Vaccination Procedures Research Articles

The Cost Analysis of Human Papillomavirus Vaccination Program in Indonesia

ObjectivesThis study aimed to analyze and describe the cost of HPV vaccination program in Indonesia. MethodsThis study identified the cost-related HPV vaccination program implemented in Makassar, Manado, and Surabaya cities, Indonesia, according to the previous activities performed. Cost information was collected and analyzed in each specific activity for each cost components, using the HPV vaccination module of the World Health Organization Cervical Cancer Prevention and Control Costing tool. ResultsAccording to the Cervical Cancer Prevention and Control Costing tool, the recurrent costs, both financial and economic costs, dominated the HPV vaccination program costs in Surabaya (US dollars [USD] 264 618; USD 268 724), Makassar (USD 166 852; USD 293 300), and Manado (USD 270 815; USD 270 946), with a total cost of USD 702 285 for financial cost and USD 832 970 for economic cost. Vaccine procurement drives the recurrent cost. ConclusionsThe implementation of demonstration program in Surabaya, Makassar, and Manado cities was considerably succeed. Any prediction related to the cost of implementation of HPV vaccination in Indonesia can be calculated and used to advocate regional or national government.

Optimal Procurement of COVID-19 Vaccine with Time-Dependent Holding Cost and Shortages under Cloud Fuzzy Demand Rate

COVID-19 vaccine has emerged as the most powerful weapon against the spread of the coronavirus. Therefore, the management of the vaccine inventory is undoubtedly the most influential and important task for the global distribution of the vaccine. This paper is an attempt to model the vaccine inventory system having time-varying holding costs and partially backlogged shortages. The concept of fuzzy set and cloud pentagonal fuzzy number has been incorporated to make the models more realistic and applicable. Models are solved and validated through numerical examples and graphical representation. Further, sensitivity analysis has been done to identify the most sensitive parameters of all. Finally, managerial insights and conclusions have been drawn to make the vaccine inventory system more robust.

Adverse Hematological Effects of COVID-19 Vaccination and Pathomechanisms of Low Acquired Immunity in Patients with Hematological Malignancies.

The SARS-CoV-2 virus and the COVID-19 pandemic have spread across the world and severely impacted patients living with hematological conditions. Immunocompromised patients experience rapidly progressing symptoms following COVID-19 infection and are at high risk of death. In efforts to protect the vulnerable population, vaccination efforts have increased exponentially in the past 2 years. Although COVID-19 vaccination is safe and effective, mild to moderate side effects such as headache, fatigue, and soreness at the injection site have been reported. In addition, there are reports of rare side effects, including anaphylaxis, thrombosis with thrombocytopenia syndrome, Guillain-Barré Syndrome, myocarditis, and pericarditis after vaccination. Further, hematological abnormalities and a very low and transient response in patients with hematological conditions after vaccination raise concerns. The objective of this review is to first briefly discuss the hematological adverse effects associated with COVID-19 infection in general populations followed by critically analyzing the side effects and pathomechanisms of COVID-19 vaccination in immunocompromised patients with hematological and solid malignancies. We reviewed the published literature, with a focus on hematological abnormalities associated with COVID-19 infection followed by the hematological side effects of COVID-19 vaccination, and the mechanisms by which complications can occur. We extend this discussion to include the viability of vaccination efforts within immune-compromised patients. The primary aim is to provide clinicians with critical hematologic information on COVID-19 vaccination so that they can make informed decisions on how to protect their at-risk patients. The secondary goal is to clarify the adverse hematological effects associated with infection and vaccination within the general population to support continued vaccination within this group. There is a clear need to protect patients with hematological conditions from infection and modulate vaccine programs and procedures for these patients.

