Availability Of Vaccines Research Articles

Influences of HPV disease perceptions, vaccine accessibility, and information exposure on social media on HPV vaccination uptake among 11,678 mothers with daughters aged 9–17 years in China: a cross-sectional study

BackgroundMothers play a crucial role in influencing their daughters’ HPV vaccination decisions. Addressing barriers to receiving HPV vaccination among mothers of girls may achieve two goals in one strike: increasing vaccination coverage among both mothers and their daughters. This study aims to examine the HPV vaccination uptake and its determinants among mothers of girls in China at both the individual and interpersonal levels.MethodsFrom July to October 2023, a cross-sectional online study was conducted to investigate HPV vaccine refusal for daughters aged 9–17 years among 11,678 mothers in Shenzhen, China. A randomized selection method was employed, targeting 11 primary schools and 13 secondary schools in Shenzhen. The research team invited mothers of girls to participate in an anonymous online survey. Multilevel logistic regression models (level 1: schools; level 2: individual participants) were employed to analyze the data.ResultsAmong 11,678 mothers, 41.1% self-reported receiving at least one dose of HPV vaccination. Through multilevel logistic regression analysis, eight items measuring illness representations of HPV, which refers to how people think about HPV, were associated with higher HPV vaccination uptake (AOR: 1.02–1.14). These items included identity (identifying symptoms of HPV), timeline (whether HPV is acute/chronic), negative consequences, personal and treatment control (whether HPV is under volitional control), concern, negative emotions, and coherence (overall understanding of HPV). In addition, participants refusing HPV vaccines for the index daughters (AOR: 0.82, 95%CI: 0.76, 0.89) had lower vaccine uptake. Perceived more difficulties in accessing the 9-valent vaccines (AOR: 1.06, 95%CI: 1.04, 1.08) and more satisfaction with vaccine-related promotional materials (AOR: 1.50, 95%CI: 1.46, 1.54) at the individual level were associated with higher vaccine uptake. At the interpersonal factors, higher frequency of exposure to testimonials given by others about HPV vaccination on social media (AOR: 1.19, 95%CI: 1.14, 1.25) and thoughtful consideration of the veracity of the information (AOR: 1.11, 95%CI: 1.07, 1.16) were correlated with higher HPV vaccination uptake.ConclusionsThese findings offer essential implications for modifying HPV disease perceptions, addressing difficulties in accessing the 9-valent HPV vaccines, and enhancing health communication needs to improve HPV vaccine uptake among mothers of girls.

Factors Influencing Herpes Zoster Vaccine Utilization Among Adults Aged 50 and Above Attending Primary Healthcare Center in Saudi Arabia: A Cross-Sectional Study.

Herpes zoster, or shingles, is a significant health concern for older adults caused by the varicella-zoster virus (VZV) reactivation. The availability of effective herpes zoster vaccines offers a crucial preventive measure to reduce the incidence and severity of this condition. However, the uptake of the available vaccine remains suboptimal, especially among adults aged 50 and above. Understanding the factors that influence vaccine utilization is not only essential for developing strategies to improve vaccination rates but also has the potential to significantly reduce the disease burden. This cross-sectional study aimed to identify factors influencing herpes zoster vaccine utilization among adults aged 50 and above attending primary healthcare centerin Saudi Arabia. Data were collected using a validated questionnaire administered to visitors attending Al-Wazarat Primary Healthcare Center in Riyadh. Descriptive and inferential statistics were employed to analyze the data. A total of 403 participants were included in the study, with 73.7% of participants having heard of the disease, yet only 34.2% had received the vaccine. Vaccine uptake was significantly associated with gender, educational level, and healthcare provider recommendations. Common barriers to vaccination included fear of side effects, lack of perceived susceptibility, concerns about vaccine effectiveness, and access to healthcare facilities. Herpes zoster vaccine utilization among older adults in Saudi Arabia is relatively low despite moderate awareness. Enhancing public education through targeted campaigns and strengthening healthcare provider recommendations are crucial to improving vaccine uptake. Addressing specific barriers and misconceptions is essential to reduce the burden of herpes zoster in this population. The need for future research to explore strategies to overcome these challenges and promote higher vaccination rates is urgent and important.

