Vaccination Program Research Articles

Evaluating the Effectiveness and Coverage of Vaccination Programs in Reducing the Incidence of Paediatric Infectious Diseases

Background: Pediatric infectious diseases pose a significant risk to child health worldwide. Vaccination programs have greatly reduced the incidence and severity of these diseases, though coverage and efficacy differ across regions. This mini-review examines how effectively these programs reduce pediatric infectious diseases by analyzing existing literature on vaccine impact in various countries. Methodology: A literature search across PubMed, MEDLINE, ScienceDirect, and CINAHL (Dec 2017 - May 2022) used specific MeSH terms, including ‘pediatric vaccination,’ ‘disease incidence,’ and ‘vaccine efficacy.’ Out of 928 articles initially retrieved, 48 underwent full-text screening, and seven met the final criteria. Results: The review highlights significant reductions in pediatric infectious diseases, particularly in regions with high vaccination coverage for diseases such as pneumococcal pneumonia, measles, and Hib (Haemophilus influenzae type b). Studies report over 90% reductions in incidence rates for certain diseases in countries with comprehensive immunization programs, showcasing the importance of sustained, widespread coverage. Conversely, in regions with lower coverage, diseases remain prevalent, indicating the need for strengthened immunization strategies. Conclusion: Effective vaccination programs are crucial for reducing pediatric disease rates, improving public health, and fostering herd immunity. Increased vaccine accessibility, education, and coverage are necessary, especially in low-coverage regions, to advance global health goals for pediatric control.

Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020

Background: The integration of maternal and child health services (MCH) with routine immunization is an important global health strategy, particularly in low- and middle-income countries (LMICs). However, evidence is lacking regarding the best practices for service integration and the effect of integration on immunization and linked health service outcomes. Methods: We searched publication databases and gray literature for articles published between 2011 and 2020 that include approaches to integrating MCH services with immunizations during the first two years of life in LMICs. Abstracts and full-text articles were screened for eligibility. For the included articles, data extraction and analysis examined the descriptive characteristics of studies, outcomes, and implementation considerations. Results: Among the 16,578 articles screened, 44 met the criteria for inclusion, representing 34 studies, of which 29 were from Africa. The commonly linked MCH services were family planning (24%), human immunodeficiency virus (HIV) diagnosis or care (21%), and malaria prevention or control (21%). Multiple integration strategies were typically used; the co-location of linked services (65%), the provision of extra services by immunization staff (41%), and/or the provision of extra information by immunization staff (41%) were the most common. In general, integration improved MCH service outcomes (76%) and was either beneficial (55%) or neutral for immunization (35%), with some examples in family planning, malaria, and HIV where integrated services were not beneficial. Important implementation considerations included the careful matching of target populations in service re-design, ensuring support from policy, logistics, and information systems, the provision of adequate training and support of staff to avoid overload, clear client communication regarding service integration, and the need to address community concerns. Conclusions: Integrating MCH services with routine immunization can expand linked services and improve immunization coverage. This study has identified key implementation considerations relevant to both childhood and adult vaccination programs. More research is needed regarding costs and client preferences.

Impact of COVID-19 Vaccination in Thailand: Averted Deaths and Severe Infections Across Age Groups

The COVID-19 pandemic has underscored the pivotal role of vaccines in mitigating the devastating impact of the virus. In Thailand, the vaccination campaign against SARS-CoV-2 began on 28 February 2021, initially prioritizing healthcare professionals before expanding into a nationwide effort on 7 June 2021. This study employs a mathematical model of COVID-19 transmission with vaccination to analyze the impact of Thailand’s COVID-19 vaccination program from 1 March 2021 to 31 December 2022. We specifically assess the potential loss of lives and occurrence of severe infections across various age groups in a hypothetical scenario where vaccines were not administered. By fitting our model with officially reported COVID-19 death data, our analysis reveals that vaccination efforts prevented a total of 300,234 deaths (95% confidence interval: 295,938–304,349) and averted 1.60 million severe COVID-19 infections (95% confidence interval: 1.54–1.65 million). Notably, the elderly population over 80 years old benefited the most from vaccination, with an estimated 84,518 lives saved, constituting 4.28% of this age group. Furthermore, individuals aged between 70 and 74 years experienced the highest reduction in severe infections, with vaccination potentially preventing 8.35% of this age bracket from developing severe COVID-19.