Analysis of a stochastic SVIR model with time‐delayed stages of vaccination and Lévy jumps

The focal point of this paper is to further enhance the existing stochastic epidemic models by incorporating several new disease characteristics, such as the validation time of the vaccination procedure, the stages of vaccine required to gain a long‐period immunity together with the time separating each stage, the deaths linked to the vaccine, and finally, the sudden environmental noise which is exhibited by sociocultural changes, such as antivaccination movements. To incorporate all the aforementioned characteristics, we extend the standard Susceptible‐Vaccinated‐Infected‐Recovered (SVIR) epidemic model to a new mathematical model, which is governed by a system of coupled stochastic delay differential equations, in which the disease transmission rates are driven by Gaussian noise and Lévy‐type jump stochastic process. First, under suitable conditions on the jump intensities, we address the mathematical well‐posedness and biological feasibility of the model, by virtue of the Lyapunov method and the stopping‐time technique. Then, by choosing an adequate positively invariant set for the considered model, we establish sufficient conditions guaranteeing the disease extinction and persistence. Lastly, to support the theoretical results, we provide the outcome of several numerical simulations which, together with our conducted analysis, indicate that the spread of the disease can be majorly altered by all the new considered characteristics.

Current Status and Challenges of Vaccination Therapy for Glioblastoma.

Glioblastoma (GBM), also known as grade IV astrocytoma, is the most common and deadly type of central nervous system malignancy in adults. Despite significant breakthroughs in current GBM treatments such as surgery, radiotherapy, and chemotherapy, the prognosis for late-stage glioblastoma remains bleak due to tumor recurrence following surgical resection. The poor prognosis highlights the evident and pressing need for more efficient and targeted treatment. Vaccination has successfully treated patients with advanced colorectal and lung cancer. Therefore, the potential value of using tumor vaccines in treating glioblastoma is increasingly discussed as a monotherapy or in combination with other cellular immunotherapies. Cancer vaccination includes both passive administration of monoclonal antibodies and active vaccination procedures to activate, boost, or bias antitumor immunity against cancer cells. This article focuses on active immunotherapy with peptide, genetic (DNA, mRNA), and cell-based vaccines in treating GBM and reviews the various treatment approaches currently being tested. Although the ease of synthesis, relative safety, and ability to elicit tumor-specific immune responses have made these vaccines an invaluable tool for cancer treatment, more extensive cohort studies and better guidelines are needed to improve the efficacy of these vaccines in anti-GBM therapy.

On the eve of smallpox vaccination: variolation in the eighteenth century and some examples in Slovenian territory

In some parts of the world, variolation constituted a tested and tried folk method for preventing smallpox infection that passed from one generation to another; however, in the eighteenth-century Europe, it turned into a complicated and costly medical procedure accessible only to the nobility and the wealthy strata of society. Although variolation was also administered in Slovenian territory by the physicians and surgeons Anton Muznik, Anton Makovic, and Vincenc Kern, the procedure did not truly take hold among the Carniolan population, most of which did not even knew it by the name. Nevertheless, it was also here that variolation paved the way towards establishing Jenner’s vaccination, especially because physicians that administered it were quick to recognize the benefits of a simpler and safer vaccination procedure and abandoned variolation by the end of the eighteenth century.

Indonesia's Relations With China in the Age of COVID-19

Seven decades after the establishment of diplomatic relations between Indonesia and China, the COVID-19 pandemic presents new prospects and challenges for bilateral cooperation. We seek to analyse various traits in China–Indonesia relations since 2020 by examining how Indonesia attempts balancing between such cooperation and maintaining peaceful ethnic relations domestically. By tracking the domestic discourse surrounding COVID-19 and China through Indonesia's domestic news media, the paper analyses the development of the pandemic in Indonesia, its procurement of vaccines, and, most significantly, domestic sentiments concerning Indonesia’s ethnic Chinese Tionghoa citizens, as well as Indonesia's bilateral relations with China in general. The article argues that while the COVID-19 pandemic has created new avenues of cooperation between Indonesia and China, it has also adversely affected the domestic relations between ethnic Chinese citizens and the rest of the population. However, this has not translated into a widespread backlash toward China that might hinder bilateral cooperation.

