Adolescent Vaccination Research Articles

Mothers’ perceptions and attitudes about HPV vaccination initiation among 9- and 10-year-olds

ABSTRACT HPV vaccination has potential to prevent 90% of HPV-associated cancers. The Advisory Committee on Immunization Practices recommends HPV vaccination for 11- and 12-year-olds, but vaccine initiation can start at age 9. The purpose of this study was to explore perceptions about starting HPV vaccination at a younger age to inform future interventions that promote initiation at ages 9 and 10 years. This was part of a larger study about vaccine hesitancy among racially/ethnically diverse parents of adolescents in the Greater Newark Area of New Jersey. We thematically analyzed transcripts from 16 interviews with English- and Spanish-speaking mothers who had at least one child ≤ 10 years. Analyses focused on perceptions of HPV-related disease risk, attitudes toward HPV vaccination need, and vaccine confidence specifically for 9- and 10-year-olds. Few parents with young adolescents reported receiving vaccination recommendations, and only one reported series initiation before age 11. Mothers’ hesitation about younger HPV vaccination initiation revolved around: 1) low perceived necessity among English-speaking mothers due to young adolescents not being sexually active, 2) concerns about potential side effects associated with vaccinating prepubescent adolescents, and 3) a desire for adolescents to be old enough to provide assent. Participants were not opposed to younger initiation but wanted and relied on pediatricians to inform them about vaccination for younger adolescents. These findings suggest mothers are willing to vaccinate at younger ages after clear provider recommendations. Equipping providers with evidence about vaccine safety and cancer prevention communication strategies may promote initiation and timely completion at younger ages.

The safety and effectiveness of COVID-19 vaccines for adolescents

Since the 2019 outbreak of COVID-19, the virus has rapidly spread worldwide, becoming the largest epidemic in recent years. Infection with SARS-CoV-2 can cause symptoms ranging from mild to severe, potentially leading to death, including for patients in intensive care units. Fortunately, scientists and researchers worldwide raced against time, quickly organized, and devoted themselves to vaccine research. After unremitting efforts, they developed a vaccine for COVID-19 at record speed, successfully slowing down and preventing its spread. However, even after more than three years, although significant progress has been made in combating the epidemic, numerous challenges still need to be addressed. One of these problems is the vaccination of young people, which poses a significant challenge. The vaccination of young people is hampered by severe side effects experienced by some individuals and concerns voiced by parents, which makes the process difficult. This paper examines literature and gathers data from sources such as CNKI, Google Scholar, Web of Science, Cochrane Library, and World Health Organization database to analyze the impact of three major COVID-19 vaccines on adolescents. The analysis focuses on vaccination responses and associated effects, aiming to provide references for future epidemic prevention. In addition, the suggestions may increase parents' trust in vaccines, provide them with important information, and help the vaccination of teenagers go more smoothly.

Chest pain attendances to a Paediatric Emergency Department pre- and post-COVID-19 vaccination.

Introduction of the mRNA vaccination for coronavirus disease 2019 (COVID-19) has been associated with an increase in cases of peri/myocarditis. In our retrospective cross-sectional study, we aim to (I) describe paediatric chest pain attendance, and (II) study resource utilisation in the Emergency Department (ED) of KK Women's and Children's Hospital (KKH), stratified by pre-pandemic, during the pandemic pre- and post-COVID vaccination introduction in adolescents. We reviewed records of adolescents aged 12 to 18 years old who presented to our ED with the triage complaint of chest pain between 1 January 2019 to 31 January 2022, and determined the attendance rates, aetiologies and resource utilisation during the above time periods. There were 2,418 ED attendances for chest pain in our study population. Among 887 inpatient admissions for chest pain, 1.8% were attributed to a cardiac cause. Comparing the pre-pandemic period to the period after the mRNA COVID-19 vaccination was introduced, ED chest pain rates increased from a median of 0.5% of ED attendances [interquartile range (IQR), 0.3-0.5%] to 0.9% (IQR, 0.7-2.0%) (P<0.001), while admission rates increased from a median of 26.2% of ED attendances (IQR, 24.1-29.1%) to 40.9% (IQR, 37.6-56.6%) (P<0.001). Cardiac enzyme orders among ED visits for chest pain increased from a pre-pandemic median of 0% (IQR, 0.0-2.6%) to a post-vaccination median of 26.1% (IQR, 17.2-56.2%) (P<0.001) and were due to concerns for vaccine-related myocarditis. Seven cases of probable vaccine-related myocarditis presented with chest pain to our ED. Paediatric chest pain is largely non-cardiac in origin. ED chest pain attendance rates and resource utilisation increased after the introduction of mRNA COVID-19 vaccination in adolescents.

