Vaccination Services Research Articles

Malaria vaccine coverage estimation using age-eligible populations and service user denominators in Kenya

BackgroundThe World Health Organization approved the RTS,S/AS01 malaria vaccine for wider rollout, and Kenya participated in a phased pilot implementation from 2019 to understand its impact under routine conditions. Vaccine delivery requires coverage measures at national and sub-national levels to evaluate progress over time. This study aimed to estimate the coverage of the RTS,S/AS01 vaccine during the first 36 months of the Kenyan pilot implementation.MethodsMonthly dose-specific immunization data for 23 sub-counties were obtained from routine health information systems at the facility level for 2019–2022. Coverage of each RTS,S/AS01 dose was determined using reported doses as a numerator and service-based (Penta 1 and Measles) or population (projected infant populations from WorldPop) as denominators. Descriptive statistics of vaccine delivery, dropout rates and coverage estimates were computed across the 36-month implementation period.ResultsOver 36 months, 818,648 RTSS/AS01 doses were administered. Facilities managed by the Ministry of Health and faith-based organizations accounted for over 88% of all vaccines delivered. Overall, service-based malaria vaccine coverage was 96%, 87%, 78%, and 39% for doses 1–4 respectively. Using a population-derived denominator for age-eligible children, vaccine coverage was 78%, 68%, 57%, and 24% for doses 1–4, respectively. Of the children that received measles dose 1 vaccines delivered at 9 months (coverage: 95%), 82% received RTSS/AS01 dose 3, only 66% of children who received measles dose 2 at 18 months (coverage: 59%) also received dose 4.ConclusionThe implementation programme successfully maintained high levels of coverage for the first three doses of RTSS/AS01 among children defined as EPI service users up to 9 months of age but had much lower coverage within the community with up to 1 in 5 children not receiving the vaccine. Consistent with vaccines delivered over the age of 1 year, coverage of the fourth malaria dose was low. Vaccine uptake, service access and dropout rates for malaria vaccines require constant monitoring and intervention to ensure maximum protection is conferred.

Distribution of Hepatitis B prevention services in Wakiso District, Central Uganda.

Hepatitis B Virus (HBV) infection remains a significant global public health challenge especially in low-and-middle income countries. Although there are significant global and national efforts to control Hepatitis B, equitable distribution and access to prevention services such as testing and vaccination remains a challenge. Efforts to increase access are hindered by inadequate evidence on the availability and distribution of HBV services. This cross-sectional study aimed at generating evidence of the distribution of HBV prevention services in Wakiso District, Uganda. A total of 55 healthcare facilities (HCFs) including 4 hospitals, and 51 primary care facilities were surveyed. Data were collected using an electronic structured questionnaire and analysed using STATA 14.0. A chi-square test was performed to establish the relationship between HCF characteristics and the availability of hepatitis B services. ArcGIS (version 10.1) was used to generate maps to illustrate the distribution of hepatitis B prevention services. We found out that the hepatitis B vaccine was available in only 27.3% (15) of the HCF, and 60% (33) had testing services. Receipt of the hepatitis B vaccine doses in the last 12 months was associated with the level (p = ≤0.001) and location (p = 0.030) of HCF. Availability of the hepatitis B vaccine at the time of the survey was associated with the level (p = 0.002) and location (p = 0.010) of HCF. The availability of hepatitis B testing services was associated with the level (p = 0.031), ownership (p≤0.001) and location (p = 0.010) of HCF. HCFs offering vaccination and testing services were mostly in urban areas, and close to Kampala, Uganda's capital. Based on this study, hepatitis B prevention services were sub-optimal across all HCF levels, locations, and ownership. There is a need to extend hepatitis B prevention services to rural, public and private-not-for-profit HCFs.

