Vaccine-preventable Infectious Diseases Research Articles

Sex differences in COVID-19 vaccine confidence in people living with HIV in Canada

BackgroundUnderstanding the roots of vaccine confidence in vulnerable populations, such as persons living with HIV (PLWH), is important to facilitate vaccine uptake, thus mitigating infection and spread of vaccine-preventable infectious diseases. In an online survey of PLWH conducted in Canada during winter 2022 (AIDS and Behav 2023), we reported that the overall COVID-19 vaccination uptake rate in PLWH was similar by sex. Here, we examined attitudes and beliefs towards vaccination against COVID-19 based on sex. MethodsBetween February and May 2022, PLWH across Canada were recruited via social media and community-based organizations to complete an online survey consisting of a modified Vaccine Hesitancy Scale (VHS) questionnaire with items from the National Advisory Committee on Immunization Acceptability Matrix. Descriptive statistics were used to summarize participant characteristics and responses to the VHS questionnaire by biological sex. The effect of biological sex on total VHS score, two subscales (“lack of confidence” and “perceived risk”) was assessed separately by linear regression adjusting for other key baseline variables. ResultsOf 259 PLWH, 69 (27 %) were females and 189 (73 %) were males. Sixty-six (26 %) of participants self-identified as a woman, 163(63 %) as a man and 28(11 %) as trans/two-spirited/queer/non-binary/agender/other. The mean age (SD) was 47 ± 14 years. Females were less likely to believe that COVID-19 vaccination was: important for his/her own health (71 % vs. 86 %); a good way to protect themselves from infection (68 % vs. 86 %); that getting the COVID-19 vaccine was important for the health of others in his/her community (78 % vs. 91 %); believed recommendations by their doctor/health care provider about COVID-19 vaccines (78 % vs. 88 %); that information about COVID-19 vaccines from public health officials was reliable and trustworthy (56 % vs. 75 % vs); COVID-19 vaccines are effective in preventing COVID-19 infections (61 % vs. 82 %) and that all COVID-19 vaccines offered by government programs in their communities were important for good health (70 % vs. 87 %). Although more males than females felt that new vaccines generally carry more risks than older vaccines (19 % vs 16 %,), fewer males than females endorsed concern about serious side effects of COVID-19 vaccines (33 % vs 45 %).The linear regression model showed females had a significantly higher VHS total score than males (adjusted mean difference 0.38; 95 % confidence interval (CI) 0.13–0.64; p = 0.004), indicating greater COVID-19 vaccine hesitancy among females. It was observed that females had a greater “lack of confidence in vaccines” score than males (adjusted mean difference 0.43; 95 % CI 0.14–0.73; p = 0.004). We did not observe a significant difference in “perceived risk in vaccines” between males and females (adjusted mean difference 0.20; 95 % CI −0.07–0.46; p = 0.1). The inadequate number of participants self-identifying as different from biological sex at birth prevented us from analyzing the VHS score based on gender identity. ConclusionsAmong PLWH, females showed greater COVID-19 vaccine hesitancy than males. Specifically, compared with males, females had a higher level of lack of confidence in vaccines. Fewer females than males believed that COVID-19 vaccines had health benefits at both the personal and societal level and that recommendations made by their doctor/health care provider and public health officials are reliable and trustworthy. Further investigation into reasons for this difference in opinion still needs to be elucidated. Educational interventions targeted toward females living with HIV are especially needed to increase confidence in vaccination.

Vaccine hesitancy among parents of children in their first two years of life.