Safety and Efficacy of a Third Dose of the BNT162b2 Vaccine in Liver-Transplanted and Healthy Adolescents.

According to our previous study, the 2-dose-BNT162b2 vaccination is less effective against the Omicron variant. This study aimed to assess the safety and efficacy of a 3-dose-BNT162b2 vaccination in liver-transplanted (LT) and healthy adolescents. LT and healthy adolescents who met the inclusion criteria received a third dose of the BNT162b2 vaccine (30 µg). Antireceptor-binding domain immunoglobulin and T-cell-specific responses to severe acute respiratory syndrome coronavirus 2 spike peptides were assessed 3 months before the third dose (Visit -1) and 0 (Visit 0), 1 (Visit 1), and 2 months (Visit 2) after the third dose. Antinucleocapsid immunoglobulin and neutralizing antibodies were assessed at Visits 0 and 1. Adverse events (AEs) were monitored. Eleven LT and 14 healthy adolescents aged 14.64 (13.2, 15.7) years (44.2% male) had antireceptor-binding domain immunoglobulin geometric mean titers of 1412.47 (95% confidence interval [CI], 948.18-2041.11) and 1235.79 (95% CI, 901.07-1705.73) U/mL at Visit -1 but increased to 38 587.76 (95% CI, 24 628.03-60 460.18) and 29 222.38 (95% CI, 16 291.72-52 401.03) U/mL (P < 0.05) at Visit 1, respectively. This was consistent with neutralizing antibodies (42.29% and 95.37% vs 44.65% and 91.68%, P < 0.001) and interferon-γ-secreting cells in LT and healthy adolescents at Visit 0 versus Visit 1, respectively. For serious AEs, an LT girl with autoimmune overlap syndrome died 5 months postvaccination from acute liver failure. In both LT and healthy adolescents, humoral and cellular immune responses were high after the 3-dose-BNT162b2 vaccination. However, serious AEs were suspected in LT adolescents with autoimmune diseases.

How is the Coping Mechanism, the Function of Adolescent Role in the Implementation of Vaccination of Covid-19 Vaccine Based on Psychological Distress? : Cross-sectional Study

Background: The role of Adolescent in implementing the Covid-19 vaccine is still lacking due to their maladaptive coping mechanisms, as indicated by unstable emotions. Maladaptive coping mechanisms hinder the optimal functioning of adolescent in vaccine implementation. Therefore, improvements in coping mechanisms are needed to enhance the optimal functioning of teenagers in this regard. This shows that the role of teenagers in implementing the Covid-19 vaccine is still low. Purpose: The aim of this research is to examine, using Callista Roy's theory, the relationship between coping strategies and the role of adolescents in implementing the Covid-19 vaccine. Methods: This study's design employed a cross-sectional analytical survey method with a population of 132 and a sample of 127 families utilizing proportionate stratified random. A questionnaire on coping strategies, social roles, and psychological discomfort was employed in this study, and the Spearman Rank test was used to analyze the results. Results: Based on the Spearman's Rank results, there is a relationship between coping strategies, adolescent role function, and psychological pressure in the implementation of the Covid-19 vaccine because the p-value is smaller than 0.05. Conclusion: Coping strategies, adolescent role functions, and psychological pressure have a significant relationship with the implementation of the covid vaccine in adolescents. As a result, it is recommended to maximize the role of adolescents, one of which is by empowering adolescent Vaccine Ambassadors who can serve as a platform for the aspirations of adolescents in the implementation and socialization of vaccines while also supporting it as a government program.

Echocardiographic function evaluation in adolescents following BNT162b2 Pfizer-BioNTech mRNA vaccination: A preliminary prospective study.