Pertussis outbreak investigation in south Gondar zone, Northwest, Ethiopia

Aims: Pertussis, also known as whooping cough, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. Though vaccines are the most successful and cost-effective way of preventing pertussis, the outbreak of pertussis is still high in the Amhara region. The study aimed to investigate the pertussis infection in Simada district, North West Ethiopia, 2021. Methods: A community-based active surveillance was conducted in the Simada district from December 3/2020 to January 05/2021. A total of 43 cases was identified using the modified Centers for Disease Control and Prevention (CDC) pertussis diagnosis criteria and line lists. The collected data were entered into the Epi-data (Epidemiological Data) version 3.1 and analyzed using R version 4.03 software and descriptive statistics computed. Results: A total of 43 cases were identified with an overall attack rate of 7.1 per 1000 population. All complicated cases occurred in children under four years of age. The most affected groups were females. There was an interrupted routine immunization service in the cluster at the health post-level to associate vaccination coverage with the occurrence of a pertussis outbreak. The outbreak was reported after three days of the occurrence of more transmission from person to person. Conclusion: The outbreak of pertussis was high and the children were suffering. It is advisable to build capacity, consolidate routine vaccination services, and enhancing the vaccine cold chain management system, surveillance and early treatment of infected patients to control the expansion of pertussis.

Investigation of Home Health Care Patients' Attitudes and Behaviors Against COVID-19 Vaccines

Introduction: We aimed to find the attitudes and behaviours of home health patients towards COVID-19 vaccines, the rates of vaccination, and the reasons for not getting the vaccine. Method: This descriptive and cross-sectional study was conducted with patients who were accepted to join this research and reachable (N:1012) registered in the Home Health Services unit of a training and research hospital in Izmir between December 2021 and March 2022. The study was conducted by contacting the patient or their relatives by phone, visiting them at home, or applying a questionnaire during their application to the polyclinic unit. Questionnaire; It consists of 15 questions that help us learn the patient's sociodemographic characteristics, current health status, and attitudes and behaviors about vaccines. The prepared database has entered the IBMSPSS 24.0 program. Results: The mean age of the participants in the study was 77.4±16.2 years. 68.6% of the participants were women. 63% of them are fully dependent on the bed. In our study, the rate of patients receiving the COVID-19 vaccine was 83.2%. 91.1% of the vaccinated individuals had the Sinovac vaccine, which was first provided to the patients. 66.1% of vaccinated individuals have accessed vaccination services at home. Those who have higher educational levels have higher vaccination rates. Those who received information from their family doctor were significantly more likely to be vaccinated. Participants most frequently stated that they were not vaccinated because they thought they did not have enough information about COVID-19 vaccines and were worried about possible side effects. Conclusion: According to this study, patients registered with Home Care Unit have a high rate of getting the COVID-19 vaccine.

Magnitude and distribution of cancer in a private teaching hospital, Bahir Dar, Ethiopia

Background Cancer affects every country in the world irrespective of their developmental status. Since most studies have been performed primarily in public referral hospitals, this study aimed to describe the prevalence and histopathological patterns of cancer in a private setting. Cancer is one of the most common noncommunicable diseases, and regional variations in cancer incidence are responsible for the majority of deaths. The main objective of this study was to determine the magnitude and distribution of cancer among patients at GAMBY Teaching General Hospital. Methods This retrospective study included a total of 4320 histopathological examination results recorded from January 1, 2016, to December 30, 2020. Descriptive statistics were used to present the results. The SPSS version 26 computer software package was used for data analysis. Results A total of 4320 examinations revealed that 895 (20.7%) patients had confirmed malignancies. A total of 655 (73.2%) of the cases were females, with a male-to-female ratio of 1:2.73. The mean age of all the confirmed cases was 49.3±14.9 years. The age range was between 2 and 85 years. The mean ages of the females and males were 47.67±13.36 and 53.19±17.93 years, respectively. The most common cancers were cervical cancer (31.9%), breast cancer (12.7%), and skin cancer (11.6%). The top five cancers in the female patients were cervical, breast, nonmelanomatous skin, thyroid, and lymph node malignancies. Among male patients’ nonmelanomatous skin cancer, lymph node malignancies, colorectal cancer, bone and soft tissue cancer, and breast cancer constituted the top five cancers. Cancer involving the lung, eye and pancreas is the least common cancer. Conclusions The results indicate that the pattern of cancer varies significantly from the global pattern of cancer distribution, as do studies in Africa and other regions of the country. The expansion of oncologic services, health education, screening and vaccination services, advancements in diagnostic modalities, and the involvement of the private sector in the management and care of cancer patients are very important health system focuses and forces policy makers to allocate resources accordingly. This study provided good insight into this pattern, but a wider multicenter survey and evaluation of sociodemographic and environmental factors are needed to assess the reasons for the variations.

Is It Not The Right Time To Consider Trivalent Mumps Vaccine (MMR) In The National Immunization Programme of Nepal? If Not Now, Then When?