Relationship between knowledge and attitude about human papillomavirus infection and vaccination in female nursing students

Introduction: Human papillomavirus (HPV) infection is the primary cause of cervical cancer, which is the second-leading cause of women’s death in Indonesia, and that is why a national HPV vaccination program is required to address this issue. A preliminary survey of 20 female nursing students revealed that 70% were unaware of the HPV virus, 80% were unaware of cervical cancer, and 80% were unaware that HPV could lead to cervical cancer. This study aimed to determine the relationship between knowledge and attitude about human papillomavirus infection and vaccination in female nursing students. Methods: This descriptive-quantitative study used a cross-sectional design and univariate and bivariate analysis.

Impact of multi-cohort HPV vaccination on cervical cancer in women below 30 years of age: Lessons learned from the Scandinavian countries.

In Scandinavia, HPV vaccination programs started in 2007/8; in Sweden and Denmark with HPV vaccination offered to multiple cohorts of young girls, while in Norway offered to a single cohort only. Interestingly, in Sweden and Denmark, cervical cancer incidence in young women decreased markedly from 2017/2018, while in Norway a steady increase was seen until 2020. As the three countries are very similar in other factors important for cervical cancer incidence rates like cervical cancer screening, the observed difference is most likely due to differences in the multi-cohort vaccination.

Childhood Mandatory Vaccinations: Current Situation in European Countries and Changes Occurred from 2014 to 2024.

Background/Objectives: Vaccination is one of the most effective public health interventions, preventing millions of deaths globally each year. However, vaccine hesitancy, driven by misinformation and reduced disease risk perception, has led to declining vaccination rates and the resurgence of vaccine-preventable diseases (VPDs) in Europe. In response to this, countries have implemented various strategies, including mandatory and recommended vaccination programs. The objective of this study is to map the current European landscape of pediatric vaccination policies, and the variations that have occurred in the last decade. Methods: This rapid review was conducted on PubMed, Google, and the European Centre for Disease Prevention and Control website, to collect all vaccination schedules in EU/EEA countries in 2024 and all documents focusing on the introduction of mandatory vaccines during the last decade. Results: As of 2024, 13 countries had at least one mandatory pediatric vaccination, with France, Hungary, and Latvia requiring all but one vaccine. In contrast, 17 countries had no mandatory vaccinations, relying only on recommendations. Between 2014 and 2024, six countries (Croatia, France, Germany, Hungary, Italy, and Poland) introduced or extended mandatory vaccinations. Conclusions: European vaccination policies show significant variation. Effective programs depend on robust healthcare systems, public trust, and adaptable strategies to address vaccine hesitancy and the resurgence of VPDs.

Boosting community engagement: Leveraging the ward health system approach for enhanced HPV vaccination acceptance in Nigeria.