Vaccination against coronavirus disease 2019 (COVID-19) is crucial for preventing and minimizing illness. Myocarditis and pericarditis after messenger RNA (mRNA) COVID-19 vaccination in adolescents and young adult males have been reported. Most of the studies in this area rely on retrospective symptom reporting, especially for adolescents experiencing myocarditis as a potential side effect. However, prospective postvaccination echocardiographic evaluation is rare. The study enrolled adolescents aged 12 to 15 years who received the second dose of the BNT162b2 Pfizer-BioNTech mRNA (BNT) vaccine. Serial echocardiographic examinations were conducted at baseline before vaccination, followed by subsequent assessments on days 2, 7, 14, and 28 to identify any notable differences or abnormal changes in cardiac function. Clinical symptom assessments were also recorded during each follow-up. The study included 25 adolescents, comprising 14 males and 11 females, who completed the four follow-ups. Their mean age was 14 ± 1 years. The average interval between the first and second BNT vaccine doses was 90 ± 7 days. Ejection fraction values were 73.8% ± 5.2% at baseline, followed by 75.7% ± 5.3%, 75.5% ± 4.6%, 75.7% ± 4.5%, and 77.8% ± 5.8% at day 2, 7, 14, and 28, respectively. The cardiac function remained stable across all time points, with no significant differences observed between male and female participants. Within postvaccination 48 hours, 18 (72%) of the enrolled adolescents experienced temporary discomfort symptoms, which completely resolved by the final follow-up on the 28th day after vaccination. Although adolescents vaccinated with the second dose of BNT vaccine commonly experienced transient postvaccination discomfort, the serial echocardiographic examinations did not reveal any significant deterioration of cardiac function within 28 days. Further studies are required to investigate the incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) mRNA vaccination-associated myocarditis in adolescents and the related mechanisms.

Safety of BNT162b2 mRNA COVID-19 vaccine in children with chronic kidney disease: a national population study from South Korea.

In South Korea, COVID-19 vaccination has been recommended to adolescents aged 12 - 17 since October, 2021. We aimed to assess the rate of adverse events following COVID-19 vaccination in adolescents with chronic kidney disease (CKD) in South Korea, using national cohort data. We retrieved the clinical information of adolescents 12 - 17years old from the Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service (K-COV-N) database, to calculate incidence rates of purpura and other hemorrhagic conditions, Guillain-Barré syndrome (GBS), Kawasaki disease/multisystem inflammatory syndrome in children (MIS-C), myocarditis and/or pericarditis, and anaphylaxis in adolescents with CKD, after BNT162b2 vaccination. Among the 2306 adolescents with CKD, 62.7% (n = 1446) had received the BNT-162b2 vaccine. GBS, Kawasaki disease/MIS-C, and anaphylaxis or anaphylactic shock did not occur during the observation period. Purpura and hemorrhagic conditions were more frequent in the unvaccinated group (7/860 vs. 1/1446), while myocarditis/pericarditis was observed only in the vaccinated group (0/860 vs. 1/1446). Adjusted odds ratio for any of the two adverse events was lower in vaccinated adolescents than in the unvaccinated group which did not reach statistical significance (adjusted odds ratio = 0.14, 95% confidence interval: 0.02, 1.16, P = 0.068). In this national cohort study of adolescents with CKD in South Korea, we observed no evidence of increased risk of adverse events following BNT162b2 vaccination. Our finding offers insights into the safety of COVID-19 vaccines, empowering adolescent patients with CKD and their caregivers to make informed decisions.

Long-term immune response to SARS-CoV-2 infection and vaccination in children and adolescents

BackgroundThis analysis examined the durability of antibodies present after SARS-CoV-2 infection and vaccination in children and adolescents.MethodsData were collected over 4 time points between October 2020-November 2022 as part of a prospective population-based cohort aged 5-to-19 years (N = 810). Results of the (1) Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for detection of antibodies to the SARS-CoV-2 nucleocapsid protein (Roche N-test); and (2) qualitative and semi-quantitative detection of antibodies to the SARS CoV-2 spike protein receptor binding domain (Roche S-test); and (3) self-reported antigen/PCR COVID-19 test results, vaccination and symptom status were analyzed.ResultsN antibody levels reached a median of 84.10 U/ml (IQR: 20.2, 157.7) cutoff index (COI) ~ 6 months post-infection and increased slightly to a median of 85.25 (IQR: 28.0, 143.0) COI at 12 months post-infection. Peak S antibody levels were reached at a median of 2500 U/mL ~6 months post-vaccination and remained for ~12 months (mean 11.6 months, SD 1.20).ConclusionsThis analysis provides evidence of robust durability of nucleocapsid and spike antibodies in a large pediatric sample up to 12 months post-infection/vaccination. This information can inform pediatric SARS-CoV-2 vaccination schedules.ImpactThis study provided evidence of robust durability of both nucleocapsid and spike antibodies in a large pediatric sample up to 12 months after infection.Little is known about the long-term durability of natural and vaccine-induced SARS-CoV-2 antibodies in the pediatric population. Here, we determined the durability of anti–SARS-CoV-2 spike (S-test) and nucleocapsid protein (N-test) in children/adolescents after SARS-CoV-2 infection and/or vaccination lasts at least up to 12 months.This information can inform future SARS-CoV-2 vaccination schedules in this age group.