Unveiling the potency of FDA-approved oxidopamine HBr for cervical cancer regulation and replication proteins.

Cervical Cancer remains a women's health concern worldwide and ranks among the most prevalent cancers, particularly in developing countries. Many women are diagnosed with cervical cancer, with a substantial number succumbing to the disease even after the availability of vaccines and drugs. The tumour microenvironment often exhibits immune evasion, including suppression of T-cell activity and altered cytokine, impacting the efficacy of therapeutic interventions and highlighting the need for treatments to modulate the immune response. Despite efforts to promote HPV vaccination and regular screenings, it causes many deaths, underscoring the urgent need for continued research, healthcare access, and rapid drug development or repurposing. In this study, we identified various proteins involved in cervical cancer cell cycle regulation and DNA replication proteins, performed the multitargeted docking with an FDA-approved library, and identified Oxidopamine HBr as a multitargeted drug. Studies extended with pharmacokinetics and compared with the standard values followed by DFT, which supported the compound as a multitargeted inhibitor. Further, the docked complexes were taken for the interaction fingerprints, and it was identified that there are many 9 polar, 5 hydrophobic, 2 aromatic, and 2 basic residues. We extended our studies for 100ns MD Simulation in water, and the computations explored the deviation and fluctuations under 2Å and many intermolecular interactions; the same trajectory files were used for the MM\GBSA studies. All the studies have supported the Oxidopamine HBr as a cervical cancer multitargeted inhibitor-however, experimental studies are needed before human use.

COVID-19 deaths in dental occupations and other healthcare occupations among U.S. decedents in 2020.

Early studies during the COVID-19 pandemic suggested dental occupations were among the highest risk for exposure to SARs-CoV-2 because of multiple factors increasing exposure, including close proximity to unmasked patients and performance of aerosol-generating procedures. However, to date, few studies have investigated COVID-19 deaths in United States dental occupations, and compared COVID-19 deaths among healthcare occupations. We analyzed 2020 mortality data collected by the National Center for Health Statistics' National Vital Statistics System. Multivariable logistic regression was used to generate odds ratios (ORs) and 95% confidence intervals for COVID-19 as the underlying cause of death in relation to occupation in working-age decedents (≤65 years), after adjusting for age, sex, race/ethnicity, education, and medical conditions associated with severe COVID-19. Dental occupations did not have significantly higher risk for COVID-19 death when compared to all other occupations combined. Among healthcare occupations with frequent, direct patient- or client interactions, LPNs and LVNs, and speech and language pathologists had significantly elevated adjusted ORs for COVID-19 death when compared to dentists, dental hygienists, or dental assistants. Similarly, nurse practitioners had significantly higher ORs for COVID-19 mortality than dentists or dental hygienists, and approached significance when compared to dental assistants. Conversely, massage therapists and other health diagnosing and treating practitioners had significantly lower adjusted ORs for COVID-19 death compared with dental occupations. Our study highlights potential differences in work-related transmission of SARs-CoV-2 and subsequent COVID-19 deaths in healthcare occupations, and furthers a previously limited understanding of COVID-19 deaths in healthcare occupations in 2020, before COVID-19 vaccine availability. Our results indicate that dental occupations were not among the highest, nor lowest risk, healthcare occupations for COVID-19 deaths in 2020, despite their known risks of direct exposure.

Activation of Antiviral Host Responses against Avian Influenza Virus and Remodeling of Gut Microbiota by rLAB Vector Expressing rIL-17A in Chickens.