Rationale The efficacy of vaccination programs, particularly for diseases like HPV, hinges on widespread acceptance and uptake within communities. However, vaccine hesitancy and inadequate healthcare infrastructure pose significant barriers to achieving optimal vaccination coverage in Nigeria. Recognizing the pivotal role of community engagement in overcoming these challenges, this study aims to explore the potential of leveraging the ward health system (WHS) to enhance HPV vaccination acceptance in Nigeria. Objective The primary objective of this study is to assess the impact of community-based approaches facilitated by the WHS on HPV vaccination demand and acceptance in Nigeria. Specifically, the study seeks to evaluate the effectiveness of ward development committees (WDCs) in mobilizing communities, addressing vaccine hesitancy, and fostering positive attitudes towards HPV vaccination. Method A comprehensive search strategy using various scholarly search engines and sources was employed to gather relevant material. Keywords such as “Boosting Community Engagement” and “Leveraging Ward Health System Approach” guided the search process. Methodical content analysis was used to examine the texts, focusing on identifying emerging trends in community engagement related to HPV vaccination. Discourse analysis further explored the linguistic features of scholarly publications to reveal implicit content through critical thinking. This rigorous approach aimed to extract trustworthy data aligning with the study’s goals, providing a robust foundation for enhancing HPV vaccination strategies in Nigeria. Results The results of the study provide comprehensive insights into the effectiveness of community-based interventions facilitated by the WHS in driving HPV vaccination demand and acceptance. Quantitative data offer valuable information on vaccination coverage rates and factors influencing vaccine acceptance, while qualitative findings provide deeper insights into community perceptions and the role of the WHS in addressing vaccine hesitancy. Conclusions Based on the findings, conclusions drawn regarding the effectiveness of leveraging the WHS to enhance HPV vaccination acceptance in Nigeria. The study highlights the importance of community engagement and the potential of the WHS in overcoming barriers to vaccination uptake. Recommendations The study conclude with recommendations for policymakers, healthcare providers, and community leaders on strategies to optimize the role of the WHS in promoting HPV vaccination acceptance. Recommendations include strengthening WDC functionality, enhancing community outreach efforts, and fostering partnerships to support vaccination programs. Significance Statement This study holds significance as it addresses a critical gap in understanding the role of community-based approaches, particularly through the WHS, in promoting HPV vaccination acceptance in Nigeria. By providing evidence-based insights and recommendations, the study aims to inform policy and practice, ultimately assisting Nigeria in achieving universal health coverage and better health outcomes.

The Effect of Interventions Based on the Information-Motivation-Behavioral Skills Model on the Human Papillomavirus Vaccination Rate Among 11-13-Year-Old Girls in Central and Western China: Protocol for a Randomized Controlled Trial.

Persistent infection of high-risk human papillomavirus (HPV) can lead to cervical intraepithelial neoplasia, cervical cancer, and even death. HPV vaccination for girls aged 9-14 years can effectively prevent the occurrence of cervical cancer. Some Chinese provinces and cities have launched free HPV vaccination programs for school-age girls; however, due to the lack of supportive government policies, the high price and supply shortage of HPV vaccines, and vaccine hesitancy, some parents refuse to vaccinate their daughters. This protocol reports the design of a randomized controlled trial (RCT) aiming to explore the efficacy of a digital HPV vaccination education intervention based on the information-motivation-behavioral skills (IMB) model in improving the HPV vaccination rate among 11-13-year-old girls in central and western China. A multicenter intervention study based on an online applet will be conducted in December 2024, and about 750 eligible parents of 11-13-year-old girls will be assigned in a 1:1 ratio to an intervention group receiving 7-day digital HPV vaccination education based on the IMB model or a control group using non-HPV publicity materials. Free HPV vaccination pilot projects will be carried out among this population by our research team in central and western China (some parents might refuse to vaccinate their daughters). All participants will be asked to complete online questionnaires at baseline; postintervention; and 1 week, 1 month, and 3 months after the intervention. The primary outcome of this study will be receipt of the first HPV vaccination within 3 months. Data will be analyzed based on an intention-to-treat approach, and Stata 16.0 will be used for statistical analysis. This study aims to improve the HPV vaccination rate among 11-13-year-old girls and will examine the impact of a digital HPV vaccination education intervention based on the IMB model. The findings of this study may offer promising intervention measures for HPV vaccine hesitancy in low-health-resource areas in the future. Chinese Clinical Trial Registry, ChiCTR2300067402; https://tinyurl.com/v5zt4hc9. PRR1-10.2196/58873.

Bioinformatics analysis to design a multi-epitope mRNA vaccine against S. agalactiae exploiting pathogenic proteins

