimed at assessing HBV vaccination coverage and reasons for possible defiance of the vaccine among healthcare workers in Bosaso, Somalia. Methodology. An institution-based cross-sectional study was conducted by using a quantitative approach to identify hepatitis B virus vaccination coverage and reasons for vaccine defiance in Bosaso from September 2020 to November 2020. Healthcare workers (HCWs) in Bosaso city both in public and private health facilities who accepted to participate in this study were interviewed by using a structured questionnaire, and SPSS was used to analyze the collected data. Results We found that only (16.4%) of HCWs were fully vaccinated. The main reasons for not taking the vaccine by the participants were the unavailability of the vaccine (42%), high vaccine cost (28.7%), lack of time (20.7%), and fear of vaccine side effects (7.5%). The majority (69.7%) of HCWs demonstrated good knowledge about HBV infection. The vaccination uptake was significantly higher among midwives (p = 0.02; OR = 1.21; 95%CI = 1.39 − 67.41) and individuals aged under 30 years (p = 0.03; OR = 8.6; 95%CI = 1.17–63.26). Conclusion Our study revealed that vaccination coverage of HCWs in Bosaso was very low because of the unavailability of vaccines, high cost of the vaccine, lack of time, and fear of vaccine side effects. Therefore, the development and implementation of policies related to HBV vaccination are recommended.

Development of Plant-Based Vaccines for Prevention of Avian Influenza and Newcastle Disease in Poultry.

Viral diseases, including avian influenza (AI) and Newcastle disease (ND), are an important cause of morbidity and mortality in poultry, resulting in significant economic losses. Despite the availability of commercial vaccines for the major viral diseases of poultry, these diseases continue to pose a significant risk to global food security. There are multiple factors for this: vaccine costs may be prohibitive, cold chain storage for attenuated live-virus vaccines may not be achievable, and commercial vaccines may protect poorly against local emerging strains. The development of transient gene expression systems in plants provides a versatile and robust tool to generate a high yield of recombinant proteins with superior speed while managing to achieve cost-efficient production. Plant-derived vaccines offer good stability and safety these include both subunit and virus-like particle (VLP) vaccines. VLPs offer potential benefits compared to currently available traditional vaccines, including significant reductions in virus shedding and the ability to differentiate between infected and vaccinated birds (DIVA). This review discusses the current state of plant-based vaccines for prevention of the AI and ND in poultry, challenges in their development, and potential for expanding their use in low- and middle-income countries.

Cost-Effectiveness of Bivalent, Quadrivalent, and Nonavalent HPV Vaccination in South Africa.

Background and ObjectivesIn South Africa, the prevalence of human papillomavirus (HPV) and associated diseases, such as cervical cancer and genital warts, is among the highest in the world. This study evaluates the cost-effectiveness of bivalent, quadrivalent, and nonavalent HPV vaccination for 9- to 14-year-old girls from the South African healthcare system perspective.MethodsA Markov model portraying the natural HPV disease progression from high-risk infection to cervical intraepithelial neoplasia (CIN) I, CIN II/III, or cervical cancer and from low-risk infection to genital warts was built. Transition probability, utility, and efficacy data were sourced from peer-reviewed literature. Vaccination costs were calculated based on the World Health Organization (WHO) guidelines. The model was populated with a cohort of 520,000 9-year-old girls to calculate incremental cost-effectiveness ratios (ICER) in South African Rand (R) per quality-adjusted life-years (QALYs) gained for each vaccination strategy.ResultsAll HPV vaccination strategies dominate the no vaccine strategy. Compared with the bivalent vaccine, the nonavalent strategy increases QALYs by 0.14 and costs by R1793 (ICER: R13,013 per QALY) per person, while the quadrivalent vaccination provides −0.02 incremental QALYs and R1748 costs (ICER: −R116,397 per QALY). Consequently, at the South African willingness-to-pay threshold of R23,630 per QALY, nonavalent vaccination is the preferred strategy, with a probability of 90.2%. Scenario analysis demonstrated that results are influenced by vaccine coverage, efficacy, and duration of efficacy.ConclusionsThe introduction of nonavalent for bivalent HPV vaccination is a cost-effective intervention in South Africa. HPV vaccination should be part of a multifaceted public health strategy entailing screening, condoms, and education of all stakeholders to reduce the significant burden of sexual transmitted diseases in South Africa. Sex-neutral and catch-up vaccinations are subjects for further research.Graphical Supplementary InformationThe online version contains supplementary material available at 10.1007/s40261-022-01138-6.