Beyond "Vaccine Nationalism": China's Cooperation with the Middle East in the COVID-19 Vaccine

:The current COVID-19 pandemic has had a huge impact on global health security, and some developed countries have promoted "vaccine nationalism" based on the principle of self-interested supremacy and have adopted the approach of seizing pre-sale opportunities in the procurement of vaccines and competing for the right to distribute vaccines to obstruct fair and reasonable distribution of vaccines worldwide. This article analyses the current situation of and predicament caused by the pandemic in the Middle East which has to bear the brunt of the influence and detrimental impact of vaccine nationalism. By analysing the vaccine cooperation model and mechanism between China and countries in the Middle East, this article investigates how China's vaccine cooperation in the Middle East has transcended vaccine nationalism. Vaccine nationalism has not only affected the availability of vaccines in countries in the Middle East but also threatened the health and safety of the region. The international vaccine cooperation between China and Middle Eastern countries is therefore an effective hedge against the negative impact of vaccine nationalism, highlighting China's fundamental stance to safeguard the attributes of vaccines as public goods and also demonstrating to the international community China's exemplary role in the fight against the pandemic.

Increasing compliance with vaccination procedures for individuals with autism.

Increasing compliance with vaccination procedures for individuals with autism.

Kidney Transplant Practice in Pandemic Times: Lessons Learned for the Future.

Kidney Transplant Practice in Pandemic Times: Lessons Learned for the Future.

Centralized vaccine procurement in the post-COVID-19 European Union

The COVID-19 pandemic has confronted healthcare systems worldwide with societal, psychological, and economic burdens. The widespread use of the developed COVID-19 vaccines has been generally pursued to stop the spread, decrease mortality rates, and lift the economic burden of healthcare systems. However, it became apparent that the demand for vaccines outnumbers the supply provided by pharmaceutical manufacturers. This policy brief explores the use of centralized procurement globally to formulate recommendations on how the European Union (EU) and its member states can benefit from such an approach.

GENDER BARRIERS AND OPPORTUNITIES ALONG THE NEWCASTLE DISEASE VACCINE VALUE CHAIN IN MACHAKOS TOWN SUB-COUNTY, KENYA

<p><strong>Background.</strong> Traditionally, poultry is kept and reared by women in extensive production systems. In Kenya and most developing countries, smallholder poultry productivity is constrained by diseases such as Newcastle disease (ND), which is preventable via a vaccine, yet contributes to significant morbidity and mortality among flocks primarily owned and managed by women in villages. <strong>Objective.</strong> This study aimed to map the Newcastle disease vaccine value chain stakeholders and identify the barriers and opportunities for women's engagement along the Newcastle disease vaccine value chain. <strong>Methodology</strong>. Qualitative data were collected with 15 key informant interviews and four focus group discussions with a total of 42 poultry farmers in Machakos Town sub-county, Kenya. <strong>Results.</strong> The majority of the vaccine value chain consumers were women, and limited information was one of the root causes for not vaccinating their chickens. Vaccines were considered expensive and difficult to access as the production areas were remote from the agrovet shops that retail vaccines. <strong>Implication.</strong> The study showed that women farmers had no financial control to enable vaccine procurement. <strong>Conclusion</strong>. Based on the results the government using the Extension service providers should train smallholder farmers on how to use the ND vaccine. Furthermore, manufacturers of thermo-stable ND vaccines should furnish Agrovet shops with data to enable its adoption in remote areas where the cold chain is unreliable.<strong></strong></p>

Examination of Preferences for COVID-19 Vaccines in Hungary Based on Their Properties-Examining the Impact of Pandemic Awareness with a Hybrid Choice Approach.