Antibiotic resistance in bacterial pathogen infections is a growing global issue that occurs due to their adaptation to changing environmental conditions. Therefore, producing an efficient vaccine as an alternative approach can improve the immune system, eradicate related pathogens, and overcome this growing problem. Streptococcus agalactiae belongs to group B Streptococcus (GBS). Colonization of GBS during pregnancy is a significant risk factor for infants and young children. S. agalactiae infected population exhibits resistance to beta-lactams, including penicillin and the second-line antibiotics erythromycin and clindamycin. On the other hand, there are currently no commercial vaccines against this pathogen. Vaccination of pregnant women is a highly effective method to protect newborns and infants from S. agalactiae infection, and it has been identified as an urgent demand by the World Health Organization. This study employed various immunoinformatic tools to develop an effective vaccine that could trigger both humoral and cell-mediated immunity and prevent disease. For this purpose, three conserved antigenic proteins of the main pathogenic strains of S. agalactiae were utilized to predict CTL, HTL, and B-cell epitopes for producing an mRNA vaccine against different strains of S. agalactiae. The selected epitopes were fused using proper linkers. The Resuscitation promoting factor E (RpfE) sequence was incorporated in the designed vaccine construct as an adjuvant to boost its immune response. Different physicochemical characteristics of the final designed vaccine, modeling of the three-dimensional structure, molecular docking, molecular dynamics simulation, and immunological response simulation were screened following vaccine administration in an in vivo model. Computational immune simulation data identified that IgG1, IgM, INF γ, IL-2, T helper, and B-cell populations increased significantly after vaccination. These findings suggested that the vaccine candidate may provide good protection against S. agalactiae infection. However, experimental and animal model studies are required for additional validation and implementation in human vaccination programs.

Vaccination strategies in a pair formation model for human papillomavirus infection: An optimal control approach

Human papillomavirus (HPV) infection is a widespread sexually transmitted infection responsible for several cancers including anal, oropharyngeal, penile, vaginal, and cervical cancer. Despite HPV vaccines have been available for almost 20 years and are incredibly effective in preventing infection, the scale-up of vaccination has been slow in many low and middle-income countries. This analysis uses a pair model that explicitly accounts for sexual partnership formation to investigate HPV immunization programs. The optimality of vaccine interventions is analyzed using optimal control theory. We give formal proof of the existence of optimal control solutions and obtain first-order optimality conditions via Pontryagin’s Maximum Principle. Extensive numerical simulations are used to investigate plausible what-if scenarios to understand under which conditions the inclusion of males should be recommended in addition to female vaccination. The results suggest that a gender-neutral vaccination program should be recommended in regions where vaccination uptake in women is still low whereas for an already existing female-only program with high uptake, it is more effective to keep increasing coverage in females.

Mathematical analysis of a three-strain model for dengue with vaccination

Abstract Dengue has emerged as the most widespread mosquito-borne ailment in humans, causing an estimated 390 million infections within the endemic regions of the world annually. In this paper, a novel mathematical model is proposed for three strains of dengue virus with vaccination measures. Some of the important qualitative analysis carried out are as follows: The dengue serotypes 1, 2 and 3 sub-models are qualitatively analyzed, using well constructed candidates of Lyapunov function. The sub-models’ infection-free equilibria are proven to be locally asymptotically stable. The infection-free and endemic equilibria of the sub-models are established to be globally asymptotically stable. The complete model’s infection-free equilibrium is proven to be locally and globally asymptotically stable. Also, simulations are also presented to validate the theoretical analysis in the paper. The solution profiles of all epidemiological compartments when the reproduction numbers are both below one and greater than one are graphically presented. It was observed that, for the scenarios when the dengue reproduction number R 0 is below and above one, the solution trajectories converge to the infection-free and dengue-endemic steady states, respectively. Sensitivity analyses using the Latin Hypercube Sampling (LHS), and also using contour plots and surface plots are performed on the dengue serotypes associated reproduction numbers. The impact of influential parameters are graphically presented. Worthy of mention, is the significant impact of dengue transmission rates (positively correlated) and dengue vaccination rates and vaccine effectiveness levels (negatively correlated). Different scenario analyses to investigate the impact of dengue vaccination measures are presented. It was observed that enhanced dengue vaccination programme under the administration of safe and highly effective vaccine could curtail the spread and co-circulation of different dengue serotypes within the population.

