Adolescent Vaccination Research Articles

Abstract 721: Vaccination barriers for HPV vaccine initiation and completion: A perception analysis using the Association of Immunization Managers annual survey

Abstract Background: Human Papillomavirus (HPV) is the most common sexually transmitted infection in the United States of America (USA) and it is associated with six types of cancers. Vaccines that protect against HPV infection have been introduced since 2006. Despite many national efforts, vaccination rates remain under 80% and many individual and systematic barriers influence HPV vaccine uptake and completion. Addressing the stem of these barriers at a national level and their regional differences, will help in understanding necessary policies for the acceptance of HPV vaccine. Objective: This study aims to describe the frequency of immunization program managers’ perceptions of the most relevant barriers to HPV vaccination in each national jurisdiction. Methods: Immunization Program Managers (IPMs) in the USA were surveyed from August 2021 to February 2022 as part of the Implementation of School-Entry Policies for Papilloma Virus Vaccination (HPV-PIVac) study with the collaboration of the Association of Immunization Managers. We gathered IPMs perceptions on the most relevant barriers to HPV vaccination within their jurisdiction. Four vaccine barriers were evaluated; for each one, IPMs reported the level (moderate, significant, no barrier) in a three-item scale. The three-item scale was merged into a two-item scale (low/high) and multiple answers from the same state were grouped. Descriptive analysis was performed for each question and results were mapped. Fisher’s exact test was performed to determine the relation between barriers. IPMs that refused or didn’t know their jurisdiction’s barriers were removed from the analysis. Results: 49 IPMs from 31 states and territories participated, resulting in a 53.4% participation rate. For the cost barrier to complete HPV vaccination of children, most IPMs perceived low barriers (51.7%) within their jurisdiction. For the perception of geographical difficulties to complete HPV vaccination, higher barriers (67.9%) were reported among participants. Limited number of providers offering the HPV vaccine was perceived equally as low or high level (50.0%), whereas lack of a strong provider recommendation or failure of providers to discuss and strongly recommend the HPV vaccine was the most significant barrier with a higher level (96.7%). Fisher’s exact test indicated independency between all barriers (p>0.05). For most variables, the Western region reported a greater level of barriers. Conclusion: This analysis documents the IPMs perception of prevalent HPV vaccine barriers for vaccine initiation and completion nationally. These results confirmed the need of further engagement for the accessibility of the vaccine, as preliminary data from NIS-Teen 2021 shows an average adolescent HPV vaccine initiation and UTD coverage of 78.2 and 62.7, respectfully. Funding: NCI Grant #R01CA232743 Citation Format: Alondra Katerina Mercado-Andino, Erick L. Suárez-Pérez, Olga L. Díaz-Miranda, Diana T. Medina-Labees, Ana P. Ortiz, Katelyn Wells, Vivian Colón-López. Vaccination barriers for HPV vaccine initiation and completion: A perception analysis using the Association of Immunization Managers annual survey [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 721.

Safety of measles, mumps, and rubella vaccine in adolescents and adults in the vaccine safety Datalink

Measles, mumps, and rubella vaccine (MMR) is routinely administered to children; however, adolescents and adults may receive MMR for various reasons. Safety studies in adolescents and adults are limited. We report on safety of MMR in this age group in the Vaccine Safety Datalink. We included adolescents (aged 9-17years) and adults (aged≥18years) who received≥1 dose of MMR from January 1, 2010-December 31, 2018. Pre-specified outcomes were identified by diagnosis codes. Clinically serious outcomes included anaphylaxis, encephalitis/myelitis, Guillain-Barré syndrome, immune thrombocytopenia, meningitis, and seizure. Non-serious outcomes were allergic reaction, arthropathy, fever, injection site reaction, lymphadenopathy, non-specific reaction, parotitis, rash, and syncope. All serious outcomes underwent medical record review. Outcome-specific incidence was calculated in pre-defined post-vaccination windows. A self-controlled risk interval design was used to determine the relative risk of each outcome in a risk window after vaccination compared to a more distal control window. During the study period, 276,327 MMR doses were administered to adolescents and adults. Mean age of vaccinees was 34.8years; 65.8% were female; 53.2% of doses were administered simultaneously with≥1 other vaccine. Serious outcomes were rare, with incidence≤6 per 100,000 doses for each outcome assessed, and none had a significant elevation in incidence during the risk window compared to the control window. Incidence of non-serious outcomes per 100,000 doses ranged from 3.4 for parotitis to 263.0 for arthropathy. Other common outcomes included injection site reaction and rash (157.0 and 112.9 per 100,000 doses, respectively). Significantly more outcomes were observed during the risk window compared to the control window for all non-serious outcomes except parotitis. Some variability was observed by sex and age group. Serious outcomes after MMR are rare in adolescents and adults, but vaccinees should be counseled regarding anticipated local and systemic non-serious adverse events.