Vaccine hesitancy is considered a primary cause of outbreaks of vaccine-preventable infectious diseases. The Austrian vaccination plan includes 24 vaccinations in the first 2 years of life, 12 for free and 12 subject to a fee. Since preterm babies are more susceptible to severe infections, immunization is a vital protection strategy. This study examines the routine immunization schedule recommended for children in Austria, the number of timely vaccinations, and the number of delayed and rejected vaccinations. Possible reasons for vaccination delays and rejection and potential influencing factors (preterm birth, COVID-19 pandemic, information sources) are also analyzed. We included children aged 2 to 5 years who presented to Vienna's largest pediatric center with an Austrian mother-child pass and spent the first 2 years of their lives in Austria. Data was collected using questionnaires about the vaccination status, parents' reasons for any rejections or delays in the recommended vaccination regimen, the impact of the COVID-19 pandemic on individuals' vaccination behavior, and child-specific influencing factors such as preterm birth and socioeconomic factors. 90% of the 150 study subjects follow the recommendations on routine vaccinations, while 40-62% accept vaccinations subject to a fee. Preterm infants received less fee-based (53%) as well as gratuitous (88%) vaccinations. While free vaccinations tend to be delayed, more fee based vaccinations are rejected. With free vaccinations, delays and refusals occur due to illness or missed appointments. In the case of fee- required vaccinations, however, fears of side effects are also one of the main reasons. Due to the COVID-19 pandemic, about a quarter of parents have become more skeptical about vaccines. However, the vaccination rate of premature babies is usually just below that of full-term babies. Physicians remain the most trustworthy source of information about vaccinations. Free vaccinations are more accepted by parents than fee based vaccinations. Preterm babies, which are a high risk group for vaccination preventable diseases, show a lower or delayed vaccination rate, which must be prevented through intensive doctor education. In addition, vaccination hesitancy changed during the COVID-19 pandemic, which needs to be addressed during the medical consultation.

Deterministic modelling of asymptomatic spread and disease stage progression in vaccine preventable infectious diseases

AbstractThis study introduces a deterministic formulation for modelling the asymptotic spread of a vaccine preventable disease as well as the different stages for the progression of the disease. We derive the formula for the associated basic reproduction number. To illustrate the proposed model, we use data from the 2017–2018 diphtheria outbreak in Yemen and fit the parameters of the model. A sensitivity analysis of the basic reproduction number, with respect to the model parameters, show that this number increases with an increase of the transmission rate while this number decreases when vaccination rate increases.

Immunity against measles, mumps, rubella, and varicella among homeless individuals in Germany - A nationwide multi-center cross-sectional study.

Homeless individuals suffer a high burden of vaccine-preventable infectious diseases. Moreover, they are particularly susceptible to adverse infection outcomes with limited access to the health care system. Data on the seroprevalence of measles, mumps, rubella, and varicella within this cohort are missing. The seroprevalence of measles, mumps, rubella, and varicella was determined within the homeless population in Germany. Predictors of lacking immune protection were determined using multivariable logistic regression analysis. Homeless individuals in Germany (n = 611) showed a seroprevalence of 88.5% (95% CI: 85.8-91.0) for measles, 83.8% (95% CI: 80.6-86.6) for mumps, 86.1% (95% CI: 83.1-88.7) for rubella, and 95.7% (95% CI 93.8-97.2) for varicella. Measles seroprevalences declined from individuals born in 1965 to individuals born in 1993, with seroprevalences not compatible with a 95% threshold in individuals born after 1980. For mumps, seroprevalences declined from individuals born in 1950 to individuals born in 1984. Here, seroprevalences were not compatible with a 92% threshold for individuals born after 1975. Seronegativity for measles, mumps and rubella was associated with age but not with gender or country of origin. Herd immunity for measles and mumps is not achieved in this homeless cohort, while there was sufficient immune protection for rubella and varicella. Declining immune protection rates in younger individuals warrant immunization campaigns also targeting marginalized groups such as homeless individuals. Given that herd immunity thresholds are not reached for individuals born after 1980 for measles, and after 1975 for mumps, vaccination campaigns should prioritize individuals within these age groups.

Study protocol: Project 2VIDA! SARS-CoV-2 vaccine intervention delivery for adults in Southern California.

To date, the United States (US) leads the world in the number of infections and deaths due to the Coronavirus Disease 2019 (COVID-19). Racial and ethnic disparities in COVID-19 morbidity and mortality are staggering. Age-adjusted data show that AA and Latino individuals have had higher rates of death over most of the pandemic and during surges. Project 2VIDA! is community-based participatory research (CBPR) that was developed to address individual, social, and contextual factors related to access and acceptance of the COVID-19 vaccine among African American and Latino communities in Southern California. This paper describes the study protocol and overarching objectives. Project 2VIDA! is a multilevel intervention that builds on the principals of CBPR and is designed to increase uptake of the COVID-19 vaccine among African American and Latino individuals (≥16 years and older) in San Diego County. The intervention was developed with a working group comprised of representatives from community and academia and centers on targeted COVID-19 individual awareness and education, linkage to medical and supportive services, COVID-19 community outreach and health promotion and offering the COVID-19 vaccine through community pop-up clinics. Findings from 2VIDA! will provide data on the impact, feasibility, and acceptability of the intervention which are all crucial for the adaptation, refinement, and improvement of vaccine outreach interventions for COVID-19 and other vaccine preventable infectious diseases that severely impact African American and Latino communities. https://clinicaltrials.gov/ct2/show/NCT05022472?term=Project+2VIDA&draw=2&rank=1, NCT05022472.

