Vaccination Schedule Research Articles

Role of Public Health Campaigns in Increasing Vaccination Rates in Rural Communities in Bangladesh

Purpose: The aim of the study was to investigate the role of public health campaigns in increasing vaccination rates in rural communities. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Public health campaigns have proven effective in increasing vaccination rates in rural communities, especially when using a combination of media and direct methods like community meetings or mobile health units. Multi-channel approaches, such as multimedia campaigns, have shown significant increases in vaccine uptake by targeting different demographic groups. Community-led educational sessions have also led to notable improvements by leveraging trusted local figures to address myths and encourage immunization. SMS reminders have helped improve adherence to vaccination schedules, though challenges like phone ownership and literacy still exist. Unique Contribution to Theory, Practice and Policy: Health belief model (HBM), diffusion of innovations theory & social ecological model (SEM) may be used to anchor future studies on the role of public health campaigns in increasing vaccination rates in rural communities. It is essential to leverage the power of trusted local figures, such as community leaders, healthcare workers, and teachers, to address vaccine hesitancy. Governments and public health bodies should develop policies that prioritize context-specific, culturally sensitive, and linguistically appropriate campaigns in rural areas.

The Rational Regional Schedule of Preventive Vaccinations

Relevance. The National vaccination schedule (NVS) of the Russian Federation includes 12 infections against 17–18 indicated in the Vaccination Schedules of most EU countries, and requires improvement in terms of expanding the number of infections and contingents subject to immunization, which is reflected in the «Strategy for the development of vaccine prevention of infectious diseases for the period up to 2035» and the roadmap for its implementation. Since the process of entry of new infections and new vaccines into NVS is quite «difficult» and economically costly (development of domestic vaccines, modernization of domestic enterprises, localization of production of foreign vaccines at Russian enterprises, formation of commitment of medical workers and public confidence in new immunobiological medicines), part of the tasks is to ensure public accessibility to vaccine prevention of infections not indicated in the The NVS can be successfully solved within the framework of regional vaccination schedules (RVS).Aims. To propose and interpret the concept of rational regional vaccination schedules, and also to outline the principles of its formation and assessment of the immediate and long-term prospects for the development of regional foundations of vaccination prevention.Results and discussion. RVS is an expanded version of NVS by including additional vaccine-controlled infections, taking into account the epidemic situation and the presence of high-risk groups of infection in the region. In modern conditions, RVS have been developed and are effectively used in a number of subjects of the Russian Federation, such as Moscow, Perm Krai, Sverdlovsk, Chelyabinsk, Tyumen Regions, Yamalo-Nenets Autonomous District, etc. The implementation of vaccine prophylaxis in the regions using this tool provides conditions for equal access of children and adults to modern highly effective vaccines, increases public awareness of the benefits and risks of vaccination and the level of population immunity, contributes to improving mechanisms for providing citizens with immunobiological drugs and the formation of epidemic well-being in the region based on a risk-based approach.Conclusions. In accordance with this paradigm, the authors introduce and interpret the concept of an «Rational regional vaccination schedules», define the basic principles of its formation and assess the short- and long-term prospects for the development of the regional foundations of vaccination.

Sociodemographic Factors and Maternal Knowledge of Childhood Vaccination in Nigeria