Cost-Effectiveness of Influenza Vaccination Strategies in Adults: Older Adults Aged ≥65 Years, Adults Aged 50-64 Years, and At-Risk Adults Aged 19-64 Years.

The high disease burden of influenza in elderly and chronically ill adults may be due to the suboptimal effectiveness and mismatch of the conventional trivalent influenza vaccine (TIV). This study evaluated the cost-effectiveness of quadrivalent (QIV), adjuvanted trivalent (ATIV), and high-dose quadrivalent (HD-QIV) vaccines versus TIV used under the current Korean National Immunization Program (NIP) in older adults aged ≥65 years. We also evaluated the cost-effectiveness of programs for at-risk adults aged 19–64 and adults aged 50–64. A one-year static population model was used to compare the costs and outcomes of alternative vaccination programs in each targeted group. Influenza-related parameters were derived from the National Health Insurance System claims database; other inputs were extracted from the published literature. Incremental cost-effectiveness ratios (ICERs) were assessed from a societal perspective. In the base case analysis (older adults aged ≥65 years), HD-QIV was superior, with the lowest cost and highest utility. Compared with TIV, ATIV was cost-effective (ICER $34,314/quality-adjusted life-year [QALY]), and QIV was not cost-effective (ICER $46,486/QALY). The cost-effectiveness of HD-QIV was robust for all parameters except for vaccine cost. The introduction of the influenza NIP was cost-effective or even cost-saving for the remaining targeted gr3oups, regardless of TIV or QIV.

Direct Medical Costs of Four Vaccine-Preventable Infectious Diseases in Older Adults in Spain.

ObjectiveProtection against vaccine-preventable diseases is especially relevant in older adults due to age-related decline in immunity (immunosenescence). However, adult vaccination remains a challenge with overall low coverage rates, which has an impact on both the patients who have these diseases and the health care system in terms of resource use and costs derived. This study aimed to estimate the direct economic impact of herpes zoster, pneumococcal disease, influenza and pertussis in Spanish adults 45 years and older.MethodsData from 2015 were extracted from two Spanish public databases: the Minimum Basic Data Set for Hospitalisations and the Clinical Database of Primary Care. Codes from the International Classification of Diseases and the International Classification of Primary Care were used to identify and classify the diseases analysed. The variables extracted and calculated were hospitalisation (cases, percentage, length of stay, costs, mortality), primary care (cases, percentage, costs) and referrals (cases, percentage, costs). Results were presented for the age groups 45–64 years, 65–74 years, > 74 years and all ages.ResultsIn adults 45 years and older, total costs amounted to €134.1 million in 2015 (i.e. 63.9% of the total direct costs for all age groups): 44.4% due to pneumococcal disease, 39.5% due to influenza, 16.0% due to herpes zoster and 0.1% due to pertussis. Hospitalisations represented 58.1% (€77.9 million) of the total costs, with 15,910 admissions, 144,752 days of hospitalisation and 1170 deaths. Primary care registered 566,556 visits with a cost of €35.0 million, and 269,186 referrals with a cost of €21.1 million.ConclusionThe direct economic burden of herpes zoster, pneumococcal disease, influenza and pertussis in adults 45 years and older was high in Spain, and may be underestimated as it only considered medical assistance and not other applicable direct or indirect costs. Increasing vaccination rates in adults may potentially reduce the economic burden derived from these diseases, although future cost-effectiveness analysis including other disease-related costs, vaccination costs and vaccination effectiveness would be needed.Graphical

Fake Covid vaccine found in Iran – and beyond?