The Influence of CD4+ T-Lymphocytes on the Strength of Anti-Diphtheria Immunity in Adult People Living with HIV

The Influence of CD4+ T-Lymphocytes on the Strength of Anti-Diphtheria Immunity in Adult People Living with HIV

Possible counter-intuitive impact of local vaccine mandates for vaccine-preventable infectious diseases.

We modeled the impact of local vaccine mandates on the spread of vaccine-preventable infectious diseases, which in the absence of vaccines will mainly affect children. Examples of such diseases are measles, rubella, mumps, and pertussis. To model the spread of the pathogen, we used a stochastic SIR (susceptible, infectious, recovered) model with two levels of mixing in a closed population, often referred to as the household model. In this model, individuals make local contacts within a specific small subgroup of the population (e.g., within a household or a school class), while they also make global contacts with random people in the population at a much lower rate than the rate of local contacts. We considered what would happen if schools were given freedom to impose vaccine mandates on all of their pupils, except for the pupils that were exempt from vaccination because of medical reasons. We investigated first how such a mandate affected the probability of an outbreak of a disease. Furthermore, we focused on the probability that a pupil that was medically exempt from vaccination, would get infected during an outbreak. We showed that if the population vaccine coverage was close to the herd-immunity level, then both probabilities may increase if local vaccine mandates were implemented. This was caused by unvaccinated pupils possibly being moved to schools without mandates.

Barriers to vaccination among older adults: Demographic variation and links to vaccine acceptance

BackgroundDespite risks of vaccine-preventable infectious diseases, many older adults are under vaccinated. The present study investigates possible barriers to acceptance of vaccines recommended for older adults and considers demographic variation and links to acceptance for distinct vaccines. MethodsA mailed survey was conducted with 901 older adults (aged 65+) across the state of North Dakota, oversampling for rural regions. The survey addressed demographic characteristics, barriers to vaccination (including needle phobia, cost, lacking doctor recommendation, transportation, and scheduling uncertainty), and vaccine acceptance (including provider guidance acceptance and uptake for influenza, shingles, pneumococcal, and COVID-19 vaccines). ResultsCost (27.2 %) and needle phobia (24.1 %) were the most prevalent barriers. Rural, lower educated, non-white, and living alone older adults experienced increased risks of barriers such as cost, lacking a doctor recommendation, transportation, and uncertainty how to schedule. Cost was associated with shingles vaccine uptake, whereas lacking doctor recommendation was associated with uptake for all vaccines except shingles. Needle phobia was associated with uptake of all vaccines except COVID-19. Transportation barrier was only associated with pneumococcal vaccine uptake. ConclusionsThese findings highlight relatively low prevalence of barriers, yet variability by older adults’ demographic characteristics. Further, the influence of barriers on acceptance varied by vaccine type. By better understanding the nuanced role of barriers to older adults’ vaccination, strategies to increase vaccination rates can be developed.

EPH269 Estimating the Burden of Vaccine-Preventable Infectious Diseases Caused by Herpesviruses Beyond Herpes Zoster in Europe: What's Going on in Spain and Germany?

EPH269 Estimating the Burden of Vaccine-Preventable Infectious Diseases Caused by Herpesviruses Beyond Herpes Zoster in Europe: What's Going on in Spain and Germany?

Rates of Seroprotection against Vaccine-Preventable Infectious Diseases in HIV-Exposed and -Unexposed Malawian Infants.