Childhood vaccination is globally recognized as one of the most cost-effective public health interventions to reduce child mortality, particularly in regions burdened by vaccine-preventable diseases (VPDs) such as measles, polio, and tuberculosis. Despite the availability of free routine vaccination services in Nigeria, suboptimal vaccination coverage persists, and maternal knowledge plays a critical role in this challenge. While much attention has been focused on the role of attitudes and practices in influencing vaccine uptake, less is known about the specific impact of socio-demographic factors on maternal knowledge of the vaccination schedule, particularly in urban areas like Ughelli, Nigeria. This study seeks to fill this gap by examining the socio-demographic determinants of maternal knowledge about childhood vaccination in Ughelli North Local Government Area (LGA) of Delta, Nigeria. A cross-sectional descriptive study was conducted among 321 mothers residing in Ughelli North LGA, utilizing a structured and pre-tested questionnaire designed to assess maternal knowledge of vaccination schedules and key vaccines for children. The study explored the association between socio-demographic factors such as age, educational level, employment status, ethnicity, and the level of maternal knowledge about childhood vaccination. Data were collected using an online survey and analysed with descriptive and inferential statistics to identify patterns and associations. The study revealed that, despite high levels of educational attainment among participants (88.8% had tertiary education), 87.5% of the respondents demonstrated poor knowledge of the full vaccination schedule, especially concerning vaccines required beyond the age of two. Socio-demographic variables, including ethnicity, employment status, and education, were not significantly associated with vaccination knowledge (p>0.05), indicating that even mothers with higher education levels exhibited gaps in specific vaccination knowledge. These results suggest that maternal education alone is not a sufficient predictor of comprehensive vaccination knowledge in this context. This study makes an original contribution to the body of knowledge by highlighting the disconnect between general education and specific health knowledge regarding childhood vaccination. While many studies have established positive links between socio-demographic factors and overall vaccine attitudes or practices, this research uniquely focuses on knowledge of the vaccination schedule, identifying critical gaps that exist independently of attitudes or socio-economic status. The findings emphasize the need for tailored health education interventions that go beyond general literacy and target the specifics of vaccine schedules and timing, particularly for vaccines administered after infancy.

R21 in Matrix-M adjuvant in UK malaria-naive adult men and non-pregnant women aged 18-45years: anopen-label, partially blinded, phase 1-2a controlled human malaria infection study.

R21 is a novel malaria vaccine, composed of a fusion protein of the malaria circumsporozoite protein and hepatitis Bsurface antigen. Following favourable safety and immunogenicity in a phase 1study, we aimed to assess the efficacy of R21 administered with Matrix-M (R21/MM) against clinical malaria in adults from the UK who were malaria naive in a controlled human malaria infection study. In this open-label, partially blinded, phase 1-2A controlled human malaria infection study undertaken inOxford, Southampton, and London, UK, we tested five novel vaccination regimens of R21/MM. Astandard three-dose regimen (groups 1and 6) was compared with a reduced (fractional) third dose (groups 2and 5) of R21/MM, concomitant administration with viral vectors ChAd63-MVA expressing ME-TRAP (group 3), and a two-dose R21/MM regimen (group 7). Controlled Human Malaria Infection (CHMI) was delivered by mosquito bite at Imperial College London, London, UK, 3-4 weeks after final vaccination (or 18months after final vaccination for group 6) alongside unvaccinated controls (groups 4A and 4B). The primary outcome measures were to assess safety of the vaccines in healthy malaria-naive volunteers and the efficacy (occurrence of blood-stage malaria infection) of the different vaccine regimens compared with non-vaccinated controls after CHMI. The trial was registered with ClinicalTrials.gov (NCT02905019). 66volunteers were enrolled with 59undergoing subsequent CHMI. All vaccination schedules were well tolerated. The highest level of protection against CHMI was observed in participants receiving the standard three-dose regimen of R21/MM (group 1, nine of 11volunteers protected) with protection maintained in three of five volunteers re-challenged by CHMI 7·5months later. Protection against malaria was also seen in group 2, group 3, and group 5compared with unvaccinated control participants. Total IgG antibody responses to the NANP repeat region of circumsporozoite protein peaked after the third dose of R21/MM in all volunteers and were well maintained to 90days after challenge. Reducing the third dose did not affect protection or antibody concentrations. Our study shows that R21/MM elicits high-level efficacy against clinical malaria in a controlled human infection model of malaria in adults who are malaria naive. These data supported the evaluation of R21/MM in field efficacy trials in the target population of young children in malaria-endemic areas. EU Horizon 2020, the UK Medical Research Council, the European Commission, the UK National Institute of Health Research, the Imperial NIHR Clinical Research Facility, the Oxford NIHR Biomedical Research Centre, and the Wellcome Trust.

Improved Uptake of Vaccinations in Children With Adverse Events Following Immunization After Specialist Immunization Service Intervention in an Australian Pediatric Hospital.