Considerations of hybrid immunity and the future of adolescent COVID-19 vaccination.

Pre-licensure clinical trials for the BNT162b2 COVID-19 vaccine showed high efficacy among adolescents.1 Similarly, post-licensure studies in this population found high mRNA vaccine effectiveness against both SARS-CoV-2 infection and hospitalisation during the pre-omicron period.2,3 However, emergence of the omicron variant in November, 2021, as well as later omicron subvariants, resulted in decreased COVID-19 vaccine effectiveness and more rapid waning of protection, particularly against infection.

Perception regarding COVID-19 vaccine and COVID appropriate behavior among adolescents at a tertiary hospital, West Bengal: A longitudinal survey

BackgroundVaccination against COVID 19 and observing COVID appropriate behavior are effective measures to control, manage and prevent COVID-19 infection. With India starting its adolescent vaccination program, this study aimed to explore the adolescents’ perception of vaccination, their COVID-appropriate behavior, compliance with two doses of COVID-19 vaccines and the experienced side effects following vaccination. MethodsA longitudinal survey was conducted among 440 adolescents visiting the COVID Vaccination Center (CVC) of a tertiary hospital in West Bengal. In the survey, adolescents were asked about family socio-demographic characteristics, their opinions on COVID-19 vaccines, and COVID-19 Appropriate Behavior (CAB) practices. Voluntary participants were given a questionnaire to fill and a telephonic interview was taken regarding side effects experienced following the vaccination and their compliance to both doses of vaccine. ResultsThe majority of adolescents (99.3%) had taken vaccines by their own wish. The reason for willingness to take the vaccine was the fear of being infected with COVID-19 infection (50.5%). Maximum adolescents got information regarding the COVID vaccination program through the internet (41.8%) followed by family members (30.5%). The majority of adolescents (70.9%) had a good perception of COVID-19 vaccination. A significant number of adolescents (44.8%) strongly disagreed with the statement that they don't need to follow COVID appropriate behavior after vaccination. ConclusionThe majority of adolescents had a good perception regarding COVID-19.

Myocarditis in Adolescents (12-17 years) Associated with the Pfizer-BioNTech (BNT162b2) Vaccine: A Systematic Review and Meta-analysis

Purpose: Data on the incidence rate of myocarditis associated with mRNA COVID-19 vaccines in adolescents is limited. The research estimated the incidence of myocarditis associated with the Pfizer- BioNTech COVID-19 vaccine (BNT162b2) in adolescents (12-17 years). 
 Methodology: This study was conducted as per the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Incidence rates were estimated after generating a random effects model.
 Findings: The Incidence rate in males after the first dose was 2.4 per 100,000 persons (0.8- 6.8 per 100,000; I2: 17.17%). The IR in females after the first dose was 1.9 per 100,000 persons (0.5-6.5 per 100,000; I2: 0.00). After the second dose, the IR in males was 15.7 per 100,000 persons (3.2-78.1 per 100,000; I2: 96.45%), while in females the IR after the second dose was 6.1 per 100,000 persons (2.9-12.1 per 100,000; I2: 0.00). The Incidence Rate Ratio (IRR) after the first dose between males and females was 1.86 (0.40-8.5; I2: 0.00) and 6.35 (2.98-13.49; I2: 0.00) after the second dose. Among individuals between 12- 17 years of age, myocarditis is a rare side effect associated with Pfizer- BioNTech COVID-19 vaccine (BNT162b2) vaccination. The incidence in males were about two times greater than females following the first dose and six times greater following the second dose.
 Recommendation: Vaccination strategy in adolescent males needs to be revisited to mitigate risk of myocarditis.