The evaluation of seroprotection rates against vaccine-preventable infectious diseases allows for the identification of risk populations. HIV-exposed infants, even if not infected with HIV, have higher morbidity and mortality in comparison to unexposed counterparts. The aim of this study was to compare the specific IgG levels against Haemophilus influenzae type-B (HiB), Hepatitis-B (HBV), and Streptococcus pneumoniae (Spn) in two groups of infants (HIV-exposed and HIV-unexposed) living in Malawi. Blood samples from 62 infants, 49 HIV-exposed, uninfected (HEU), and born to women living with HIV and 13 HIV-unexposed and uninfected (HUU), were collected at 6 months, and specific IgG levels were determined using ELISA tests. The antibody levels against HiB, HBV, and Spn were similar in the two groups. At six months, all HUU infants and 81.6% of HEU infants showed seroprotective levels against HiB, while a percentage of protection varying from 80.6 to 84.6% was observed for HBV and Spn regardless of HIV exposure. Only 59.2% of HEU and 69.2% of HUU infants showed antibody protection against all three pathogens. These results indicate similar rates of seroprotection among HEU and HUU infants but also suggest that a consistent fraction of infants received incomplete vaccinations. Strategies to enforce participation in immunization programs in Malawi should be a health priority.

Vaccination, information and parental confidence in the digital age in England

BackgroundImmunisation programmes have led to substantial reductions in vaccine-preventable infectious diseases globally. A variety of factors have been shown to impact parental confidence and uptake of childhood vaccines, from concerns about vaccine safety to a lack of perceived need. Determinants of vaccine decision making include information, risk perceptions, and modifying factors such as attitude, identity, norms, habit and barriers. With the rise of the internet and social media, there has been a vast increase in information available about vaccines, not all scientifically-based and well-informed. Methods285 locations in England were randomly selected to survey a nationally representative sample of the English population. 1735 primary care givers of children aged between 2 months and <5 years old from England were randomly selected and surveyed via face-to-face interviews between January and March 2019. ResultsA much higher percentage of parents surveyed trust health care workers, the NHS, pharmacists and government for advice about immunisation, in comparison to media, the internet and social media. Most parents use official sources to obtain information on vaccines including parents who use the internet. The small proportion of parents who reported having seen negative information about vaccines were more likely to find it on the internet. Parents who felt they did not have enough information were more likely to have delayed or refused a vaccine for their child. InterpretationThis study showed that for parents of young children in England, vaccination continues to be the social norm but this can rapidly change and clear, consistent messaging from trusted sources continues to be important. Although a proportion do seek vaccine information on the internet, the majority use official sources. Representative attitudinal surveys continue to be key in identifying any emerging threats to parental vaccine confidence.

SARS-CoV-2 Immunity in Hematopoietic Stem Cell Transplant and Cell Therapy Recipients: What Do We Know, and What Remains to Be Determined?

Hematopoietic stem cell transplantation (HSCT) results in profound immunosuppression for the first few months after the procedure, requiring patients to be revaccinated against childhood vaccine-preventable infectious diseases. Patients who undergo allo-HSCT are at high risk of bacterial, fungal, and viral infections, with infectious complications responsible for at least one third of deaths. Even before the COVID-19 pandemic, respiratory virus infections were known to be more severe in HSCT recipients. The pandemic has highlighted the vulnerability of HSCT recipients, who experience an increased risk of morbidity and mortality after COVID-19 compared with healthy populations due to their severe immunodeficiency status. However, the current pandemic has also provided an exceptional scenario to better understand the immune response to SARS-CoV-2 cases and mRNA vaccines in HSCT recipients, including those receiving CD19-directed chimeric antigen receptor T cell (CAR-T) therapy. Researchers have focused on the role of the immune system in protecting against severe SARS-CoV-2 in patients with hematologic malignancies, including HSCT recipients. Insights gained during the pandemic will likely soon be used to improve preventive strategies in this population against viral infections in the near future. This narrative review summarizes the current knowledge on SARS-CoV-2 immunity in HSCT and cell therapy recipients following SARS-CoV-2 cases or vaccination.

Vaccine Hesitancy in Women of Childbearing Age and Occupational Physicians: Results from a Cross-Sectional Study (Italy, 2022)