Adverse Events Following Immunization (AEFI) have significant implications for public health, potentially leading to decreased immunization rates and vaccine hesitancy. Understanding the characteristics and outcomes of children experiencing AEFI is crucial for effective intervention strategies and informed decision-making. This study aimed to describe the diverse range of AEFI presentations, identify common referral sources and assess factors influencing vaccination uptake following specialist consultation. A single-center retrospective cohort study was conducted from 2019 to 2022, analyzing AEFI data from 191 children referred to a Specialist Immunization Service (SIS) at an Australian pediatric health service. Demographic data, referral details, vaccination history, and AEFI types were considered. Statistical analyses, including univariate and multivariate models, were employed to predict vaccination outcomes post-SIS consultation. The median age of children referred was 2 years. General practitioners were the major referral source (68%). Urticarial rash was the most prevalent AEFI referred (29%). Pneumococcal conjugate vaccine was the most implicated vaccine (38%). The majority (69%) were successfully vaccinated following SIS consultation with 3% experiencing a subsequent AEFI (all mild). Older age is found to be associated with less likelihood for vaccination (odds ratio = 0.93, 95% confidence interval: 0.88-0.99, P = 0.027). Formal reporting of AEFI was low (26%). Severe adverse events, including anaphylaxis, were rare, and a SIS played an important role in vaccinating children following AEFI. Vaccination following urticarial rash is likely safe, and options such as a drop-in immunization center in a hospital setting may reduce delay to the next dose in scheduled vaccinations following AEFI. AEFI reporting needs to be promoted, and a patient-initiated reporting system may enhance this.

Strengthening Public Child Healthcare: Development of an Immunization Management Information System for a Local Community in Southern Mindanao, Philippines

While the private healthcare sector rapidly embraces technological advancements, public and local communities struggle to keep pace with these innovations. Community health personnel's reliance on outdated manual methods for managing children's immunization records hinders timely updates and impedes the creation of reliable vaccination schedules, creating obstacles in providing accurate services to the growing young population. To address these challenges, the researchers developed an Immunization Management Information System, employing the Evolutionary Prototyping Software Development Model, which allowed for iterative improvements and customization to meet specific requirements. It incorporates technologies such as a centralized database, a web-based interface, and Short Message Service notification functionality to automate immunization management tasks. Healthcare professionals can record and track immunization details, manage vaccine inventory, generate reports, and send notifications to parents about upcoming immunization schedules. The results demonstrated a system that streamlines and enhances the management of immunization records and processes at the health center, ensuring efficient and timely delivery of services. Discussions on the system's technological features and future research directions are provided, encouraging Information System scholars to contribute to impactful research and development.

Factors associated with vaccination coverage: a population-based survey in Vitória, Espírito Santo, Brazil, 2020-2021.

To estimate prevalence of the full vaccination schedule for children 12 to 24 months old and to analyze associated factors. Survey with cluster sampling carried out in Vitória, Espírito Santo, Brazil, between December 16, 2020, and January 4, 2021. Children born in Vitória in 2017 and 2018 were included. We estimated the prevalence of vaccination schedules. Poisson regression was used to verify association with full vaccination coverage. We included 788 children. Full vaccination coverage was found to be 57% taking a 95% confidence interval (95%CI 50.98;62.98). Prevalence of full vaccination coverage was lowest when private services were used for immunization (prevalence ratio [PR] 0.67; 95%CI 0.51;0.86) and when mothers had ≥ 4 children (PR 0.55; 95%CI 0.32;0.94). We found low vaccination coverage and a drop in booster doses. Use of private services for immunization and number of children were associated with incomplete vaccination coverage.

A discrete choice experiment on Chinese parents' preferences of vaccine schedules against six childhood infectious diseases.

China's Expanded Program on Immunization (EPI) provides vaccinations against 12 vaccine preventable diseases (VPDs) at no cost to families. For some VPDs, parents may opt to substitute equivalent non-program vaccines, including combination vaccines, for EPI vaccines; substitute vaccines must be paid for by the family. Although parents have several choices for vaccinating their children, their preferences for vaccines and immunization schedules have not been systematically evaluated. We used a discrete choice experiment to evaluate four attributes of vaccines for routine immunization: number of injections, risk of mild side-effects, out-of-pocket cost, and location of manufacturer (domestic or imported). In a questionnaire-based survey conducted in vaccination clinics, guardians were asked to select their preferred vaccination schedule from five options in ten choice sets with the four attributes. We used a mixed logit model to determine parental preferences for vaccination schedules, relative importance of attributes, and predict the likelihood of successful vaccination under different scenarios. A total of 581 parents from seven provinces and cities in China participated in the survey, and 488 respondents had internally consistent responses and were included in the analysis. The number of injections in the schedule was the most important attribute for predicting uptake, followed by risk of mild side-effects. Preferences varied by region and parental role. Predicted uptake in the preferred vaccination scenario relative to base-case schedule uptake was a 99.55% increase. Number of injections and risk of mild side-effects were the two most important attributes of the routine immunization schedule. Results from this study can help optimize the immunization schedule in China to improve coverage of childhood vaccines.