Low-pathogenic avian influenza virus (LPAIV) remains the most common subtype of type-A influenza virus that causes moderate to severe infection in poultry with significant zoonotic and pandemic potential. Due to high mutability, increasing drug resistance, and limited vaccine availability, the conventional means to prevent intra- or interspecies transmission of AIV is highly challenging. As an alternative to control AIV infections, cytokine-based approaches to augment antiviral host defense have gained significant attention. However, the selective application of cytokines is critical since unregulated expression of cytokines, particularly proinflammatory ones, can cause substantial tissue damage during acute phases of immune responses. Moreover, depending on the type of cytokine and its impact on intestinal microbiota, outcomes of cytokine-gut microflora interaction can have a critical effect on overall host defense against AIV infections. Our recent study demonstrated some prominent roles of chicken IL-17A (ChIL-17A) in regulating antiviral host responses against AIV infection, however, in an in vitro model. For more detailed insights into ChIL-17A function, in the present study, we investigated whether ChIL-17A-meditated elevated antiviral host responses can translate into effective immune protection against AIV infection in an in vivo system. Moreover, considering the role of gut health in fostering innate or local host responses, we further studied the contributory relationships between gut microbiota and host immunity against AIV infection in chickens. For this, we employed a recombinant lactic acid-producing bacterial (LAB) vector, Lactococcus lactis, expressing ChIL-17A and analyzed the in vivo functionality in chickens against an LPAIV (A/H9N2) infection. Our study delineates that mucosal delivery of rL. lactis expressing ChIL-17A triggers proinflammatory signaling cascades and can drive a positive shift in phylum Firmicutes, along with a marked decline in phylum Actinobacteriota and Proteobacteria, favoring effective antiviral host responses against AIV infection in chickens. We propose that ChIL-17A-mediated selective expansion of beneficial gut microbiota might form a healthy microbial community that augments the effective immune protection against AIV infections in chickens.

Mapping the Implementation Determinants of Second Dose Measles Vaccination in the World Health Organization African Region: A Rapid Review.

The second dose of measles-containing vaccines (MCV2) has significant programmatic relevance in the current immunisation landscape because it serves as both an opportunity to reduce measles immunity gaps and strengthen second year of life vaccination platforms. However, MCV2 coverage remains suboptimal across countries in the World Health Organization (WHO) African Region and this puts a significant number of children at risk of morbidity and mortality from measles despite the availability of an effective vaccine. There is an urgent need to strengthen the implementation of MCV2 but this requires a thorough and systematic understanding of contextual factors that influence it. The literature that describes the determinants of implementation of MCV2 in a manner that adequately accounts for the complexity of the implementation context is scarce. Therefore, the purpose of this rapid review was to explore the implementation determinants of MCV2 in the WHO African Region using systems thinking. Literature search in two databases (PubMed and Google Scholar) were conducted. After screening, a total of 17 eligible articles were included in the study. Thematic analysis of extracted data was performed to identify the implementation determinants, after which they were mapped using the Consolidated Framework for Implementation Research (CFIR). A causal loop diagram (CLD) was used to illustrate the linkages between identified determinants. We found 44 implementation determinants across the five CFIR domains, i.e., innovation, outer setting, inner setting, individual, and implementation process. The majority of identified determinants are within the individual domain followed by the inner setting domain. The CLD showed that multiple contingent connections and feedback relationships exist between the identified implementation determinants within and across CFIR domains. The linkages between the implementation determinants revealed three balancing and reinforcing loops each. The findings suggest that implementation determinants of second-dose measles vaccination in the WHO African Region are complex, with multiple interconnections and interdependencies, and this insight should guide subsequent policies. There is an urgent need for further implementation research with embedded CLD in specific settings to inform the design of tailored systemic strategies to improve the implementation effectiveness of MCV2.

Heterogeneous empathic reactions and their associations with adherence and prosocial behaviors during a pandemic

AbstractThe present research utilized the backdrop of the COVID-19 pandemic as a case study to explore the motives driving individuals to adhere to recommended health standards. One month into the first lockdown and eight months before the availability of vaccinations, a large sample of 1,263 individuals completed measures of empathic concern and personal distress in response to a person who contracted the virus. In addition, we measured their COVID-related behaviors, relating to benefitting another person (i.e., donation), the self (i.e., physical hygiene), or both self and other (i.e., physical distancing). Consistent with the Empathy-Altruism Hypothesis (Batson et al., 2015), we found that individuals who experience higher empathic concern, maintain greater physical distance and physical hygiene and act more generously. We further found that individuals who experienced high personal distress were less likely to act generously, albeit more likely to maintain personal hygiene and physical distance. These findings suggest that compliance with health recommendations can be encouraged by eliciting empathic concern or personal distress. Yet, compliance per se is not prosocial behavior. Any intervention aiming to increase prosocial motivation should focus on enhancing empathic concern while minimizing personal distress.