Effect of school-based HPV vaccine campaigns on inequalities in uptake in France: the PrevHPV trial

Abstract Background HPV vaccination is recommended in France for all adolescents aged 11-14. Coverage has increased over recent years but remains below 50% by age 15, with social disparities by area deprivation level, parental education and income. We analysed the effect of school-wide campaigns on adolescent vaccine uptake and related disparities. Methods PrevHPV is a controlled cluster-randomised trial to assess the effectiveness and efficiency of a multi-component intervention targeting middle schools and general practitioners. Sixty-one French middle schools were randomised in a partial factorial design to one of six intervention arms, some of which included school-based vaccine campaigns combined with in-class education and motivation. We assessed HPV vaccine status using online questionnaires that were administered in class to pupils (aged 13-15 years) at baseline and after 5 months. Using linear regression, we explored the decomposed effect of campaigns on vaccine uptake and interactions of the effect with sociodemographic variables. Results In total, 2639 adolescents provided complete vaccination data on both questionnaires, with a ≥ 1-dose coverage of 24% at baseline. Among previously unvaccinated pupils (N = 2017), 21% (7%) of girls (boys) in the control group reported receipt of first vaccine dose during the follow-up period, compared to 49% (33%) in arms with vaccine campaigns. Adjusting for baseline vaccine intention, vaccine campaigns increased the 5-month probability of a first dose by 25 (95% confidence interval: 19-31) percentage points compared to the control group. The effect of vaccine campaigns on student-reported vaccine uptake did not substantially vary by school area deprivation level, parental education level, or family multilingualism (compared to French monolingual family). Conclusions School-based campaigns substantially increased vaccine coverage among all adolescents within a short time period. Yet, underlying disparities in HPV vaccination were unchanged. Key messages • School-based vaccine campaigns can quickly increase HPV vaccine uptake among adolescents. • Vaccination campaigns need tailored implementation strategies to eventually reduce social disparities in HPV vaccination.

Trust in Physicians in the Context of HPV Vaccination of Children from the Perspective of Social Exchange Theory: A Representative Study of Polish Parents.

The vaccination of children against human papillomavirus (HPV) effectively prevents HPV infection and HPV-related cancers in women and men. However, HPV vaccination programs are met with vaccine hesitancy, which varies between countries. The coverage in Poland is low, although introducing nationally funded HPV vaccination for girls aged 12-13 in mid-2023 may increase it. The uptake of the HPV vaccine in adolescents is highly affected by parental decisions, which in turn can be influenced by interactions with the physician. The present representative study aimed to analyze the acceptance of the HPV vaccine among Polish parents (n = 360) and the level of trust in HPV vaccination in the pediatrician/general practitioner who takes care of their children aged 9-15 years. The data were gathered in September 2022 using computer-assisted telephone interviews. Most surveyed parents reported trusting their child's physician regarding vaccine recommendations (89.2%) and vaccinated their child with all or most of the vaccines recommended by a national vaccination guideline (94.7%). However, 13.3% declared themselves as moderate or strong vaccine opponents, a group characterized by high (83.4%) distrust in physicians. There was no difference in the awareness of HPV in groups varying in trusting the physicians, but parents who trusted them were more frequently aware of the HPV vaccine. Parental willingness to vaccinate their child against HPV was highly differentiated by the level of trust in the child's physician. The results highlight that trust in physicians is a critical factor shaping decisions for children's vaccination, stressing a continuous need to improve strategies to communicate with patients.

Kidney complications associated with COVID-19 infection and vaccination in children and adolescents: a brief review.

Coronavirus disease 2019 (COVID-19) has spread considerably across the globe, affecting numerous children and adolescents besides adults. Despite its relatively lower incidence rates in children and adolescents than in adults, some infected children and adolescents exhibit a severe postinflammatory response known as multisystem inflammatory syndrome in children, followed by acute kidney injury, a common complication. Meanwhile, few reports have been available regarding kidney complications such as idiopathic nephrotic syndrome and other glomerulopathies associated with COVID-19 infection and vaccination in children and adolescents. However, the morbidity and mortality of these complications are not exceptionally high; more importantly, causality has yet to be clearly established. Finally, vaccine hesitancy in these age groups should be addressed, considering the strong evidence of COVID-19 vaccine safety and efficacy.