Acceptability and completeness of vaccination schedules recommended for transgender women and travestis in the city of São Paulo, Brazil: a cross-sectional study, 2019-2020.

To assess adherence to and completeness of vaccination schedules against human papillomavirus (HPV) and hepatitis A and B among transgender women and travestis in São Paulo, capital city of São Paulo state. This was a secondary data analysis of the multicenter TransOdara study. Data were collected from 403 transgender women and travestis aged 18 years or older, recruited through respondent-driven sampling between December 2019 and October 2020. High adherence to vaccines was observed (88.8%), but completeness of the analyzed vaccination schedules was low: 12% (95%CI 8.0; 17.3) for hepatitis A, 7.2% (95%CI 3.5; 12.8) for hepatitis B and 8.1% (95%CI 3.0; 16.6) for HPV, with no statistically significant differences between them. Despite high adherence, the low completion of vaccination schedules highlighted the need for diversified strategies to improve vaccination coverage and reduce the prevalence of vaccine-preventable sexually transmitted infections in this population.

School vaccination programmes to increase HPV vaccination coverage - Experiences from Bremen, Germany.

Germany primarily relies on a practice-based, opportunistic immunisation system. Despite the introduction of the Human papillomavirus (HPV) vaccine into the German vaccination schedule in 2007, coverage remains low. International experience suggests that school-based vaccination can increase HPV coverage. Therefore, in 2013/14 Bremen's public health department offered HPV vaccinations within a school programme, targeting all 8th-graders. We aimed to evaluate the programme, with a focus on vulnerable groups. In a retrospective cohort design, we analysed vaccination status and uptake among all 8th-graders from 2015/16 to 2018/19 (girls) and 2022/23 (girls and boys). Sub-analyses were based on the School Social Index (SSI), which ranges from 1 (higher socio-economic position, SEP) to 5 (lower SEP), considering factors like poverty, migration, and living environment. The study included 13,550 students from 1,440 classes in 56 schools. Among previously unvaccinated students, 26-35% of girls and 39% of boys annually accepted and received the school-based HPV vaccination. Uptake was higher among students from lower as compared to higher SEP schools (SSI 5: 37% vs. SSI 1: 30%, p=0.022). Vaccine uptake among unvaccinated students remained stable over time, with one-third receiving at least one HPV vaccination at school. The remaining two-thirds of unvaccinated did not make use of the vaccination offer at school. It needs to be investigated if this is possibly due to vaccine hesitancy or a preference for practice-based vaccinations. While school vaccination programmes can improve uptake, implementing a nationwide programme in Germany will be challenging and may not address all existing major uptake barriers.

Risk factors and preventive role of vaccination in adult tetanus fatality: a systematic review of reported cases (1990-2024) and meta-analysis.

This study identifies key risk factors for fatality among adult tetanus patients and assesses the impact of vaccination status and antibody levels on disease severity and outcomes in tetanus cases. Despite widespread vaccination, fatality rates remain high due to diagnostic and management challenges. A meta-analysis of 182 tetanus cases from 36 countries, published since 1990, was conducted. The analysis focused on risk factors such as autonomic dysfunction, opisthotonus, incubation time, diabetes, cardiovascular diseases, and skin infections. Key risk factors for fatality included autonomic dysfunction, opisthotonus, shorter incubation periods, diabetes, cardiovascular diseases, and cutaneous infections. Interestingly, fatalities occurred in patients with antibody levels above the proposed protective threshold, showing that serological evidence of immunity is not absolute. Importantly, patients with a complete vaccination history experienced less severe disease, and no fatalities were observed among those who had received a full course of childhood vaccinations. The findings highlight the importance of maintaining up-to-date vaccination schedules to reduce the severity of disease and improve outcomes in tetanus cases. The results suggest that while immunity may not always prevent infection, prior vaccination significantly mitigates disease severity. Given that immunity may not be entirely protective and up-to-date vaccinations seem to improve the outcomes, prompt diagnosis and effective booster vaccinations are crucial to further reduce mortality in tetanus patients.