Sociodemographic determinants of HPV vaccine awareness, uptake, and intention among parents of adolescents in France 2021-22

ABSTRACT Human Papillomavirus (HPV) vaccine coverage was <50% in France in 2022 and even lower among socially disadvantaged populations. We aimed to evaluate socio-demographic determinants of HPV vaccine awareness, uptake, and intention among parents of adolescents, and related attitudes and knowledge items. Parents of adolescents attending middle schools across France, who participated in a randomized trial responded to an anonymous baseline survey, conducted between November 2021 and February 2022. We used logistic regression models adjusting for a child’s age and sex to explore sociodemographic determinants (including at-home multilingualism, occupational categories, local deprivation index and urbanity) of HPV vaccine awareness, uptake, and intention. Among the 1889 participants from 61 schools, parents working as factory workers/farmers had significantly lower odds of vaccine awareness compared to executives/professionals, both if they reported (OR = 0.07; 0.03–0.15) or not (OR = 0.20; 0.11–0.36) speaking also another language than French at home. Parents in lower occupational categories with multilingual families were less likely to have the intention to vaccinate their child (OR = 0.19; 0.07–0.56). Recent physician visit or vaccine offer was strong positive determinants of awareness, uptake and intention. A substantial gradient across occupational categories was observed for attitudes and knowledge around HPV vaccine usefulness, safety, and accessibility. This study confirms the disparities on HPV vaccine uptake in France and provides insight into mechanisms of social disparities in HPV vaccine awareness, access and intention.

An Analysis of the Knowledge Among Midwifery Students at Medical University-Pleven Regarding Human Papillomavirus (HPV) and HPV-Associated Diseases.

Background and objective Comprehensive health literacy and prevention have been the key methods to reduce the spread of human papillomavirus (HPV) and HPV-associated diseasedevelopment. Raising awareness among young individuals about the risk factors and the ways to prevent the infection is often the starting point of primary prevention. In light of this, we aimed to assess the awareness ofmidwifery students at Medical University-Pleven about(HPV) and HPV-associated diseases. Material and methods We conducted a survey-based studyamong first-year studentsat Medical University-Pleven in the period spanning January to March 2020, which involved a direct group survey. We initially reached out to 445 students and 284 (63.8%) of them responded; 12 of them were midwifery students. In the period from May through November 2022, the same type of survey was repeated among 75 midwifery students, and 47 (62.7%) responded.A set of classic statistical methods were used to present and analyze the collected quantitative and qualitative data. Theresponses in the questionnaires were reviewed and recoded according to the requirements of the statistical program.The significance of the results, the findings, and the conclusions was set at p<0.05. A comparative analysis was employed to statistically compare the results to present the differences between the groups of traits studied. Data processing was performed using MS Office Excel 2019 and SPSS Statistics v.28 (IBM Corp., Armonk, NY). Results Over half (70.6%) of the first-year midwifery students were aware of the infection caused by HPV. Among them, 10 students (29.4%) were familiar with the risk factors for HPV and HPV-associated diseases, and all of the fourth-year respondents knew about the studied issue.The majority of the respondents - 61.8% of the freshmen and 100% of the fourth-year students- were aware of HPV vaccine availability. Conclusions In the course of their training, the midwifery students at Medical University-Pleven acquired enough knowledge about the risk factors ofHPV-associated diseases and the availability of vaccines to prevent them.