Tężec w Polsce w latach 2020-2022

BackgroundTetanus is an infectious disease caused by the bacterium <i>Clostridium tetani,</i> which produces a neurotoxin (tetanospasmin) that causes spastic paralysis. This disease can only be prevented by vaccination. Tetanus is very rare in EU countries, where it mainly affects people over 60 years of age. Tetanus is a serious health problem in countries with low vaccination rates and poor hygiene conditions, and neonatal tetanus is a particularly significant problem in these countries. In Poland, according to the Vaccination Program, mandatory vaccinations against tetanus should be given to children and adolescents up to the age of 19.ObjectiveThe aim of the study was to assess the epidemiological situation of tetanus in Poland in 2020-2022.Material and methodsThe assessment of the epidemiological situation of tetanus in Poland in 2020-2022 was made based on the interpretation of data from the annual bulletins "Infectious diseases and poisonings in Poland" for 2020-2022 and the bulletins "Vaccinations in Poland" for 2020-2022 as well as data from individual epidemiological reports on diseases registered in the "Epibaza" system.ResultsIn 2020, 2 cases of tetanus were registered in Poland, in 2021 – 5 cases, and in 2022 also 5 cases. The total incidence in 2020 was 0.005 per 100 000 people, in 2021 and 2022 – 0.013 per 100 000 and was lower compared to the median for 2015-2019 (0.031). In 2020-2021, all reports concerned hospitalized people, while in 2022 one person was treated as an outpatient. No cases were recorded in people under 30 years of age.ConclusionsIn Poland, a decrease in the number of reported tetanus cases was observed in 2020-2022 compared to previous years. Sporadic tetanus cases in Poland are recorded mainly in older age groups but also occur among adults under 60 years of age. The cases can be associated with the lack of booster vaccinations in adults.

Study of rotavirus genotypes G and P in one Egyptian center-cross-sectional study

BackgroundRotavirus-associated gastroenteritis is a common health problem in children, different variations of rotavirus genotypes differ according to geographic locations and the practice of wide-scale vaccination. Therefore, the present study aimed to detect both the G and P genotypes of rotavirus in children ≤ 5 years old in one center in Egypt as a cross-sectional study, to correlate the genotypes with various demographic and clinical data in infected children and to evaluate the common mixed genotypes G and P in infected children.MethodThe cross-sectional study included children with acute gastroenteritis ≤ 5 years old from January 2023 till March 2024 recruited from Mansoura University Children’s Hospital, Egypt based upon laboratory diagnosis by exclusion of bacterial and protozoa pathogens. The stool samples were obtained from each child and subjected to detection of rotavirus antigen by enzyme-linked immunosorbent assay (ELISA) followed by genotypes identification of G and P genotypes by nested polymerase chain reaction (PCR).ResultA nested PCR study for rotavirus genotypes revealed that G1 was the most common genotype (24.7%) followed by G2 (21.1%), G3 (20%), G9 (20%), and G4 (14.1%). The genotyping of the P genotype revealed that P9 was the commonest genotype (24.7%), followed by P4 (21.2%), P10 (20%), P8 (17.6%) and P6 (16.5%). The commonest combined genotypes of G and P were G1P4 (85.7%), G3P8(88.2%), followed by G2P6 (77.8%) and G9P9(76.5%) and G4P9 (66.7%) followed by G4P10 (33.3%), G9P10(23.5%), G2P10(22.2%), G1P10 (14.3%), G3P10(11.8%). The distribution was significant (P = 0.001). The positive rotavirus antigen was more frequently detected in females (55.3%) than males (44.7%, Odd ratio 0.2, 95% CI 0.22–0.71, P = 0.001). There was a significant association between the summer season and positive rotavirus antigen (P = 0.001) and rural residence of the patients (Odd ratio 6,9 95%CI 3,5-13.5, P = 0.001). The significant associated clinical sign with positive rotavirus antigen was fever (Odd ratio 3,3, 95%CI 1,8-6.05, P = 0.001). The genotypes G and P were significantly associated with positive rotavirus antigen as all cases positive by antigen had been detected by nested PCR with the commonest genotypes G4 (24.7%, P = 0.001) and genotype P9 (24.7%, P = 0.001).ConclusionThe present study highlights the common genotypes of rotavirus at one center in Egypt, G1, G2, and G3 were the commonest G genotypes. As regard genotype P the commonest genotypes were P9, P4, and P10. The commonest combined genotypes were G1P4, G3P8, G2P6. There was no effect of the practice of rotavirus vaccination at limited rates at private health sections as the rotavirus is still a major pathogen of acute gastroenteritis in children. There is a need for the inclusion of rotavirus vaccination in the national program of children vaccination in Egypt.