Pertussis Clinical Profile Shift, Severity, Prediction in a Tertiary Hospital: A Comparative Study Before, During, and After COVID-19 in Southern China

ObjectiveTo analyze the epidemiological characteristics, clinical manifestations, antimicrobial resistance and develop a predictive model for severe pertussis spanning five years – before, during, and after the COVID-19 pandemic – in Shenzhen children’s hospital in southern China, aiming to provide insights into the pandemic impact and control measures on the pertussis disease profile. MethodsDemographic, clinical, vaccination, and laboratory data were collected for patients who tested positive for pertussis by polymerase chain reaction and/or culture from January 1, 2019, to March 30, 2024. Analysis included changes in demographic and clinical features, indicators of severe cases, and resistance patterns over the study period. ResultsDuring this period, 3963 patients were diagnosed, with 79 severe (PICU admitted) cases; 1433 isolates underwent antimicrobial susceptibility testing. In late 2023, pertussis cases began to increase. From 2019 to 2024, the proportion of cases among 4-6 year olds rose from 4.9% to 28.6%, and among 7-11 year olds from 0.7% to 21.2%. Macrolide resistance surged from 46.5% in 2019 to 97.3% in 2024, with 80% of resistant hospitalized cases initially treated with macrolides. Clinical severity and co-infection increased post-pandemic, with a larger number of cases necessitating antibiotic changes and enhanced supportive care. Vaccination protected against severe disease. Indicators such as white blood cell count, lymphocyte to neutrophil ratio, platelet count, cyanosis and pneumonia predicted disease severity. ConclusionsPost-pandemic, pertussis cases shifted from infants to school-aged children, with increased clinical severity and high macrolide resistance. Urgent measures are needed to optimize vaccination schedules and develop management strategies addressing and changing epidemiological patterns.

Analysis of antibody titers according to anti-SARS-CoV-2 vaccination schedules, assessed through protein S, discriminated according to history of Covid-19 disease, comorbidities, age and sex. City of San Lorenzo, period October-November 2021

Analysis of antibody titers according to anti-SARS-CoV-2 vaccination schedules, assessed through protein S, discriminated according to history of Covid-19 disease, comorbidities, age and sex. City of San Lorenzo, period October-November 2021

Impact of training on knowledge of pharmacy students regarding animal bite management and rabies

Background: Rabies is a highly fatal viral zoonotic disease but preventable by timely and appropriate post exposure prophylaxis. Most animal bite cases are found in rural areas where victims of animal bite don’t get proper treatment due to shortage of doctors. Pharmacists are important part of primary level health care. Methods: A cross-sectional study was conducted between February to May 2023. 100 pharmacy students, posted for their internship in ARC of MKCG Medical College were included in the study. Their knowledge was assessed by pre-test using a self-administered questionnaire. Training was given for 7days on animal bite management and prophylaxis against rabies, then post-test was administered. Data was analysed using Jamovi software. Results: The number of correct responses to questions about animal causing rabies, correct schedule, site and mode of vaccination improved from 16 to 33, 33 to 89, 72 to 93, 68 to 88 respectively after training. Conclusions: Training was effective in improving the knowledge regarding animal bite management and rabies among pharmacy students. Therefore, regular training should be conducted for updated knowledge of pharmacists as well as all medical professionals to achieve elimination of rabies by 2030.

Vaccination After Haematopoietic Stem Cell Transplant: A Review of the Literature and Proposed Vaccination Protocol.