The effect of public tolerance towards corruptive behaviour on healthcare efficiency and equity – The case of the UK's COVID-19 vaccination programme

Over the past four years, the COVID-19 pandemic has caused significant uncertainty, suffering, and economic disruption on a global scale. In response, governments have been under pressure to ensure equitable vaccine access while meeting vaccination targets quickly. These challenging circumstances created opportunities for nepotism and bribery, increasing attention to corruption risks associated with the pandemic response. This study investigates the relationship between public attitudes towards corruptive behaviour and the efficiency and equity of the UK's COVID-19 vaccination programme. It integrates primary data on public tolerance towards corruptive behaviour with secondary data on the efficiency of the vaccination program at the local authority level in England and Scotland. Employing a survival analysis approach, we estimate Cox Proportional Hazards Models to examine the time required to reach vaccination targets. Our findings suggest moderate tolerance towards corruptive behaviour among the British public, with 28% of survey participants considering monetary bribery and 34% considering nepotism/favouritism as acceptable means to secure early vaccination access. Notably, while public tolerance towards corruptive behaviour generally had a negative impact on the efficiency of the local rollout of the vaccination programme, it appeared to have accelerated its rollout in politically aligned local authorities governed by the Conservative and Unionist Party. However, this increase in efficiency seems to have come at the cost of reduced equity in vaccine distribution. These findings suggest a trade-off between efficiency and equity in vaccine distribution during public health crises, emphasising the need for balanced health policies that ensure fair and effective distribution of vaccines in the future.

Ultrafast and highly sensitive detection of SARS-CoV-2 spike protein by field-effect transistor graphene-based biosensors

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), etiological agent for the coronavirus disease 2019 (COVID-19), has resulted in over 775 million global infections. Early diagnosis remains pivotal for effective epidemiological surveillance despite the availability of vaccines. Antigen-based assays are advantageous for early COVID-19 detection due to their simplicity, cost-effectiveness, and suitability for point-of-care testing (PoCT). This study introduces a graphene field-effect transistor-based biosensor designed for high sensitivity and rapid response to the SARS-CoV-2 spike protein. By functionalizing graphene with monoclonal antibodies and applying short-duration gate voltage pulses, we achieve selective detection of the viral spike protein in human serum within 100 µs and at concentrations as low as 1 fg ml−1, equivalent to 8 antigen molecules per µl of blood. Furthermore, the biosensor estimates spike protein concentrations in serum from COVID-19 patients. Our platform demonstrates potential for next-generation PoCT antigen assays, promising fast and sensitive diagnostics for COVID-19 and other infectious diseases.

Phenotypic and molecular characterization of Streptococcus pneumoniae serotype 3 isolates from blood and respiratory samples in Canada: CANWARD 2007-21.

Lower respiratory infections and invasive disease caused by Streptococcus pneumoniae serotype 3 remain major clinical challenges around the world, despite widespread availability of updated vaccines. As part of CANWARD, antimicrobial susceptibility testing and serotyping were performed on all S. pneumoniae isolates from 2007 to 2021. A subset of 226/264 (85.6%) serotype 3 isolates were selected for WGS to determine sequence type (ST)/clonal cluster (CC) and correspondence of antimicrobial resistance determinants (erm, mefAE, tetM, cat, folA, folP) with resistance phenotype. Of the 3,039 S. pneumoniae isolates obtained from 2007 to 2021, 8.7% (n = 264) were serotype 3, with 64.0% of respiratory origin and 36.0% from blood. Of 226 sequenced serotype 3 isolates, 184 (81.4%) were ST180 (GPSC12). The proportion of ST8561 (single locus variant of ST180) increased from 7.2% to 16.6% during the study period. An increasing proportion of serotype 3 isolates had phenotypic resistance (P = 0.0007) and genetic resistance determinants (P = 0.004), comparing 2017-21 to 2007-11, largely due to a recently expanded ST180 clade with cat, tetM and mef determinants. S. pneumoniae serotype 3 from GPSC12 continues to dominate throughout Canada, with an increase in the proportion of ST8561. The proportion of serotype 3 isolates that are phenotypically resistant and with genetic resistance determinants is increasing over time, reflecting a global increase in GPSC12 genotypes with known resistance determinants. Phylogenomic characterization of isolates collected over time and from around the world may facilitate improved treatment and enhanced prevention strategies, including new vaccines with activity against S. pneumoniae serotype 3.

A Dynamic Prognostic Model for Identifying Vulnerable COVID-19 Patients at High Risk of Rapid Deterioration.