Italian occupational physicians (OPs) are instrumental in promoting vaccination practice in occupational settings, and this study aims to characterize their attitudes, knowledge, and practices (collectively, KAP) towards immunization practice in women of childbearing age. A convenience sample of 120 OPs (50.8% males, mean age of 48.2 ± 5.9 years old) completed a structured online questionnaire (potential recipients: 2034; response rate: 5.9%) assessing their understanding of official recommendations, their general knowledge of vaccine practice, their attitudes towards vaccines, and their risk perception about vaccine-preventable infectious diseases. The sampled OPs exhibited a good understanding of official recommendations, and they were largely favorable towards vaccination of pregnant women. Knowledge status was relatively good (potential range 0 to 100%, average score 22 74.5% ± 18.2), while risk perception towards sampled disorders was heterogenous: the greatest was the one for SARS-CoV-2 (52.7% ± 32.9), followed by seasonal influenza (45.3% ± 31.6), and pertussis (37.8% 24 ± 28.2). The main predictors for promoting vaccination were higher knowledge about seasonal influenza vaccine (SIV; adjusted Odds Ratio [aOR] 102.2, 95% Confidence Interval [95%CI] 9.68–1080.26), tetanus-diphtheria-acellular pertussis vaccine (Tdap; aOR 12.34, 95%CI 2.62; 58.22) 27 and SARS-CoV-2 vaccine (aOR 14.76, 95%CI 2.74–79.69). A better attitude towards SIV was positively associated with previous vaccination of the respondent (aOR 4.90, 95%CI 1.19–20.14), while higher risk perception towards SIV was characterized as a negative predictor (aOR 0.04, 95%CI 0.01–0.35), as was working as an OP in healthcare facilities (aOR 0.03, 95%CI 0.01–0.43). Tdap was positively associated with male gender of respondents (aOR 10.22, 95%CI 2.60 to 40.24) and higher risk perception about pertussis (aOR 10.38, 95%CI 1.47 to 73.47). Overall, our data suggest that improving the understanding of OPs about the health burden of frequently encountered pathogens could be instrumental in increasing their involvement in the promotion of vaccine practice. Because of the low rate of response to our survey, our conclusions remain tentative.

Adverse Events Following Immunizations in Infants Under 1 Year of Age in Lorestan Province, Western Iran.

Vaccination is an important intervention for preventing disease and reducing disease severity. Universal vaccination programs have significantly reduced the incidence of many dangerous diseases among children worldwide. This study investigated the side effects after immunization in infants under 1 year of age in Lorestan Province, western Iran. This descriptive analytical study included data from all children <1 year old in Lorestan Province, Iran who were vaccinated according to the national schedule in 2020 and had an adverse event following immunization (AEFI). Data were extracted from 1084 forms on age, sex, birth weight, type of birth, AEFI type, vaccine type, and time of vaccination. Descriptive statistics (frequency, percentage) were calculated, and the chi-square test and Fisher exact test were used to assess differences in AEFIs according to the abovelisted variables. The most frequent AEFIs were high fever (n=386, 35.6%), mild local reaction (n=341, 31.5%), and swelling and pain (n=121, 11.2%). The least common AEFIs were encephalitis (n=1, 0.1%), convulsion (n=2, 0.2%), and nodules (n=3, 0.3%). Girls and boys only showed significant differences in mild local reactions (p=0.044) and skin allergies (p=0.002). The incidence of lymphadenitis (p<0.001), severe local reaction (p<0.001), mild local reaction (p=0.007), fainting (p=0.032), swelling and pain (p=0.006), high fever (p=0.005), and nodules (p<0.001) showed significant differences based on age at vaccination. Immunization is a fundamental public health policy for controlling vaccine-preventable infectious diseases. Although vaccines such as the Bacillus Calmette-Guérin vaccine, oral poliovirus vaccine, and pentavalent vaccine are well-researched and reliable, AEFIs are inevitable.