Adaptive immune response to BNT162b2 mRNA vaccine in immunocompromised adolescent patients.

Protective immunity against COVID-19 is orchestrated by an intricate network of innate and adaptive anti-viral immune responses. Several vaccines have been rapidly developed to combat the destructive effects of COVID-19, which initiate an immunological cascade that results in the generation of neutralizing antibodies and effector T cells towards the SARS-CoV-2 spike protein. Developing optimal vaccine-induced anti-SARS- CoV-2 protective immunity depends on a fully competent immune response. Some evidence was gathered on the effects of vaccination outcomes in immunocompromised adult individuals. Nonetheless, protective immunity elicited by the Pfizer Biontech BNT162b2 vaccine in immunocompromised adolescents received less attention and was mainly focused on the antibody response and their neutralization potential. The overall immune response, including T-cell activities, was largely understudied. In this study, we characterized the immune response of vaccinated immunocompromised adolescents. We found that immunocompromised adolescents, which may fail to elicit a humoral response and develop antibodies, may still develop cellular T-cell immunity towards SARS-CoV-2 infections. Furthermore, most immunocompromised adolescents due to genetic disorders or drugs (Kidney and liver transplantation) still develop either humoral, cellular or both arms of immunity towards SARS-CoV-2 infections. We also demonstrate that most patients could mount a cellular or humoral response even after six months post 2nd vaccination. The findings that adolescents immunocompromised patients respond to some extent to vaccination are promising. Finally, they question the necessity for additional vaccination boosting regimens for this population who are not at high risk for severe disease, without further testing of their post-vaccination immune status.

Perceived Barriers and Use of Evidence-Based Practices for Adolescent HPV Vaccination among East Texas Providers.

Adolescents living in rural areas are less likely to be up to date on the human papillomavirus (HPV) vaccine, which can prevent cervical cancer. We administered a telephone survey to 27 clinics in rural East Texas to assess perceived barriers to HPV vaccination and current use of evidence-based interventions to promote HPV vaccination. Perceived barriers were assessed using a 5-point Likert scale and clinical implementation of evidence-based practices was determined. Findings are reported using descriptive statistics. The most commonly reported barriers were missed vaccination opportunities due to the pandemic (66.7%), followed by vaccine hesitancy due to the pandemic (44.4%) and due to the HPV vaccine specifically (33.3%). Fewer than a third of clinics reported using the evidence-based strategies of use of a "refusal to vaccinate" form (29.6%), having an identified HPV vaccine champion (29.6%), and recommending the HPV vaccine at age 9 (22.2%). While many clinics surveyed currently implement evidence-based practices to promote HPV vaccination, there is a need and desire for additional HPV vaccination interventions in East Texas clinics.

Getting Human Papillomavirus Vaccination Back on Track: A National Survey

PurposeAdolescent human papillomavirus (HPV) vaccine uptake in the United States dropped during the COVID-19 pandemic due to a decrease in well visits. This study sought to identify opportunities for primary care professionals (PCPs) to get adolescent vaccination back on track. MethodsIn early 2021, we recruited 1,047 PCPs (71% physicians) who provided adolescent vaccines in the United States from an existing panel. Participants completed an online survey about changes in adolescent HPV vaccine uptake and actions taken to promote vaccination during the pandemic, as well as intentions to engage in activities to increase adolescent vaccination in the next 3 months. ResultsA substantial proportion of PCPs (43%) reported that HPV vaccine uptake decreased in the first year of the pandemic; few (7%) PCPs reported an increase in uptake. PCPs reporting increased uptake were more likely to have used nurse-only vaccination visits, held drop-in and drive-through vaccination clinics, and used telehealth visits to recommend vaccination (all p < .05). Nearly two-thirds (62%) of all PCPs planned to promote adolescent vaccine uptake in the next 3 months. Planning was more common among PCPs who believed HPV vaccine uptake at their clinics increased during the pandemic, who saw more than 10 adolescent patients per week, who had ever reviewed their clinic's vaccination rates, and were nurses (all p < .05). DiscussionMany PCPs saw HPV vaccination drop during the pandemic. Several interventions could help clinics get HPV vaccination back on track, including increasing the availability of nurse-only vaccination visits and vaccination-only clinics.