Vaccination is the process of administration of a vaccine to help the immune system develop immunity from a disease resulting in reduction of child mortality, morbidity and disability in vaccine preventable diseases. Nepal started its pilot vaccination program in 1979 (2034 B.S) and after a decade (1989), the Expanded Program on Immunization (EPI) was followed to the whole country with the aim of universal vaccination in children. National immunization programme (NIP) provides vaccination services free of cost to the children living in marginalized communities and geographical regions difficult to reach through outreach sessions. Although many more vaccines have been added to the NIP of Nepal since then, vaccination against mumps is still missing. Nepalese children are being vaccinated with MR vaccine (measles and rubella) at 9 completed months and a booster at 15 months in spite of MMR (measles, mumps and rubella) vaccine. The time to re-think and consider mumps vaccine (MMR) in the immunization schedule of Nepal by the government of Nepal has arrived now. Including MMR vaccine in the national immunization schedule would ultimately result in the reduction of the outbreaks and associated morbidity that occur annually along with the economic benefits.

Influence of access to extension services on milk productivity among smallholder dairy farmers in Njoro Sub-County, Nakuru County, Kenya

Inaccessibility to extension services by smallholder farmers remains one of the impediments to achieving high agricultural productivity and food security. Extension services play a critical role in information dissemination that can avert food insecurity and increase smallholder dairy farmers' incomes. However, access to extension services remains a significant challenge in developing countries. This study investigated the influence of access to extension services on milk productivity among smallholder dairy farmers in Njoro Sub-County, Nakuru County, Kenya. The study's target and accessible population was 17,000 smallholder dairy farmers. The study used simple random and proportionate sampling techniques to select study farmers. Nassiuma's formula generated a sample of 120 smallholder dairy farmers. The hypothesis underwent testing using simple linear regression. The regression results found a statistically significant influence between access to extension services and milk productivity at a 5% significance level (p < 0.05). Findings show that most smallholder dairy farmers accessed extension services through television, radio, neighbours, and friends. In contrast, the top animal husbandry practices that most farmers were interested in were parasite and disease control, breed selection, and feed preparation. The Government of Kenya mainly provided vaccination services, while the other veterinary services, including deworming, pregnancy and disease diagnosis, breed selection, and treatment, were dominated by private entities. The Government of Kenya should improve smallholder dairy farmers' access to extension services. The study recommends channeling agricultural information in all possible vernacular languages and Kiswahili, the national language, via television and radio platforms to reach all smallholder dairy cow farmers. Additionally, more emphasis should be on the importance of appropriate milking techniques and record-keeping among smallholder dairy farmers to help monitor their animals' health, feeding, breeding, and milk productivity.

COLLABORATIVE GOVERNANCE DI MASA KRISIS: UPAYA PERCEPATAN PELAYANAN VAKSINASI COVID-19 DI PROVINSI DAERAH ISTIMEWA YOGYAKARTA

The purpose of this study is to identify and discuss collaborative governance during times of crisis at the local level by taking case studies of accelerated COVID-19 vaccination services in the Province of the Special Region of Yogyakarta (DIY). Collaborative governance of accelerating COVID-19 vaccination in DIY involves government actors, both central and regional governments, entrepreneurs including corporations on various scales from international, regional, national and local as well as business associations, as well as civil society with a membership base that varies from professional expertise to religion. This study used a qualitative method with data collection carried out through a desk study. Collaborative governance allows the exchange of resources between actors that are cross-sectoral and the flexibility of mobility between actors to accelerate people's access to vaccines as a public good. Collaborative governance is a potential solution for building and developing a better service system for public needs.

ADOPTION OF DIGITAL VACCINATION SERVICES FROM A LITERALLY PROFESSIONAL VIEW: A COMMENTARY ON “IT IS THE CLICK FLOW, NOT THE VALUE” FROM A HEALTH CARE WORKERS AND AGILITY PERSPECTIVE