Awareness and Knowledge of Hepatitis B Vaccination Among Newly Enrolled First-Year Medical Undergraduates in South India: A Cross-Sectional Survey.

Hepatitis B poses a significant public health risk, particularly for healthcare professionals who face heightened exposure in clinical settings. This study assesses the awareness and knowledge of hepatitis B vaccination among first-year medical undergraduates in their preclinical stage before transitioning to clinical phases. This cross-sectional survey was conducted among newly enrolled first-year medical undergraduate students at a medical college before the commencement of a planned vaccination drive, allowing the institution to assess baseline knowledge and logistical needs for the drive. A self-administered questionnaire was used to evaluate students' awareness and understanding of hepatitis B transmission, vaccination, and the occupational risks associated with healthcare work. The data gathered from this survey provided critical insights for optimizing the logistics and educational components of the upcoming vaccination program for the incoming cohort. Among the 126 respondents, there was a slightly higher representation of male participants (53.17%, n=67), while 46.83% (n=59) were females. Awareness of hepatitis B as a highly contagious liver infection was high, with 88.9% of students agreeing or strongly agreeing. The knowledge that hepatitis B is a public health concern and can lead to severe conditions such as liver cancer was similarly prevalent (97.6% and 90.4%, respectively). Most respondents (80.2%) were aware of the heightened risk for healthcare professionals and viewed vaccination as an effective preventive measure (96.1%). Awareness of transmission routes, including contact with infected blood (96%) and unprotected sexual contact (97.6%), was also strong. However, fewer students were informed about the recommended vaccination schedule (63.4%) or the necessity of booster doses for high-risk individuals (70.6%). Additionally, 93.7% believed healthcare workers should be vaccinated, while 88.9% recognized the need for immunity status checks in healthcare settings. Only 16.66% (n=21) reported receiving the hepatitis B vaccine, with 14.28% having completed the full three-dose series, while 2.38% received only one or two doses. A significant portion (62.69%) reported not being vaccinated, and 20.63% were unsure of their vaccination status. Key reasons for incomplete vaccination included lack of awareness about the full series (58.73%), fear of side effects (6.34%), and perceived lack of necessity (7.93%). Access challenges were also noted by 2.38% of students. Only 1.58% of respondents had checked their immunity status through anti-hepatitis B surface antibody (HBsAb) testing. Newly enrolled medical undergraduates show substantial foundational knowledge of hepatitis B and its prevention. However, targeted educational and peer-led initiatives are recommended to bridge the remaining gaps, ensuring future healthcare professionals have comprehensive knowledge for effective hepatitis B prevention. The findings also underscore the need for improved vaccination awareness and accessibility to achieve comprehensive immunization among medical undergraduates.

Assessing yellow fever outbreak potential and implications for vaccine strategy.

Yellow fever (YF), a vector-borne viral hemorrhagic fever, is endemic in tropical regions of Africa and South America, with large vaccination programmes being used for control. However, significant outbreaks have occurred in recent years. Data on infection rates and seroprevalence is often sparse, requiring robust mathematical models to estimate the burden of yellow fever. In particular, modelling is required to estimate the risk of outbreaks and inform policy decisions regarding the targeting of vaccination. We present a dynamic, stochastic model of YF transmission which uses environmental covariates to estimate the force of infection due to spillover from the sylvatic (non-human primate) reservoir and the basic reproduction number for human-to-human transmission. We examine the potential for targets identified by the World Health Organization EYE Strategy (50%, 60% or 80% vaccination coverage in 1-60 year olds) to achieve different threshold values for the effective reproduction number. Threshold values are chosen to reflect the potential for seasonal and/or climatic variation in YF transmission even in a scenario where vaccination lowers the median reproduction number below 1. Based on parameter estimates derived from epidemiological data, it is found that the 2022 EYE Strategy target coverage is sufficient to reduce the static averaged annual effective reproduction number R below 1 across most or all regions in Africa depending on the effectiveness of reported vaccinations, but insufficient to reduce it below 0.5 and thereby eliminate outbreaks in areas with high seasonal range. Coverage levels aligned with the 2026 targets are found to significantly decrease the proportion of regions where R is greater than 0.5.