The COVID-19 pandemic has posed a huge challenge to the world in recent years. The development of vaccines that are as effective as possible and accessible to society offers a promising alternative for addressing the problems caused by this situation as soon as possible and to restore the pre-epidemic system. The present study investigated the preferences of residents in Hungary's second-largest city (Debrecen) for the COVID-19 vaccine. To achieve this aim, a discrete choice experiment was conducted with 1011 participants, and the vaccine characteristics included in the design of the experiment were determined by qualitative methods and a pilot survey: (1) country of origin; (2) efficiency; (3) side effect; and (4) duration of protection. During the data collection at three vaccination sites, respondents were asked to choose between three vaccine alternatives and one "no choice" option in eight decision situations. Discrete choice model estimations were performed using a random parameter logit (RPL) specification with the final model extended to include a latent variable measuring pandemic awareness. The results showed that the vaccine with a Chinese country of origin is the least preferred among the respondents, while the Hungarian and the European vaccines are the most preferred. Furthermore, the increase in the vaccine efficiency level increased the respondents' sense of utility for the vaccine; the short-term side effect was preferred to the long-term one; and the increase in the duration of protection provided by the vaccine increased the respondents' sense of utility for the vaccine. Based on the parameter estimated for the latent variable, it can be concluded that as the level of pandemic awareness (which is more positive among people with chronic diseases and less important among health workers) increases, the choice of a vaccine option becomes more preferred among respondents compared to the "no choice". The results of our investigation could contribute towards increasing compliance in the case of the vaccination-rejecting population, not only for COVID-19, but for any kind of vaccination procedure.

Cancer and COVID-19 Vaccines on Twitter:The Voice and Vaccine Attitude of Cancer Community

We investigate social media discourses on the relationship between cancer and COVID-19 vaccinesfocusing on the key textual topics, themes reflecting the voice of cancercommunity, authors who contribute to the discourse, and valence toward vaccines. We analyzed 6,427 tweets about cancer and COVID-19 vaccines, posted fromwhen vaccines were approved in the U.S. (December 2020) to the February 2022. Wemixed quantitative text mining, manual coding and statistical analysis, and inductive qualitative thematic analysis. Nearly 16% of the tweets posted by a cancer community member mentioned about refusal or delayof their vaccination at the state/local level during the initial rollout despite the CDC’s recommendation to prioritize adults with high-risk medical conditions. Most tweets posted by cancer patients (pro = 82.4% vs. anti = 5.1%) and caregivers (pro = 89.2% vs. anti = 4.2%) showed positive valence toward vaccines and advocated for vaccine uptake increase among cancer patients and the general population. Vaccine hesitancy, self-reported adverse events, and COVID-19 disruption of cancer treatment also appeared as key themes. The cancer community called for actions to improve vaccination procedures to become safe and accessible especially for elderly cancer patients, develop COVID-19 vaccines suitable for varying type, stage, and treatment of cancer, and advance cancer vaccines. Future research should continue surveilling conversations around continuous impacts of COVID-19 interference with the cancer control continuum, beyond vaccination, focusing on the voice and concern of cancer community.

The threat of Monkeypox in the Philippines: another problematic preparation and management for the healthcare system?

The Philippines is still in a tight battle with the coronavirus disease 2019 pandemic since many cases are detected daily. With the continuous spread of another disease worldwide-monkeypox, many Filipinos are alarmed if the country's healthcare system is prepared enough, especially with the detection of its first case. Learning from the unfortunate experiences of the country during the current pandemic is essential in facing another health crisis. With this, recommendations for a robust healthcare system are proposed centered on: a massive digital information campaign about the disease; training healthcare workers to raise awareness about the virus and its transmission, management, and treatment; an intensified surveillance and detection procedure to monitor cases and execute contact tracing properly; and a persistent procurement of vaccines and drugs for treatment, with a well-designed vaccination program.