Background/Objectives: Haematopoietic stem cell transplantation (HCT) induces profound immunosuppression, significantly increasing susceptibility to severe infections. This review examines vaccinations' necessity, timing, and efficacy post-HCT to reduce infection-related morbidity and mortality. It aims to provide a structured protocol aligned with international and national recommendations. Methods: A systematic review of current guidelines and studies was conducted to assess vaccination strategies in HCT recipients. The analysis included the timing of vaccine administration, factors influencing efficacy, and contraindications. Recommendations for pre- and post-transplant vaccination schedules were synthesised, specifically for graft-versus-host disease (GVHD), immunosuppressive therapy, and hypogammaglobulinemia. Results: Vaccination is essential as specific immunity is often lost after HCT. Inactivated vaccines are recommended to commence three months post-transplant, including influenza, COVID-19, and pneumococcal vaccines. Live attenuated vaccines remain contraindicated for at least two years post-transplant and in patients with ongoing GVHD or immunosuppressive therapy. Factors such as GVHD and immunosuppressive treatments significantly impact vaccine timing and efficacy. The review also underscores the importance of pre-transplant vaccinations and ensuring that patients' close contacts are adequately immunised to reduce transmission risks. Conclusions: Implementing a structured vaccination protocol post-HCT is critical to improving patient outcomes. Timely and effective vaccination strategies can mitigate infection risks while addressing individual patient factors such as GVHD and immunosuppression. This review highlights the need for tailored vaccination approaches to optimize immune reconstitution in HCT recipients.

Challenges and Opportunities for Adult Vaccine Coverage: Insights for Healthcare Professionals Focusing on Herpes Zoster in Mexico.

Herpes zoster (HZ) is a common disease in older adults and immunocompromised patients, and is frequently associated with long-term complications that impact quality of life. Fortunately, more than one vaccine against HZ is now available in Mexico. Two expert consensus groups discussed adult vaccination strategies in Mexico, focusing on HZ in older adults and immunocompromised individuals; their insights are reported here. HZ is usually treated inappropriately in Mexico. Late diagnosis and suboptimal management are common, as is a lack of treatment options, particularly for pain, which is often unresponsive to standard painkillers. Improving vaccination rates against HZ in Mexico is therefore important, but several barriers to HZ vaccination exist. It is not included in the national vaccination schedule, where included vaccines usually have higher coverage. Actions to overcome barriers include improving awareness of HZ and vaccine availability, developing and promoting guidelines and recommendations for vaccination, and expanding access and infrastructure for vaccination.

Analysis of contributing factors to immunization errors in Brazil: an integrative review

Introduction: Surveillance of adverse events following immunization (AEFI) has been recommended by the World Health Organization (WHO) since 1991 and, in Brazil, it was structured by the National Immunization Program (PNI) in 1992, consolidating with the Information System for Surveillance of Adverse Events Following Immunization (SIEAPV) in 2000. However, the reporting of immunization errors (IE) was only fully incorporated in 2014. Objective: The aim of this study was to analyze contributing factors to the occurrence of immunization errors reported in Brazil. Method: This is an integrative review, in which a search was carried out in the BVS and SCIELO databases using the descriptors “Medication errors”, “Vaccination” and “Immunization” (combined using the Boolean operators AND and OR). The articles were selected according to PRISMA, ensuring methodological rigor and transparency in the synthesis of the data obtained. Results: Of the 69 studies initially identified, 10 met the final criteria and were included in the review. The results showed that most errors are related to the administration of vaccines at non-recommended ages and inadequate intervals between doses. Factors such as lack of training of professionals, complexity of vaccination schedules, and inadequate environmental conditions (such as noise and physical space) were frequently cited as causes of errors. Conclusion: Thus, strengthening vaccine safety practices and promoting a culture of transparency are essential to reduce immunization errors, protect public health and maintain public confidence in the immunization system.

Protektem pikinini blong yu trial: protocol for a single arm field trial to assess the effectiveness of treating-all pregnant women with hepatitis B infection with tenofovir prophylaxis to prevent mother-to-child transmission in Vanuatu, 2024–2025