We aimed to validate and, if performance was unsatisfactory, update the previously published prognostic model to predict clinical deterioration in patients hospitalized for COVID-19, using data following vaccine availability. Using electronic health records of patients ≥18 years, with laboratory-confirmed COVID-19, from a large care-delivery network in Massachusetts, USA, from March 2020 to November 2021, we tested the performance of the previously developed prediction model and updated the prediction model by incorporating data after availability of COVID-19 vaccines. We randomly divided data into development (70%) and validation (30%) cohorts. We built a model predicting worsening in a published severity scale in 24 h by LASSO regression and evaluated performance by c-statistic and Brier score. Our study cohort consisted of 8185 patients (Development: 5730 patients [mean age: 62; 44% female] and Validation: 2455 patients [mean age: 62; 45% female]). The previously published model had suboptimal performance using data after November 2020 (N = 4973, c-statistic = 0.60. Brier score = 0.11). After retraining with the new data, the updated model included 38 predictors including 18 changing biomarkers. Patients hospitalized after Jun 1st, 2021 (when COVID-19 vaccines became widely available in Massachusetts) were younger and had fewer comorbidities than those hospitalized before. The c-statistic and Brier score were 0.77 and 0.13 in the development cohort, and 0.73 and 0.14 in the validation cohort. The characteristics of patients hospitalized for COVID-19 differed substantially over time. We developed a new dynamic model for rapid progression with satisfactory performance in the validation set.

Identifying psychological predictors of SARS-CoV-2 vaccination: A machine learning study

BackgroundMajor barriers to addressing SARS-CoV-2 vaccine hesitancy include limited knowledge of what causes delay/refusal of SARS-CoV-2 vaccination and limited ability to predict who will remain unvaccinated over significant time periods despite vaccine availability. The present study begins to address these barriers by developing a machine learning model that prospectively predicts who will persist in not vaccinating against SARS-CoV-2. MethodUnvaccinated individuals (n = 325) who completed a baseline survey were followed over the six-month period when vaccines against SARS-CoV-2 were first widely available (April–October 2021). A random forest model was used to predict who would remain unvaccinated against SARS-CoV-2 from their baseline measures, including demographic information (e.g., age), medical history (e.g., of influenza vaccination), Health-Belief Model constructs (e.g., perceived vaccine dangerousness), conspiracist ideation, and task-based metrics of vulnerability to conspiracist ideation (e.g., tendency toward illusory pattern perception). ResultsThe resulting model significantly predicted vaccination status (AUC-PR = 0.77, 95%CI [0.56 0.90]). At the optimal probability threshold determined by the Generalized Threshold Shifting Protocol, the model was moderately precise (0.83) when identifying individuals who remained unvaccinated (n = 80), and had a very low rate (0.04) of false-positives (incorrectly suggesting that individuals remained unvaccinated). Permutational importance tests suggested that baseline SARS-CoV-2 vaccine intentions conveyed the most information about future SARS-CoV-2 vaccination status. Conspiracist ideation was the second most informative predictor, suggesting that misinformation influences vaccination behavior. Other important predictors included perceived vaccine dangerousness, as expected under the Health Belief Model, and influenza vaccination history. ConclusionsThe model we developed can accurately and prospectively identify individuals who remain unvaccinated against SARS-CoV-2. It could therefore facilitate empirically-informed allocation of interventions that encourage vaccine uptake. The predictive value of conspiracist ideation, perceived vaccine dangerousness, and vaccine intentions in our model is consistent with potential causal relations between these variables and SARS-CoV-2 vaccine uptake.

How did New Zealanders decide to get vaccinated against COVID-19? Developing a novel comprehensive model of vaccination intention

ABSTRACT This research introduces and validates the Comprehensive Model of Vaccination Intention (CMVI) to offer a holistic understanding of COVID-19 vaccination uptake in New Zealand. The CMVI excels by presenting a highly explanatory model, incorporating trust in the government's vaccination policy along with and a spectrum of social, cognitive, contextual, and affective variables from theories of Interpersonal Behavior, Planned Behavior, and Health Belief Model. A nationally representative sample of 993 participants was analyzed using confirmatory factor analysis and structural equation modeling. The findings underscore the positive impact of subjective norms and societal perceptions of vaccination, attitude toward vaccination, trust in government, and vaccination habits on COVID-19 vaccination intention. This study highlights the importance of normalizing vaccination to boost intention and shows how emotions shape attitudes. It also finds that better vaccine accessibility and trust in the government lower perceived costs and raise perceived benefits, improving overall attitude and strengthening vaccination intention.