We are bringing this matter to our readers and regional doctors attention as sadly there is always someone prepared to prey on others misfortune. The original article is on the WHO website and they provide detail on how to identify fake vaccines and those vials that have been tampered with. It was Astra Zeneca fake vaccine discovered in the original report. https://www.who.int/news/item/04-11-2021-medical-product-alert-n-7-2021-falsified-covid-19-vaccine-astrazeneca It is not clear if fake vaccine is still circulating or has been fully removed from circulation but all patients, doctors, health systems and governments should remain vigilant. We stress that all vaccine should be acquired from a reliable and long trusted source. There are implications on various levels, i.e. a systemic flaw where not all vaccines in the system can be trusted and from the population health viewpoint where not all people will necessarily have the immunity they assumed they had. We also need to be aware that whatever was injected was also not necessarily harmless. Ideally the Iranian government should pay for re-vaccination as it is the national system that was flawed and ordinary Iranian people can ill afford the cost of vaccination. We have also found that immunity decreases after vaccination and after infection with COVID-19, and with new variants arising in the community, free (re)vaccination of all citizens will cover any shortfalls caused by fake vaccines and will be a positive population health approach on many levels. It has also been suggested that there may be further corruption within the system whereby casting doubt on A-Z, which is a reputable vaccine, allows some other vaccine vendors to push their own brand and after this reported subterfug,e can providers of competing vaccines/sources all be trusted? It is a systemic failure that a fake vaccine could be introduced in the first place and proper precautions need to be taken to prevent fake vaccines entering the system in all countries. POSTSCRIPT WAR: Once again we have innocent people being slaughtered by the armies of, let us be frank, evil and insane men. The dangerously mentally ill rule most of the planet. How on earth does this happen? How on earth does it still happen in 2022? Family medicine deals with the physical, mental and psychological health of all people and as Publisher of World Family Medicine Journal I feel obliged to speak up about the endless slaughter, the endlessly brutalisation, and the endless dispossession. Today it is Ukraine, yesterday it was Myanmar and who knows who it will be tomorrow. It must stop now and we have to find a way to make it stop forever as it is the biggest family medicine issue on the planet and always has been.

Modeling comparative cost-effectiveness of SARS-CoV-2 vaccine dose fractionation in India

Given global Coronavirus Disease 2019 (COVID-19) vaccine shortages and inequity of vaccine distributions, fractionation of vaccine doses might be an effective strategy for reducing public health and economic burden, notwithstanding the emergence of new variants of concern. In this study, we developed a multi-scale model incorporating population-level transmission and individual-level vaccination to estimate the costs of hospitalization and vaccination and the economic benefits of reducing COVID-19 deaths due to dose-fractionation strategies in India. We used large-scale survey data of the willingness to pay together with data of vaccine and hospital admission costs to build the model. We found that fractional doses of vaccines could be an economically viable vaccination strategy compared to alternatives of either full-dose vaccination or no vaccination. Dose-sparing strategies could save a large number of lives, even with the emergence of new variants with higher transmissibility.

Projecting the cost of introducing typhoid conjugate vaccine (TCV) in the national immunization program in Malawi using a standardized costing framework

BackgroundThere is a substantial typhoid burden in sub-Saharan Africa, and TCV has been introduced in two African countries to date. Decision-makers in Malawi decided to introduce TCV and applied for financial support from Gavi, the Vaccine Alliance in 2020. The current plan is to introduce TCV as part of the national immunization program in late 2022. The introduction will include a nationwide campaign targeting all children aged 9 months to 15 years. Following the campaign, TCV will be provided through routine immunization at 9 months. This study aims to estimate the cost of TCV introduction and recurrent delivery as part of the national immunization program. MethodsThis costing analysis is conducted from the government's perspective and focuses on projecting the incremental cost of TCV introduction and delivery for Malawi’s existing immunization program before vaccine introduction. The study uses a costing tool developed by Levin & Morgan through a partnership between the International Vaccine Institute and the World Health Organization and leverages primary and secondary data collected through key informant interviews with representatives of the Malawi Expanded Programme on Immunization team at various levels. ResultsThe total financial and economic costs of TCV introduction over three years in Malawi are projected to be US$8.5 million and US$29.8 million, respectively. More than two-thirds of the total cost is made up of recurrent costs. Major cost drivers include the procurement of vaccines and injection supplies and service delivery costs. Without vaccine cost, we estimate the cost per child immunized to be substantially lower than US$1. DiscussionFindings from this analysis may be used to assess the economic implications of introducing TCV in Malawi. Major cost drivers highlighted by the analysis may also inform decision-makers in the region as they assess the value and feasibility of TCV introduction in their national immunization program.

An Economic Analysis of Mumps Vaccination in Fiji: Static Model Simulation of Routine Measles-Mumps-Rubella (MMR) Vaccination Instead of Current Measles-Rubella (MR) Vaccination.