BackgroundHepatitis B infection is a major public health concern in Vanuatu, with approximately 9% of the general population estimated to be living with chronic hepatitis B. Most new infections are due to mother-to-child transmission (MTCT). Hepatitis B vaccination is available in Vanuatu, but coverage rates for first dose within 24 h of birth and third dose are suboptimal. While treatment of chronic hepatitis B infection with tenofovir disoproxil fumarate (TDF) is available in country, there is no capacity to test hepatitis B e antigen and limited capacity to test hepatitis B virus (HBV) DNA viral load, which is a current eligibility requirement for women in pregnancy to access hepatitis B prophylaxis for MTCT per National guidelines. Recently, the World Health Organization guidelines have been updated to recommend universal peripartum antiviral prophylaxis (PAP) of pregnant women living with hepatitis B to prevent MTCT of HBV, without assessment of viral load in places without access to testing. However, these recommendations are conditional based on low-certainty evidence. The aim of this trial is to evaluate the effectiveness and safety of universal PAP and provide evidence for the global guidelines.MethodsA single arm field trial compared to real world control sites will be conducted in Vanuatu involving pregnant women attending antenatal care services with positive HBsAg rapid tests. Participants at the control sites will undergo routine care. Participants at the intervention sites will all receive oral TDF prophylaxis from second trimester to completion of infant primary hepatitis B vaccination schedule. Primary data analysis will be by intention-to-treat. Initial analyses will be unadjusted comparisons of the intervention sites and control sites. Adjusted analyses will be performed, as needed, and presented in addition to unadjusted comparisons.DiscussionThis study will provide evidence of acceptability, effectiveness and cost-effectiveness of prophylaxis for all women with hepatitis B during pregnancy, as per the updated WHO guidelines, compared with current practice. The outcome of this trial will provide critical information to inform national and global guidelines around universal peripartum antiviral prophylaxis for hepatitis B during pregnancy.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), ACTRN: ACTRN12623001202651p. Registered 21 November 2023.

Impact of Repeated Variant Exposures on Cellular and Humoral Immunogenicity Induced by SARS-CoV-2 Vaccines.

The emergence of the Omicron variant has complicated COVID-19 control and prompted vaccine updates. Recent studies have shown that a fourth dose significantly protects against infection and severe disease, though long-term immunity data remain limited. This study aimed to assess Anti-S-RBD antibodies and interferon-γ levels in healthcare workers 12 months after receiving bivalent Original/Omicron BA.4-5 fourth SARS-CoV-2 vaccine. In this prospective cohort study, 549 healthcare workers were categorized by the initial vaccination schedule, with 229 individuals having received the fourth SARS-CoV-2 vaccine dose. Blood samples were collected from all participants 12 months post-vaccination. Significant differences in Anti-S-RBD antibody levels were observed between those receiving a fourth dose and those who did not, while no differences were seen in interferon-γ levels. After 12 months, there were no significant differences in humoral and cellular immunity response between volunteers primoinfected or reinfected across different periods by the Omicron variant. A multivariable analysis revealed an association between high antibody levels (>6000 U/mL) and interferon-γ levels (OR: 3.13; 95% CI: 1.3-7.7; p < 0.05). Regarding primary vaccine schedules, participants vaccinated with ChAdOx1 (a single or double dose) had notably lower antibody levels compared to those who received mRNA-based vaccines. Additionally, the study shows a higher frequency of multiple infections among those with a single-dose ChAdOx1 primary schedule (OR: 6.24; 95% CI: 1.25-31.15; p < 0.01). Overall, mRNA-based vaccines exhibited stronger long-term immunogenicity. Repeated exposure to the Omicron variant seems to mitigate immune imprinting from the wild-type SARS-CoV-2. An association was observed between high antibody levels and a strong cellular response, although the correlation was not linear.

Smart Buff Manager: A Co-Designed Mobile Application for Enhancing Buffalo Farm Management in Thailand

This study focuses on the co-design and development of a smartphone application, the "Smart Buff Manager," especially for smallholder buffalo farmers in Thailand. The application aims to meet the needs of buffalo farmers by providing an effective and user-friendly tool for record-keeping and farm management. We employed the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) instructional design method to ensure the application addressed the practical needs and preferences of the farmers. The primary features of the app include record-keeping, health monitoring, and breeding management, focusing on various issues faced by smallholder farmers. The user-centered design method provides an intuitive interface that gathers feedback from users, resulting in increased satisfaction and a higher tendency to recommend apps. Implementation of the app significantly improved farm management by enhancing operational efficiency, productivity, and animal welfare. Users of the application reported much greater compliance with vaccination schedules than non-users, potentially improving herd health and long-term production. This case study confirms the potential of mobile technology to improve farm operations and decision-making while also highlighting the essential role of involving end-users in the design process to develop appropriate and effective digital farming systems.