108. Immune Status of Indian Pediatric Health Care Workers against Various Vaccine Preventable Diseases

Abstract Background Health care workers (HCWs) possess a potential risk to acquire and spread various infections. This study was planned to assess the immune status of HCWs in pediatric departments of two tertiary care hospitals in Northern India. Methods In this cross-sectional study, HCW’s (Indians), working in pediatric departments of these hospitals, over 6-months period (July18-Dec18) were enrolled after taking written consent and their 5-ml venous blood sample was collected. Ethical clearance was obtained from Institute Ethics committee, before enrolling subjects. Serum were tested for antibodies against diphtheria-toxin (DT), pertussis-toxin (PT), measles, mumps, rubella, varicella, hepatitis-B (HbsAb) and hepatitis-A using commercial IgG (quantitative) ELISA kits. Results A total of 160 HCW’s (M:F=77:83), having mean age 30.6±7.8 years, were enrolled. Out of them 106 (66.3%) were resident doctors, 31 (19.4%) nursing-staff, 18 (11.3%) faculty members, 3 (1.9%) research-staff and 2 (1.3%) paramedical-staff. In our study, antibodies (IgG) against DT were between 0.01 to 0.1 IU/ml in 78.1% (120/160); requiring a Tdap booster; while 7 out of 125 had titers &amp;lt; 0.01 IU/ml, which needed 3-doses of primary vaccination. Antibodies (IgG) against PT &amp;lt; 30 IU/ml were seen in 60.6% (97/160), which were considered as seronegative, as per kit recommendations. A total of 3% (5/160), 13.1% (21/160), 10% (16/160), 17.5% (28/160) had titers &amp;lt; 12 IU/ml for IgG antibodies against measles, mumps, rubella and varicella respectively; were considered unprotected. A total of 25% (40/160) had Anti-HBs antibody titers &amp;lt; 20 mIU/ml; which were low, therefore were advised to take one booster dose of Hep-B vaccine. A total of 15.6% (25/160) had IgG antibodies against hepatitis-A &amp;lt; 10 mIU/ml; were unprotected. Conclusion Alarming proportions of pediatric-HCWs had low antibody titres against DT (78.1%) and PT (60.6%), necessitating a dose of Tdap. A total of 10%, 17.5% and 15.6% lacked protective antibodies against rubella, varicella and hepatitis-A. A quarter of screened population had low anti-Hbs titres, requiring boosting of immunity. Our study emphasizes the urgent need for improving immunization status of pediatric HCW’s; as they continue to remain susceptible to various vaccine preventable infectious diseases. Disclosures All Authors: No reported disclosures.

Knowledge of Silesia adult inhabitants regarding preventive vaccinations effect on cardiovascular diseases

ObjectivesProtective vaccinations are important in maintaining health and reducing suffering from infectious diseases. Also, vaccine-preventable infectious diseases are associated with the development and progression of cardiovascular diseases.AimThe study aimed to test adults' knowledge of the role of protective vaccinations in the prevention of cardiovascular diseases, and their opinions on the quantity of the information provided by doctors in this regard.MethodsA total of 700 adults participated in the study, most of whom were women (500; 71.43%). The study used an original questionnaire containing questions covering vaccinations and cardiovascular diseases, and the general characteristics of the participants. The inclusion criteria for the study were 18 years of age and written informed consent to participate in the study.ResultsOver 60% of the participants did not know of, or denied the possibility of, developing cardiovascular diseases as a result of avoiding required preventive vaccinations. More than half of the participants stated that there is no need to recommend influenza vaccination to patients with cardiovascular diseases. Over 70% of participants stated that family doctors did not provide sufficient information about protective vaccinations.ConclusionIn these adults, knowledge of the role of preventive vaccinations in the prevention of cardiovascular diseases was low, and the quantity of the information provided by doctors about preventive vaccinations were considered to be insufficient. Public awareness of the effects of avoiding preventive vaccinations should be raised especially among people with CVD.

DÜNYADA VE TÜRKİYE’DE AŞILANMA TUTUMU VE COVID-19 AŞILARINA BAKIŞ

Aşılama, en maliyet etkili toplum müdahalelerinden biridir ve her yıl milyonlarca ölümü engelleyerek insanların daha uzun ve daha sağlıklı yaşamasına katkı sağlamaktadır. Aşıyla önlenebilen bulaşıcı hastalıkların ortaya çıkışının engellenmesi ve salgınların önlenebilmesi için, toplumda belirli bir bağışıklık düzeyinin üzerine çıkılması gerekmektedir. Hedeflenen bağışıklık düzeylerine ulaşmanın önündeki temel engeller arasında, aşı tedarik ve dağıtımıyla birlikte aşı reddi ve aşı tereddütü de bulunmaktadır. Son yıllarda dünyada ve ülkemizde yaygınlığı giderek artan aşı reddi ve aşı tereddütü, toplumdaki tüm bireylerin sağlığını tehdit etmektedir. Yapılan çalışmalarda, aşı reddi ve aşı tereddütünün en sık nedenleri arasında, aşı güvenliğine ve yan etkilere yönelik endişeler ile aşılama ve önemi konusunda bilgi ve farkındalık eksikliği gösterilmektedir. Ayrıca, aşılara karşı sergilenen olumsuz tutum, diğer aşılarda olduğu gibi COVID-19 aşılamasında da hedeflenen oranlara ulaşılmasına engel olmaktadır. Aşılama oranlarını artırmak için, dünya genelinde ülkelerde zorunlu aşılama da dahil olmak üzere çeşitli aşılama politikaları uygulanmaktadır. Bu derlemenin amacı, aşı tereddütünün ve aşı reddinin nedenlerini, dünyadaki ve Türkiye’deki mevcut durumu, ülkelerdeki aşılama politikalarını ve yasal durumu ortaya koyup çözüm önerileri sunmaktır.Anahtar kelimeler: Aşılama, aşı reddi, aşı tereddütü, COVID-19.