The interplay of innovation and health care workers (HCWs) focusing on vaccination were key in mastering the COVID-19 pandemic, which led to serious health, social and economic problems worldwide (Holzmann-Littig et al., 2022). Apart from optimizing traditional approaches to contain the pandemic outbreak, such as hygiene rules, testing regime, contact tracing, quarantine (Saw et al., 2021), new mRNA-vaccines and innovative digital technologies such as vaccination platforms were introduced (Kis et al., 2021). In this context, the study “Adoption of Digital Vaccination Services: It Is the Click Flow, Not the Value—An Empirical Analysis of the Vaccination Management of the COVID-19 Pandemic in Germany” (Alscher et al., 2023) focused on the digital management of vaccination processes. Existing adoption theories and acceptance models from consumer market research were adapted to the public health sector and formed into a digital platform framework for policy makers and pandemic managers to manage public health services, such as vaccination offerings. Based on a survey in Germany’s federal state with the highest vaccination rate, results showed that (1) the usability barrier is the most important barrier which harms adoption, whereas the most emphasized value barrier does not play a dominant role in contrast to consumer market research. By analyzing the three digital platform configuration areas Communication, Data Management, Personalization, (2) Personalization stood out as the most important factor for managing the usability barrier by optimizing the best click flow on the digital health platform to address the needs, preferences, and situation of the citizens as users. &#x0D; “Yet, the endgame of the pandemic is not vaccines; it is vaccination” (Dai &amp; Song, 2021, p. 455) and thus, the fast implementation of the vaccination by health care workers (HCWs) are critical premises and antecedents for a successful vaccination adoption (Scroggins et al., 2023). In this direction, we want to highlight the role of professional HCWs in the adoption of digital vaccination services: First, their own adoption of the vaccination as a role model and their position as first priority vaccination group, and second, their contribution in adapting their service to the new pandemic situation from an agility point of view.

Underlying Factors Associated with COVID-19 Vaccine Hesitancy and Refusal among the Iranian Population: A Qualitative Content Analysis

Background: COVID-19 vaccination is one of the most successful ways to control the ongoing pandemic and prevent severe diseases, hospitalization, and death. Current evidence suggests COVID-19 vaccine hesitancy (a delay in accepting or rejecting the vaccine despite the availability of vaccination services) is a barrier to successful vaccination programs worldwide. This study aimed to explore the underlying factors associated with COVID-19 vaccine hesitancy among the Iranian population. Methods: This qualitative content analysis study was conducted using in-depth semi-structured interviews. A total of 32 Iranian participants with diverse ethnicity, language, age, and gender were selected through purposive sampling. Interviews were analyzed using Graneheim and Lundman’s qualitative content analysis method. MAXQDA software was used for data analysis. Results: Three themes and eight subthemes emerged from the qualitative interviews. Individual underlying factors included knowledge, beliefs, and the fear of COVID-19 infection. Social factors included social media, the health system, and governance. Institutional factors included vaccine opponents and health experts that fueled COVID-19 vaccine hesitancy and refusal among the participants. Conclusion: Poor knowledge, misbelief, and fear were the most commonly reported causes of vaccine hesitancy and refusal among Iranians. Therefore, targeted interventions are recommended to address misinformation among the Iranian population.

Reducing Vaccination Disparities During a National Emergency Response: The US Mpox Vaccine Equity Pilot Program.

In response to the first reported mpox cases in May 2022, the US government implemented plans to bring testing, treatment, and vaccines to communities disproportionately affected by mpox-including the population of men who have sex with men (MSM) and Black/African American and Hispanic/Latino men, 2 subpopulations experiencing vaccination disparities. We describe the development and implementation of the US Mpox Vaccine Equity Pilot Program (MVEPP), characteristics of completed vaccination projects, and challenges that occurred. We also discuss opportunities for reducing vaccination disparities in future outbreaks. To address reported vaccination disparities, the US government launched MVEPP in 2 phases. Phase 1 centered around public events attended by large numbers of gay, bisexual, and other MSM, such as Pride festivals. Phase 2 asked health departments to propose mpox vaccination projects specifically aimed at reducing or eliminating racial/ethnic and other demographic disparities in mpox vaccination. MVEPP received 35 vaccination project proposals. We analyzed data from 22 completed projects that resulted in 25 675 doses of JYNNEOS administered. We note 3 innovative strategies that were implemented in several projects: direct collaboration with organizations providing services to MSM and transgender women; implementation of MVEPP projects in unique nonclinical community settings and at venues frequented by MSM and transgender women; and offering an array of services as part of mpox vaccination projects, rather than offering only mpox vaccination. MVEPP highlighted the importance of recognizing and working to eliminate racial/ethnic and other disparities in access to medical countermeasures during a public health emergency. Jurisdictions developed and implemented innovative strategies to bring mpox vaccination and related services to communities disproportionately affected by mpox-including MSM and the subpopulations of Black/African American and Hispanic/Latino MSM. Lessons learned from MVEPP may inform efforts to reduce disparities during future public health responses.