Investigation the longevity of hepatitis B surface antibody in vaccinated students of Hormozgan university of medical sciences.

Hepatitis B is a common chronic viral infection in humans. Universal use of hepatitis B vaccine is crucial for controlling the infection, but the duration of vaccine-induced immunity remains uncertain. This study aimed to assess hepatitis B antibody levels (anti-HBs) after vaccination in infancy and adolescence, and explore the relationship between immunity levels and variables such as age, sex, BMI, place of birth, and duration since last vaccination among students at Hormozgan University of Medical Sciences from 2019 to 2021. The study included 1134 students who completed a questionnaire and provided blood samples for ELISA-based measurement of antibody titers. The findings revealed that 727 students (64.1%) had no protective antibody level (anti-HBs <10 mIU/ml), 299 (26.4%) had partial immunity (anti-HBs 10-100 mIU/ml), and 108 (9.5%) had complete immunity (anti-HBs >100 mIU/ml). No statistically significant relationships were observed between anti-HBs titer and age, sex, or BMI. However, antibody titer decreased with increasing time since last vaccination (P<0.001). This study highlights the decline in antibody titer over time following primary vaccination. Sustained immunity against hepatitis B virus relies on antibody durability or robust immunological memory, suggesting the importance of timing booster vaccinations.

A modelled analysis of the impact of COVID-19-related disruptions to HPV vaccination.

COVID-19 disrupted school attendance in many countries, delaying routine adolescent vaccination against human papillomavirus (HPV) in some settings. We used Policy1-Cervix, a dynamic model simulating HPV transmission, natural history, vaccination, cervical screening, and diagnosis of HPV-related cancers, to estimate the impact on HPV-related cancers from disruptions to HPV vaccination in a high-income setting. A baseline scenario of no disruption to HPV vaccination was modelled, which assumed uptake of the nonavalent vaccine at the age of 12 by 82.4% of females and 75.5% of males, as is the coverage in Australia. Additional lifetime HPV-related cancer cases were calculated for three disruption scenarios affecting one birth cohort (2008; aged 12 in 2020) compared to the baseline scenario: (1) 1-year delay (no doses missed); (2) 1- to 7-year delay (slow catch-up); (3) no catch-up (herd effects only). A fourth scenario assumed no catch-up HPV vaccination for two birth cohorts, that is all individuals born in 2008 and in 2009 missed vaccination (worst-case scenario). Compared to 1532 HPV-related cancer cases estimated for the baseline no disruption scenario, we found a 1-year delay could result in ≤0.3% more HPV-related cancers (n = 4) but the increase would be greater if catch-up was slower (5%; n = 70), and especially if there was no catch-up (49%; n = 750). Additional cancers for a single missed cohort were most commonly cervical (23% of the additional cases) and anal cancers (16%) in females and oropharyngeal cancers in males (20%). In the worst-case scenario of two birth cohorts missing vaccination, ≤62% more HPV-related cancers would be diagnosed (n = 1892). In conclusion, providing catch-up of missed HPV vaccines is conducted, short-term delays in vaccinating adolescents are unlikely to have substantial long-term effects on cancer.

A Multivariate Probit Regression of the Uptake of Adolescent Vaccines Among Racial/Ethnic Minority Adolescents Before and During the COVID-19 Pandemic

