Benefits Of Vaccination Research Articles

Clinical and immunological benefits of full primary COVID-19 vaccination in individuals with SARS-CoV-2 breakthrough infections: A prospective cohort study in non-hospitalized adults

BackgroundSARS-CoV-2 variants of concern (VOC) may result in breakthrough infections (BTIs) in vaccinated individuals. The aim of this study was to investigate the effects of full primary (two-dose) COVID-19 vaccination with wild-type-based SARS-CoV-2 vaccines on symptoms and immunogenicity of SARS-CoV-2 VOC BTIs. MethodsIn a longitudinal multicenter controlled cohort study in Bavaria, Germany, COVID-19 vaccinated and unvaccinated non-hospitalized individuals were prospectively enrolled within 14 days of a PCR-confirmed SARS-CoV-2 infection. Individuals were visited weekly up to 4 times, performing a structured record of medical data and viral load assessment. SARS-CoV-2-specific antibody response was characterized by anti-spike-(S)- and anti-nucleocapsid-(N)-antibody concentrations, anti-S-IgG avidity and neutralization capacity. ResultsA total of 300 individuals (212 BTIs, 88 non-BTIs) were included with VOC Alpha or Delta SARS-CoV-2 infections. Full primary COVID-19 vaccination provided a significant effectiveness against five symptoms (relative risk reduction): fever (33 %), cough (21 %), dysgeusia (22 %), dizziness (52 %) and nausea/vomiting (48 %). Full primary vaccinated individuals showed significantly higher 50 % inhibitory concentration (IC50) values against the infecting VOC compared to unvaccinated individuals at week 1 (269 vs. 56, respectively), and weeks 5–7 (1,917 vs. 932, respectively) with significantly higher relative anti-S-IgG avidity (78% vs. 27 % at week 4, respectively). ConclusionsFull primary COVID-19 vaccination reduced symptom frequencies in non-hospitalized individuals with BTIs and elicited a more rapid and longer lasting neutralization capacity against the infecting VOC compared to unvaccinated individuals. These results support the recommendation to offer at least full primary vaccination to all adults to reduce disease severity caused by immune escape-variants.

Psychological Impact of COVID-19 and Its Influence on Parental Willingness to Vaccinate Children: A Cross-Sectional Study at a Tertiary Care Hospital in Kolkata.

Background COVID-19 has affected the physical and mental health of people globally, and vaccination is seen as a crucial tool in controlling the pandemic. However, the readiness to vaccinate children remains a concern, particularly in India. Aim The study aimed to investigate the association between the psychological impact of COVID-19 and willingness to vaccinate their children among attendees of the COVID-19 vaccination clinic at Nil Ratan Sircar Medical College, Kolkata. Method The study used an observational, cross-sectional design and collected data from 356 participants between August and September 2022. The COVID-19 Perceived Stress Scale-10 was used to assess participants' psychological impact, and willingness to vaccinate was determined using a survey. Results Approximately 64% (n=227) and 71% (n=253) of the participants exhibited a high level of perceived stress and willingness to vaccinate their children. The vaccine acceptance was significantly associated with perceived stress level and other factors such as family type, presence of chronic illness, and history of acquaintances suffering from COVID-19. Conclusion The study highlights the importance of addressing parental stress and anxiety to enhance vaccination rates among children. To achieve this, population-level awareness of vaccine safety measures and benefits should be raised to alleviate stress and increase vaccine uptake.

Comparisons of Pediatric and Adult SARS-CoV-2-Specific Antibodies up to 6 Months after Infection, Vaccination, or Hybrid Immunity.

Characterization of longitudinal SARS-CoV-2-specific antibody responses in children following infection and vaccination is needed to inform SARS-CoV-2 vaccine policy decisions for children, which may differ from adults. We enrolled individuals at the time of SARS-CoV-2 infection or vaccination for longitudinal serological testing and compared SARS-CoV-2-spike-specific IgG and neutralization activity in children and adults stratified by infection and vaccination status using enzyme-linked immunosorbent and virus neutralization assays. Between June 2020 and December 2022, we collected sera from 669 participants aged 40 days to 55 years, including 330 unvaccinated individuals with laboratory-confirmed SARS-CoV-2 infection, 180 vaccinated SARS-CoV-2-naïve individuals, and 159 vaccinated previously infected individuals. Half (n = 330, 49.3%) were children. SARS-CoV-2-specific IgG and neutralization activity in children < 12 years old in response to infection persisted at higher levels than those of adults through at least 6 months (spike-specific IgG levels, 2.05 [95% CI: 1.4-3.1] times higher than adults; neutralizing activity, median 88.8 vs 75.2%, respectively, p = .04). In addition, all pediatric participants had significantly higher IgG levels compared with adults at 6 months following infection or vaccination, regardless of prior infection status. Vaccine-induced SARS-CoV-2-specific IgG responses in previously infected individuals persisted at higher levels than those from infection alone at 6 months (median AUC, children 5-11 years old, 9115 vs 368; adolescents 3613 vs 475; adults 1956 vs 263, all p < .001). These data demonstrate the robust and persistent immunologic response of SARS-CoV-2 vaccination in children and emphasize the benefit of vaccination after SARS-CoV-2 infection.