Accelerating COVID-19 Vaccination Amid Natural Disasters in Indonesia

The COVID-19 vaccination program continues to be intensified around the world to control widespread coronavirus which continues to mutate. Indonesia affected by COVID-19 and currently accelerating vaccination to the entire population throughout the archipelago in achieving herd immunity. The biggest challenge experienced by Indonesia at this moment is delivering COVID-19 vaccination during the event of natural disasters that continue to occur during 2020-2021 pandemic. This article written based on a review of legitimate Indonesian government sources, supported by research articles and official online news published in English and Indonesian language. The review indicated that Indonesian government committed to accelerate the vaccination with various measures. The Indonesian government's policy, Presidential Decree no. 99 year 2020 specified the provision and implementation of COVID-19 vaccine and initialization of the program across all regions. The government synergizes with community, while cross-sectoral collaboration highly visible upon the developed strategies amid disasters events. The strategies include mapping of disaster area, execute vaccinations in disaster areas, involving military and police in the national vaccine program, and introductory of proactive vaccination procedure by taking advantages of central public facilities for vaccination venue and involvement of health students serving as the vaccinator team. The results of this hard work have been proven to stimulate positive impact since Indonesia's vaccination rate has beyond the WHO target. 93.86% of the Indonesian population have received first dose vaccination, while 75.67% completed two-doses and 9.52% received third dose of COVID-19 vaccine. Indonesia is shifting the country status from pandemic to endemic.

Barriers to Timely Administration of Hepatitis B Birth Dose Vaccine to Neonates of Mothers With Hepatitis B in Ghana: Midwives' Perspectives.

The global health sector strategy on viral hepatitis aims to reduce new hepatitis B infections by 90% by 2030. Yet, hepatitis B birth dose (HepB-BD) vaccination, which is effective in preventing mother-to-child transmission of hepatitis B, remains low in sub-Saharan Africa. Given the essential role that midwives play in infants' birth dose immunisation, we explore their perspectives on the reasons for delays and non-administration of HepB-BD to eligible neonates in Ghana. We conducted interviews with 18 midwives, stratified by region (Greater Accra and Northern regions). Participants were selected purposively. The data were transcribed, coded, and analysed following the Braun and Clarke data analysis procedure. The participants conveyed a broad range of barriers to HepB-BD vaccination in Ghana. These include the mother's denial of hepatitis B seropositivity; the mother's ignorance of the impact of hepatitis B on their newborn; partners' non-involvement in post-test counselling; and the high cost of hepatitis B immunoglobulin and hepatitis B monovalent vaccine. Other reasons included vaccine unavailability and midwives' oversight and documentation lapses. We recommend educating expectant mothers on the importance and effectiveness of HepB-BD vaccination during antenatal care (ANC) visits, as well as educating midwives on HepB-BD vaccination procedures. In addition, ensuring sufficient supplies and administering hepatitis B vaccines in the delivery ward should be done to guarantee that babies receive the vaccines on time. Importantly, Ghana needs policies that require HepB-BD vaccination as part of the Expanded Programme on Immunisation (EPI) to ensure the investments and funding it needs.

Health System Barriers to Child Mandatory and Optional Vaccination among Ukrainian Migrants in Poland in the Context of MMR and HPV Vaccines-A Qualitative Study.

Background Migrants' access to healthcare services is limited. This study aimed to identify health system barriers to vaccination, specifically HPV/MMR vaccination among children in Ukrainian economic migrants (UMs). Methods Between December 2021-March 2022, a qualitative study of UMs living in Poland was conducted. Six focus groups were held with 53 UMs aged 15-45; in-depth interviews with 12 healthcare workers (HCWs) were also performed. A thematic analysis was conducted based on the six WHO health system building blocks. Results HCWs described gaps in integrating migrant status in accessible healthcare data which impeded active management of vaccination procedures. UMs reported that the digitization of healthcare services, intensified during the COVID-19 pandemic, reduced their access to primary care. Inadequate health information systems caused problems with the provision of credible vaccine information in translated forms, and language difficulties, experienced by both UMs and HCWs; this was enhanced by a lack of professional interpreting services. Although most UMs reported vaccinating children according to the Polish schedule, the variations in schedules across countries caused concern among UMs and increased HCWs' uncertainty about how to interpret vaccination cards, particularly in the context of possible false certificates. UMs were affected by discrimination through HCWs. HPV was deprioritized by UMs due to misconceptions about non-mandatory vaccinations; the cost was also a barrier. Conclusions The study findings have implications for migrant vaccination delivery targeting children in Poland, and other UMs receiving countries. A concerted effort is required to improve UM's awareness of the significance of vaccinations. Barriers to healthcare access must be recognized by policymakers. Importantly, removing the cost barrier may increase the uptake of the HPV vaccine among Ukrainian migrant adolescents.