The Social Significance of Vaccination and Infodemia in the Context of COVID-19

The most important preventive health services for the individuals, one of the fundamental steps in protection and promotion of public health, is immunization. Vaccination has many benefits for both public health and socioeconomic aspects. Vaccines rank at the top of the most important breakthroughs in public health in the twentieth century. Currently, humanity is afflicted with a new pandemic. Today, humanity is in trouble with a new pandemic. There is no medication known to cure COVID-19 completely. It is currently treated symptomatically. Besides the social struggle such as social isolation, hygiene, mask, distancing, our sole weapon is vaccination and herd immunity. In countries succeeding in vaccinating against Covid-19 in the world, the rates of infection, need for intensive care and hospitalization and death toll are decreased with increases in vaccination rates above a certain level. However, recently, anti-vaccine attitudes, discourses and behaviors have started to constitute the agenda. It is vital to be vaccinated to protect the population from vaccine-preventable infectious diseases. Therefore, vaccine hesitancy, anti-vaccine and infodemic must be combated.

Effects of meteorological factors on the incidence of varicella in Lu'an, Eastern China, 2015-2020.

Varicella (chickenpox) is a serious public health problem in China, with the most reported cases among childhood vaccine-preventable infectious diseases, and its reported incidence has increased over 20-fold since 2005. Few previous studies have explored the association of multiple meteorological factors with varicella and considered the potential confounding effects of air pollutants. It is the first study to investigate and analyze the effects of multiple meteorological factors on varicella incidence, controlling for the confounding effects of various air pollutants. Daily meteorological and air pollution data and varicella cases were collected from January 1, 2015, to December 31, 2020, in Lu'an, Eastern China. A combination of the quasi-Poisson generalized additive model (GAM) and distributed lag nonlinear model (DLNM) was used to evaluate the meteorological factor-lag-varicella relationship, and the risk of varicella in extreme meteorological conditions. The maximum single-day lag effects of varicella were 1.288 (95%CI, 1.201-1.381, lag 16 day), 1.475 (95%CI, 1.152-1.889, lag 0 day), 1.307 (95%CI, 1.196-1.427, lag 16 day), 1.271 (95%CI, 0.981-1.647, lag 4 day), and 1.266 (95%CI, 1.162-1.378, lag 21 day), when mean temperature, diurnal temperature range (DTR), mean air pressure, wind speed, and sunshine hours were -5.8°C, 13.5°C, 1035.5 hPa, 6 m/s, and 0 h, respectively. At the maximum lag period, the overall effects of mean temperature and pressure on varicella showed W-shaped curves, peaked at 17.5°C (RR=2.085, 95%CI: 1.480-2.937) and 1035.5hPa (RR=5.481, 95%CI: 1.813-16.577), while DTR showed an M-shaped curve and peaked at 4.4°C (RR=6.131, 95%CI: 1.120-33.570). Sunshine hours were positively correlated with varicella cases at the lag of 0-8 days and 0-9 days when sunshine duration exceeded 10 h. Furthermore, the lag effects of extreme meteorological factors on varicella cases were statistically significant, except for the extremely high wind speed. We found that mean temperature, mean air pressure, DTR, and sunshine hours had significant nonlinear effects on varicella incidence, which may be important predictors of varicella early warning.

Vaccination strategies for Korean patients with inflammatory bowel disease.

Patients with inflammatory bowel disease (IBD) are vulnerable to vaccine-preventable infectious diseases. Immunosuppressive drugs, which are often used to manage IBD, may increase this vulnerability and attenuate vaccine efficacy. Thus, healthcare providers should understand infectious diseases and schedule vaccinations for them to reduce the infection-related burden of patients with IBD. All patients with IBD should be assessed in terms of immunity to vaccine-preventable diseases at the time of IBD diagnosis, and be vaccinated appropriately. Vaccination is becoming more important because of the unprecedented coronavirus disease 2019 (COVID-19) global health crisis. This review focuses on recent updates to vaccination strategies for Korean patients with IBD.