1152. Quantifying the health equity related public health impact of national immunisation programmes

Abstract Background COVID-19 highlighted health inequities and the differential impact that vaccination can have on health, with respect to social advantage. While many national immunisation programmes (NIP) consider health equity as a key recommendation criterion, most lack robust frameworks and methods to quantify the impact of healthcare interventions on health equity. Equity strata can be defined by socioeconomic status, race/ethnicity, geographic location, etc… Methods The inclusion of equity in guidelines for vaccination recommendation was assessed. Vaccination policy experts and health economists were consulted on how to best capture the equity-related public health impact (PHI) of NIP. The framework of distributional cost-effectiveness analysis (DCEA) was selected to be further explored. A stepwise approach was applied to account for equity in PHI analysis i.e., the impact on health outcome distribution by equity strata, by estimating the distributional impact (step 1) and HE impact (step 2) of vaccination. A practical application of the method was illustrated through a case study on the meningococcal B (MenB) disease vaccination program in England. Results Impact of vaccination in health equity is formally captured in policy decision making in the US ACIP Evidence to Recommendation framework and the Canadian EEFA (Ethics, Equity Feasibility, Acceptability) Framework. In UK, France, Australia, Spain and Germany it is qualitatively included as part of the deliberative process, while it is not captured in the Netherlands. The DCEA framework was applied for health equity benefits of MenB infant vaccination in UK, with impact assessed across population subgroups categorised using a deprivation index. Nearly 80% of prevented cases were among the three most deprived groups. Additionally, MenB vaccination decreased inequity in the population, with positive net equity impact. Conclusion PHI of vaccination on health equity can be quantified and usefully considered in decision making. The case study demonstrates how the proposed framework could be applied to fully incorporate impact on equity in cost-effectiveness analysis. The health equity impact of vaccination can be captured in health economic evaluation although there is a need to improve the evidence base and its implementation Disclosures Eliana Biundo, PhD, GSK: employee|GSK: Stocks/Bonds Mariia Dronova, PhD, GSK: Grant/Research Support Annie Chicoye, PhD, GSK: Board Member|GSK: Grant/Research Support|GSK: Honoraria Richard Cookson, PhD, Genetech: Advisor/Consultant Nancy Devlin, PhD, GSK: Honoraria T. Mark Doherty, PhD, GSK: employee|GSK: Stocks/Bonds Antonio J Garcia-Ruiz, PhD, CHIESI: Advisor/Consultant|CHIESI: Grant/Research Support|CHIESI: Honoraria|Consumers and Users Organisations (CEACCU): Advisor/Consultant|Consumers and Users Organisations (CEACCU): Grant/Research Support|Consumers and Users Organisations (CEACCU): Honoraria|Foundation for Progress and Health (Andalusian Regional Government): Advisor/Consultant|Foundation for Progress and Health (Andalusian Regional Government): Grant/Research Support|Foundation for Progress and Health (Andalusian Regional Government): Honoraria|GSK: Honoraria|Ministry of Science and Innovation of Spain: Advisor/Consultant|Ministry of Science and Innovation of Spain: Grant/Research Support|Ministry of Science and Innovation of Spain: Honoraria|Official College of Physicians: Advisor/Consultant|Official College of Physicians: Grant/Research Support|Official College of Physicians: Honoraria|Royal Academy of Medicine and Surgery of Eastern Andalusia: Advisor/Consultant|Royal Academy of Medicine and Surgery of Eastern Andalusia: Grant/Research Support|Royal Academy of Medicine and Surgery of Eastern Andalusia: Honoraria|Sanofi Pasteur: Advisor/Consultant|Sanofi Pasteur: Grant/Research Support|Sanofi Pasteur: Honoraria|Sociedade Galega de Neuroloxía: Advisor/Consultant|Sociedade Galega de Neuroloxía: Grant/Research Support|Sociedade Galega de Neuroloxía: Honoraria|UCB: Advisor/Consultant|UCB: Grant/Research Support|UCB: Honoraria Louis P Garrison, PhD, GSK: Honoraria Terry Nolan, MD, PhD, Clover: Board Member|CSL Seqirus: Advisor/Consultant|CSL Seqirus: Grant/Research Support|Dynavax: Grant/Research Support|GSK: Advisor/Consultant|GSK: Board Member|GSK: Grant/Research Support|Iliad: Grant/Research Support|Moderna: Advisor/Consultant|Moderna: Grant/Research Support|MSD: Advisor/Consultant|MSD: Grant/Research Support|Novavax: Board Member|Pfizer: Advisor/Consultant|Sanofi: Advisor/Consultant|Sanofi: Grant/Research Support|SK Bio: Board Member Maarten Postma, Dr., Consumers and Users Organisations (CEACCU): Advisor/Consultant|Consumers and Users Organisations (CEACCU): Honoraria|Foundation for Progress and Health (Andalusian Regional Government): Advisor/Consultant|Foundation for Progress and Health (Andalusian Regional Government): Honoraria|GSK: Honoraria|Royal Academy of Medicine and Surgery of Eastern Andalusia: Advisor/Consultant|Royal Academy of Medicine and Surgery of Eastern Andalusia: Honoraria David M. Salisbury, CB FMedSci FRCP FRCPCH FFPH, Clover Pharmaceuticals: Advisor/Consultant|GSK: Advisor/Consultant|Moderna: Advisor/Consultant|Novavax Inc: Honoraria|Sanofi: Advisor/Consultant Hiral Shah, PhD, GSK: employee|GSK: Stocks/Bonds Jurgen Wasem, PhD, AstraZeneca: Advisor/Consultant|AstraZeneca: Honoraria|Clover: Advisor/Consultant|Clover: Board Member|GSK: Board Member|GSK: Honoraria|Merck: Advisor/Consultant|Merck: Honoraria|Sanofi Pasteur: Advisor/Consultant|Sanofi Pasteur: Honoraria|Seqirus: Advisor/Consultant|Seqirus: Honoraria|Serum Institute of India: Advisor/Consultant|Serum Institute of India: Board Member|Zeria: Advisor/Consultant|Zeria: Board Member Ekkehard Beck, PhD, GSK: employee|GSK: Stocks/Bonds