Mumps remains endemic in Fiji, with 7802 cases reported between 2016 and 2018. The introduction of mumps vaccination has been discouraged due to perceptions of mumps as a self-limited disease and the perceived high cost of mumps vaccines. We estimated the benefits and costs of introducing a mumps vaccination program in Fiji. First, we estimated the burden of mumps and mumps-related complications in Fiji based on the reported cases in the Fiji National Notifiable Disease Surveillance System between 2016 and 2018. We then developed a static simulation model with stable mumps herd immunity after routine measles–mumps–rubella (MMR) vaccination. Finally, we compared the estimated economic burden of mumps with current MR vaccination and the assumptive burden of the stable-state simulation model after routine MMR vaccination. The benefit–cost ratios (BCRs) were 2.65 from the taxpayer view and 3.00 from the societal view. A probabilistic sensitivity analysis indicated that the 1st and 99th percentiles of BCRs were 1.4 and 5.2 from the taxpayer’s perspective and 1.5 and 6.1 from the societal perspective. From both the taxpayer and societal perspectives, the probability of BCRs greater than 1.0 was 100%. A routine MMR program has value for money from both the taxpayer and societal perspectives. MMR vaccination should be urgently introduced in Fiji.

Estimating the cost of COVID-19 vaccine deployment and introduction in Ghana using the CVIC tool

BackgroundThis study estimated cost of COVID-19 vaccine introduction and deployment in Ghana. MethodsUsing the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool Ghana’s Ministry of Health Technical Working Group for Health Technology Assessment (TWG-HTA) in collaboration with School of Public Health, University of Ghana, organized an initial two-day workshop that brought together partners to deliberate and agree on input parameters to populate the CVIC tool. A further 2–3 days validation with the Expanded Program of Immunization (EPI) and other partners to finalize the analysis was done. Three scenarios, with different combinations of vaccine products and delivery modalities, as well as time period were analyzed. The scenarios included AstraZeneca (40%), Johnson & Johnson (J&J) (30%), Moderna, Pfizer, and Sputnik V at 10% each; with primary schedule completed by second half of 2021 (Scenario 1); AstraZeneca (30%), J&J (40%), Moderna, Pfizer, and Sputnik V at 10% each with primary schedule completed by first half of 2022 (Scenario 2); and equal distribution (20%) among AstraZeneca, J&J, Moderna, Pfizer, and Sputnik V with primary schedule completed by second half of 2022 (Scenario 3). ResultsThe estimated total cost of COVID-19 vaccination ranges between $348.7 and $436.1 million for the target population of 17.5 million. These translate into per person completed primary schedule cost of $20.9–$26.2 and per dose (including vaccine cost) of $10.5–$13.1. Again, per person completed primary schedule excluding vaccine cost was $4.5 and $4.6, thus per dose excluding vaccine also ranged from $2.2 – $2.3. The main cost driver was vaccine doses, including shipping, which accounts for between 78% and 83% of total cost. Further, an estimated 8,437–10,247 vaccinators (non-FTEs) would be required during 2021–2022 to vaccinate using a mix of delivery strategies, accounting for 8–10% of total cost. ConclusionThese findings provide the estimates to inform resource mobilization efforts by government and other partners.

Spread of Aujeszky’s disease among wild boars and domestic pigs in Ukraine

Aujeszky’s disease, also known as pseudorabies is an acute infectious viral disease in a variety of mammals caused by Suid herpesvirus 1, a member of the subfamily Alphaherpesvirinae and the family Herpesviridae. This virus causes significant economic losses in agriculture of numerous countries. In particular, in pig farming, the main losses are currently associated with restrictions of international trade, as well as the cost of vaccination or slaughter of infected animals. The main reservoirs species of this disease are considered to be wild boars and domestic pigs. So, in this article the authors performed a comparative retrospective analysis of the prevalence of Aujeszky’s disease among these species in Ukraine over 2009–2020 by systematizing and analyzing the epizootic data and results of serological studies. As a result of the conducted research, there is a clear trend that shows the reduction in the number of locations in Ukraine (farms, households, etc.) with domestic pigs affected by Aujeszky’s disease. Thus, in 2009 four such farms were found, and in 2018 – only one. During 2014–2016 and 2019–2020, affected farms and locations were not registered for this disease. In total, 21 such points with infected pigs were registered during the analyzed period. As for wild boars, during the analyzed 12 years, locations with animals affected by Aujeszky’s disease were registered only in 2013 and 2014 (two and one, respectively). It should be noted that all of those with infected wild boars were found in the AR Crimea. For the twelve years, the number of tested sera samples from domestic pigs amounted to 378,678 (7.4% were positive) and from wild boars – 9,052 (19.8% were positive). As a result of comparative geographical analysis of the obtained data on the detection of specific humoral antibodies to the Aujeszky’s disease virus among both species for 12 years in the regions of Ukraine, there is no established clear correlation between the spread of the disease among wild boars and domestic pigs. Thus, the highest seroprevalence rates among wild boars were observed in the northern and northeastern parts of Ukraine, and in domestic pigs, on the contrary, in the southern and central parts of this country. It should be noted, that since 2014 the number of serological tests among both species for carriers of Aujeszky’s disease has significantly decreased.