Assessment of Maternal Knowledge, Attitudes, and Practices Regarding Breastfeeding at Kampala International Teaching Hospital: A Study Spanning May 2021 to July 2022

This study aimed to evaluate the knowledge, attitudes, and practices regarding exclusive breastfeeding (EBF) among mothers attending vaccination and pediatric inpatient services at Kampala International Teaching Hospital. Additionally, it sought to identify influential variables associated with exclusive breastfeeding practices in this cohort. Employing a descriptive cross-sectional survey, 187 respondents were randomly selected. Data collection involved the utilization of a questionnaire, and analysis comprised descriptive statistics focusing on frequency and percentages. The study revealed significant findings: 71.2% of respondents were knowledgeable about the accurate definition and duration of exclusive breastfeeding. Among them, 59.7% exclusively breastfed their infants for the recommended initial six months. Notably, 100% provided colostrum to their babies, recognizing its nutritional and protective benefits, while 87% practiced on-demand breastfeeding. Furthermore, the study highlighted a positive attitude toward exclusive breastfeeding, with 86.6% acknowledging breast milk's adequacy for infants during the first six months and recognizing the mutual benefits of EBF for both infants and mothers. Regarding weaning, 51% of respondents initiated it between 15 and 18 months, while 41% did so between 19 and 24 months. The findings underscored a commendable level of breastfeeding knowledge among respondents, with a majority adhering to recommended EBF practices. Additionally, the overwhelmingly favorable attitude toward exclusive breastfeeding signifies its perceived advantages for both infants and mothers. This study emphasizes the importance of continued support and education to reinforce positive breastfeeding practices among mothers attending Kampala International Teaching Hospital. Keywords: Exclusive breastfeeding, Babies, Newborn, Mothers, Weaned.

Development and Implementation of Workshops to Optimize the Delivery of Vaccination Services in Community Pharmacies: Thinking beyond COVID-19.

Vaccines are widely recognized as the most economically efficient strategy to combat infectious diseases. Community pharmacists, being highly accessible healthcare professionals, have the potential to significantly contribute to the promotion and facilitation of vaccination uptake. In Canada, the jurisdiction of healthcare falls under provincial legislation, leading to variations in the extent of pharmacist practice throughout the country. While some pharmacists in Canada already functioned as immunizers, Québec pharmacists gained the authority to prescribe and administer vaccines in March 2020 amidst the COVID-19 pandemic. Our workshop aimed to equip pharmacists in Québec with the necessary guidance to optimize vaccinations, emphasizing the importance of maintaining and expanding immunization services beyond influenza and COVID-19 vaccines in the future. During the workshop, pharmacists had the opportunity to exchange valuable insights and best practices regarding workflow optimization, identifying areas for improvement in competency, effectively reaching vulnerable population groups, and integrating allied team members into their practice. Participants were also asked to develop a plan of action to help implement practice change beyond the workshop. Interactive workshops centered around discussions like these serve as catalysts for advancing the pharmacy profession, uniting professionals with a collective aim of enhancing patient care.

Caregivers' understanding of childhood influenza vaccination during the epidemic in China. A mixed-methods study.