1140. Impact of an Implementation Science Initiative to Improve Vaccine Confidence for Invasive Meningococcal Disease (IMD) Prevention within American Indian (AI) Communities

Abstract Background Meningococcal vaccine uptake among adolescents remains suboptimal. This project aimed to identify barriers and motivators for vaccination in AI communities. Methods Between 12/2022 and 2/2023, 3 live family education sessions were held within AI communities in WI and ND. Healthcare provider (HCP) participants also attended a workshop to review current vaccine recommendations. Surveys were administered before/after the workshop and family education sessions. Results Surveys were completed by 56 family members. Baseline confidence in vaccine safety, efficacy and benefit was low, which increased after the sessions (Fig. 1). Parent understanding that the vaccine cannot cause disease improved from 51% to 82% (p =.001). Top reported barriers to vaccination were concern for immediate side effects and long-term side effects, and low perceived risk for IMD (34%, 26%, 25%, respectively). Parents identified learning more about IMD (40%), friends/family getting vaccinated (19%), and a local outbreak (12%) as top motivators to seek vaccination. When asked what they thought would motivate families to seek vaccination, HCPs leading the sessions (n=11) identified learning more about IMD (82%) and friends/family getting vaccinated (27%) only. HCP confidence in counseling families was low and improved after the sessions (Fig. 2). HCPs attending the workshop (n=28) reported discomfort contradicting patients/families as the top challenge in addressing vaccine hesitancy, and more HCPs felt confident having conversations to reduce vaccine hesitancy after the workshop (80%) than before (28%). HCP knowledge improved after the workshop, and more HCPs understood that MenACWY booster doses are not needed when initial vaccination occurs at age ≥16 (50%), and correctly identified “provider recommendation” as the top literature-reported factor influencing parental vaccine decisions (50%) compared to baseline (32% and 14%, respectively). HCP action plans for after the sessions prioritized routinely discussing vaccines at well visits (80%), providing written materials (50%) and staying current on new vaccines (50%). Conclusion Parent and provider knowledge and confidence improved after the program and offered insights into community-level motivators and barriers to vaccination. Disclosures All Authors: No reported disclosures

2333. Knowledge, attitudes, and practices regarding vaccination against COVID-19 among medical students at a private university in Lima – Peru