Caregivers’ hesitancy and outright refusal toward children’s COVID-19 vaccination in the Democratic Republic of Congo: A community-based cross-sectional study

ABSTRACT Data from the global South show higher COVID-19-related mortality in children compared to the North. Parents’ willingness to vaccinate their children once COVID-19 vaccines are available is poorly documented. We assessed parents’ willingness to vaccinate their children in the DRC. A year after the vaccination program started, we conducted a population and online-based cross-sectional study, using the WHO modified Behavior and Social Drivers questionnaire among parents and caregivers in the eastern DRC. We performed Modified Poisson regressions to determine factors associated with vaccine hesitancy and outright refusal, focusing on the intention to vaccinate one’s children as our primary outcome. Of the 1709 respondents aged 38 years, 82.56% were unwilling to vaccinate their children, of which 26.80% were hesitant and 55.76% were outright refusals. Drivers of hesitancy were religious refusal of vaccine, non-healthcare status, and caregiver beliefs about vaccine unsafety. Independent predictors of refusal were religious refusal of vaccine, neither healthcare nor student status and belief about vaccine effectiveness, unsafety, and distrust. In addition, both hesitancy and refusal to vaccinate one’s children were driven by not being ready to get vaccinated if recommended or mandated. In contrast, parents’ and caregivers’ trust in the government and readiness to vaccinate themselves reduced hesitancy and outright refusal to vaccinate one’s children, respectively. Briefly, COVID-19 vaccine hesitancy and outright refusal in eastern DRC are influenced by individual (subjective convictions) and system-level factors (government confidence, mandate trust). It is important to address these issues to improve vaccine coverage during disease outbreaks and mitigate public health risks.

Vaccination of endangered wildlife as a conservation tool: Hindsights and new horizons in the pandemic era

Vaccines are an established conservation tool that can reduce the threat of infectious disease in endangered wildlife populations. Vaccines exist for many infectious pathogens, and at a time of rapid technological advances in vaccinology, developing vaccines and vaccination programs for free-living endangered wildlife could help efforts to prevent extinctions from disease threats. Vaccination efforts could focus on protecting members of the target species or could be directed at reservoir populations to prevent pathogen spillover. Vaccination strategies need to be substantiated by research on safety and effectiveness, include risk and feasibility assessments, account for differences in host biology and disease epidemiology, and align with relevant regulatory frameworks. Engagement with stakeholders and the public is important to ensure the success of endangered species vaccination programs. Challenges such as funding, regulation, and societal acceptance are barriers to progress in vaccination programs for some species and geographic regions. We recommend the development of scientifically based international guidelines and a transdisciplinary forum with a specific emphasis on endangered wildlife vaccination. New technologies could be used collaboratively to prevent transmission of diseases for which vaccines are not currently available. Careful approaches and enhanced collaborations could help ensure the successful development of wildlife vaccination programs and promote resilience of endangered wildlife populations to increasing anthropogenic and environmental stressors on biodiversity.

Facilitating knowledge transfer during Australia’s COVID-19 vaccine rollout: an examination of ‘Functional Dialogues’ as an approach to bridge the evidence–policy gap

Background: Our interdisciplinary team initiated a project to inform the COVID-19 vaccination programme. We developed a novel research co-creation approach to share emerging findings with government. Aims and objectives: We critically assess the ‘Functional Dialogue’ (FD) programme for future research translation practices in time-limited policy-making scenarios. We identify what factors helped us to put the FDs together and consider their effects on all aspects of the research programme. We draw out key moments of impact, weaknesses and challenges and identify how future FDs might be enhanced. Methods: Between January 2021 and June 2022, we conducted 14 FDs with state and federal government, exploring attendees’ attitudes, beliefs, experiences, roles and observations regarding our research. FDs and research team debriefs were audio-recorded, transcribed and analysed thematically. Findings: FD processes proved invaluable to the timeliness, impact and flow of our research project by creating systems that helped to bridge the evidence–policy gap. Relationships and reciprocity helped, but other professional commitments of our government partners posed challenges and produced fluctuating engagement. FDs built the capacity of the research team, strengthening communication skills and creating opportunities to contribute to pandemic policies. Discussion and conclusion: We struggled to quantify the impact of FDs on policy decisions due to the ethical requirements of academic research, barriers for policy makers in isolating and/or acknowledging impact, and the collaborative nature of dialogue. Nevertheless, the structures of knowledge transfer that we foresaw as necessary to ensure impact became the central plank of the project’s broader success.