Influenza vaccination uptake among young children has been poor in China, but it is unclear how it changed during the COVID-19. This study aimed to investigate the uptake status and reasons of childhood influenza vaccination during the pandemic in China. A mixed-methods study combining a questionnaire survey and semi-structured interviews was conducted in Anhui, Shaanxi, and Guangdong provinces between September and November 2021. 2081 caregivers completed the valid questionnaire. 38 caregivers participated in interviews, and data were analyzed thematically, using deductive and inductive coding. A total of 2081 caregivers completed the valid questionnaire, and 38 caregivers participated in interviews. Among the caregivers, a total of 1796 were in the age group for high-risk groups in the 2019-2020 flu season, and 46.10% reported that their children received influenza vaccination in the 2019-2020 flu season; 43.63% said that they vaccinated their children against influenza in the 2020-2021 flu season. Many caregivers indicated that the adoption of nonpharmacologic interventions (NPIs) during COVID-19 reduced the risk of influenza infection for children. Most caregivers consider the severity of influenza to be low, and some confused the common cold with influenza. Meanwhile, some caregivers lack confidence in the vaccine's effectiveness and importance. They thought that vaccines are not effective in preventing the constantly mutating virus. Despite clear perceptions about the severity of influenza and the effectiveness of the vaccine, we found that most caregivers did not receive any relevant medical information, and the communication about vaccines between caregivers and professional information sources, such as healthcare workers, is inadequate. Hence, caregivers have no scientific evidence to back up their perceptions. In terms of access to vaccination service, caregivers reported conflicts between time of vaccination service and their schedule, and the need for vaccine prices to be reduced. Targeted interventions are needed to address caregivers' lack of risk perception on influenza during COVID-19 and promote communication between caregivers and professional information sources. Extending vaccination service hours and increasing the number of vaccine clinics close to residential areas and expansion of financing sources for self-paid vaccination could facilitate the access to influenza vaccination service.

Satisfaction with vaccination services and its relationship to emotional responses of service users in Lima. LEGADO's quality management model as a public solution to promote citizen emotional well-being during pandemic.

This article analyzes the levels of citizen satisfaction with LEGADO's quality management model service during the first year of vaccination against SARS-CoV-2 in public spaces administered by LEGADO, and its relationship with the user's emotional responses. To this end, a survey study has been developed from July 2021 until March 2022 at 4 moments to citizens (n = 1,697) who attended 3 vaccination locations administered by LEGADO (VIDENA, Complejo VMT and Polideportivo VES). The results show a high level of satisfaction with LEGADO's quality model service, which is associated with a positive emotional balance. Specifically, the elements that have the greatest effect on positive emotions are the cleanliness and facilities' organization and the agility of service. These results are discussed emphasizing the importance of the role of public institutions in developing inclusive quality public services for all citizens. This strategy of public quality model service according to citizens' necessities should result in confidence towards public institutions and socially responsible behavior among citizens through the reduction of social gaps. The research establishes the urgency to promote this model in order to bring legitimacy and confidence to public institutions in Perú.

Racial, Ethnic, and Gender Differences in the Timing of Initiating the HPV Vaccine in the UnitedStates: the Case of Southeast Asian Americans.

Despite the availability of the human papillomavirus (HPV) vaccine, non-Latinx (NL) Southeast Asian Americans have the highest incidence of HPV-associated cervical cancer in the US. Little is known about NL-Southeast Asian Americans' HPV vaccination coverage due to being categorized under the "Asian American" monolith. Therefore, this study uses restricted data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) to disaggregate NL-Southeast Asian Americans and compare this population's age-specific probabilities of initiating HPV vaccinations to two Asian American subgroups (NL-East Asian and NL-South Asian Americans) and NL-White, NL-Black, and Latinx Americans. Multinomial logistic regression models examine the differences in the timing of initiating the HPV vaccine series, late (ages 13-26) or never, relative to on-time vaccination (by age 12). NL-Southeast Asian Americans are significantly more likely to never vaccinate and to vaccinate late than NL-White, NL-Black, and Latinx Americans, relative to on-time vaccination. NL-Southeast Asian American boys/men are significantly more likely to never initiate the HPV vaccine than Latinx boys/men, relative to on-time vaccination. NL-Southeast Asian American girls/women are significantly more likely to never vaccinate and vaccinate late than NL-White, NL-Black, and Latinx girls/women, relative to on-time vaccination. There are significant gender differences in uptake among all racial and ethnic groups, except among NL-Southeast and NL-East Asian Americans. Disaggregated data on NL-Southeast Asian Americans helps scholars and public health officials uncover health disparities and improve health interventions. Targeted HPV vaccine promotion and services for this population are needed to mitigate current and future health disparities and promote health equity.

Low-threshold starts with communication

With the fourth event on the topic of vaccination, ‚Monitor Versorgungsforschung‘ is expanding its view to European best practice approaches on the one hand and to very practical findings from low-threshold vaccination services already existing in Germany, both in pharmacies and in companies as well as in the broad, but so far not very well-known field of activity of the public health service on the other.