Abstract Background Vaccination against COVID-19 is one of the most important measures to reduce the spread, morbidity, and mortality of the disease. Methods We conducted a cross-sectional study to evaluate knowledge, attitudes, and practices regarding vaccination against COVID-19 in medical students at Universidad Peruana Cayetano Heredia (UPCH), for which an online survey was administered through e-mail and WhatsApp in July 2022. The following independent variables were evaluated: To be in the clinical phase of medical school (last four years), having more online classes ( &amp;gt;= 4 semesters with non-face-to-face classes), having received &amp;gt;= 3 doses of COVID-19 vaccine, and having reliable sources of information (scientific articles, conferences, and seminars). Through linear regression multivariate analysis, we assessed the factors associated with the number of correct answers (knowledge), the standardized attitude index (attitudes), and the number of vaccine doses received (practice). Results A total of 352 medical students completed the survey. 96.6% of participants knew that vaccines improved immunity, and 91.2% believed they were effective in reducing hospitalizations, severe illness, and death. 98% of students agreed that the benefits of vaccination outweighed the risks, 90.9% would recommend the population to get vaccinated, and 59.1% agreed that vaccines were safe. 99.7% of respondents have received at least one dose of vaccine, of which 100% received at least two doses, 88% three, and 4.8% four or more. In the multivariate analysis, we found that being in the clinical phase of medical school was associated with a higher knowledge and a higher standardized attitude index. Having received &amp;gt;=3 doses was associated with a higher standardized attitude index. Lastly, having a higher standardized attitude index was associated with having received more vaccine doses. (Table. 1) Table 1 Conclusion Regarding vaccination against COVID-19, medical students at UPCH have a high level of knowledge, a positive attitude, and good practices. Our study suggests that educational strategies in the pre-clinical phase may be needed to improve knowledge and attitudes regarding vaccination. Also, a higher standardized attitude index may predict a higher number of vaccine doses. Disclosures All Authors: No reported disclosures

1167. The Value of Influenza Vaccination in the Older Adult Population. A Stochastic Model Estimation of the benefit of vaccination to prevent the Severe Outcomes in the U.S.

Abstract Background Influenza is associated with substantial morbidity and mortality in the United States. Increasing influenza vaccination rates among all persons extends the benefits of immunization programs on reducing illnesses, especially those accrued to the older adult population who has the highest risk of severe outcomes. This research assesses the value of influenza vaccination by estimating the number of severe outcomes such as, respiratory and cardiovascular hospitalizations and deaths averted through immunization in the U.S. older adult population. Methods Severe hospitalizations and deaths prevented were estimated through a decision-tree model using a stochastic approach. Model’s incidence rate as well as complications probabilities were calibrated to reflect the reported U.S. CDC data. This analysis compares no vaccination of older adult population against influenza immunization with either a standard-dose quadrivalent vaccine (QIVe) or an enhanced quadrivalent vaccine recommended by ACIP. Absolute vaccine effectiveness and relative vaccine effectiveness of enhanced quadrivalent vaccine vs QIVe for hospitalizations averted were obtained from a targeted literature review. Median value and 95% CI were estimated from a 1000 stochastic simulation. Results In comparison to no vaccination, the number of respiratory and cardiovascular hospitalizations prevented with QIVe was 49,323 (19,584-91,620) and 93,950 (41,537-186,224), respectively. In addition, the number of respiratory and cardiovascular deaths prevented with QIVe vs no vaccination was 4,481 (1,517-9,701) and 8,277 (3,124-19,548), respectively. In the case, older adults were vaccinated with an enhanced vaccine, such as aQIV, then the number of respiratory and cardiovascular hospitalizations prevented against no vaccination was 52,428 (21,354-96,922) and 99,948 (44,400-197,284), respectively. Lastly, 4,742 (1,612-10,202) and 8,787 (3,314-20,910) were the estimated deaths prevented due respiratory and cardiovascular hospitalizations, respectively. Conclusion Influenza vaccination in older adult population reduces almost by 50% severe complications. The use of an enhanced vaccine such as the adjuvanted formulation increases further the clinical benefits. Disclosures Stephen I. Pelton, MD, CSL Seqirus Inc.: Advisor/Consultant|CSL Seqirus Inc.: Honoraria Van Nguyen, PhD, CSL Seqirus Inc.: Advisor/Consultant|CSL Seqirus Inc.: Advisor/Consultant|CSL Seqirus Inc.: Honoraria Joaquin F. Mould-Quevedo, PhD, CSL Seqirus Inc.: Employee|CSL Seqirus Inc.: Employee|CSL Seqirus Inc.: Stocks/Bonds|CSL Seqirus Inc.: Stocks/Bonds

Examining the Impact of the COVID-19 Vaccine on Smokers and Diabetic Individuals: Unveiling the Efficacy and Unraveling Side Effects in Al Jouf Region, KSA.

The assessment of the side effects of the COVID-19 vaccine is crucial to inform individuals about the potential risks and benefits of vaccination and to provide appropriate medical care if necessary. The study aimed to assess the effect of the COVID-19 vaccine on smokers and diabetic individuals and to investigate the occurrence of any side effects in the subpopulation of the Al Jouf region, KSA. The questionnaire had three main sections: the first covered basic information including gender, age, general health status, place, socio-economic position, nationality, smoking, and diabetes. Section 2 included the COVID-19 vaccination status and side effects, and the third section dealt with the dental history. Informed consent was obtained from the recruited individuals. Participants completed a Google self-administered questionnaire. One hundred and twenty participants responded to the survey forms. Similarly, for diabetics versus non-diabetics, there was no statistically significant difference in the type of vaccine received (chi-square value = 3.125, p-value = 0.682). For smokers versus non-smokers, the chi-square test showed a non-significant difference in side effects (chi-square = 2.56, p-value = 0.109), indicating that there was no significant difference in the side effects experienced by smokers and non-smokers. For diabetics versus non-diabetics, the chi-square test showed a non-significant difference in side effects (chi-square = 0.34, p-value = 0.560), indicating that there was no significant difference in the side effects experienced by diabetics and non-diabetics. Smokers and diabetics had higher harmful effects than non-smokers and non-diabetics. These findings need larger, robust trials to support treatment decision-making.