Immunogenicity against wild-type and Omicron SARS-CoV-2 after a third dose of inactivated COVID-19 vaccine in healthy adolescents.

Two doses of inactivated SARS-CoV-2 vaccine CoronaVac cannot elicit high efficacy against symptomatic COVID-19, especially against the Omicron variant, but that can be improved by a third dose in adults. The use of a third dose of CoronaVac in adolescents may be supported by immunobridging studies in the absence of efficacy data. With an immunobridging design, our study (NCT04800133) tested the non-inferiority of the binding and neutralizing antibodies and T cell responses induced by a third dose of CoronaVac in healthy adolescents (N=94, median age 14.2 years, 56% male) compared to adults (N=153, median age 48.1 years, 44% male). Responses against wild-type (WT) and BA.1 SARS-CoV-2 were compared in adolescents. Safety and reactogenicity were also monitored. A homologous third dose of CoronaVac further enhanced antibody response in adolescents compared to just 2 doses. Adolescents mounted non-inferior antibody and T cell responses compared to adults. Although S IgG and neutralizing antibody responses to BA.1 were lower than to WT, they remained detectable in 96% and 86% of adolescents. T cell responses to peptide pools spanning only the mutations of BA.1 S, N and M in adolescents were preserved, increased, and halved compared to WT respectively. No safety concerns were identified. The primary vaccination series of inactivated SARS-CoV-2 vaccines for adolescents should include 3 doses for improved humoral immunogenicity.

Analysis of a Serological Study of Pertussis among Children and Adolescents in the Republic of Kazakhstan

Relevance. In 2018 over 151 000 cases of whooping cough were reported worldwide. In the Republic of Kazakhstan the incidence of whooping cough has always remained relevant. The incidence is recorded mainly among children under 14 years of age, whose share is 96–100% of the total incidence in certain years. It should also be noted that 82,9–96% of sick people are not vaccinated against whooping cough. Aims. Assessment of the duration of protection after vaccination against pertussis infection in Kazakhstan using antibodies against pertussis toxin (PT) and (IgA and IgG) as a specific marker of pertussis infection or vaccination in children and adolescents in the cities of the Republic of Kazakhstan: Aktobe, Karaganda, Taldykorgan, Shymkent for evaluation appropriate age for booster vaccination. Materials and methods. For the study included medical organizations in the cities of Aktobe, Karaganda, Taldykorgan, Shymkent. Participants aged 10–14 years who were hospitalized in children's hospitals and 15–18 years old who visited polyclinics were invited to participate in the study. Each city has 1 children's hospital (4 in total) and 2 polyclinics (8 in total). A total of 520 people of different age groups participated. Study period: February 2021 – October 2021. Inclusion criteria were such aspects as: age from 10 years to 18 years 11 months 29 days, informed consent obtained from parents or guardian(s) and patient consent, enrollment after visiting the clinic, the presence of documented evidence of immune status. An association between two qualitative variables is considered statistically significant if the p-value calculated using the Chi-squared test is less than 0.05. Results. Among 520 participants aged 10–14 years – 200 (38.5%) and 15–18 years – 320 (61.5%), including boys – 284 (54.6%), girls – 236 (45.4%). The largest number of study participants was aged 15, 16 and 17 years, 10 participants (1.9%) had periods of prolonged coughing in the past 6 months. The first, second and third pertussis vaccines were received by 100% of children. The first and second vaccine for all children was the Adsorbed Diphtheria-Tetanus-Pertussis Vaccine (DPT). The third vaccine for 519 children was also DPT, for one child – AbDPT, due to the transition to a cell-free vaccine from the second half of 2013. The additional vaccine scheduled at 18 months of age was given to 519 participants (99.8%), of which 517 children (99.6%) received DPT and two children (0.4%) DPT. Just over half of the children (276 or 53.1%) also received the whooping cough vaccine at age 6. In biological blood samples of 17 participants (3.3%). antibodies of the IgA class were detected in 245 samples (47.1%) – antibodies of the IgG class. Of the 17 participants with IgA antibodies, 15 also tested positive for IgG. In total antibodies of the IgA and IgG classes were detected in 247 participants which amounted to 47.5%. Conclusions. This study showed the duration of protection after pertussis vaccination in Kazakhstan among different age groups. In total, antibodies of the IgA and IgG classes were detected in 247 participants out of 520 which amounted to 47.5%. IgA antibodies were detected in biological blood samples in 17 participants (3.3%), IgG class antibodies in 245 samples (47.1%). The prevalence of IgA antibodies was statistically significantly higher among older children and among children who had respiratory symptoms in the 6 months prior to the study. The prevalence of IgG antibodies was statistically significantly higher among children vaccinated against whooping cough at the age of 6 years (47.1%) and at the age of 10–14 years (56.2%) than in the age group of 15–18 years (43.8%) and also significantly higher among those, who share a bedroom with other family members compared to children living in separate rooms. Thus an increase in whooping cough and a decrease in protective vaccine immunity among older age groups can be stated which raises concerns about transmission of the infection in the home to vulnerable children and the need to strengthen vaccination strategies.