Satisfaction among caregivers of beneficiaries with the services provided at the well-baby clinic of a tertiary care hospital, Kolkata

Background: Well-baby clinics (WBC) are health facilities for providing primary care, including immunization services to infants and children. Caregivers’ satisfaction is a vital indicator of the quality of healthcare services provided. Aims and Objectives: This study aims to assess the caregivers’ satisfaction with the services provided at the WBC of a tertiary care hospital in Kolkata, West Bengal and to identify the associated sociodemographic factors. Materials and Methods: A descriptive-type of observational study with a cross-sectional design, was conducted from June to July 2022, using a predesigned pretested and structured schedule, among 106 caregivers of beneficiaries attending WBC. Satisfaction was assessed using 24 items answered on a 5-point Likert scale, ranging from “highly satisfied” to “highly dissatisfied.” Data were tabulated in MS Excel 2021 and analyzed using statistical package for the social sciences v25.0. Bivariate Logistic Regression was performed to examine the association of sociodemographic factors with caregivers’ satisfaction. Results: High satisfaction with the services was observed among 52.8% participants. Least number of caregivers were satisfied with the vaccination services. Caregivers’ gender, mothers’ education and beneficiaries’ gender were found to be statistically significant with their satisfaction. Furthermore, the female caregivers had lower odds of statistically significant high satisfaction than the males. Conclusion: Almost half of the caregivers were less satisfied with the services offered at the WBC, while the least number of caregivers were satisfied with the vaccination services. Extensive research is needed to identify the factors contributing to the satisfaction of caregivers with the services, mainly vaccination.

Impact of the COVID-19 pandemic on routine vaccination services in Shaanxi province, Northwest China: Non-pharmaceutical intervention period and mass COVID-19 vaccination period

ABSTRACT To better understand the impact of COVID-19 epidemic on routine vaccination, a cross-sectional study was carried out during non-pharmaceutical intervention period (2020) and mass COVID-19 vaccination period (2021) in Shaanxi province. Data on NIP (National Immunization Program, Free), nNIP (non-National Immunization Program, Paid), and COVID-19 vaccines inoculated and vaccination clinics were collected. At the beginning of the COVID-19 epidemic, the rate of routine vaccination clinics providing vaccination services was only 20.0%, rabies vaccination clinics was 89.9% and obstetric vaccination clinics was 95.9%. Compared with 2019 (as baseline), NIP vaccines inoculated in 2020 and 2021 decreased by 3.5% and 19.2%, respectively, on the contrary, nNIP vaccines increased by 25.8% and 34.7%, respectively. In 2021, 74.9% of vaccination clinics were involved in mass COVID-19 vaccination, and there was not a significant impact of mass COVID-19 vaccination on the number of other vaccines inoculated. Vaccination coverage of all NIP vaccines was not different from that in previous years. COVID-19 epidemic had a short-term impact on routine vaccination at beginning. The impact of mass COVID-19 vaccination on routine vaccination could even be ignored. The COVID-19 epidemic has once again made people realize the great harm of infectious diseases, and has improved everyone’s willingness to receive routine vaccines.

The Coverage Rate of Superior Native Chicken Vaccination and Factors Determining Farmers' Decision in the Vaccination Program

The Ministry of Agriculture distributed superior native chicken (KUB) through the BEKERJA program, which was followed by vaccination services as a determinant affecting chicken productivity. This study examined the coverage rate of chicken vaccination and the factors that influence farmers' decision to vaccinate their chickens during the BEKERJA program in Indramayu District, West Java Province. Primary data were collected during vaccination, and secondary data on household characteristics were obtained from the Ministry of Social Affairs. Farmers from 1,549 impoverished households who vaccinated or did not vaccinate their chickens were chosen at random in three sub-districts, and monitoring was done from March to September 2019 during the vaccination program. Descriptive analysis was used to determine farmer characteristics and chicken vaccination coverage rate, while logistic regression analysis was used to determine factors influencing farmers' decision to vaccinate their chickens. The coverage rate of chicken vaccination decreased from 88 percent in the first vaccination period to 63 percent in the sixth vaccination period. Farmers refused vaccination because of previous failures, increasing the mortality rate. Furthermore, the likelihood of implementing a chicken vaccination program was significantly higher for households with a large number of chicken populations, livestock farming experience, and larger land size. However, the number of family members had a smaller effect and respondents' age and residence status did not affect vaccination decisions. As a result, a household's understanding of the importance of vaccination, and the required condition of chickens, must be considered for an effective vaccination strategy.