Effect of chronic diseases on willingness to receive the second COVID-19 vaccine booster dose among cancer patients: A multicenter cross-sectional survey in China

Cancer patients and those with chronic diseases face severe outcomes from SARS-CoV-2 infection. However, their willingness to receive a second booster dose remains low. This study identified factors affecting the willingness of cancer patients with chronic diseases (CPCD) and cancer patients without chronic diseases (non-CPCD) to receive the second COVID-19 booster vaccine dose. A multicenter cross-sectional study was conducted across 4 tertiary care hospitals in China. Based on the Health Belief Model, a questionnaire assessed respondents' perceptions of the second booster dose. Multivariable logistic regression analyzed factors influencing the willingness to receive a second vaccine dose. Out of 171 CPCD and 722 non-CPCD, CPCD showed a higher willingness to receive the second booster dose than non-CPCD (46.8% vs 32.3%, P<.001). Factors influencing CPCD's willingness included the belief that vaccination was detrimental to cancer treatment and the perceived higher infection risk compared to healthy individuals. Fear of vaccination's negative impact on cancer treatment was the main factor affecting non-CPCD's willingness (each P<.05). Different factors influenced the willingness of the 2 groups. Health education interventions should be implemented alongside vaccination, involving patients' relatives and medical staff, for both CPCD and non-CPCD populations. Additionally, health management service interventions should emphasize the benefits of vaccination for CPCD to improve their second dose coverage.

Sociodemographic factors and attitudes associated with Australian parental acceptance of paediatric COVID-19 vaccination

IntroductionThe COVID-19 vaccine coverage among children in countries where COVID-19 vaccines are recommended has been suboptimal. Conflicting information in the media leads to parental anxiety and confusion around COVID-19 vaccination in children. The scepticism expressed by certain experts regarding the importance of COVID-19 vaccines in children has also had a negative impact on parental attitudes towards COVID-19 vaccination. This study aimed to understand parental concerns and preferences for paediatric COVID-19 vaccination, and identify potential vaccination promotion (“nudge”) interventions to optimise paediatric COVID-19 vaccine uptake. MethodsMixed methods including Focus Group Discussions and a Discrete Choice Experiment survey were used. The Discrete Choice Experiment survey design was based on a literature review and the findings of Focus Group Discussions. The study was conducted on a nationally representative sample of parents in Australia. ResultsIn total, 1039 parents participated in the study. Parents showed strong preferences for a COVID-19 vaccine with lower risk of serious side effects and longer protection duration, followed by higher vaccine effectiveness and delivery via oral tablets. Promotion strategies were similarly preferred by parents. Latent class logit analysis identified three groups, interpretable as COVID-19 vaccine “accepters (35.3%)”, “deliberators (31.7%)”, and “rejecters (33.1%)”. The “deliberators” composed of more parents, residing in metropolitan areas, having concerns about vaccine effectiveness, and believing that disease risks outweigh vaccine benefits than the “accepters”. The “rejecters” were more likely to not be vaccinated themselves, and generally have less trust in vaccines than the “accepters”. The “deliberators” and “rejecters” were less likely to be parents aged ≥25 years and complete final year of high school than the “accepters”. ConclusionsParents’ sociodemographic factors and vaccine perceptions were associated with different levels of acceptance toward paediatric COVID-19 vaccination, which may help to better understand how to “nudge” vaccine hesitancy.

Attitudes toward COVID-19 and Other Vaccines: Comparing Parents to Other Adults, September 2022.

Few analyses of COVID-19 vaccine attitudes also cover routine vaccines or focus on parents. In this cross-sectional study, we surveyed US adults in September 2022, immediately following the authorization of updated bivalent COVID-19 boosters for adults but before their authorization for children. The vaccine attitudes of parents were compared to other adults. Fewer parents were up-to-date on COVID-19 vaccines than other adults (54% vs. 67%), even after adjusting for age, education, and race/ethnicity (Adjusted Odds Ratio: 0.58; 95% Confidence Interval: 0.45-0.76). More parents had concerns about COVID-19 vaccines' safety in children (67% vs. 58%; aOR: 1.59; 95%CI: 1.23-2.06) and vaccine ingredients (52% vs. 45%; aOR: 1.41; 95%CI: 1.09-1.81), and more parents perceived COVID-19 in children to be no worse than a cold or the flu (51% vs. 38%; aOR: 1.56; 95%CI: 1.22-2.01). Fewer parents supported COVID-19 vaccine school requirements (52% vs. 57%; aOR: 0.75; 95%CI: 0.58-0.97) and perceived high vaccine coverage among their friends (51% vs. 61%; aOR: 0.60; 95%CI: 0.46-0.78). However, three-quarters of parents intended their child to receive all routinely recommended vaccines, whereas only half of adults intended to receive all routinely recommended vaccines themselves. To improve parental informed vaccine decision-making, public health must ensure pediatric providers have updated resources to support their discussions of vaccine risks and benefits with their patients' parents.