Trends in Adolescent Human Papillomavirus Vaccination and Parental Hesitancy in the United States.

Human papillomavirus (HPV) vaccination coverage remains suboptimal in the United States, underscoring the importance of monitoring trends in vaccine hesitancy. Cross-sectional data from the 2011-2020 National Immunization Survey-Teen were used to assess trends in HPV vaccination initiation among 13-17-year-olds, parental intent to initiate vaccination, and primary reasons for parental hesitancy. Among all sex and race and ethnicity groups, the prevalence of HPV vaccination initiation increased over time, but parental intent to vaccinate against HPV for unvaccinated teens remained consistently low (≤45%). Among hesitant parents, "safety concerns" increased in nearly all demographic groups, with the greatest increases observed for non-Hispanic white female and male teens and no change for non-Hispanic black female teens. In 2019-2020, parents of unvaccinated non-Hispanic white teens were least likely to intend on vaccinating their teens, and the most common reason for hesitancy varied by sex and race and ethnicity (eg, "safety concerns" for white teens and "not necessary" for black female teens). Although HPV vaccination initiation increased over time, a substantial fraction of parents remain hesitant, and trends in their reason varied by sex and race and ethnicity. Health campaigns and clinicians should address vaccine safety and necessity.

Anaphylaxis rates following mRNA COVID-19 vaccination in children and adolescents: Analysis of data reported to EudraVigilance.

The present study aimed to estimate the anaphylaxis rates following mRNA COVID-19 vaccination in children and adolescents in Europe. We retrieved data on 371 anaphylaxis cases following mRNA COVID-19 vaccination in children≤17years old notified to EudraVigilance as of October 8, 2022. Overall, 27,120,512 doses of BNT162b2 vaccine and 1,400,300 doses of mRNA-1273 vaccine have been delivered to children during the study period. The overall mean anaphylaxis rate was 12.81 [95% confidence interval (CI): 11.49-14.12] per 106 mRNA vaccine doses [12.14 (95% CI: 6.37-17.91) per 106 doses for mRNA-1273 and 12.84 (95% CI: 11.49-14.19) per 106 doses for BNT162b2]. Children 12-17years old accounted for 317 anaphylaxis cases, followed by 48 cases in children 3-11years old, and 6 cases in children 0-2years old. Children 10-17years old had a mean anaphylaxis rate of 13.52 (95% CI: 12.03-15.00) cases per 106 mRNA vaccine doses and children 5-9years old had a mean anaphylaxis rate of 9.51 (95% CI: 6.82-12.20) cases per 106 mRNA vaccine doses. There were two fatalities, both in the 12-17years age group. The fatal anaphylaxis rate was 0.07 cases per 106 mRNA vaccine doses. Anaphylaxis is a rare adverse event after receiving an mRNA COVID-19 vaccine in children. Continuous surveillance of serious adverse events is needed to guide vaccination policies as we move towards SARS-CoV-2 endemicity. Larger real-world studies on COVID-19 vaccination in children, using clinical case confirmation, are imperative.

COVID-19 Vaccines for Children: An Update.