PurposeThe uptake of adolescent vaccines has improved over the years. However, research of the effects of the COVID-19 pandemic on this uptake among racial/ethnic minority adolescents has been limited. This study was conducted to compare the probability of uptake of the human papillomavirus (HPV); tetanus, diphtheria, and acellular pertussis (Tdap); and quadrivalent meningococcal conjugate (MenACWY) vaccines among racial/ethnic minority adolescents ages 13–17 years in 2019, 2020, and 2021. MethodsUsing a cross-sectional design to examine data from the National Immunization Survey–Teen (2019–2021), multivariate probit regression was used to model variation in uptake of these three adolescent vaccines (n = 38,128). The outcome measures were HPV, Tdap, and MenACWY vaccine uptake. ResultsThe probability of uptake of HPV vaccine was higher in 2020 (Coef = 0.09 [95% confidence interval (CI), 0.03–0.16]) and 2021 (Coef = 0.07 [95% CI, 0.00–0.15]) than in 2019. The probability of uptake of MenACWY vaccine was higher in 2020 (Coef = 0.08 [95% CI, 0.02–0.15]) than in 2019. The probability of uptake of recommended vaccines varied among racial/ethnic minorities with non-Hispanic Black adolescents exhibiting higher probability of uptake of HPV vaccine (Coef = 0.10 [95% CI, 0.01–0.19]) than Tdap vaccine. U.S. Census region and insurance status were associated with the uptake of all recommended vaccines. DiscussionProgress in the uptake of these recommended vaccines may not have been interrupted by the COVID-19 pandemic. Also, disparities in uptake of the recommended vaccines still exist despite increased uptake during the pandemic. Future research should examine the disparities as well as examine regional differences in the uptake of these three adolescent vaccines.

Experience in the use of vaccine Gam-Kovid-Vak-M for the prevention of COVID-19 in children

The goal is to evaluate the tolerability and effectiveness of the domestic vector vaccine Gam-Covid-Vak-M in children aged 12—17 years, adherence to vaccination of adolescents and parents to improve work on the prevention of COVID-19. Materials and methods. A retrospective analysis of the medical records of 115 children aged 12—17 years who were vaccinated in 2022 with the Gam-COVID-Vac-M vaccine in two children's polyclinics in St. Petersburg was carried out. Additional information was collected through telephone interviews. A cross-sectional anonymous online survey of adolescents aged 15—17 was also conducted to study awareness of COVID-19 and adherence to vaccination. Results. Only 23.5% of those vaccinated were at risk for severe and complicated COVID-19. Parents showed low adherence to vaccination against COVID-19 — 71.3% vaccinated themselves and 73.1% considered it necessary to protect the child. Only in 14.1% of cases, a teenager aged 15—17 made the decision to be vaccinated. According to 76.9% of adolescents, COVID-19 is a dangerous disease, while 55.6% consider vaccination unnecessary, mainly due to ineffective protection and the possibility of complications. Nevertheless, side effects after the first and second components of Gam-COVID-Vac-M were observed in 24.3% and 24.2%, respectively, which is 4 times less than with foreign vaccines. Systemic and local reactions were observed on days 1—2 after immunization. All manifestations were mild or moderate and resolved within 1—2 days on average. Serious adverse events were not registered. The effectiveness of the vaccine was 97.4%. Conclusion. Preliminary results indicate good tolerance and efficacy of the domestic vaccine Gam-COVID-Vac-M.

Improving human papilloma virus vaccination rates among adolescents.

The human papilloma virus (HPV) is the leading cause of cervical cancer worldwide and is responsible for genital warts and five other types of cancers. The HPV vaccine was introduced in 2006 and demonstrated to be safe and more effective than expected, yet adolescent rates of immunization in the United States remain low. Adolescent HPV vaccine rates were below the national average, and effective vaccine recommendation strategies were not used at an urban pediatric primary care office in southern Florida. The percentage of HPV vaccine rates in this primary care office were measured among adolescents ages 13-17 years using data obtained from Florida's state vaccine registry before implementation of the intervention, after the intervention, and monthly over a 90-day period. Interventions aimed to improve vaccine rates included implementing an HPV protocol consisting of education on providing a strong bundled recommendation, appointing a vaccine champion, implementing standing vaccine orders, and educational materials. The vaccine rates among adolescents increased by 11% for the initial dose, 7% for the second dose, and 6% for the vaccine completion rate. Chi-square test demonstrated statistical significance, for the initial vaccine. A nurse practitioner-led application of an evidenced-based HPV vaccine protocol positively affected the care of adolescents in this primary care setting.

Decision-Making Regarding Elective Child and Adolescent Vaccinations Among Native Hawaiian and Pacific Islander Parents in Orange County.