Interventions to Improve Knowledge, Attitudes, and Uptake of Recommended Vaccines during Pregnancy and Postpartum: A Scoping Review.

Tetanus, pertussis, influenza, and COVID-19 vaccines are recommended for the prevention of related morbidity and mortality during pregnancy and postpartum. Despite the established benefits of vaccination for prenatal and postnatal women, maternal vaccination is not universally included in routine antenatal programs, especially in low- and middle-income countries. Furthermore, the uptake of recommended vaccines among pregnant and postpartum women remains below optimum globally. This review aimed to map the evidence on interventions to improve knowledge, attitudes, and uptake of recommended vaccines among pregnant and postpartum women. We conducted a comprehensive and systematic search for relevant literature in PubMed, Scopus, Web of Science, EBSCOhost, and Google Scholar. Overall, 29 studies published between 2010 and 2023 were included in this review. The majority (n = 27) of these studies were from high-income countries. A total of 14 studies focused on the influenza vaccine, 6 on the Tdap vaccine, 8 on both influenza and Tdap vaccines, and only one study on the COVID-19 vaccine. Patient-centered interventions predominated the evidence base (66%), followed by provider-focused (7%), health system-focused (10%), and multilevel interventions (17%). Overall, the effect of these interventions on knowledge, attitudes, and uptake of maternal vaccines was variable.

Correlates of human papillomavirus vaccination intent for oropharyngeal cancer prevention among gay and bisexual men living in the United States

BackgroundGay and bisexual men (GBM) are at increased risk of developing human papillomavirus (HPV)–associated oropharyngeal cancer (OPC). Vaccination may prevent OPC in GBM; however, vaccination rates are low. The authors explored the correlates associated with HPV vaccination intent for OPC prevention among GBM. MethodsThe authors conducted a cross-sectional study in which they surveyed 1,700 adult GBM with a profile on 2 online dating sites. Eligibility criteria included self-identified GBM living in the United States, aged 18 through 45 years who had sex with a man in the past 5 years. Factors associated with participants’ HPV vaccination status and intent to vaccinate were assessed via the online questionnaire using the Health Belief Model. ResultsMost of the 1,108 eligible GBM had not received 1 dose or more of the HPV vaccine (54.2%), were aged 27 through 37 years (52.3%), were White (58.3%), identified as cisgender men (93.4%), were gay (79.3%), were in a monogamous relationship (99.4%), and had a bachelor’s degree (29.4%) or higher college education (26.1%). Among unvaccinated GBM, 25.3% reported intent to receive the vaccine. In the multivariable model, independent associations (P < .05) were found for the Health Belief Model constructs (perceived benefits and perceived barriers) with HPV vaccine intent, after adjusting for all other predictor variables in the model. ConclusionsThe benefits of HPV vaccination for the prevention of OPC is associated with intent to vaccinate among GBM. Dental care providers can use this information to educate patients in this high-risk population on prevention of HPV–associated OPC. Practical ImplicationsDentists can advocate for HPV vaccination uptake among GBM patients by means of discussing the benefits of vaccination in the prevention of HPV-associated OPC.

EGS P13 Adherence to Guidelines for Post-Splenectomy Patients in a Primary Care Practice in North West England