The highly pathogenic avian influenza H5N8 sublineage 2.3.4.4b virus: A critical analysis of genetic steadiness based on full HA gene sequencing in Egypt

The highly pathogenic avian influenza virus (HPAIV) continues to be a significant threat to the poultry industry despite the implementation of vaccination programs. The main goal of this study was to explore the incidence of avian influenza viruses (AIVs) and the stability of the hemagglutinating (HA) gene sequence. For this drive, oropharyngeal swabs (n=425) were collected from various wild and domesticated bird species from 13 provinces in Egypt from 2019 to 2021. Viral isolation in specific pathogen-free chicken embryos revealed positive HA activity in 9.88% (n=32) of the wild and 36.37% (n=64) of domesticated species. Only eight H5N8 avian influenza viruses were delivered (4/each category) in mixed infection with Newcastle disease virus (NDV). Clinically, domesticated examined birds exhibited clinical findings suggesting avian influenza, but AIVs were delivered from both apparently healthy and sick wild birds. A/chicken-cobb/Egypt/55/2019(H5N8) sequence generated in this study has been submitted to GenBank under the accession number ON724339, and its in vivo pathogenicity was evaluated in four-week-old chickens, which revealed 90% mortality and typical clinical findings of HPAIV. Based on the full HA gene sequence, the strain has a Furin-sensitive cleavage site in the HA protein, which is an HPAIV. It has been clustered in clade 2.3.4.4b within AIVs from 2016 to 2023 and coexistence of genetically stable viruses 2016-2019 with 99.8-100% similarity. The existing strain is fully identical to three strains: A/green-winged teal/Egypt/877/2016(H5N8), A/northern shoveler/Egypt/MB-D-816OP/2016(H5N8), and A/duck/Egypt/N13736E/2017 (H5N8), with the only point of mutation at position 284 (G284E). In our analysis, the majority of H5NX AIV strains detected in Egypt since 2016 possessed 156T. As a result, there is evidence suggesting that H5N8 has been introduced sequentially through the migration of European wild birds along the Black Sea–Mediterranean and East Asia–West Africa flyways. This raises the possibility of future adaptation to mammals due to spillover from avian-origin strains, especially in native aquatic birds such as geese and ducks.

Measuring the Vaccine Success Index: A Framework for Long-Term Economic Evaluation and Monitoring in the Case of Rotavirus Vaccination.

New vaccination programs measure economic success through cost-effectiveness analysis (CEA) based on an outcome evaluated over a certain time frame. The reimbursement price of the newly approved vaccine is then often reliant on a simulated ideal effect projection because of limited long-term data availability. This optimal cost-effectiveness result is later rarely adjusted to the observed effect measurements, barring instances of market competition-induced price erosion through the tender process. However, comprehensive and systematic monitoring of the vaccine effect (VE) for the evaluation of the real long-term economic success of vaccination is critical. It informs expectations about vaccine performance with success timelines for the investment. Here, an example is provided by a 15-year assessment of the rotavirus vaccination program in Belgium (RotaBIS study spanning 2005 to 2019 across 11 hospitals). The vaccination program started in late 2006 and yielded sub-optimal outcomes. Long-term VE surveillance data provided insights into the infection dynamics, disease progression, and vaccine performance. The presented analysis introduces novel conceptual frameworks and methodologies about the long-term economic success of vaccination programs. The CEA evaluates the initial target vaccination population, considering vaccine effectiveness compared with a historical unvaccinated group. Cost-impact analysis (CIA) covers a longer period and considers the whole vaccinated and unvaccinated population in which the vaccine has direct and indirect effects. The economic success index ratio of CIA over CEA outcomes evaluates long-term vaccination performance. Good performance is close to the optimal result, with an index value ≤1, combined with a low CEA. This measurement is a valuable aid for new vaccine introductions. It supports the establishment of robust monitoring protocols over time.