Native Hawaiians and Pacific Islanders (NHPIs) in aggregate experience greater health burdens than non-Hispanic Whites, such as a higher incidence of cervical cancer and COVID-19. Given the importance of vaccinations in preventing and reducing the severity of diseases, such as the flu, cervical cancer, and COVID-19, the receipt of vaccines during childhood and adolescence is crucial. Therefore, this qualitative study aimed to explore the factors associated with NHPI parents' decisions regarding vaccinating their children with these elective vaccinations-that is, vaccinations not required for child care, preschool, or K-12 admissions in California but highly recommended. A total of 15 NHPI parents were recruited through a community-based organization. Semi-structured interviews explored parents' reasons for accepting or denying each vaccine for their child(ren). Results demonstrated variable acceptance of each vaccine, though consistent themes included protection and concerns over side effects. This study also found two general types of parents-those who treat vaccines the same and those with varying opinions about each vaccine. Results from this study demonstrate the family- and community-oriented nature of NHPI communities, suggesting that future interventions target not only parents but also their families and communities to cultivate vaccine acceptance through social networks. Furthermore, addressing all three vaccines during well-child visits may benefit parents who view each vaccine as separate entities with individual pros and cons. Such interventions could contribute toward reducing the burdens of particularly chronic health disparities.

Effectiveness of COVID-19 vaccines among children and adolescents against SARS-CoV-2 variants: a meta-analysis.

This systematic review and meta-analysis aimed to evaluate the effectiveness of COVID-19 vaccines among children and adolescents against SARS-CoV-2 variants. We searched PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov for studies published on or before June 20, 2023. Studies evaluating the effectiveness of COVID-19 vaccines in children and adolescents (≤ 18years of age) were included. Data extraction, quality assessment, and analysis were conducted following PRISMA guidelines. Ten studies were included, comprising five cohort studies (527,778 participants) and four case-control studies (1,477,422 participants). The overall vaccine effectiveness (VE) against SARS-CoV-2 variants was 68% (95% CI = 60-74%). In terms of age, the VE was higher in adolescents aged 12-18years [69%(95% CI = 61-75%)] than in children aged 5-11years [44%(95% CI = 1-68%)]. "Fully vaccinated" may offer greater protection than "partially vaccinated," with a VE of 71% (95%CI = 59-79%) and 66% (95%CI = 51-76%), respectively. Conclusion: This meta-analysis presents moderate-quality evidence that the COVID-19 vaccine is effective in safeguarding children and adolescents from the SARS-CoV-2 variant. Being fully vaccinated may offer greater protection than being partially vaccinated. Nevertheless, additional high-quality controlled trials are required to verify this finding. What is Known: • The COVID-19 pandemic has led to the rapid development and deployment of vaccines worldwide. Children and adolescents are a unique population for vaccination, and the effectiveness of vaccines against SARS-CoV-2 variants in this age group is of concern. What is New: • The COVID-19 vaccine is effective in protecting children and adolescents against the SARS-CoV-2 variant. Being fully vaccinated may offer greater protection than being partially vaccinated.

Factors Related to the Compliance of Arab Parents in Israel to the Vaccination of Children and Adolescents against COVID-19.

To examine the influence of factors on the willingness of parents to vaccinate their young and adolescent children and if there is a difference between parents' attitudes to both groups. The survey examined correlations between variables and attitudes toward the vaccine and the pandemic and was disseminated anonymously to parents of children between the ages of 5 and 18 in the Arab population of Israel through social media networks, using the snowball method. Statistical analyses included the Pearson correlation, MANCOVA, and logistic regression tests. In total, 361 Arab Israeli parents participated. As mentioned above, 130 parents had both children and adolescents. Overall, 48 parents (36.9%) chose not to vaccinate both their children and adolescents, 52 parents (40.0%) chose to vaccinate only their adolescents, only 1 parent (0.8%) chose to vaccinate only the child, and 29 parents (22.3%) vaccinated both their children and adolescents. Significant correlations were found among a higher age of parents and socioeconomic status, attitudes toward COVID vaccination, subjective norms, perceived severity of the disease, perceived benefits of vaccination, and trust in formal sources. There is a difference between parents' decision to be vaccinated and their willingness to vaccinate their children. There is a difference between their decision to vaccinate their adolescents and their young children. Different factors positively or negatively influenced parents' decisions. Addressing these factors by authorities may increase compliance of Arab minorities with instructions in the future.

Association between use of antipyretics and antibody titers after two doses of the BNT162b2 SARS-CoV-2 vaccine in adolescents and young adults with underlying diseases

There are few reports on the association between antipyretic use and antibody titers in adolescents and young adults following SARS-CoV-2 vaccination. Multivariable linear regression analyses were performed to examine the association between antipyretic use and antibody titers. The use of antipyretics was not associated with antibody titers (β coefficient [95% CI] = −0.107 [–0.438 to 0.224]).