Abstract Background Splenectomy is indicated in haematological, oncological disorders and occasionally during emergency (trauma) surgery. Given the spleens role in the immunological response, overwhelming infection remains an area of concern for post-splenectomy patients with low prevalence (0.1-0.5%) but high mortality (∼50%). Strep pneumoniae, H influenzae Type B and Neisseria meningitidis are common bacterial perpetrators. At present, Public Health England and the British Society for Haematology recommends regular influenza, pneumococcal and meningococcal vaccinations for patients with asplenia or hyposplenism. They should also be on lifelong prophylactic antibiotics. This audit aimed to assess the adherence to vaccination and antibiotic prophylaxis guidelines for post-splenectomy patients. Methods 19 patients post splenectomy patients were identified at a primary care practice in North West England. Data was retrospectively collected from the last 10 years with two researchers manually searching through their GP records. Parameters collected included both compliance and timeliness with vaccinations and antibiotic prophylaxis as per national guidance. Where there was a deviation from the guidance, the records were again searched to identify any cause. Results 109/162 (67.3%) ‘vaccination opportunities’ for the recommended yearly influenza vaccination were successfully delivered. 17/19 (89.4%) patients had no documented initial pneumococcal vaccination at time of splenectomy. 23/162 (14.2%) influenza and 22/37 (56.4%) pneumococcal vaccination opportunities were missed with no documentation explaining why. Only 1 patient received the recommended MenACWY/MenB vaccination at diagnosis, 5 received delayed vaccinations and 13/19 (68.4%) patients received no meningitis vaccination. 7/19 (37%) patients were not on prophylactic antibiotics as recommended with no documented explanation. 2 of those patients were issued one-off antibiotic prescriptions and 1 had their prescription stopped due to non-compliance. Conclusions Significant improvement is needed with regards to antibiotic prophylaxis, pneumococcal and meningococcal vaccinations with over 50% of vaccinations being missed. Poor documentation and a shift to electronic health records are possible factors that have affected data collection, particularly as a significant number of the splenectomies performed were prior to 2000. Recommendations include routine reviews for asplenic patients, encouragement for opportunistic vaccination and increasing awareness of the risks of post-splenectomy sepsis and the benefits of vaccinations. Future scope could include looking at the same guidelines for other hyposplenic/asplenic conditions.

RTS,S/AS01 malaria vaccine pilot implementation in western Kenya: a qualitative longitudinal study to understand immunisation barriers and optimise uptake

BackgroundMalaria is a significant public health threat in sub-Saharan Africa, particularly among children. The RTS,S/AS01 malaria vaccine reduces the risk and severity of malaria in children. RTS,S/AS01 was piloted in three African countries, Ghana, Kenya and Malawi, to assess safety, feasibility and cost-effectiveness in real-world settings. A qualitative longitudinal study was conducted as part of the feasibility assessment. This analysis explores RTS,S/AS01 vaccination barriers and identifies potential motivators among caregivers in three sub-counties in western Kenya.MethodsA cohort of 63 caregivers with a malaria vaccine eligible child was interviewed at three time points over 24 months. A sub-set of 11 caregivers whose eligible children were either partially or non-vaccinated were selected for this sub-analysis. The 5A Taxonomy for root causes of under-vaccination was used to organise the inductively-coded data into categories (awareness, acceptance, access, affordability, and activation) and identify the factors influencing uptake across caregivers. A trajectory analysis was conducted to understand changes in factors over time within each caregiver experience. Caregiver narratives are used to illustrate how the factors influencing uptake were interrelated and changed over time.ResultsLack of awareness, previous negative experiences with routine childhood immunisations and the burden of getting to the health facility contributed to caregivers initially delaying uptake of the vaccine. Over time concerns about vaccine side effects diminished and anticipated vaccination benefits strongly motivated caregivers to vaccinate their children. Persistent health system barriers (e.g., healthcare provider strikes, vaccine stockouts, negative provider attitudes) meant some children missed the first-dose eligibility window by aging-out.ConclusionsCaregivers in this study believed the RTS,S/AS01 to be effective and were motivated to have their children vaccinated. Despite these positive perceptions of the malaria vaccine, uptake was substantially hindered by persistent health system constraints. Negative provider attitudes emerged as a powerful deterrent to attending immunisation services and hampered uptake of the vaccine. Strategies that focus on improving interpersonal communication skills among healthcare providers are needed.

Factors Influencing COVID-19 Vaccine Uptake among Spanish-Speaking Pregnant People.

The coronavirus disease 2019 (COVID-19) pandemic exposed the vulnerability of pregnant women to excess morbidity and mortality, as well as the disproportionate disease burden in certain racial, ethnic, and sociodemographic groups. Vaccine hesitancy represents a major threat to public health, and crafting messages that reach vulnerable groups and address their intersectionality remains a weakness for pandemic preparedness. We sought to investigate factors that influenced vaccine acceptance and social media ad response in a mixed-methods study of Spanish-speaking women living in the rural Western United States who were pregnant or recently pregnant between November 2022 and June 2023. Direct interviews were translated, transcribed, and coded, while the ad ratings were analyzed using linear mixed models. Participants most favorably rated ads that featured doctors and text-heavy content describing benefits of vaccination. Qualitative data illustrated how information from trusted medical providers along with generational and cultural history of vaccine acceptance positively impacted perspectives on vaccination. Immigration status had varying influences on vaccination perspectives. Future vaccination campaigns targeting Spanish-speaking pregnant individuals in rural communities should use medical providers as ad messengers and dispel fears that vaccine acceptance may lead to problems with immigration status.