The coronavirus disease 2019 (COVID-19) pandemic has had a large effect on the pediatric population, with 16,000,000 cases and counting. Currently, there are two messenger RNA (mRNA)-based and a single adjuvanted, protein-based COVID-19 vaccine approved for use in children and adolescents in the United States. Multiple studies have highlighted that these vaccines are safe for use in children and adolescents and are effective at reducing COVID-19 infection and complications. Given the risk of the SARS-CoV-2 virus to the pediatric population and ongoing global viral transmission, it is advised that providers emphasize the value of COVID-19 vaccination for children and adolescents. [Pediatr Ann. 2023;52(3):e83-e88.].

Sikap, Jarak Pelayanan Kesehatan dan Dukungan Orang Tua untuk Kesediaan Vaksinasi HPV pada Remaja

This study aims to see the relationship between attitude, distance to health services, and parental support with the willingness to the HPV vaccine in adolescents. This research method is cross-sectional. The results of this study show that attitude (p=0.000) [PR= 2.234, 95% CI 1.512-3.300] and parental support (p=0.028) [PR=1.549, 95% CI 1.041-2.306] have a significant relationship with willingness to vaccinate HPV. Meanwhile, the distance from home to health services (p=0.151) [PR=0.729, 95% CI 0.464-1.145] had no relationship with willingness to vaccinate against HPV. In conclusion, adolescents with good parental attitudes and support are more likely to be willing to vaccinate against HPV.&#x0D; Keywords: Human Papilloma Virus (HPV), Cervical Cancer, Adolescents, Attitudes, Vaccines

Short Message Service Reminder Nudge for Parents and Influenza Vaccination Uptake in Children and Adolescents With Special Risk Medical Conditions

Children with chronic medical conditions are at increased risk of severe influenza. Uptake of influenza vaccination in children and adolescents with these identified special risk medical conditions (SRMCs) is suboptimal. To assess the effectiveness of Flutext-4U, a parent short message service (SMS) reminder nudge intervention, in increasing influenza immunization in children and adolescents with SRMCs. This randomized clinical trial was conducted at a tertiary pediatric hospital in Adelaide, South Australia, from April 15 to September 30, 2021. Children and adolescents aged 6 months to younger than 18 years with SRMCs and a subspecialist outpatient appointment over a 5-month period during the Australian seasonal influenza vaccination season (April-August 2021) were eligible to participate. Follow-up was until September 30, 2021. Participants were randomly assigned (1:1 ratio) to control: clinician nudges (hospital vaccine availability, ease of access, and recommendation from hospital subspecialists) or SMS intervention (control conditions plus an additional SMS reminder nudge to parents), with randomization stratified by age group (<5 years, 5-14 years, or >14 to <18 years). The primary outcome was influenza vaccination, as confirmed by the Australian Immunisation Register. A total of 600 participants (intervention group: 298 [49.7%]; mean [SD] age, 11.5 [4.6] years; 162 female participants [54.4%]; control group: 302 [50.3%]; mean [SD] age, 11.4 [4.7] years; 155 female participants [51.3%]) were included. Influenza vaccination was 38.6% (113 of 293) in the SMS intervention group compared with 26.2% (79 of 302) in the control group (adjusted odds ratio [aOR], 1.79; 95% CI, 1.27-2.55; P = .001). Time to vaccine receipt was significantly lower among SMS participants (adjusted hazard ratio, 1.67; 95% CI, 1.25-2.22; P < .001). For participants randomly assigned by June 15, a significantly greater proportion receiving the SMS intervention were vaccinated during the optimal delivery period April to June 30 (SMS group: 40.0% [76 of 190] vs 25.4% [50 of 197]; aOR, 1.97; 95% CI, 1.28-3.06; P = .002). Results of this randomized clinical trial suggest that an additional SMS reminder nudge for parents delivered in the tertiary care hospital setting to children and adolescents with SMRCs resulted in higher influenza vaccine uptake compared with clinician nudges alone. ANZCTR Identifier: ACTRN12621000463875.