Spatial clusters and social inequities in COVID-19 vaccine coverage among children in Brazil.

This study examined the spatial distribution and social inequalities in COVID-19 vaccine coverage among children aged 5-11 in Brazil. First and second dose vaccine coverage was calculated for all Brazilian municipalities and analyzed by geographic region and deciles based on human development index (HDI-M) and expected years of schooling at 18 years of age. Multilevel models were used to determine the variance partition coefficient, and bivariate local Moran's I statistic was used to assess spatial association. Results showed significant differences in vaccine coverage rates among Brazilian municipalities, with lower coverage in the North and Midwest regions. Municipalities with lower HDI and expected years of schooling had consistently lower vaccine coverage rates. Bivariate clustering analysis identified extensive concentrations of municipalities in the Northern and Northeastern regions with low vaccine coverage and low human development, while some clusters of municipalities in the Southeast and South regions with low coverage were located in areas with high HDI-M. These findings highlight the persistent municipal-level inequalities in vaccine coverage among children in Brazil and the need for targeted interventions to improve vaccine access and coverage in underserved areas.

Assessment Of Knowledge And Practices Of Influenza And Pneumococcal Vaccination Among Type 1 And Type 2 Diabetes Patients In Bewal International Hospital

Patients with diabetes have high risk of developing pneumococcal and influenza infections and are advised to take immunization for prevention against the disease. Objective: To determine the level of awareness and immunization behaviors for influenza and pneumonia among patients with type 1 and type 2 diabetes received treatment at Bewal International Hospital, Gujar Khan. Methods: This cross-sectional study was performed at the diabetic clinic of Bewal International Hospital, Gujar Khan, from June 2023 to August 2023. A total of 200 patients with diabetes were included in the study. Socio-demographic details were noted on a pre-structured questionnaire. Questions about knowledge and practices of vaccination particularly influenza and pneumococcal were asked and responses were noted. Results: The mean age of the patients was 47.0 ± 1.18 years. 193 (96.5%) had poor knowledge regarding influenza and pneumococcal infections and their vaccines. An alarming 99% of the people did not have any clue about any vaccination against pneumococcal and influenza infection in patients with diabetes. Similarly, only 1.0% of patients had good practices regarding these vaccinations. Conclusions: The knowledge and practice of influenza and pneumococcal vaccination in patients with diabetes is drastically low in the study population. The health care providers should educate the patients and the government should take concrete steps towards education and improvement of the socioeconomic condition of people along with cost-effectiveness and availability of vaccines for every individual

Relative vaccine effectiveness of ChAdOx1/AZD1222 vaccines as booster dose via intradermal injection with a one-fifth dose compared with the intramuscular injection in the prevention of SAR-CoV-2 infections in Phuket: A retrospective cohort study

ObjectivesThis study assessed the real-world relative vaccine effectiveness of the ChAdOx1/AZD1222 vaccine given intradermally at one-fifth dose compared to the standard intramuscular injection, following the completion of 2 doses of CoronaVac, due to limited vaccine availability in Thailand during the Coronavirus disease 2019 (COVID-19) pandemic. MethodThis retrospective cohort study used 138,264 records from Vachira Phuket Hospital, Phuket, Thailand. The records were divided into 2 groups: 49,387 recipients received one-fifth doses via intradermal injections, and 88,877 recipients received standard-dose intramuscular injections from September 14 to October 3, 2021, with follow-up until December 31, 2021. Relative vaccine effectiveness for the cohorts was estimated using Cox regression, adjusting for demographic and clinical risk factors. ResultsThe adjusted hazard ratio between the intradermal and intramuscular groups was 0.88 (95% Confidence Interval 0.76-1.02, P = 0.09), indicating a nonsignificant protective factor for the intradermal group. Further stratified analysis revealed no significant difference between the 2 groups. The 21 and 28-day postvaccination periods minimized the possibility of confounding due to differences in the cohorts’ timeframes. ConclusionA booster dose of ChAdOx1/AZD1222 given intradermally at one-fifth dose did not show a significant difference compared to the standard intramuscular injection.