The role of vaccine in COVID-19

The sudden outbreak of COVID-19 in Wuhan, China, has brought sudden harm to people. Under such circumstances, many vaccines have been invented and created, and all kinds of vaccines also carry their own advantages and disadvantages. It is essential for population to understand the working principle and basic production method of each vaccine. At present, there are many vaccines for the novel coronavirus epidemic, but there are three vaccines that mainly occupy the market. Recent study has found that adenovirus vaccine is effective to safe people from the virus, but it can give people some bad symptoms. mRNA vaccines can increase the immune system after a second or multiple doses, especially in people over 40 years-old. In the meantime, recombinant protein COVID-19 vaccine has a strong immune response with stability of the vaccine immunity. In this paper, the most basic principles and the lowest logic of these vaccines are introduced respectively. In addition, these vaccines are combined with some studies on clinical symptoms. This article also analyzes the shortcomings and benefits of these different vaccines, and this review will recommend methods to avoid infection based on the structure of all COVID-19 vaccines and pathogens.

Human Papillomavirus Vaccination Status and Correlates Among Mid-Adult Women: Connecticut, USA, 2016-2019.

Background: In 2019, the CDC expanded their recommendations for human papillomavirus (HPV) vaccination beyond age 26 years to include shared clinical decision-making (SCDM) among adults aged 27-45 years ("mid-adults"). The purpose of this study was to describe HPV vaccination status among mid-adult women before the implementation of SCDM for HPV vaccination. Methods: A cross-sectional survey was conducted during 2016-2019 in Connecticut, United States, and enrolled women born in 1981 or later (birth cohorts eligible for HPV vaccination). This analysis was restricted to participants aged 27 years and older at the time of the survey. Correlates of vaccination status, sources of vaccine information, and reasons for not receiving the vaccine were examined. Results: Among 298 participants, 64.4% had not received HPV vaccine. Other than age (younger age was associated with being vaccinated), no other demographic or behavioral correlates were associated with vaccination. Compared with unvaccinated women, vaccinated women were more likely to have heard about the HPV vaccine from a doctor (odds ratio [OR] = 3.45, 95% confidence interval [CI]: 2.00-5.88) and less likely to have heard about it from television (OR = 0.23, 95% CI: 0.13-0.41). The main reasons for not being vaccinated were "vaccine not offered" (48%) and "too old" (40%). Conclusions: A majority of mid-adult women in this study were not previously vaccinated against HPV, signaling the large opportunity for SCDM with this population. This may be facilitated by ensuring health care providers and mid-adult women know about the availability and potential benefits of HPV vaccination to inform decision making.

Digital Technologies and COVID-19 Vaccine Acceptance

In light of the controversies surrounding COVID-19 vaccines, this study explored vaccine adoption through a theoretical model, focusing on France (n=2001) and South Africa (n=1107). Analysis using structural equation modelling and hierarchical cluster analysis revealed that social influences, personal opinions on vaccines, perceived severity of the pandemic, and perceived benefits of vaccination were primary drivers of adoption in both countries. Belief in conspiracy theories and perceptions of social distancing and stay-at-home measures had no influence on acceptance. Trust significantly influenced adoption intentions only in South Africa. Cluster analysis revealed four distinct opinion groups—“enthusiasts,” “doubters,” “followers,” and “conspirationists”—each preferring different health information sources and technologies, with a common preference for traditional media over social media. These findings have implications for developing targeted health policies, communication, and trust-building strategies.

Analyzing real-world data to understand COVID-19 vaccination effects on hospitalization rates in patients with solid malignancies

The impact of COVID-19 vaccination on hospitalizations in individuals with solid malignancies remains uncertain. This nationwide retrospective study aims to clarify this issue. We analyzed data from 1,126,946 confirmed COVID-19 cases between March 2020 and June 2022, obtained from the Ministry of Health’s United Information Portal. Outcomes were compared between fully vaccinated and non-vaccinated cohorts, stratified by sex, age and viral variant. Among the 1,126,946 confirmed COVID-19 cases, 0.53% (n = 6025) had solid malignancies and comorbidities. Of these, 31.3% (n = 1797) had sole solid malignancies. In this subgroup, 40% (n = 764) required hospitalization, with a median age of 63 years. Unadjusted univariate analysis showed a significant reduction in hospitalization rates among COVID-19 vaccinated patients with isolated solid malignancies [OR 0.2776 (95% CI 0.1621 to 0.4753); p < 0.0001], especially in those aged over 63 [OR 0.5981 (95% CI 0.4244 to 0.8429); p = 0.0033]. Lower ICU admission rates favored vaccinated cohorts [OR 0.3418 (95% CI 0.2023 to 0.5777); p = 0.0001]. These reductions were observed exclusively with mRNA-based vaccines [OR 0.5845 (95% CI 0.4333 to 0.7884); p = 0.0004]. Statistically significant vaccination benefits were found only within the omicron cohort [OR 0.2307 (95% CI 0.13687 to 0.3890); p < 0.0001]. The results from the analysis suggest that individuals with sole solid malignancies face an increased risk of hospitalization and ICU admission. However, these risks can be mitigated through vaccination, particularly with an mRNA-based vaccine, especially in those aged 63 years or older.