160. Physician Communication with Patients/Parents on MenB Vaccination for Older Adolescents and Young Adults

160. Physician Communication with Patients/Parents on MenB Vaccination for Older Adolescents and Young Adults

Safety and immunogenicity of a protein subunit COVID-19 vaccine (ZF2001) in healthy children and adolescents aged 3–17 years in China: a randomised, double-blind, placebo-controlled, phase 1 trial and an open-label, non-randomised, non-inferiority, phase 2 trial

Safety and immunogenicity of a protein subunit COVID-19 vaccine (ZF2001) in healthy children and adolescents aged 3–17 years in China: a randomised, double-blind, placebo-controlled, phase 1 trial and an open-label, non-randomised, non-inferiority, phase 2 trial

Adolescents Who Have Undergone Human Papillomavirus Vaccination Are More Likely to Get a COVID-19 Vaccine

PurposeHuman papillomavirus (HPV) and COVID-19 vaccination are both recommended for adolescents of ages 12–17. In May 2021, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices allowed the two vaccines to be administered concurrently. MethodsWe identified adolescents of ages 12–17 using electronic health records from a large integrated delivery system. We assessed associations between socio-demographic characteristics and uptake of HPV vaccination and COVID-19 vaccination, as well as the cumulative proportion of adolescents who obtained a COVID-19 vaccine over time by HPV vaccination status. ResultsWe identified 40,819 adolescents; 65% had received any COVID-19 vaccination, and 79% had received any HPV vaccination. Adolescents who had initiated HPV vaccination had about 4-fold greater odds of having obtained a COVID-19 vaccine than those who had not (odds ratio = 4.02, 95% confidence interval = 3.81, 4.24). DiscussionPatterns of vaccination uptake suggest possible advantages to co-promotion of adolescent vaccines.

Adolescent Self-Consent for COVID-19 Vaccination: Views of Healthcare Workers and Their Adolescent Children on Vaccination Autonomy

PurposeThis study explored the perceptions of healthcare worker parents (physicians, nurses, and staff) and their adolescents (aged 12–17 years) on adolescent self-consent to COVID-19 vaccination by applying the concept of positive deviance of those already vaccinated against COVID-19. MethodsWe used a qualitative descriptive design to conduct individual, semi-structured interviews with COVID-19–vaccinated healthcare workers in Southern California and their vaccinated adolescent children. Separate interviews were conducted with parents and adolescents from November to December 2021 using digital phone conferencing software. All interviews were recorded and transcribed. Thematic and constant comparative analysis techniques were used to identify relevant themes and subthemes. ResultsTwenty one healthcare workers (9 nurses, one nurse practitioner, one technologist, and 10 physicians) and their adolescents (N = 17) participated. Three overarching themes were identified to describe participants' perspectives about adolescent self-consent for COVID-19 vaccination: (1) Family values and practices around adolescent vaccination; (2) Differences in parent and adolescent support for vaccine self-consent laws; and (3) Parent and adolescent uncertainty on readiness for vaccine self-consent laws. Adolescents largely supported self-consent while parents supported the policy if they would be able to have a discussion with their adolescent prior to the decision. DiscussionParents and adolescents supported adolescent self-consent for COVID-19 vaccination, with the reservation that adolescents should discuss the decision alongside their parents to exercise their medical autonomy with supportive guidance. Greater adolescent involvement in making decisions and providing self-consent for healthcare, including vaccines, could prepare adolescents to have a greater sense of autonomy over their health and contribute to population health measures.

Expert consensus on the immunization strategy and practice of human papillomavirus vaccine for female adolescents in the Yangtze River Delta region

Persistent infection of high-risk human papillomavirus (HPV) is the leading cause of cervical cancer. In order to achieve the goal of cervical cancer elimination, the World Health Organization (WHO) proposed the "90-70-90" goal, one of which is "90% of girls fully vaccinated with HPV vaccine by age 15 years". Based on the epidemiological characteristics of HPV infection and the characteristics of HPV vaccine, it is important to give priority to female adolescents to be vaccinated with HPV vaccine. CAV Affiliated Association for Standardized Management and Practice of Immunization Program organized an expert group to develop an expert consensus on the immunization strategy and practice of human papillomavirus vaccine for female adolescents in the Yangtze River Delta region. This consensus introduces HPV infection and related disease burden, safety, efficacy and effectiveness of HPV vaccination for female adolescents, factors affecting the health benefits of HPV vaccination for female adolescents, current HPV vaccination strategies for female adolescents, the expert advice, common problems and precautions in the Yangtze River Delta region. This consensus is developed to guide HPV vaccination for female adolescents in the Yangtze River Delta region and provide reference for other regions.