Epidemiology, Natural History, and Outcome of Chronic Hepatitis B in Children

Abstract Hepatitis B virus (HBV) infection is a global epidemic whose prevention and control among children warrant significant attention. Despite the availability of effective vaccines, the disease continues to affect millions of children worldwide, underscoring the need for a comprehensive understanding of its epidemiology and natural history in this vulnerable population. While research on HBV in adults has advanced considerably, the natural history of HBV infection in children remains less well-defined and may differ from adult studies due to unique immunological and physiological characteristics. This article reviews the epidemiological characteristics of HBV infection in children worldwide and summarizes the research progress on the natural outcomes of children with chronic HBV infection. Furthermore, the necessity of this review stems from the critical role that early detection, monitoring, and timely intervention play in mitigating the long-term consequences of chronic hepatitis B (CHB) in children. By synthesizing current evidence and identifying knowledge gaps, we hope to inform clinical practice, guide future research directions, and ultimately improve the health outcomes of children living with HBV. In doing so, this review article offers a valuable reference for healthcare providers, researchers, and policymakers working to combat the global challenge of HBV infection among children. The aim is to provide a relevant reference for the monitoring, screening, diagnosis, and treatment of children with CHB.

Analyzing Google COVID-19 Vaccine Intent Search Trends and Vaccine Readiness in the United States: Panel Data Study.

Factors such as anxiety, worry, and perceptions of insufficient knowledge about a topic motivate individuals to seek web-based health information to guide their health-related decision-making. These factors converged during the COVID-19 pandemic and were linked to COVID-19 vaccination decision-making. While research shows that web-based search relevant to COVID-19 was associated with subsequent vaccine uptake, less is known about COVID-19 vaccine intent search (which assesses vaccine availability, accessibility, and eligibility) as a signal of vaccine readiness. To increase knowledge about vaccine intent search as a signal of vaccine readiness, we investigated the relationship between COVID-19 vaccine readiness and COVID-19 vaccine intent relative search volume on Google. We compiled panel data from several data sources in all US counties between January 2021 and April 2023, a time during which those with primary COVID-19 vaccinations increased from <57,000 to >230 million adults. We estimated a random effects generalized least squares regression model with time-fixed effects to assess the relationship between county-level COVID-19 vaccine readiness and COVID-19 vaccine intent relative search volume. We controlled for health care capacity, per capita COVID-19 cases and vaccination doses administered, and sociodemographic indicators. The county-level proportions of unvaccinated adults who reported that they would wait and see before getting a COVID-19 vaccine were positively associated with COVID-19 vaccine intent relative search volume (β=9.123; Z=3.59; P<.001). The county-level proportions of vaccine-enthusiast adults, adults who indicated they were either already vaccinated with a primary COVID-19 vaccine series or planned to complete the vaccine series soon, were negatively associated with COVID-19 vaccine intent relative search volume (β=-10.232; Z=-7.94; P<.001). However, vaccine intent search was higher in counties with high proportions of people who decided to wait and see and lower in counties with high proportions of vaccine enthusiasts. During this period of steep increase in COVID-19 vaccination, web-based search may have signaled differences in county-level COVID-19 vaccine readiness. More vaccine intent searches occurred in high wait-and-see counties, whereas fewer vaccine intent searches occurred in high vaccine-enthusiast counties. Considering previous research that identified a relationship between vaccine intent search and subsequent vaccine uptake, these findings suggest that vaccine intent search aligned with people's transition from the wait-and-see stage to the vaccine-enthusiast stage. The findings also suggest that web-based search trends may signal localized changes in information seeking and decision-making antecedent to vaccine uptake. Changes in web-based search trends illuminate opportunities for governments and other organizations to strategically allocate resources to increase vaccine uptake. Resource use is part of the larger public policy decisions that influence vaccine uptake, such as efforts to educate the public during evolving public health crises, including future pandemics.