Impact of co-evolution of negative vaccine-related information, vaccination behavior and epidemic spreading in multilayer networks

In this paper, we establish a three-layer coupled network model to analyze the co-evolution of negative vaccine-related information, vaccination behavior, and epidemic spread. The three layers are used to represent negative vaccine-related information dissemination, vaccination behavior diffusion and epidemic propagation, respectively. The comprehensive impact of vaccination costs and herd mentality are firstly considered in the diffusion of vaccination behavior. Then, we use the micro-Markov chain (MMC) method to derive the system dynamics equations and the epidemic threshold. The analytical results show that the proportion of efficaciously vaccinated individuals and the topology of the epidemic spread layer both determine the epidemic threshold. Finally, a large number of simulation experiments are conducted to investigate the impact of various factors on the epidemic spread, which include negative vaccine-related information diffusion, rational judgment and herd mentality during the process of vaccination decision, and cost of vaccine. The results demonstrate the role of negative vaccine-related information diffusion and vaccination behavior spread in epidemic control, and may provide some valuable clues for policymakers to formulate appropriate measures to prevent and control epidemics.

Microparticles entrapping pneumococcal protein SP0845 show improved immunogenicity and temperature stability

Protein based vaccines are the most safe and affordable strategy to combat pneumococcal disease circumventing the limitations of conventional polysaccharide-based vaccines like serotype dependence, high cost and inability to be administered to immunocompromised. SP0845 is a highly conserved vaccine candidate shown to provide protection against heterologous strains of Streptococcus pneumoniae, the primal cause of pneumonia. However, the associated poor immunogenicity warrants the need for adjuvants and multiple doses to mount desired responses. The present study relates to improve the immunogenicity of pneumococcal protein SP0845 by use of poly lactic acid biodegradable polymer microparticles. The immunization studies showed that microparticles elicited higher antibody response compared to alum adjuvanted protein and this immunopotentiation was achieved without the use of any additional adjuvant. They were also capable of eliciting secondary antibody response upon boosting after four months. Further, the particles upon storage at 25 and 37 °C for one month were still capable of mounting an immune response equivalent to those stored in cold chain. Thus, using microparticles entrapping SP0845 for immunization not only improve the immunogenicity but also offer better temperature stability. This can greatly reduce the cost and increase access of protein-based vaccine to resource limited settings.

Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics.

Mandatory vaccination has been a highly disputed policy for tackling infectious diseases. Here I argue that a universal mandatory vaccination policy for the general public against the COVID-19 pandemic is ethically preferable when grounded in the concept of solidarity, which is defined by Barbara Prainsack and Alena Buyx as an enacted commitment to a relevant respect recognized by a group of individuals with equal moral status. This approach is complementary to utilitarian accounts and could better address other reasonable oppositions to mandatory vaccination. From a solidaristic account, the recognized relevant respect is to end the COVID-19 pandemic as soon as possible. This group of individuals would be willing to carry costs to assist each other in this respect, and a mandatory vaccination policy could be their institutionalized mutual assistance. The costs to be carried include both the financial costs of vaccination and the health costs stemming from potential adverse events and scientific uncertainties. The proposed social health insurance similarity test suggests the degree of coercion the mandatory vaccination policy could undertake within each state's specific legal and judicial context. (Am J Public Health. 2022;112(2):255-261. https://doi.org/10.2105/AJPH.2021.306578).