COVID-19 Vaccines: How Efficient and Equitable Was the Initial Vaccination Process?

With nearly 11 billion doses of the COVID-19 vaccine being administered, stark differences in the vaccination rates persist. Vaccine distribution initiatives such as COVAX and African Vaccine Acquisition Trust (AVAT) were formed to ensure equitable vaccine delivery. This review evaluates the initial COVID-19 vaccination efforts and the impact of different vaccine distribution initiatives on equitable vaccination coverage in the early phase. We conducted a descriptive and trend analysis with sub-groups by various context parameters of data on COVID-19 vaccination from December 2020 till February 2022, from four public databases including UNICEF, WHO, COVID-19 Task Force and Our World in Data to examine COVID-19 vaccine distribution progress and the contributions of vaccine procurement initiatives. We found that High Income Countries (HICs) had much higher vaccination rate (78.4%) than Lower-Middle-Income Countries (LMICs) (55.5%) and Low-Income Countries (LICs) (10.9%). Large differentials (>80% to <10%) in the vaccination rates of eligible population of adults in LMICs and LICs existed. Differentials in the total vaccine doses delivered to each country ranged from 355.6% to 4.8% of the total population. In LICs, 53.3% of the total doses were obtained via COVAX, 30.9% by bilateral/multilateral agreements, 6.5% by donations and 3.8% by AVAT. In LMICs, 56.4% of total vaccines procured were via bilateral/multilateral agreements, 21.4% by COVAX, 4.2% by donations and 0.5% by AVAT. COVAX delivered 1 billion doses by January 2022 which constituted 53.2% and 21.4% of procured doses in LICs and LMICs. In LICs and LMICs, 6.5% and 4.2% of total doses were acquired through donations while 30.9% and 56.4% of doses were purchased. Despite global efforts, significant disparities were present in COVID-19 vaccination efforts amongst countries of different income groups. Future efforts should focus on addressing vaccine inequities explicitly and in improving global vaccine distribution.

VACS: VAccination disComfort Scale.

The vaccination of children is a crucial tool to protect both individuals and the world in general from various diseases and pathogens. Unfortunately, the vaccination procedure is not a pleasant one for all children, with many experiencing various levels of discomfort, sometimes reaching intolerable levels. In the first part of this work, we develop VACS, a tool that measures the discomfort children experience during vaccination. VACS takes into consideration the complete timeline of the vaccination experience from the perspective of the child, starting from the moment the child enters the doctor's office through to their departure, and also the complete range of manifestations of discomfort, ranging from moaning and crying to facial expressions and posture. Their discomfort is quantified as a number from 0 to 25, with zero corresponding to a smooth vaccination and 25 to maximal/unbearable discomfort. In the second part of the work, we apply VACS to 40 vaccinations of children aged 2 to 12. Our findings show that approximately 40% of the children do not face discomfort during vaccination, but for the rest discomfort of varying degrees is observed. We also find that doctors are content with their patients facing considerably higher discomfort levels than what the children themselves are willing to withstand: doctors are content with VACS values up to 19 whilst children start to suffer when the VACS value exceeds 11. Surprisingly, characteristics such as (a) gender, (b) whether the state's recommended vaccination program has been implemented in full, and even (c) prior negative vaccination experiences are found to be poor predictors of vaccination discomfort. Age on the other hand may be a factor, with younger children experiencing discomfort more often and more intensely; more research is required in order to validate this with higher confidence. The formulation of VACS opens the door for more systematic work towards the mitigation of vaccination discomfort for children.